Can signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) be used as an indicator of endothelial dysfunction in acromegaly patients?

PURPOSE: Acromegaly is closely related to increased oxidative stress and endothelial dysfunction (ED). This study aimed to evaluate, for the first time in the literature, signal peptide-CUB-EGF domain-containing protein 1 (SCUBE-1) and endothelial nitric oxide synthase e(NOS) levels in the setting of acromegaly. METHOD: A total of 56 acromegaly patients and a control group composed of 30 healthy volunteers were included in this study. In the postoperative follow-up, patients were grouped as active or in-remission according to their GH and IGF-1 levels in oral glucose stimulation test (OGST). After detailed physical examination of acromegaly patients and the control subjects, 8-hour fasting blood samples were collected to evaluate biochemical parameters including lipid profile, anterior pituitary hormones, and SCUBE-1 and e(NOS) levels. RESULTS: Inactive and active acromegaly was noted in 78.6% and 21.4% of patients, respectively. The median (min-max) SCUBE-1 levels were significantly higher in the inactive acromegaly and active acromegaly groups than in the control group (1.6(0.4-2.4) and 1.8(1.1-2.5) vs. 0.4(0.2-1.0) ng/mL, respectively, p < 0.001 for each). The median (min-max) e(NOS) levels were significantly higher in the inactive acromegaly and active acromegaly groups than in the control group (132.7 (26.8-602.9) and 137.3 (69.7-488.7) vs. 83.9 (16.4-218.7) pg/mL, p = 0.018 and p = 0.048, respectively). We have also detected positive correlations of e(NOS) with leukocyte (r = 0.307, p = 0.021) and neutrophil counts (r = 0.309, p = 0.021). CONCLUSION: Our study revealed for the first time in literature that SCUBE-1 levels, being a novel marker for ED, were significantly higher in acromegaly patients than in control subjects. When supported with clinical studies, SCUBE-1can be used as an early indicator of endothelial damage in acromegaly patients.

Functional and biochemical improvement following total knee arthroplasty in early postoperative period.

OBJECTIVE: There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels. METHODS: A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels. RESULTS: In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week. CONCLUSION: Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.

Analytical performance evaluation of sensitive and old generation reagent in routine practical use: estradiol experience.

Evaluation of the analytical performance of tests in medical laboratories is important. Total Error (TE) and sigma analysis have been used as a quantitative indicator of quality for many years. The aim of this study is to evaluate the analytical performance of Beckman Coulter Access Estradiol (E2) and Sensitive E2 reagents. Analytical performance of two reagents were evaluated with TE, six sigma and measurement uncertainty values. Two Beckman Coulter Unicel DxI-800 autoanalyzers (A1 and A2) included in the study. Quality control data between December 2017 and December 2019 were used. CLIA-2019 values were used for total allowable error (TEa) limits. Uncertainty values were calculated with ISO/TS 20914. The median TE of the old generation and sensitive E2 reagent were 27.46% (between 13.49 and 48.88) and 11.16% (between 7.08 and 24.81), respectively (p < .005) The process sigma results were below 3 sigma in all months with the old reagent, whereas with the new reagents it was seen to be above 3 sigma in 11 of 12 months for both autoanalyzers. Uncertainty of old reagent is higher than new reagent. Imprecisions decrease as concentration increases with both reagents. The uncertainty values of low concentration levels are greater than high concentration levels. In conclusion, in both auto analyzers, Sensitive E2 reagent was found to have better performance than old reagent in terms of TE, process sigma and measurement uncertainty. We believe that the sensitive E2 reagent still needs further improvement for patients who have low E2 levels.

Functional and biochemical improvement following total knee arthroplasty in early postoperative period

SUMMARY OBJECTIVE: There are very few studies about total knee arthroplasty biomechanical and biochemical effects in the early postoperative period. The aim of this study was to investigate the effect of total knee arthroplasty on pain intensity, knee joint valgus angle, malalignment, functional status, knee joint position sense, and cytokine levels. METHODS: A total of 29 patients (female/male: 24/5) who underwent total knee arthroplasty were included in the late-stage knee osteoarthritis group, and 22 patients (female/male: 13/9) with grade 4 osteoarthritis were included in the early-stage knee osteoarthritis group. The visual analog scale and the Western Ontario and McMaster Universities Osteoarthritis Index were used to evaluate the pain intensity and functional status. Alignment and knee position sense measurements were also calculated. Systemic venous blood samples were taken to evaluate the interleukin-6, tumor necrosis factor-alpha, and interleukin-1 beta cytokine levels. RESULTS: In the study group, there were positive improvements in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 70° knee flexion angle parameters, and interleukin-6 of patients at the postoperative 6th week compared to the preoperative period (p<0.05). The patients in the study group had similar or better results in pain intensity, functional status, valgus angle, malalignment, amount of joint position sense deviation at 35°, 55°, and 70° knee flexion angles parameters, and in interleukin-6, compared to the control group at postoperative 6th week. CONCLUSION: Total knee arthroplasty provides improvements in pain, function, valgus angle, joint position sense, and interleukin-6 in the early postoperative period.

Reference change value and measurement uncertainty in the evaluation of tumor markers.

The use of measurement uncertainty among clinical laboratories becomes widespread. Measurement uncertainty can be reported with the result, as well as be used in certain reference change value (RCV) calculation equations. RCV is especially recommended for use in tests with a low individuality index. In our study, we calculated the measurement uncertainty of AFP, CA 125, CA 15-3, CA 19-9, CEA tumor markers with the ISO TS 20914:2019. We compared results with limits. Two Beckman Coulter DXI-800 (Minnesota, USA) autoanalysers' results were used. We calculated the RCV values using the classical Fraser method, logarithmic Lund Method, and Clinical Laboratory Standards Institute (CLSI) method as Minimal Difference (MD). We found the same permissible measurement uncertainty limit as 15.97% for all five tumor markers. The highest RCV value was found as 90% upstream for AFP test with Lund logarithmic approach, the lowest RCV value was found as 12% for CEA with MD, all other RCV results were between these two values. We do not recommend the use of MD, as values for Biological variation are not used in the MD approach. We also recommend using the logarithmic approach, although it gives higher results. There are also clinical studies on the significance of tumor markers in a follow-up that show different results. These differences may be because the studies are conducted with different systems. Therefore, each laboratory needs to calculate its own RCV values. We also recommend informing the clinicians about the tests with high measurement uncertainty.

Effects of different lipid emulsions on serum adipokines, inflammatory markers and mortality in critically ill patients with sepsis: A prospective observational cohort study.

BACKGROUND & AIMS: Intravenous lipid emulsions in parenteral nutrition may cause different metabolic responses and immune effects in critically ill patients with sepsis. The aim of this study is to investigate the effects of different lipid emulsions on changes in concentrations of adipokine and cytokine and their relationship with mortality in patients. METHODS: Patients enrolled in this prospective, single-center, observational cohort study, were estimated to require more than ten days of parenteral nutrition. They were treated with soybean oil-based or olive oil-based parenteral lipid emulsions. Adipokine and cytokine concentrations of septic patients were determined at enrollment and ten days after, in accordance with the diagnostic criteria of SEPSIS-3. The concentrations levels were measured in an enzyme-linked immunosorbent assay. Mortality was analyzed using the Kaplan-Meier method and Cox regressions. RESULTS: Over a 25-month period, 145 patients were assessed for eligibility and consequently, 40 patients were analyzed. On admission, both groups had comparable physiological scores, comorbidities, malnutrition risk, anthropometric measurements, metabolic/hematologic biomarkers and concentrations of adipokines and cytokines (p > .05). Serum leptin, resistin, and cytokines (IL-6, IL-10, IL-1ß and TNF-α) decreased significantly in the entire cohort over ten days following sepsis (p < .05). Serum resistin decreased in both olive oil-based and soybean oil-based lipid emulsions groups. Serum adiponectin only decreased in soybean oil-based lipid emulsions group (p < .05). There was association between survival and percentage changes in adiponectin, resistin and visfatin concentrations (log rank test: p < .05). CONCLUSION: Adipokine and cytokine responses are affected by medical nutritional therapy in the sepsis process and adipokines may represent functional prognostic biomarkers in critically ill patients with sepsis.

HMGB-1, TLR4, IL-1R1, TNF-α, and IL-1ß: novel epilepsy markers?

The purpose of this study was to compare HMGB-1, TLR4, IL-1ß, IL-1R1, and TNF-α levels in patients with mild and severe epilepsy with those in a healthy control group. Children aged 4-17 years, diagnosed with epilepsy for at least three years and with no progressive neurological disease, metabolic disease or infection, were selected for the study. The severe epilepsy group consisted of 28 children with at least one episode a week despite receiving three or more antiepileptic drugs. The mild epilepsy group consisted of 29 children with no seizures in the previous year, receiving only one antiepileptic drug, while 27 healthy children were selected as the control group. HMGB-1, TLR4, IL-1R1, TNF-α and IL-1ß levels were investigated in these three groups. The MRI findings and clinical characteristics of the patients in the epilepsy group were also compared with these markers. HMGB-1, TLR4, TNF-α, and IL-1ß levels in the severe epilepsy group were higher than in the control group and the mild epilepsy group (p<0.05), and were higher in the mild epilepsy group than in the control group (p<0.05). IL-1R1 was also higher in the severe epilepsy group than in the control group (p<0.05). In this first report to identity a possible correlation between HMGB-1, TLR4, IL-1ß, IL-1R1, and TNF-α levels and severity of epilepsy, our data demonstrates that the serum level of these cytokines is higher in cases of drug-refractory epilepsy.

Thiol/Disulphide Homeostasis, Ischemia Modified Albumin, and Ferroxidase as Oxidative Stress Markers in Women with Obesity with Insulin Resistance.

BACKGROUND: The purpose of the study was to determine oxidative stress-related plasma thiol/disulphide, ischemia-modified albumin (IMA) levels and ferroxidase activity among women with obesity in insulin-resistant and non-insulin-resistant groups in comparison with an overweight group. METHODS: We compared plasma thiol/disulphide, IMA levels, and ferroxidase activity between the study groups. We analyzed plasma thiol/disulphide homeostasis with a newly developed automated measurement method; IMA with Albumin Cobalt Binding Test and ferroxidase (ceruloplasmin) levels with an automated, colourimetric method. RESULTS: There were no significant differences between insulin-resistant and non-insulin-resistant women with obesity in terms of plasma native thiol, total thiol, disulphide, disulphide/native thiol ratio, disulphide/total thiol or native thiol/total thiol values. Ferroxidase activity was higher in insulin-resistant than in non-insulin-resistant women with obesity and higher in the total women with obesity group than in the overweight subjects (p<0.001, and p=0.014, respectively). IMA was lower in the insulin-resistant group than in the non-insulin-resistant group and overweight groups (p=0.011, and p=0.042, respectively). CONCLUSIONS: The significantly greater increase in ferroxidase activity in insulin-resistant subjects with obesity may reflect its role as a positive acute phase protein. These findings may be related to the pathogenesis of the disease. Changes in oxidative status occur in women with obesity, and partially in overweight subjects. The ferroxidase activity of ceruloplasmin plays a crucial role in iron homeostasis and lowers oxidative stress by reducing the detrimental effects of iron.

Tr-KIT/c-KIT ratio in renal cell carcinoma.

Truncated KIT (tr-KIT) is an alternative variant of c-KIT protein. Previous studies have clearly documented that c-KIT was associated with various oncogenic processes in RCC. However, the biological significance of tr-KIT in RCC development and progression remains unclear. So, it was aimed to investigate the possible association between RCC and tr-KIT which is thought to activate some oncogenic pathways. In this study, Kidney Cancer cDNA Array containing a total of 48 cDNA samples from the normal kidney tissues of 9 healthy subjects and kidney tumor tissues of 10 stage-1, 5 stage-2, 13 stage-3 and 11 stage-4 RCC patients was used for gene expression analysis. Real-Time PCR method was used to measure tr-KIT/c-KIT expression ratios. tr-KIT/c-KIT expression ratio was compared between tumor and normal samples, and statistically correlated with the clinical parameters of RCC patients. tr-KIT/c-KIT expression ratio was approximately 4-times higher in tumor samples than control ones (p = 0.001). Also, tr-KIT/c-KIT expression ratio was approximately two, three and six times higher in Fuhrman nuclear grades 2, 3 and 4 than normal, respectively (p = 0.009). Moreover, clear cell and papillary RCC has a significantly higher level of tr-KIT/c-KIT expression ratio than chromophobe RCC (p = 0.016). In the current study, it was stated for the first time that tr-KIT/c-KIT expression ratio was up-regulated in RCC tissues, and high tr-KIT/c-KIT expression ratio was correlated with more aggressive clinical features and poor patient prognosis. Our results suggest that increased tr-KIT/c-KIT expression ratio might be useful as a prognostic marker for RCC patients.

Blood levels of interleukin-1 beta, interleukin-6 and tumor necrosis factor-alpha and cognitive functions in patients with obsessive compulsive disorder.

BACKGROUND: Cognitive dysfunction and immune system disorders are two actual issues for the patients with Obsessive Compulsive Disorder (OCD). The cognitive dysfunctions have been considered to substantial part of clinical phenomenon of OCD but exploration of various etiopathogenesis of cognitive dysfunction is needed. Immune dysfuncion has been implicated to be important part of pathopysiology of OCD and different lines of evidence suggests immune abnormalities in OCD. But whether these immune changes are traits of disease or secondary to clinical burden of the disease such as cognitive dysfunctions has not been determined. Data regarding relation between the cognitive dysfunctions and immune system disorders in OCD is unsatisfied. In this study we aimed to investigate the relation of blood levels of interleukin 1-beta (IL-1ß), interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) with various neurocognitive functions in patients with OCD in comparison with its autogenous/reactive subtypes and healthy controls. Further exploration of the effects of various clinical variables on cognitive functioning in patients with OCD and additional investigation of whether the cognitive dysfunction associated with this disorder differs from or overlap with that in other anxiety disorders are needed. METHODS: Forty-two patient with OCD and 45 age, sex and educational level matched healthy control were enrolled in the study. The diagnosis of OCD was made with Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Yale- Brown Obsessive-Compulsive Scale, Beck Anxiety and Depression Inventory Scales were administered. Neuropsychological test battery including Wisconsin Card Sorting Test (WCST), Trail Making Test A and B (TMT-A, TMT-B) were used for evaluation of the patients and healthy control. The plasma of interleukin-1beta (IL-1ß), interleukin-6 (IL-6), Tumor Necrosis Factor-Alpha (TNF-α) of both groups were measured with ELISA kits. RESULTS: Blood levels of IL-1ß, IL-6 and TNF-α were significantly higher in patients with OCD than the healthy control. There was significant difference in IL-1ß, IL-6 but not in TNF-α between autogenous/reactive subtypes and healthy controls. TNF-α is positively correlated with TMT-A, TMT-B and Stroop Test Part 5, negatively correlated with immediate memory, verbal learning, interference effect, immediate recall, delayed recall and recognition in RAVLT. IL-1ß was positively correlated with TMT-A score. IL-6 was positively correlated with scores of TMT-A, TMT-B. IL-6 was negatively correlated with immediate memory, verbal learning, interference effect, immediate recall and delayed recall in RAVLT, positively correlated with number of perseverative error and negatively correlated with the number of categories completed in WCST. CONCLUSION: This is the first study that investigates the relation of IL- 1ß, IL-6 and TNF-α levels with cognitive functions in OCD. There may be a contribution to pathogenesis of OCD and subtypes then new choices for treatment might be developed. Moreover, uncovering the effect of cytokine blood levels on cognitive function of OCD, new data concerning etiopathogenesis and further treatment choices can be gained.

Acute pancreatitis in children: A single center experience over ten years.

Sag E, Kaya G, Bahat-Özdogan E, Karahan SC, Imamoglu M, Sarihan H, Çakir M. Acute pancreatitis in children: A single center experience over ten years. Turk J Pediatr 2018; 60: 153-158. Acute pancreatitis (AP) is an inflammatory disease characterized by sudden onset abdominal pain together with elevation of pancreatic enzymes and radiographic changes. Increased incidence of AP in children have been reported in recent reports. In this study; we aimed to analyze the demographic characteristics, etiology, outcome and incidence of AP among hospitalized children in our center. Medical records of the children with AP since January 2005 were analyzed from hospital files (N=63). Major etiologies were systemic diseases (14.3%), trauma (11.1%), cholelithiasis (9.5%); 54% (N=34) of the patients had mild AP, while 28.6% (N=18) had moderately severe AP and 17.4% (N=11) had severe AP. Organ dysfunction was found in 11 patients (17.4%) at initial examination. During the follow-up period (68.1±24.3 months), 10 patients (15.9%) experienced 24 recurring AP (RAP) attacks. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic and hereditary diseases were associated with the increased risk of RAP (p < 0.05 for all). The mortality rate associated with AP was 4.84%. There was an increase in the incidence of AP since 2010 (9.57 in 2009-2010 vs. 39.17/10,000 patients in 2015-2016 years; p=0.0002; OR: 4.1) among the hospitalized patients. Our results indicate that AP is a mild disease in children and the incidence is increasing among hospitalized children. Male gender, presence of local pancreatic or systemic complications at initial attack, metabolic diseases and hereditary diseases were associated with the increased risk of RAP.

Circulating parameters of oxidative stress and hypoxia in normal pregnancy and HELLP syndrome.

BACKGROUND: The HELLP syndrome (Hemolysis, Elevated Liver enzymes and Low Platelets) is a complication of severe pre-eclampsia, a condition characterized by oxidative stress elevation caused by disequilibrium between lipid peroxidation and antioxidant defense mechanisms, which, in turn, results in endothelial compromise and free radical-mediated cell damage. While several studies have examined the relationship between pre-eclampsia and oxidative stress, research investigating oxidative and hypoxic status in HELLP syndrome is limited. OBJECTIVES: The aim of this study was to compare the levels of oxidative stress markers - total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and malondialdehyde (MDA) - and a hypoxia marker - carbonic anhydrase IX (CA IX) - in patients with HELLP syndrome and in healthy pregnant women. MATERIAL AND METHODS: A total of 23 women with HELLP syndrome and 30 healthy pregnant women were included in the study. Serum levels of oxidative stress markers were determined using colorimetric methods, while serum levels of CA IX were measured using an enzyme-linked immunosorbent assay (ELISA) kit. RESULTS: The TOS, OSI, MDA, and CA IX levels were significantly higher in women with HELLP syndrome than in the controls (p = 0.0001, p = 0.0001, p = 0.0001, and p = 0.008, respectively). CONCLUSIONS: Increased levels of oxidative stress and hypoxia markers in women with HELLP syndrome suggest that oxidative stress and hypoxia may be significantly involved in the pathophysiology of the disease. Further follow-up studies are now needed to investigate the prognostic roles of these parameters in patients with HELLP syndrome.

A Comparison of the Effects of Grayanotoxin-Containing Honey (Mad Honey), Normal Honey, and Propolis on Fracture Healing.

OBJECTIVES: Delayed healing and non-union of fractures have a significant effect upon patient morbidity. Studies have therefore largely concentrated on accelerating fracture healing. This study was intended to compare the effect of "mad honey" and propolis on fracture healing using radiological and histopathological analysis. SUBJECTS AND METHODS: Femur fracture was surgically performed on 48 rats, followed by fixation. Animals were then divided into 8 groups: 2 control groups (15- and 30-day) and 6 treatment groups (15- and 30-day normal honey, 15- and 30-day "mad honey," and 15- and 30-day propolis). Rats were sacrificed at the end of these periods, and radiological and histological examinations were performed. RESULTS: Radiological healing in the propolis group after 15-day therapy was statistically better than in the control (p = 0.004) and normal honey (p = 0.006) groups. After 30-day therapy, healing in the propolis group (p = 0.005) and grayanotoxin-containing "mad honey" group (p = 0.007) were significantly better than in the control group. Histologically, there was a statistically significant difference between the 15-day propolis group and the other groups (control, honey, mad honey: p = 0.003, p = 0.003, and p = 0.002, respectively). We also found a statistically significant difference when the 30-day propolis group (p = 0.005) and "mad honey" group (p = 0.007) were compared to the control group. CONCLUSIONS: This study shows that grayanotoxin-containing "mad honey" and propolis can accelerate fracture healing.

Carbonic anhydrase I-II autoantibodies and oxidative status in long-term follow-up of patients with Crimean-Congo haemorrhagic fever.

CONTEXT: Crimean-Congo haemorrhagic fever (CCHF) is a life-threatening acute febrile haemorrhagic disease. OBJECTIVE: This study was to measure levels of the oxidative stress biomarkers malondialdehyde (MDA), total oxidant status (TOS), total antioxidant status (TAS) and oxidative stress index (OSI) and of CA I-II autoantibodies as biomarkers for autoimmunity and course of disease in patients with CCHF. METHODS: Seventy CCHF patients and 39 healthy control volunteers were included in the study. RESULTS: Serum MDA and TAS levels were significantly higher (p < .0001) and serum TOS and OSI levels were significantly lower (p < .0001) in both the acute period and at 6th-month follow-up in the CCHF patients compared to the healthy volunteers. CA II levels were significantly higher in the acute period compared to the healthy volunteers (p < .005) and were significantly lower at 6th-month follow-up (p < .05). CONCLUSION: Serum MDA and CA II autoantibodies appear to reflect oxidative stress status and disease progression in CCHF and may be used as biomarkers for oxidative stress and disease progression.

The prognostic significance of serum TGF-ß1 levels in patients with Crimean-Congo hemorrhagic fever.

Crimean-Congo Hemorrhagic Fever (CCHF) may exhibit a mild clinical course or a severe profile like mortal bleeding. The pathogenesis of the illness and reason of bleeding are unclear. However, endothelial injury is a key factor in the pathogenesis of the illness. Transforming growth factor beta (TGF-ß) is one of the materials involved in repairing injured endothelium. This is a significant polypeptide released in pretty much all cells and important for the regulation of cellular events, epithelium formation, inflammation, blood coagulation, and collagen synthesis. This study aimed to determine the prognostic significance of serum TGF-ß1 levels in CCHF patients. We examined 120 patients hospitalized with CCHF diagnosis and their serum TGF-ß1 was investigated, retrospectively. Patients were put into two groups according to the existence of hemorrhage. Forty-four (36.7%) patients had hemorrhage. TGF-ß1 levels in patients with bleeding were 5.2 ± 1.8, and 7.1 ± 2.2 for non-bleeding (P < 0.0001). When ROC analysis was performed in patients with CCHF alone in order to identify patients with bleeding, at a TGF-ß1 cut-off point of 4.9, AUC was 0.762 (0.675-0.835), sensitivity 59.1%, specificity 85.5%, PPV 70.3%, and NPV 78.3%. We summarize that TGF-ß1 level and endothelial dysfunction can be related. A decreased TGF-ß1 level is a likely prognostic and diagnostic factor for bleeding in CCHF patients. Therefore, this marker should be considered in the treatment strategy for these patients. J. Med. Virol. 89:413-416, 2017. © 2016 Wiley Periodicals, Inc.

Prognostic impact of platelet distribution width in patients with Crimean-Congo hemorrhagic fever.

Platelet distribution width (PDW) is a readily available blood test involving calculations performed by automated blood analyzers. Crimean-Congo hemorrhagic fever (CCHF) may exhibit a severe profile with fatal hemorrhaging or else present with a mild clinical process. The purpose of our study was to investigate the importance of PDW in CCHF patients and its clinical prognostic value. This study was conducted with patients with CCHF. Patients were divided into two groups on the basis of presence or absence of bleeding. Demographic characteristics, clinical findings, PDW, and other laboratory tests were recorded onto forms. A total of 423 patients were included. Hemorrhaging was observed in 27.9% during hospitalization. PDW on the first day of hospitalization was 17.2 ± 0.9% in the hemorrhagic patients and 17.1 ± 0.6% in the cases without hemorrhage (P = 0.290). On the third day of hospitalization, PDW was 17.6 ± 0.8% in the hemorrhagic patients and 17.0 ± 0.7% in the cases without hemorrhage (P < 0.001). At a third-day PDW level cut-off point of 17.1%, AUROC was 0.677, sensitivity 65.5%, specificity 54.6%, PPV 35.5%, and NPV 80.6%. A one-unit raise in third day PDW stepped up the probability of bleeding in patients with CCHF 3.45-fold at logistic regression analysis. This study shows that PDW is a parameter that may be used to determine disease severity. This parameter may be at least as useful as platelet count in helping clinicians identify severe cases. Early identification of cases with a severe course will make it possible to provide early planning of modalities such as intensive care support. J. Med. Virol. 88:1862-1866, 2016. © 2016 Wiley Periodicals, Inc.

Systemic oxidant/antioxidant balance in human abdominal aortic aneurysm.

The aim of this study was to evaluate the oxidant-antioxidant balance in patients with abdominal aortic aneurysms (AAA). Forty-two consecutive patients with AAA and 46 control subjects were included. Total oxidant status (TOS) and total antioxidant status (TAS) levels were measured and the oxidative stress index (OSI) value determined. Serum TOS and OSI values in patients with AAA were higher than those in the controls (p < 0.001, p < 0.001, respectively). There was a positive correlation between abdominal aortic diameters, serum TOS levels (r = 0.592, p < 0.001) and OSI values (r = 0.598, p < 0.001). A cut-off value of 17.68 µmol H2O2equivalent/L for TOS was associated with 86% sensitivity and 83% specificity and a cut-off value of 1.77 for OSI was associated with 86% sensitivity and 81% specificity for predicting AAA. Systemic oxidative imbalance develops in patients with AAA, particularly as a result of an increase in TOS.

A new player in chronic kidney disease mineral and bone disorder: tenascin-C.

AIMS: Chronic kidney disease-mineral and bone disorder (CKD-MBD) is a condition frequently observed in CKD. The search for a reliable and easy to use biomarker in the diagnosis of CKD-MBD is continuing. Tenascin-C (TN-C) is an important extracellular (ECM) protein synthesized by osteoblasts during bone growth and morphogenesis. The purpose of this study was to assess the relation between inflammation and MBD and TN-C in HD patients and to identify a new marker that can be used to help diagnose CKD-MBD. MATERIALS AND METHODS: 136 HD patients and 22 healthy controls were enrolled in this cross-sectional, observational multicenter study. Once patients' demographic and biochemical parameters had been recorded, peripheral blood samples were collected for TN-C measurement before the mid-week HD session. The relationship between TN-C levels and demographic and biochemical parameters was then assessed. RESULTS: TN-C levels were significantly higher in the HD patient than in the control group (P<.001). Intact parathormone (iPTH) affected TN-C levels in the HD patient group. TN-C levels was significantly higher in both the high (>300 pg/ml) and low iPTH groups (<150 pg/ml) compared to the 150-300 pg/ml iPTH group (P<.001, <.001 respectively). CONCLUSIONS: This study showed, for the first time in the literature, high levels of TN-C in the low and high iPTH groups and that this elevation was associated with iPTH. We think that if our study is supported by further research, TN-C can be a biomarker capable of use in diagnosing CKD-MBD.

Diagnostic Value of Procalcitonin Levels in Acute Mesenteric Ischemia.

BACKGROUND: Acute mesenteric ischemia (AMI) is a potentially fatal disease. Difficulties in diagnosis make it essential to find early biomarkers. AIMS: This study investigated the diagnostic value of procalcitonin (PCT) levels in AMI. STUDY DESIGN: Animal experimentation. METHODS: Rats were divided into six groups of six animals each. In the experimental group, an experimental ischemia model was established by clamping the superior mesenteric artery from the aortic outflow tract. Blood and tissue specimens were collected from rats in the experimental mesenteric ischemia model at 30 min and 2 and 6 h, and these were compared with specimens from the respective control groups. PCT levels were compared at 30 min and 2 and 6 h. RESULTS: PCT levels were 185.3 pg/mL in the control group and 219.3 pg/mL in the study group, 199.6 pg/mL in the control group and 243.9 pg/mL in the study group, and 201.9 pg/mL in the control group and 286.9 pg/mL in the study group, respectively, at 30 minute, 2 and 6 hours. Significant differences were determined between 6-h control group and ischemia group PCT levels (p=0.005). CONCLUSION: The absence of a significant increase in PCT levels in the early period, while a significant difference was detected in the later period (6 h), shows that PCT levels rise late in mesenteric ischemia and can be a marker in the late period.

The value of signal peptide-CUB-EGF domain-containing protein-1 (SCUBE1) in the diagnosis of pulmonary embolism: a preliminary study.

OBJECTIVES: The diagnosis of pulmonary embolism (PE) in the emergency department still poses difficulties because symptoms and signs are nonspecific. There is a need for more reliable noninvasive diagnostic tests to support clinical suspicion before the costly invasive procedures with complication risks still used in the diagnosis of PE. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-EGF (epidermal growth factor) domain-containing protein 1 (SCUBE1) is a novel, secreted cell surface protein expressed during early embryogenesis. The goal of this study was to compare the SCUBE1 levels between PE patients and healthy subjects and also investigate the value of SCUBE1 in the diagnosis of PE. METHODS: Eleven patients diagnosed with PE using spiral computerized tomographic pulmonary angiography were included in the study. A control group of 23 age-matched, healthy volunteers served as a reference for biochemical parameters. RESULTS: Mean (±SD) SCUBE1 levels were 72.0 (±32.6) ng/mL in the patients with PE and 31.4 (±13.8) ng/mL in the control group. SCUBE1 levels were significantly higher in the patients with PE (p = 0.001). Receiver operating characteristic (ROC) curve analysis was performed to determine cutoff thresholds in discriminating between PE and control group plasma SCUBE1 levels. Area under the ROC for that purpose was 0.862 (95% confidence interval [CI] = 0.70 to 1). A SCUBE1 cutoff point in patients with PE > 46 ng/mL had specificity and sensitivity of 91% (95% CI = 0.70% to 0.98%) and 82% (95% CI = 0.48% to 0.97%), respectively. CONCLUSIONS: This preliminary study suggests that plasma SCUBE1 values have a good level of specificity for PE and may be of use in the diagnosis of PE. Further studies involving larger case series and also clinical studies are needed to corroborate these findings.