Unusual Rearrangements in Cyclohex-3-ene-1-carboxamide Derivatives: Pathway to Bicyclic Lactones.

The synthesis of new bicyclic lactone derivatives was carried out starting from 2-methyl/phenyl-3a,4,7,7a-tetrahydro-1H-isoindole-1,3(2H)-dione. 6-(Hydroxymethyl)-N-methyl/phenylcyclohex-3-ene-1-carboxamide derivatives were obtained from the reduction of tetrahydro-1H-isoindole-1,3(2H)-diones with NaBH4. Bromination and epoxidation reactions of both compounds were examined, and the structures of the resulting products were determined by spectroscopic methods. Substituted bicyclic lactone compounds, which are interesting rearrangement products in both bromination and epoxidation reactions, were obtained. In particular, hydroxymethyl (-CH2OH) and amide (-CONHR) groups attached to the cyclohexene ring in the bromination and epoxidation reactions were found to be effective in product formation. As a result, a new and applicable method was developed for the synthesis of bicyclic lactone derivatives.

The detect consensus report on Attention Deficit/Hyperactivity Disorder and its management among Turkish children and adolescents (Detect: consensus report on ADHD among Turkish youth).

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common and heritable neurodevelopmental disorders which may last through the life-span. A consensus report on diagnosis and management of ADHD among Turkish youth was prepared previously. However, the participants as well as the management options were rather limited and developments in the past decade necessitated a revision and update of the consensus. Therefore, this review aims to summarize the consensus among Child and Adolescent Psychiatrists from Türkiye on the nature and management of pediatric ADHD. For those aims, the etiology of ADHD, diagnostic and evaluation process, epidemiology, developmental presentations, differential diagnoses and comorbidities, course/outcome and pharmacological as well as non-pharmacological management options were reviewed and suggestions for clinical practice are presented. Since ADHD is a chronic disorder with wide-ranging effects on functionality that is frequently accompanied by other mental disorders, a multidimensional therapeutic approach is recommended. However, since the disorder has neurobiological basis, pharmacotherapy represents the mainstay of treatment. Additional therapies may include psychosocial therapy, behavioral therapy, school-based therapeutic approaches, and family education. This review provides recommendations for ADHD at the national and global levels. It contains information about ADHD that will contribute to and facilitate clinicians' decision-making processes. It is advisable to consider this guideline in clinical practice.

Synthesis, cytotoxicity, and antibacterial studies of 2,4,5,6-substituted hexahydro-1H-isoindole-1,3(2H)-dione.

In this study, synthesis of novel isoindole-1,3-dione analogues bearig halo, hydroxy, and acetoxy groups at the position 4,5,6 of the bicyclic imide ring was performed to examine their potential anticancer effects against some cell lines. A multistep chemical pathway was used to synthesize the derivatives. The cytotoxic effect of trisubstituted isoindole derivatives were evaluated by determining cellular viability using the MTT assay against A549, PC-3, HeLa, Caco-2, and MCF-7 cell lines. The C-2 selective ring-opening products were obtained from the ring-opening reaction of 5-alkyl/aryl-2-hydroxyhexahydro-4H-oxireno[2,3-e]isoindole-4,6(5H)-diones with nucleophiles such as chloride (Cl- ) and bromide (Br- ) ions. In addition, the ring-opening products halodiols were converted to their related acetates. The anticancer activity of synthesized isoindole-1,3-dione derivatives was investigated against HeLa, A549, MCF-7, PC3, and Caco-2 cells in vitro and resulted in varies cytotoxic effect depend on the group attached to the isoindole molecule. Furthermore, the evaluation of the antimicrobial action of trisubstituted isoindole derivatives against Gram-positive (Staphylococcus aureus) and Gram-negative (Escherichia coli) bacteria was assessed and found out selective inhibition of the both bacterial growth via different trisubstituted isoindole derivatives. The results of this work encourage further research on the potential utilization of trisubstituted isoindole derivatives as cytotoxic and antimicrobial agents.

Synthesis of Schiff Bases Containing Phenol Rings and Investigation of Their Antioxidant Capacity, Anticholinesterase, Butyrylcholinesterase, and Carbonic Anhydrase Inhibition Properties.

The widespread usage of Schiff bases in chemistry, industry, medicine, and pharmacy has increased interest in these compounds. Schiff bases and derivative compounds have important bioactive properties. Heterocyclic compounds containing phenol derivative groups in their structure have the potential to capture free radicals that can cause diseases. In this study, we designed and synthesized eight Schiff bases (10-15) and hydrazineylidene derivatives (16-17), which contain phenol moieties and have the potential to be used as synthetic antioxidants, for the first time using microwave energy. Additionally, the antioxidant effects of Schiff bases (10-15) and hydrazineylidene derivatives (16-17) were studied using by the bioanalytical methods of 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) cation radical (ABTS•+) and 1,1-diphenyl-2-picrylhydrazyl (DPPH•) scavenging activities, and Fe3+, Cu2+, and Fe3+-TPTZ complex reducing capacities. In the context of studies on antioxidants, Schiff bases (10-15) and hydrazineylidene derivatives (16-17) were found to be as powerful DPPH (IC50: 12.15-99.01 µg/mL) and ABTS•+ (IC50: 4.30-34.65 µg/mL). Additionally, the inhibition abilities of Schiff bases (10-15) and hydrazineylidene derivatives (16-17) were determined towards some metabolic enzymes including acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and human carbonic anhydrase I and II (hCAs I and II), enzymes that are linked to some global disorders including Alzheimer's disease (AD), epilepsy, and glaucoma. In the context of studies on enzyme inhibition, it was observed that the synthesized Schiff bases (10-15) and hydrazineylidene derivatives (16-17) inhibited AChE, BChE, hCAs I, and hCA II enzymes with IC50 values in ranges of 16.11-57.75 nM, 19.80-53.31 nM, 26.08 ± 8.53 nM, and 85.79 ± 24.80 nM, respectively. In addition, in light of the results obtained, we hope that this study will be useful and guiding for the evaluation of biological activities in the fields of the food, medical, and pharmaceutical industries in the future.

Assessment of Plasma-Endogenous Opioid Neuropeptide Levels and Psychometric Properties of Non-Suicidal Self-Injury in Adolescents.

OBJECTIVE: Non-suicidal self-injury (NSSI) is one of the most common mental health problems and growing public-health issues, coupled with a significant population-level burden among adolescents in both developed and developing countries. We aimed to assess the role of endogenous opioid system-emotion regulation circuitry in NSSI through measurement of plasma beta-endorphin (ß-EP), met-enkephalin (MENK) levels, and determination of psychometric features of Turkish adolescent subjects. METHOD: In this research, we measured plasma ß-EP and MENK levels of 49 adolescents with NSSI and 39 control subjects without NSSI between the ages of 12-18 years. All adolescent subjects were observed in the outpatient clinic, and their clinical and sociodemographic characteristics were examined. All subjects were assessed using the Brief Symptom Inventory (BSI) and Inventory of Statements About Self Injury (ISAS). RESULTS: Plasma ß-EP levels were statistically lower in adolescents with NSSI than control group, whereas there was no statistically significant difference in MENK levels. ß-EP levels showed a negative correlation with depression severity. The data obtained from BSI and ISAS were not found to be associated with both ß-EP and MENK levels, while subscale scores exhibited versatile correlations. CONCLUSION: Our findings supported the salient role of ß-EP in NSSI behavior. Also, decreased plasma ß-EP could be assessed as a reliable indicator for NSSI. However, it is possible that measurement of basal plasma levels of neuropeptides might also bring many confounders and could cause bias. Therefore, repeated measurements of plasma-endogenous opioid neuropeptides in a time-dependent manner-concomitant to engage of NSSI behavior-might give more reliable results.

Effect of Impairment on the Prevalence and Comorbidities of Attention Deficit Hyperactivity Disorder in a National Survey: Nation-Wide Prevalence and Comorbidities of ADHD.

OBJECTIVE: This study aimed to determine the prevalence and comorbidities of attention-deficit hyperactivity disorder (ADHD) by evaluating a large-scale nation-wide sample of children. METHOD: The inclusion criterion was being enrolled as a 2nd, 3rd, or 4th-grade student. A semi-structured diagnostic interview (K-SADS-PL), DSM-IV-Based Screening Scale for Disruptive Behavior Disorders, and assessment of impairment (by both parents and teachers) were applied to 5,842 participants. RESULTS: The prevalence of ADHD was 19.5% without impairment and 12.4% with impairment. Both ADHD with and without impairment groups had similar psychiatric comorbidity rates except for oppositional defiant disorder (ODD) and conduct disorder (CD) diagnoses. Impairment in the ADHD group resulted in significantly higher ODD and CD diagnoses. CONCLUSION: Even when impairment is not described, other psychiatric disorders accompany the diagnosis of ADHD and may cause impairment in the future. Impairment in the diagnosis of ADHD significantly increases the likelihood of ODD and CD.

Evaluation of isoindole derivatives: Antioxidant potential and cytotoxicity in the HT-29 colon cancer cells.

Norcantharimides have an isoindole skeleton structure, and some isoindoline derivatives have positive effects on inflammatory pathologies, including cancers. The present study aims to evaluate the antioxidant and cytotoxic potential of four synthesized isoindoline derivatives (NCTD1-4). HT-29 cells exposed to 10, 50, 100, and 200 µM doses of each derivative were incubated for 24 and 48 h, respectively. The cytotoxicity of the new derivatives was analyzed using the cell growth inhibition assay and the cell membrane damage test. In vitro antioxidant activity studies showed that the derivatives have free radical-scavenging effects in a dose-dependent manner. NCTD3 and NCTD4 apparently have antioxidant effects when compared with the control group treated with dimethyl sulfoxide. Furthermore, NCTD4 inhibited the growth of the HT-29 cells due to membrane damage and exhibited a dose-dependent cytotoxic effect on colon adenocarcinoma cells. The findings suggest that NDTD4 has the highest potential for colon cancer treatment and may be interpreted as a candidate anticancer agent.

The Prevalence of Internet Addiction in Turkish Adolescents with Psychiatric Disorders.

INTRODUCTION: The aim of this study is to determine the prevalence of Internet addiction (IA) in adolescents with psychiatric disorders. METHODS: A total of 310 adolescents, aged from 12 to 18, participated in the study. The psychiatric sample group included 162 participants who had applied to the child psychiatry outpatients service. The psychiatric disorders among those in this group were assessed through clinical interviews based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Text Revision (DSM-IV-TR). The control group was chosen from adolescents of families who had never sought psychiatric help. The demographics of the participants and the features of their Internet usage habits were gathered through a questionnaire prepared by researchers. Young's Internet Addiction Test was used to assess internet addiction. RESULTS: The frequency of IA was found to be significantly higher in the psychiatric sample group than in the control group (24.1% vs. 8.8%, respectively). A total of 23.9% of the subjects had one, and 12.6% had two or more co-morbid psychiatric diagnoses. The frequencies of the diagnostic groups were as follows: attention deficit hyperactivity disorder 55.6%, anxiety disorder 29.0%, mood disorder 21.0%. CONCLUSION: IA was found to be significantly more common among adolescents in the child psychiatry outpatient department than among the adolescents who had no psychiatric history, even after confounding variables had been controlled. Further studies are needed to define IA more precisely and to improve prevention approaches.

The prevalence of childhood psychopathology in Turkey: a cross-sectional multicenter nationwide study (EPICPAT-T).

AIM: The aim of this study was to determine the prevalence of childhood psychopathologies in Turkey. METHOD: A nation-wide, randomly selected, representative population of 5830 children (6-13 years-old) enrolled as a 2nd,3rd or 4th grade student in 30 cities were evaluated for presence of a psychiatric or mental disorder by a Sociodemographic Form, Kiddie Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL), and DSM-IV-Based Screening Scale for Disruptive Behavior Disorders in Children and Adolescents scales. Impairment criterion was assessed via a 3 point-Likert scale by the parent and the teacher independently. RESULTS: Overall prevalence of any psychopathology was 37.6% without impairment criterion, and 17.1% with impairment criterion. Attention-deficit hyperactivity disorder was the most frequent diagnosis, followed by anxiety (19.5% and 16.7% without impairment, 12.4% and 5.3% with impairment, respectively). Lower education level and presence of a physical or psychiatric problem of the parents were independent predictors of any psychopathology of the offspring. CONCLUSION: This is the largest and most comprehensive epidemiological study to determine the prevalence of psychopathologies in children and adolescents in Turkey. Our results partly higher than, and partly comparable to previous national and international studies. It also contributes to the literature by determining the independent predictors of psychopathologies in this age group.

Ten-Year Experience Outcomes of a Day Treatment for Children and Adolescents with Psychiatric Disorders.

INTRODUCTION: It was aimed to evaluate the efficacy of a day treatment clinic in Turkey and which has been serving for ten years for children and adolescents with psychiatric disorders. METHODS: 262 patients who completed day treatment within ten years were tested at intake and discharge. The patients' functioning was assessed using the Children's Global Assesment Scale (CGAS), Clinical Global Impression Scale (CGIS), state-trait anxiety inventory for children, depression rating scale for children, Coopersmith self-esteem inventory for children. Pre/post treatment comparisons were made on same variables. RESULTS: Statistical analyses showed that, improvement was maintained on all measures. The high CGAS scores at discharge were showed well-being and good functioning of patients. The CGIS scores varied from moderately disturbed (4.83±0.88) to much improved (2.55±0.93) demonstrated that treatment responses showed improvement. Wilcoxon T tests showed that patients were significantly more anxious and depressive at intake and had more problems in self esteem. State-trait anxiety inventory for children and depression rating scale for children scores decreased and Coopersmith self-esteem inventory for children scores improved with day treatment. CONCLUSION: This study points that as results of ten-year experience, day treatment approach seems effective and therefore to be the treatment of choice for treating children and adolescents with psychiatric disorders. It also shows the necessity of a treatment that combines multiple modalities like day treatment and day treatment must be more generalize for these patient population.

Prevalence of Childhood Affective disorders in Turkey: An epidemiological study.

AIM: To determine the prevalence of affective disorders in Turkey among a representative sample of Turkish population. METHODS: This study was conducted as a part of the "The Epidemiology of Childhood Psychopathology in Turkey" (EPICPAT-T) Study, which was designed by the Turkish Association of Child and Adolescent Mental Health. The inclusion criterion was being a student between the second and fourth grades in the schools assigned as study centers. The assessment tools used were the K-SADS-PL, and a sociodemographic form that was designed by the authors. Impairment was assessed via a 3 point-Likert type scale independently rated by a parent and a teacher. RESULTS: A total of 5842 participants were included in the analyses. The prevalence of affective disorders was 2.5 % without considering impairment and 1.6 % when impairment was taken into account. In our sample, the diagnosis of bipolar disorder was lacking, thus depressive disorders constituted all the cases. Among depressive disorders with impairment, major depressive disorder (MDD) (prevalence of 1.06%) was the most common, followed by dysthymia (prevalence of 0.2%), adjustment disorder with depressive features (prevalence of 0.17%), and depressive disorder-NOS (prevalence of 0.14%). There were no statistically significant gender differences for depression. Maternal psychopathology and paternal physical illness were predictors of affective disorders with pervasive impairment. CONCLUSION: MDD was the most common depressive disorder among Turkish children in this nationwide epidemiological study. This highlights the severe nature of depression and the importance of early interventions. Populations with maternal psychopathology and paternal physical illness may be the most appropriate targets for interventions to prevent and treat depression in children and adolescents.

Effects of tirofiban on acute systemic inflammatory response in elective percutaneous coronary interventions.

OBJECTIVE: In this study the effect of a specific glycoprotein IIb/IIIa inhibitor, tirofiban [which also has antiplatelet activity on acute systemic inflammatory responses (IR) during elective percutaneous coronary intervention (PCI)] was evaluated. PATIENTS AND METHODS: Patients with stable angina pectoris and similar baseline characteristics who angiographically had a single lesion in their coronary arteries with a PCI performed on that lesion were enrolled in the study. One group of patients (control group, n = 52) received 0.9% NaCl (15 mL/h for 24 h) and the other group (tirofiban group, n = 55) had tirofiban (10 microg/kg bolus infusion in 3 min and 0.15 microg/kg/min for 24 h) in addition to stenting without pre-dilatation. The effect of interventional procedure on levels of cardiac troponin T (cTnT) and several parameters of acute IR (leukocytes, fibrinogen, C-reactive protein, interleukin-1, interleukin-6, interleukin-8 and tumor necrotizing factor-alpha) was assessed on blood samples obtained from all patients before PCI and at pre-specified time points after PCI. RESULTS: During the follow-up after PCI, the number of patients becoming cTnT-positive (> 0.1 ng/mL) was greater in the control group [12 (23%) patients vs. 3 (5%) patients, p = 0.01]. However, both groups had changes (generally observed as elevations) in their levels of all inflammatory parameters during the study and C-reactive protein, interleukin-6 and tumor necrotizing factor-alpha levels were elevated significantly. Yet, no significant difference occurred between groups due to these changes in any phase of the study (p > 0.05). CONCLUSIONS: Based on the findings of this study, it was concluded that although tirofiban limits development of myocardial necrosis during elective PCI, it does not directly affect the acute systemic inflammatory responses.

The effect of long-term clopidogrel use on neointimal formation after percutaneous coronary intervention.

OBJECTIVE: The purpose of this study was to evaluate the long term effect of clopidogrel-based antiplatelet therapy on neointimal formation. METHODS: This study comprised 78 patients with typical stable angina pectoris or documented myocardial ischaemia, and with only one angiographic lesion in one native coronary artery undergoing successful stent implantation without predilatation with C-reactive protein levels < or =5 mg/l at 72 h after the procedure. All patients received dual antiplatelet therapy with 75 mg/day clopidogrel and 300 mg/day aspirin for four weeks. Clopidogrel was switched to isochronous placebo in half of the patients (n=39) at the end of the fourth week. This allocation was maintained for 20 weeks, and at week 24 of the study, coronary angiography and intravascular ultrasound imaging were performed again in all cases in order to evaluate the changes that had occurred in the in-stent neointimal formation; rates of restenosis were also recorded RESULTS: At the end of the follow-up period, angiographic stenosis diameter and restenosis rates were smaller in the clopidogrel group than in the placebo group (23.3% versus 35.6%, p=0.05 and 5.12% versus 10.25%; p=0.03 respectively); the intravascular ultrasonographic neointimal cross sectional area was also smaller in the clopidogrel group (3.6 +/- 2.7 mm(2) versus 5.2 +/- 2.5 mm(2), p=0.03). CONCLUSIONS: Long-term clopidogrel administration significantly reduced neointimal formation at the stent site as well as reducing major clinical events in patients who did not develop high-risk systemic inflammatory response after percutaneous coronary intervention.

Use of excimer laser for thrombus containing lesion.

The presence of thrombus in the lesion before balloon angioplasty increases the complications arising from mechanical intervention. It is known that the use of Gp llb/llla receptor blockers before the intervention enhances the reliability of the procedure. Laser thrombolysis was applied to a patient who underwent coronary angiography due to recurrent chest pain after thirty six hour administration of tirofiban and who was found to have a thrombus so large as to block the distal vessel bed of the right coronary artery. Following the procedure, the entire thrombus was broken down and Grade III distal myocardial perfusion was achieved. This case is important in demonstrating that laser application is a viable alternative in such instances, especially considering that intervention in acute coronary syndromes is on the increase and cardiologists will frequently encounter such cases.