The diagnostic importance of periostin as a biomarker in chronic rhinosinusitis with nasal polyp.

PURPOSE: The current studies in the literature report that periostin contributes to the formation of nasal polyps and may be a molecular biomarker for chronic rhinosinusitis with nasal polyps (CRSwNP). This study aims to investigate the effect of periostin in determining polyp burden in CRSwNP patients and evaluate its impact on postoperative surgical results and its functionality as a biomarker. METHODS: The study included 26 patients who underwent endoscopic sinus surgery due to CRSwNP and 30 patients who were scheduled to undergo septoplasty due to isolated nasal septum deviation. We performed preoperative Lund-Mackay scoring and preoperative and postoperative SNOT-22 and Modified Lund-Kennedy scoring for the patients. Tissue and serum samples were collected from all patients in surgery and another serum sample was taken from CRSwNP patients at postoperative month 6. RESULTS: Tissue eosinophil (p < 0.001), preoperative serum (p < 0.001), and tissue (p = 0.002) periostin were significantly higher in the CRSwNP group. We observed a statistically significant positive correlation between tissue eosinophil values and tissue periostin values in CRSwNP patients (p = 0.004). We found a statistically significant positive correlation between the tissue periostin values and postoperative SNOT-22 scores of the CRSwNP group patients (p = 0.005). CONCLUSION: According to the results of our study, we think that periostin can be used as a biomarker in the prediction, determination of disease severity, and prognosis of CRSwNP. Comprehensive cohort studies with larger patient series are needed to provide more information on the role and effects of periostin in cases of CRSwNP undergoing surgical treatment.

The protective effect of boric acid on cholestatic rat liver ischemia reperfusion injury.

BACKGROUND: To evaluate the potential protective effects of boric acid (BA) in experimental cholestatic liver ischemia reperfusion (IR) injury model. METHODS: The study included 24 female rats which were divided into 3 groups each containing 8 rats. The control group (Group 1) only received laparotomy. In the IR group (Group 2) biliary tract ligation was applied and 1 week later 45 min ischemia and 1 h reperfusion with relaparotomy without any treatment was implemented. In the treatment BA+IR group (Group 3). 1 week after the biliary ligation intraperitoneal administration of 200 mg/kg BA was given 10 min before the ischemia for 45 min and reperfusion for 1 h with relaparotomy. Liver tissue and blood samples were taken for histopathological and biochemical examination. Ischemia modified albumin (IMA), SCUBE1, total antioxidant status (TAS), and total oxidant status (TOS) levels were also examined. RESULTS: Compared to control, groups IR and BA+IR had higher serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), total, and direct bilirubin levels. Albumin value was high in the control group and low in the other groups. In terms of IMA levels there was no significant difference between groups (p > 0.05). When SCUBE-1 levels were examined groups IR and BA+IR were significantly higher than the group 1. TAS was highest in the group BA+IR whereas TOS was highest in the group IR and lower in the group BA+IR. In histopathological analysis, loss of intercellular border loss in hepatocytes, diffuse nuclear pycnosis and mild to moderate neutrophilic cell infiltration were observed in the IR group. Statistically significant dissociation, hemorrhage and severe neutrophilic cell infiltration were seen in hepatocytes of rats with IR (p < 0.05). DISCUSSION: BA has promising results in the treatment of experimental IR injury of the cholestatic liver because of its antioxidant effects. It may be used in clinical practice after more extensive studies about the effects of BA on IR injury of the cholestatic liver.

Ameliorating effects of agomelatine on testicular and epididymal damage induced by methotrexate in rats.

The aim of this study was to investigate the possible prophylactic effects of agomelatine (AGO) against testicular and epididymal damage induced by methotrexate (MTX) in rats. Twenty-four male Wistar albino rats were divided into three groups: Group I (control group), Group II (MTX group: 20 mg/kg MTX, i.p, single dose), and Group III (MTX+AGO group: 20 mg/kg MTX, i.p, single dose+40 mg/kg AGO; gavage, 7 days). The rats were killed under anesthesia 24 hours after the last AGO application. Testicular and epididymal tissues were bilaterally removed for morphometric, biochemical, pathological, and immunohistochemical analyses. Body, testicular, and epididymal weights were measured. Malondialdehyde (MDA), superoxide dismutase, catalase, and glutathione peroxidase levels were measured in testes. Sperm count, hyperemia, edema, inflammatory reaction, degenerated and necrotic cells were evaluated by histopathological analysis. In addition, inducible nitric oxide synthase (iNOS), granulocyte colony-stimulating factor (G-CSF), osteopontin (OPN), and heat shock protein-70 (HSP70) immune reactions were analyzed in testes and epididymides. Decreased epididymal weights, increased MDA levels, decreased sperm count, hyperemia, edema, inflammatory reaction, and degenerated and necrotic cells were observed in the MTX group. In addition, iNOS, HSP70, G-CSF, and OPN immune reactions were increased. AGO improved morphometric, biochemical, histopathological, and immunohistochemical findings. The present study confirms that MTX induces testicular and epididymal damage both biochemically and immunohistochemically. However, AGO demonstrated ameliorative effects on both biochemical and pathological findings of the current study.

Short-Term Effect of High-Dose Pantoprazol on Serum and Urinary Magnesium Levels.

BACKGROUND: Proton pump inhibitor (PPI) induced hypomagnesemia is a completely unexplained issue and cases are still being reported. Long-term use is the main factor, but there are a few articles stating that it may also emerge with short-term use. We aimed to evaluate the changes of serum and urine magnesium levels during shortterm high dose pantoprazol treatment. METHODS: The serum and 24-hour urine magnesium levels of 58 patients were evaluated during the course of 2 days. Of 58 patients, 25 were allowed oral intake on the 3rd day of hospitalization and thus, 24-hour urine for 3 days was collected from 33 patients. RESULTS: There were no significant differences in the mean levels of serum magnesium and the median levels of urine magnesium. When the magnesium levels were evaluated by age over and under 60 years, the baseline serum magnesium level was significantly higher than the 1st level in patients aged ≥ 60 years (p = 0.029). The 3rd day serum magnesium level was significantly higher than the baseline and 1st day levels in those aged < 60 years (p = 0.049). CONCLUSIONS: We showed that plasma levels and urinary excretion of magnesium did not change significantly during high-dose pantoprazol treatment. It can be hypothesized that magnesium levels are not affected by PPIs in short-term usage. Age and other contributing factors may have more impact on PPI induced hypomagnesemia. Patients aged over 60 years might be handled carefully under proton pump inhibitors treatment.

The impact of electromagnetic radiation (2.45 GHz, Wi-Fi) on the female reproductive system: The role of vitamin C.

The present study investigated the effects of applied continuous 2.45 GHz electromagnetic radiation (EMR), which might cause physiopathological or morphological changes in the ovarian, fallopian tubal, and uterine tissues of rats. We proposed that the addition of vitamin C (Vit C) may reduce these severe effects. Eighteen female Sprague Dawley rats were randomly divided into three groups with six animals in each: Sham, EMR (EMR, 1 h/day for 30 days), and EMR + Vit C (EMR, 1 h/day for 30 days 250 mg/kg/daily). Total oxidant status (TOS) and oxidative stress index (OSI) levels increased ( p = 0.011 and p = 0.002, respectively) in the EMR-only group in ovarian tissues. In all tissues, TOS and OSI levels significantly decreased in the Vit C-treated group in ovarian, fallopian tubal, and uterine tissues ( p < 0.05). Anti-müllerian hormone levels significantly increased in the EMR group ( p < 0.05) and decreased in the Vit C-treated groups. Estrogen (E2) levels were unchanged in the EMR group, as the differences were not statistically significant. Immunohistochemical examination of the ovaries revealed significant increases in Caspase-3 expressions in the epithelial cells of the EMR group ( p < 0.05). In the EMR group, hyperemia was observed in uterine tissues. Also, Caspase-3 and Caspase-8 were significantly increased in the EMR group ( p < 0.001). Caspase-3 was significantly diminished with Vit C application in the ovarian and uterine tissues ( p < 0.05). Caspase-8 was significantly diminished only in uterine tissues ( p < 0.05). These results indicate that prolonged EMR exposure induced physiopathological changes in the ovarian, fallopian tubal, and uterine tissues due to oxidative damage. Under the conditions of this study, Vit C may have protective effects on female reproductive system against oxidative damage.

Pathology of cigarettes on the reproductive system and ameliorative effects of alpha lipoic acid: A rat model study.

Cigarette smoking (CS) has some detrimental effects that occur via oxidative stress (OS). The aim of this work was to demonstrate the pathological and immunohistochemical effects of CS and the protective effects of a strong antioxidant alpha lipoic acid (ALA) on CS-induced genital system changes in a rat model. Twenty-eight female rats were randomly allocated to three groups as control, CS-exposed, and CS-exposed and ALA-treated. Reproductive tract organs were collected for biochemical and pathological examinations. In the CS group, OS markers increased in the tissues of both the ovary and fallopian tubes. Decreased follicle numbers in the ovary, marked cilial loss in the fallopian tubes, and pathologic changes in the uterus were observed in the CS group. Positive calcitonin gene-related peptide (CGRP), caspase 3α, hypoxia-inducible factor 1α (HIF-1α), tumor necrosis factor-α (TNF-α) immunoreactions were observed in uterine tissues and HIF-1α immunoreactions in tubal and uterine epithelial cells of the CS group. ALA reversed all these findings effectively. CS has negative effects on the female reproductive system via HIF-1α in tuba uterina and HIF-1α, HIF-2α, TNF-α, caspase 3, and CGRP in the uterus, and ALA could protect against the negative effects of CS on the female reproductive system.

The association between serum ghrelin levels and large-for-gestational-age fetuses in patients with gestational diabetes mellitus.

We aimed to determine the relationship between serum ghrelin levels and large-for-gestational-age (LGA) fetuses in patients with gestational diabetes mellitus (GDM). A case-control study was conducted in 32 women with GDM and LGA fetuses (GDM + LGA group), 35 women with GDM and appropriate-for-gestational-age (AGA) fetuses (GDM + AGA group), 32 women with normal glucose tolerance (NGT) and LGA fetuses (NGT + LGA group), and 31 women with NGT and AGA fetuses (NGT + AGA group). All participants were recruited at the time of GDM diagnosis between 24 and 30 weeks of pregnancy. Participants also underwent ultrasonographic examinations. Serum ghrelin levels were significantly higher in GDM + LGA and GDM + AGA groups than in the NGT + AGA group. In the univariate model, biparietal diameter, head circumference, abdominal circumference (AC), femur length and ghrelin values were significant predictors of LGA fetuses. In the multivariate model, only AC remained as a predictor of LGA fetuses.

Assessment of circulating betatrophin concentrations in lean glucose-tolerant women with polycystic ovary syndrome.

The aims of the current study were to investigate the betatrophin levels in lean glucose-tolerant women with polycystic ovary syndrome (PCOS), and to explore the relationships between these levels and antropometric, hormonal and metabolic parameters. The study population consisted of 50 lean (body mass index [BMI] < 25 kg/m2) women diagnosed with PCOS using the Rotterdam criteria, and 60 age- and BMI-matched healthy controls without any features of clinical or biochemical hyperandrogenism. Before recruitment, glucose tolerance was evaluated in all of the subjects using the 2-h 75 g oral glucose-tolerance test, and only those exhibiting normal glucose tolerance were enrolled. Serum betatrophin levels were significantly higher in women with PCOS (median 322.3; range 44.7-1989.3 ng/L) compared to the controls (median 199.9; range 6.2-1912.9 ng/L; p = .005). In the control group, no significant correlation was evident between betatrophin levels and clinical or biochemical parameters. In the PCOS group, betatrophin levels were positively correlated with prolactin levels (r = .286, p = .046) and negatively correlated with BMI (r = -.283, p = .049), waist/hip ratio (r = -.324, p = .023), and low-density lipoprotein cholesterol levels (r = -.385, p = .006). Impact statement What is already known on this subject: Several studies have suggested that primary alteration in beta-cell function is a pathophysiological feature of PCOS, and insulin resistance is the most significant predictor of beta-cell dysfunction independent of obesity. Betatrophin is a circulating protein that is primarily expressed in the liver in humans. Early experimental investigations demonstrated that overexpression of betatrophin significantly promoted pancreatic beta-cell proliferation, insulin production and improved glucose tolerance. Few studies have investigated the association between PCOS and betatrophin. However, in contrast to our study, the authors included overweight/obese patients and glucose tolerance was not evaluated before recruitment. What the results of this study add: Our results showed that serum betatrophin levels were significantly higher in lean glucose-tolerant PCOS women than in age- and BMI-matched healthy controls. What are the implications of these findings for clinical practice and/or further research: Elevated betatrophin levels in PCOS women, in the absence of obesity and glucose intolerance, may reflect a compensatory mechanism in order to counteract metabolic syndrome-related risk factors.

Investigation of oxidant and antioxidant levels in patients with acute stroke in the emergency service.

OBJECTIVE: In this study, we aimed to identify oxidative stress and the disruption in the oxidant-antioxidant balance in the acute phase of stroke and, therefore, to detect markers that will guide in the diagnosis and treatment of stroke. MATERIALS AND METHODS: Eighty-six patients who were admitted to Antalya Training and Research Hospital Emergency Department between June 2013 and December 2013 and who were diagnosed as having stroke were enrolled in this study. The control group consisted of 40 healthy volunteers. Blood samples collected from all participants were screened for albumin, ischemic modified albumin (IMA), IMA/albumin ratio (IMAR), total antioxidant status, total oxidant status (TOS), and oxidative stress index (OSI). RESULTS: Sixty (70%) patients were diagnosed as having acute cerebral infarction (ACI) and 26 (30%) as having acute intracerebral hemorrhage (AIH). Statistically significant difference was found between AIH and control groups in terms of albumin, IMAR, TOS, OSI levels (P < .001, P < .001, P < .001, and P < .001, respectively). Statistically significant difference was found between ACI and control groups in terms of albumin, IMA, IMAR, TOS, and OSI levels (P < .001, P = .045, P < .001, P < .001, and P < .001, respectively). There was no difference between ACI patients with detected acute infarcts on cranial computed tomographic scans (n = 31) and ACI patients with normal cranial computed tomography results (n = 29) in terms of oxidant-antioxidant levels. There was a significant difference between patients admitted within 3 hours and healthy adults regarding the levels of IMAR, TOS, and OSI (P < .001, P < .001, and P < .001, respectively). DISCUSSION AND CONCLUSION: It was seen that oxidant-antioxidant balance was impaired in favor of oxidants in ACI and AIH. In addition, impairment in oxidant-antioxidant balance was found in the early stages of ACI. Therefore, these biomarkers can be used especially in the early diagnosis of thrombolytic therapy candidates in ACI.

Increased serum ghrelin in preeclampsia: is ghrelin a friend or a foe?

OBJECTIVES: To investigate maternal serum ghrelin levels in pregnancies complicated by preeclampsia and to explore the relationship between ghrelin level and disease severity. MATERIALS AND METHODS: This case-control study included 40 healthy pregnant women, 42 women with mild preeclampsia, and 40 women with severe preeclampsia. The groups were matched in terms of maternal and gestational age and body mass index. Serum ghrelin levels were measured via enzyme immunoassay. RESULTS: Serum ghrelin levels were significantly higher in women with mild and severe preeclampsia than in healthy controls (p < 0.001). Although serum ghrelin levels were somewhat higher in the severe compared to the mild preeclampsia group, the difference was not statistically significant (p > 0.05). In the control group, no significant correlation was observed between ghrelin level and any other parameter, but in the preeclampsia group, serum ghrelin levels were negatively correlated with uterine artery Doppler index values and both systolic and diastolic blood pressure (all p-values < 0.05). Multivariate stepwise linear regression analysis revealed that systolic blood pressure (ß = 0.493, p = 0.023) was independently associated with serum ghrelin level. CONCLUSION: Elevated blood ghrelin levels were correlated with disease severity in pregnancies complicated by preeclampsia.

The Cutoff Level for Urine Protein in Urine Immunofixation Electrophoresis.

BACKGROUND: Immunofixation electrophoresis (IFE) maintains its importance in diagnosing monoclonal gammopathies. In particular, urine IFE detects free light chains (FLC) in urine samples even at low concentrations and offers higher sensitivity compared to serum electrophoresis and serum IFE. The aim of the present study was to determine the place and significance of quantitative urinary protein measurement before IFE in interpreting the results of subsequent IFE and to determine the most appropriate protein concentrations for the appearance of bands. METHODS: The records of a total of 600 patients, who underwent screening for Bence Jones proteinuria using IFE on 24-hour urine, were retrospectively reviewed. Urine IFE was performed using Helena SAS-I and SAS-I devices. The total protein concentration in the urine was quantitatively determined by the Pyrogallol red method, and the urine albumin level was determined using the immunoturbidimetric method. These analyses were measured on an Olympus/Beckmann AU5800. RESULTS: The evaluation of IFE results revealed that 311 patients had normal results, 108 patients had monoclonal bands, five patients had biclonal bands, 28 had polyclonal bands, and 148 patients had various degrees of proteinuria. ROC curves were created in order to determine the most appropriate urinary protein and albumin levels to observe bands in IFE. Accordingly, urine baseline protein level (mg/dL) showed the highest AUC value (cutoff value: 19.4 mg/dL, sensitivity: 92%, specificity: 98.2%, AUC: 0.972). CONCLUSIONS: The present study showed that quantitative protein measurement before IFE eliminated the disadvantages associated with the IFE method and its interpretation.

The Diagnostic Value of Oxidative/Antioxidative Balance Parameters in Venous Thromboembolism.

BACKGROUND: The aim of this study is to observe the association between venous thromboembolism (VTE) and oxidative stress and to see if there is a diagnostic value in the oxidative/antioxidative balance parameters like total oxidant status (TOS), total antioxidant status (TAS), paraoxonase-(PON1), and arylesterase (ARE) enzyme activities in this specific disease. METHODS: Sixty-nine patients with deep vein thrombosis and/or pulmonary embolism and 40 control subjects were included in the study. Oxidative stress index, total oxidant status, and antioxidant status were examined in addition to the PON1 and ARE enzyme activities in both groups. RESULTS: Serum PON1 and ARE activities were significantly lower in the VTE patients, whereas total oxidant status was higher in patients compared to the controls. CONCLUSIONS: This preliminary study showed that oxidative/antioxidative balance shifted towards the oxidative status in venous thromboembolism. ROC analysis results suggested that the parameters used in this study were not good enough to be used in the diagnosis of VTE.

Evaluation of circulating betatrophin levels in gestational diabetes mellitus.

Experimental data indicate that betatrophin plays a significant role in the regulation of lipid metabolism and glucose homeostasis. In recent years, considerable attention has focused on the relationship between betatrophin and diabetes mellitus in humans. This case-control study included 45 women diagnosed with gestational diabetes mellitus (GDM) and 45 pregnant healthy controls. The groups were matched for maternal and gestational age and body mass index. Serum betatrophin levels were significantly higher in women with GDM (median = 635.8 ng/L; range: 290-1841.6 ng/L) compared to control subjects (median = 320.1 ng/L; range: 94.6-936.8 ng/L; p = 0.001). No significant correlations were observed between serum betatrophin levels and clinical or biochemical parameters in the control group. However, in the GDM group, serum betatrophin levels were positively correlated with weight gain during pregnancy (r = 0.304, p = 0.042), systolic blood pressure (r = 0.394, p = 0.007), fasting insulin level (r = 0.348, p = 0.019), and homeostatic model assessment insulin resistance (HOMA-IR; r = 0.311, p = 0.038). Multivariate stepwise linear regression analysis revealed that fasting insulin levels (ß = 0.342, p = 0.022) and HOMA-IR (ß = 0.312, p = 0.037) were independently associated with serum betatrophin levels.

Decrease of Urotensin II activity can impact on the volume status in predialysis chronic kidney disease.

Urotensin II (U-II) was thought to be one of the mediators of primary renal sodium retention due to effects on renal sodium excretion. For this purpose, the relationship between U-II and overhydration was investigated. A total of 107 patients were enrolled in the study. According to body compositor monitor analysis, fluid overload up to 1.1 L, was considered normohydration. Patients were divided according to hydration status; overhydrate (n = 42) and normohydrate (n = 65) were studied in both groups. Pulse waveform velocity propagation for arterial stiffness and blood pressure analysis and echocardiographic left ventricular and left atrial indices were performed with known fluid overload-related parameters. U-II levels were measured by using Human ELISA kit. In overhydrated group, U-II levels were significantly lower. All parameters (blood pressure, arterial stiffness parameters, echocardiographic data, age, gender, diabetes, U-II, hemoglobin) correlated with overhydration, were determined by linear regression model (method = enter), when considered together, U-II was found to be an independent predictor from other conventional overhydration-related parameters. Male sex, left ventricular mass index, left atrial volume index, hemoglobin value were found to be independent predictors for overhydration. Considering the association of low U-II levels with adverse cardiovascular events and its role in sodium retention, we think that low U-II levels can be accepted as a potential therapeutic target in patients with hypervolemic cardio-renal syndrome.

Multiple myeloma: relationship to antioxidant esterases.

OBJECTIVE: To investigate the status of the oxidant/antioxidant balance in patients with multiple myeloma compared to healthy controls. MATERIALS AND METHODS: This study was conducted on 40 multiple myeloma patients and 40 healthy controls of matched age and sex. Serum total thiol, oxidative stress index (OSI), total oxidant status (TOS), and total antioxidant status (TAS) were measured using colourimetric methods; paraoxonase-1 and arylesterase enzyme activities were also quantified. RESULTS: Serum paraoxonase-1 and arylesterase activities and total thiol levels were significantly lower (p = 0.0001, p = 0.036 and p < 0.0001, respectively), whereas TOS and OSI levels were significantly higher (p < 0.0001 for both parameters) in multiple myeloma patients compared to controls. However, no significant differences in TAS were identified when the two groups were compared. CONCLUSIONS: Our findings indicate an impaired oxidative/antioxidative balance in multiple myeloma. We recommend further studies with larger groups to investigate the possible relationship between oxidative stress and the aetiopathogenesis of multiple myeloma.

An investigation of the umbilical artery N-terminal proBrain natriuretic peptide levels of fetuses due to fetal distress in term pregnancies.

OBJECTIVE: This study aimed to investigate umbilical artery N-terminal proBrain natriuretic peptide (NT-proBNP) in fetuses delivered by cesarean section due to fetal distress in term pregnancies. METHODS: This prospective case-control study was conducted at the Antalya Training and Research Hospital Obstetric Department, Turkiye. A total of 140 pregnant women, 70 underwent elective cesarean sections between weeks 37 and 40 of gestation (Group 1, the control group) and 70 underwent cesarean sections due to fetal distress (Group 2, the study group), were included. The participants' sociodemographic and obstetric data and fetal umbilical blood NT-proBNP levels were recorded in a database. RESULTS: Age, body mass index, gestational age, prenatal diagnostic tests, fetal anatomical scanning, and baby gender ratios were comparable between the groups (p>0.05), while statistically significant differences were observed in terms of gravidity (3.0 vs. 1.0, p≤0.001) and parity numbers (2 vs. 0, p≤0.001), baby height (50.36±0.88 vs. 49.80±0.86, p≤0.001) and weight (3422.43±409.16 vs. 3239.86±293.74, p=0.003), 1-min Apgar (9.0±0.1 vs. 8.5±1.3, p≤0.001) and 5-min Apgar (10.0±0.1 vs. 9.8±0.4, p=0.026) scores, umbilical artery pH (7.32±0.05 vs. 7.25±0.07, p≤0.001), umbilical artery base deficit (-2.48±1.23 vs. -4.36±1.09. p≤0.001), and NT-proBNP levels [8.77 (7.72-9.39) vs. 12.35 (9.69-12.92), p<0.001]. CONCLUSION: This study showed that NT-proBNP can be used as an important marker in the diagnosis of fetal distress. Prospective studies with more participants are now needed to confirm the accuracy of our results.

Effect of ischemia-reperfusion injury on elafin levels in rat liver.

BACKGROUND: The aim of this study was to quantify serum levels of elafin, a serine protease inhibitor, and to assess its effects on histopathological and biochemical parameters in hepatic ischemia-reperfusion injury. METHODS: Forty female Wistar albino rats were divided into five groups: Group 1 served as the control group. Liver ischemia was induced for 30 minutes in the other four groups. An additional 1-hour, 2-hour, and 3-hour reperfusion was induced in Groups 3, 4, and 5, respectively. At the end of the experiment, intracardiac blood samples were obtained for biochemical examination, and tissue samples from the liver were taken for histopathological examination. Levels of elafin, ischemia-modified albumin (IMA), total antioxi-dant status (TAS), and total oxidant status (TOS) were also examined. RESULTS: Serum elafin levels decreased beginning from Group 2, with the lowest level reached in Group 5 (p<0.01). The IMA level was the lowest in the control group and the highest in Group 5 (p<0.01). TOS, aspartate aminotransferase (AST), and alanine amino-transferase (ALT) levels were lowest in the control group and highest in Group 5 (p<0.01). Group 5 had the highest IMA/albumin ratio, although no significant differences were found between these four groups. The lowest TAS level was found in the control group, but a stable and significant increase was not detected in the other groups. No significant differences were found between the groups in terms of alkaline phosphatase (ALP) and albumin levels. A negative correlation was observed between serum elafin levels and AST, ALT, and TOS levels (p<0.01). The number of Grade 1 histopathological results was found to be higher in the groups with reperfusion (Groups 3, 4, 5). In histopathological subgroup analysis, while the elafin level was lower in Grade 1 group, AST, ALT, and TOS levels were higher (p<0.01). Additionally, the IMA/albumin ratio was found to be higher in the Grade 1 group (p=0.02). CONCLUSION: In hepatic ischemia-reperfusion injury, elafin levels decreased as the reperfusion time increased. As the reperfusion time increased, both hepatocyte damage and oxidant capacity increased, with a negative correlation observed between these findings and elafin levels. Therefore, elafin may play a protective role in hepatic ischemia-reperfusion injury and could assist clinicians in assessing liver injury.

Practicability of Serum Kallistatin Levels as a Biomarker in the Diagnosis of Tubo-Ovarian Abscess.

Objective: This study investigates the practicability of serum kallistatin as a biomarker in the diagnosis of tubo-ovarian abscess (TOA) because C-reactive protein (CRP) is insufficiently specific for diagnosis. Methods: Thirty patients (control group) who presented for elective gynecological surgeries and 30 who were hospitalized due to TOA (study group) at the Antalya Training and Research Hospital Gynecology Clinic, Türkiye, between January 1 and December 31, 2022, were included in the study. Blood samples were collected for the calculation of complete blood count, biochemistry, CRP, and serum kallistatin values, and the results were recorded in a database. Results: Although no significant differences were observed between the control and study groups in terms of age or body mass index, significant differences were observed in terms of marital status, number of pregnancies, parity number, intrauterine device history, and previous surgical history (p > 0.05). Serum hemoglobin levels (12.61 ± 1.30 vs. 11.47 ± 1.77; p = 0.008), white blood cell (7.9 [6.15 ± 9.7] vs. 17.0 [11.6-19.6]; p < 0.001), neutrophil (4.6 [3.6-6.12] vs. 13.6 [9.25-16.1]; p < 0.001), lymphocyte (2.51 ± 0.71 vs. 2.33 ± 0.69; p = 0.307), and platelet counts (285.63 ± 78.0 vs. 407.03 ± 131.96; p < 0.001), neutrophil-lymphocyte ratio (2.11 ± 0.93 vs. 6.18 ± 2.20; p < 0.001), neutrophil-lymphocyte ratio (123.16 ± 52.63 vs. 184.39 ± 63.90; p < 0.001), hs-CRP (1.20 [5.55-1.92] vs. 240 [138.25-291.0]; p < 0.001), kallistatin (7.18 ± 3.15 vs. 3.83 ± 3.69; p = 0.006), and urine leukocyte values (1 [0.75-3] vs. 3 [1-6.5]; p = 0.038) also differed significantly between the control and study groups. Conclusion: The study findings show that serum kallistatin levels can be used as a biomarker in the diagnosis of TOA. Further studies involving more participants are now needed to test the accuracy of our results.

Serum testosterone levels and oxidative stress in type 1 diabetes, type 2 diabetes, and obesity.

INTRODUCTION: Obesity, type 1 diabetes mellitus (T1DM), and type 2 diabetes mellitus (T2DM) are metabolic diseases that continue to be a global problem. Testosterone levels in men are affected by several factors, including obesity and DM. Although the relationship between diabetes and testosterone is not fully understood, oxidative stress is thought to play a major role. The aim of this study was to compare serum testosterone levels and oxidative stress markers [total antioxidant status (TAS), total oxidant capacity (TOS), oxidative stress index (OSI), and ischaemic modified albumin (IMA)] among the control group and experimentally induced obese, T1DM, and T2DM rats. MATERIAL AND METHODS: The study included 28 male Sprague-Dawley rats divided into 4 groups: the obesity group were fed a high-fat diet (HFD), the T2DM group received a HFD plus a single dose of streptozocin (STZ), the T1DM group received only STZ, and there was a control group. Serum testosterone, TAS, TOS, OSI, and IMA were analysed. RESULTS: Serum testosterone levels were lower in the T1DM and T2DM groups compared to the control and obesity groups. The TOS levels were highest in the T2DM group, followed by the T1DM group, the obesity group, and finally the control group. No significant difference was found between the obesity group and the control group in terms of TOS levels. Regarding TAS levels, the order observed was control group > obesity group > T2DM > T1DM. Testosterone was positively correlated with TAS and negatively correlated with TOS and OSI. CONCLUSIONS: Increased oxidative stress in diabetes may be an important factor that decreases serum testosterone levels.

Evaluation of Afamin Level after Bariatric Surgery in Patient with Obesity.

BACKGROUND: The aim of this study is to evaluate afamin levels after weight loss in obese patients who underwent laparoscopic sleeve gastrectomy (LSG) and to investigate the relationship between them. In addition, after bariatric surgery, thyroid stimulating hormone (TSH), thyroxine (T4), low-density lipoprotein (LDL), very low-density protein (VLDL), total cholesterol, triglyceride (TG), high-density lipoprotein (HDL), insulin, and hemoglobin A1c (HgbA1c) levels were evaluated. METHODS: Preoperative and postoperative 6th month venous blood samples were obtained from 43 patients included in this study. The preoperative and postoperative 6th month body mass index (BMI), TG, total cholesterol, VLDL, HDL, insulin, HgbA1c, TSH, T4, and afamin levels of the patients who underwent bariatric surgery with obesity were compared. RESULTS: Serum afamin levels of patients decreased at 6 months postoperatively; however, it was not statistically significant. We observed a statistically significant decrease in patients' BMI, HDL, VLDL, TG, total cholesterol, TSH, T4, HgbA1c, and insulin values (p < 0.05). There were significant increases in HDL and T4 values. The change in LDL value was statistically insignificant. CONCLUSIONS: Recent studies have shown that there may be a cause-effect relationship between afamin and obesity. In our study, we observed a decrease in serum afamin levels after weight loss following bariatric surgery. In addition, we think that afamin may be used as a potential marker of metabolic syndrome in the future and may lead to improvements in the medical treatment of obesity.