Objective Thyroid hormones are known to affect the biosynthesis and degradation of antioxidant compounds, suggesting a possible link between hypothyroidism and oxidative stress. However, there is no clear consensus in the literature regarding this association. The aim of this study was to evaluate oxidative stress markers (extracellular thiol-disulfide homeostasis and intracellular glutathione homeostasis) in patients with hypothyroidism due to autoimmune (Hashimoto’s thyroiditis) or nonautoimmune thyroid disease rendered euthyroid after levothyroxine replacement. Subjects and methods The study included 116 patients [...] ABSTRACT Objective Thyroid hormones are known to affect the biosynthesis and degradation of antioxidant compounds, suggesting a possible link between hypothyroidism and oxidative stress. However, there is no clear consensus in the literature regarding this association. The aim of this study was to evaluate oxidative stress markers (extracellular thiol-disulfide homeostasis and intracellular glutathione homeostasis) in patients with hypothyroidism due to autoimmune (Hashimoto’s thyroiditis) or nonautoimmune thyroid disease rendered euthyroid after levothyroxine replacement. Subjects and methods The study included 116 patients

Objectives: Thiol-disulfide measurements will assess obesity-related oxidative stress. Methods: A prospective observational study was done at two tertiary care centers. The participants were divided into three distinct categories based on their body mass index (BMI): The control group (Group 1) consisted of 116 individuals with a BMI ranging from 18 to 25 kg/m², while the overweight group (Group 2, n = 89) included those with a BMI between 25 and 30 kg/m². The obese group (Group 3, n = 39) comprised individuals with a BMI of 30 kg/m² or greater. This approach primarily utilizes the disulfide/native thiol ratio, disulfide/total thiol ratio, and native thiol/total thiol ratio as key metrics. All patients' demographics, waist circumference, hip circumference, height, weight, hemoglobin, hematocrit, white blood cell count, glucose, C-reactive protein, disulfide, native-thiol (NT), total-thiol (TT), lipid hydroperoxide radical (LOOH), and absolute ischemia-modified-albumin (ABSO) levels were recorded on calculations and records were made for disulfide to native and total thiol ratios. Results: Thiol-disulfide equilibrium differed between the three groups. NT concentrations averaged 368.87 mmol/L across all individuals and were significantly higher in the normal-weight cohort (BMI 18-25 kg/m2) at 380.60 mmol/L, compared to overweight and obese populations (p<0.001). TT concentrations were higher in normal-weight individuals, with an average of 426.36±54.48 mmol/L, compared to 405.41±52.14 and 391.07±46.45 in overweight and obese individuals, respectively (p<0.001). Conclusions: Reduced native and total thiol levels, along with altered disulfide concentrations in obese individuals, serve as indicators of oxidative stress.

Introduction: The effects of 25-hydroxyvitamin D (25(OH) D) on inflammation are gaining attention, particularly for diabetic individuals with COVID-19. Therefore, we examined 25(OH) D and inflammation-related markers in diabetic subjects with mild COVID-19. Materials and Methods: This investigation was intended to be retrospective. The present study covered the medical records of patients who applied to the our hospital between March 2020 and November 2022. All patients suffer from COVID-19. The control group (n = 30) had no diabetes, while the study group (n = 36) had diabetes. Inflammatory markers such as ferritin, C-reactive protein and erythrocyte sedimentation rate were measured in addition to 25 (OH) D levels in each subject. Also, the results of the complete blood count were obtained from the hospital database. Results: Our participants were matched in terms of gender and age between study groups. ESR, CRP, ferritin, and 25 (OH) D levels, among other variables, did not significantly differ between the non-DM and DM groups (p>0.05). Also, we evaluated all participants according to deficiency of 25 (OH) D, and inflammatory markers were not evaluated in diabetic subjects with COVID-19. However, our findings showed that ferritin levels and Hba1c levels in diabetic individuals significantly correlated positively. Conclusion: Diabetes mellitus and deficiency of 25 (OH) D are known as risk factors for COVID-19. But as compared to non-diabetic participants with COVID-19, our findings did not reveal any considerable elevation neither inflammatory markers nor changes 25 (OH) D in the diabetics.

Purpose: Modification of Diet in Renal Disease’ (MDRD) and 'Chronic Kidney Disease Epidemiology Collaboration’ (CKD-EPI) formulas are generally accepted and widely utilized tools to assess renal function. In this study, we aimed to investigate the power of the MDRD and CKD-EPI formulas, which are the two most used formulas in the measurement of eGFR in patients with multiple myeloma (MM). Materials and Methods: A total of 40 patients, newly diagnosis with MM, were consecutively enrolled to the study and their records were analyzed in terms of demographic features and laboratory parameters of the patients, type of paraproteinemia and stage of disease. MDRD and CKD-EPI formulas were used to evaluate renal function. Results: The difference found between basal and third-month estimated Glomerular Filtration Rate (eGFR) using MDRD (61±15.4 mL/min/1.73 m², third month 75±18.2 mL/min/1.73 m²) and CKD-EPI formulas (62±15.7 mL/min/1.73 m², third month 76±18.4 mL/min/1.73 m²) were significant. There was no significant difference between two formulas regarding basal and third month eGFR mean values. According to CKD staging, 12.5% of all subjects changed and 80% of them moved to better stage. Conclusion: CKD-EPI tends to produce higher eGFR values with compared to MDRD, especially when they are used to evaluate mildly impaired renal function. Hence, prevalence of renal disease was determined lower when assessed with CKD-EPI. Therefore, we recommend that it is important to use the same eGFR estimation formula for a consistent outcomes analysis.

Aim: Malnutrition and inflammation are critical factors affecting the duration of hospitalization. Although the Nutritional Risk Screening 2002 (NRS-2002) is widely recommended for nutritional assessment, its predictive value for length of stay (LOS) remains controversial. The C-reactive protein to albumin ratio (CAR) has emerged as an objective inflammatory-nutritional marker. This study aimed to compare the prognostic performance of NRS-2002 and CAR in predicting prolonged hospitalization in an internal medicine cohort.Methods: This retrospective cohort study included 375 adult patients hospitalized in the internal medicine ward of a tertiary care hospital between April and October 2023. Prolonged LOS was defined as a hospitalization duration exceeding the median value (>9 days). The predictive performance of NRS-2002, albumin, CRP, and CAR was analyzed using univariate and multivariate binary logistic regression and receiver operating characteristic (ROC) curve analysis.Results: The median LOS was 9 days, and 48.8% of patients experienced prolonged hospitalization. In univariate analysis, CAR (8.5 [24.3] vs. 15 [36.9], p=0.004), albumin (3.3 [0.9] vs. 3.0 [0.8] g/dL, p=0.001) and CRP (25.9 [72.5] vs. 46.0 [104.8] mg/L, p=0.008) differed significantly between the normal and prolonged LOS groups. NRS-2002 scores did not differ between groups (3 [2] vs. 3 [2], p=0.617), and nutritional risk prevalence (NRS-2002 ≥3) was identical in both groups (68.3%). ROC analysis showed that CAR (area under the curve [AUC]=0.585) and albumin (AUC=0.604) had superior discriminative ability compared with NRS-2002 (AUC=0.515). In multivariate analysis, CAR remained an independent predictor (odds ratio [OR]=1.01, p=0.038), whereas NRS-2002 was not (p=0.598).Conclusion: CAR index outperforms the NRS-2002 screening tool in predicting prolonged hospital stay in internal medicine inpatients. While NRS-2002 remains essential for identifying patients in need of nutritional intervention, the integration of objective inflammatory-nutritional biomarkers such as CAR may improve risk stratification for hospitalization outcomes.

Background/Objectives: Simple admission laboratory indices have been proposed for early risk stratification in acute pancreatitis (AP), but their relative performance and their value beyond established severity assessment are rarely examined directly. We performed an exploratory head-to-head comparison of eight admission inflammatory and immunonutritional indices, including the Global Immune-Nutrition-Inflammation Index (GINI), for a composite adverse in-hospital outcome. Methods: This single-center retrospective study (2020 to 2026) analyzed the index admission of each adult hospitalized with AP (one observation per patient). Eight indices were evaluated (NLR, CAR, PIV, PNI, HALP, CALLY, CCR, GINI). The primary endpoint was a composite of in-hospital death, intensive care unit (ICU) admission, or prolonged hospitalization (a length of stay of at least 7 days). We assessed discrimination (area under the curve, AUC, with DeLong intervals and Holm-corrected comparison), age-adjusted logistic regression, calibration, bootstrap validation, and incremental value over the Bedside Index for Severity in Acute Pancreatitis (BISAP), with a patient-clustered robustness analysis. Results: Of 238 patients, 73 (30.7%) met the composite outcome (prolonged stay 63, ICU 15, death 2). After age adjustment, all eight indices were associated with the outcome (all p < 0.001). The three numerically highest were NLR (age-adjusted AUC 0.737, 95% CI 0.667 to 0.808), CALLY (0.735), and GINI (0.734), with no significant pairwise difference after correction. Each added discrimination beyond BISAP (BISAP alone AUC 0.631 vs. BISAP plus CALLY 0.752; likelihood ratio p < 0.001). GINI was numerically higher but not significantly better than its components (CAR 0.710, PIV 0.708). Models were well calibrated (calibration slope 0.97 to 1.00). Conclusions: In AP, several admission indices, led by NLR, CALLY, and GINI, gave modest, broadly comparable discrimination for a composite adverse in-hospital outcome and added information beyond BISAP. No index was superior, and the composite was driven largely by prolonged hospitalization. These exploratory findings require prospective external validation before any clinical use.