The association of anti-CCP antibodies with disease activity in rheumatoid arthritis

Antibodies to citrullinated proteins have been described in patients with rheumatoid arthritis (RA) and these appear to be the most specific markers of the disease. Our objective was to determine the frequency of antibodies to cyclic citrullinated peptides (CCPs) in patients with RA and the association of anti-CCP antibodies with disease activity, radiological erosions and HLA DR genotype. Forty patients with RA and 38 patients with fibromyalgia were included in this study. Serum samples were collected from both patient groups with RA and fibromyalgia. Anti-CCP was measured by the corresponding enzyme-linked immunosorbent assay. Additionally, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), disease activity score (DAS), visual analog scala (VAS), HLA genotype and radiographic information were determined in patients with RA. The rate of sensitivity and specificity of anti-CCP reactivity for the diagnosis RA were measured (sensitivity 50%, specificity100%). There is no significant difference between anti-CCP (+) and anti-CCP (−) RA patients for DAS28, VAS, ESR, CRP, disease duration, HLA genotype, and radiological assessment of hand. However, there was a significant difference between anti-CCP (+) and anti-CCP (−) RA patients for RF and the radiological assessment of left and right wrists (respectively, P < 0.05, P = 0.04, P = 0.01). There was no significant correlation between anti-CCP antibody and ESR, CRP, VAS, DAS 28 or radiological assessment. A small but significant correlation was found between RF and anti-CCP antibody (P = 0.02, r = 0.35)

Efficient synthesis of chromeno[2,3-b]pyridine derivatives using Zn(OTf)2 as a catalyst: DFT computations, molecular docking and ADME studies

An efficient method was developed for the synthesis of chromeno[2,3-b]pyridine derivatives by using Zn(OTf)2 (Zinc trifluoromethanesulfonate) via one-pot [3 + 3] cascade annulation methods using 2-amino-4H-chromen-4-one with a different substituted group (1–6) and trans-chalcone. This strategy offers the pharmacological importance of 2-amino-4H-chromen-4-one derivatives in reaction time and good yields. This approach also brings a different perspective to the literature as an intramolecular cyclization pathway. All computational works were performed at the B3LYP/6–311++G** level of theory. After confirming the optimized structures and comparing the calculated spectroscopic data with corresponding experimental data, the intramolecular interactions were evaluated on the basis of NBO “Natural Bond Orbital” theory. The quantum chemical reactivity features and FMO “Frontier Molecular Orbital” analyses were conducted at the same level of theory. The solvent effect on the reactivity behaviors was also investigated by using the results that were determined by obtaining the different solvent environments. Molecular docking was employed to explore the binding affinities of the compounds against AChE (Acetylcholinesterase), BuChE (Butyrylcholinesterase), and HSA (Human serum albümin). Also, the bioavailability and drug-likeness properties of compounds 1–6 were determined to explore the possible usage in further drug design works. © 2023 Elsevier B.V.Türkiye Bilimsel ve Teknolojik Araştırma Kurumu, TÜBİTAK: 112 T503; Tekirdağ Namık Kemal Üniversitesi, TNKUFinancial support for this research from the Scientific and Technological Research Council of Turkey (TUBITAK Project No. 112 T503). The authors thank Namık Kemal University for the analysis of our article structure. All calculations have been carried out at TUBITAK ULAKBIM, High Performance and Grid Computing Center (TR-Grid e-Infrastructure).Financial support for this research from the Scientific and Technological Research Council of Turkey (TUBITAK Project No. 112 T503). The authors thank Namık Kemal University for the analysis of our article structure. All calculations have been carried out at TUBITAK ULAKBIM, High Performance and Grid Computing Center (TR-Grid e-Infrastructure)

Acute first seizures and seizure-like events in the pediatric emergency unit

Aim: We studied the etiological spectrum of children with acute first seizures and seizure-like events in the pediatric emergency unit of a tertiary care hospital. Material and Methods: Seventy-five children were related to acute first seizures and 32 children were to seizure-like events. Results: Syncope (17%) was the most common cause of seizure-like events. Epilepsy was identified for 28 (37%) children with acute first seizure. Nine children (12%) were considered as first unprovoked afebrile seizure. The remaining seven children with acute first seizure (9.3%) had acute symptomatic seizures based on the extensive metabolic screening and MRG studies. Fifteen children (20%) had seizure reoccurrence in the emergency unit. Conclusion: Status epilepticus occured in 4 patients (5.3%) and those were admitted into the intensive care unit.Amaç: Bu retrospektif çalışmada Çocuk Acil Servisine nöbet ve nöbet benzeri olaylar nedeniyle getirilen çocuklarda etyolojik nedenler araştırıldı. Yöntem ve Gereç: Yetmiş beş çocuk akut nöbet ve 32 çocuk nöbet benzeri olaylar nedeniyle çalışmaya dahil edildiler.Nöbet ve nöbet benzeri olaylar tanımlanarak etyolojik nedenler gözden geçirildi. Bulgular: Nöbet benzeri olaylar arasında senkop %17 en sık karşılan non-epileptik fenomen olarak belirlendi. Epilepsi tanısı 28 çocukta (%37 ) vardı. İlk afebril nöbet 9 çocukta (%12) tanı olarak konuldu. Akut semptomatik nöbet tanısı 7 çocukta (%9.3) metabolik tarama testleri ve kraniyal MRG incelemeleri ardından konuldu. Acil serviste nöbet rekürrensi 15 çocukta (%20) gözlendi. Sonuç: Acil servise ilk nöbet yakınması ile getirilen 4 çocukta (%5.3) status epileptikus izlendi

Effect of the timing of dialysis initiation on left ventricular hypertrophy and ınflammation in pediatric patients

PubMedID: 28396941Background: The optimal time for dialysis initiation in adults and children with chronic kidney disease remains unclear. The aim of this study was to evaluate the impact of dialysis timing on different outcome parameters, in particular left ventricular (LV) morphology and inflammation, in pediatric patients receiving peritoneal dialysis and hemodialysis. Methods: The medical records of pediatric dialysis patients who were followed-up in nine pediatric nephrology centers in Turkey between 2008 and 2013 were retrospectively reviewed. In addition to demographic data, we retrieved anthropometric measurements, data on dialysis treatment modalities, routine biochemical parameters, complete blood count, serum ferritin, parathormone, C-reactive protein (CRP), and albumin levels, as well as echocardiographic data and hospitalization records. The patients were divided into two groups based on their estimated glomerular filtration ?rate (eGFR) levels at dialysis initiation, namely, an early-start group, characterized by an eGFR of &gt;10 ml/min/1.73 m 2 , and a late-start group, with an eGFR of &lt; 7 ml/min/1.73 m 2 . The collected data were compared between these groups. Results: A total of 245 pediatric dialysis patients (mean age ± standard deviation 12.3 ± 5.1 years, range 0.5–21 years) were enrolled in this study. Echocardiographic data were available for 137 patients, and the mean LV mass index (LVMI) was 58 ± 31 (range 21–215) g/m 2.7 . The LVMI was 75 ± 30 g/m 2.7 (n = 81) and 34 ± 6 g/m 2.7 (n = 56) in patients with or without LV hypertrophy (LVH) (p &lt; 0.001). Early-start (eGFR &gt;10 ml/min/1.73 m 2 ) versus late-start dialysis (eGFR &lt; 7 ml/min/1.73 m 2 ) groups did not significantly differ in LVMI and LVH status (p &gt; 0.05) nor in number of hospitalizations. Serum albumin levels were significantly higher in the early-dialysis group compared with the late-dialysis group (3.3 ± 0.7 vs. 3.1 ± 0.7 g/dl, respectively; p &lt; 0.05). The early-start group had relatively higher time-averaged albumin levels (3.2 ± 0.5 vs. 3.1 ± 0.5 g/dl; p = &gt; 0.05) and relatively lower CRP levels (3.64 ± 2.00 vs. 4.37 ± 3.28 mg/L, p &gt; 0.05) than the late-start group, but these differences did not reach statistical significance. Conclusion: Although early dialysis initiation did not have a significant effect on important clinical outcome parameters, including LVH, inflammatory state, and hospitalization, in our pediatric dialysis patients, this area of study deserves further attention. © 2017, IPNA

Time-averaged hemoglobin values, not hemoglobin cycling, have an impact on outcomes in pediatric dialysis patients

PubMedID: 30105415Background: During erythropoietin-stimulating agent (ESA) treatment, hemoglobin (Hb) levels usually fluctuate; this phenomenon is known as “Hb cycling (HC).” In this study, we aimed to evaluate the predictors of HC and its impact on left ventricular hypertrophy (LVH) as a patient-important outcome parameter in pediatric dialysis patients. Methods: Records of patients followed up in nine pediatric nephrology centers between 2008 and 2013 were reviewed. More than 1 g/dL decrease or increase in Hb level was considered as HC. Patients were divided into two groups according to 12-month Hb trajectory as rare cycling (RC) (? 3) and frequent cycling (FC) (&gt; 3 fluctuation) as well as three groups based on T-A-Hb levels: &lt; 10, 10–11, and &gt; 11 g/dL. Results: Two hundred forty-five dialysis (160 peritoneal dialysis (PD) and 85 hemodialysis (HD)) patients aged 12.3 ± 5.1 (range 0.5–21) years were enrolled in this study. Fifty-two percent of the patients had RC, 45% had FC, and only 3% had no cycling. There were no differences between HC groups with respect to age, dialysis modality, having anemia, hospitalization rate, residual urine volume, and mortality. Although left ventricular mass index (LVMI) tended to be higher in RC than FC group (65 ± 37 vs 52 ± 23 g/m2.7, p = 0.056), prevalence of LVH was not different between the groups (p = 0.920). In regression analysis, FC was not a risk factor for LVH, but low T-A Hb level (&lt; 10 g/dL) was a significant risk for LVH (OR = 0.414, 95% CI 0.177–0.966, p = 0.04). The target Hb levels were more often achieved in PD patients, and the number of deaths was significantly lower in non-anemic patients (Hb level &gt; 11 g/dL). Conclusion: Hb cycling is common among dialysis patients. Severity of anemia rather than its cycling has more significant impact on the prevalence of LVH and on inflammatory state. © 2018, IPNA