Verification studies in glucometers: Should we use capillary blood or venous blood for comparison?

Glucometers are widely used in the diagnosis of blood glucose levels in patients with diabetes mellitus. EN ISO 15197 suggests that glucometer comparison studies should have 100 capillary blood samples be worked on at least twice. In this study, we planned on comparing the glucose results measured in a routine biochemistry analyzer from two different glucometers, capillary and venous blood samples, and aimed to discuss the effects of blood taking systems on the glucometer validation studies. Capillary and venous blood samples were taken from 101 individuals and their glucose concentrations measured simultaneously using two different glucometers (Accu-chek and GlucoMax). Capillary and venous blood samples were centrifuged after clotting and analyzed in the Roche P modular system. In the fasting condition, the equations for regression analysis that were found y=0,873x+24,32 (r=0,857) in between Accu-chek and venous blood glucose, y=0,9x+16,15 (r=0,920) in between Accu-chek and capillary blood glucose, y=0,811x+20,94 (r=0,776) in between GlucoMax and venous blood glucose, and y=0,851x+12,28 (r=0,863) in between GlucoMax and capillary blood glucose.In the postprandial state, the equations were y=0,713x+48,46 (r=0,258) in between Accu-chek and venous blood glucose, y=0,981x+11,77 (r=0,718) in between Accu-chek and capillary blood glucose, y=0,706x+39,12 (r=0,453) in between GlucoMax and venous blood glucose, and y=0,790+22,35 (r=0,787) in between GlucoMax and capillary blood glucose. In the fasting and postprandial state, the capillary glucose levels showed better correlation with glucometer measurements than venous blood glucose levels. In glucometer verification studies, capillary blood obtained with capillary blood sampling systems and used instead of venous blood should be the preferred sample. [Med-Science 2018; 7(1.000): 218-221

Zależność między stężeniem albuminy modyfikowanej niedokrwieniem a dobrze rozwiniętym krążeniem obocznym

Background: It is important to determine the grade of the coronary collateral circulation (CCC) in patients with stable coronary artery disease. Aim: In this study, we aimed to investigate the relationship between the ischaemia-modified albumin (IMA) level and good CCC. Methods: A total of 95 patients with coronary angiography and at least one epicardial coronary artery obstruction were included in the study. The Rentrop classification was used with CCC grading, where 0 and 1 were defined as poor collateral, and 2 and 3 were defined as good collateral. The IMA level of the patients was measured using an enzyme-linked immunosorbent assay (ELISA). The receiver–operating characteristic curve was used to show the sensitivity and specificity of IMA levels and the optimal cut-off value for predicting good CCC. Results: The multiple logistic regression analysis revealed that the IMA level in the good CCC group was higher (p &lt; 0.045). Conversely, the high-sensitivity C-reactive protein level was lower in the good CCC group (p &lt; 0.023). We found an IMA cut-off value (4.7 ng/mL) that indicated good CCC level, and this shows good CCC with 70.2% sensitivity and 60.3% specificity. Conclusions: The IMA level could serve as a simple and useful predictor of well-developed CCC.Wstęp: U chorych ze stabilną chorobą wieńcową (CAD) istotne jest ustalenie stopnia rozwoju wieńcowego krążenia obocznego (CCC). Cel: Badanie przeprowadzono w celu oceny zależności między stężeniem albuminy modyfikowanej niedokrwieniem (IMA) a dobrze rozwiniętym CCC. Metody: Do badania włączono 95 chorych z dostępnym wynikiem koronarografii, u których stwierdzono co najmniej jedno zwężenie nasierdziowej tętnicy wieńcowej. Do określenia stopnia CCC używano klasyfikacji Rentropa, w której oceny 0 i 1 oznaczały słabe krążenie oboczne, natomiast 2 i 3 — dobre krążenie oboczne. Stężenie IMA mierzono za pomocą metody immunoenzymatycznej (ELISA). Wyznaczono krzywe ROC w celu określenia czułości i swoistości oznaczania stężeń IMA oraz optymalnej wartości granicznej pozwalającej na predykcję dobrze rozwiniętego CCC. Wyniki: W analizie wielokrotnej regresji logistycznej wykazano, że stężenie IMA było wyższe w grupie z dobrym CCC (p < 0,045). Z kolei stężenie białka C-reaktywnego oznaczane metodą wysokoczułą było niższe u osób z dobrym CCC (p < 0,023). Autorzy określili wartość graniczną stężenia IMA (4,7 ng/ml), która wskazywała na obecność dobrze rozwiniętego CCC z czułością wynoszącą 70,2% i swoistością równą 60,3%. Wnioski: Stężenie IMA może służyć jako łatwy w zastosowaniu i użyteczny predyktor dobrze rozwiniętego CCC

Differences between Epilepsy Patients Under Politherapy and Epilepsy Patients Under Monotherapy

AbstractObjective: This study aimed to evaluate demographical variables, clinicalfeatures, neurological examination and cranial imaging results which cause ordetermine the necessity for politherapy treatment in epilepsy patients.Patients and Methods: The patient files of 785 epileptic patients were followedby Marmara University Epilepsy Outpatient Clinic were scanned retrospectivelyand a questionnaire was filled in for each file. Patients were grouped asmonotherapy or politherapy, considering the number of antiepileptics theyused. The demographical variables, clinical features, neurological examinationand imaging results of the two groups were compared. The results wereanalyzed by Student's-t test and chi-square tests.Results: A history of craniotomy and intracranial tumors is more frequent inpolitherapy patients. Also, simple partial seizure, convulsive status epilepticus,pathological neurological examination findings, abnormal EEG, cranialimaging (MRI/CT) and SPECT results were found to be higher in politherapypatients.Conclusion: Politherapy is an important step in epilepsy treatment. However,because of drug-drug interactions and drug side effects it is not the first choice.Determining the differences between patients who use politherapy andmonotherapy will help recognizing the clinical data which may lead topolitherapy need

SERUM TNF- RELATED WEAK INDUCER OF APOPTOSIS (TWEAK), TNF- RELATED APOPTOSIS-INDUCING LIGAND (TRAIL) LEVELS IN PATIENTS WITH BIPOLAR DEPRESSION, MAJOR DEPRESSION AND A HEALTHY CONTROL GROUP

Background: A low-grade inflammation is presumed to be related to the etiopathogenesis of major depressive disorder (MDD) and bipolar disorder. Tumor necrosis factor (TNF) superfamily members have roles in the pathogenesis of neuropsychiatric disorders because of the relationship with inflammation and neurogenesis. The aim of this study was to investigate the serum TNFrelated weak inducer of apoptosis (TWEAK) and TNF-related apoptosis-inducing ligand (TRAIL) levels in patients with bipolar depression (BD), MDD and a healthy control (HC) group to determine any differences between MDD and BD in terms of inflammation biomarkers. Subjects and methods: After a 12-hour overnight fast, 5 milliliter (mL) samples of fasting blood were obtained from the participants. The TWEAK and TRAIL plasma levels were calculated using ELISA kits. Results: The TWEAK levels were found to be higher in the BD group than in the HC group (p=0.03). No statistically significant differences were determined between the BD vs MDD and MDD vs HC groups (p=0.17, p=0.37, respectively). There were no statistically significant differences between the three groups (BD vs HC; BD vs MDD; MDD vs HC) in terms of TRAIL levels (p=0.21). Conclusion: To the best of our knowledge, this study is the first to have explored TWEAK levels in patients with BD. The higher TWEAK levels in BD than in the control group is compatible with the inflammation hypothesis of BD. Limitations of the study were the differences in medications of the patient groups and that it was a cross-sectional study. There is a need for further longitudinal studies with larger sample size and medication-free patients

Association of oxidative stress marker ischemia modified albumin and polycystic ovary syndrome in adolescent and young girls

Objective: The pathophysiologic features of polycystic ovary syndrome (PCOS) seem to be a combination of genetic predisposition and environmental factors. However, data regarding the exact effect of oxidative stress on PCOS is conflicting. This cross sectional and case-control study was designed to compare the serum ischemia modified albumin (IMA) levels in adolescent and young girls with and without PCOS

Assessment of Metabolic Profile and Ischemia-modified Albumin Level in Patients with Alopecia Areata: A Case-Control Study

Background: Alopecia areata (AA) is an autoimmune-mediated hair follicle disorder. In the literature, there is no study evaluating metabolic syndrome and levels of ischemia-modified albumin (IMA) which is proposed as an oxidative stress biomarker in patients with AA. Aims: The aim was to investigate the presence of metabolic syndrome and the levels of IMA, small dense low-density lipoprotein (sd-LDL), and visfatin levels in AA patients. Settings and Design: A hospital-based cross-sectional study was undertaken among AA patients and controls. Subjects and Methods: Thirty-five patients with AA and 35 sex-, age-, and body mass index-matched healthy controls were enrolled. Clinical and laboratory parameters of metabolic syndrome were examined in all participants. Furthermore, IMA, sd-LDL, and visfatin levels were assessed and analyzed with regard to disease pattern, severity and extent, severity of alopecia tool score, duration, and recurrence. Results: The median IMA and adjusted IMA levels were significantly increased compared with controls (P<0.05 and P=0.002, respectively). Patients with pull test positivity displayed higher levels of adjusted IMA levels (P<0.05). In AA group, there was a positive correlation between adjusted IMA and waist circumference (r=0.443, P=0.008), adjusted IMA and triglyceride levels (r=0.535, P=0.001), and adjusted IMA and sd-LDL levels (r=0.46, P<0.05). We observed no statistically significant difference in fasting blood glucose and lipid profile, sd-LDL, and visfatin levels of the patients and healthy controls. Conclusions: AA patients and controls have similar metabolic profile. Raised levels of adjusted IMA levels may be associated with antioxidant/oxidant imbalance and with risk of cardiovascular disease

Thiol/Disulfide Homeostasis in Bipolar and Unipolar Depression

Objective: Bipolar disorder and unipolar depressive disorder are complex phenotypes. There appear to be phenotypical, mechanistic, and therapeutic differences between bipolar depression (BD) and unipolar depression (UD). There is a need for understanding the underlying biological variation between these clinical entities. The role of oxidative processes underlying bipolar disorder and depression has been demonstrated. Thiol-disulfide homeostasis (TDH) is a recent oxidative stress marker. In this study, we aimed to inspect patients with bipolar depression and unipolar depression in terms of thiol-disulfide balance and to compare them with healthy controls. Methods: Patients admitted to the outpatient clinic of Ankara Numune Training and Research Hospital and diagnosed either as a depressive episode with bipolar disorder (n = 37) or unipolar depression (n = 24) according to DSM-5 criteria, along with healthy controls (HC) (n = 50), were included in the study. Native thiol, total thiol, and disulfide levels were compared across the groups. Results: In comparison to HC, both BD and UD groups had higher disulfide levels, disulfide/native thiol ratio, and disulfide/total thiol ratio. No significant differences between BD and UD were detected in terms of disulfide level, disulfide/native thiol ratio, and disulfide/total thiol ratio. Conclusion: Increased levels of disulfide, native thiol, and disulfide/total thiol ratios compared to healthy controls in both UD and BD groups may be indicative of the presence of oxidative damage in these two clinical conditions. To clarify the role of oxidative stress in the pathophysiology of depressive disorders and investigate TDH, longitudinal studies in patients with medication-free UD and BD are required

Leukemogenesis as a new approach to investigate the correlation between up regulated gene 4/upregulator of cell proliferation (URG4/URGCP) and signal transduction genes in leukemia

WOS: 000316221100032PubMed ID: 23266667The aim of the study is to the determine the profiles of cell cycle genes and a new candidate oncogene of URG4/URGCP which play role in leukemia, establishing the association between the early prognosis of cancer and the quantitation of genetic changes, and bringing a molecular approach to definite diagnosis. In this study, 36 newly diagnosed patients' with ALL-AML in the range of 0-18 years and six control group patients' bone marrow samples were included. Total RNA was isolated from samples and then complementary DNA synthesis was performed. The obtained cDNAs have been installed 96 well plates after prepared appropriate mixtures and assessed with LightCycler(A (R)) 480 Real-Time PCR quantitatively. CHEK1, URG4/URGCP, CCNG1, CCNC, CDC16, KRAS, CDKN2D genes in the T-ALL group; CCND2, ATM, CDK8, CHEK1, TP53, CHEK2, CCNG2, CDK4, CDKN2A, E2F4, CCNC, KRAS genes in the precursor B-ALL group and CCND2, CDK6 genes in the AML group have shown significant increase in mRNA expression level. In the featured role of acute leukemia the regulating signaling pathways of leukemogenesis partially defined, although identification of new genetic markers in acute leukemia subgroups, will allow the development of early diagnostic and new treatment protocols.Ege University Research Projects (APAK)Ege University [2009-TIP-34]This study is supported by Ege University Research Projects (APAK) within the scope of the project numbered 2009-TIP-34

Serum glial cell line-derived neurotrophic factor levels and impulsivity in heroin addiction: a cross-sectional, case-control study of 129 heroin addicts

OBJECTIVE: Glial cell line-derived neurotrophic factor (GDNF), being a protective of dopaminergic neurons, is reported to modulate addictive behaviours and have a role as a negative regulator for biochemical and behavioural adaptations to drug abuse. We aimed to reveal impulsivity and serum GDNF levels in patients with heroin addiction and investigate their relationships in order to contribute to the understanding of behavioural aspects and biological mechanisms in heroin addiction via this study. METHODS: This study was performed at the Department of Psychiatry of Ankara Numune Training and Research Hospital, Turkey. We recruited 129 heroin-dependent patients and 90 age, sex, and smoking-matched healthy controls with no major psychopathology. Barratt Impulsivity Scale-11, Hospital Anxiety and Depression Scale (HADS) and sociodemographic data form were applied to all participants. Laboratory analysis for serum GDNF levels was performed for each participant's blood sample. RESULTS: Total impulsivity scores and scores of Attentional Impulsivity, Motor Impulsivity, and Unplanned Impulsivity subscales were all higher in heroin addicts compared to the controls. Heroin addicts had also lower serum GDNF levels and lower GDNF levels were associated with high impulsivity and high HADS scores in heroin addicts. CONCLUSION: Decrement in GDNF levels in heroin addiction seems as to be an important data which could be associated with impulsivity, anxiety, and depressive symptoms. GDNF could find a prominent place among the target molecules in the treatment of heroin addiction