The Relationship Between Laboratory Findings and Mortality in COVID-19 Patients Requiring Intensive Care.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) shows a wide clinical manifestation from asymptomatic infection to life-threatening respiratory failure. This study aimed to determine the relationship between the survival and demographic data, comorbidity status, and laboratory parameters of coronavirus disease 2019 (COVID-19) patients requiring intensive care. MATERIAL AND METHODS: We retrospectively analyzed 236 patients requiring intensive care whose diagnosis was confirmed by the SARS-CoV-2 reverse transcription-polymerase chain reaction (RT-PCR) test. The patients were divided into two groups in terms of survival. Demographic data; procalcitonin and C-reactive protein (CRP) levels; leukocyte, lymphocyte, and neutrophil counts in hemogram and neutrophil-to-lymphocyte ratio (NLR) levels; and lower respiratory and blood cultures were examined, and the relationships between these parameters and survival were evaluated with hypothesis testing. RESULTS:  In the study, 156 (66.1%) males and 80 (33.9%) females, a total of 236 patients, were included. Sixty-seven (28.3%) surviving patients were determined as Group 1, and 169 (71.7%) deceased patients were determined as Group 2. A statistically significant difference was found between the groups in terms of mean age (p<0.001) and gender distribution (p=0.011). In laboratory parameters, a significant difference was observed between the groups in lymphocyte count (p=0.001), NLR (p<0.001), and procalcitonin levels (p<0.001). Although leukocyte (p=0.075), neutrophil (p=0.031), and CRP (p=0.112) levels were higher in Group 2, there was no statistical difference. Mortality was found to be higher in patients with comorbidity (p=0.012) or co-infection (p=0.002). CONCLUSION: High levels of neutrophil count, NLR, and procalcitonin; low lymphocyte count; the presence of comorbidity; and secondary bacterial infection were found to be associated with mortality in COVID-19 patients in the intensive care unit.

Seroprevalence of Toxoplasma, Rubella and Cytomegalovirus in Women of Fertility Age in Our Region

Objective: Toxoplasma gondii (T. gondii), Rubella and Cytomegalovirus (CMV) infections can cause severe morbidity in the fetus when transmissed during pregnancy. In our study, it was aimed to examine the seropositivity rates for T. gondii, Rubella and CMV infections in women of childbearing age who applied to our hospital. Methods: Anti-Toxoplasma IgG, anti-Toxoplasma IgM, anti-Rubella IgG, anti-Rubella IgM, anti-CMV IgG and anti-CMV were studied in women of childbearing age (18-49 years old) who applied to our hospital's outpatient clinics between January 2018 and December 2020. The tests were performed in our microbiology laboratory using the ELISA method on Architect i2000 (Abbott, USA) and COBAS e601 (Roche, Germany) devices. Results: As a result of the data obtained, the percentages of IgM and IgG positivity for anti-Toxoplasma were calculated as 1.4% and 30.9%, respectively. Anti-Rubella IgM positivity was 0.7%, anti-Rubella IgG positivity was 91%, anti-CMV IgG positivity was 98.8%, and anti-CMV IgM positivity was 2%. Conclusion: Having its own seroprevalence for each region has is important in terms of planning pregnancy screenings. The seropositivity rates in our region are in line with other studies in the country. Since CMV seropositivity is very high in the population and there is no effective treatment or vaccine, screening may not be not necessary. T. gondii and Rubella screenings can be recommended due to the lower immunity rates and the availability of vaccine and treatment options.

Inhibition of methotrexate induced toxicity in the adult rat spleen by adalimumab.

Methotrexate (MTX) has been in use for the treatment of rheumatoid arthritis (RA), psoriasis, and cancer since 1948. Its toxic side effects on tissues and organs have been well documented but splenotoxicity has not been addressed. This study set out to investigate this issue by examining the effectiveness of anti-TNFα agents against MTX-induced toxicity in T lymphocytes and macrophages via the regulation of CD3, CD68, and CD200R. Twenty-four Sprague Dawley rats were allocated to three groups: control (received saline solution only), MTX (20 mg/kg of single-dose of MTX), and Ada + MTX (single dose of 10 mg/kg Adalimumab before MTX administration). The spleens were removed 5 days after MTX administration. The number of CD3+/mm3cells for the control, MTX and Ada + MTX groups were, respectively, 2.69 ± 0.86, 20.51 ± 2.7, (p = 0.000) and 11.07 ± 2.01 (p = 0.000). The number of CD68+ macrophages/mm3 in the control, MTX and Ada + MTX groups were, respectively, 8.62 ± 1.08, 38.19 ± 1.37 (p = 0.000), and 16.87 ± 12.57 (p = 0.000). The number of macrophages that were CD200R+/mm3 in the control, MTX, and Ada + MTX groups were 3.33 ± 1.66, 25.77 ± 2.37 (p = 0.000), and 8.68 ± 2.66 (p = 0.000), respectively. We also observed that Ada reduced the numerical densities of these cells following MTX administration (p < 0.05). Ada may, therefore, be a promising candidate for the prevention of the deleterious effects on T lymphocytes and macrophages of MTX-induced toxicity.

Secondary Bacterial Infection Rates Among Patients With COVID-19.

Objective The aim of this study was to determine the factors and rates of secondary bacterial infections developed in patients after the diagnosis of COVID-19 and antimicrobial susceptibility to guide the empirical treatment and contribute to epidemiological data. Materials and Methods In our study, 1,055 patients diagnosed with COVID-19, hospitalized at Recep Tayyip Erdogan University Training and Research Hospital, Rize, between the dates March 24, 2020 and December 31, 2020, were recruited. The diagnoses of all patients were confirmed by positive SARS-CoV-2 polymerase chain reaction (PCR) tests. In addition, the blood and respiratory tract cultures of the patients recruited in the study were analyzed retrospectively. Results Ninety-two (8.7%) patients were found to have microbiologically proven respiratory or circulatory tract infections via microbial culture results. Respiratory tract infections were detected as monomicrobial in 44 patients and as polymicrobial in 17 patients, among a total of 61 patients. In addition, 59 (64.1%) patients were male patients, and 33 (35.9%) were female patients. Among the microorganisms grown in blood cultures, coagulase-negative staphylococci with a percentage of 31% and Acinetobacter baumannii with a percentage of 27.5% were prominent. In respiratory tract cultures, A. baumannii constitutes the majority with a percentage of 33.3%, followed by Staphylococcus aureus and Klebsiella pneumoniae with a percentage of 9.5% each. The most resistant bacteria were A. baumannii, resistant to all antibiotics other than colistin. Conclusion Secondary bacterial infection rates in patients with COVID-19 are lower than influenza pandemic. However, the frequency of empirical antibiotics use seems relatively high.

Dynamic thiol/disulphide balance in patients undergoing hypotensive anesthesia in elective septoplasties.

OBJECTIVE: We aimed to investigate the effects of hypotensive anaesthesia on oxidative stress with serum thiol/disulphide balance in patients undergoing elective septoplasty procedures under general anaesthesia. METHODS: Seventy-two patients between the ages of 18-60, with a physical condition I -II, according to the American Society of Anesthesiologists, were included in this prospective observational study. Septoplasty was chosen for standard surgical stress. According to the maintenance of anaesthesia, patients were divided into the groups as Hypotensive Anaesthesia (n = 40) and Normotensive Anaesthesia (n = 32). Serum thiol/disulphide levels were measured by the method developed by Erel & Neselioglu. RESULTS: The native thiol and total thiol values of both groups measured at the 60th min intraoperatively were significantly lower than the preoperative values (both P < .01). Intraoperatively, at the 60th min, there was no significant difference in terms of post-native thiol and post-total thiol levels between hypotensive and normotensive anaesthesia groups (P = .68 and .81, respectively). Age >40 years and female gender were found to have a significant effect on dynamic oxidative stress (P = .002 and .001, respectively). CONCLUSION: This pilot study has found that hypotensive anaesthesia had no adverse effect on dynamic thiol/disulphide balance in elective surgeries.

The protective role of fosfomycin in lung injury due to oxidative stress and inflammation caused by sepsis.

AIM: Early and prompt treatment of sepsis by effective antibiotics against susceptible organisms may be lifesaving. However, increased antibiotic resistance and side effects of chemotherapeutic agents limiting their tolerability result in a restricted use of medications. This has led to an increased search for solution oriented novel treatments and therapeutic targets, as well as investigations on the pathogenesis and physiology of sepsis. In this study, we aimed to examine the antioxidant and anti-inflammatory effects of fosfomycin in sepsis resulting from other causes. MAIN METHODS: Sprague Dawley rats were assigned into three groups. Randomly selected control rats received intraperitoneal saline solution only. Only caecal puncture and ligation were carried out in the caecal ligation and puncture (CLP) group, while in the CLP + fosfomycin group (CLP + FOS), together with sepsis due to caecal puncture and ligation, 500 mg/kg of FOS was administered intraperitoneally (i.p.). KEY FINDINGS: As compared to the control group, elevated TBARS and TNF-α levels as well as increased expression of NF-kB/p65 and TLR-4 and reduced -SH levels were found in the lung tissue of CLP rats. On the other hand, TBARS and TNF-α levels were reduced and NF-kB/p65 and TLR-4 expressions were decreased together with increase in total -SH levels among CLP + FOS (500 mg/kg i.p.) rats. SIGNIFICANCE: FOS treatment may represent a promising agent in terms of reducing the sepsis-related lung injury due to its antimicrobial effects as well as its antioxidant and anti-inflammatory properties.

Correlation of Suicidal Thoughts and Toxoplasmosis in Patients With Depression.

Objective We investigated the correlation between serum anti-Toxplasma gondii IgG and suicidal thoughts in depressive patients. Methods Depressive patients with (n = 100) and without (n = 100) suicidal thoughts along with 100 healthy control subjects were recruited for this study. In all three groups, a semi-structured clinical interview form called Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) Axis-I Disorder (SCID-I), Hamilton Depression Rating Scale (HAMD), suicidal behavior scale, and a sociodemographic data form were completed. Sera from all participants were taken, and anti-toxoplasma IgG was measured by Enzyme Linked Immunosorbent Assay (ELISA)-Chemiluminescent Microparticle Immunoassay. Statistical analysis of the data was performed. Results The serum anti-toxoplasma IgG levels of patients with suicidal thoughts were significantly higher than those without suicidal thoughts and the controls, which were 80.04 ± 40.66, 78 ± 14.82, and 19.98 ± 14.65, respectively, p < 0.001. There was no correlation between toxoplasma IgG and HAMD score in patients lacking suicidal thoughts (r = -0.112, p = 0.463). Conclusion This study shows a correlation between seropositivity for anti-Toxoplasma gondii IgG and depression with suicidal thoughts.

Relationship between disease and disease severity and semaphorin 5A and hemogram level in obsessive-compulsive disorder.

OBJECTIVE: Semaphorin 5A (SEMA 5A) is a neuroprotein that regulates the formation of excitatory synapses between neurons, important in autoimmunity, inflammatory processes and behaviors. This study aimed to investigate the SEMA 5A levels in patients with obsessive-compulsive disorder (OCD) diagnosed for the first time and evaluate the relationship of disease and disease severity with the blood SEMA 5A level and hemogram. METHODS: More than 41,465 patients who applied to the psychiatry clinic from January 2018 to December 2020 were evaluated according to the DSM-5 criteria; 57 patients diagnosed with OCD for the first time, who met the inclusion criteria, were included in the study. Disease severity was investigated administering the Yale Brown Obsessive Compulsion Scale. The peripheral blood SEMA 5A level and hemogram were measured and evaluated in relation to platelet (PLT) activity, neutrophil-lymphocyte ratio (NLR), PLT-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), C-reactive protein (CRP), and compared with control group of 26 people. RESULTS: The comparison of the groups revealed a significant difference in SEMA 5A and CRP level, neutrophil count and percentage, lymphocyte count, PLT activity. A significant correlation was found between disease and SEMA 5A level, NLR, PLR, and PLT parameters in diagnosis of OCD. As the severity of OCD increased, the SEMA 5A level and PLT count decreased, while the PDW and MLR values increased. CONCLUSION: In patients with OCD, a relationship was found between plasma SEMA 5A, PLT activity, NLR, PLR, and MLR activity levels with disease and the disease severity.

COVID-19 infection produces subarachnoid hemorrhage; acting now to understand its cause: A short communication.

In the medical literature, some case reports on the association of the COVID-19 infection and occurrence of spontaneous subarachnoid hemorrhage (SAH)have been reported Aim of the present paper is to search the causes of this association The diagnosis of COVID-19 was based on the real-time reverse-transcription polymerase chain reaction (PCR) test and computed tomography (CT) of the chest. There were four patients, whose median ages were 46,758, ranged 36-54 years). In conclusion, Spontaneous SAH can occur in the early and late course of COVID-19 infection. Its early recognition of the patient with spontaneous SAH is imperative.

Serum visfatin level is associated with complexity of coronary artery disease in patients with stable angina pectoris.

BACKGROUND: Visfatin is an adipokine that plays a role in the inflammatory process of atherosclerosis. This study aimed to investigate whether adipokine is associated with the extent of stable coronary artery disease (CAD). METHODS: The study population included 110 patients who underwent elective coronary angiography (CAG) due to stable angina pectoris. The severity of CAD was assessed by the 'Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX)' score. We evaluated patients in two groups: group 1 with a SYNTAX score <22 (low) and group 2 with a SYNTAX score ⩾22 (intermediate to high). RESULTS: Serum visfatin (8.6 ± 4.2 ng/ml versus 13.4 ± 5.2 ng/ml, p < 0.001) and serum C-reactive protein (CRP) levels [0.46 (0.25-0.77) mg/dl versus 0.71 (0.32-1.10) mg/dl, p < 0.001] were lower in group 1. A positive significant correlation was found between serum visfatin level and SYNTAX score (r = 0.559, p < 0.001). In a multivariate logistic regression analysis, visfatin [odds ratio (OR) 1.22, 95% confidence interval (CI) 1.10-1.36; p < 0.001], CRP (OR 6.22, 95% CI 1.70-22.7; p = 0.006), and diabetes mellitus (OR 3.83, 95% CI 1.10-13.2; p = 0.034) were found to be independent predictors of SYNTAX score. CONCLUSIONS: Serum visfatin level was positively correlated with CAD severity in patients with high SYNTAX score. Serum visfatin level can be a useful biomarker for predicting high SYNTAX scores in patients with angina pectoris undergoing CAG.

The effects of mobile phone exposure on mast cells in rat dura mater / Efectos de la exposición del teléfono móvil en los mastocitos de la duramadre de ratas

Mobile phone use has increased rapidly. The central nervous system has been shown to be adversely affected by its electromagnetic field (EMF) resulting in headache and sleep disturbances. How the cells make up the CNS and are affected by EMF is unclear. However, because of their central role in inflammation through diverse stimuli including radiation, this study aimed to investigate the effects of electromagnetic fields induced by mobile phones on mast cells in rat dura mater. A total of 18 adult, female, SpragueDawley rats were divided into two groups. The choice of female rats for his study was based on recent surveys demonstrating that mobile phone use is more frequent and prolonged among females. The study group was exposed to 900 MHz electromagnetic field (1 h/day for 45 days). In the end of the study, duramater tissue was extracted and stained using Toluidine blue. Mast cells were counted and results were analysed using Student t test. Mean mast cell number was 202.33±9.82 and 456.78±35.01 in the control and study groups, respectively (p<0.05). Analysis of serum electrolyte and immunoglobulin E levels showed no statistically significant difference between the two groups (p>0.05). The study showed that mobile phone exposure increased mast cell number and degranulation in rat dura mater. Further studies are required to evaluate the clinical implications of these findings.

El uso del teléfono móvil ha aumentado rápidamente. Se ha demostrado que el sistema nervioso central (SNC) se ve afectado de manera adversa debido al campo electromagnético (CEM) que produce dolor de cabeza y trastornos del sueño. No está claro cómo se ve afectada la composición celular del SNC por el CEM. Sin embargo, debido a su función principal en la inflamación a través de diversos estímulos que incluyen la radiación, este estudio tuvo como objetivo investigar los efectos de los campos electromagnéticos inducidos por los teléfonos móviles en los mastocitos de la duramadre de ratas. Un total de 18 ratas Sprague-Dawley adultas, hembras, se dividieron en dos grupos. Se usaron ratas hembras para este estudio en base a investigaciones recientes que han demostrado que el uso de teléfonos móviles es más frecuente y prolongado en las mujeres. Los grupos de estudio fueron expuestos a un campo electromagnético de 900 MHz (1 h / día durante 45 días). Al término del estudio, fue extirpado el tejido de la duramadre y teñido con azul de toluidina. Se contaron los mastocitos y se analizaron los resultados utilizando la prueba t de Student. La cantidad media de células cebadas fue de 202,33 ± 9.82 y 456,78 ± 35,01 en los grupos control y estudio, respectivamente (p <0,05). El análisis del electrolito sérico y los niveles de inmunoglobulina E no mostraron diferencias estadísticamente significativas entre los dos grupos (p> 0,05). El estudio mostró que la exposición a teléfonos móviles aumentó el número de mastocitos y la desgranulación en la duramadre de las ratas. Se requieren estudios adicionales para evaluar las implicaciones clínicas de estos hallazgos.

Left ventricular hypertrophy is associated with increased sirtuin level in newly diagnosed hypertensive patients.

Background: Arterial hypertension is one of the leading causes of mortality and morbidity in general population. Sirtuin 1 (SIRT1) has diverse anti-inflammation, anti-oxidant, and anti-apopytosis effects on endothelium and is associated with endothelial aging and dysfunction. The objective of this study was to evaluate the relation of serum SIRT1 level with left ventricular hypertrophy (LVH) in newly diagnosed hypertensive patients. Methods: One hundered and twenty-five consecutive, newly diagnosed hypertensive patients were divided into two groups with regard to presence of LVH and compared to 40 healthy control subjects. LVH was determined by transthoracic echocardiography using the cube formula. Serum SIRT1 level was analyzed with enzyme-linked immunosorbent assay. Results: Serum SIRT1 level was significantly higher in patients with LVH compared to those without LVH (14.3 ± 3.9 ng/ml vs. 7.9 ± 3.6 ng/ml, ​P < 0.001) and healthy control subjects (14.3 ± 3.9 ng/ml vs 6.6 ± 2.0 ng/ml, P < 0.001). Multivariate logistic regression analysis revealed higher serum SIRT1 level independently predicted LVH in hypertensive patients (OR 1.50; 95% CI, 1.30-1.73; P < 0.001). Receiver-operating characteristic curve analysis demonstrated a cutoff value of 9.4 had a sensitivity of 90% and specificity of 74% for the prediction of LVH (AUC 0.885; 95% CI, 0.815-0.935; ​P < 0.0001). Conclusion: SIRT1 was a powerful biomarker for predicting LVH in hypertensive patients.

The Relationship between Serum Apelin Levels and the Severity of Calcific Aortic Stenosis.

Background: Apelin, an endogenous peptide, has recently gained attention due to its positive inotropic effects in heart failure physiopathology. We investigated the relationship between serum apelin levels and the severity of calcific aortic stenosis (AS). Methods: A total of 68 consecutive patients diagnosed with calcific AS and a control group of 32 subjects were included in the study. The subjects were divided into three group as follows: the control group, the mild-moderate AS group and the severe AS group. Blood samples were obtained from all of the subjects, which were used for biochemical comparisons of apelin 36 and high-sensitive C-reactive protein (hsCRP) levels. Results: Plasma apelin 36 levels were significantly lower in the patients with severe AS [490 (247-1074) pg/ml] compared to both the mild-moderate AS [209 (97-453) pg/ml] and control [660 (378-1200) pg/ml] groups (p < 0.001). Correlation analysis between the left ventricular mass index and apelin concentrations revealed a significant negative correlation between the two parameters (p < 0.001, r = -0.478). Conclusions: Our study demonstrated decreased apelin levels and increased hsCRP concentrations in patients with severe calcific AS. Our findings may help to clarify the exact pathophysiologic role of apelin in cardiovascular diseases.

Oxidative status and prolidase activities in generalized anxiety disorder.

OBJECTIVE: Prolidase (Pro), an intracellular enzyme necessary for collagen turnover, matrix remodelling and cell growth has been shown to be related to Oxidative Stress (OS). To our knowledge, serum Pro activity in generalized anxiety disorder (GAD) has not been documented yet. In this study, we aimed to evaluate OS and its relation with Pro activity in patients diagnosed with GAD. METHOD: Thirty untreated GAD patients and 30 healthy controls were included in the study. Blood samples were collected from all subjects to quantify total oxidant status (TOS), total antioxidant status (TAS) and Pro activity. Oxidative stress index (OSI), the ratio of TOS to TAS, is calculated to evaluate the balance between antioxidants and oxidants. Hamilton Anxiety Rating Scale (HARS) was used to determine the anxiety levels of all subjects. RESULTS: GAD group demonstrated statistically significantly higher TOS, OSI and Pro levels, when compared with the control group (t=2.947, p=0.005; t=2.874, p=0.006; and t=9.396, p<0.001 respectively). HARS scores were found to be positively correlated with TOS, OSI and Pro levels (p=0.008, r=0.338; p=0.008, r=0.339; and p<0.001, r=0.751 respectively). CONCLUSION: The degree of severity of OS is correlated with the levels of Pro. Thus, Pro might be the target enzyme, promising to be a marker for the follow-up of GAD patients. To the best of our knowledge, this study is the first to report a significant relation between Pro activity and GAD.

Prolidase activity and oxidative stress in patients with schizophrenia: a preliminary study.

OBJECTIVE: To determine whether serum prolidase levels are associated with the etiopathogenesis of schizophrenia. METHODS: The study was conducted at the psychiatry outpatient clinics of the University Hospitals of Recep Tayyip Erdogan and Afyonkocatepe in spring 2013. It comprised patients with schizophrenia who were consecutively recruited from the Psychiatry outpatient clinics of the hospital. An equal number of healthy individuals were recruited from the community. Each patient underwent a detailed diagnostic evaluation by psychiatry residents by using the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders-IV. Serum prolidase activity and oxidative parameters were measured in patient and control groups.The severity of psychotic symptoms was assessed using the positive and negative syndrome scale. SPSS 16 was used for statitistical analysis. RESULTS: There were 30 subjects in each group, with 18 (60%) females among the patients and 21 (70%) among the controls. Serum prolidase level was significantly higher in schizophrenia patients compared to the controls (p < 0.001). Total Oxidative Stress and Oxidative Stress Index parameters were found to be significantly different between the patients and the controls (p = 0.024 and p < 0.001). Serum prolidase level did not show any correlation with markers of oxidative stress in the patients. CONCLUSION: Prolidase activity, glutamate transmission and oxidative stress may be inter-related in the etiopathogenesis of schizophrenia.

Prolidase activity and oxidative stress in patients with major depressive disorder.

BACKGROUND: The aim of the current study was to determine whether the serum prolidase levels are associated with the etiopathogenesis of depression. SUBJECTS AND METHODS: This study included 29 patients with major depressive disorder (MDD), who were consecutively recruited from the psychiatric outpatient clinic, and 30 healthy individuals recruited from the general community. Each patient underwent a detailed diagnostic evaluation by two psychiatrists using the Structured Clinical Interview for DSM-IV (SCID-I). Serum prolidase activity and oxidative parameters were measured in the patient and control groups. The severity of depressive symptoms was assessed using the Hamilton Depression Rating Scale. RESULTS: Serum prolidase level was significantly higher in patients with MDD compared to healthy subjects (p<0.001). Total Oxidant Status (TOS) levels and Oxidative Stress Index (OSI) were also significantly higher in patients with MDD (p<0.001), whereas no significant difference was observed between the groups in the TAS levels (p=0.297). Serum prolidase level did not show any correlation with markers of oxidative stress in patients with MDD. CONCLUSION: Increased serum prolidase levels in patients with MDD may be interpreted as the interaction of prolidase activity, glutamate transmission and oxidative stress. It is suggested that prolidase activity is involved in the etiopathogenesis of depressive disorder.

Serologic diagnosis of syphilis: comparison of different diagnostic methods.

Diagnostic and therapeutic approaches in syphilis show wide variation. The use of only one type of serologic test is insufficient for diagnosis. However, current international recommendations cannot be applied due to various reasons (cost, availability, etc.). The aim of the study was to review serologic data of syphilis patients to determine diagnostic performance of three different methods. In 117 patients suspected of having syphilis, syphilis was diagnosed serologically and clinically. Three different methods were used for detection of antibodies: Rapid Plasma Reagin (RPR), Treponemal Chemiluminescence Microparticle Enzyme Immunoassay (CMIA) and Treponema pallidum hemagglutination (TPHA). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy were calculated for the former two methods against TPHA. The sensitivity of RPR and CMIA against TPHA was 58% and 98%, respectively. The specificity of RPR and CMIA against TPHA was 0% and 100%, respectively. Automated enzyme immunoassay systems could contribute to reducing errors that depend on the person, especially while monitoring titration changes.