The effect of acid use as a preservative on the results of biochemical tests measured in 24-h urine.

Twenty-four-hour urine measurements play a crucial role in the diagnosis, follow-up and treatment of various diseases. There are different approaches to the collection of urine in patients who need to collect multiple urine samples at a time, especially in hospitals with heavy workloads. In this study, we compared the sodium, potassium, chloride, amylase, calcium, creatinine, phosphorus, microalbumin, protein, magnesium, urea, uric acid, adrenaline, noradrenaline, dopamine, metanephrine, normetanephrine, vanillylmandelic acid, 5-hydroxyindoleacetic acid and homovanillic acid results of 24-h urine samples analyzed immediately without acid addition, which we accepted as the reference and baseline measurement, with the results of the samples analyzed after waiting for 24 h without acid addition, analyzed immediately with acid addition and analyzed after waiting for 24 h with acid addition. Chloride, microalbumin, amylase and protein tests, which are recommended to be measured in the sample without preservatives, are affected by acid addition. Adrenaline, noradrenaline and dopamine, which are the tests recommended to be measured in acid-added urine are degraded in the samples without acid, and the levels of metanephrine and normetanephrine were not significantly degraded in the absence of preservatives.

Convalescent plasma therapy in patients with COVID-19.

INTRODUCTION: Passive antibody therapy has been used to immunize vulnerable people against infectious agents. In this study, we aim to investigate the efficacy of convalescent plasma (CP) in the treatment of severe and critically ill patients diagnosed with COVID-19. METHOD: The data of severe or critically ill COVID-19 patients who received anti-SARS-CoV-2 antibody-containing CP along with the antiviral treatment (n = 888) and an age-gender, comorbidity, and other COVID-19 treatments matched severe or critically ill COVID-19 patients at 1:1 ratio (n = 888) were analyzed retrospectively. RESULTS: Duration in the intensive care unit (ICU), the rate of mechanical ventilation (MV) support and vasopressor support were lower in CP group compared with the control group (p = 0.001, p = 0.02, p = 0.001, respectively). The case fatality rate (CFR) was 24.7 % in the CP group, and it was 27.7 % in the control group. Administration of CP 20 days after the COVID-19 diagnosis or COVID-19 related symptoms were associated with a higher rate of MV support compared with the first 3 interval groups (≤5 days, 6-10 days, 11-15 days) (p=0.001). CONCLUSION: CP therapy seems to be effective for a better course of COVID-19 in severe and critically ill patients.

Arsenic-induced inflammation in workers.

Occupational and environmental exposures to metal and metalloids can result in neurotoxicity and immunotoxicity. Selenium (Se) is essential for the proper functioning of neutrophils, macrophages, natural killer (NK) cells, T-lymphocytes and other immune mechanisms, while zinc (Zn) is a trace element essential for basic cell activities, including cell growth and differentiation. Arsenic (As) may lead to different types of immunosuppressive effects. This study consisted of 62 male workers, who had been exposed to arsenic for different durations and 73 non-exposed male workers (control group) with no history of occupational toxic metal exposure. Whole blood and serum samples were taken from each participant for immunological, toxicological and routine analysis during their annual periodical examination. Arsenic, selenium and zinc levels were determined by the ICP-MS and cytokines, IL-6, IL-10, TNF-α, sE-selectin and VCAM-1, were measured by ELISA. There were statistically significant differences (p < 0.001) between control and As-exposed group in As (1.37 ± 0.42 vs. 4.27 ± 1.54 µg/L) and Se levels (106.37 ± 48.04 vs. 74.70 ± 30.45 µg/L). The changing levels of As, Zn and Se seems to affect the severity of inflammatory reactions based on IL-6, IL-10 and TNF-α levels (r = 0.755, r = 0.679 and r = 0.617, respectively, for all p < 0.01). Selenium was found to have a suppressive effect on cytokines, as evidenced by Pearson correlations and regression analysis. These findings support the need to closely monitor Se levels in individuals exposed to arsenic and benefits for Se supplementation in the case of arsenic exposure, occupationally or environmentally.

Comparison of noninvasive and invasive point-of-care testing methods with reference method for hemoglobin measurement.

BACKGROUND: Rapid and practical point-of-care testing (POCT) devices become more popular, especially in blood donation centers for determining predonation hemoglobin (Hb) concentrations. The purpose of this study was to evaluate accordance between the POCT methods and the venous method as the reference to Hb screening. METHODS: A total of 353 subjects with no known significant health problems were included in the study. Hb screening was performed by two different POCT methods, a noninvasive method (Haemospect, MBR, Germany) and an invasive method (HemoControl, EKF Diagnostic, Germany), and a venous method as the reference (Sysmex XE-2100, Sysmex Europe, Germany). The obtained results were compared. RESULTS: The sensitivity and the specificity values of the invasive POCT method (83.3%, 87.9%) were higher than the noninvasive POCT method (66.7%, 77.1%). The Bland-Altman analysis was evaluated for both sexes and the bias of the noninvasive POCT method of the males (-0.97 g/dL) was higher than the bias of the invasive POCT method of the males (-0.07 g/dL). We found a better correlation between the invasive POCT method (r = .908) compared with the venous method than the noninvasive POCT method (r = .634). CONCLUSION: Predonation Hb measurements must be performed with accurate, precise, and practical methods. Although the noninvasive POCT method was practical and painless, it had lower levels of specificity and sensitivity, and more false deferral and pass rates than the invasive POCT method. The POCT methods agreeable to the venous method as the reference might be suitable for Hb screening especially for centers of excessive numbers of blood donation.

A novel clinical index for the assessment of RVD in acute pulmonary embolism: Blood pressure index.

BACKGROUND: This study aims to investigate the role of the blood pressure index (BPI), which is a new index that we developed, in detection of right ventricular dysfunction (RVD) in acute pulmonary embolism (APE). METHODS: A total of 539 patients, (253 males and 286 females), diagnosed with APE using computer tomography pulmonary angiography were included in the study. The BPI was obtained by dividing systolic blood pressure (SBP) by diastolic blood pressure (DBP). RESULTS: Mean DBP (75±11mmHg vs 63±15mmHg; p<0.001, respectively) was found to be higher in RVD patients compared to those without RVD, whereas BPI (1.5±0.1 vs 1.9±0.2; p<0.001, respectively) was lower. Examining the performance of BPI in prediction of RVD using receiver operating characteristic curve analysis (area under curve±SE=0.975±0.006; p<0.001), it was found that BPI could predict RVD with very high sensitivity (92.8%) and specificity (100%) and had a positive predictive value of 100% and a negative predictive value of 42.1%. According to the analysis, the highest youden index for the optimal prediction value was found to be 0.478 and the BPI≤1.4 was found to predict mortality 68.6% sensitivity and 80.8% specificity (Area under curve±SE=0.777±0.051; p<0.001). CONCLUSIONS: We found that BPI was an index with high positive predictive value and low negative predictive value in detection of RVD.

Diagnostic validity of hematologic parameters in evaluation of massive pulmonary embolism.

BACKGROUND: The aim of this study was to determine the hematologic parameter with the highest diagnostic differentiation in the identification of massive acute pulmonary embolism (APE). METHODS: A retrospective study was performed on patients diagnosing with APE between June 2014 and June 2016. All radiological and laboratory parameters of patients were scanned through the electronic information management system of the hospital. PLR was obtained from the ratio of platelet count to lymphocyte count, NLR was obtained from the ratio of neutrophil count to lymphocyte count, WMR was obtained from white blood cell in mean platelet volume ratio, MPR was obtained from the ratio of mean platelet volume to platelet count, and RPR was obtained from the ratio of red distribution width to platelet count. RESULTS: Six hundred and thirty-nine patients consisting of 292 males (45.7%) and 347 females (54.3%) were included in the research. Independent predictors of massive risk as compared to sub-massive group were; pulmonary arterial systolic pressure (PASP) (OR=1.40; P=.001), PLR (OR=1.59; P<.001), NLR (OR=2.22; P<.001), WMR (OR=1.22; P<.001), MPR (OR=0.33; P<.001), and RPR (OR=0.68; P<.001). Upon evaluation of the diagnostic differentiation of these risk factors for massive APE by employing receiver operating characteristic curve analysis, it was determined that PLR (AUC±SE=0.877±0.015; P<.001), and NLR (AUC±SE=0.893±0.013; P<.001) have similar diagnostic differentiation in diagnosing massive APE and these two parameters are superior over PASP, MPR, WMR, and RPR. CONCLUSION: We determined that the levels of NLR and PLR are superior to other parameters in the determination of clinical severity in APE cases.

The relationship between procalcitonin and thyroid autoantibodies in patients with autoimmune thyroiditis.

BACKGROUND: The aim of this study is to investigate the serum levels of procalcitonin and its association with autoantibodies in patients with euthyroid Hashimoto's thyroiditis. METHODS: A total of 80 participants were included in the study; 40 of which were newly diagnosed with Hashimoto's thyroiditis, aged over 18, and 40 of which were healthy volunteers. The serum levels of procalcitonin were measured by enzyme-linked immunosorbent assay kit. Thyroid function tests were analyzed in hormone laboratory with Electro-chemiluminescence immunoassay. RESULTS: Hashimoto's thyroiditis patients had higher median procalcitonin levels than those of the control group (34.3 pg/mL vs 27.8 pg/mL respectively; P=.037). Also, male patients had higher median procalcitonin levels as compared to female patients (37 pg/mL vs 27 pg/mL respectively; P=.013). In the Hashimoto's thyroiditis group, procalcitonin level was positively correlated with anti-thyroglobulin and anti-thyroid peroxidase levels (r=.559, P<.001; r=634, P<.001, respectively). The procalcitonin and anti-thyroid peroxidase levels were identified to be an independent predictor in diagnosis of Hashimoto's thyroiditis. CONCLUSIONS: The fact that procalcitonin was found to be correlated with thyroid autoantibodies and found to be an independent risk factor for Hashimoto's thyroiditis in the regression analysis in the framework of this study urges us to think that procalcitonin may be associated with the autoimmunity.

Inflammation and chemerin in colorectal cancer.

Chemerin is expressed mainly in the adipose tissue. It is an agonist of chemokine-like receptor-1, which is expressed by the immune system cells. Chemerin stimulates the chemotaxis of the immune system cells, and this indicates the function of chemerin and chemokine-like receptor-1 in the immune response. The tumor microenvironment is very important for determining cancer cell growth and spreading. Therefore, we aimed to investigate the association between colorectal cancer, inflammation, and adipokines including chemerin, adiponectin, and vaspin. The study group consisted of patients with colon cancer, whereas the control subjects consisted of patients with benign conditions, diagnosed with colonoscopy. The two groups were compared in terms of the C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fibrinogen, adiponectin, chemerin, and vaspin. A total of 41 (28 men, 13 women) patients with confirmed colon cancer, and 27 (15 men, 12 women) controls without, confirmed by colonoscopy, were enrolled. The median chemerin levels were found significantly higher in the study group than the controls (390 vs. 340 ng/mL, p = 0.032), whereas the mean vaspin and adiponectin levels were not significantly different. The median values for the CRP, fibrinogen, and ESR were significantly higher in the patients with colon cancer, when compared to the control group (6.08 vs. 1.4 mg/L, p < 0.0001; 408 vs. 359 mg/dL, p = 0.002; and 30 vs. 8 mm/h, p < 0.0001, respectively). Our results show that higher levels of circulating chemerin, CRP, fibrinogen, and ESR are associated with an increased risk of developing colorectal cancer.

Is disulphide/thiol ratio related to blood pressure in masked hypertension?

Dynamic thiol/disulphide homeostasis plays a critical role in numerous intracellular enzymatic pathways including antioxidant defence and detoxification. In this study, we sought to investigate dynamic thiol/disulphide homeostasis in patients with masked hypertension (MHT) and its relationship with blood pressure. Forty patients (23 men, 17 women) with newly diagnosed MHT and not yet on medical therapy, and 40 healthy volunteers (21 men, 19 women) were enrolled. Blood thiol/disulphide homeostasis was measured in both groups. Serum native and total thiol levels were measured using the novel, fully automated colorimetric method developed by Erel et al. Serum disulphide level was calculated as (serum total thiol - serum native thiol)/2. Native and total thiol levels (p = 0.001) and native thiol/total thiol ratio (p = 0.023) were found to be lower in patients with MHT when compared to those of the control group. Disulphide level and ratios of disulphide/native thiol and disulphide/total thiol were higher in patients with MHT than in the control group (p = 0.001). A positive correlation of systolic blood pressure (SBP) and diastolic blood pressure (DBP) was observed with disulphide/native thiol ratio (p < 0.001). Stepwise multivariable regression analysis showed disulphide/native thiol ratio to be an independent risk factor of SBP and DBP, and SBP to be an independent risk factor of disulphide/thiol ratio (p = 0.001). In this study, we found that dynamic thiol/disulphide homeostasis shifted towards disulphide formation due to thiol oxidation in patients with MHT. Prospective randomised controlled studies are required to elucidate whether abnormal thiol/disulphide status lies in the pathogenesis of MHT or is a consequence of MHT.

Dynamic thiol/disulfide homeostasis in patients with autoimmune subclinical hypothyroidism.

OBJECTIVE: The aim of this study was to investigate dynamic thiol/disulfide homeostasis in autoimmune subclinical hypothyroidism. METHODS: Forty-eight patients with a new diagnosis of subclinical hypothyroidism due to Hashimoto thyroiditis who were not yet under medical therapy, and 48 healthy control subjects were enrolled. Thiol/disulfide homeostasis [native thiol-disulfide exchanges] was measured in both groups using the automated method developed by Erel and Neselioglu. An absolute difference of 0.5 between the total thiol and native thiol concentrations revealed the disulfide bond amount. RESULTS: The native thiol level (p = 0.014) and native thiol/total thiol ratio (p = 0.001) were lower in patients with subclinical hypothyroidism than in the control group. Meanwhile, the disulfide level (p = 0.004), disulfide/native thiol ratio (p = 0.001), and disulfide/total thiol (p = 0.001) ratio were higher in patients with subclinical hypothyroidism than in the control group. The antithyroid peroxidase and anti-thyroglobulin levels were positively correlated with the disulfide/native thiol ratio (r = 0.339, p = 0.019; r = 0.243, p = 0.023, respectively) and the disulfide/total thiol ratio (r = 0.133, p = 0.019; r = 0.238, p = 0.026, respectively) and negatively correlated with the native thiol/total thiol ratio (r = -0.292, p = 0.004; r = -0.233, p = 0.022, respectively). CONCLUSION: We found that thiol/disulfide homeostasis shifted to disulfide formation in patients with subclinical hypothyroidism and that thyroid autoantibodies were positively correlated with thiol oxidation. It is not clear whether abnormal thiol/disulfide homeostasis is a cause or a consequence in Hashimoto thyroiditis. Further studies are required.

Comparison of Improvacuter™ tubes with BD Vacutainer™ tubes for various hormones in the aspects of stability and influence of gel separators.

BACKGROUND: Validation of blood collection tubes are important to determine the role of different collection tubes which influence the assurance of laboratory results. We compared two different tubes (Improvacuter™ and Becton Dickinson [BD] Vacutainer™) and investigated the effect of gel and storage time in comparison with each other. METHODS: We compared the results of nine immunoassays performed on UniCel® DxI 800 using blood samples collected in BD Vacutainer SST II Advance tubes, Improvacuter Gel and Clot Activator tubes, BD Vacutainer Clot Activator tubes and Improvacuter tubes. Analytes were measured in all tubes on 3 consecutive days to study the effect of long-term storage. Evaluation of clinical significance was performed based on total allowable error. RESULTS: Estradiol and testosterone concentrations obtained from Improvacuter Gel and Clot Activator tubes and BD Vacutainer SST II Advance tubes remained below the lower limits of analytical range for the same analytes while they were within the limits in BD Vacutainer Clot Activator tubes and Improvacuter tubes. Statistical significance of stability was not clinically significant for the hormone parameters we tested in all four tubes. CONCLUSIONS: Gel containing tubes (both BD and Improve) gave comparable results with the tubes which do not contain gel except for estradiol and testosterone. The use of gel containing tubes for estradiol and testosterone are not recommended on UniCel® DxI 800 according to our results. The change in the analyte concentrations over 48 h remained within the TEA limits for the studied analytes. Improve tubes gave similar results to BD tubes.

Comparison of iSED and Ves-Matic Cube 200 Erythrocyte Sedimentation Rate Measurements With Westergren Method.

BACKGROUND: The erythrocyte sedimentation rate (ESR) test is performed widely in laboratories. Besides the traditional Westergren method, new methods have been developed for ESR measurements. We aimed to compare the instruments using new methods, iSED (Alcor Scientific) and Ves-Matic Cube 200 (Diesse Diagnostica Senese, Italy) with the Westergren method. METHODS: Blood samples from 136 patients were taken into EDTA tubes for automated analyzers and citrated tubes for Westergren method. Patients were divided into three groups- low, medium, and high-according to their sedimentation rates. Precision, stability, and interference studies of the methods were performed. RESULTS: The iSED sedimentation method (n = 136) yielded a slope of (0.61-0.84), with an intercept of (-2.32 to 1.89), which resulted in a mean bias of 13; and the Ves-Matic Cube 200 method (n = 136) yielded a slope of (0.85-1.00), with an intercept of (0.00-3.07), which resulted in a mean bias of 1.4 in Passing-Bablok regression analysis compared to the reference method. CONCLUSION: iSED sedimentation showed a poor correlation and a high bias (>10%) with the Westergren method, and Ves-Matic Cube 200 method showed a higher correlation and a lower bias than the iSED device when compared with Westergren reference method. These instruments should be carefully monitored.

A comparison of the effects of ketamine and remifentanil on renal functions in coronary artery bypass graft surgery.

We have investigated the effects of ketamine-based and remifentanil-based anesthetic protocol on perioperative serum cystatin-C levels, and creatinine and/or cystatin-C-based eGFR equations in terms of acute kidney injury in coronary artery bypass graft (CABG) surgery. Using a simple randomization method (coin tossing), patients were divided into the two groups and not-blinded to the anesthetist. Remifentanil-midazolam-propofol or ketamine-midazolam-propofol-based anesthetic regimen was chosen. Different eGFR formulas using creatinine (MDRD, CKD-EPI, Cockrauft Gault); cystatin-C (eGFR1, eGFR2) or a combination of creatinine and cystatin-C (eGFR 3) were used to calculate estimated glomerular filtration rates (eGFRs). High-sensitive troponin T was used to determine if ketamine use in coronary surgery contributed to myocardial cell damage. Thirty-seven patients were included in the study (remifentanil group = 19, ketamine Group = 18). Urea, creatinine, cystatin-C levels were comparable between the groups in all the measurement times and also postoperative day 2 samples showed statistically higher results compared to baseline (p < 0.001). Effects of ketamine and remifentanil on renal functions were found similar. Creatinine and cystatin-C-based eGFR equations resulted similar in our study. Reversible stage 1 acute kidney injury (AKI) was observed on postoperative day 2 in seven patients from the remifentanil group and six patients from the ketamine group. Hs-troponin T was found to be higher in postoperative day 1 samples; there were no significant difference between the groups. Our results indicated that patients who have normal renal functions undergoing on-pump coronary bypass surgery, effects of ketamine and remifentanil on renal functions in terms of AKI were found to be similar.

Non-functioning adrenal incidentalomas are associated with higher hypertension prevalence and higher risk of atherosclerosis.

INTRODUCTION: Adrenal incidentalomas (AIs) have been associated with an increased incidence of several cardiovascular risk factors. The aim of this study was to investigate plasma adiponectin, leptin, resistin, homocysteine, high sensitive C-reactive protein levels, and carotid intima media thickness (CIMT) in patients with non-functioning AI (NFAI). MATERIALS AND METHODS: This study included data from 28 patients with NFAI (Group 1) and 41 controls (Group 2). Of the patients, 50 were female and 19 were male, and the mean age was 46.7 (range 37-65) years. RESULTS: There were no significant differences between Group 1 and 2 in terms of age, sex, or BMI. Hypertension prevalence was significantly higher in the NFAI group than in the control group (p = 0.01). Both groups had similar lipid, blood glucose, homocysteine, uric acid, high-sensitivity CRP levels. Adiponectin, leptin, and resistin levels were similar in both groups. CIMTs were significantly higher in the NFAI group. CONCLUSION: There is increasing evidence that several cardiometabolic risk factors occur with higher prevalence in non-functioning adrenal incidentaloma patients compared to age-matched healthy subjects. In our study, hypertension prevalence and CIMT were higher in the NFAI group. Serum adipokine levels were similar for both groups.

Evaluation of adipocytokine levels and vascular functions in young aged to middle aged men with idiopathic hypogonadotrophic hypogonadism.

OBJECTIVE: Hypogonadism has major effects on the urogenital system, in addition to other systems, the cardiovascular system in particular. There have been few studies conducted on markers of atherosclerosis, such as flow mediated dilatation (% FMD), carotid intima-media thickness (CIMT) and adipocytokine levels in idiopatic hypogonadotropic hypogonadal (IHH) males mostly in adult patients. The aim of this study was to evaluate the relationship between androgens and adipocytokines and parameters of vascular functions in hypogonadal men. MATERIALS AND METHODS: The study population consisted of 11 treatment naive IHH patients (group 1) and 15 age-matched healthy control males (group 2). A fasting blood sample was obtained for leptin, adiponectin and resistin. The endothelial functions were evaluated by studying % FMD and CIMT by high resolution B-mode ultrasound. RESULTS: No significant differences in age, body mass index, systolic and diastolic blood pressure were recorded between the two groups. The leptin level was significantly higher in group 1, whereas adiponectin and resistin levels were same between two groups. There was a negative correlation between total testosterone and carotid intima-media thickness (r=-0.656, p=0.008), and a negative correlation between total testosterone and leptin level (r=-0.794, p<0.001). No correlation was found between leptin and CIMT (p=0.184). CONCLUSION: Testosterone deficiency in hypogonadal men is associated with vascular parameters of atherosclerosis. The findings may establish indications for testosterone replacement therapy in hypogonadal men.

Evaluation of Ves-Matic Cube 200 for erythrocyte sedimentation rate determination.

BACKGROUND: International Council for Standardization in Haematology suggested Westergren method as the reference method to analyze erythrocyte sedimentation rate (ESR). However, in recent years closed automated systems that measure ESR directly from a capped EDTA blood sample tube have been developed. We evaluated the analytic performance of one of these new methods, the Ves-Matic Cube 200. METHODS: K(2) EDTA and citrated blood samples were taken from 101 randomly selected outpatients in Ankara Numune Education and Research Hospital. The ESR results using Ves-Matic Cube 200 and Westergren as reference method from 101 patients were compared and interference studies were performed. RESULTS: We found the mean difference between the two methods as 0.19 ± 15.85 mm/hr (-3.317 to 2.940 mm/hr, 95% confidence interval). Regression analysis yielded the equation "y = -2.59 + 1.15x" between the two methods (r = 0.82). CONCLUSIONS: Ves-Matic Cube 200 should be monitored carefully for good quality control. Temperature correction should be applied to study control material as recommended by the manufacturer. Ves-Matic Cube 200 device should be monitored carefully, performance studies should be performed, and the results should be checked in order to eliminate the random errors during the routine studies.

The role of irisin and asprosin level in the pathophysiology of prediabetes.

PURPOSE: We aimed to examine whether irisin and asprosin have a role in the physiopathology of prediabetes. METHODS: Hundred people were selected between the age of 18-65 years for the study population (60 prediabetes, 40 healthy). For the follow-up study, the patients with prediabetes were offered a 3-month program for lifestyle change and then reevaluated. Our research is a single-center, prospective observational study. RESULTS: Among the healthy group and patients with prediabetes, irisin levels were lower and asprosin levels were higher (p < 0.001) in patients. In the follow-up part, the patients' insulin levels, HOMA index scores, and asprosin levels were decreased while irisin levels were elevated (p < 0.001). Sensitivity was 98.3% and specificity was 65% for asprosin of > 56.3 ng/mL, while they were 93.3% and 65% for irisin of ≤ 120.2 pg/mL, respectively. It was found that irisin had diagnostic performance similar to insulin and the HOMA index, while asprosin performed similarly to glucose, insulin, and the HOMA index. CONCLUSION: Both irisin and asprosin have been found to be related to the prediabetes pathway and it has been shown that these molecules may be useful in daily clinical practice with diagnostic performances similar to those of the HOMA index and insulin.

Evaluation of serum TWEAK concentration in patients with acute pancreatitis.

BACKGROUND AND AIM: Tumor necrosis factor-like weak inducer of apoptosis (TWEAK) is a member of the tumor necrosis factor super family of structurally-related cytokines. The aim of this study was to determine the diagnostic and prognostic role of serum TWEAK concentration in patients with acute pancreatitis. METHODS: Twenty four patients with acute pancreatitis and 24 consecutive healthy age- and sex-matched control subjects were included in the study. The serum concentrations of TWEAK were measured at admission and then at remission. The average time between admission and remission was 7-10 days. RESULTS: At admission, TWEAK concentration was significantly lower in patients with acute pancreatitis compared to control subjects (p < 0.001). Serum TWEAK concentrations were elevated after the remission period, however the differences were not statistically significant. In addition, serum TWEAK concentration showed a significant, inverse correlation with amylase, lipase, CRP, AST, fibrinogen, LDH and a positive correlation with calcium, albumin and platelet count. CONCLUSIONS: Patients with acute pancreatitis have lower serum TWEAK concentration than healthy subjects. These results suggest that serum TWEAK concentration could be a potential biomarker of acute pancreatitis.

Sialic acid levels in the blood in pregnant women with impaired glucose tolerance test.

PURPOSE: Gestational diabetes (GDM) is a metabolic disease characterized by the impairment of glucose tolerance during pregnancy. Sialic acid (SA) is a component of glycolipid and glycoproteins found in hormone and enzymes in serum and tissues and high serum SA levels are observed in diabetic patients. METHODS: Serum SA levels were investigated in three groups, namely 61 normal pregnant women with normal 50 gr glucose loading test (group 1: gr 1), 36 patients with high 50 gr test values and normal 100 gr test (group 2: gr 2: group with impaired glucose tolerance test, IGT), and 8 patients with diagnosis of GDM (group 3:gr 3). RESULTS: According to Kruskal-Wallis test, significant difference was observed in SA levels between gr1 and gr2-gr3 (p = 0.001). Difference was observed between groups with respect to age (p < 0.001), the number of pregnancies (p = 0.001), BMI (p = 0.001), and diabetes history in the family (p = 0.001) (Table 1). Table 1 Summary of results and statistical relationship Variable Group 1 (n = 61) Group 2 (n = 36) Group 3 (n = 8) p Age 24 (18-38) 28 (19-38) 31 (20-38) <0.001 Pregnancy week 26 (24-29) 26 (24-32) 26,5 (24-29) 0.126 Pregnancy number 2 (0-6) 2 (1-5) 3.5 (1-5) <0.001 BMI 23.7 (17.9-38.2) 27.6 (17.04-41.14) 30.8 (21.9-43.8) <0.001 Weight taken 7 (1-13) 6 (2-12) 6 (4-10) 0.954 Sialic acids 2.66 (1.2-4.59) 3.22 (2.34-5.04) 3.05 (2.67-3.49) <0.001 Fetal weight 3,380 (2,310-4,290) 3,400 (2,650-4,600) 3,655 (3,270-3,960) 0.092 Smoking 5 (%8.2) 2 (%5.6) 0 (%0) 1 Family history 22 (%36.1) 10 (%27.8) 8 (%100) <0.001. CONCLUSION: Our study demonstrated that SA values are increased in GDM and IGT groups, which demonstrates that inflammatory disorders may occur also in IGT group, which is considered like normal pregnancy, and that this group may be considered in the same way as GDM.