👤 Hafize E Sönmez

Juvenile idiopathic arthritis (JIA) is the most common childhood chronic arthritis, and pain may persist despite controlled inflammation, potentially due to central sensitization. This study aimed to evaluate the effects of very early-onset arthritis on pain, behavior, and cognition using a collagen-induced arthritis model in juvenile rats. Thirty-six three-week-old male Wistar rats were divided into control, sham (saline), and arthritis (type II collagen with incomplete Freund's adjuvant) groups. Disease severity was monitored via joint thickness and VAS. Pain (hot plate, Randall-Selitto), behaviors (EPM, MFST), and cognition (PAT) were assessed. Locomotor activity was assessed. Joints were analyzed histologically (H&E); hippocampal BDNF and TNF-α were examined immunohistochemically. Arthritis severity progressed over six weeks, with increased joint thickness and VAS scores in the arthritis group (p < 0.05). Mechanical hyperalgesia showed a paw- and time-dependent pattern, with earlier changes in some paws and more consistent reductions during the late phase (weeks 4-6). Locomotor activity did not differ among groups, indicating no motor deficits. The arthritis group exhibited greater anxiety (EPM, p = 0.001) and depression-like behavior (FST, p = 0.004), while cognition (PAT) remained unaffected. Hippocampal TNF-α increased, whereas BDNF was unchanged. Very early-onset arthritis is associated with mechanical hyperalgesia and emotional disturbances, accompanied by hippocampal TNF-α alterations, and exhibits features consistent with central sensitization, without significant effects on cognition or hippocampal BDNF expression. Early juvenile arthritis showed mild severity with delayed mechanical hyperalgesia. Thermal hyperalgesia and locomotor deficits were not observed in arthritic rats. Hippocampal TNF-α increase was linked to anxiety and depression-like behaviors. Hippocampal BDNF levels remained stable, suggesting intact learning processes. Show less

This study aimed to compare the safety profile of high-power (HPL) and low-power (LPL) Holmium:YAG lasers in retrograde intrarenal surgery (RIRS), using urinary Kidney Injury Molecule-1 (KIM-1) as an early biomarker for acute kidney injury (AKI). Sixty patients with renal stones (1.5-2.5 cm) were prospectively randomized into HPL and LPL groups. Urinary KIM-1 and KIM-1/creatinine ratios were measured preoperatively and at 4 and 24 h postoperatively. Intraoperative parameters, stone-free rates (SFR), complications, and renal function (eGFR, serum creatinine) were also assessed. Intrarenal temperatures were recorded before and after lithotripsy. Operative time, SFR, complication rates, and renal function parameters were similar between groups (p > 0.05). However, KIM-1 levels were significantly higher in the HPL group at 24 h postoperatively (278.8 ± 239.6 pg/mL vs. 170.3 ± 172.9 pg/mL, p = 0.003), and the KIM-1/creatinine ratio was also elevated (5.5 ± 4.5 vs. 3.1 ± 2.0, p = 0.035). No significant differences were observed in postoperative serum creatinine or eGFR. Intraoperative renal temperatures increased slightly in the HPL group, but the difference was not statistically significant. While high-power laser lithotripsy does not adversely affect global renal function, it is associated with elevated levels of renal injury biomarkers, suggesting greater subclinical renal stress. Show less