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• IFN-γ, IL-17A and IL-22 related to γδ T cells are evaluated in Behçet's disease (BD) • Functional states of both CD4+ and γδ T cells are compared in ex vivo samples • Only IFN-γ production was increased in γδ T cells of active BD patients • IL-17A and IL-17A/IFN-γ double producer CD4+ T cells were increased in active BD • Along with CD4+ T cells, γδ T cells have complementary roles in BD Involvement of γδ T cells is implicated in the pathogenesis of Behçet's disease (BD) as a bridge between innate and adaptive responses. IL-17 and IL-22 have also been shown to participate in the BD pathogenesis in addition to IFN-γ. Mainly CD4+ T cells are investigated previously for the production of these inflammatory cytokines. In this study, the role of γδ T cells in cytokine-related mechanisms was evaluated in BD in comparison to CD4+ T cells. Surface expression of markers for functional states of both CD4+ and γδ T cells were compared in ex vivo samples collected from patients with BD and healthy controls (HC). Sixteen active BD (a-BD), 9 inactive BD (i-BD) patients and 25 HC were investigated. The expression of CD161, CCR6 as markers for IL-17 producing cells were analyzed on γδ and CD4+ T cells. IFN-γ, IL-17A, IL-22, as well as CD107a (LAMP1) and CD16 (FcγRIII) were evaluated in both cell subtypes after in vitro stimulation. Only IFN-γ production was increased in γδ T cells of a-BD patients. There was no difference in increase of CD107a or decrease of CD16 surface expression on γδ T cells upon stimulation between the groups. Ex vivo IL-17A and both IL-17A/IFN-γ production and expression of CD161, CCR6 by CD4+ T cells were increased in a-BD. Along with CD4+ T cells, γδ T cells have complementary roles in cytokine production in BD. Higher IFN-γ production of γδ T cells suggests the role of an environmental triggers in BD pathogenesis, whereas IL-17 related activity is mainly provided by CD4+ T cells. [ABSTRACT FROM AUTHOR]

On the contrary, mRNA COVID-19 vaccines induce the production of antibodies against only the spike protein, and anti-spike antibodies did not promote antibody-mediated enhancement by the infection of monocytes and macrophages. Keywords: autoimmunity; biodistribution; mRNA; nucleic acid-based vaccines; vaccine; viral infection EN autoimmunity biodistribution mRNA nucleic acid-based vaccines vaccine viral infection 1 3 3 11/29/22 20221201 NES 221201 We read with interest the letter by Polykretis,1 which summarized some basic immunological principles in relation to COVID-19 vaccines. Nucleic acid-based vaccines mimic the viral infection itself, but since these vaccines cannot replicate, the induction of viral protein synthesis by their nucleic acid sequence is limited in terms of duration and involved tissues. [Extracted from the article]

In the Qur'an, it is reported that the mountains, which are described as piles that nailed the Earth for the earth to stand still without shaking, were created as balance elements. In addition, to that, mountains have added material value to human life and have an important role because they function as natural water tanks and contain many natural riches in them. Mountains have an important function in the history of religions with the spiritual value they carry. The mountains, which are considered as sacred centers, also stand out as the places where revelation descends. They are also seen as places endowed with divine power manifested by God. The mountains, which are the symbol of power and Glory, are manifested as the power that emphasizes the greatness of Allah with their height and glory and are shown as examples at the point of breaking man's arrogance. Except for this, the mountains, which are mentioned in the Qur'an in other features, were offered trust, but they refused to undertake it being afraid thereof. They felt awe and feared from the revelation of the Qur'an. Moses was honored with revelation on the mountain, and the mountain was chosen for him as a place of the covenant with Allah. Likewise, the mountain hosted the first revelation to the Prophet. The mountains, which are the symbol of Allah's greatness, have been used in the Qur'an to form nuance with various words in different contexts. These mentioned features of the mountains brought about the formation of metaphorical interpretations in the understanding of the verses about them. In this article, the conceptual area of the mountain in the Qur'an and the metaphorical interpretations that make themselves clear in the Sufi explanation will be given. [ABSTRACT FROM AUTHOR]

While Sûfîs interpreting the Qur'an, they acted according to the interpretation theory they developed. This interpretation can follow a course from literal meaning to esoteric meaning. Sometimes they have expanded the meaning of text(nass), and sometimes they have restricted the meaning by acting exclusively. The interpretations of Sûfîs, which evolved from the literal meanings of words to connotation or metaphorical meanings, can be said to have been made to elucidate matters that were in fact closed. It can be said that they have created a language unique to them in these aspects, and that the possibility of understanding and healing it is possible by passing the declaration interpretation criteria. In order to protect the bâtinî (esoteric) interpretations, which are the walking leg of the interpretation of wisdom, from falsification, the conditions of interpretation have been set out and a purpose has been aimed at the healthy functioning of the interpretation mechanism. When the Sûfîs interpreted the Qur'an, they incorpareted into tafseers some of the meanings that they called işarah (signs). In this article, the Sûfî commentaries on Heaven and hell will be given and how the Sûfîs try to understand the Qur'an will be examined. [ABSTRACT FROM AUTHOR]

After the emergence of a novel coronavirus named SARS‐CoV‐2, coronavirus disease 2019 (COVID‐19) was initially characterized by fever, sore throat, cough, and dyspnea, mainly manifestations of respiratory system. However, other manifestations such as headache, abdominal pain, diarrhea, loss of taste and smell were added to the clinical spectrum, during the course of the COVID‐19 pandemic. The reports on the neurological findings are increasing rapidly and headache seems to be the leader on the symptom list. Headache was reported in 11%‐34% of the hospitalized COVID‐19 patients, but clinical features of these headaches were totally missing in available publications. According to our initial experience, significant features of headache presentation in the symptomatic COVID‐19 patients were new‐onset, moderate‐severe, bilateral headache with pulsating or pressing quality in the temporoparietal, forehead or periorbital region. The most striking features of the headache were sudden to gradual onset and poor response to common analgesics, or high relapse rate, that was limited to the active phase of the COVID‐19. Symptomatic COVID‐19 patients, around 6%‐10%, also reported headache as a presenting symptom. The possible pathophysiological mechanisms of headache include activation of peripheral trigeminal nerve endings by the SARS‐CoV‐2 directly or through the vasculopathy and/or increased circulating pro‐inflammatory cytokines and hypoxia. We concluded that as a common non‐respiratory symptom of COVID‐19, headache should not be overlooked, and its characteristics should be recorded with scrutiny. [ABSTRACT FROM AUTHOR]

When the Prophet was alive, Sahabah had no difficulty finding answers to his questions on religious issues. It is known that they solved the answers they could not find on religious issues according to their own ijtihad. This situation usually it stands out as the points which the Prophet approves of, which are passed on in his account. In later periods, the subject of ijtihad was discussed while the Prophet was alîve, the ijtihad of the sahabah was rarely encountered during this period. With the expansion of the borders of the Islamic State with the death of the Prophet, the task of extracting judgment from The Book and the Sunnah in order to answer and solve the questions and problems of the new peoples who are included in Islam has gained momentum. This provided the basis for various orientations in the commentary of the Sahabah. Sahabah had two tendency when interpreting the Qur'an. These can be classified as fiqh and linguistic (lughavi) tendency. Fiqh tendency is the basis of the procedure and furu of fiqh Tafsir and Islamic Law. Linguistic tendency, on the other hand, contains linguistic data that will provide a more accurate understanding of the Qur'an and contributes to the understanding of the Qur'an. It is possible to see these tendencies as the main characteristics of sahabi exegesis. This article will focus on the Fiqh (Islamic Law) Tendency of the Sahabah. [ABSTRACT FROM AUTHOR]

Background: Necrotizing enterocolitis (NEC) is a serious, life-threatening pathology seen especially in the neonatal period. It is characterized by inflammation of the intestinal mucosa and ischemic necrosis. When it progresses, intestinal perforation can lead to peritonitis, sepsis, and even to death (50%). We present our anesthesia practices in 5 premature patients with very low birth weight (VLBW) (<=1500 g) who underwent surgery for intestinal perforation after NEC. Case report: All patients were ASA V E and in need of invasive respiratory support with cardiac and respiratory co-morbidities. The demographic and peroperative data of the patients are shown in the table. Gas distention and dilated bowel loops were observed in the abdomen on radiological imaging. Transfers to the operating room were provided in a heated incubator with a transport ventilator and monitor. Inotropic support was continued during transport. The operating room and operating table were preheated. ECG, SpO2, noninvasive blood pressure and body temperature monitoring was achieved. Inotropic support was continued. Fluid management was provided with 3.33% dextrose-0.3% sodium chloride. Four extremities and head circumferences were wrapped with cotton to reduce heat loss. Since the patients were hemodynamically labile, ketamine was generally preferred for anesthesia induction and maintenance. Pressure-controlled mechanical ventilation was administered with neonatal breathing circuits. No patient needed muscle relaxants. After surgery, all patients were successfully transferred to the intensive care unit. Discussion: Many factors may be responsible for the etiology of NEC, but the strongest risk factor is prematurity. The morbidity and mortality rates are higher in patients requiring surgical intervention. Interventions to prevent NEC development are the most effective way to avoid negative consequences. Preventive interventions should start from the maternal period and include the intensive care hospitalization and the arrival to the operating room. The transfers of VLBW prematures between the intensive care and the operating room, operating room preparation and anesthesia applications require more caution. Conclusion: Detailed and careful preparation, communication between teams and a multidisciplinary approach are required to achieve success in these babies with high mortality and morbidity rates. [ABSTRACT FROM AUTHOR]

Spondyloarthritis encompasses a group of inflammatory disorders characterized by shared pathogenic mechanisms and articular and extraarticular clinical manifestations. Spondyloarthritis is strongly associated with MHC Class I HLA alleles; and both HLA and non-HLA genetic susceptibility factors are associated with increased production of IL-23, increased sensitivity of IL-23R, and IL-17 and TNF associated inflammatory response developing mainly at the entheseal sites and leading to clinical manifestations. IL-17 plays the major role in the inflammatory response and produced by cells of the adaptive and innate immunity. New bone formation develops during the repair phase of enthesitis, which results in bony ankylosis and movement restrictions. Treatments aiming IL-23 and IL-17 cytokines reveals differing efficacy results in findings affecting skin, enthesis and intestine, which suggest a heterogeneity in the regulation of inflammatory response at the tissue level. Further data are needed to plan a phenotype-based treatment aiming precision medicine in spondyloarthritis. [ABSTRACT FROM AUTHOR]

Spondyloarthritis encompasses a group of inflammatory disorders characterized by shared pathogenic mechanisms and articular and extraarticular clinical manifestations. Spondyloarthritis is strongly associated with MHC Class I HLA alleles; and both HLA and non-HLA genetic susceptibility factors are associated with increased production of IL-23, increased sensitivity of IL-23R, and IL-17 and TNF associated inflammatory response developing mainly at the entheseal sites and leading to clinical manifestations. IL-17 plays the major role in the inflammatory response and produced by cells of the adaptive and innate immunity. New bone formation develops during the repair phase of enthesitis, which results in bony ankylosis and movement restrictions. Treatments aiming IL-23 and IL-17 cytokines reveals differing efficacy results in findings affecting skin, enthesis and intestine, which suggest a heterogeneity in the regulation of inflammatory response at the tissue level. Further data are needed to plan a phenotype-based treatment aiming precision medicine in spondyloarthritis. [ABSTRACT FROM AUTHOR]

Objective: Acne-like skin lesions and more severe disease course in males suggest a role for sex hormones in the pathogenesis of Behçet disease (BD). HLA-B51 is the main genetic susceptibility factor for BD, and CYP21A2 gene responsible for most of congenital adrenal hyperplasia (CAH) is located within the MHC locus on chromosome 6p21.3. We aimed to investigate the possible role of 21-hydroxylase deficiency in linkage disequilibrium with HLA-B51 and causing androgen excess. Materials and Methods: We studied 18 healthy controls, 29 BD patients and 15 patients with ankylosing spondylitis (AS). All subjects underwent ACTH stimulation test. Basal and stimulated serum cortisol and 17-OH-progesterone (17-OH-P) levels and basal dehydroepiandrosterone sulfate (DHEA-S), total testosterone and sex hormone binding globulin (SHBG) levels were measured. Results: According to current guidelines, we accepted 10 ng/mL as the cut-off point for 17-OH-P to define non-classic CAH (NCAH). After ACTH stimulation 3 of BD patients (10.3%) and 5 AS patients (33.3%) had high 17-OH-P concentrations. Those individuals were considered as NCAH or possible carriers for CAH mutations. Three out of 8 BD patients with prominent acne were identified as NCAH biochemically. Mean total testosterone levels of BD patients were significantly lower than those of healthy controls, however these levels were normal in BD patients with high 17-OH-P. Conclusion: This preliminary work documented high 17-OH-P levels following ACTH stimulation in a subset of BD and AS patients, and genetic studies are necessary to investigate the role of 21-hydroxylase deficiency in association with HLA-B alleles in their pathogenesis. [ABSTRACT FROM AUTHOR]

Burnout is a serious problem for psychiatrists that has implications for clinical practice and personal health. While burnout is known to affect cognitive functions, no studies have examined the relationship between sluggish cognitive tempo (SCT) and burnout. This study aimed to examine this relationship and related factors as socio-demographic, occupational environment in psychiatrists. Participants(n=201, aged between 25 and 52 years,57.7% female) completed socio-demographic information form, Maslach Burnout Inventory and SCT Scale. According to our results, we have shown that total burnout scores and emotional exhaustion (EE) scores were significantly higher in psychiatrists with SCT. SCT scores were positively correlated with mean total burnout, EE, and depersonalization scores. We did not find any differences between subgroups according to departments, therapeutic approaches and gender. In conclusion, we want to highlight that psychiatrists with SCT were more proneness to general burnout symptoms and were more emotionally exhausted regardless of their therapeutic approach or their profession as adult or child/adolescent psychiatrists. [ABSTRACT FROM AUTHOR]

Holy is one of the axis concepts in the history of religion. The idea of holy begins with human history. The sacred that surrounds the life, repeats itself linearly and sometimes circularly in this circle, appears as existence itself or reason for existence. Holiness in religions with or without a Holy Book is expressed in different terms. In the Qur'an, the last chain of divine religions, there are many concepts about holy and holiness. This article studies these concepts in the Qur'an. [ABSTRACT FROM AUTHOR]

Background: Phantom pain is a common condition that occurs after both upper and lower extremity amputations. The most common causes of amputation in the pediatric population are trauma, cancer, and congenital amputations. For trauma-related amputations, recorded prevalence of phantom pain is 12% and 83%. We aimed to present the frequency of phantom pain in patients hospitalized in our hospital after Pazarcık earthquake due to amputation. Material and Methods: Children aged 0-18 years with extremity amputations due to trauma followed in Ankara Etlik City Hospital after Pazarcık earthquake were included in the study. Data were obtained from the patient files and hospital records. All patients were evaluated daily for Phantom sensation or Phantom pain in a standardized fashion. The severity, time and character of the pain were questioned in patients with Phantom pain. Results and Discussion: Nineteen patients with traumatic amputation were included in the study. Demographic values and amputation sites are shown in Table I and II. In the follow-up of the patients at the end of one month; Phantom sensation and Phantom pain was detected in 16 (88.9%) and 11 (61.1%) patients respectively (Table III). The lower extremity rate in traumatic amputations has been reported to be 80-85% in the literature, as in our results. Wilkins et al found the incidence of Phantom pain to be 48.5% in children aged 8-18 who underwent traumatic amputation. However, we found a higher incidence (61.1%) in our patients. This high incidence may be due to the fact that we started to follow patients immediately after they were admitted to the hospital. Conclusion: Phantom sensation and Phantom pain are seen with considerable frequency after traumatic amputation in children. It may be valuable to evaluate the treatment plan in the early period and to improve the quality of life. [ABSTRACT FROM AUTHOR]

Sahabah (companions) were very careful when commenting on the Qur'an; they used various methods in this regard. As generally expressed, these methods are interpreting the Quran by itself, by Sunnah and by the Arabic Language. This last method, which we can characterize as Tafsir by ra'y (sound opinion), is one of the tafsir methods, frequently applied by sahabah and it has been maintained its effectiveness until today. The mutashabih (allegoricial) and mubham (indefinite) words in the Quranic sciences have been explained by using the data of the Arabic language. This fact has importance in that it shows that the language plays a leading role in Tafsir. Although Sahabah do not possesses the same accumulation of knowledge and culture on the occasion of being mostly Arab, they took into account the vocabulary of language and rhetoric when interpreting the Qur'an because of their familiarity with the fluent, eloquence and rhetoric of the language. Even though the name of the rhetoric was not given in that day in the present sense, they have interpreted the Qur'an as distinguished people, being aware of that. This article will focus on the linguistic tafsir of sahabah and provides their linguistic explanations and istishhad (citing as evidence) on the verses. In addition, it examines the means which they used in the verses they interpret due to their acquaintance with the Arabic language and rhetoric. To sum up, this article argues that linguistic tafsir began with sahabah. [ABSTRACT FROM AUTHOR]

Objective: Although several studies have shown that childhood traumas play an important role in the etiology and maintenance of depressive, anxiety, and dissociative disorders, little is known about the relative specificity of several types of childhood abuse and neglect.The aim of this study is to evaluate the impact of specific childhood traumas on the relationship between depression, anxiety, and dissociative symptomatology. Methods: Fifty female and fifty male patients with unipolar depression have been enrolled. All patients were administered sociodemographic data form, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI), and Dissociative Experiences Scale (DES). Experiences of childhood abuse and neglect were assessed by Childhood Trauma Questionnaire (CTQ-28). Results: Our results suggested that there were many similarity and gender-specific differences among the patients with traumatic experiences in terms of relationship between depression, anxiety, and dissociation symptoms. Firstly, female patients with childhood traumas have a moderate association between depression-anxiety and anxiety-dissociation symptoms whereas male patients have a high grade association between depression and dissociative symptoms directly. Secondly, in case of exposure of all abuse and neglect types, except emotional abuse, we found a positive association between depression and anxiety symptoms. Interestingly, except for emotional abuse, depression-dissociation relationship was evident in depressive patients with no maltreatment history. And finally, we found a positive relationship between anxiety and dissociation symptoms in all types of maltreatment exposure, except for sexual abuse. Conclusions: Information about childhood trauma history and gender-specific differences among symptoms would additionally help to identify individual's risk for depressive, anxiety or dissociative disorders and/ or predict response to treatment. Future studies should focus on prospective examinations of potential predictors and mediators in this area. [ABSTRACT FROM AUTHOR]

Aims: Attention Deficit/Hyperactivity Disorder (ADHD) is a common neuropsychiatric disorders in the pediatric population. Genetic, biological and psychosocial factors are involved in the occurrence of ADHD but the exact etiology is still unknown. Thyroid functions are critical to neurocognitive development in childhood. The aim of this study was to investigate the relationship between ADHD, thyroid functions and weight gain in children. Methods: Children aged 7 to 15 years having a diagnosis of ADHD who were consulted to the pediatric endocrinology unit for weight gain were recruited. Anthropometric measurements, blood levels of thyroid stimulating hormone (TSH), free (F) T3, FT4, Anti (thyroglobuline) TG and Anti (thyroid peroxidase) TPO were obtained and a thyroid sonography was performed for each patient. Results: Among the participants (n=11), 4 (36.4%) were obese and 4 (36.4%) had subclinical hypothyroidism. Two patients (18.2%) were both obese and had subclinical hypothyroidism. Patients with ADHD and subclinical hypothyroidism had higher mean TSH level than patients those with ADHD and obese ones, but had lower FT4 levels. Thyroid volume of a 13-year-old girl who had subclinical hypothyroidism was>+2SD. Conclusions: Although there is not enough evidence that hypothyroidism is an important problem in ADHD, we found a higher ratio of subclinical hypothyroidism and obesity in this sample. This is an important result and should be carried out in consultation-liaison patients. [ABSTRACT FROM AUTHOR]

15N labeled soluble metallo- and metal-free phthalocyanines are described for the first time. The complexes were synthesized starting from phthalic anhydride derivatives using 98% 15N enriched urea. The effects of the substitution pattern, aggregation, and coordinated metal on 15N chemical shifts in liquid state NMR were studied. [ABSTRACT FROM AUTHOR]

New tetra-cobaltacarborane modified zinc, cobalt and manganese phthalocyanine complexes have been synthesized via nucleophilic attack of the reference hydroxylated phthalocyanines to the oxonium adduct of cobalt bis(dicarbollide). The compounds were characterized by elemental analysis, FT-IR, 1 H NMR, 11 B NMR, UV–vis and mass spectroscopic data. Photophysical properties of zinc phthalocyanine 6 suggest that it may have potential application as dual sensitizers in the PDT and BNCT treatment of tumors. The electrochemical, in situ spectroelectrochemical and electrocolorimetric properties of these phthalocyanine conjugates were investigated together with reference phthalocyanines. In the case of electroactive Co- and Mn-phthalocyanine with cobaltacarborane substituents, in addition to ring based reduction, metal based reductions in both phthalocyanine core and cobaltocarborane units have been clearly identified. [ABSTRACT FROM AUTHOR]

Behçet's disease (BD) is an inflammatory disorder of unknown aetiology characterised by recurrent attacks affecting the mucocutaneous tissues, eyes, joints, blood vessels, brain and gastrointestinal tract. It is a multifactorial disease classified as a variable vessel vasculitis, and several environmental triggers may induce inflammatory episodes in genetically susceptible individuals. BD has several autoinflammatory features including recurrent self-limited clinical manifestations overlapping with monogenic autoinflammatory disorders, significant host predisposition and abnormally increased inflammatory response, with a robust innate component. Human leukocyte antigen (HLA)-B*51 is the strongest susceptibility factor described so far affecting the disease risk and typical phenotype. Non-HLA genetic associations such as endoplasmic reticulum aminopeptidase 1 (ERAP1), interleukin 23 receptor (IL23R) and IL10 variations suggest that BD shares susceptibility genes and inflammatory pathways with spondyloarthritis. Although genomewide association studies revealed an increased risk associated with recessively inherited ERAP1 variations in HLA-B*51 positive patients, it is not clear yet whether certain peptide-HLA allele combinations result in an adaptive response by a self-antigen-directed cytotoxic response or an innate response by modulating an NK cell activity or causing an unfolded protein response. Understanding of major histocompatibility complex (MHC) Class I-driven inflammatory response is expected to provide insights for the development of better treatment and remission-induction options in BD as well as in ankylosing spondylitis (AS) and psoriasis. [ABSTRACT FROM AUTHOR]

The recent advances in the synthesis of carborane and boronic ester-substituted tetrapyrroles (porphyrins, porphyrazines, and phthalocyanines) are reviewed together with their possible utilization as agents for photodynamic therapy (PDT) and boron neutron capture therapy of cancer (BNCT) as well as dual PDT/BNCT sensitizers. [ABSTRACT FROM AUTHOR]

Abstract: In this work, a new hexadeca substituted zinc phthalocyanine 4 bearing hexyloxy groups in nonperipheral positions and 3-(diethylamino)phenoxy groups in peripheral positions and its corresponding water-soluble octacationic derivative 5 have been reported. The new compounds have been characterized by elemental analysis, IR, UV, NMR and mass spectra. Zinc phthalocyanine showed excellent solubility in organic solvents of wide polarity range due to its amphiphilic nature and it enabled us to carry out detailed UV–Vis studies in different solvents. Octacationic zinc phthalocyanine 5 was soluble in DMF, DMSO and water. UV–Vis spectra of 5 in DMSO, DMF and water showed sharp Q band absorption as an indication of monomeric form even in aqueous media. This property of water-soluble non-aggregating zinc phthalocyanine is promising as a photosensitizer in Photodynamic Therapy of Cancer. [Copyright &y& Elsevier]

Abstract: With the aim of preparing a novel Zn phthalocyanine bearing four phenylboronic azaester substituents at peripheral positions, 4-[2-(bis(2-hydroxyethyl)amino)ethoxy]phthalonitrile (2) was synthesized by the aromatic nucleophilic substitution reaction of 4-nitrophthalonitrile with triethanolamine. 2,9(10),16(17),23(24)-Tetrakis-[2-(bis(hydroxyethyl)amino)ethoxy]-phthalocyaninatozinc (II) (4) was prepared from the cyclotetramerization of dinitrile 2 in the presence of anhydrous zinc(II) acetate by microwave irradiation. Alternatively, treatment of 2 with phenylboronic acid yielded the phenylboronic azaester (3), namely 4-(2-(2-phenyl-1,3,6,2-dioxazaborocan-6-yl)ethoxy)phthalonitrile. Treatment of phthalocyanine 4 with phenylboronic acid in a mixture of DMSO/toluene (20/1, v/v) afforded the desired phthalocyanine 5. The novel compounds were characterized by elemental analyses, IR, UV–Vis, 1H, 13C and 11B NMR spectra. The 11B NMR data indicated that the boron atom of phthalonitrile 3 is in the tetracoordinated state with the formation of a coordinative Nlosed form), while in the case of phthalocyanine 5, the open conformer possessing a tricoordinated B atom is favoured. [Copyright &y& Elsevier]

Abstract: 4-(4-Formyl-3-hydroxyphenoxy)phthalonitrile (3) and its condensation product with 2-aminophenol have been synthesized to reach 4-(3-hydroxy-4-(((2-hydroxyphenyl)imino)-methyl)phenoxy)phthalonitrile (5), a tridentate ligand possessing ONO binding sites. Subsequent condensation of phenylboronic acid with 5 afforded a novel boronic ester of a Schiff base with a phthalonitrile group (7). Boronate 7 displays high stability and can be handled in air due to the presence of coordinative B–N and covalent B–O bonds in its structure. The novel compounds were characterized by elemental analyses, IR, UV–vis, mass, 1H-, 13C- and 11B NMR spectra. [Copyright &y& Elsevier]

Tetrapyrazinoporphyrazines (TPyPzs) are the structures that are formed from the annulation of four pyrazine rings to the porphyrazine (Pz) framework. Other extensively denomination use of TPyPz is ‘‘azaphthalocyanine’’(AzaPc). In comparison to phthalocyanines (Pcs), the eight additional nitrogen atoms in TPyPzs induce large electronic effects on the structure. AzaPcs are formed by cyclotetramerisation of pyrazine-2,3-dicarbonitrile or its substituted derivatives. Like Pcs, AzaPcs can be substituted in their peripheral 2,3-positions. This situation may further enhance their solubility of substituted TPyPzs and their metal complexes in organic solventsand also influence the electronic excitation energies of these compounds. The TPyPzs have specific optical properties because they have symmetrical rich 18 -electron aromatic macrocycle, which can play host to different metal ions in its central cavity. Therefore, they have been extensively used in optical recording media, photosensors, optical filters and copy preventing inks. In this work, octasubstituted symmetric metallo and metal-free azapcs containing sulphur as heteroatom on the periphery and their cationic derivatives that are soluble in water were synthesized. Metallo azapcs can be readily prepared either by a direct cyclotetramerisation of dinitrile precursors like Pcs or by a metal insertion into metal-free derivative as Pzs in the presence of corresponding metal salts. Metal-free azapcs can be obtained from either dilithium or magnesium azapc using weak or strong acid. For this porpuse, 5,6-dichloropyrazine-2,3- dicarbonitrile 1, that is easily accessible from diaminomaleodinitrile (DAMN) in a two stepreaction, was chosen as a starting material. Because of the strong electron withdrawing abilityof cyano and chlorine atoms, this compound undergoes ready substitution in positions 5 ve 6 with nucleophiles like primary and secondary amines, alcoholates, thiolates. Consequently, treating 1 with 2- dimethylaminoethanthiol hydrochloride at room temperature afforded 2 in rather high yield. In order to convert to ligand 2 into azapc 3, we made use of its template reaction in the presence of magnesium propanolate. Mg azapc 3 was crystallized from ethanol/water. Treatment of Mg azapc 3 with trifluoroacetic acid gave the metal-free azapc 4. Zinc azapc 5 was prepared through the insertion of Zn ion into metal-free azapc 4. However, the cobalt azapc 6, was directly synthesized by cyclotetramerization of 2 in the presence of anhydrous cobalt acetate. When azapcs 3 and 4 were treated with methyliodide in chloroform, the hygroscopic azapc products 7 and 8 with eight quaternary ammonium groups were obtained. The new compounds were characterized by using standard spectral methods (elemental analysis, 1H NMR, UV/Vis, IR and Mass spectroscopy). From the FT-IR spectrum of 2 , the characteristic stretching vibrations of CN group was observed at 2232 cm-1. When the precursor 2 was converted into new metallo or metal-free azapcs (3, 4, 5, 6), this sharp peak disappeared as a proof of the cyclotetramerization reaction of dinitrile. IR spectra of azapcs 3, 5and 6 is similar to the IR spectrum of dinitril compound 2. In the IR spectrum of 4 the NH groups in the inner core give absorption at 3292 cm-1. Besides, no major change in the IR spectra was found after quaternization. In the 1H NMR spectrum of compound 2 (CDCl3), the aliphatic protons are observed at 3.38(S-CH2), 2.63(N-CH2) and 2.30 (CH3) ppm. 1H NMR spectra of 3 and 4 are almost the same as compound 2. However, 1H NMR spectrum of metal-free azapc 4 shows an additional peak at -3.32 ppm due to NH groups in the inner core. Furthermore, in the mass spectrum, we observed the molecular ion peaks at m/z: 337.10 for 2 and at m/z: 1410.7 for 5 which confirm the proposed structures. In the electronic absorption spectra of the complexes (3, 5 and 6), Q bands were observed at 644, 644 and 648 nm, respectively in CHCl3. The D2h symmetry ofthe metal-free azapc 4 is verified by two broad absorptions in the visible region (633-658 nm). A second intense and broad -* transition in the range 358-373 nm which is called Soret or B band is also a characteristic band as expected for tetrapyrroles. When the UV-Vis spectra of quaternized products 7 and 8 were analyzed in aqueous solution. Besides, in this study aggregation properties that can be observed at UV-vis spectrum of Mg azapc 3 were investigated by the dropwise addition of 0.01 M HClto their THF solution. [ABSTRACT FROM AUTHOR]

Objective: To assess the indications and distribution of cases chosen for termination of pregnancy and reasons delaying until third trimester termination. Methods: Retrospective study of cases between 2002 and 2006 in the hospital council. Cases were divided in two groups , as early termination (<23 weeks of gestation) and late termination (≥23 weeks of gestation). All pregnant women who underwent termination were classified according to related systemic pathology and chorionicity. Reasons for delaying until third trimester termination were evaluated in four groups. Results: During this five year period 1.449 complicated pregnancies were counseled and in 713 cases termination was offered. Of 677 cases (94.95%) with termination, 412 cases (60.09%) had early and 265 cases (39.91%) late termination. The most frequent indications were central nervous system abnormalities (51.7%), chromosomal abnormalities (11.7%), and urogenital abnormalities (8.4%). The main reason for delaying termination was failure of screening by ultrasound (65.6%). Conclusion: Systematic screening for fetal anomalies is the main step for prevention of affected pregnancies. Information given to parents for TOP is important, but the decision for TOP is influenced by many factors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the sonographic characteristics of fetuses with trisomy 18 and trisomy 13. Materials and Methods: From March 2002 to December 2006, we reviewed the database and medical records of 25 cases with trisomy 18 and trisomy 13. The subjects were recruited from pregnant women undergoing prenatal sonographic examinations at 13-28 weeks of gestation and subsequently proven trisomy 18 or 13. The results of ultrasound findings were reviewed in these cases with chromosomes confirmed as trisomy 18 and/or 13. Results: All cases had at least one abnormal sonographic finding. The common sonographic findings included choroid plexus cysts, abnormal head shape, cardiac anomalies, holoprosencephaly with associated facial anomalies, abnormal feet and/or hands, especially polydactyly, clenched hand, omphalocele. Non-structural abnormal findings such as polyhydroamnios or fetal growth restriction were seen in less than one third of the fetuses. Discussion: Nearly all fetuses with trisomy 18 or 13 had characteristic sonographic patterns of abnormalities demonstrated at midpregnancy. Detailed ultrasound at midpregnancy could effectively screen fetuses with trisomy 18 or 13 for further genetic testing. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the sonographic characteristics of fetuses with trisomy 18 and trisomy 13. Materials and Methods: From March 2002 to December 2006, we reviewed the database and medical records of 25 cases with trisomy 18 and trisomy 13. The subjects were recruited from pregnant women undergoing prenatal sonographic examinations at 13-28 weeks of gestation and subsequently proven trisomy 18 or 13. The results of ultrasound findings were reviewed in these cases with chromosomes confirmed as trisomy 18 and/or 13. Results: All cases had at least one abnormal sonographic finding. The common sonographic findings included choroid plexus cysts, abnormal head shape, cardiac anomalies, holoprosencephaly with associated facial anomalies, abnormal feet and/or hands, especially polydactyly, clenched hand, omphalocele. Non-structural abnormal findings such as polyhydroamnios or fetal growth restriction were seen in less than one third of the fetuses. Discussion: Nearly all fetuses with trisomy 18 or 13 had characteristic sonographic patterns of abnormalities demonstrated at midpregnancy. Detailed ultrasound at midpregnancy could effectively screen fetuses with trisomy 18 or 13 for further genetic testing. [ABSTRACT FROM AUTHOR]

Porphyrins, phthalocyanines, tetrabenzo porphyrins and porphyrazines which are tetrapyrrole derivatives. Because of both theoretical studies and applications in advanced materials science, tetrapyrrole derivatives receive extensive attention. Porphyrins are important not only from biological aspect but also for coordination chemistry as catalysis and material science. Phthalocyanines which are used in electro-photography, optic data collection, gas sensor, liquid crystal, laser technology and the photodynamic therapy of tumors as well as their classical fields as pigments and dyes, are completely synthetic materials. Porphyrazines that have functionalized groups at pheripheral positions have the potential to exhibit novel optical, magnetic and electronic properties. They also maintain some additional features superior to the values met in related materials. Additions of the transition metal ion in the inner core of a porphyrazine offer new ways to induce, modify and control molecular properties. The starting point for a novel porphyrazine structure with eight (1- naphthyl) groups bound to the periphery is 1,2-bi ( naphthyl )dinitrile which was obtained by oxidative coupling of 1-naphthylacetonitrile in the presence of I2. The solid product was obtained in a yield of 21%. It was a mixture of maleo-and fumaro-nitriles and the latter was present in higher ratio as expected from the presence of bulky naphthyl substituents. The mixture of maleo-and fumaro-nitrile reluctance to turn into porphyrazine under the usual conditions (i.e. Mg(OR)2 in refluxing propanol or butanol) points out the lower ratio of the maleonitrile component. This problem was solved by activation of the fumaronitrile derivative to the corresponding pyrroline derivative 3,4-(1-naphthyl)pyrroline-2,5- diimine which cyclizes quite easily to porphyrazine at reflux temperature of propanol or butanol. Conversion of 3,4-(1-naphthyl)pyrroline-2,5-diimine into porphyrazine was achieved by the template effect of magnesium butanolate. Cyclotetramerization gave green-colored octakis(1-naphthyl) porphyrazinato magnesium in yield (70%). It is soluble in chloroform, dichloromethane and acetone, but insoluble in apolar hydrocarbon solvents such as n-hexane. Intensive research interest on peripherally functionalized porphyra-zines during the last decade has shown that these tetrapyrrol derivatives should be considered in many respects as an alternative to phthalocyanines. The porphyrazine macrocycles afford a skilful platform to build up detailed molecular superstructures and this property coupled with a full and well-improved synthetic chemistry has surpassed to the synthesis of different catalytically essential metallo porphyrazines and original model compounds of various functions.… [ABSTRACT FROM AUTHOR]

Objective: We have aimed to evaluate perinatal outcome of selective fetocide in monochorionic diamniotic twins discordant for major fetal anomalies. Materials and Methods: The study group included nine cases of monochorionic diamniotic twin (triplet) pregnancies discordant for major fetal anomalies including anencephaly (n=2), inencephaly (n=1), lumbar meningomyolocele (n=1), hydrops fetalis (n=1), acardiac twin (n=2), twin-to-twin transfusion syndrome (stage III, n=1) and monochorionic triamniotic triplet discordant for anencephaly (n=1). For bipolar coagulation of the umbilical cord, we used 3.5 mm laparoscopic trocar and 3.0 mm bipolar forcep. The procedures were performed under the guidance of transabdominal ultrasonography. Results: The mean gestational age of the cases at intervention and at delivery were 20 weeks (R=16-24) and 34 weeks (R=22-38), respectively. The procedure of bipolar coagulation was carried out in mean 20 min (R=15-40 min) without maternal complication. One case was aborted at 20 weeks of gestation because of preterm premature rupture of membrane after the procedure. Another case was delivered before 32 weeks, at 28+4 week of gestation, and died six months postnatally which was unrelated to the intervention. The other seven cases were delivered after 32 gestational weeks. In eight cases, the procedures were performed without fetal complication. Perinatal outcome was as 88.8% (n=8/9) live births. Postnatal ages of surviving seven babies were between 8-40 months, and they have been growing up as healthy. Discussion: Ultrasonographic guided bipolar cord coagulation as a selective fetocide can be succesfully performed to increase the survival rate or prevent morbidity of healthy co-twin in the cases of monochorionic diamniotic (triplets), discordant major fetal anomalies candidate for selective termination, and should be offered as a choice of prenatal therapy after the parents were informed of the intervention or follow up. [ABSTRACT FROM AUTHOR]

Abstract: Metal-free 3 and metallophthalocyanines 4, 5 (Nith four, peripheral 4-pyridylmethyloxy groups were synthesized by cyclotetramerization of 4-(4-pyridylmethyloxy)-phthalonitrile (2). The zinc derivative 5 was converted into the water-soluble quaternized product 6 by its reaction with methyl iodide. The new compounds were characterized by elemental analysis, IR, NMR and their mass and electronic spectra. [Copyright &y& Elsevier]

A new phthalonitrile derivative with two different substituents on 4- and 5-positions has been synthesized and its cyclotetramerization in the presence of anhydrous metal salts without any solvent resulted with phthalocyanines (4–6) containing a hexylthio group and malonylester on each benzo unit. When phthalocyanine formation was carried out in high-boiling alcohols in the presence of a base transesterification of malonyl esters gave products with enhanced solubility in apolar solvents. These new compounds have been characterized by 1H NMR, FT-IR, UV–vis and mass spectroscopies. [Copyright &y& Elsevier]

Abstract: A new magnesium porphyrazinate with eight [triphenyl-(2-sulfanyl-ethoxycarbonyl-2-propyl)phosphonium]bromide groups has been prepared from octakis(2-hydroxyethylthio)porphyrazinatomagnesium and (2-carboxy-1-methylethyl)triphenylphosphonium bromide {[(Ph)3PCH2CH(Me)CO2H]Br}. The new compound has been characterized by FT-IR, UV–Vis, 1H and 31P NMR together with elemental analysis. [Copyright &y& Elsevier]

Chlorooctakis(octylthio)porphyrazinatoiron(III) (FePzCl) was prepared by the reaction of metal-free porphyrazine with iron(II) acetate and further treatment with HCl solution. The monomeric bisaxial complex FePz(py)2 as well as the bridged complex [FePz(pyz)]n were formed as stable complexes by reacting FePzCl with pyridine or pyrazine, respectively. These complexes were characterized by elemental analysis and spectroscopic methods. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the prenatal findings, associated anomalies, and prognosis of right aortic arch (RAA) anomalies. Material and Methods: All cases referred for detailed ultrasonography and fetal echocardiography between October 2006 and July 2009 were systematically examined for aortic arch anomalies and associated cardiac and extracardiac anomalies. Prenatal findings of all cases with aortic arch anomalies and intracardiac and extracardiac findings were prospectively registered in an electronic database that included fetal echocardiography. Outcomes of the cases were collected postnatally from the patients' obstetricians, neonatal unit archieves, and pediatric cardiologists. Results: We detected 12 cases of RAA (0.37%; n=12/3200). Mean gestational age at diagnosis was 24 weeks (range, 21-33 weeks). Of the 12 cases of RAA, five (41.7%) had a major cardiac defect, including tetralogy of Fallot (n= 3), atrioventricular septal defect (n=1), and ventricular septal defect (n=1). An extracardiac anomaly was observed in three cases (25%). The fetal karyotype was trisomy 21 in one case with increased nuchal translucency (6.6 mm). Microdeletion 22q11 analyses performed in three cases were normal. The postnatal courses of the cases with isolated RAA were uneventful. Two cases associated with major cardiac and extracardiac anomalies were lost in the early neonatal period. The case of trisomy 21 was terminated. The other four cases of RAA with an associated cardiac anomaly are currently in follow up. Conclusion: Aortic arch anomalies, particularly RAA, can be diagnosed by fetal echocardiography. The prognosis for isolated RAA is relatively good compared with that for RAA with associated anomalies. [ABSTRACT FROM AUTHOR]

A porphyrazine based supramolecule with a nonanuclear structure has been prepared by the ready coordination of pyridine donor sites in octakis(4-pyridoxyethylthio)porphyrazinatomagnesium with vanadyl bis(acetylacetonate) and characterized by EPR spectroscopy. [Copyright &y& Elsevier]

Objective: The annual hospitalization rate of patients with systemic lupus erythematosus (SLE) is approximately 10%, and hospitalizations are responsible for most of the healthcare expenses. Herein, we analyzed 5-year hospitalization data of SLE patients and determined factors leading to hospitalization. Methods: Clinical, laboratory, and hospitalization data of SLE patients admitted to our rheumatology clinic in 2015–2020 were retrieved from our SLE database and analyzed. SLICC SLE damage index (SDI) and disease activity at admission (SLEDAI-2K) were determined. Results: Among 161 hospitalized patients, 86% were females. Total rheumatologic hospitalization number was 298, and 38% of the patients were hospitalized more than once (1.85 ± 1.56). The mean hospitalization duration covering all stays for each patient was 25 ± 26.5 days. Active disease, infection, and damage-related complications were first three causes of hospitalization. Compared to patients hospitalized for active disease or damage, patients hospitalized for infection had a significantly higher number of readmissions (p <.05) and their total hospital stay was longer (p <.01). The frequency of patients with damage and the mean SDI score was significantly lower in the active disease group (68%, 1.93 ± 2.05) than hospitalizations for infection (90%, 2.68 ± 1.63) and damage-related causes (96%, 3.04 ± 1.65) (p <.05). The mean SDI score and duration (r = 0.551, p <.001) and the number of hospitalizations (r = 0.393, p <.001) were positively correlated. The mean disease activity scores of patients hospitalized for active disease, infection, and damage-related reasons were 11.03 ± 6.08, 3.21 ± 2.80, and 2.96 ± 3.32, respectively (p <.001). Renal active disease was the most common (44%), followed by hematological (34.8%), articular (21.7%), and mucocutaneous (21%) activity. Ten percent of the patients all of whom had damage were admitted to intensive care unit (ICU). Total hospitalization duration, mean SDI, antiphospholipid syndrome, lupus anticoagulant, thrombocytopenia, serositis, pulmonary hypertension, history of alveolar hemorrhage, and cardiac valve involvement were associated with ICU admission (p <.05 for all). Conclusion: Disease activity, infections, and damage are the leading causes of hospitalization in SLE patients. Damage prolongs hospital stay and increases hospitalization rate and ICU need. Tight control of disease activity with rational use of immunosuppressive treatment is important to reduce damage and hospitalizations. [ABSTRACT FROM AUTHOR]

Background/aim: In this prospective study, we aimed to investigate the association of serum (s) and urine (u) IP-10, galectin-9, and SIGLEC-1 with disease activity in patients with systemic lupus erythematosus (SLE). Materials and methods: Sixty-three patients with active SLE (31 renal, 32 extrarenal) were included. Thirty patients with inactive SLE (15 renal, 15 extrarenal), 17 with renal active AAV, and 32 healthy volunteers were selected as control groups. Serum and urine IP-10, galectin-9, and SIGLEC-1 were tested using ELISA. Results: Levels of sIP-10 (p = 0.046), uIP-10 (p < 0.001), sGalectin-9 (p = 0.03), and uSIGLEC-1 (p = 0.006) were significantly higher in active SLE group compared to the inactive SLE; however, no differences were detected in the comparison of uGalectin-9 (p = 0.18) and sSIGLEC-1 (p = 0.69) between two groups. None of the biomarkers discriminated patients with active renal SLE from active extrarenal SLE. ROC analyses revealed an AUC of 0.63 (0.52--0.73) for sIP-10, 0.78 (0.68--0.86) for uIP-10, 0.64 (0.53--0.74) for sGalectin-9, and 0.68 (0.57--0.77) for uSIGLEC-1 in discriminating disease activity in SLE, which did not outperform C3 (0.75, 0.64--0.84) and C4 (0.72, 0.61--0.82). sIP-10 (p = 0.001), uIP-10 (p = 0.042), and uGalectin-9 (p = 0.009) were significantly increased in patients with active renal SLE compared to active renal AAV. sGalectin-9 (p < 0.001) and sIP-10 levels (p = 0.06) were decreased after 8 (5--22.5) months of treatment. Conclusion: sIP-10, uIP-10, sGalectin-9, and uSIGLEC-1 reflect global disease activity in SLE but do not outperform C3 and C4. sIP-10 and uIP-10 may be specific for active SLE compared to active AAV. sIP-10 and sGalectin-9 might be valuable in monitoring response after treatment. [ABSTRACT FROM AUTHOR]

Background: Rituximab (RTX) is being used for both induction and maintenance of anti‐neutrophil cytoplasmic antibody (ANCA) ‐associated vasculitis. However, the efficacy of RTX for the granulomatous findings of granulomatosis with polyangiitis (GPA) has not been demonstrated as clearly as its vasculitic manifestations. Case summary: A 46‐year‐old man was diagnosed in 2019 with GPA with constitutional symptoms, bilateral mastoiditis, prostatic necrosis, nodules in both lungs, pauci‐immune necrotizing glomerulonephritis and high level of PR3‐ANCA. He reached clinical remission after induction with high‐dose corticosteroids and intravenous cyclophosphamide pulses at the 3rd month. Two months following the second cycle of RTX as maintenance, he developed multiple cranial mass lesions, and excisional biopsy revealed necrotizing vasculitis with granuloma formation. Remission was achieved with long‐term high‐dose corticosteroid therapy after surgical excision. Conclusion: We observed a relapse of GPA with intracranial granulomatous lesions in a patient under RTX maintenance. Limited efficacy of RTX should be considered for mainly granulomatous manifestations in patients with GPA. [ABSTRACT FROM AUTHOR]

Background/aim: The aim of this study is to evaluate the baseline F18-FDG PET/CT findings of individuals diagnosed with giant cell arteritis (GCA) and to explore its association with clinical findings and classification criteria. Materials and methods: We analysed data from patients who underwent F18-FDG PET/CT scans to investigate large vessel (LV) involvement between 2010 and 2019. Only patients with a clinical diagnosis of GCA and at least 6 months of follow-up were included. We compared initial clinical features and laboratory findings based on the presence of LV vasculitis on PET/CT and the maximum standard uptake value (SUVmax) of vascular territories. Results: Twenty-nine patients (median age at diagnosis: 70, F/M: 24/5) were included in the study. Among them, 21 patients (72.4%) presented with cranial symptoms, while 8 patients (27.5%) had isolated LV-GCA. Twenty-two patients (75.9%) met the ACR/EULAR 2022 GCA classification criteria. LV vasculitis was detected on PET/CT in 23 patients (79.3%). A positive correlation was observed between SUVmax in the thoracic aorta and both CRP and ESR levels (r = 0.50, p = 0.026 and r = 0.63, p = 0.002, respectively). PET/CT positive patients were found to be younger (p = 0.016) and more frequently female (p = 0.017). They also exhibited fewer headaches (56.5% vs. 100%, p = 0.04), experienced fewer flares during follow-up (p = 0.03), and had a lower cumulative glucocorticoid dose at the 6th month (p = 0.036). Comparison of PET/CT-positive patients (n = 23) based on the fulfilment of the ACR/EULAR 2022 classification criteria revealed that patients who met these criteria were older (p = 0.02) and had significantly lower CRP levels at diagnosis (p = 0.02). Conclusion: The performance of F18-FDG PET/CT in diagnosing LV involvement in GCA is favourable, and the severity of FDG uptake in the vessel wall correlates with the acute phase response. Patients with extracranial involvement on PET/CT exhibit distinct features, including a younger age and female predominance. Additionally, these patients appear to experience fewer relapses and require lower doses of glucocorticoids. However, the clinical significance of PET/CT in patients who met ACR/EULAR classification criteria, predominantly consisting of patients with ischemic cranial symptoms, could not be determined in our study. [ABSTRACT FROM AUTHOR]

Objective: In this study, our pregnant systemic lupus erythematosus (SLE) cohort, which was under medical surveillance of both our Rheumatology and Obstetrics departments, was analyzed. We intended to determine the effects of pregnancy on disease activity and the correlation between disease flares and adverse pregnancy outcomes. Methods: One hundred sixty eight pregnancy data involving 136 patients with SLE were examined. Cumulative clinical, laboratory, and serological parameters were described. Disease activity and flares were calculated using the systemic lupus erythematosus disease activity index 2000 (SLEDAI-2K) in the pre/postpartum periods and the SLEPDAI in the three trimesters of pregnancy. Patients with a SLEDAI-2K or SLEPDAI ≥ 4 were classified as "active." Patients with lupus low disease activity state (LLDAS) during each of these periods were identified. Fetal/neonatal death, premature birth due to pre-eclampsia, eclampsia or hemolysis, elevated Liver enzymes (HELLP) syndrome, and neonates small for gestational age were determined as adverse pregnancy outcomes (APO). Results: Out of 168 pregnancies, there were 60 (35.7%) pregnancies with flares covering the pregnancy and 6 months of postpartum period. The mean SLEDAI in the 6 months postpartum period was significantly higher compared to mean disease activity during pregnancy (p <.05). Of all pregnancies, 132 (78.6%) were in LLDAS during pregnancy. Comparison of the frequency of severe postpartum flares in patients who were in LLDAS during pregnancy revealed a lower percentage of flares compared to those who were not in the LLDAS group (11 vs 29%, p <.05). APO was observed in 33.9% of 168 pregnancies. The mean SLEPDAI score was significantly higher in APO+ pregnancies than in APO− pregnancies (4.9 ± 6.1 vs 2.8 ± 4.9, p =.002). Comparison of SLICC damage score between APO – and + pregnancies revealed a significantly higher score in APO+ pregnancies (1.8 ± 2.1 vs 0.8 ± 1.3, p =.001). Conclusion: Postpartum six-month period appears to have the highest risk for disease flares during SLE pregnancies. Disease activity during pregnancy increases the risk of APO. In order to achieve a positive pregnancy outcome and lower maternal morbidity, regular follow-up of patients is necessary. [ABSTRACT FROM AUTHOR]

Background/aim: B-cell depletion with rituximab (RTX) is widely used as a rescue therapy in patients with systemic sclerosis (SSc). The aim herein was to analyze the progress of disease-related outcomes after RTX therapy in severe SSc patients. Materials and methods: Included in this study were 27 SSc patients who were followed-up between 2012 and 2020 and received at least 1 cycle of RTX for active disease, despite receiving standard immunosuppressives (ISs). In addition to the European Scleroderma Study Group and European Scleroderma Trials and Research Group activity scores, Medsger's severity, and the recently developed Scleroderma Clinical Trials Consortium Damage Index values were evaluated initially and at 1 year after the first infusion. The progress of individual organ damage was also assessed at the end of the follow-up period (at least 6 months after the last infusion) using the data extracted from the medical records. Results: Disease activity and severity-improved and disease-related overall damage worsened after the first year of RTX therapy (p < 0.001, p = 0.008, and p = 0.005). Some of the disease-related organ damage had improved at the end of the follow-up period, indicating its reversibility. Overall damage scores =11 after the first year of RTX therapy were found to be associated with mortality (p = 0.035). Conclusion: RTX contributed to reducing the activity and severity in SSc patients with severe disease, nonetheless the efficacy related to the damage was limited. High damage scores in the first year were found to be associated with mortality. Spontaneous progress of manifestations requiring a longer period to improve and irregular consecutive RTX courses might lead to difficulties in differentiation between activity and damage. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective study, we aimed to identify factors associated with increased thrombotic risk by comparing primary (P) or systemic lupus erythematosus (SLE) associated antiphospholipid syndrome (APS) patients with vascular thrombosis (VT) or pregnancy morbidity (PM). Methods: Demographics, clinical and laboratory characteristics of 169 patients with APS (73 PAPS and 96 SLE+APS) were obtained from the patient database. IgG and IgM isotypes of anticardiolipin and anti- β2-glycoprotein I (aβ2GPI) antibodies were measured by ELISA and lupus anticoagulant was measured by aPTT and dRVVT tests. The patients were classified as VT only, PM only or VT+PM according to their clinics. The adjusted global APS score (aGAPSS) was calculated for each patient. Results: 47.3% of the patients had VT only, 20.1% had PM only and 32.5% had VT+PM. Fifty-nine patients had only from arterial thrombosis, 53 venous thrombosis, 21 had both and 2 patients had microvascular thrombosis. While antiphospholipid antibody profile did not differ between VT only and PM only groups, hypertension, hyperlipidemia and smoking were more prevalent in the VT only group (50.0% vs 17.6%, p=0.001; 45.0% vs 23.5%, p=0.02; 28.8% vs 11.8%, p=0,04, respectively). The prevalence of hypertension and hyperlipidemia was also higher in patients with arterial thrombosis only compared to those with venous thrombosis only (57.6% vs 32.1%, p=0.006; 54.2% vs 32.1%, p=0.015, respectively). Conclusion: Our results suggest that patients with thrombotic APS have a significantly higher frequency of cardiovascular risk factors and control of these may help to lessen the risk of thrombosis, especially arterial one. [ABSTRACT FROM AUTHOR]

Objective: In this retrospective study, we aimed to identify factors associated with increased thrombotic risk by comparing primary (P) or systemic lupus erythematosus (SLE) associated antiphospholipid syndrome (APS) patients with vascular thrombosis (VT) or pregnancy morbidity (PM). Methods: Demographics, clinical and laboratory characteristics of 169 patients with APS (73 PAPS and 96 SLE+APS) were obtained from the patient database. IgG and IgM isotypes of anticardiolipin and anti- ß2-glycoprotein I (aß2GPI) antibodies were measured by ELISA and lupus anticoagulant was measured by aPTT and dRVVT tests. The patients were classified as VT only, PM only or VT+PM according to their clinics. The adjusted global APS score (aGAPSS) was calculated for each patient. Results: 47.3% of the patients had VT only, 20.1% had PM only and 32.5% had VT+PM. Fifty-nine patients had only from arterial thrombosis, 53 venous thrombosis, 21 had both and 2 patients had microvascular thrombosis. While antiphospholipid antibody profile did not differ between VT only and PM only groups, hypertension, hyperlipidemia and smoking were more prevalent in the VT only group (50.0% vs 17.6%, p=0.001; 45.0% vs 23.5%, p=0.02; 28.8% vs 11.8%, p=0,04, respectively). The prevalence of hypertension and hyperlipidemia was also higher in patients with arterial thrombosis only compared to those with venous thrombosis only (57.6% vs 32.1%, p=0.006; 54.2% vs 32.1%, p=0.015, respectively). Conclusion: Our results suggest that patients with thrombotic APS have a significantly higher frequency of cardiovascular risk factors and control of these may help to lessen the risk of thrombosis, especially arterial one. [ABSTRACT FROM AUTHOR]

Metallophthalocyanine complexes (M = Pd, FeCl, VO, or MnCl) bearing four hydroxyl-terminated aliphatic groups were prepared by cyclotetramerization 4-(hydroxyethylsulfanyl)phthalonitrile. Aggregation tendencies of these phthalocyanines were investigated in varying concentrations from 4 × 10–5 to 8 × 10–6 M in DMF. Spin coating method was used to prepare thin films of metallophthalocyanines substituted with four hydroxyethylsulfanyl groups. The optical properties of the films were investigated as a function of the different metal ions in the inner core, with the transmittance spectrum measured at a wavelength range of 200–1000 nm. The results show that different metal ions in the inner core clearly change the transmittance values of the thin films of metallophthalocyanine. Morphological results also show that surface of the metallophthalocyanines has changed considerably according to the nature of the metal ion. [ABSTRACT FROM AUTHOR]

Methylphenidate (MPH) is the most preferred drug for treatment of the attention deficit hyperactivity disorder (ADHD). Here, we aimed to discuss the possible effects and mechanisms of MPH on precocious puberty (PP) via a case series with seven children who had normal body mass index. In this case series we evaluated seven children with ADHD, who had received MPH for at least 6 months (0.5 mg/kg/dose three times a day, maximum 60 mg) and admitted to Department of Pediatric Endocrinology with PP symptoms. The mean age was 8.16 years. Basal hormonal levels (luteinizing hormone [LH], follicle stimulating hormone, and estrogen/testosterone) were within normal range. Results of LH-releasing hormone stimulation tests demonstrated central pubertal responses. Glutamine, dopamine and noradrenaline are most important excitatory neurotransmitters that have a role at the beginning of puberty. The effect of MPH, cumulating dopamine and noradrenaline in the synaptic gap could be associated with the acceleration of puberty with the excitatory effect of dopamine’s gonadotropin-releasing hormone (GnRH) release, excitatory effect of noradrenaline’s GnRH release and the disappearance of GnRH receptor expression suppressor effect on prolactin disinhibitory effect. [ABSTRACT FROM AUTHOR]

Background/aim: In this cross-sectional study, it was aimed to test the predictive value of noncriteria antiphospholipid antibodies (aPL) in addition to the global antiphospholipid syndrome score (GAPSS) in predicting vascular thrombosis (VT) in a cohort of patients with APS and aPL (+) systemic lupus erythematosus (SLE). Material and methods: This study included 50 patients with primary APS, 68 with SLE/APS, and 52 with aPL (+) SLE who were classified according to VT as VT ± pregnancy morbidity (PM), PM only or aPL (+) SLE. Antiphospholipid serology consisting of lupus anticoagulant (LA), anticardiolipin (aCL) immunoglobulin G (IgG)/IgM/IgA, antibeta2 glycoprotein I (aß2GPI) IgG/IgM/IgA, antiphosphatidylserine/prothrombin (aPS/PT) IgG/IgM and antidomain-I (aDI) IgG was determined for each patient. The GAPSS and adjusted GAPSS (aGAPSS) were calculated for each patient, as previously defined. Logistic regression analysis was carried out with thrombosis as the dependent variable and high GAPSS, aCL IgA, aß2GPI IgA, and aDI IgG as independent variables. Results: The mean GAPSS and aGAPSS of the study population were 11.6 ± 4.4 and 9.6 ± 3.8. Both the VT ± PM APS (n = 105) and PM only APS (n = 13) groups had significantly higher GAPSS and aGAPSS values compared to the aPL (+) SLE (n = 52) group. The patients with recurrent thrombosis had higher aGAPSS but not GAPSS than those with a single thrombotic event. The computed area under the receiver operating characteristic curve demonstrated that a GAPSS =13 and aGAPSS =10 had the best predictive values for thrombosis. Logistic regression analysis including a GAPSS =13, aCL IgA, aß2GPI IgA, and aDI IgG showed that none of the factors other than a GAPSS =13 could predict thrombosis. Conclusion: Both the GAPSS and aGAPSS successfully predict the thrombotic risk in aPL (+) patients and aCL IgA, aß2GPI IgA, and aDI IgG do not contribute to high a GAPSS or aGAPSS. [ABSTRACT FROM AUTHOR]

Background: The interleukin-1 receptor antagonist (IL-1Ra) is a crucial molecule that counteracts the effects of interleukin-1 (IL-1) by binding to its receptor. A high concentration of IL-1Ra is required for complete inhibition of IL-1 activity. However, the currently available Escherichia coli-expressed IL-1Ra (E. coli IL-1Ra, Anakinra) has a limited half-life. This study aims to produce a cost-effective, functional IL-1Ra on an industrial scale by expressing it in the pyrG auxotroph Aspergillus oryzae. Results: We purified A. oryzae-expressed IL-1Ra (Asp. IL-1Ra) using ion exchange and size exclusion chromatography (53 mg/L). Sodium dodecyl sulfate–polyacrylamide gel electrophoresis (SDS-PAGE) analysis revealed that Asp. IL-1Ra is N-glycosylated and approximately 17 kDa in size. We conducted a comparative study of the bioactivity, binding kinetics, and half-life between Asp. IL-1Ra and E. coli IL-1Ra. Asp. IL-1Ra showed good bioactivity even at a low concentration of 0.5 nM. The in vitro half-life of Asp. IL-1Ra was determined for different time points (0, 24, 48, 72, and 96 h) and showed higher stability than E. coli IL-1Ra, despite exhibiting a 100-fold lower binding affinity (2 nM). Conclusion: This study reports the production of a functional Asp. IL-1Ra with advantageous stability, without extensive downstream processing. To our knowledge, this is the first report of a recombinant functional and stable IL-1Ra expressed in A. oryzae. Our results suggest that Asp. IL-1Ra has potential for industrial-scale production as a cost-effective alternative to E. coli IL-1Ra. [ABSTRACT FROM AUTHOR]

Objective The skin pathergy test (SPT) is an important tool in the diagnosis of Behçet disease (BD), but its decreasing sensitivity over years has resulted in less frequent use in the clinical practice. This study aimed to improve the sensitivity of the SPT without compromising its specificity. Methods BD patients, patients with other inflammatory diseases, recurrent aphthous stomatitis, and healthy controls comprised the study group. The SPT was conducted using 20G needle and 21G lancet pricks, or with additional application of 23-valent polysaccharide pneumococcal vaccine (PS-23), Alum, or ATP to the prick site. Development of erythema and induration at 24 h/48 h were evaluated by the same observer. Induration (≥2 mm) with erythema at 48 h was accepted as a positive reaction. Proinflammatory cytokine production following stimulation with lipopolysaccharide or PS-23 was investigated by whole-blood assay (WBA) in a subgroup. Results Stimulation of the forearm skin by PS-23 and a 20G needle prick showed the highest sensitivity and specificity in BD (64.3% and 100%, respectively), especially in patients with active disease (80.3% and 100%, respectively), compared with a sensitivity of 4.8% in all and 6.1% in active patients using a single 20G prick. A positive result was associated with active disease and no use of immunosuppressives. In WBA, increased IL-1β and IL-1Ra production in response to PS-23 was observed in the group with active BD, while the cytokine response to lipopolysaccharide was similar in all groups. Conclusions The SPT conducted using a 20G needle prick and PS-23 antigens was shown to be a promising tool for the diagnosis of BD owing to its improved sensitivity compared with the standard approach. [ABSTRACT FROM AUTHOR]

Olgu: Elli yedi yaşında erkek hasta 2017'de tipik göğüs ağrısıyla başvuran hastaya Hb: 5,9 saptanması üzerine anemi etiyolojisi açısından araştırıldığı sırada D. coombs +4 saptanması üzerine OIHA tanısı konuldu. Sedimentasyon yüksekliği nedeniyle ileri tetkik edilen hastada toraks BT'de multipl patolojik görünümde hiler LAP ve her iki akciğerde nodüler kaviter lezyonlar saptandı. Tbc ve fungal enfeksiyon açısından yapılan incelemeler negatif sonuçlandı. LAP eksizyonu yapılan hastada parakortikal alanda trabeküller oluşturan plazma hücreleri izlendi. Ancak klonalite lehine bulgu saptanmadı. Çekilen PET-BT'de sol akciğer alt lobda 18 mm*12 mm boyutlarında malignite açısından kuşkulu görünüm saptanan hastaya eksizyonel biyopsi yapıldı. Biyopsi materyalinin patolojik incelemesi ile IgG kappa hafif zincir fenotipli lenfoplazmositer lenfoma tanısı konuldu. BORID rejimi (borteozomib-ritüksimab-deksametazon) sonrasında remisyona giren hasta takibe alındı. Bir yıl sonra başlayan karın ağrısı ve alt ekstremitede döküntü şikayetiyle tarafımıza başvurdu. Fizik muayenesinde batında yaygın hassasiyeti ve her iki alt ekstremitede palpabl purpura karakterinde döküntüleri saptandı. Batın BT'sinde duodenumda ve proksimal jejunal anslarda duvar kalınlık artışı görüldü. Toraks BT'sinde kaviter komponent dominant multipl sayıda nodül formasyonu izlendi. Ön planda lenfoplazmositer lenfomayla ilişkili düşünüldü. Alt ekstremitedeki döküntülerinden punch biyopsi alındı. Papiller dermiste birkaç küçük çaplı damar duvarında granüler karakterde IgA-C3 birikimi saptandı. Serum kreatinin değerinde progresyon, nefrotik düzeyde proteinüri, aktif idrar sedimenti olması nedeniyle böbrek biyopsisi yapılan hastada 24 glomerülün 12'sinde sellüler kresent ve immünfoloresan incelemede IgA-C3 birikimi saptandı. Kongo ve kriyoglobulin negatif saptandı. Böbrekte selüler kresentik IgA vasküliti saptanan hastaya pulse metilprednizolon ve siklofosfamid indüksiyon tedavisi uygulandı. Lenfoplazmositer lenfoma hastalık durumunu değerlendirmek açısından kemik iliği biyopsisi yapıldı ve PET/BT çekildi. Kemik iliği aspiratı ve biyopsisinin değerlendirmesinde lenfoplazmositer lenfoma lehine infiltrasyon saptanmadı. PET/BT'de sağ akciğer üst lob apikal segmentte 30*20 mm'lik artmış FDG tutulumu saptandı. Klinik olarak lenfoma progresyonu kabul edilerek Ibrutinib-deksametazon tedavisi başlanması planlandı. Sonuç: Vaskülitler malignitelerin seyrinde ortaya çıkabilir. Bu olgu literatürde bildirilen ilk lenfoplazmositer lenfoma seyrinde görülen sistemik IgA vasküliti olgusudur. [ABSTRACT FROM AUTHOR]