In this study, we aimed to evaluate the serum creatinine (SCr) levels with the reference change value (RCV) in patients receiving colistin treatment. We retrospectively recorded the SCr levels of 47 patients receiving colistin treatment before treatment and on days 3 and 7 after treatment. RCV was calculated with the asymmetrical RCV formula (Z = 1.64, P < .05). Percent (%) increase in the SCr results of the patients was compared with RCV and values exceeding RCV were regarded as statistically significant. The RCV was calculated as 15.6% for SCr. Compared with pretreatment values, SCr value on day 3 was 32/47 and on day 7 it was 36/47; as these results exceeded RCV, they were considered statistically significant. Use of RCV in the interpretation of results between serial measurements will provide a more rapid and sensitive method when making decisions.

Objectives: This study aimed to investigate the first involved joints and associated factors in Turkish patients with rheumatoid arthritis (RA). Patients and methods: This retrospective cross-sectional study included 300 newly diagnosed and disease-modifying antirheumatic drug-naïve RA patients (240 females, 60 males; mean age: 54±1.2 years; range, 18 to 82 years). Baseline demographic, clinical, and laboratory data were evaluated between January 2022 and December 2022. The patients were divided into four groups according to autoantibody profile: antibody-negative patients (Group 1; both RF and anti-CCP were negative in this group of patients), RF-positive patients (Group 2), anti-CCP-positive patients (Group 3), and patients with dual seropositivity with RF and antiCCP (Group 4). The patients were also divided into two groups according to the size of the first affected joint: patients with SJI at diagnosis and patients without SJI involvement at diagnosis. Results: Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) antibody positivity rates were 40.3% and 35.6%, respectively. The mean lag time to diagnosis was 25±36 months. At the disease onset, 20% of patients did not have small joint involvement (SJI). Seronegative patients tended to be female (p=0.001), had longer lag time (p=0.001), and had lower levels of C-reactive protein (p=0.025), white blood count (p=0.005), and neutrophil/lymphocyte ratio (p=0.001) compared to the dual seropositive group. Patients presenting with SJI had a younger age (p=0.002), tended to be female (p=0.001), and had lower RF (p=0.034) and anti-CCP (p=0.031) positivity. Only age (p=0.005) and dual seronegativity (RF and anti-CCP; p=0.035) were the independent predictors of SJI in multivariate analysis. Conclusion: The decreasing age and seronegative status were defined as independent risk factors of SJI at the onset of RA. Population-based, prospective studies are needed for earlier diagnosis.

Objective: The aim of this study is to determine the reference ranges of 25 hydroxyvitamin D (25(OH)D) levels from the serum 25(OH)D results of the patients and to investigate variations across age and gender groups. Methods: The patients (n=26829) who applied to Hatay Mustafa Kemal University Hospital between January 2018 and December 2019 and whose 25(OH)D levels were studied were included in this retrospective study. Serum 25(OH)D levels were studied by the chemiluminescence immunoassay method. The hospital information management system was used to obtain the test results and patient data. The indirect method was used to determine the reference ranges. Results: The prevalence of 25(OH)D deficiency in the patients participating in this study was 60.9% in the general population, 54.9% in men, and 67.5% in women. It has been observed that 25(OH)D deficiency is more common in women than in men. The reference ranges determined in this study were lower than the reference ranges provided by the manufacturer. Conclusion: In this study, 25(OH)D levels and reference ranges of Hatay Region were determined in a very large population. It can be said that the results of our region will contribute to the studies to be carried out on the determination of 25(OH)D levels and reference ranges throughout the country.

Leucine rich alpha-2-glycoprotein 1 (LRG1) is a novel mediator involved in the abnormal angiogenesis. We aimed to investigate circulating LRG1 levels and their relationship with proangiogenic mediators in sickle cell disease (SCD). A total of 50 patients with SCD, 25 in steady-state conditions (SCD-SS), 25 in painful VOC periods (SCD-VOC), and 25 healthy controls were included in the study. Demographical and clinical data were collected from hospital records. Serum LRG1, VEGFA, and HIF1A levels were measured by ELISA, and CRP by the nephelometric method. Routine biochemical parameters were assessed using an auto analyzer. Multinomial logistic regression was used to analyze ELISA parameters, and ROC curves were constructed to determine the optimal cut-off point for HIF1A to estimate VOC in SCD patients. LRG1 and VEGFA levels were significantly higher in SCD patients than controls (p<0.001), with no difference between SCD-SS and SCD-VOC groups. HIF1A, CRP, and LDH levels differed significantly across all groups, highest in SCD-VOC (p<0.001). After adjusting for age and gender, LRG1, HIF1A, and VEGFA remained elevated in SCD groups. HIF1A correlated with CRP (r = 0.351, p = 0.024), but LRG1 showed no correlation with proangiogenic mediators in SCD-VOC group. The area under the curve (AUC) was calculated as 0.694 (95% CI, 0.542-0.845, p=0.021) and the optimal cut-off point were 494.5 pg/ml for HIF1A parameter to estimate VOC in patients with SCD. Circulating LRG1 levels may reflect neutrophil activation and contribute to the cross-talk between proangiogenic mediators released in SCD.

Objectives: Familial Mediterranean Fever (FMF) is an autoinflammatory disease. We aimed to investigate serum soluble Triggering Receptor Expressed on Myeloid Cells‐1 and 2 (sTREM‐1 and sTREM‐2) levels in patients with FMF during both attack and attack‐free periods and their relationship with disease activity.Methods: Fifty‐seven FMF patients, 27 in the attack and 30 in the attack‐free period, along with 30 age‐ and sex‐matched healthy controls, were enrolled in the study. Demographic and clinical data were obtained from hospital records, and the disease severity scores (DSS) were calculated. Serum levels of sTREM‐1, sTREM‐2, TNF‐α, and IL‐1β were assayed by ELISA. CRP levels were measured by the nephelometric method. Receiver operating characteristic (ROC) analysis was performed for sTREM‐1 levels to detect attacks in patients with FMF.Results: sTREM‐1 levels were significantly higher in the attack group than in the attack‐free and control groups (p < 0.001). IL‐1β levels were elevated in FMF patients (p = 0.003), and CRP levels differed significantly among the groups (p < 0.001). No significant differences in sTREM‐2 or TNF‐α were observed. In the FMF‐attack group, sTREM‐1 positively correlated with TNF‐α (r = 0.526, p = 0.005), IL‐1β (r = 0.475, p = 0.014), CRP, and fibrinogen (p < 0.001). The DSS was significantly correlated with sTREM‐1 and CRP levels in FMF patients (respectively, r = 0.270, p = 0.042; r = 0.292, p = 0.027). The area under the curve (AUC) was 0.807 (95% CI, 0.695–0.92, p < 0.001), with an optimal sTREM‐1 cutoff of 232 pg/mL to detect attacks.Conclusion: sTREM‐1 may play a critical role in the inflammatory response in FMF disease and could serve as a potential marker for assessing disease activity.

Background/aim: Rheumatoid arthritis (RA) is an autoimmune disease that is characterized by persistent inflammation and progressive damage to the joints. In this study, it was aimed to explore the role of interleukin (IL)-40, a newly discovered cytokine, in the pathogenesis of RA. We also aimed to investigate the relationship between IL-40 and other cytokines such as IL-4, transforming growth factor (TGF)-β1 and tumor necrosis factor (TNF)-α. Materials and methods: This single-center, cross-sectional study included 87 participants divided into three groups: healthy controls (n = 29), newly diagnosed RA patients (n = 29), and RA patients with remission under methotrexate (MTX) monotherapy (n = 29). Serum samples were collected and analyzed for IL-40, IL-4, TGF-β1 and TNF-α levels using ELISA. Disease activity score, presence of autoantibodies and other relevant clinical data were obtained from hospital electronic records. Results: Elevated IL-40 levels were found in the newly diagnosed RA patients and in those treated with MTX compared to the control group (p < 0.001). Logistic regression analysis confirmed IL-40 as an independent predictor in the newly diagnosed (OR = 1.023, 95% CI: 1.010–1.035, p = 0.002) and RA MTX-treated patients (OR = 1.023, 95% CI: 1.011–1.036, p < 0.001). IL-40 levels remained unchanged in the newly diagnosed RA group compared to RA patients in the MTX-treated group. In the dual-seropositive patients, TGF-β1 was lower in the MTX-treated RA patients compared to the naive patients (p = 0.013) and in the dual-seronegative patients, TNF-α was decreased in the MTX-treated RA patients in comparison to naive patients (p = 0.043). Conclusion: This study demonstrates that IL-40 levels are elevated in RA patients and highlights its potential role in RA. The fact that IL-40 levels did not change despite the antiinflammatory effects of MTX suggests that IL-40 is involved in immunological pathways that are less responsive to treatment.