Malnutrition has been associated with increased morbidity and mortality. The objective of this study was to determine the nutritional status and micronutrient levels of hospitalized patients in an infectious disease clinic and investigate their association with adverse clinical outcomes. The nutritional status of the study participants was assessed using the Nutritional Risk Screening 2002 (NRS 2002) and micronutrient levels and routine biochemical parameters were tested within the first 24 h of the patient’s admission. The incidence of zinc, selenium, thiamine, vitamin B6, vitamin B12 deficiency were 66.7% (n = 40), 46.6% (n = 29), 39.7% (n = 27), 35.3% (n = 24), 14.1% (n = 9), respectively. Selenium levels were significantly higher in patients with urinary tract infections, but lower in soft tissue infections. Copper levels were significantly higher in patients with soft tissue infections. In the Cox regression models, lower albumin, higher serum lactate dehydrogenase levels and higher NRS-2002 scores were associated with increased death. Thiamine, selenium, zinc and vitamin B6 deficiencies but not chromium deficiencies are common in infectious disease clinics. New associations were found between micronutrient levels and infection type and their adverse clinical outcomes. Hypoalbuminemia and a high NRS-2002 score had the greatest accuracy in predicting death, systemic inflammatory response syndrome and sepsis on admission.

Background/aim: Spontaneous wheals and/or angioedema lasting longer than six weeks are described as chronic spontaneous urticaria (CSU). Omalizumab is used for the treatment of antihistamine-resistant CSU. The neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) are considered important indicators of inflammation and platelet activation in chronic diseases. We aimed to determine the NLR, PLR, MPV, and PDW levels in patients with CSU compared with healthy controls. We also aimed to investigate the effects of omalizumab therapy on these parameters in CSU patients. Materials and methods: This hospital-based, retrospective study included 143 patients with CSU and 132 healthy controls with a mean age of 40.0 +/- 13.17 and 42.0 +/- 16.34, respectively. Patients with equal or higher-than-baseline UAS scores at week 12 of omalizumab treatment were considered nonresponders, others were considered responders. We analyzed the neutrophils, lymphocytes, platelet counts, NLR, PLR, MPV, and PDW before, during, and after omalizumab treatment and compared the results with those of healthy controls. Results: CSU patients presented higher baseline MPV (P = 0.035) and lower baseline PDW values (P < 0.001) than healthy controls. There were statistically significant increases in the MPV (P < 0.001), MPV/platelet count (P = 0.005), and PDW (P = 0.003) and there was a statistically significant decrease in the NLR (P = 0.018) during omalizumab treatment. The percent increase of MPV was low in nonresponders (P = 0.009). Nonresponders had lower PDW values than responders (P = 0.040). Conclusion: The increase in the MPV and PDW may be due to platelet activation during omalizumab treatment. The decrease in the NLR may be regarded as an antiinflammatory effect of omalizumab. The effect of omalizumab on platelet and inflammatory markers may be used to discriminate the responders from nonresponders.

The aim of this study was to assess the acute and chronic effects of vigorous physical activity, with and without zinc supplementation, on distribution of elements in young amateur boxers. The 8 week intervention trial experiment was designed with 32 healthy adolescent males in three parts: part 1, a 1 hour boxing training program; part 2, 4 weeks of regular boxing training without any supplementation; part 3, 4 weeks of regular boxing training with supplementation of pills containing 50 mg oral zinc. Plasma calcium, phosphorus, zinc, iron, copper, and magnesium levels of all participants were measured before and after each part of the study. After acute exercise serum calcium, zinc, copper levels decreased (p < 0.001; 0.001 and 0.017, respectively) and phosphorus increased (p < 0.001); iron and magnesium levels did not differ (p > 0.05). However, after 4 weeks of regular boxing training there was a decrease in zinc (93.92 +/- 9.03 microg/dL vs. 85.86 +/- 10.32 microg/dL, p < 0.001) and an increase in calcium concentrations (9.62 +/- 0.34 microg/dL vs. 9.90 +/- 0.26 microg/dL, p < 0.001). Zinc supplementation increased plasma calcium, phosphorus, and iron and decreased copper and magnesium (p < 0.001). The body element distribution of children in pubertal age changes with physical activities. Zinc supplementation can negatively affect their magnesium and copper concentrations.

Objective: Indirect bilirubin exerts an antioxidant effect when increased mildly. This study aimed to investigate whether increased bilirubin levels lead to an oxidant effect in newborns with hyperbilirubinemia requiring phototherapy. Patients and methods: The study included 30 term newborn infants aged 0–7 days with indirect hyperbilirubinemia requiring phototherapy and no comorbid disease as the study group. In addition, 30 term healthy newborn infants aged 0–7 days without indirect hyperbilirubinemia were employed as a control group. Serum triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), serum paraoxonase (PON) levels and malondialdehyde (MDA) levels were compared between the groups. Results: Serum MDA, total bilirubin, and LDL and HDL levels were significantly higher and the serum PON level was significantly lower, in the study group compared with the controls (p < 0.05). Conclusion: In newborns with hyperbilirubinemia requiring phototherapy, an increased bilirubin level causes oxidative stress by decreasing the level of serum PON and increasing the level of MDA.

Nephrotic syndrome (NS) is associated with an increased rate of cardiovascular events. The YKL-40 level is associated with atherosclerosis, endothelial dysfunction and proteinuria in renal and non-renal populations. The aim of this study was to investigate the relationships between the YKL-40 level and both vascular injury and proteinuria in NS patients. Sixty-nine NS patients and 20 healthy subjects were enrolled in the present study. The endothelial function was assessed according to the flow mediated dilatation (FMD) and the degree of arterial stiffness was determined based on the pulse wave velocity (PWV). The serum YKL-40 levels were measured using ELISA. The YKL-40 levels and PWV values were higher and the FMD values were lower in the NS patients than in the healthy controls. However, the CA-IMT and LVEF levels were not statistically different between the two groups. The patients were divided into three groups with respect to the extent of proteinuria: the normoproteinuria group (n:18), non-nephrotic proteinuria group (n:33) and nephrotic proteinuria group (n:18). Consequently, the YKL-40 levels and PWV values were significantly increased and the FMD values were decreased in the nephrotic proteinuria group compared to that observed in both the non-nephrotic proteinuria and normoproteinuria groups. Furthermore, the YKL-40 level correlated with the FMD and PWV values in the NS patients. In addition, proteinuria correlated with the YKL-40, FMD, PWV, eGFR and fasting LDL cholesterol values in this patient group. Multivariate linear regression analyses showed that the YKL-40 and eGFR values were effective in predicting proteinuria in the NS patients. The serum YKL-40 level is associated with endothelial dysfunction and increased arterial stiffness in NS patients and may be an indicator of the level of proteinuria in this patient population.