The use of measurement uncertainty among clinical laboratories becomes widespread. Measurement uncertainty can be reported with the result, as well as be used in certain reference change value (RCV) calculation equations. RCV is especially recommended for use in tests with a low individuality index. In our study, we calculated the measurement uncertainty of AFP, CA 125, CA 15-3, CA 19-9, CEA tumor markers with the ISO TS 20914:2019. We compared results with limits. Two Beckman Coulter DXI-800 (Minnesota, USA) autoanalysers’ results were used. We calculated the RCV values using the classical Fraser method, logarithmic Lund Method, and Clinical Laboratory Standards Institute (CLSI) method as Minimal Difference (MD). We found the same permissible measurement uncertainty limit as 15.97% for all five tumor markers. The highest RCV value was found as 90% upstream for AFP test with Lund logarithmic approach, the lowest RCV value was found as 12% for CEA with MD, all other RCV results were between these two values. We do not recommend the use of MD, as values for Biological variation are not used in the MD approach. We also recommend using the logarithmic approach, although it gives higher results. There are also clinical studies on the significance of tumor markers in a follow-up that show different results. These differences may be because the studies are conducted with different systems. Therefore, each laboratory needs to calculate its own RCV values. We also recommend informing the clinicians about the tests with high measurement uncertainty.

Objectives: The reference interval is the primary tool used to interpret laboratory test results. Each laboratory should determine reference intervals (RIs) that reflect their population. In this study, it was aimed to determine the RIs of hemogram routine and advanced clinical test parameters for our hospital and region by indirect method and to compare these calculated RIs with the limits recommended by the current manufacturer and the literature. Methods: The hemogram results of patients aged 18–65 years who applied to Kastamonu Training and Research Hospital between July 2020 and June 2022, were included in the study. Hemogram analyzes were performed on Sysmex XN-1000 (Kobe, Japan) hematology auto analyzers. The RIs were determined by indirect method from the obtained data using the non-parametric percentage estimation method. Harris-Boyd method was used to decide on subgroup separation based on gender. Results: All parameters had non-parametric distribution. RBC, HGB, HCT, MCH, MCHC, PLT, RDW-CV, RDW-SD, PCT, monocytes count, eosinophils count, monocytes % and macroR parameters which required gender-spesific RIs were determined separately for genders. Conclusions: When the results are evaluated, it shows that the manufacturer’s recommendations together with the studies in the literature do not fully reflect the RIs of our population. Therefore, it is very important for each laboratory to determine its own RIs due to the differences in population, diet, technical equipment used and reference group. In addition, we think that our study will make a significant contribution to the literature, since there is insufficient data in the literature on RIs for advanced clinical parameters.

This study evaluates the effects of exenatide (EXE), a glucagon-like peptide-1 (GLP-1) receptor agonist, on bone healing in rats using a single radius cortical defect model and histopathological, biochemical, and in silico methods. Forty-two male Sprague–Dawley rats, excluding controls, were divided into 7 groups after receiving a standard radius defect. The serum levels of total protein (TP), calcium (Ca2+), phosphorus (P), alkaline phosphatase (ALP), osteocalcin (OC), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) in each specimen were measured. Radius samples were examined histopathologically using hematoxylin and eosin (H&E) and Masson’s trichrome staining. Molecular docking analyses were used to assess EXE interactions with the GLP-1 receptor and osteogenic transcription factors. Statistical significance was set at p < 0.05. Changes in the selected serum markers were observed in the blood samples obtained from the specimens; however, these changes may not have been due to EXE administration. No significant negative effect on bone healing was observed in the groups that received subcutaneous EXE after the bone defect was created. By contrast, it was observed that for the treatment group that received EXE for 7 consecutive days before the bone defect was created on Day 7, bone healing progressed more slowly than in the groups treated with saline. Regarding the binding of EXE to the other target receptors, root mean square deviation (RMSD) values were low, bruised surface area (BSA) was high, and electrostatic interactions were strong, indicating that the ligand (i.e., EXE) binds to the selected receptor surfaces. Although the data obtained from the in vitro analyses in this study were verified using molecular docking, it should be noted that its design is preclinical. Given the widespread clinical use of GLP-1 receptor agonists in the management of type 2 diabetes mellitus (T2DM), our research findings may have translational relevance. Although derived from an experimental animal model, these results suggest that GLP-1 agonists such as EXE can exert additional effects on bone healing and inflammatory processes, thus warranting further studies, including controlled clinical investigations, to elucidate the potential implications for patient care.

Objectives: Reference change value (RCV) is an objective tool that indicates whether the change between consecutive measurements is clinically significant. This study aimed to determine the instrument-specific RCVs of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), thyroglobulin (Tg), thyroglobulin antibody (Anti-Tg), and thyroperoxidase antibody (Anti-TPO) tests, which are routinely analyzed for the diagnosis, case-finding, and screening of thyroid diseases. Methods: This cross-sectional study was conducted between January 1 and December 31, 2018. The twelve-month mean analytical imprecision (CV _A ) was calculated from internal quality control data for each test on three different instruments. All tests’ individuality index (II) was calculated using the biological variation data. RCVs were determined by both conventional and logarithmic approaches. Results: It was shown that the II of all tests was 0.6 and below. Upward logarithmic RCVs were slightly higher than conventional RCVs, while downward logarithmic RCVs were lower (e.g., conventional RCV for TSH 39 %, whereas upward and downward RCVs 48 and 32 %, respectively). Conclusions: Due to high individuality, the results of thyroid-related biomarkers would be more appropriate to evaluate with RCV instead of reference interval. Instrument-specific RCVs should be determined because the analytical imprecision of analyzers may vary. Most presentations to the hospital are not healthy individuals, so logarithmic RCV could provide a more accurate assessment of significant change.

Background/Objectives: Specialized pro-resolving lipid mediators (SPMs), such as Resolvin E1 (RvE1) and Resolvin D1 (RvD1), play a critical role in the resolution phase of inflammation. However, their relevance to tendon pathology and tissue-specific degeneration in rotator cuff tears remains unclear. This study aimed to investigate the relation between serum RvE1 and RvD1 levels and the morphological severity of tendon retraction and muscle fatty degeneration in patients with full-thickness rotator cuff tears. Methods: A total of 70 participants were included: 35 patients with full-thickness rotator cuff tears determined by magnetic resonance imaging (MRI) and 35 healthy controls. Tendon retraction and muscle fatty degeneration were graded using Patte and Goutallier classifications, respectively. Serum RvE1 and RvD1 levels were measured using enzyme-linked immunosorbent assay (ELISA). Group comparisons were performed using Welch’s t-test, and correlations were analyzed with Spearman’s coefficient. Results: RvE1 and RvD1 levels were significantly lower in patients compared to controls (p < 0.001). RvE1 showed a moderate positive correlation with Patte score (ρ = 0.37, p = 0.027), while no significant correlation was observed with Goutallier classification (ρ = 0.19, p = 0.27). RvD1 levels demonstrated no significant relationship with either morphological parameter. Conclusions: These findings suggest that decreased serum RvE1 levels are associated with the severity of tendon retraction but not with muscle fatty degeneration. Therefore, RvE1 may serve as a potential biochemical biomarker reflecting tendon damage severity and the impaired resolution of inflammation in rotator cuff tears.