Objective: Sickle cell disease (SCR described as a group of inherited blood disorders, affects millions of people throughout the world and is particularly common in the southern part of Turkey. We aimed to determine the relationship between ischemia-modified albumin (IMA) and the dynamic thiol/disulfide balance in SCD. Materials and Methods: Fifty-four adult SCD patients and 30 healthy controls were included in the study. The 54 adult patients included 30 (56% males and 24 (44%/) females with a mean age of 28.3 +/- 8.4 years (minimum-maximum: 18-46 years). Of the 54 patients, 46 had homozygous sickle cell anemia (HbSS) and 8 had sickleni/beta-thalassemia (HbS/(beta(+)-thalassemia). Fasting blood samples were collected. After centrifugation at 1500xg for 10 min, plasma samples were portioned and stored at -80 degrees C. IMA levels were determined by albumin cobalt binding test, a colorimetric method. Total and native thiols and disulfide were analyzed with a novel spectrophotometric method. Results: We found significantly lower levels of native thiol (-SH) (284.0 +/- 86.3 mu mol/L), disulfide levels (14.6 +/- 7 pmol/L), and total thiols (-SH + -S-S-) (313.0 +/- 89.3 ilmol/L) in SCD patients compared to healthy controls (respectively 417.0+54.2, 22.7+11.3, and 462.0 +/- 58.7 mu twill.). Plasma albumin levels (34.9 +/- 7.9 g/L) were lower and IMA levels (13.6 +/- 3.1 g/L) were higher in SCD patients compared to controls (respectively 43.5 +/- 3.1 and 8.4 +/- 1.6 g/L). Plasma albumin levels were strongly correlated with both plasma native (r=0.853; p=0.0001) and total thiols (r=0.866; p=0.0001). Conclusion: Decreased plasma native and total thiol levels and increased IMA levels are related to increased oxidative stress and provide an indirect and quick reflection of the oxidative damage in SCD patients.

Sepsis, a life-threatening dysregulated immune response to infection, necessitates reliable biomarkers for early risk stratification and prognosis. Sepsis occurs when bacteria that cause an infection the body's overwhelming inflammatory reaction to an infection leads to extensive tissue injury, organ dysfunction, and can be deadly if not promptly addressed. This study investigates the role of Systemic immune-inflammation index (SII), Systemic inflammatory response index (SIRI) and Aggregate Index of Systemic Inflammation (AISI) score in patients with sepsis. This retrospective study included 127 patients diagnosed with sepsis between November 2023 and March 2024. Neutrophil, lymphocyte and platelet levels statistically significant differences were observed in between the groups (p<0.0001). However, inflammatory indices calculated for the study groups did not show significant differences in terms of SII, SIRI, AISI (p<0.05). This study highlights SII and AISI as accessible, cost-effective biomarkers for assessing systemic inflammation and predicting adverse outcomes in sepsis. This research also emphasizes the predictive significance of SII and AISI, which are straightforward and regularly measured biomarkers. Further prospective studies are warranted to validate these findings and explore their utility in dynamic monitoring of sepsis progression.

Polycystic ovary syndrome (PCOS) is a prevalent endocrine-metabolic disorder among women of reproductive age, associated with hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Insulin resistance and lipid metabolism abnormalities are common in PCOS, increasing the risk of metabolic syndrome and type 2 diabetes mellitus (T2DM). Isthmin-1 (ISM1) is a novel adipokine that regulates glucose and lipid metabolism, but its role in PCOS remains unknown. This study aimed to investigate whether serum ISM1 levels are altered in women with PCOS compared to healthy controls and whether ISM1 is associated with key metabolic (e.g., insulin resistance, homeostasis model assessment of insulin resistance [HOMA-IR]) and hormonal parameters (e.g., follicle-stimulating hormone [FSH], luteinizing hormone [LH], estradiol [E2], testosterone, dehydroepiandrosterone sulfate [DHEA-S]). Emerging evidence highlights the role of novel adipokines in the metabolic dysregulation associated with PCOS. Among these, ISM1 has gained attention due to its insulin-mimetic effects and its role in glucose and lipid metabolism. Given the central role of insulin resistance and obesity in PCOS pathogenesis, investigating whether ISM1 is altered in women with PCOS could provide new insights into its potential role in disease mechanisms. Furthermore, exploring its association with insulin resistance markers may help determine whether ISM1 can serve as a supportive metabolic biomarker. Therefore, this study aimed to compare serum ISM1 levels between women with PCOS and healthy controls, and to examine the relationship between ISM1 levels and key metabolic and hormonal parameters. This case-control study included 60 women aged 18-45 years: 30 women with PCOS diagnosed using the Rotterdam 2003 criteria and 30 age-matched healthy controls. Anthropometric measurements (body mass index [BMI], waist circumference), metabolic parameters (fasting/postprandial glucose, fasting insulin, HOMA-IR, hemoglobin A1c [HbA1c], lipid profile), and hormonal markers (FSH, LH, estradiol, testosterone, DHEA-S, prolactin, thyroid-stimulating hormone [TSH], free thyroxine [FT4]) were assessed. Serum ISM1 concentrations were measured using an enzyme-linked immunosorbent assay (ELISA). Statistical analyses included independent t-tests, Mann-Whitney U tests, Spearman correlation, and ROC analysis. Median ISM1 concentration was significantly higher in the PCOS group (1.60 ng/mL) compared to the control group (1.34 ng/mL, p = 0.03). ISM1 levels positively correlated with fasting insulin (r = 0.26, p = 0.04) and HOMA-IR (r = 0.29, p = 0.03). No significant correlation was found between ISM1 and reproductive hormones or lipid profile components. ROC analysis demonstrated that ISM1 had moderate diagnostic performance in identifying PCOS, with an area under the curve (AUC) of 0.658 (95% CI: 0.52-0.77, p = 0.026). At an optimal cut-off value of 1.85 ng/mL, the sensitivity was 43.3% and specificity was 90.0%. Elevated serum ISM1 levels and their correlation with insulin resistance suggest that ISM1 may contribute to the metabolic pathophysiology of PCOS. Although its diagnostic performance is limited due to low sensitivity, ISM1 may serve as a supportive biomarker in identifying metabolic risk in women with PCOS. Further large-scale and mechanistic studies are needed to validate these findings and clarify the functional role of ISM1.

This study aimed to evaluate the levels of vitamin D among children and adults in Ordu, Türkiye, and to analyze variations based on age, gender, and seasonal effects. A total of 29,556 patients (7.620 children and 21.936 adults) were included in this retrospective study, with data collected from the automation system of Ordu Training and Research Hospital between April 1, 2021, and December 31, 2022. Statistical analysis was performed using Microsoft Excel and MedCalc software, employing methods such as descriptive statistics, the Mann-Whitney U test for group comparisons, and the Chi-square test for categorical data. Results indicated that vitamin D levels varied significantly based on age and gender, with 79.1% of male and 86% of female children exhibiting vitamin D deficiency (<30 ng/mL). Among adults, 89.6% of male and 92% of female patients were found to be deficient. Seasonal variations further revealed that children had higher vitamin D levels in summer compared to winter (26.3 ng/mL vs. 17.6 ng/mL). Similarly, adults showed a seasonal trend, with summer average levels being higher than winter. The findings confirm a high prevalence of vitamin D deficiency in both children and adults in Ordu. The study underscores the importance of monitoring vitamin D levels across different demographics and emphasizes the need for public health interventions, including awareness campaigns and supplementation strategies, to combat vitamin D deficiency in the region.

The Potential Renoprotective Effect of Sugammadex in Renal Ischemia-reperfusion Injury - Turkish Journal of Anaesthesiology and Reanimation

Background/aim: Acute appendicitis (AA) is a frequent indication for emergency surgery in children; accurate diagnosis is essential to prevent complications. We examined whether serum Galectin-3 is associated with pediatric AA and quantified its diagnostic performance relative to routine inflammatory markers. Materials and methods: This prospective, single-center study was conducted in a tertiary emergency department between July 1, 2023, and January 31, 2024. Children younger than 18 years with pathologically confirmed AA were enrolled as cases; age-compatible healthy volunteers served as controls. Venous blood was obtained at presentation before any therapeutic intervention. Galectin-3 concentrations were quantified using a commercial enzyme-linked immunosorbent assay. The primary endpoint was the ability of Galectin-3 to discriminate AA from controls. Receiver operating characteristic analysis was performed to assess discrimination, yielding area under the curve estimates with 95% confidence intervals (CIs); sensitivity and specificity were quantified at prespecified thresholds. Results: Seventy-four children were analyzed (AA group n = 47; control group n = 27). Compared with controls, the AA group had higher Galectin-3, leukocyte and neutrophil counts, C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lower lymphocyte counts and platelet-to-neutrophil ratio (PNR) (all p < 0.05). Galectin-3 yielded an area under the curve (AUC) value of 0.680 (95% CI, 0.55–0.81). At a threshold of >130.71 pg/mL, sensitivity was 91.49% and specificity was 33.33%; at >115.71 pg/mL, sensitivity was 100.00% with the same specificity; at >254.90 pg/mL, specificity was 92.30% with sensitivity 29.79%. Conclusion: Serum Galectin-3 is elevated in pediatric AA and affords moderate discrimination. Owing to limited specificity at pragmatic cut-offs, Galectin-3 alone is insufficient as a standalone test; however, it may serve as a rule-out adjunct within multimodal pathways. External validation in larger, multicenter cohorts is warranted.