Assessing the educational value of laparoscopic radical nephrectomy videos on YouTube®: A comparative analysis of short versus long videos.

INTRODUCTION: To evaluate the quality of laparoscopic radical nephrectomy videos and determine the extent to which they are informative and educational for healthcare professionals. PATIENTS AND METHODS: We used the YouTube® search engine to search for the term 'laparoscopic radical nephrectomy' with time filters of 4-20 min (Group 1) and >20 min (Group 2) and then sorted the results uploaded chronologically before January 2023. One hundred videos were analysed for each group. The reliability of the videos was assessed using the Journal of American Medical Association (JAMA) Benchmark Criteria and DISCERN questionnaire scores (DISCERN). Educational quality was assessed using the Global Quality Score (GQS) and a 20-item objective scoring system (OSS) for laparoscopic nephrectomy. The popularity of the videos was evaluated using the video power index (VPI). RESULTS: The mean video duration was 8.9 ± 4.3 min in Group 1 and 52.02 ± 31.09 min in Group 2 (P < 0.001). The mean JAMA (2.49 ± 0.61) and OSS scores (60 ± 12.3) were higher in Group 2 than in Group 1, while no significant difference was observed in the mean GQS (2.53 ± 0.7, 2.39 ± 0.88, respectively) between the groups (P < 0.001, P = 0.039, P = 0.131, respectively). CONCLUSION: While the standardisation of surgical videos published on YouTube® and the establishment of auditing mechanisms do not seem plausible, high total OSS, periprocedural OSS, and VPI scores, and high OSS, JAMAS, GQS and DISCERN scores in long videos indicate that such videos offer a greater contribution to education.

Calcineurin inhibitors experience in unplanned pregnancies with active lupus disease: A retrospective observational study.

OBJECTIVES: To evaluate the use of calcineurin inhibitors (CNIs), specifically tacrolimus, in unplanned pregnancies with active lupus disease among patients with systemic lupus erythematosus (SLE). MATERIALS AND METHODS: The study includes data from pregnancies in women diagnosed with SLE at Gazi University Hospital in Ankara, Türkiye, between January 2010 and July 2022. The study categorized pregnancies into planned and unplanned groups based on lupus nephritis presence, emphasizing the need for inactive lupus disease for at least 6 months before attempting conception in planned pregnancies. The outcomes of pregnancies involving CNIs, particularly tacrolimus, were assessed. RESULTS: In our cohort comprising 632 SLE patients, 39 individuals reported 42 pregnancies. Among the 42 pregnancies, 14 have a history of lupus nephritis. We observed that 8 of 14 patients with a history of lupus nephritis had unplanned pregnancies. Three patients used cyclosporine and 2 used tacrolimus during their pregnancy; their pregnancies were completely healthy, and no lupus flare was observed during their pregnancies. The pregnancy of 2 patients who used azathioprine and 1 last patient who used no immunosuppressive treatment ended in abortion. CONCLUSION: This study reveals that tacrolimus can be effectively used in unplanned pregnancies with active lupus disease, providing favorable maternal and fetal outcomes. The findings emphasize the importance of considering CNIs, particularly tacrolimus, in the management of SLE pregnancies, even in cases of unplanned pregnancies with a history of lupus nephritis.

Ultrasound-based predictive indicators for treatment outcomes in pediatric vesicoureteral reflux.

PURPOSE: To evaluate the effectiveness of preoperative ultrasound (US) measurements in predicting pediatric vesicoureteral reflux (VUR) treatment outcomes. METHODS: This prospective study enrolled 35 patients (53 renal units) aged 1-16 years who underwent subureteric injection therapy for primary VUR between July 2020 and June 2022. Preoperative ultrasound examinations measured the bladder wall thickness at the ureteral orifice, ureteral submucosal tunnel length, distal ureteral diameter, patient demographics, VUR grade, presenting complaints, bladder-bowel dysfunction, and renal scarring, and the impact of these variables on treatment success was analyzed. RESULTS: Among the patients, 91.4% were female, with a mean age of 6.83 ± 3.84 years. A comparison between the treatment success and failure groups revealed no significant differences in the age, sex, VUR grade, laterality, bilaterality, presenting complaints, bladder-bowel dysfunction, bladder wall thickness, or distal ureteral diameter (p > 0.05). However, renal scarring occurred in 16 (38.1%) patients in the treatment success group and 10 (90.9%) in the treatment failure group (p = 0.002). The treatment failure group had shorter detrusor-to-ureteral orifice distances and smaller detrusor-ureteral orifice distance-to-distal ureteral diameter (D/U) ratios than that of the success group (p = 0.004 and p = 0.006, respectively). Patients with a detrusor-to-ureteral orifice distance < 7.4 mm had an 81.82% likelihood of treatment failure. CONCLUSION: Ultrasound measurements of the detrusor-to-ureteral orifice distance and D/U ratio proved reliable in predicting the success of endoscopic subureteric injection therapy for VUR.

Acanthocephala Species of Mammals in Türkiye and A New Species Record from Foxes.

Acanthocephaliasis is a zoonotic parasitic infection of vertebrates. The phylum Acanthocephala contains nearly 1500 acanthocephalan species. The Archiacanthocephala class is observed in terrestrial habitats and usually has a large, spineless trunk. Acanthocephalans are parasitic worms that use insects as intermediate hosts in their two-host life cycles. Insects, millipedes, and crustaceans in terrestrial areas serve as intermediate hosts and birds and mammals as definitive hosts. Acanthocephalans collected from the red fox (Vulpes vulpes) found dead on the road to Sarikamis-Kars in 1995 and stored in formaldehyde were kept in Ondokuz Mays University Faculty of Veterinary Medicine, Veterinary Parasitology Laboratory Museum until 2023 after our parasitological study found an infected red fox with Pachysentis sp. This study provides the anatomy of the acanthocephalans and the laboratory practice necessary for a good and reliable diagnosis. This study reports a new species, Pachysentis sp., of acanthocephalan (thorny-headed worm) found in red foxes for Türkiye. On the basis of relevant articles, we have created a key to Acanthocephala species occurring in mammals.

Pharmacological Potential Effects of Algerian Propolis Against Oxidative Stress, Multidrug-Resistant Pathogens Biofilm and Quorum-Sensing.

Objectives: This study sought to examine the chemical profile, antioxidant, antimicrobial, antibiofilm, and anti-quorum sensing potential of two propolis ethanolic extracts (PEEs) collected from northeast Algeria. Materials and Methods: To achieve the main objectives of this study, multiple in vitro tests were employed. The phenolic and flavonoid contents were analyzed, and the chemical composition of both PEE was determined by high-performance liquid chromatography. The antioxidant properties of the propolis extracts were investigated using six complementary tests. The inhibitory effects of propolis extracts were evaluated against multidrug-resistant (MDR) clinical isolates using agar well diffusion and microdilution methods, whereas their antibiofilm and quorum-sensing disruption effects were determined by spectrophotometric microplate methods. Results: The results demonstrated that phenolic and flavonoid contents were higher in propolis from the Guelma (PEEG) region (PEEG; 188.50 ± 0.33 µg GAE/mg E, 144.23 ± 1.03 µg QE/mg E), respectively. Interestingly, different components were identified, and cynarin was the major compound detected. The PEEG sample exhibited potential antioxidant effects in scavenging ABTS•+ radicals with minimal inhibitory concentration values equal to 10.46 ± 1.40 µg/mL. Furthermore, the highest antibacterial activity was recorded by PEEG against Gram-positive Staphylococcus aureus MDR1. Similarly, PEEG effectively inhibited the biofilm formation of S. aureus MDR1 and the degradation of biofilm was up to 60%. In addition, quorum sensing disruption revealed that both extracts have a moderate capacity for violacein inhibition by the Chromobacterium violaceum ATCC 12472 strain in a concentration-dependent manner. Conclusion: These findings indicate that propolis can be regarded as a natural therapeutic agent for health problems associated with MDR bacteria and oxidative stress.

Easy method to determine fluid responsiveness in septic shock patients: end-tidal CO2 - a prospective observational study.

BACKGROUND: In critically ill patients, especially those with septic shock, fluid management can be a challenging aspect of clinical care. One of the primary steps in treating patients with hemodynamic instability is optimizing intravascular volume. The Passive Leg Raising (PLR) maneuver is a reliable test for assessing fluid responsiveness, as demonstrated by numerous studies and meta-analyses. However, its use requires the measurement of cardiac output, which is often complex and may necessitate clinician experience and specialized equipment. End-Tidal Carbon Dioxide (ETCO2) measurement is relatively easy and is generally stable under steady metabolic conditions. It depends on the body's CO2 production, diffusion of CO2 from the lungs into the bloodstream, and cardiac output. If the other two parameters (metabolic conditions and minute ventilation) are constant, ETCO2 can provide information about cardiac output. The aim of the present study is to investigate the sensitivity of ETCO2 measurement in demonstrating fluid responsiveness. METHODS: All patients diagnosed with septic shock and meeting the inclusion criteria were subjected to a passive leg raising test, and cardiac outputs were measured by echocardiography. An increase in cardiac output of 15% or more was considered indicative of the fluid responder group, while patients with an increase below 15% or no increase were classified as the non-responder group. Patients' intensive care unit admission diagnoses, initial laboratory parameters, tidal volume, minute volume before and after the PLR maneuver, mean and systolic blood pressure, heart rate, Pulse Pressure Variation (PPV) values, and ETCO2 values were recorded. RESULTS: Before and after the ETCO2 test, there was no statistically significant difference between the two groups. However, the change in ETCO2 (ΔETCO2) was significantly higher in the responder group. In the non-responder group, ΔETCO2 was 2.57% (0.81), whereas it was 5.71% (2.83) in the responder group (p<0.001). Receiver Operating Characteristic (ROC) analysis was performed for ΔETCO2, baseline Stroke Volume Variation (SVV), ΔSVV, baseline Heart Rate (HR), ΔHR, baseline PPV, and ΔPPV to predict fluid responsiveness. ΔETCO2 predicted fluid responsiveness with a sensitivity of 85% and a specificity of 86% when it was 4% or higher. When ΔETCO2 was 5% or higher, it predicted fluid responsiveness with a specificity of 99.3% and a sensitivity of 75.5%, with an Area Under the Curve (AUC) of 0.89 (95% confidence interval, 0.828-0.961). CONCLUSION: This study demonstrates that in septic patients, ETCO2 during the PLR test can indicate fluid responsiveness with high sensitivity and specificity and can be used as an alternative to cardiac output measurement.

Evaluation of Foot Deformities in Patients With Ingrown Nails.

INTRODUCTION: Ingrown nail is a condition caused by the perforation of the periungual soft tissues on nail folds by the sides of nail plaque, causing inflammation and severe pain. Recently, the role of foot anatomical disorders in ingrown nail development has been emphasized. OBJECTIVES: The main objective of this study aimed to determine whether foot deformities played significant roles in ingrown nail development with objective radiological parameters. METHODS: The study included 64 patients diagnosed with clinical ingrown nail and 71 patients as controls without any ingrown nail history. In both groups, we evaluated the bilateral foot radiographs of patients with ingrown nails for hallux valgus angle (HVA), interphalangeal angle (IPA), and intermetatarsal angle (IMA) associated with hallux valgus, and the calcaneal pitch angle (CPA), talohorizontal angle (THA), and talometatarsal angle (TMA) related to pes planus. RESULTS: No significant difference was found in terms of hallux valgus radiological measurements of HVA, IPA and IMA as well as pes planus radiological measurements of CPA and TMA values, when compared to controls. THA was statistically significantly higher in the control group (P = 0.025). There was a moderate strength positive relationship between ingrown nail stage and measured TMA for pes planus diagnosis (rho = 0.326; P = 0.04), yet there are no significant correlations between ingrown nail stage and other angles. CONCLUSIONS: Therefore, we do not recommend foot anatomy correction in the prevention and treatment of ingrown nails, unless there is an accompanying foot deformity; however, pes planus is a foot deformity that can accompany patients with severely ingrown nails.

Detection of tongue edema caused by endotracheal intubation tube in ICU patients by ultrasonography: a prospective, observational, clinical study.

PURPOSE: We aimed to determine the tongue edema that may develop due to the pressure exerted by the endotracheal intubation (ETI) tube on the tongue during the follow-up period of mechanical ventilation in patients intubated in the intensive care unit (ICU) by submental ultrasonography (USG). Also, we aimed to investigate the effect of tongue edema on the oxygen saturation values (SpO2) measured two h after extubation. METHODS: One hundred patients aged 18-65 years, who were followed up with mechanical ventilation in the ICU from the 0th day of intubation, were included. Patients (n = 57) who were followed up on mechanical ventilation for four days or longer after ETI were included in the study group. Those who were followed up on mechanical ventilation for three days or less after endotracheal intubation and were extubated during this period were included in the control group (n = 43). The tongue cross-sectional areas (TSAs) of patients in both groups were measured twice with submental USG. The first measurement (TSA1) was performed on the 0th day of ETI in all patients in both groups. The second measurement (TSA2) was performed on the 4th day of ETI in the study group and just before extubation in the control group. The difference between TSA2 and TSA1 was defined as tongue edema. Also, the effect of tongue edema on the oxygen saturation levels measured at the 2nd h after extubation of the patients in the control group was investigated. RESULTS: The tongue edema was more prevalent in the study group (p < 0.01). A significant negative correlation was found between the SpO2 levels two hours after extubation and the increase in the mean TSA values indicating tongue edema (p < 0.01). The oxygen saturations of the patients with tongue edema were 4% lower than those without tongue edema. CONCLUSIONS: Tongue edema may develop due to the long-term application of pressure of the ETI tube on the tongue and may impair oxygenation after extubation. GOV IDENTIFIER: NCT05249738.

Factors effecting the success of retrograde intrarenal surgery in pediatric patients with renal stones: The experience of two tertiary centres with 368 renal units.

INTRODUCTION AND OBJECTIVES: Currently, in the field of pediatric urology, the primary aim of surgical approaches for the treatment of renal stone disease is to provide a stoneless state through minimally invasive methods, and to prevent the damage that such stones may cause in the urinary system and stone recurrence. The aim of this study was to evaluate the efficacy and safety of RIRS and the factors affecting its success in the surgical treatment of renal stones in pediatric patients. METHODS: Data from 357 pediatric and 368 renal units were collected retrospectively. The recorded parameters were age, gender, location and burden of the stone, and presence of postoperative residual stones. RESULTS: The stone location was the upper pole in 28 (7.6 %) patients, the middle pole in 44 (12 %), the pelvis in 98 (26.6 %), the lower pole in 139 (37.8 %), and multiple locations in 59 (16 %) patients. A stoneless state was achieved in 277 (75.3 %) units, while 91 units (24.7 %) had residual stones at the end of the first month. In the multivariate analysis, the development of residual stones was found to be significantly associated with age (odds ratio [OR], 1.123; p = 0.012) and stone location (OR, 3.142; p = 0.018). DISCUSSION: RIRS is an endourological procedure with a high success rate in the achievement of a stoneless state in both pediatric and adult age groups, with an 82-100 % success rate reported in various studies. A full stoneless state was achieved in 277 (75.3 %) units after the initial RIRS in the present study, and full stone clearance was achieved in 304 units after the second RIRS session, with a success rate of 82.6 %. A limitation of our study is that it was not performed by a single surgeon, and stone samples could not be taken from all patients for stone analysis. CONCLUSION: RIRS has also been associated with a high success rate in the endoscopic treatment of renal stones and is an efficient and safe method with a minimal rate of complications, especially in the pediatric age group.

Colchicine-intolerant familial mediterranean fever patients: A comparative study between different colchicine doses and IL-1 inhibitor monotherapy.

OBJECTIVE: Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease. Colchicine is the primary treatment for FMF, although some patients do not respond well or are unable to tolerate it. For these patients, the addition of interleukin-1 (IL-1) antagonists is the preferred option. However, the impact of colchicine treatment alongside the use of IL-1 antagonists remains unclear. METHODS: We recruited adult FMF patients who satisfied the Eurofever and Pediatric Rheumatology International Trials Organization classification criteria and were receiving IL-1 antagonist treatment from our FMF cohort. All the patients exhibited colchicine intolerance or resistance. As per the FMF cohort protocol, the patients were longitudinally followed up, including assessments of their C-reactive protein, erythrocyte sedimentation rate, autoinflammatory disease activity index (AIDAI), and autoinflammatory damage index (ADDI). RESULTS: Among the 125 patients (68 female and 57 male), 96 received a combination of IL-1 antagonists and the maximum tolerated dose of colchicine, whereas 29 were treated exclusively with IL-1 antagonists due to colchicine intolerance. The patients' inflammatory markers, AIDAI activity, and ADDI damage scores did not differ significantly between the two groups during the follow-up period. Notably, the drug retention rates were significantly higher in the patients treated solely with IL-1 antagonists. CONCLUSION: While the typical approach is to maintain colchicine treatment alongside the use of IL-1 antagonists, for patients who cannot tolerate effective colchicine doses, IL-1 antagonists alone may effectively control FMF disease activity.

Is compressed colchicine tablet superior to other colchicine preparations in patients with familial Mediterranean fever?

AIMS: The aim of our study is to evaluate the differences in effectiveness, dosage, and side effect profiles in the use of colchicine preparations and evaluate the superiority of compressed colchicine tablets in familial Mediterranean fever (FMF) patients with resistance or intolerance to coated colchicine tablets. MATERIALS AND METHODS: Patients who were diagnosed with FMF according to the Tel Hashomer criteria, aged 18 years and older, and switched from compressed colchicine to coated colchicine tablets in the rheumatology clinic of Gazi University were identified. The daily colchicine dose and FMF attack frequency before and after switching from coated colchicine tablets to compressed colchicine tablets were compared. RESULTS: The study included 43 female (72.9%) and 16 male patients (27.1%), and the mean age was 34.54 ± 8.3 years. The number of attacks per year was significantly reduced after switching to compressed colchicine tablets, and daily colchicine doses were lower after switching to compressed colchicine tablets (1.97 ± 0.23 vs 1.78 ± 0.39 mg, p < 0.001). CONCLUSION: Compressed colchicine tablets were shown to be superior to other colchicine preparations and compressed colchicine tablets to be a useful treatment option before initiating biological agents in patients who were unresponsive to coated colchicine.

iNClusive: a database collecting useful information on non-canonical amino acids and their incorporation into proteins for easier genetic code expansion implementation.

The incorporation of non-canonical amino acids (ncAAs) into proteins is a powerful technique used in various research fields. Genetic code expansion (GCE) is the most common way to achieve this: a specific codon is selected to be decoded by a dedicated tRNA orthogonal to the endogenous ones. In the past 30 years, great progress has been made to obtain novel tRNA synthetases (aaRSs) accepting a variety of ncAAs with distinct physicochemical properties, to develop robust in vitro assays or approaches for codon reassignment. This sparked the use of the technique, leading to the accumulation of publications, from which gathering all relevant information can appear daunting. Here we present iNClusive (https://non-canonical-aas.biologie.uni-freiburg.de/), a manually curated, extensive repository using standardized nomenclature that provides organized information on ncAAs successfully incorporated into target proteins as verified by mass spectrometry. Since we focused on tRNA synthetase-based tRNA loading, we provide the sequence of the tRNA and aaRS used for the incorporation. Derived from more than 687 peer-reviewed publications, it currently contains 2432 entries about 466 ncAAs, 569 protein targets, 500 aaRSs and 144 tRNAs. We foresee iNClusive will encourage more researchers to experiment with ncAA incorporation thus contributing to the further development of this exciting technique.

The Effect of Nurses' Holistic Competence in Chronic Disease Management on Their Attitudes Toward Caregiver Roles.

The purpose of this study was to investigate the impact of nurses' holistic nursing competence in chronic disease management on their attitudes toward caregiving roles. The sample of the study, which was carried out in descriptive design, consists of 114 nurses (52.6% female and 47.4% male). The research data were gathered with sociodemographic characteristics form, the Holistic Nursing Competence Scale (HNCS), and the Attitude Scale for Nurses in Caregiving Roles (ASNCR). The influence of HNCS, gender, years of job, working style, professional status, weekly working time, and difficulty caring for chronic patients on ASNCR explained 38.1% of the variance. The impact of the ASNCR, gender, years of work in the job, working type, weekly working hours, and having difficulties caring for chronic patients on HNCS explained 54.5% of the variance. Our findings demonstrated the impact of holistic competence on nurses' positive attitudes toward the role of caregiver.

In Vitro Antibacterial, Antioxidant, Anticholinesterase, and Antidiabetic Activities and Chemical Composition of Salvia balansae.

CONTEXT: Salvia balansae de Noé (S. balansae) (Lamiaceae) is known to be an important plant used in folk medicine as an herbal remedy in Algeria. OBJECTIVE: The purpose of the present study was to demonstrate the phytochemical composition, antioxidant activities, enzyme inhibitory activities, and antimicrobial activities of S. balansae extracts. MATERIALS AND METHODS: A methanolic extract and a petroleum ether extract from the aerial parts of the plant were assessed for their chemical composition. HPLC-MS and HPLC-DAD assessed the content of phenols, GC-MS the fatty acid composition, and ICP-MS the mineral profiles of the plant. Additionally, we evaluated the bioactivities of S. balansae extracts by the DPPH, ABTS, and CUPRAC assays, including the antioxidant potential against AChE, BChE, α-amylase, and α-glucosidase for enzyme inhibition. The antibacterial and antifungal activities of the methanolic extract were determined by the disc diffusion test against several strains of bacteria and yeasts. RESULTS: Our findings revealed that the aerial parts of S. balansae were rich in phytochemical components and contained large amounts of minerals. Quantitative analysis of phenolic compounds by HPLC-DAD revealed the presence of 12 compounds in three major classes, flavonoids, hydroxycinnamic acid, and phenolic acid derivatives, with 0.61, 0.45, and 0.29 mg/g of extract, respectively. Nine phenolic constituents were quantified by HPLC-MS analysis; catechin (72.5%) was the main compound, followed by myricetin (21.7%). The fatty acid composition of the S. balansae petroleum ether extract by GC-MS analysis was quantified. Seventeen compounds, including palmitic acid, were identified as the major fatty acids. The antioxidant activity of the S. balansae extracts was measured by three different methods: the methanol extract provided better results than the petroleum ether extract, and interesting values were noted for the DPPH, ABTS, and CUPRAC assays of 242.7 ± 7.44, 124.1 ± 9.70, and 222.9 ± 6.05 µg/mL, respectively. The enzyme inhibition activity of the plant could not be determined. The antimicrobial results of the methanolic extract obtained from the disc diffusion method, followed by measurements of MIC, MBC, and MFC against several bacteria and yeasts, indicated that S. balansae exhibited noticeable antimicrobial and antifungal activities. CONCLUSIONS: These results provided new data about the main phenolic compounds and biological activities of extracts of the aerial parts of S. balansae, which might be an alternative source for synthetic bioactive compounds.

Could serum HMGB1 levels be a predictor associated with psoriatic arthritis?

Background/aim: Psoriasis is a chronic autoimmune disease that predominantly affects the skin and musculoskeletal system. We hypothesized that HMGB1, an inflammatory nuclear protein, may play a role in the musculoskeletal involvement of psoriasis. Methods: Forty patients with psoriasis and 45 with psoriatic arthritis were involved in the study; the results were compared with 22 healthy controls. Serum HMGB1 levels were evaluated from peripheral blood samples. Results: Serum HMGB1 levels were found to be significantly higher in patients with psoriasis regardless of joint involvement (p < 0.001). Also, HMGB1 levels were correlated with the extent of psoriasis. Conclusion: Serum HMGB1 levels may contribute to the progression of psoriasis to psoriatic arthritis and correlate with the severity of skin involvement.

Psoriasis is an autoimmune skin disease that may also affect the joints. Factors leading to the progression of psoriasis to psoriatic arthritis are still a mystery despite an increasing number of animal studies and real-life data. HMGB1 is a nuclear protein that leads to an increase in molecules that increase inflammation (TNF-α, IL-1 and IL-6) in the body. Until now, there was no report about the relationship between psoriatic arthritis and serum HMGB1 levels. Our study aimed to find any difference in HMGB1 levels between healthy and psoriatic patients. Psoriatic arthritis patients had higher levels of serum HMGB1 than patients with psoriasis. Also, HMGB1 levels were correlated with the severity of skin involvement. Our results showed that serum HMGB1 may indicate a high risk for developing psoriasis that involves the joints. Therefore the HMGB1 level in psoriasis patients can potentially serve as a predictor associated with disease severity and the risk of developing psoriatic arthritis.

Low relapse rate in patients with giant cell arteritis in a multi-centre retrospective Turkish Registry.

OBJECTIVES: Glucocorticoids (GC) are widely accepted as the standard first-line treatment for giant cell arteritis (GCA). However, relapse rates are reported up to 80% on GC-only protocol arms in controlled trials of tocilizumab and abatacept in 12-24 months. Herein, we aimed to assess the real-life relapse rates retrospectively in patients with GCA from Turkey. METHODS: We assembled a retrospective cohort of patients with GCA diagnosed according to ACR 1990 criteria from tertiary rheumatology centres in Turkey. All clinical data were abstracted from medical records. Relapse was defined as any new manifestation or increased acutephase response leading to the change of the GC dose or use of a new therapeutic agent by the treating physician. RESULTS: The study included 330 (F/M: 196/134) patients with GCA. The mean age at disease onset was 68.9±9 years. The most frequent symptom was headache. Polymyalgia rheumatica was also present in 81 (24.5%) patients. Elevation of acute phase reactants (ESR>50 mm/h or CRP>5 mg/l) was absent in 25 (7.6%) patients at diagnosis. Temporal artery biopsy was available in 241 (73%) patients, and 180 of them had positive histopathological findings for GCA. For remission induction, GC pulses (250-1000 methylprednisolone mg/3-7 days) were given to 69 (20.9%) patients, with further 0.5-1 mg/kg/day prednisolone continued in the whole group. Immunosuppressives as GC-sparing agents were used in 252 (76.4%) patients. During a follow-up of a median 26.5 (6-190) months, relapses occurred in 49 (18.8%) patients. No confounding factor was observed in relapse rates. GC treatment could be stopped in only 62 (23.8%) patients. Additionally, GC-related side effects developed in 64 (24.6%) patients, and 141 (66.2%) had at least one Vasculitis Damage Index (VDI) damage item present during follow-up. CONCLUSIONS: In this first multi-centre series of GCA from Turkey, we observed that only one-fifth of patients had relapses during a mean follow-up of 26 months, with 76.4% given a GC-sparing IS agent at diagnosis. At the end of follow-up, GC-related side effects developed in one-fourth of patients. Our results suggest that patients with GCA had a low relapse rate in real-life experience of a multi-centre retrospective Turkish registry, however with a significant presence of GC-associated side effects during follow-up.

Design, Synthesis, Pharmacological Activities, Structure-Activity Relationship, and In Silico Studies of Novel 5-Substituted-2-(morpholinoimino)-thiazolidin-4-ones.

This study is aimed to synthesize morpholine- and thiazolidine-based novel 5-(substituted)benzylidene)-2-(morpholinoimino)-3-phenylthiazolidin-4-ones (3-26) and characterized by molecular spectroscopy. The synthesized compounds were subjected to antioxidant activity with anticholinesterase, tyrosinase, and urease inhibition activities and evaluated the structure-activity relationship (SAR) of enzyme inhibition activities. Compound 11 was found to be the most active antioxidant. In anticholinesterase inhibition, compound 12 (IC50: 17.41 ± 0.22 µM) was the most active against AChE, while compounds 3-26 ( except 3, 8, and 17) showed notable activity against BChE. Compounds 17 (IC50: 3.22 ± 0.70 mM), 15 (IC50: 5.19 ± 0.03 mM), 24 (IC50: 7.21 ± 0.27 mM), 23 (IC50: 8.05 ± 0.11 mM), 14 (IC50: 8.10 ± 0.22 mM), 25 (IC50: 8.40 ± 0.64 mM), 26 (IC50: 8.76 ± 0.90 mM), and 22 (IC50: 9.13 ± 0.55 mM) produced higher tyrosinase inhibition activity. In urease inhibition activity, compounds 20 (IC50: 16.79 ± 0.19 µM), 19 (IC50: 18.25 ± 0.50 µM), 18 (IC50: 20.24 ± 0.77 µM), 26 (IC50: 21.51 ± 0.44 µM), 25 (IC50: 21.70 ± 0.06 µM), and 24 (IC50: 22.49 ± 0.11 µM) demonstrated excellent activities. Besides, the molecular docking study was applied to better understand the inhibitory mechanism between (1-26) compounds and enzymes at the molecular level. According to the results of this study, the synthesized compounds exhibited a better binding affinity toward these enzymes compared to the positive control. Further, molecular mechanics Poisson-Boltzmann surface area (MM/PBSA) binding free energy and molecular dynamics (MD) simulation analyses were performed for AChE with compound 26, which showed high inhibitory activity in silico and in vitro studies. In conclusion, novel morpholine and thiazolidine-based derivative compounds may be pharmacologically effective agents for AChE, BChE, tyrosinase, and urease enzymes.

Evaluation of Anti-Mullerian Hormone Levels, Antral Follicle Counts, and Mean Ovarian Volumes in Chemotherapy-Induced Amenorrhea among Breast Cancer Patients: A Prospective Clinical Study.

Estradiol (E2), a follicle-stimulating hormone (FSH), AMH, and inhibin B levels, along with AFC and MOV, are used to determine ovarian reserve in pre-menopausal women. Studies have shown that AMH levels are more sensitive than those of E2, FSH, and inhibin B and that AFC and MOV can be used to evaluate ovarian reserve. AMH, AFC, and MOV measurements were performed before and after adjuvant SC in 3-month periods for one year. Patients were classified as experiencing chemotherapy-induced amenorrhea (CIA) if they did not have menstrual cycles for a period of six months or longer following the conclusion of their chemotherapy treatment. We aimed to evaluate the factors affecting chemotherapy-induced amenorrhea in breast cancer patients treated with adjuvant chemotherapy and the performance of baseline measurements of AMH, AFC, and MOV to predict chemotherapy-induced amenorrhea. The effects of different chemotherapy regimens on the AMH level, AFC, and MOV in CIA patients were investigated. Seventy-one patients were eligible for this study, and the median age was 38 years (range: 23-45). The median follow-up was 37 months (range: 20-51), and CIA developed in 62% of the patients. The AMH level and AFC were significantly decreased one year after SC (p < 0.0001), whereas MOV was not (p = 0.507). AMH levels before chemotherapy (median: 1.520 vs. 0.755, p = 0.001) and at the end of the first year (median: 0.073 vs. 0.010, p = 0.030) and pre-treatment AFC (median: 12 vs. 4.50, p = 0.026) were lower in patients with CIA compared to those without CIA. The AMH levels before SC were the most valuable and earliest factor for predicting CIA development. In addition, there was no difference between the chemotherapy regimens (including or not including taxane) in terms of CIA development.

ReverseDock: a web server for blind docking of a single ligand to multiple protein targets using AutoDock Vina.

Several platforms exist to perform molecular docking to computationally predict binders to a specific protein target from a library of ligands. The reverse, that is, docking a single ligand to various protein targets, can currently be done by very few web servers, which limits the search to a small set of pre-selected human proteins. However, the possibility to in silico predict which targets a compound identified in a high-throughput drug screen bind would help optimize and reduce the costs of the experimental workflow needed to reveal the molecular mechanism of action of a ligand. Here, we present ReverseDock, a blind docking web server based on AutoDock Vina specifically designed to allow users with no computational expertise to dock a ligand to 100 protein structures of their choice. ReverseDock increases the number and type of proteins a ligand can be docked to, making the task of in silico docking of a ligand to entire families of proteins straightforward. We envision ReverseDock will support researchers by providing the possibility to apply inverse docking computations using web browser. ReverseDock is available at: https://reversedock.biologie.uni-freiburg.de/.

Examining the relationship between the pre-hospital incident scene management of the paramedic students and their anxiety levels and perception of leadership.

AIM: The aim of this study is to examine the relationship between the pre-hospital incident scene management of paramedic students and their anxiety levels and perception of leadership. METHOD: The sample of this descriptive correlational study consisted of 2nd-year students (N = 157) attending the associate degree program of the vocational school of healthcare services in two universities located in the eastern Turkey. No sample selection was used and the study was completed with 130 students. The data were collected using Socio-Demographic Data Form, Incident Scene Description Form, Intolerance of Uncertainty Scale, and Multidimensional Leadership Orientations Scale. The data were analyzed using number, percentage distribution, mean, and standard deviation. Normally distributed data were analyzed by correlation analysis. RESULTS: It was found that 65.4 % of the participants were female, 69.2 % received education on incident scene at the university, 52.3 % stated that this education was adequate, 58.5 % received education on leadership and crisis management at the university, and 60.7 % had no further suggestions for their education at the university. The mean scores of the students' knowledge on incident scene management were 15.77 ± 4.5, their total mean scores of the Intolerance of Uncertainty Scale were 35.38 ± 10.31, and their total mean scores of the Multidimensional Leadership Orientations Scale were 57.77 ± 20.26. A statistically significant negative very weak correlation was found between the Intolerance of Uncertainty Scale and the Multidimensional Leadership Orientations Scale (r = -0.225, p < 0.010). CONCLUSION: The results of this study revealed that the students had a low level of knowledge about crime scene management. As their anxiety levels increased, their perception of leadership decreased. It can be suggested to organize in-service and simulation trainings that will increase students' awareness of the courses related to crime scene management in their curriculum.