Relationship of immature granulocytes with disease activity in rheumatoid arthritis.

AIM: To determine whether the IG count (#) and IG percentage (%) are associated with disease activity in rheumatoid arthritis (RA). METHODS: This retrospective study included 65 RA patients and 65 healthy controls. Clinical and demographic characteristics of controls and RA patients (at active period and when the patients achieved remission) were obtained from medical records. Disease activity was defined by disease activity score 28 (DAS28). Furthermore, the clinical disease activity index (CDAI), and simple disease activity index (SDAI) were calculated. For the differential diagnosis of RA patients from healthy controls, the cut-off value was estimated by making receiver-operator curves (ROC). RESULTS: In active RA patients, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), IG#, and IG% levels were significantly higher compared to the healthy controls (p < .001, for all). When the patients achieved remission, DAS28, CDAI, SDAI, ESR, CRP, IG#, and IG% values were significantly decreased (p < .001, for all). IG# and IG% were significantly positively correlated with DAS28, CDAI, SDAI, ESR, and CRP (p = .024, p = .008, p = .003, p < .001, p < .001, respectively). According to ROC curve analysis, IG% and IG# were the biomarkers to have a significant diagnostic value for RA with the area under the curve of 0.853 and 0.865 (p < .001, for all). CONCLUSION: The present study demonstrated that two novel inflammatory markers, IG# and IG%, can be useful for monitoring RA patients' disease activity. Furthermore, IG# and IG% can also be used as fast, inexpensive, and easily available complementary diagnostic markers to diagnose RA patients.

Red cell distribution width and its association with retinopathy of prematurity.

OBJECTIVE: The aim of this study was to evaluate whether there is a relationship between red cell distribution width (RDW) values and the development of retinopathy of prematurity (ROP) in premature infants. METHODS: This retrospective study was conducted on a total of 159 infants with gestational age (GA) < 35 weeks including 77 infants diagnosed as ROP (patients' group) and 82 infants without ROP (control group) between September 2015 and January 2018. RDW values of the preterm infants were obtained from their medical records (routine postpartum cord blood sample and follow-up venous blood samples taken at first week, second week and first month). The possible relationship between RDW values and clinical features of ROP development was evaluated. RESULTS: The mean GA of all infants was 29.2 ± 2.4 (24-35) weeks, and the mean birth weight was 1268 ± 419 (550-2500) g. The RDW values measured in the first and the second weeks were significantly higher in infants with ROP compared with those wihout ROP (p < .001 for both). There was no statistically significant difference between the groups in terms of cord blood and first month RDW values (p = .719, p = .108, respectively). The first and second week's RDW values of infants with ROP requiring treatment (severe ROP) were significantly higher than those of infants with ROP not requiring treatment (mild ROP) (p = .005, p = .031, respectively), but no statistically significant difference was observed between the groups in terms of cord blood and first month values (p = .114 and p = .371, respectively). CONCLUSION: RDW is an easily accessible and inexpensive marker that may reflect the clinical risk factors for ROP. Follow-up measures of RDW have the potential to help clinicians for the prediction of ROP development in the first 2 weeks postnatally.

Disordered bone metabolism in hereditary spherocytosis patients.

Aim: This study was planned to evaluate bone health in patients with hereditary spherocytosis.Materials and methods: In this prospective study, a total of 30 hereditary spherocytosis patients which followed in the Pediatric Hematology and Oncology Department of KSU Medical Faculty and 30 patients for control group were included. Patient and control group were chosen equal in age and sex. Hemogram and biochemical tests (serum calcium, phosphorus, alkaline phosphatase, parathormone, vitamin D) and osteocalcin were studied from the patient and control groups. Also DXA examination was performed in the patient group.Results: There was a significant difference in hemogram parameters between the two groups due to hemolytic anemia in hereditary spherocytosis patients. In the patient group, osteocalcin was 6.88 ± 4.35 ng/ml, vitamin D was 17.74 ± 7.76 ng/ml and in the control group osteocalcin was 11.93 ± 8.92 ng/ml, vitamin D was 24.04 ± 11.70 ng/ml. There was a statistically significant difference between the vitamin D and osteocalcin levels of the two groups (p = 0.017 and 0.008, respectively). Bone density was assessed in the patient group. In patients DXA results showed lower Z-scores then the normal population according to age and sex.Conclusion: Hereditary spherocytosis patients should be followed closely in terms of development, puberty, bone health as they are in other hemolytic anemias. Nutritional recommendations, vitamin D supplementation, physical activity should be advised to protect bone health.

Preoperative Serum Leptin Level Is Associated with Preoperative Pain Threshold and Postoperative Analgesic Consumption in Patients Undergoing Cesarean Section.

OBJECTIVE: This study aimed to investigate the preoperative level of serum leptin in cesarean section (C-section) patients with and without acute labor pain and its association with postoperative analgesic consumption and preoperative pain threshold. MATERIALS AND METHODS: Preoperative leptin levels, preoperative pain threshold, postoperative analgesic consumption in the first 24 h, and postoperative pain severity (visual analog scale (VAS) scores at 1, 2, 4, 6, 12, and 24 h postoperatively) in C-section patients with labor pain (emergency C-section; n = 21) and without labor pain (elective C-section; n = 25) were compared. RESULTS: There were no significant differences between the groups regarding the demographic characteristics. Leptin levels, postoperative VAS scores, and analgesic consumption were significantly higher in the group with labor pain, while the preoperative pain threshold was lower. Serum leptin levels correlated negatively with pain threshold and positively with postoperative analgesic consumption. Multiple linear regression analyses in our study revealed that the preoperative leptin levels and having an emergency C-section independently affected the postoperative analgesic consumption and preoperative pain threshold, whereas their combined effects on these parameters were statistically not significant. CONCLUSION: Preoperative levels of serum leptin were higher in C-section patients with labor pain than in those without labor pain, and increased serum leptin levels were associated with decreased preoperative pain threshold and increased postoperative analgesic consumption in our study population. Postoperative analgesic requirements may vary among patients, and their requirements might be predicted using preoperative indicators. Serum levels of leptin might be one such indicator and this warrants further studies with larger sample sizes.

The C-Reactive Protein/Albumin Ratio and Complete Blood Count Parameters as Indicators of Disease Activity in Patients with Takayasu Arteritis.

BACKGROUND This study aimed to evaluate the ratio of C-reactive protein (CRP) to albumin, inflammatory markers, and parameters from the complete blood count (CBC) in patients with Takayasu arteritis and the association with disease activity. MATERIAL AND METHODS A retrospective study included thirty-two patients with Takayasu arteritis and 32 healthy controls. Clinical and demographic characteristics of patients with Takayasu arteritis were recorded at baseline, before medication and on remission. Similar data were obtained for the controls at recruitment. Remission was defined as more than six months of stable disease without new vascular lesions in patients who previously had active disease. Kerr's criteria were used to define active Takayasu arteritis. RESULTS In patients with Takayasu arteritis, the erythrocyte sedimentation rate (ESR), CRP, CRP/albumin ratio, red cell distribution width (RDW), neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and monocyte-lymphocyte ratio (MLR) were significantly higher, and albumin and MPV were significantly lower compared with controls. The ESR, CRP, CRP/albumin ratio, NLR, PLR, and MLR were decreased in remission, whereas MPV was increased. CRP and the CRP/albumin ratio were positively correlated and albumin and MPV were negatively correlated with disease activity. The CRP/albumin ratio had the highest correlation with disease activity in Takayasu arteritis. The CRP/albumin ratio, RDW, NLR, PLR, and MLR were positively correlated with CRP and ESR. CONCLUSIONS The CRP/albumin ratio, RDW, NLR, PLR, MLR, and MPV were markers of remission of active disease, and the CRP/albumin ratio, total albumin, and MPV were markers of disease activity in Takayasu arteritis.