Background: Delayed diagnosis and inadequate treatment of infectious and inflammatory diseases, such as Brucella, lead to high rates of mortality and morbidity. The aim of our study was to investigate the association between serum levels of apelin, presepsin, and irisin with inflammation, laboratory parameters, and blood culture in patients with brucella. Patients and methods: This prospective case-control study involves 30 patients with brucellosis and 30 healthy, matched control subjects. Thirty patients who were diagnosed with brucellosis were aged ≥ 18 years. Blood samples were taken from the patients on the first day they were diagnosed with brucellosis. The values of irisin, presepsin, and apelin were studied. In addition, blood samples were also taken from 30 healthy individuals for the control group. Irisin, presepsin, and apelin values that were measured in the patients on the first day were compared with those values measured in the control group. Results: The sex and age statuses of the subjects are matched among the groups. The levels of irisin were significantly higher in patients with brucellosis compared to the control group (p<0.045). There was no significant difference between the two groups in terms of apelin and presepsin levels (p values 0.087 and 0.162, respectively). There was a positive correlation between irisin levels and elevated ALT levels, as well as positive blood cultures. Conclusions: It appears that the measurement of irisin levels may be beneficial in patients with brucellosis. Irisin can be used as a diagnostic marker for brucella infection and may greatly clinicians to predict the severity disease and treatment response.
Background: Studies on biomarkers in the diagnosis of myocardial infarction are ongoing. Adropin is a biomarker that has been studied and has been shown to have different effects. This study aimed to examine the adropin level of patients with myocardial infarction within the first 24 hours, as well as its relationship with cobalamin and folic acid. Material and methods: The control group included 70 patients whose troponin values did not increase and no coronary lesions were detected. In the ST-elevation myocardial infarction (STEMI) group, 70 patients with ST elevation on ECG and coronary total thrombosis on coronary angiography were evaluated. Coronary lesion severity was measured using the SYNergy between percutaneous coronary intervention (PCI) with TAXUS and Cardiac Surgery (SYNTAX) score tool. Hemogram, troponin, adropin, c-reactive protein (CRP), cobalamin, folic acid, and other biochemical parameters were evaluated in all patients. Results: In the STEMI group, a significant increase was observed in the adropin level along with the troponin and CRP levels in the first 24 hours (p<0.001). Cobalamin and folic acid levels were low in the same group (p:0.016, p<0.001). While a strong negative correlation was observed between adropin and cobalamin, no correlation was found with other parameters. Conclusion: The study supports that adropin could be used as a cardiac biomarker in the early stages of STEMI patients. Another result is with low cobalamin and folic acid levels in patients with myocardial infarction which needs to be further explained with the strong negative correlation between adropin and cobalamin.
Background: Diabetic foot ulceration represents one of the most severe diabetic complications, with 50–60% progressing to diabetic foot infection (DFI). All diabetic wounds and diseases originate from peripheral vasculopathy and neuropathy, which are caused by oxidative stress and inflammatory processes. We investigated the utility of neutrophil-to-lymphocyte ratio (NLR) and CRP-to-albumin ratio (CAR) as cost-effective inflammatory biomarkers in DFI. Methods: The study included 58 DFI patients and 45 healthy controls. Disease severity was assessed using PEDIS staging. Routine laboratory parameters, NLR, derived NLR (d-NLR), and CAR were measured and compared. Results: In DFI patients, statistically significant increases (p < 0.001) were observed in NLR (3.12 vs. 1.99, p < 0.001), d-NLR (2.13 vs. 1.49, p = 0.003), CAR (0.91 vs. 0.03, p < 0.001), CRP (30.5 vs. 1.3 mg/L, p < 0.001) and PCT (0.1 vs. 0.02 μg/L, p < 0.001) values compared to the control group. Strong correlations existed between NLR, CAR and disease severity markers (CRP, PCT, HbA1c, osteomyelitis, PEDIS stage). ROC analysis revealed excellent discriminatory power for CAR (AUC = 0.915), PCT (AUC = 0.952), and CRP (AUC = 0.902), while NLR showed moderate performance (AUC = 0.702). Conclusions: NLR/CAR demonstrate excellent discrimination vs. healthy controls (AUC 0.915/0.702). The proposed workflow (NLR screening → CAR severity → PCT confirmation) requires prospective validation against with guidelines.
Background: Urinalysis has an important place in evaluating kidney and urinary tract infections. Automated urine analyzers enhance productivity and turnover in laboratories and economize time and labor required for analysis. In the present study, we evaluated and compared analytic and diagnostic performance of UriSed2 with LX-8000R, which is a novel image-based automated urine sediment analyzer. Methods: A total of 178 urine samples sent to our laboratory were evaluated by the two urine analyzers and standard manual microscopy. Precision and comparison studies were done in accordance with CLSI guidelines. Results: Sensitivity assessment revealed similar outcomes with both UriSed2 and LX-8000R devices for erythrocyte count (RBC), whereas UriSed2 device yielded higher outcomes for leukocyte count (WBC) and epithelial cells (EPI) than LX-8000R analyzer. Specificity of UriSed2 for WBC and RBC was higher than that of LX-8000R device. According to Gamma statistics, both urine analyzers showed perfect consistency for WBC, RBC and EPI cell counts. Manuel microscopy revealed statistically significant correlation between LX-8000R and UriSed2 in terms of WBC and RBC. Manual evaluation by Bland-Altman analysis demonstrated lower WBC and RBC values and higher EPI as compared to both UriSed2 and LX-8000R devices. As the result of Passing-Bablok regression analysis, both devices were found to be inconsistent with manual microscopy. Conclusion: We think that evaluation of automated urine analyzers will be more meaningful when they are evaluated together with urine samples and patient clinic in addition to comparing with manual microscopy.
Background: Dried blood spot samples are suitable for diagnosing some congenital errors of metabolism; however, they provide limited benefit in the regular monitoring of amino acids. Objectives: The present study aimed to evaluate alanine (Ala), arginine (Arg), citrulline (Cit), glutamic acid (Glu), glycine (Gly), isoleucine (Ileu), leucine (Leu), methionine (Met), ornithine (Orn), phenylalanine (Phe), tyrosine (Tyr), and valine (Val) amino acid concentrations in dried blood and plasma samples obtained simultaneously. Methods: Amino acid concentrations were determined in the plasma, and dried blood spot samples obtained simultaneously from 145 patients (50 females and 95 males). Amino acid concentrations in the plasma and dried blood spot samples were studied by LC-MS/MS using original kits. Results: There were significant differences between dried blood spots and plasma in all amino acid concentrations, except for Met and Val. Bland-Altman analysis revealed the highest mean differences in Glu (-148.1), Gly (-70.1), and Ala (-58.1). Deming regression analysis showed that plasma and dried blood spot samples were consistent concerning Cit, Met, Phe, and Tyr concentrations. Conclusions: Differences in methodology and sample can influence amino acid concentrations. Dried blood spot samples might cause errors in amino acid screening programs.