Unusual Metastasis to Eyelid from Extraocular Merkel Cell Carcinoma

Merkel cell carcinoma (MCC) is an unusual skin tumor that has a significant rate of distant and local metastases. It is known that primary MCC of the eyelid usually occurs at the upper eyelid. Here we report an unusual case of MCC metastasis to the eyelid. A 63-year-old male was diagnosed with MCC three years earlier after initially presenting with a mass in his right thigh. After histopathological diagnosis, the patient received medical therapy. During treatment, he developed multiple distant metastases and a firm, purple, vascularized lesion on the upper eyelid. We confirmed the lesion was an eyelid metastasis of MCC by histopathological examination and imaging methods. This case shows that extraocular MCC can metastasize to the eyelids, particularly the upper eyelid, where primary periocular MCC usually appears.

Investigation of pre-discharge learning needs and affecting factors in individuals with burns

BACKGROUND

In discharge phase process, supporting patients to develop their own self-care strategies will increase their self-management skills and reduce complications and other health problems that may arise.

AIM

The aim of the study is to examine the learning needs of individuals with burns regarding pre-discharge care and treatment and the factors affecting them.

METHOD

Data from this cross-sectional study was collected with the "Descriptive Characteristics Form" and "Patient Learning Needs Scale (PLNS)". The study population consisted of patients hospitalized in the adult burn unit of a university hospital in eastern Turkey between May and October 2021.

RESULTS

In the present study, it was observed that the pre-discharge learning needs of the patients were at a high level according to the mean score of the general score of the PLNS. Education level, marital status, companion experience and body mass index effected PLNS.

CONCLUSIONS

In light of the results, it is recommended that discharge training be planned individually and determined according to the individual's learning needs and affecting factors.

Design, Synthesis, and In Vivo Evaluation of a New Series of Indole-Chalcone Hybrids as Analgesic and Anti-Inflammatory Agents

Indole-chalcone hybrids have burst into prominence as potent weapons in the battle against pain and inflammation due to their unique features, allowing these ligands to form pivotal interactions with biological targets. In this context, the base-catalyzed Claisen-Schmidt condensation of 3',4'-(methylenedioxy)acetophenone with heteroaromatic aldehydes carrying an indole scaffold yielded new chalcones (1-7). The central and peripheral antinociceptive activities of all chalcones (compounds 1-7) at the dose of 10 mg/kg (i.p.) were evaluated by hot plate (supraspinal response), tail immersion (spinal response), and acetic acid-induced writhing tests in mice. The anti-inflammatory activities of compounds 1-7 were also investigated by means of a carrageenan-induced mouse paw edema model. The results revealed that compounds 1-7 extended the latency of response to thermal stimulus significantly in a hot-plate test similar to dipyrone (300 mg/kg; i.p.), the positive control drug. However, only compounds 2-7 were found to be significantly effective in the tail-immersion test. Compounds 1-7 also significantly showed analgesic effect by reducing the number of writhes and anti-inflammatory activity by inhibiting edema formation at different time intervals and levels. 1-(1,3-Benzodioxol-5-yl)-3-(1-methyl-1H-indol-2-yl)prop-2-en-1-one (4) drew attention by providing the highest efficacy results in both acute analgesia and inflammation models. Based on the in silico data acquired from the QikProp module, compound 4 was predicted to possess favorable oral bioavailability and drug-like properties. Taken together, it can be concluded that chalcones (1-7), especially compound 4, are outstanding candidates for further research to investigate their potential use in the management of pain and inflammation.

COVID-19 in hospitalized infants aged under 3 months: multi-center experiences across Turkey

To investigate coronavirus disease 2019 (COVID-19) in infants aged 0 to 3 months because there is currently a significant gap in the literature on the subject. A cross-sectional study was conducted with the involvement of 19 medical centers across Turkey and 570 infants. The majority of the patients were male (58.2%), and the three most common symptoms were fever (78.2%), cough (44.6%), and feeding intolerance (39.9%). The results showed that a small percentage of infants had positive blood (0.9%) or urine cultures (10.2%). Most infants presented with fever (78.2%). Children without underlying conditions (UCs) had mostly a complicated respiratory course and a normal chest radiography. Significant more positive urine culture rates were observed in infants with fever. A higher incidence of respiratory support requirements and abnormal chest findings were seen in infants with chronic conditions. These infants also had a longer hospital stay than those without chronic conditions.  Conclusions: Our study discloses the clinical observations and accompanying bacterial infections found in infants aged under 3 months with COVID-19. These findings can shed light on COVID-19 in infancy for physicians because there is limited clinical evidence available. What is Known: • COVID-19 in infants and older children has been seen more mildly than in adults. • The most common symptoms of COVID-19 in infants are fever and cough, as in older children and adults. COVID-19 should be one of the differential diagnoses in infants with fever. What is New: • Although most infants under three months had fever, the clinical course was uneventful and respiratory complications were rarely observed in healthy children. • Infants with underlying conditions had more frequent respiratory support and abnormal chest radiography and stayed longer in the hospital.

Design, Synthesis, and Evaluation of a New Series of 2-Pyrazolines as Potential Antileukemic Agents

In an attempt to identify small molecules for the treatment of leukemia, 12 new pyrazolines (2a-l) were synthesized efficiently. WST-1 assay was performed to examine their cytotoxic features on HL-60 human acute promyelocytic leukemia (APL), K562 human chronic myeloid leukemia (CML), and THP-1 human acute monocytic leukemia cells. Four compounds (2e, 2f, 2g, and 2h) were determined as promising antileukemic agents on HL-60 and K562 cells. IC50 values of compounds 2f, 2h, 2e, 2g, and bortezomib for the HL-60 cell line were found as 33.52, 42.89, 48.02, 62.34, and 31.75 μM, while IC50 values of compounds 2h, 2g, 2f, 2e, and bortezomib for K562 cells were determined as 33.61, 50.23, 57.28, 76.90, and 42.69 μM, respectively. Further studies were carried out to shed light on the mechanism of antileukemic action. According to the data obtained by in vitro experiments, 1-(4-fluorophenyl)-3-(thiophen-3-yl)-5-(4-(4-methylpiperazin-1-yl)phenyl)-2-pyrazoline (2f) and 1-(3-bromophenyl)-3-(thiophen-3-yl)-5-(4-(4-methylpiperazin-1-yl)phenyl)-2-pyrazoline (2h) have proved to be potential antileukemic agents with remarkable cytotoxicity against HL-60 and K562 cells by activation of caspase 3, thereby inducing apoptosis.

Is methyl methacrylate fixator reliable for the treatment of gartland type IV supracondylar fractures?

Background

In childhood supracondylar fractures of the humerus, fixation with percutaneous Kirschner wire is the standard treatment. In the case of irreducible-unstable fractures, these can be defined as fractures in which reduction is not well-achieved or in which fixation cannot be achieved with the K-wire. Intraoperative management of these types of fractures may be difficult. Treatment with a methyl methacrylate fixator consisting of K-wire and methyl methacrylate cement, as defined by the senior author of the article, may be a good option for Gartland type IV supracondylar humeral fractures where the fracture is unstable in flexion and extension due to complete periosteal tearing.

Materials and Methods

The short-term and mid-term results of 27 patients between the ages of 4-12 with Gartland type IV supracondylar fracture of the humerus treated with methyl methacrylate fixation were reviewed. The patients were scored in terms of function and cosmetic satisfaction.

Results

A total of 19 of the 27 patients treated with the methyl methacrylate fixator had full elbow motion function and rated the outcome of the treatment as excellent, which was judged by orthopedic surgeons on the basis of Flynn's criteria. Six patients had nearly full elbow motion and evaluated their recovery outcome as good. Two patients reported nearly full range of motion (ROM) and evaluated the method as moderate in terms of treatment.

Discussion

Treatment with the methyl methacrylate fixation method is an inexpensive method that allows early joint mobilization, provides strong biomechanical stability, ensures good outcomes, and should be considered in the treatment of irreducible and unstable supracondylar fractures of the humerus.

Design, Synthesis, and Evaluation of a New Series of Hydrazones as Small-Molecule Akt Inhibitors for NSCLC Therapy

In an endeavor to identify small molecules for the management of non-small-cell lung carcinoma, 10 new hydrazone derivatives (3a-j) were synthesized. MTT test was conducted to examine their cytotoxic activities against human lung adenocarcinoma (A549) and mouse embryonic fibroblast (L929) cells. Compounds 3a, 3e, 3g, and 3i were determined as selective antitumor agents on A549 cell line. Further studies were conducted to figure out their mode of action. Compounds 3a and 3g markedly induced apoptosis in A549 cells. However, both compounds did not show any significant inhibitory effect on Akt. On the other hand, in vitro experiments suggest that compounds 3e and 3i are potential anti-NSCLC agents acting through Akt inhibition. Furthermore, molecular docking studies revealed a unique binding mode for compound 3i (the strongest Akt inhibitor in this series), which interacts with both hinge region and acidic pocket of Akt2. However, it is understood that compounds 3a and 3g exert their cytotoxic and apoptotic effects on A549 cells via different pathway(s).

Discovery of Small Molecule COX-1 and Akt Inhibitors as Anti-NSCLC Agents Endowed with Anti-Inflammatory Action

Targeted therapies have come into prominence in the ongoing battle against non-small cell lung cancer (NSCLC) because of the shortcomings of traditional chemotherapy. In this context, indole-based small molecules, which were synthesized efficiently, were subjected to an in vitro colorimetric assay to evaluate their cyclooxygenase (COX) inhibitory profiles. Compounds 3b and 4a were found to be the most selective COX-1 inhibitors in this series with IC₅₀ values of 8.90 µM and 10.00 µM, respectively. In vitro and in vivo assays were performed to evaluate their anti-NSCLC and anti-inflammatory action, respectively. 2-(1H-Indol-3-yl)-N'-(4-morpholinobenzylidene)acetohydrazide (3b) showed selective cytotoxic activity against A549 human lung adenocarcinoma cells through apoptosis induction and Akt inhibition. The in vivo experimental data revealed that compound 3b decreased the serum myeloperoxidase and nitric oxide levels, pointing out its anti-inflammatory action. Moreover, compound 3b diminished the serum aminotransferase (particularly aspartate aminotransferase) levels. Based on the in vitro and in vivo experimental data, compound 3b stands out as a lead anti-NSCLC agent endowed with in vivo anti-inflammatory action, acting as a dual COX-1 and Akt inhibitor.

A new series of hydrazones as small-molecule aldose reductase inhibitors

In the search for small-molecule aldose reductase (AR) inhibitors, new tetrazole-hydrazone hybrids (1-15) were designed. An efficient procedure was employed for the synthesis of compounds 1-15. All hydrazones were subjected to an in vitro assay to assess their AR inhibitory profiles. Compounds 1-15 caused AR inhibition with K_i values ranging between 0.177 and 6.322 µM and IC₅₀ values ranging between 0.210 and 0.676 µM. 2-[(1-(4-Hydroxyphenyl)-1H-tetrazol-5-yl)thio]-N'-(4-fluorobenzylidene)acetohydrazide (4) was the most potent inhibitor of AR in this series. Compound 4 markedly inhibited AR (IC₅₀  = 0.297 µM) in a competitive manner (K_i  = 0.177 µM) compared to epalrestat (K_i  = 0.857 µM, IC₅₀  = 0.267 µM). Based on the in vitro data obtained by applying the MTT test, compound 4 showed no cytotoxic activity toward normal (NIH/3T3) cells at the tested concentrations, indicating its safety as an AR inhibitor. Compound 4 exhibited proper interactions with crucial amino acid residues within the active site of AR. In silico QikProp data of all hydrazones (1-15) were also determined to assess their pharmacokinetic profiles. Taken together, compound 4 stands out as a promising inhibitor of AR for further in vivo studies.

A new series of thiazole‐hydrazone hybrids for Akt‐targeted therapy of non‐small cell lung cancer

In an attempt to identify potent antitumor agents for the fight against non-small cell lung cancer, new thiazolyl hydrazones (2a-n) were synthesized and examined for their in vitro cytotoxic effects on A549 human lung adenocarcinoma and L929 mouse embryonic fibroblast cells by means of the MTT assay. Furthermore, the effects of the most potent anticancer agents on apoptosis and Akt inhibition were investigated. 2-[2-((Isoquinolin-5-yl)methylene)hydrazinyl]-4-(4-methylsulfonylphenyl)thiazole (2k) (IC₅₀  = 1.43 ± 0.12 µM) and 2-[2-((isoquinolin-5-yl)methylene)hydrazinyl]-4-(1,3-benzodioxol-5-yl)thiazole (2l) (IC₅₀  = 1.75 ± 0.07 µM) displayed more pronounced anticancer activity than cisplatin (IC₅₀  = 3.90 ± 0.10 µM) on A549 cell lines; 2-[2-((isoquinolin-5-yl)methylene)hydrazinyl]-4-(4-methoxyphenyl)thiazole (2j) (IC₅₀  = 3.93 ± 0.06 µM) showed anticancer activity close to cisplatin. These compounds were found to induce apoptosis in A549 cells. Compound 2j (IC₅₀  = 3.55 ± 0.64 µM) showed stronger Akt inhibitory activity than GSK690693 (IC₅₀  = 4.93 ± 0.06 µM), while compounds 2k and 2l did not cause Akt inhibition at IC₅₀ concentrations (1.43 and 1.75 µM, respectively). To comprehensively elucidate the binding pose of compound 2j and to provide a detailed understanding on the ligand' binding mechanism, induced-fit docking calculations were also conducted. Both in vitro and in silico studies suggest that compound 2j shows its cytotoxic and apoptotic effects on A549 cell lines via Akt inhibition. However, it is understood that compounds 2k and 2l exert their strong anticancer effects on A549 cells through different pathways.

AB1076 IS THERE AN ADDITIONAL IMPACT OF STIMULATING CD8+ LYMPHOCYTES TO DETECT LATENT TUBERCULOSIS IN PATIENTS WITH RHEUMATIC DISEASES?

Background

Purified protein derivative skin test (PPD) or interferon gamma release assays (IGRAs) are used as diagnostic tools to detect latent tuberculosis. QuantiFERON-TB Gold Plus (QFT-Plus) is a new test that detects latent tuberculosis. Antigens of Mycobacterium tuberculosis (ESAT-6 and CFP-10) are used. The test contains two tubes: TB1 and TB2. TB1 tube contains peptides of these antigens that induce CD4+T cell response while TB2 tube contains peptides designed to stimulate both CD4+ and CD8+ T cells. The amount of interferon gamma releases from those cells are determined by ELISA method. In patients with recent exposure to tuberculosis, there is an increased amount of CD8+ expression in comparison to patients with past exposure to tuberculosis.

Objectives

To investigate the additional impact of stimulating CD8+ lymphocytes with QFT-Plus test in order to detect latent tuberculosis in patients with inflammatory rheumatic diseases.

Methods

Hacettepe University Rheumatology Biologic Registry Database (HURBIO) database was used in this study. QFT-Plus test of patients with rheumatoid arthritis (RA) and spondyloarthritis (SPA) between January 2018 and March 2021 during work up before biologic/targeted therapy were analysed, retrospectively. Positivity of any of tubes has been reported as QFT (+). The impact of each tube on QFT positivity is analysed.

Results

1480 patients (946 (64%) SPA, 534 (36%) RA) were enrolled. 957 patients were women. The median age was 45 (min-max:18-82). Totally 12.2% of patients had been reported as QFT(+). In 6% of QFT (+) patients only TB2 tube is positive (Table 1).

Table 1.

The impact of each tube on QFT-Plus positivity

QFT-Plus test (n=1480)Negative86.2%Indeterminate1.5%PositiveOnly TB1 tube positivity8% of positively reported patients12.2% of all patientsOnly TB2 tube positivity6% of positively reported patientsTB1 and TB2 positivity86% of positively reported patients

Conclusion

Disease inflammatory cascades along with ongoing usage of immunosuppressive agents could affect results of QFT-plus assay in rheumatic diseases. TB2 tubes stimulating CD8(+) T lymphocytes have additional impact in detecting latent TB infection in patients with RA and SpA.

Disclosure of Interests

None declared

POS1187 DO IMMUNOSUPPRESSIVE AGENTS AFFECT IGRA TESTS IN PATIENTS WITH RHEUMATOID ARTHRITIS?

Background

Tuberculin skin test (PPD) or interferon gamma release assays (IGRAs) are used to detect latent tuberculosis infection. Induration of 15 mm or more is considered positive in any person whereas this cut-off is ≥5 mm for immunosuppressed individuals such as Rheumatoid arthritis. Since IGRAs are dependent on normal T-cell function, it may result in false-negatives for among RA patients due to disease itself and immunosuppressive drugs.

Objectives

We aimed to compare IGRA results of RA patients using high dose DMARDS vs. not using any of them.

Methods

Totally 534 RA patients among Hacettepe University Rheumatology Biologic Registry Database (HURBIO) database was enrolled into this study. QFT-Plus test of patients with rheumatoid arthritis (RA) between January 2018 and March 2021 during work up before biologic/targeted therapy were analysed, retrospectively. The patient group was divided into two according to the drugs have been using at the time of IGRA test. Patients using methotrexate ≥ 10 mg or leflunomide (any dose) or steroids (≥7.5 mg prednisolone) or any combination thereof were classified as the “High Dose” group. The other group consisted of patients who did not take these drug doses. Demographic characteristics, comorbidities, drugs and doses used, and hemogram, sedimentation, and CRP values of the patients were recorded. QuantiFERON test was recorded as positive, negative, indeterminate.

Results

353(66.1%) RA patients were in the high dose patient group and also 287(81.3%) of these patients were female, the median age was 55 years (min:19- max:82). The high dose group was older than the other group. When the two groups were compared, no statistically significant difference was found between comorbidity, and smoking (Table 1). While QFT positivity was detected in 37 (10.5%) patients in the high-dose group, it was found to be positive in 37 (20.4%) patients in the other group (p<0.001). However, there was no significant difference regarding acute phase reactants, hemogram including lymphocyte counts and IFN-gamma levels in the tubes between these two groups.

Table 1.

Comparison of RA patients’ groups using high-dose immunosuppressives and not using any of them

High Dose Methotrexate or Leflunomide or Steroid (+), (%)66.1High Dose Methotrexate or Leflunomide or Steroid (-), (%)33.9P ValueFemale81.375.10.09Age, med (min-max)55 (19-82)52 (19-81)0.01Diabetes Mellitus1110.50.84Hypertension30.624.90.16Chronic Renal Failure0.300.66Chronic Obstructive Pulmonary Disease4.23.30.59Coronary Artery Disease3.76.10.20History of malignancy0.81.70.40SmokingNever4952.50.19Ever24.127.6Quit26.318.8Leukocyte,*103/mlMedian (min-max)7.6 (2.8-28.8)7.9 (3.5 – 20.8)0.26Neutrophil,*103/ml4.8 (0.2-23.0)5.0 (1.5-19.1)0.18Lymphocyte,*103/ml1.9 (0.4-5.9)1.8 (0.5-5.3)0.67Thrombocyte,*103/ml285 (117-669)285.5 (60-724)0.79Hemoglobine,g/dL12.8 (7.7-17.9)12.8 (9.3-16.6)0.41Sedimentation,mm/saat30 (2-294)28 (2-104)0.27C Reactive Protein,mg/dl1.1 (0.1-62.8)1.1 (0-20.7)0.96QuantiFERON-TB Gold-Plus (QFT-Plus)10.520.40.00Nil med (min-max)0.07 (0-2.7)0.05 (0-0.85)0.48QFT-Plus TB-1 med (min-max)1 (0->10)0.99 (0->10)0.25QFT-Plus TB-2 med (min-max)1 (0->10)1.1 (0->10)0.42Mitogen med (min-max)10 (0->10)9.5 (0->10)0.27MethotrexateNot Taking31.433.7Less than 10 mg44.266.310 mg and more24.40LeflunomideNot Taking25.8100Taking74.20HydroxychloroquineNot Taking25.240.9Taking74.859.1SulfasalazineNot Taking62.661.9Taking37.438.1SteroidsNot Taking4.219.9Less than 7.5 mg66.380.17.5 mg and more29.50

Conclusion

Our results confirmed a significantly lower QFT-Plus positivity in patients with RA taking methotrexate ≥ 10 mg or leflunomide (any dose) or steroids (≥7.5 mg prednisolone). Physicians should be careful in interpretation of QFT-Plus in patients with rheumatoid arthritis. Further analysis including flow cytometry analysis is required to better identifying cut-offs for immunosuppressive individuals and patients with inflammatory rheumatic diseases.

Disclosure of Interests

None declared

The Investigation of Cognitive Functions and Clinical High Risk Status for Psychosis in First-Degree Relatives of Patients with Substance Induced Psychotic Disorder

Introduction

The etiology of substance-induced psychotic disorder (SIPD) is an important research area to study.

Objectives

It is aimed to investigate clinical risk status for psychosis, schizotypal features and neurocognitive functions in siblings of the patients who have been diagnosed as SIPD and who have no family history of psychotic spectrum disorder.

Methods

This study included 41 healthy siblings of patients who have been diagnosed as SIPD according to DSM-V and 41 healthy controls without family history of psychiatric disorders (matched on age, gender, and years of education). The data collected with sociodemographic and clinical data form, Digid Span Test, Trail Making Test A, Trail Making Test B, Verbal Fluency Test and Stroop Test, Comprehensive Assesment of At-Risk Mental States (CAARMS) and Structured Interview for Schizotypy-Revised.

Results

It is determined that %41.5 of siblings and %7.3 of healthy controls are in one of the clinical high risk groups for psychosis according to CAARMS. There is significant difference in Trail Making Test A error and Trail Making Test B error and correction, verbal fluency test- lexical fluency-perseveration mean scores between siblings of patients and healthy controls.

Conclusions

Siblings of patients with SIPD have more schizotypal features than healthy control group and they take part more frequent in one of high risk group for psychosis. Schizotypal features are known as trait factor and show genetic predisposition. Siblings who are in high risk groups have more schizotypal features and it may point that predisposition to psychosis is more related to underlying genetic predisposition than environmental factors and social stressors.

Disclosure

No significant relationships.

A new series of thiosemicarbazone-based anti-inflammatory agents exerting their action through cyclooxygenase inhibition

In an endeavor to identify potent anti-inflammatory agents, new thiosemicarbazones (TSCs) incorporated into a diaryl ether framework (2a-2l) were prepared and screened for their in vitro inhibitory effects on cyclooxygenases (COXs). 4-[4-(Piperidin-1-ylsulfonyl)phenyl]-1-[4-(4-cyanophenoxy)benzylidene]thiosemicarbazide (2c) was the most potent and selective COX-1 inhibitor in this series, with an IC₅₀ value of 1.89 ± 0.04 µM. On the other hand, 4-[4-(piperidin-1-ylsulfonyl)phenyl]-1-[4-(4-nitrophenoxy)benzylidene]thiosemicarbazide (2b) was identified as a nonselective COX inhibitor (COX-1 IC₅₀  = 13.44 ± 0.65 µM, COX-2 IC₅₀  = 12.60 ± 0.78 µM). Based on molecular docking studies, the diaryl ether and the TSC groups serve as crucial moieties for interactions with pivotal amino acid residues in the active sites of COXs. According to MTT test, compounds 2b and 2c showed low cytotoxic activity toward NIH/3T3 cells. Their in vivo anti-inflammatory and antioxidant potencies were also assessed using the lipopolysaccharide-induced sepsis model. Compounds 2b and 2c diminished high-sensitivity C-reactive protein, myeloperoxidase, nitric oxide, and malondialdehyde levels. Both compounds also caused a significant decrease in aspartate aminotransferase levels as well as alanine aminotransferase levels. In silico pharmacokinetic studies suggest that compounds 2b and 2c possess favorable drug-likeness and oral bioavailability. It can be concluded that these compounds may act as orally bioavailable anti-inflammatory and antioxidant agents.

Does religious attitude affect organ donation and transplantation?

INTRODUCTION

While the reasons for opposition to organ donation and transplantation include several factors such as socioeconomc status, education and culture, religious belief has been reported to be the most important factor.

AIM

The aim of this study was to determine the effect of the religious attitude on organ donation and transplantation.

MATERIAL AND METHOD

The study universe of this descriptive and relational study comprised adults living in the city centre of Kahramanmaraş. To give 99% power and a significance level of α = 0.05, the sample was formed of 406 individuals who agreed to participate in the study between February and March 2021. The study data were collected using a Personal Information Form, the Religious Attitudes Scale, and the Organ Donation Attitude Scale. In the data analysis, descriptive statistics were stated as mean and standard deviation values, number, and percentage. Correlation and regression analyses were performed to determine the relationship between religious belief and attitude to organ donation and transplantation.

RESULTS

The study participants comprised 84% females, 76.82% were aged 18-28 years, 92.1% were university graduates and 71.7% were not working. Of the total participants, 86.0% stated that nobody close to them had undergone organ transplantation, 92.6% that nobody close to them was waiting for organ transplantation, 50.7% that they had received positive information from a religious perspective about organ donation, 82.0% that they had not sought information themselves about organ donation, 67.2% that they had received no education about organ transplantation, 46% that they found the education given sufficient, 66.7% that they knew about the organ and tissue donation system, and 49.0% that they thought official approval was not required for organ donation. As a result of the correlation and regression analyses, a statistically significant relationship was determined between religious attitude and the subdimension of fear of medical neglect in the the Organ Donation Attitude Scale (p < 0.05).

CONCLUSION

The results of this study demonstrated a relationship between religious attitudes and the attitude to organ transplantation. In the light of this result it can be recommended that a multidisciplinary team is established, including nurses and religious clerics, for the public to have correct information for the evaluation of organ transplantation from a religious perspective and to eliminate the concerns of society on this subject.

A New Series of Indeno[1,2-c]pyrazoles as EGFR TK Inhibitors for NSCLC Therapy

Non-small cell lung cancer (NSCLC) is the leading cause of cancer-related death throughout the world. Due to the shortcomings of traditional chemotherapy, targeted therapies have come into prominence for the management of NSCLC. In particular, epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) therapy has emerged as a first-line therapy for NSCLC patients with EGFR-activating mutations. In this context, new indenopyrazoles, which were prepared by an efficient microwave-assisted method, were subjected to in silico and in vitro assays to evaluate their potency as EGFR TK-targeted anti-NSCLC agents. Compound 4 was the most promising antitumor agent towards A549 human lung adenocarcinoma cells, with an IC₅₀ value of 6.13 µM compared to erlotinib (IC₅₀ = 19.67 µM). Based on its low cytotoxicity to peripheral blood mononuclear cells (PBMCs), it can be concluded that compound 4 exerts selective antitumor action. This compound also inhibited EGFR TK with an IC₅₀ value of 17.58 µM compared to erlotinib (IC₅₀ = 0.04 µM) and induced apoptosis (56.30%). Taking into account in silico and in vitro data, compound 4 stands out as a potential EGFR TKI for the treatment of NSCLC.

Tubular calcium, magnesium, and phosphate excretion during therapeutic hypothermia for neonatal hypoxic-ischemic encephalopathy: A prospective study

OBJECTIVES

Hypocalcemia, hypomagnesemia, and hyperphosphatemia are common electrolyte disturbances in perinatal asphyxia (PA). Different reasons have been proposed for these electrolyte disturbances. This study investigated the effect of the urinary excretion of calcium (Ca), magnesium (Mg), and phosphorus (P) on the serum levels of these substances in babies who were treated using therapeutic hypothermia for hypoxic ischemic encephalopathy (HIE) caused by PA. This study sheds light on the pathophysiology that may cause changes in the serum values of these electrolytes.

METHODS

This study included 21 healthy newborns (control group) and 38 patients (HIE group) who had undergone therapeutic hypothermia due to HIE. Only infants with a gestational age of 36 weeks and above and a birth weight of 2000 g and above were evaluated. The urine and serum Ca, Mg, P, and creatinine levels of all infants were evaluated at 24, 48, and 72 h.

RESULTS

The lower serum Ca value and the higher serum P value of the HIE group were found to be statistically significant compared to the control group (p<0.05). There was no significant difference in serum Mg values between the groups. However, hypomagnesemia was detected in five patients from the HIE group. The urine excretion of FeCa and FeMg at 24 h, and FeP excretion at 48 and 72 h were found to be significantly higher in the HIE group compared to the control group.

CONCLUSIONS

This study determined that the urinary excretion of Ca, Mg, and P has an effect on the serum Ca, Mg, and P levels of infants with HIE.

The Effect of Immunosuppressant Therapy Adherence on the Comfort of Liver Transplant Recipients

Inadequate immunosuppressive therapy causes rejection, whereas an overdose may lead to infections or malignancy to affect a patient's life and comfort. This study used a descriptive correlational design to determine how compliance with immunosuppressive therapy affected the well-being of liver transplant patients. The study was conducted in the liver transplant unit of a university hospital with 103 patients who underwent liver transplant surgery. The target population included patients who received treatment in liver transplant clinics between July 2016 and August 2017. Mean age of the patients in the study was 44.66 ± 14.86 years and the time after transplant was 15.48 ± 16.90 months on the average. A significant difference was found between mean General Comfort Scale scores according to the variable of adherence status (t = 6.898, p < .05). Simple linear regression analysis showed a positive moderate, significant correlation between the adherence variable and mean General Comfort Scale scores (R = 0.543, p < .001). It was found that the patients who adhered to immunosuppressive therapy experienced higher levels of comfort. Therefore, arrangements to improve patient adherence to therapy, hence comfort, are recommended, as well as periodic evaluations of patient comfort levels.

Identification of a new class of potent aldose reductase inhibitors: Design, microwave-assisted synthesis, in vitro and in silico evaluation of 2-pyrazolines

Aldose reductase (AR) acts as a multi-disease target for the design and development of therapeutic agents for the management of diabetic complications as well as non-diabetic diseases. In the search for potent AR inhibitors, the microwave-assisted synthesis of twenty new compounds with a 1,3-diaryl-5-(4-fluorophenyl)-2-pyrazoline moiety as a common fragment in their structure (1-20) was carried out efficiently. Compounds 1-20 were subjected to in vitro studies, which were conducted to assess their AR inhibitory effects and cytotoxicity towards L929 mouse fibroblast (normal) cells. Among these compounds, 1-(3-bromophenyl)-3-(4-piperidinophenyl)-5-(4-fluorophenyl)-2-pyrazoline (20) was identified as the most promising AR inhibitor with an IC₅₀ value of 0.160 ± 0.005 μM exerting competitive inhibition with a K_i value of 0.019 ± 0.001 μM as compared to epalrestat (IC₅₀ = 0.279 ± 0.001 μM; K_i = 0.801 ± 0.023 μM) and quercetin (IC₅₀ = 4.120 ± 0.123 μM; K_i = 6.082 ± 0.272 μM). Compound 20 displayed cytotoxicity towards L929 cells with an IC₅₀ value of 18.75 ± 1.06 μM highlighting its safety as an AR inhibitor. Molecular docking studies suggested that π-π stacking interactions occurred between the m-bromophenyl moiety of compound 20 and Trp21. Based on in silico pharmacokinetic studies, compound 20 was found to possess favorable oral bioavailability and drug-like properties. It can be concluded that compound 20 is a potential orally bioavailable AR inhibitor for the management of diabetic complications as well as non-diabetic diseases.

Olfactory bulb volume in patients with normal-pressure hydrocephalus: an MRI evaluation

AIM

To investigate changes in olfactory bulb (OB) volume in patients with idiopathic normal-pressure hydrocephalus (NPH).

MATERIALS AND METHODS

This multicentric retrospective study included a test group of 23 patients with NPH (10 male and 13 female patients) and a control group of 27 healthy participants without hydrocephalus. The OB volume in all participants had been measured using cranial magnetic resonance imaging (MRI). In the NPH group, positivity for disproportionately enlarged subarachnoid space hydrocephalus (DESH) was also evaluated.

RESULTS

The OB volumes of the NPH group (R 38.29 ± 9.34 mm³ and L37.52 ± 9.59 mm³) were significantly lower than those of the control group (R 45.87 ± 7.33 mm³ and L48.41 ± 7.62 mm³) bilaterally. There were no significant differences between right and left OB volumes in the NPH group. Nine of the 23 patients were DESH positive and 14 were DESH negative. There were no significant differences between OB volumes of the DESH positive and DESH vpatients in the NPH group. In both groups, there was a positive correlation between right and left OB volumes. There were no significant correlations between OB volumes and age or gender. In the NPH group, there were no significant correlations between DESH positivity and OB volumes.

CONCLUSION

OB volume decrease and olfactory problems should be taken into account in idiopathic NPH patients. When expanded ventricles and decreased OB volume are observed at cranial MRI, a diagnosis of idiopathic NPH should be considered.

A New Series of Antileukemic Agents: Design, Synthesis, In Vitro and In Silico Evaluation of Thiazole-Based ABL1 Kinase Inhibitors

BACKGROUND

After the approval of imatinib, more than 25 antitumor agents targeting kinases have been approved, and several promising candidates are at various stages of clinical evaluation.

OBJECTIVES

Due to the importance of the thiazole scaffold in targeted anticancer drug discovery, the goal of this work is to identify new thiazolyl hydrazones as potent ABL1 kinase inhibitors for the management of Chronic Myeloid Leukemia (CML).

METHODS

New thiazolyl hydrazones (2a-p) were synthesized and investigated for their cytotoxic effects on the K562 CML cell line. Compounds 2h, 2j and 2l showed potent anticancer activity against K562 cell line. The cytotoxic effects of these compounds on other leukemia (HL-60, MT-2 and Jurkat) and HeLa human cervical carcinoma cell lines were also investigated. Furthermore, their cytotoxic effects on Mitogen-Activated Peripheral Blood Mononuclear Cells (MA-PBMCs) were evaluated to determine their selectivity. Due to its selective and potent anticancer activity, compound 2j was benchmarked for its apoptosis-inducing potential on K562 cell line and inhibitory effects on eight different Tyrosine Kinases (TKs), including ABL1 kinase. In order to investigate the binding mode of compound 2j into the ATP binding site of ABL1 kinase (PDB: 1IEP), a molecular docking study was conducted using MOE 2018.01 program. The QikProp module of Schrödinger's Molecular modelling package was used to predict the pharmacokinetic properties of compounds 2a-p.

RESULTS

4-(4-(Methylsulfonyl)phenyl)-2-[2-((1,3-benzodioxol-4-yl)methylene)hydrazinyl]thiazole (2j) showed antiproliferative activity against K562 cell line with an IC₅₀ value of 8.87±1.93 μM similar to imatinib (IC50= 6.84±1.11μM). Compound 2j was found to be more effective than imatinib on HL-60, Jurkat and MT-2 cells. Compound 2j also showed cytotoxic activity against HeLa cell line similar to imatinib. The higher selectivity index value of compound 2j than imatinib indicated that its antiproliferative activity was selective. Compound 2j also induced apoptosis in K562 cell line more than imatinib. Among eight TKs, compound 2j showed the strongest inhibitory activity against ABL1 kinase enzyme (IC₅₀= 5.37±1.17μM). According to molecular docking studies, compound 2j exhibited high affinity to the ATP binding site of ABL1 kinase, forming significant intermolecular interactions. On the basis of in silico studies, this compound did not violate Lipinski's rule of five and Jorgensen's rule of three.

CONCLUSION

Compound 2j stands out as a potential orally bioavailable ABL1 kinase inhibitor for the treatment of CML.

A new series of 2,4-thiazolidinediones endowed with potent aldose reductase inhibitory activity

In an effort to identify potent aldose reductase (AR) inhibitors, 5-(arylidene)thiazolidine-2,4-diones (1–8), which were prepared by the solvent-free reaction of 2,4-thiazolidinedione with aromatic aldehydes in the presence of urea, were examined for their in vitro AR inhibitory activities and cytotoxicity. 5-(2-Hydroxy-3-methylbenzylidene)thiazolidine-2,4-dione (3) was the most potent AR inhibitor in this series, exerting uncompetitive inhibition with a K i value of 0.445 ± 0.013 µM. The IC50 value of compound 3 for L929 mouse fibroblast cells was determined as 8.9 ± 0.66 µM, pointing out its safety as an AR inhibitor. Molecular docking studies suggested that compound 3 exhibited good affinity to the binding site of AR (PDB ID: 4JIR). Based upon in silico absorption, distribution, metabolism, and excretion data, the compound is predicted to have favorable pharmacokinetic features. Taking into account the in silico and in vitro data, compound 3 stands out as a potential orally bioavailable AR inhibitor for the management of diabetic complications as well as nondiabetic diseases.

Synthesis of New Bis-pyrazolines Endowed with Potent Antifungal Activity against Candida albicans and Aspergillus niger

Background:

Due to the increasing number of cases of invasive fungal infections (IFIs), there is an urgent need to identify potent antifungal agents capable of combating IFIs. Pyrazolines are one such class of therapeutically active agents that could be considered to fulfill this need.

Objective:

In this context, this paper aims to identify two new series of bis-pyrazolines endowed with potent antifungal activity against Candida albicans and Aspergillus niger.

Methods:

Two new series of bis-pyrazolines (4a-i, 5a-e) were synthesized through an efficient and versatile synthetic procedure. The compounds were screened for their antifungal effects on C. albicans and A. niger using a broth microdilution method. Their cytotoxic effects on NIH/3T3 mouse embryonic fibroblast cells were determined using MTT assay. Molecular docking studies were performed in the active site of lanosterol 14α-demethylase (CYP51) to shed light on their antifungal effects using Schrödinger’s Maestro molecular modeling package.

Results:

5,5'-(1,4-Phenylene)bis[1-(2-(5-phenyl-1,3,4-oxadiazol-2-yl)thio)acetyl)-3-(2-thienyl)-4,5- dihydro-1H-pyrazole] (4a) and 5,5'-(1,4-phenylene)bis[1-(2-(4-(2-hydroxyethyl)-1-piperazinylthiocarbamoyl) thio)acetyl)-3-(2-thienyl)-4,5-dihydro-1H-pyrazole] (5a) were found as the most promising antifungal agents in this series. Compounds 4a and 5a showed pronounced antifungal activity against C. albicans (MIC= 0.016 mg/mL) and A. niger (MIC= 0.008 mg/mL). Based on MTT assay, their antifungal effects were selective (IC50 > 0.500 mg/mL for NIH/3T3 cell line). Molecular docking studies suggested that compounds 5a-e might show their anticandidal effects via CYP51 inhibition in regard to their stronger interactions in the active site of CYP51.

Conclusion:

Compounds 4a and 5a stand out as potential antifungal agents for the management of IFIs caused by C. albicans and A. niger.

The effect of nurses' compassion on burnout: A cross-sectional study

PURPOSE

This study was carried out to determine the effect of nurses' compassion on burnout.

DESIGN AND METHODS

This cross-sectional descriptive study was conducted with 177 nurses. An introductory information form, the compassion scale and the Maslach burnout inventory were used as the data collection tools. Frequency, percentage, t test, analysis of variance, Kruskal-Wallis, correlation, and regression were used in the analysis of the data.

FINDINGS

The majority of the participants were determined to be female, married and university graduates. It was determined that there was a significant negative relationship between the nurses' sense of compassion and burnout levels, and burnout decreased as compassion increased.

PRACTICAL IMPLICATION

Burnout and compassion fatigue may lead to inadequate care for the patient. This situation will negatively influence nurses' care quality.

A New Series of Triazolothiadiazines as Potential Anticancer Agents for Targeted Therapy of Non-small Cell Lung and Colorectal Cancers: Design, Synthesis, In Silico and In Vitro Studies Providing Mechanistic Insight into Their Anticancer Potencies

BACKGROUND

Targeted therapies acting on specific molecular targets in cancer cells with better curative efficacy and lower toxicity have come into prominence for the management of non-small cell lung cancer (NSCLC) and colorectal cancer (CRC). COX-2 stands out as a plausible target for anticancer agents due to its pivotal role in tumor initiation, progression and invasion.

OBJECTIVES

Due to the importance of triazolothiadiazine scaffold in targeted anticancer drug discovery, the aim of this work is the design of new triazolothiadiazines as potential anticancer agents for the targeted therapy of NSCLC and CRC.

METHODS

New triazolo[3,4-b]-1,3,4-thiadiazines (2a-g) were synthesized via the ring closure reactions of 2-bromo-1- arylethanones with 4-amino-5-((5-methoxy-2-methyl-1H-indol-3-yl)methyl)-2,4-dihydro-3H-1,2,4-triazole-3-thione (1), which was obtained via the solvent-free reaction of 5-methoxy-2-methyl-3-indoleacetic acid with thiocarbohydrazide. MTT assay was performed to determine their cytotoxic effects on A549 human lung adenocarcinoma, Caco-2 human colorectal adenocarcinoma and CCD-19Lu human lung fibroblast cells. The most potent compounds were evaluated for their effects on apoptosis, caspase-3, mitochondrial membrane potential, cell cycle, ultrastructural morphological changes and COX-2 in A549 and Caco-2 cells. In silico docking and Absorption, Distribution, Metabolism and Excretion (ADME) studies were also performed using Schrödinger's Maestro molecular modeling package.

RESULTS

6-(4-Chlorophenyl)-3-[(5-methoxy-2-methyl-1H-indol-3-yl)methyl]-7H-[1,2,4]triazolo[3,4-b][1,3,4]thiadiazine (2e) was the most potent and selective anticancer agent in this series against A549 and Caco-2 cell lines. Compound 2e induced early apoptosis, caused mitochondrial membrane depolarization and arrested cell cycle at G0/G1 phase in A549 cells. On the other hand, compound 2e triggered intrinsic apoptotic pathway involving caspase-3 activation in Caco-2 cells. Compound 2e caused apoptotic morphological changes in both cancer cell lines. The cytotoxic and apoptotic effects of this compound on CRC were found to be related to its selective COX-2 inhibitory activity. According to molecular docking studies, compound 2e showed good affinity to the active site of COX-2 (PDB code: 4COX). Based on in silico ADME studies, the compound is predicted to possess a favorable ADME profile.

CONCLUSION

According to in vitro and in silico studies, compound 2e was identified as a potential orally bioavailable anticancer agent for COX-2-targeted therapy of CRC.

Design, synthesis, in vitro and in silico investigation of aldose reductase inhibitory effects of new thiazole-based compounds

Aldose reductase (AR) catalyzes the NADPH-dependent reduction of glucose to sorbitol in the polyol pathway, which plays an important role in the development of diabetic complications including cataract, retinopathy, nephropathy, and neuropathy. AR has been considered as an important target to heal these long-term diabetic complications and for this reason the development of new AR inhibitors is an important approach in modern medicinal chemistry. In the current study, new 4-aryl-2-[2-((3,4-dihydro-2H-1,5-benzodioxepine-7-yl)methylene)hydrazinyl]thiazole derivatives (1-12) were synthesized and screened for their inhibitory effects on AR which was purified by diverse chromatographic methods with a yield of 1.40% and a specific activity of 2.00 EU/mg. All compounds were determined as promising AR inhibitors with the K_i values in the range of 0.018 ± 0.005 μM-3.746 ± 1.321 μM compared to the quercetin (K_i = 7.025 ± 1.780 μM). In particular, 4-(4-cyanophenyl)-2-[2-((3,4-dihydro-2H-1,5-benzodioxepin-7-yl)methylene)hydrazinyl]thiazole (3) was detected as the most potential AR inhibitor in this series with the K_i value of 0.018 ± 0.005 µM and the compound showed competitive AR inhibition. The cytotoxic effects of compounds 1-12 were investigated on L929 mouse fibroblast (healthy) cells using MTT assay and all these compounds were defined as non-cytotoxic agents against L929 cells. Molecular docking studies, which were employed to determine the affinity of compounds 1-12 into the active site of AR, highlighted that the thiazole scaffold of all these compounds presented π-π stacking interactions with Trp20 and Phe122. According to both in vitro and in silico assays, these potential AR inhibitors may have great importance in the prevention of diabetic microvascular conditions.

A Series of Furan-based Hydrazones: Design, Synthesis, and Evaluation of Antimicrobial Activity, Cytotoxicity and Genotoxicity

Background:

Hydrazones, frequently occurring motifs in many bioactive molecules, have attracted a great deal of interest as potent antimicrobial agents.

Objective:

The aim of this work was to design and synthesize new hydrazone-based antimicrobial agents.

Methods:

4-[2-((5-Arylfuran-2-yl)methylene)hydrazinyl]benzonitrile derivatives (1-10) were obtained via the reaction of 4-cyanophenylhydrazine hydrochloride with 5-arylfurfurals. Compounds 1-10 were evaluated for their antimicrobial effects using a broth microdilution method. Their cytotoxic effects on NIH/3T3 mouse embryonic fibroblast cell line were determined using XTT assay. The most effective antimicrobial agents were investigated for their genotoxic effects using Ames MPF assay. In silico docking and Absorption, Distribution, Metabolism and Excretion (ADME) studies were also performed using Schrödinger’s Maestro molecular modeling package.

Results:

The antifungal effects of the compounds were more significant than their antibacterial effects. Compound 5 bearing 3-nitrophenyl moiety was the most potent antifungal agent against Candida albicans, Trichoderma harzianum and Fusarium species, whereas compound 10 bearing 4- chloro-2-nitrophenyl moiety was the most effective antifungal agent on Aspergillus ochraceus. According to XTT and Ames MPF assays, these compounds were neither cytotoxic nor genotoxic at the concentrations tested. Docking studies suggested that these compounds showed good affinity to the active site of lanosterol 14α-demethylase (CYP51) (PDB code: 5V5Z) and interacted with the key residues such as Hem601 and Cys470. Based on in silico ADME studies, the compounds are expected to have high oral bioavailability.

Conclusion:

According to the in vitro and in silico studies, compounds 5 and 10 stand out as potential orally bioavailable antifungal agents for further studies.

IS IRON DEFICIENCY A RISK FACTOR FOR THE DEVELOPMENT OF THYROID AUTOANTIBODIES IN EUTHYROID WOMEN WITH REPRODUCTIVE AGES?

Contex

The first trimester of pregnancy is the most sensitive period in terms of thyroid hypofunction. Iron deficiency has been associated with both thyroid function and thyroid autoimmunity.

Objective

We aimed to investigate whether iron deficiency is a risk factor for thyroid autoimmunity in non-pregnant women at childbearing age.

Design

This cross- sectional study was conducted in non-pregnant women who presented to the Internal Medicine Policlinic between January 2018 and December 2018 in the University of Health Sciences "Fatih Sultan Mehmet" Training and Research Hospital.

Methods

Three hundred fifty-eight non-pregnant women of reproductive ages (203 iron deficient-ID, 155 control) participated in this study. Women with known thyroid disease, currently undergoing treatment for thyroid disease or whose thyroid function tests were outside the reference range were excluded from the study. Blood sample was taken after at least 8-10 hours of fasting for measurement of serum iron (Fe), total iron binding capacity (TIBC), serum ferritin (SF), whole blood count, thyroid function tests (fT4, TSH), anti-thyroid peroxidase antibodies (TPOAb) and anti-thyroglobulin antibody (TgAb). The patients with SF levels ≤ 15 ng/dL were accepted as iron deficiency.

Results

The group with ID had higher TSH and lower T4 values that did not reach statistical significance compared to the control group (p=0.101 and p=0.098, respectively). Antibody positivity was more frequent in the ID group than in the control group (35.96% vs. 20.65%, p = 0.002).

Conclusions

Iron deficiency is associated with thyroid autoimmunity and it should be considered as a risk factor for screening thyroid antibody, particularly in pregnancy planning women.

Obestatin Reduces Intestinal Damage in Experimental Necrotizing Enterocolitis in Newborn Rats

OBJECTIVE

To investigate the effect of pretreatment with obestatin (OB), an endogenous hormone also found in mother's milk, in experimental necrotizing enterocolitis (NEC).

STUDY DESIGN

Pups were randomized into four groups: control, OB-control, NEC, and OB-NEC. NEC was induced by asphyxia and hypothermia in the NEC and OB-NEC groups. OB was administered to the OB-control and OB-NEC groups. Macroscopic scoring of the intestinal tract was evaluated and tissue samples were obtained for histopathological and biochemical examination on the fourth day.

RESULTS

OB improved the macroscopic appearance of the gut and the clinical score during the experiment (p  <  0.05). The rate of occurrence of NEC in the OB-NEC group was lower than the NEC group (p  =  0.001). OB prevented necrosis and reduced the number of apoptotic cells in the OB-NEC group compared with the NEC group (p  =  0.006). Furthermore, interleukin-6 and malondialdehyde levels in the OB-NEC group were lower than the NEC group (p  <  0.05).

CONCLUSION

OB reduced intestinal damage and prevented necrosis through anti-inflammatory and antiapoptotic effects in experimental NEC. This effect of OB should be confirmed in clinical studies. Furthermore, future research should investigate whether OB plays a role in NEC pathogenesis or NEC is associated with OB levels in the serum and in breast milk.

Effects of infliximab against carbon tetrachloride-induced intestinal injury via lipid peroxidation and apoptosis

Carbon tetrachloride (CCL₄) is often employed in the production of chlorofluorocarbons, petroleum refining, oil and rubber processing, and laboratory applications. Oral, subcutaneous, and inhalation exposure to CCL₄ in animal studies have been shown to be capable of leading to various types of cancer (benign and malignant, liver, breast, and adrenal gland tumors). The present study also evaluated the protective role of infliximab (INF) against the deleterious effects of CCL₄ on the intestinal system. Twenty-four male Sprague-Dawley rats were randomly assigned into three groups, control (n = 8), CCL₄ (n = 8), and CCL₄ + INF (n = 8). The control group received 1 mL isotonic saline solution only via intraperitoneal (i.p.) injection. The CCL₄ group received a single i.p. dose of 2 mL/kg CCL₄. The CCL₄ + INF group received a single i.p. dose of 7 mg/kg INF followed 24 h later by a single dose of 2 mL/kg CCL₄. All rats were euthanized 2 days following drug administration. CCL₄ group samples also exhibited diffuse loss of enterocytes, vascular congestion, neutrophil infiltration, an extension of the subepithelial space and significant epithelial lifting along the length of the villi with a few denuded villous tips. In addition, CCL₄ treatment increased intestinal malondialdehyde (MDA) level and caspase-3 positivity. On the other hand, INF decreased MDA levels, caspase-3 positivity, and loss of villous. Our findings suggest that CCL₄ appears to exert a highly deleterious effect on the intestinal mucosa. On the other hand, INF is effective in preventing this CCL₄-induced intestinal injury by reducing oxidative stress and apoptosis.

Synthesis and Evaluation of a Series of 1,3,4-Thiadiazole Derivatives as Potential Anticancer Agents

BACKGROUND AND METHODS

In an attempt to develop potent antitumor agents, the synthesis of a series of N-(6-substituted benzothiazol-2-yl)-2-[(5-(arylamino)-1,3,4-thiadiazol-2-yl)thio]acetamides (1-14) was described and their cytotoxic effects on A549 human lung adenocarcinoma, MCF-7 human breast adenocarcinoma, HepG2 human hepatocellular carcinoma and NIH/3T3 mouse embryonic fibroblast cell lines were investigated using MTT assay.

RESULTS

Phenyl-substituted compounds (8-14) were found to be more effective than naphthyl-substituted compounds (1-7) on cancer cells. Compounds 8, 9, 10, 12, 13 and 14 were identified as the most potent anticancer agents on MCF-7 and HepG2 cell lines and therefore their effects on DNA synthesis and apoptosis/necrosis in MCF-7 cell line were evaluated. Among these compounds, N-(6-methoxybenzothiazol-2-yl)-2-[(5- (phenylamino)-1,3,4-thiadiazol-2-yl)thio]acetamide (13) was the most selective anticancer agent against MCF-7 and HepG2 cell lines with a SI value of 100. On the other hand, compounds 8, 9, 10, 12, 13 and 14 inhibited DNA synthesis in MCF-7 cell line in a dose-dependent manner. Flow cytometric analyses clearly indicated that the compounds showed significant anticancer activity against MCF-7 cell line via the induction of apoptosis dose dependently.

CONCLUSION

According to in vitro assays, compounds 8, 9, 10, 12, 13 and 14 stand out as promising candidates for further studies.

Biological evaluation of a series of benzothiazole derivatives as mosquitocidal agents

Aedes aegypti is associated with the transmission of numerous human and animal diseases, such as yellow fever, dengue fever, chikungunya, and more recently Zika virus. Emerging insecticide resistance has created a need to develop new mosquitocidal agents for effective control operations. A series of benzothiazole-piperidine derivatives (1-24) were investigated for their larvicidal and adulticidal effects on Ae. aegypti It was observed that compounds 2, 4, 6, 7, 8, 11 and 13 showed notable larvicidal activity. Furthermore, compounds 6 and 10 showed promising adulticidal activity. Based on the mosquitocidal properties of these compounds, docking studies were also carried out in the active site of the AeSCP2 enzyme to explore any insights into further in vitro enzyme studies. Docking results indicated that all these active compounds showed reasonable interactions with critical residues in the active site of this enzyme. This outcome suggested that these compounds might show their larvicidal and adulticidal effects via the inhibition of AeSCP2. According to in vitro and in silico studies, compounds 2, 4, 6, 7, 8, 10, 11 and 13 stand out as candidates for further studies.

The Effect of Comedy Films on Postoperative Pain and Anxiety in Surgical Oncology Patients

Objectives: To determine the effect of watching Turkish comedy films on postoperative pain and anxiety in oncology surgical patients. Design: This study was conducted using a pre- and post-test randomized controlled trial model. Materials and Methods: The study was conducted in a general surgery clinic of a hospital in eastern Turkey between January 2016 and January 2017. The sample of the study consisted of 88 patients (44 test, 44 control) selected by using the randomized sampling method. In the experimental group, funny videos from Turkish old comedy movies were watched for 10 min before surgery. Anxiety, measured by the State-Trait Anxiety Inventory, and vital signs were measured before and after the experimental protocol. In the analysis of the data, descriptive statistics, χ2 and t test were used. Results: The state-trait anxiety pre- and post-test mean score of the experimental group was found to be 39.59 ± 3.66 and 37.54 ± 3.52 before and after watching the video, respectively, indicating a statistically significant difference between these two values (p ≤ 0.05). No statistically significant difference was found between the pre- and post-test state-trait anxiety scores of the patients in the control group. The decrease from the pre- to post-test mean pain score was determined as 0.65 ± 1.05 in the experimental group and 0.11 ± 0.96 in the control group. A statistically significant difference was found between the groups’ post-test mean pain scores (p ≤ 0.05). Conclusion: The study results suggest that watching Turkish comedy movie videos has a positive effect on postoperative pain and anxiety in surgical oncology patients.

Neonatal Hypopituitarism: Approaches to Diagnosis and Treatment

Hypopituitarism is defined as a decreased release of hypophyseal hormones, which may be caused by disease of the pituitary gland disease or hypothalamus. The clinical findings of neonatal hypopituitarism depend on the causes and on presence and extent of hormonal deficiency. Patients may be asymptomatic or may demonstrate non-specific symptoms, but may still be at risk for development of pituitary hormone deficiency over time. Patient history, physical examination, endocrinological, radiological and genetic evaluations are all important for early diagnosis and treatment. The aim of this paper was to present a review of etiological factors, clinical findings, diagnosis and treatment approaches in neonatal hypopituitarism.

Synthesis and Evaluation of a New Series of Arylidene Indanones as Potential Anticancer Agents

Background:

Arylidene indanones have attracted a great deal of interest due to their outstanding therapeutic applications. In particular, considerable research has pointed out the importance of arylidene indanones in the field of cancer research.

Objective:

The aim of the current work was to design and synthesize arylidene indanone-based anticancer agents.

Method:

New arylidene indanones were obtained via the Claisen-Schmidt condensation of 5-chloro-6-methoxy- 2,3-dihydro-1H-inden-1-one with p-substituted benzaldehyde derivatives. MTT assay was performed to evaluate their cytotoxic effects on MCF-7 human breast adenocarcinoma, HeLa human cervix carcinoma and NIH/3T3 mouse embryonic fibroblast cell lines. The most effective derivatives were evaluated for their DNA synthesis inhibitory and apoptotic effects. The most apoptotic compounds were also investigated for their effects on caspase-3 activation in HeLa cells. The binding interactions of the most effective caspase-3 activator at the active site of caspase-3 were confirmed through molecular docking studies using Schrodinger’s Maestro molecular modeling package.

Results and Conclusion:

Compounds 2, 3, 4, 5, 6 and 7 exhibited selective anticancer activity against HeLa cells, whilst compounds 7 and 10 showed selective anticancer activity against MCF-7 cells. Compound 10 caused significant DNA synthesis inhibition on MCF-7 cells, whereas compound 3 caused significant DNA synthesis inhibition on HeLa cells. Compounds 2 and 3 were determined as the most apoptotic agents against HeLa cells, whereas compounds 7 and 10 showed apoptotic activity against MCF-7 cells. Besides, compound 2 was identified as the most effective compound on caspase-3 activation in HeLa cells. Docking studies showed that compound 2 interacted with the residues His121 and Tyr204 forming π-π stacking interactions.

A potential serious complication in infants with congenital obstructive uropathy: Secondary pseudohypoaldosteronism

Patients who have secondary pseudohypoaldosteronism (PHA) in addition to hyponatraemia, hyperpotassaemia and high serum aldosterone levels for the age were included in this retrospective study.Among eight patients, seven patients were diagnosed with PHA secondary to obstructive uropathy (OUP), whereas one patient had PHA secondary to ileostomy. Six patients with OUP had simultaneous urinary tract infection (UTI) and in all except one patient, secondary PHA recovered with only UTI treatment before applying surgical correction. All the patients were younger than 3 months age. In three patients with PUV diagnosis, salt wasting recurred in an UTI episode under 3 months of age.

Synthesis and Evaluation of a New Series of Thiazolyl-pyrazoline Derivatives as Cholinesterase Inhibitors

Objectives

In recent years, the design of anticholinesterase agents based on molecular hybridization of pharmacologically active scaffolds has attracted a great deal of interest in medicinal chemistry. For this purpose, we aimed to design and synthesize anticholinesterase agents based on the molecular hybridization of thiazole and pyrazoline scaffolds.

Materials and Methods

New thiazolyl-pyrazoline derivatives were synthesized via the ring closure reaction of 3-(2-furyl)-5-(1,3-benzodioxol-5-yl)-1-thiocarbamoyl-4,5-dihydro-1H-pyrazole with 2-bromo-1-arylethanone derivatives. The compounds were investigated for their inhibitory effects on AChE and BuChE using a modification of Ellman's spectrophotometric method. As a part of this study, the compliance of the compounds to Lipinski's rule of five was evaluated. The physicochemical parameters (log P, TPSA, nrotb, molecular weight, number of hydrogen bond donors and acceptors, molecular volume) were calculated using Molinspiration software.

Results

2-[5-(1,3-Benzodioxol-5-yl)-3-(2-furyl)-4,5-dihydro-1H-pyrazol-1-yl]-4-(naphthalen-2-yl)thiazole was found to be the most effective AChE inhibitor (38.5±2.85%), whereas 2-[5-(1,3-benzodioxol-5-yl)-3-(2-furyl)-4,5-dihydro-1H-pyrazol-1-yl]-4-(4-fluorophenyl)thiazole was found as the most potent BuChE inhibitor (43.02±2.71%) in this series. These compounds only violated one parameter of Lipinski's rule of five. On the basis of Lipinski's rule, they were expected to have reasonable oral bioavailability.

Conclusion

In the view of this study, the structural modification of the identified compounds is on-going for the generation of new cholinesterase inhibitors with enhanced efficacy.

New Benzodioxole-based Pyrazoline Derivatives: Synthesis and Anticandidal, In silico ADME, Molecular Docking Studies

Background:

Azoles are commonly used in the treatment and prevention of fungal infections. They suppress fungal growth by acting on the heme group of lanosterol 14α-demethylase enzyme (CYP51), thus blocking the biosynthesis of ergosterol. </P><P> Objectives: Due to the importance of pyrazolines in the field of antifungal drug design, we aimed to design and synthesize new pyrazoline-based anticandidal agents.

Methods:

New pyrazoline derivatives were synthesized via the reaction of 1-(chloroacetyl)-3-(2- thienyl)-5-(1,3-benzodioxol-5-yl)-2-pyrazoline with aryl thiols. These compounds were evaluated for their in vitro antifungal effects on Candida species. Docking studies were performed to predict the affinity of the most effective anticandidal agents to substrate binding site of CYP51. Furthermore, MTT assay was performed to determine the cytotoxic effects of the compounds on NIH/3T3 mouse embryonic fibroblast cell line. A computational study for the prediction of ADME properties of all compounds was also carried out.

Results:

Compounds 5, 8, 10 and 12 were found as the most potent anticandidal agents against Candida albicans and Candida glabrata in this series with the same MIC values of ketoconazole and they also exhibited low toxicity against NIH/3T3 cells. Docking results indicated that all these compounds showed good binding affinity into the active site of CYP51. In particular, chloro substituted compounds 8 and 12 bind to CYP51 through direct coordination with the heme group. According to in silico studies, compound 8 only violated one parameter of Lipinski’s rule of five, making it a potential orally bioavailable agent.

Conclusion:

Compound 8 was defined as a promising candidate for further in vitro and in vivo studies.

Design, Synthesis, and Neuroprotective Effects of a Series of Pyrazolines against 6-Hydroxydopamine-Induced Oxidative Stress

Parkinson's disease (PD) is a chronic, progressive, and age-related neurodegenerative disorder characterized by the loss of midbrain dopaminergic neurons caused by the accumulation of free radicals and oxidative stress. Based on the neuroprotective properties of 2-pyrazoline derivatives, in the current work, 1-(phenyl/4-substituted phenyl)-3-(2-furanyl/thienyl)-5-aryl-2-pyrazolines (3a⁻i, 4a⁻i) were synthesized via the cyclization of the chalcones (1, 2) with suitable phenylhydrazine hydrochloride derivatives. All these compounds were investigated for their neuroprotective effects using an in vitro 6-hydroxydopamine (6-OHDA)-induced neurotoxicity model of PD in the rat pheochromocytoma (PC-12) Adh cell line. In addition, some different pharmacokinetic parameters of all compounds were in silico predicted by the QikProp module of Schrödinger's Maestro molecular modeling package. 4-Methylsulfonylphenyl substituted compounds 3h (20%) and 4h (23%) were determined as the most promising neuroprotective agents related to their inductive roles in cell viability when compared with the 6-OHDA-positive control group (43% and 42%, respectively). Moreover, in silico pharmacokinetic results indicated that all compounds were within the acceptable range intended for human use. According to both in vitro and in silico studies, compounds 3h and 4h draw attention as potential orally bioavailable therapeutic drug candidates against neurodegeneration in PD.

Design, synthesis, in vitro and in silico evaluation of a new series of oxadiazole-based anticancer agents as potential Akt and FAK inhibitors

In the current work, new 1,3,4-oxadiazole derivatives were synthesized and investigated for their cytotoxic effects on A549 human lung adenocarcinoma, C6 rat glioma and NIH/3T3 mouse embryonic fibroblast cell lines. Compounds 2, 6 and 9 were found to be the most potent anticancer agents against A549 and C6 cell lines and therefore their effects on apoptosis, caspase-3 activation, Akt, FAK, mitochondrial membrane potential and ultrastructural morphological changes were evaluated. N-(5-Nitrothiazol-2-yl)-2-[[5-[((5,6,7,8-tetrahydronaphthalen-2-yl)oxy)methyl]-1,3,4-oxadiazol-2-yl]thio]acetamide (9) increased early and late apoptotic cell population in A549 and C6 cells more than cisplatin and caused more mitochondrial membrane depolarization in both cell lines than cisplatin. On the other hand, N-(6-methoxybenzothiazol-2-yl)-2-[[5-[((5,6,7,8-tetrahydronaphthalen-2-yl)oxy)methyl]-1,3,4-oxadiazol-2-yl]thio]acetamide (6) caused higher caspase-3 activation than cisplatin in both cell lines. Compound 6 showed significant Akt inhibitory activity in both cell lines. Moreover, compound 6 significantly inhibited FAK (Phospho-Tyr397) activity in C6 cell line. Molecular docking simulations demonstrated that compound 6 fitted into the active sites of Akt and FAK with high affinity and substrate-specific interactions. Furthermore, compounds 2, 6 and 9 caused apoptotic morphological changes in both cell lines obtained from micrographs by transmission electron microscopy. A computational study for the prediction of ADME properties of all compounds was also performed. These compounds did not violate Lipinski's rule, making them potential orally bioavailable anticancer agents.

A Study of the Relationship Between Cystatin C and Metabolic Bone Disease in Preterm Infants

OBJECTIVE

Cystatin C (CysC) is commonly used as a marker of renal failure in premature infants. The aim of this study was to investigate serum CysC levels in osteopenia of prematurity (OP) and determine whether CysC could be safely used as a marker of renal insufficiency in infants with OP.

METHODS

Subjects were 50 preterm infants (≤32 gestational weeks). Calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) serum levels were measured in postnatal week nine, and bone density was measured concurrently by quantitative ultrasonography. Patients with a Z score of <-2 were considered to have OP.

RESULTS

The mean serum CysC levels in preterm infants in postnatal week nine were 1.50±0.19 mg/L. Serum CysC levels were not correlated with speed of sound values, Z scores, serum Ca, P or ALP levels. Serum CysC levels were not significantly different between infants with OP [1.50 (1.35-1.61) mg/L] and in infants without OP [1.58 (1.28-1.70) mg/L].

CONCLUSION

The presence of OP does not affect the safety of CysC as a marker of renal insufficiency in preterm infants.

Design, Synthesis, and Evaluation of a New Series of Thiazole-Based Anticancer Agents as Potent Akt Inhibitors

In an attempt to develop potent anticancer agents targeting Akt, new thiazole derivatives (1⁻10) were synthesized and investigated for their cytotoxic effects on A549 human lung adenocarcinoma, C6 rat glioma, and NIH/3T3 (healthy) mouse embryonic fibroblast cell lines. The most potent compounds were also investigated for their effects on apoptosis and Akt pathway. The most promising anticancer agent was found to be 2-[2-((4-(4-cyanophenoxy)phenyl)methylene)hydrazinyl]-4-(4-cyanophenyl)thiazole (6), due to its selective inhibitory effects on A549 and C6 cells with IC₅₀ values of 12.0 ± 1.73 µg/mL and 3.83 ± 0.76 µg/mL, respectively. Furthermore, compound 6 increased early and late apoptotic cell population (32.8%) in C6 cell line more than cisplatin (28.8%) and significantly inhibited the Akt enzyme. The molecular docking study was performed to predict the possible binding modes of compounds A, 6, and 8 inside the active site of Akt (PDB code: 4EJN). Molecular docking simulations were found to be in accordance with in vitro studies and, hence, supported the biological activity. A computational study for the prediction of absorption, distribution, metabolism and excretion (ADME) properties of all compounds was also performed. On the basis of Lipinski's rule of five, the compounds were expected to be potential orally bioavailable agents.