An online functional assessment experience in individuals over 65+ during Covid 19 pandemics: physiotherapist opinion & participant opinion

Funding Acknowledgements

Type of funding sources: None.

Background

The quarantine during COVID-19 pandemic affects the clinical visits of elderly people. Since, telehealth gained importance, it is essential to adapt routine visits to the tele-assessment for elderly people especially in high risk factor for both functional impairment and fall risks. Our aim was to present our online assessment experiences in the elderly who underwent particular home quarantine during COVID-19 pandemics. Method: Thirty-three participants aged 65-85 (mean = 71.33 ± 5.35/years, 20 women, 13 men) those never attended an online assessment before were invited to a video-conference based assessment session. It was advised that a relative of the participant or caregiver must attend the online assessment session and follow the instructions of the physiotherapist. The assessments were conducted in the following sequence over seven main topics that are important in terms of functionality in the elderly: (1) physical activity were questioned using International Physical Activity Questionnaire-Short Form, (2) the functional performance were tested with 30 seconds Sit-to-Stand test (SST), (3) participation to the daily living activities with KATZ Index, (4) coronavirus anxiety with Coronavirus Anxiety Scale (CAS), (5) fear of falling with Falls Efficacy Scale, (6) the balance and mobility with Timed-Up and Go test (TUG) in a 3-meter corridor, and (7) frailty with Clinical Frailty Scale. The assessments were done by six physiotherapists (one PhD, 2 MSc, and 3 BSc). The opinions of the participants and physiotherapists regarding their experiences were noted. Result: All participants were finished the assessment and not reported adverse events. The mean of all outcomes showed in Table 1. The mean assessment time was 23.26 ±6.89 minutes. The bad internet connection reported in only one session. Seven of the participants (21.2%) mentioned that SST or TUG were somewhat effortful despite their short duration. The physiotherapists also reported that ensuring an appropriate testing environment for the sit to stand test and Timed-Up and Go test were not always possible. In addition, the sit-to stand test Two of the participants (6 %) were felt discomfort from the questions of CAS. Twenty-one (63.6 %) online assessment were rated as "good" while 12 (36.4 %) were rated as "fair" by the relative of the participant or caregiver in terms of preparing the tools (chair etc.) and testing environment. No problem reported by both therapists and participants related to the questions of IPAQ-SF, CFS, KATZ or FES. Conclusion: This study indicated that an online tele-assessment session is safe and applicable in elderly who underwent home quarantine during COVID-19 pandemic. It was observed that an application of survey based assessments were easier than functional assessments. The results of this study offer an exemplary tele-assessment session for elderly people. Future studies may focus the consistency of the tele-assessment and clinic based assessment results.

The frailty and falling in related with functional performance, balance and physical activity in elderly during Covid-19 pandemics

Funding Acknowledgements

Type of funding sources: None.

Background

Falls and frailty are main causes of morbidity and frequenty associated with functional performance, balance and physical activity. The restrictions imposed by the COVID-19 pandemic force the elderly to spend most of their time at home which may cause further functional problems. Therefore, identifying the risk factors during the pandemic can help to prevent the elderly from frailty and falls. Aim: Our aims are to investigate the clinical frailty profile and falls in relation to functional performance, balance, fear of falling and physical activity and to compare these parameters of the elderly with and without falling history during the COVID-19 pandemics. Method: Thirty-three participants aged 65-85 (mean = 71.33 ± 5.35/years, 20 women, 13 men) who have never had COVID-19 were included in the study. The participants were invited to an online video-conference based assessment. The number of falls during the last year were asked. Clinical frailty severity was assessed with Clinical Frailty Scale. The fear of falling were assessed using Falls Efficacy Scale (FES). The functional performance of the participants were tested with 30 seconds Sit-to-Stand test. The balance and mobility was evaluated with Timed-Up and Go test in a 3 meter corridor. The physical activity level of the participants were questioned using International Physical Activity Questionnaire-Short Form (IPAQ-SF) and vigorous level of physical activity (VPA), moderate level of physical activity (MPA) and walking were also calculated. Results: The mean scores of the outcomes among participants were shown in Table 1. Clinical frailty was significantly higher in women compared to men (p = 0.08). Clinical frailty score, fear of falling and sit to stand performance were significantly worse in fallers. There were negative weak to moderate correlations between frailty and sit to stand performance (p = 0.001) and MPA (p = 0,016). The clinical frailty was also positively correlated with FES (p < 0.001). FES showed positive correlation with Time-Up and Go performance (p = 0.001) and negative correlation with sit to stand performance (p < 0.001) and MPA (p = 0,036). Conclusion: Our results demonstrated that; clinical frailty, fear of falling and sit to stand performance were associated with the fall history in elderly. In addition, clinical frailty score were higher in women. Our results indicate that, people who have fall history may tend to be frailer and may have lower functional performance, balance and physical activity. The encouragement of the elderly to increased physical activity and exercise program may decrease the frailty score and falling risk especially in elderly women during COVID-19 pandemics.

Is Prevention of Hemolysis Possible in Blood Samples Collected from IV catheters in the Emergency Department?

BACKGROUND

The effectiveness of aspiration and vacuum filling method with an adaptor in reducing hemolysis was investigated.

METHODS

The study was conducted in the yellow zone of the Emergency department. Two different apparatuses that draw blood with two different techniques from an IV catheter were compared with our routine procedure. The first system drew blood with aspiration technique into 4.9 mL serum gel tube (Sarstedt S-Monovette®). The second was vacuum filling with a specific adaptor attached to the same catheter drawing the blood into vacuumed serum separator tubes (BD Vacutainer® SST™II and Luer-Lok™ Access Device (LLAD). In our routine, we use plastic syringes and deliver it into the same serum separator vacuum tubes. We measured the hemolysis index, AST, CK, potassium, and LDH.

RESULTS

Hemolysis rates of aspiration method vs. routine were 0.80% and 38.7% (p < 0.001) and of vacuum filling with adaptor vs. routine were 13.5% and 40.6%, respectively (p = 0.0001). The hemolysis rate of the aspiration method was lower than the vacuum filling adaptor method (p = 0.0004). Both techniques showed better performance when measured parameters were compared; aspiration technique being the superior (all p < 0.0001).

CONCLUSIONS

Aspiration method was more successful then vacuum filling methods in reducing hemolysis.

The positive psychology constructs of parents of children with intellectual and developmental disabilities in Turkey

BACKGROUND

The purpose of this exploratory study was to examine positive psychology constructs (life orientation/optimism, life satisfaction, happiness, psychological well-being and personal well-being) that may predict the family quality of life (FQOL) of parents of children with intellectual and developmental disabilities (IDD) in Turkey.

METHODS

Data were obtained from a convenience sample of 660 parents of children with IDD who responded to six assessments, including a measure of FQOL. An analysis using stepwise multiple regression was conducted to identify predictors of FQOL as rated by parents.

RESULTS

The four constructs including personal well-being, psychological well-being, life orientation (optimism) and life satisfaction significantly explained 60% of the total variance of FQOL. The amount of explained variance, beta scores and correlations suggests that these positive psychology constructs are significant predictors of FQOL of parents of children with IDD in Turkey.

CONCLUSION

The study findings suggested that positive psychological constructs at the individual level were positively related to FQOL at the group level. Personal well-being was the strongest predictor of FOQL of parents who have children with IDD in Turkey. The results also indicated that other constructs including psychological well-being, an optimistic life orientation and life satisfaction contribute significantly to the FQOL of parents of children with IDD.

Temporal Trends in the Epidemiology of HIV in Turkey

OBJECTIVE

The aim of this study was to analyze the temporal trends of HIV epidemiology in Turkey from 2011 to 2016.

METHODS

Thirty-four teams from 28 centers at 17 different cities participated in this retrospective study. Participating centers were asked to complete a structured form containing questions about epidemiologic, demographic and clinical characteristics of patients presented with new HIV diagnosis between 2011 and 2016. Demographic data from all centers (complete or partial) were included in the analyses. For the cascade of care analysis, 15 centers that provided full data from 2011 to 2016 were included. Overall and annual distributions of the data were calculated as percentages and the Chi square test was used to determine temporal changes.

RESULTS

A total of 2,953 patients between 2011 and 2016 were included. Overall male to female ratio was 5:1 with a significant increase in the number of male cases from 2011 to 2016 (p<0.001). The highest prevalence was among those aged 25-34 years followed by the 35-44 age bracket. The most common reason for HIV testing was illness (35%). While the frequency of sex among men who have sex with men increased from 16% to 30.6% (p<0.001) over the study period, heterosexual intercourse (53%) was found to be the most common transmission route. Overall, 29% of the cases presented with a CD4 count of >500 cells/mm3 while 46.7% presented with a CD4 T cell count of <350 cells/mm3. Among newly diagnosed cases, 79% were retained in care, and all such cases initiated ART with 73% achieving viral suppression after six months of antiretroviral therapy.

CONCLUSION

The epidemiologic profile of HIV infected individuals is changing rapidly in Turkey with an increasing trend in the number of newly diagnosed people disclosing themselves as MSM. New diagnoses were mostly at a young age. The late diagnosis was found to be a challenging issue. Despite the unavailability of data for the first 90, Turkey is close to the last two steps of 90-90-90 targets.

AB0437 OESOPHAGEAL DILATATION ON HIGH-RESOLUTION CT CHEST IN SYSTEMIC SCLEROSIS: SIGNIFICANT INDEX?

Background:

Systemic sclerosis (SSc) is chronic, autoimmun multisystem disorder presented by thickening and fibrosis of the skin and internal organs. Esophageal involvement is one of the most common manifestation. Esophageal enlargement on HRCT is a common finding in scleroderma patients and may also be associated with other scleroderma-related clinical findings (1).

Objectives:

The aim of this study to evaluate the association between esophageal dilatation on chest HRCT at diagnosis with the other SSc features.

Methods:

The study was planned for SSc patients registered between October 2007 and September 2020 in Dokuz Eylul University Rheumatology Department database. Demographics, clinical features and medical history were recorded. The baseline HRCT reports were screened in terms of esophageal dilatation. Then, the initial HRCT images were assessed for esophageal dilatation by an experienced chest radiologist according to recommendation of Pitrez et al.

Results:

In our study, there were 233 SSc patients (f:206 M:27, mean age 59.9±12.7 years) 71 (31.4%) of them diagnosed with diffuse disease. Median follow-up of study was 73 (1-272) months. Esophageal dilatation on HRCT was detected in 60 (25.8%) of SSc patients. 67 out of 155 patients (43.2%) had proof of esophageal involvement in esophageal transit scintigraphy. There is no statistical correlation was found between esophageal dilatation on HRCT with gender, smoking, arthritis, pulmonary hypertension and autoantibody subtypes. Development of digital ulcer and telangiectasia is statistically higher in SSc patients with oesophageal dilatation on baseline chest HRCT (p=0.001 and p=0.039, respectively). There was a positive correlation between Modified Rodnan Skin Score (mRss) and esophageal dilatation (r=0.213, p: 0.004).

Conclusion:

HRCT can be a reproducible and non-invasive method for evaluating esophageal dilatation. Presence of esophageal dilatation at baseline HRCT might be indicative for pulmonary involvement and SSc related gastrointestinal complications. Consecutive chest HCRT should be evaluated to obtain more reliable data about the relationship between esophageal dilatation and SSc related clinical features.

References:

[1]Pitrez EH, Bredemeier M, Xavier RM et al.Ooesophageal dysmotility in systemic sclerosis:comparison of HRCT and scintigraphy. Br J Radiol 2006; 79: 719–24.

Table 1.

Clinical and demographic characteristics of the presence of esophageal dilatation on HRCT

Esophageal dilatation on HRCTTotal (n=233)Yes (n=60, 25.8%)No (n=173, 74.2%)pMean±SD.Mean±SD.Mean±SD.Age, years59.9±12.759.7±12.260.1 ±12.6>0.05n%n%n%Female20688,4%5388,3%14986,1%>0.05Smoking7933,9%1931,7%6034,7%>0.05Diffuse SSc7130,5%2338,3%4425,4%>0.05Overlap syndrome3314,2%813,3%2514,5%>0.05Pulmonary fibrosis11850,6%4270,0%7643,9%>0.05Arthritis8034,3%2338,3%5632,4%>0.05Telengiectasia15667,0%4880,0%10560,7%0,039Digital ulcer8737,3%3456,7%5129,5%0,001Anti-Scl 70 (+)8938,2%2846,7%5934,1%>0.05Anti-centromer (+)7532,2%1525,0%5934,1%>0.05

Disclosure of Interests:

None declared

Application of magnetic nanomaterials in bioanalysis

The importance of magnetic nanomaterials and magnetic hybrid materials, which are classified as new generation materials, in analytical applications is increasingly understood, and research on the adaptation of these materials to analytical methods has gained momentum. Development of sample preparation techniques and sensor systems using magnetic nanomaterials for the analysis of inorganic, organic and biomolecules in biological samples, which are among the samples that analytical chemists work on most, are among the priority issues. Therefore in this review, we focused on the use of magnetic nanomaterials for the bioanalytical applications including inorganic and organic species and biomolecules in different biological samples such as primarily blood, serum, plasma, tissue extracts, urine and milk. We summarized recent progresses, prevailing techniques, applied formats, and future trends in sample preparation-analysis methods and sensors based on magnetic nanomaterials (Mag-NMs). First, we provided a brief introduction of magnetic nanomaterials, especially their magnetic properties that can be utilized for bioanalytical applications. Second, we discussed the synthesis of these Mag-NMs. Third, we reviewed recent advances in bioanalytical applications of the Mag-NMs in different formats. Finally, recently literature studies on the relevance of Mag-NMs for bioanalysis applications were presented.

Navigated iliac screw placement may reduce radiation and OR time in lumbopelvic fixation of unstable complex sacral fractures

Purpose

Instability of the posterior pelvic ring may be stabilized by lumbopelvic fixation. The optimal osseous corridor for iliac screw placement from the posterior superior iliac spine to the anterior inferior iliac spine requires multiple ap- and lateral-views with additional obturator-outlet and -inlet views.

The purpose of this study was to determine if navigated iliac screw placement for lumbopelvic fixation influences surgical time, fluoroscopy time, radiation exposure, and complication rates.

Methods

Bilateral lumbopelvic fixation was performed in 63 patients. Implants were inserted as previously described by Schildhauer. A passive optoelectronic navigation system with surface matching on L4 was utilized for navigated iliac screw placement. To compare groups, demographics were assessed. Operative time, fluoroscopic time, and radiation were delineated.

Results

Conventional fluoroscopic imaging for lumbopelvic fixation was performed in 32 patients and 31 patients underwent the procedure with navigated iliac screw placement. No differences were found between the groups regarding demographics, comorbidities, or additional surgical procedures.

Utilization of navigation led to fluoroscopy time reduction of more than 50% (3.2 vs. 8.6 min.; p < 0.001) resulting in reduced radiation (2004.5 vs. 5130.8 Gy*cm²; p < 0.001). Operative time was reduced in the navigation group (176.7 vs. 227.4 min; p = 0.002) despite the necessity of additional surface referencing.

Conclusion

For iliac screws, identifying the correct entry point and angle of implantation requires detailed anatomic knowledge and multiple radiographic views. In our study, additional navigation reduced operative time and fluoroscopy time resulting in a significant reduction of radiation exposure for patients and OR personnel.

Antibacterial, Antiviral, and Self-Cleaning Mats with Sensing Capabilities Based on Electrospun Nanofibers Decorated with ZnO Nanorods and Ag Nanoparticles for Protective Clothing Applications

The COVID-19 pandemic has clearly shown the importance of developments in fabrication of advanced protective equipment. This study investigates the potential of using multifunctional electrospun poly(methyl methacrylate) (PMMA) nanofibers decorated with ZnO nanorods and Ag nanoparticles (PMMA/ZnO-Ag NFs) in protective mats. Herein, the PMMA/ZnO-Ag NFs with an average diameter of 450 nm were simply prepared on a nonwoven fabric by directly electrospinning from solutions containing PMMA, ZnO nanorods, and Ag nanoparticles. The novel material showed high performance with four functionalities (i) antibacterial agent for killing of Gram-negative and Gram-positive bacteria, (ii) antiviral agent for inhibition of corona and influenza viruses, (iii) photocatalyst for degradation of organic pollutants, enabling a self-cleaning protective mat, and (iv) reusable surface-enhanced Raman scattering substrate for quantitative analysis of trace pollutants on the nanofiber. This multi-functional material has high potential for use in protective clothing applications by providing passive and active protection pathways together with sensing capabilities.

An environment-friendly and rapid liquid-liquid microextraction based on new synthesized hydrophobic deep eutectic solvent for separation and preconcentration of erythrosine (E127) in biological and pharmaceutical samples

In this study, a new deep eutectic solvent (DES) consist of tetrabuthylammonium bromide (TBABr) and 1-octanol at 1:2 M ratio was prepared for the first time and characterized by Fourier transform infrared spectroscopy (FT-IR), proton nuclear magnetic resonance (¹H NMR) and carbon nuclear magnetic resonance (¹³C NMR) techniques. The new DES was used as an extraction solvent in the ultrasound assisted liquid-liquid microextraction (UA-LLME) of Erythrosine (E127) in blood, urine, pharmaceutical tablet and syrup samples. Accurate and sensitive determination of erythrosine was accomplished with the combination use of DES-UA-LLME and UV-Vis spectrophotometric detection. Before applying UA-LLME, while protein precipitation was applied to blood samples, pharmaceutical tablets were homogenized and dissolved in methanol. The proposed DES-UA-LLME/UV-VIS procedure was applied directly to urine, syrup sample and supernatant of blood and tablet samples with high recoveries in range of 90% and 100%. Erythrosine in the aqueous sample phase was extracted into 200 μL hydrophobic DES phase at pH 7.0. The effect of important analytical variables such as pH of sample solution, mol ratio of DES components, volume of DES, ultrasonic-based extraction time, sample volume and salt effect were optimized. The preconcentration factor (PF), limit of detection (LOD), intra-day and inter-day relative standard deviations (RSD, %) for the developed procedure were found as 40, 3.75 μg·L^-1, 2.6% and 4.6%, respectively.

An environmentally friendly and novel amine-based liquid phase microextraction of quercetin in food samples prior to its determination by UV-vis spectrophotometry

A novel and environmentally-friendly method, which includes determination of trace amounts of quercetin in samples by using UV-vis spectrophotometry after enrichment with amine-based liquid phase microextraction (LPME), has been developed. As extraction solvent, N,N-dimethyl-n-octylamine has been used and the quercetin concentration in extraction phase was determined by UV-vis spectrophotometry at 382.5 nm. Important analytical parameters such as pH, extraction solvent type and volume, sample volume, extraction time were optimized by the method. Quercetin in the sample solution was extracted to 200 μL of N,N-dimethyl-n-octylamine phase at pH 4.0. The detection limit (LOD) and the quantitation limit (LOQ) values for quercetin were calculated as 0.07 μg·mL^-1 and 0.24 μg·mL^-1, respectively. Accuracy studies for the food samples was carried out by addition and recovery experiments. The developed method has been successfully applied to different food samples including spinach, green pepper, red onion and dill weed.

A new liquid phase microextraction method-based reverse micelle for analysis of dexketoprofen in human plasma by HPLC-DAD

A new liquid phase microextraction method was developed by used reverse micelle-based coacervates as microextraction agents for the separation of dexketoprofen (DKT) from human plasma before its determination by high-performance liquid chromatography with photodiode-array detection (HPLC-DAD). The change in the concentration of dexketoprofen in the plasma of the male and female patients was successfully monitored by using this method. The proposed method involves the use of reverse micelles of decanoic acid (DA) are dispersed in tetrahydrofuran (THF) and aqueous system. After addition of the DA and THF to the aqueous sample phase, the formation of micelles of nano and molecular size was observed in an ultrasonic bath. The solution was centrifuged, and the DKT extracted into the DA phase was analyzed by HPLC-DAD. Some analytical parameters that important in the developed procedure were examined in detail. The limit of detection (LOD), the limit of quantification (LOQ), the intraday, and inter day relative standard deviation (RSD, %) of the developed method in the plasma sample were found to be 12.8 ng mL−1, 38.8 ng mL−1, 1.7 and 3.9%, respectively. Additional/recovery studies were performed in plasma samples with proposed method, and quantitative recoveries were obtained in the range of 97–100%. The developed microextraction method was applied to human plasma that taken from volunteer patients for the determination of DKT.

Graphical abstract

Deep Eutectic Solvent-Based Microextraction of Lead(II) Traces from Water and Aqueous Extracts before FAAS Measurements

Microextraction procedures for the separation of Pb(II) from water and food samples extracts were developed. A deep eutectic solvent composed of α-benzoin oxime and iron(III) chloride dissolved in phenol was applied as a phase separator support. In addition, this deep eutectic mixture worked as an efficient extractor of Pb(II). The developed microextraction process showed a high ability to tolerate the common coexisting ions in the real samples. The optimum conditions for quantitative recoveries of Pb(II) from aqueous extracts were at pH 2.0, conducted by adding 150 µL from the deep eutectic solvent. The quantitative recoveries were obtained with various initial sample volumes up to 30 mL. Limits of detection and limits of quantification of 0.008 and 0.025 µg L^-1 were achieved with a relative standard deviation (RSD%) of 2.9, which indicates the accuracy and sensitivity of the developed procedure. Recoveries from the reference materials, including TMDA 64.2, TMDA 53.3, and NCSDC-73349, were 100%, 97%, and 102%, respectively. Real samples, such as tap, lake, and river water, as well as food samples, including salted peanuts, chickpeas, roasted yellow corn, pistachios, and almonds, were successfully applied for Pb(II) analysis by atomic absorption spectroscopy (AAS) after applying the developed deep eutectic solvent-based microextraction procedures.

Application and implication of scanning electron microscopy for evaluation of palyno-morphological features of Vitaceae from Pakistan

The present study aimed to investigate the palyno-morphological features of species of family Vitaceae from Pakistan. A total of nine species, belonging to four genera were collected, pressed, identified, and then analyzed microscopically. Both quantitative and qualitative characters of the pollen grains were recorded including polar and equatorial diameter, P/E ratio, number of colpi and pores, exine thickness and shapes of the pollen in both polar and equatorial view, and exine sculpturing using Leica microscope fitted with camera Meiji Infinity 1 and then analyzed statistically using software IBM SPSS Statistics 20. The results of the present study demonstrated the variations in polar and equatorial diameter, exine thickness, P/E ratio, pollen shape, and exine sculpturing of the studied species and highlighted the significance of pollen morphology as an identification tool. The present study may contribute to better understand the classification at genus level, which will support the future phylogenetic characterization of the family.

A new strategy for the combination of supramolecular liquid phase microextraction and UV-Vis spectrophotometric determination for traces of maneb in food and water samples

A novel and green method was developed for enrichment of maneb (manganese ethylene-bisdithiocarbamate) with a supramolecular solvent liquid phase microextraction method. The microextraction method has been used for the first time in the literature for separation-preconcentration of maneb. 1-decanol and tetrahydrofuran were used in the supramolecular solvent formation. The Mn²⁺ content of maneb was extracted in the supramolecular solvent phase as 1-(2-pyridylazo)-2-naphthol complex at pH 12.0. Manganese concentration was determined by UV-Vis spectrophotometer at 555 nm. Then, the maneb concentration equivalent to manganese concentration was calculated. The analytical parameters which effective in the method, including pH, volume of reagents, and sample volume were optimized. The limit of detection and the limit of quantification values for maneb were calculated as 2.22 μg L^-1 and 7.32 μg L^-1, respectively. The method was successfully applied in the analysis of the maneb content of water and food samples.

Association between human leukocyte antigen gene polymorphisms and multiple EPIYA-C repeats in gastrointestinal disorders

BACKGROUND

Polymorphisms of human leukocyte antigen (HLA) genes are suggested to increase the risk of gastric cancer (GC).

AIM

To investigate the HLA allele frequencies of patients with GC relative to a control group in terms of CagA+ multiple (≥ 2) EPIYA-C repeats.

METHODS

The patient group comprised 94 patients [44 GC and 50 duodenal ulcer (DU) patients], and the control group comprised 86 individuals [(50 non-ulcer dyspepsia patients and 36 people with asymptomatic Helicobacter pylori (H. pylori)]. Polymerase chain reaction was performed for the amplification of the H. pylori cagA gene and typing of EPIYA motifs. HLA sequence-specific oligonucleotide (SSO) typing was performed using Lifecodes SSO typing kits (HLA-A, HLA-B HLA-C, HLA-DRB1, and HLA-DQA1-B1 kits).

RESULTS

The comparison of GC cases in terms of CagA+ multiple (≥ 2) EPIYA-C repeats showed that only the HLA-DQB1*06 allele [odds ratio (OR): 0.37, P = 0.036] was significantly lower, but significance was lost after correction (Pc = 0.1845). The HLA-DQA1*01 allele had a high ratio in GC cases with multiple EPIYA-C repeats, but this was not significant in the univariate analysis. We compared allele frequencies in the DU cases alone and in GC and DU cases together using the same criterion, and none of the HLA alleles were significantly associated with GC or DU. Also, none of the alleles were detected as independent risk factors after the multivariate analysis. On the other hand, in a multivariate logistic regression with no discriminative criterion, HLA-DQA1*01 (OR = 1.848), HLA-DQB1*06 (OR = 1.821) and HLA-A*02 (OR = 1.579) alleles were detected as independent risk factors for GC and DU.

CONCLUSION

None of the HLA alleles were detected as independent risk factors in terms of CagA+ multiple EPIYA-C repeats. However, HLA-DQA1*01, HLA-DQB1*0601, and HLA-A*2 were independent risk factors with no criterion in the multivariate analysis. We suggest that the association of these alleles with gastric malignancies is not specifically related to cagA and multiple EPIYA C repeats.

Role of the O-GlcNAc modification on insulin resistance and endoplasmic reticulum stress in 3T3-L1 cells

O-linked N-acetyl-glucosamine (O-GlcNAc) is a post-translational protein modification that regulates cell signaling and involves in several pathological conditions. O-GlcNAc transferase (OGT) catalyzes the attachment, while O-GlcNAcase (OGA) splits the GlcNAc molecules from the serine or threonine residues of the nuclear and cellular proteins. The hexosamine biosynthesis pathway (HBP) is a small branch of glycolysis that provides a substrate for the OGT and serves as a nutrient sensor. In this study, we investigated the impact of external O-GlcNAc modification stimulus on the insulin signal transduction, unfolded protein response, and HBP in 3T3-L1 cells. First, we treated cells with glucosamine and PUGNAc to stimulate the O-GlcNAcylation of total proteins. Also, we treated cells with tunicamycin as a positive internal control, which is a widely-used endoplasmic reticulum stressor. We used two in vitro models to understand the impact of the cellular state of insulin sensibility on this hypothesis. So, we employed insulin-sensitive preadipocytes and insulin-resistant adipocytes to answer these questions. Secondly, the OGT-silencing achieved in the insulin-resistant preadipocyte model by using the short-hairpin RNA (shRNA) interference method. Thereafter, the cells treated with the above-mentioned compounds to understand the role of the diminished O-GlcNAc protein modification on the insulin signal transduction, unfolded protein response, and HBP. We found that elevated O-GlcNAcylation of the total proteins displayed a definite correlation in insulin resistance and endoplasmic reticulum stress. Furthermore, we identified that the degree of this correlation depends on the cellular state of insulin sensitivity. Moreover, reduced O-GlcNAcylation of the total proteins by the shRNA-mediated silencing of the OGT gene, which is the only gene to modify proteins with the O-GlcNAc molecule, reversed the insulin resistance and endoplasmic reticulum stress phenotype, even with the externally stimulated O-GlcNAc modification conditions. In conclusion, our results suggest that OGT regulates insulin receptor signaling and unfolded protein response by modulating O-GlcNAc levels of total proteins, in response to insulin resistance. Therefore, it can be a potential therapeutic target to prevent insulin resistance and endoplasmic reticulum stress.

Association between polymorphisms in HLA-A, HLA-B, HLA-DR, and DQ genes from gastric cancer and duodenal ulcer patients and cagL among cagA-positive Helicobacter pylori strains: The first study in a Turkish population

Colonization of the human gastric mucosa by H. pylori may cause peptic and duodenal ulcers (DUs), gastric lymphomas, and gastric cancers. The cagL gene is a component of cag T4SS and is involved in cagA translocation into host. An association between the risk of gastric cancer and the type of HLA class II (DR and/or DQ) was suggested in different populations. The aim of this study was to investigate, the clinical association of the cagL gene with host HLA alleles in H. pylori strains that were isolated from patients with gastric cancer, DU, and non-ulcer dyspepsia (NUD) and to determine the HLA allele that confers susceptibility or resistance for the risk of gastric cancer and DU development in Turkish patients. A total of 94 patients (44 gastric cancer and 50 DU patients; 58 male, 36 female; mean age, 49.6 years), and 86 individuals (50 NUD patients and 36 persons with normal gastrointestinal system [NGIS]; 30 male, 56 female; mean age, 47.3 years) were included as the patient and the control groups, respectively. CagA and cagL were determined by PCR method. DNA from peripheral blood samples was obtained by EZ-DNA extraction kit. For HLA SSO typing, LIFECODES SSO Typing kits (HLA-A, HLA-B HLA-C, HLA-DRB1 and HLA-DQA1/B1 kits) were used. The CagL/CagA positivity distribution in the groups were as follows: 42 (95.4%) gastric cancer, 46 (92%) DU and, 34 (68%) NUD and no NGIS cases. The HLA-DQA1*01 (OR: 3.82) allele was significantly different, suggesting that these individuals with H. pylori strains harbouring the CagL/CagA positivity are susceptible to the risk of gastric cancer and DU, and the HLA-DQA1*05 (OR, 0.318) allele was suggested as a protective allele for the risk of gastric cancer and DU using univariate analyses. HLA-DQA1*01 (OR, 2.21), HLA-DQB1*06 (OR, 2.67), sex (male, OR, 2.27), and CagL/CagA/(<2) EPIYA C repeats (OR, 5.72) were detected independent risk factors that increased the risk of gastric cancer and DU using multivariate analyses. However, the HLA-DRB1*04 (OR, 0.28) allele was shown to be a protective allele, which decreased the risk of gastric cancer and DU. Gastric pathologies result from an interaction between bacterial virulence factors, host epigenetic and environmental factors, and H. pylori strain heterogeneity, such as genotypic variation among strains and variations in H. pylori populations within an individual host.