The Sysmex Coagulation System-2500 (CS-2500) is a fully automated coagulation analyzer that uses the optical reaction method. In this study, we aimed to evaluate performance characteristics of the CS-2500 in two coagulation tests [prothrombin time (PT) and activated partial thromboplastin time (aPTT)] at our hospital laboratory. PT and aPTT measurements were performed using the CS-2500 and STA-Compact Diagnostica Stago coagulometers (STA-Compact). Then, precision, accuracy, reference range verification, and method comparison statistics were performed. In the precision study, which was performed with normal and pathologic controls for the PT-international normalized ratio (INR) and aPTT tests, all coefficient of variation% were found less than 3.5%. In the comparison study, the Passing-Bablok regression analysis demonstrated the good agreement between each analyzer for PT-INR (y = −0.081 + 1.07x and r = 0.962) and for aPTT (y = 5.498 + 0.86x and r = 0.944). Both analyzers exhibited less than 9.9% bias in the accuracy study. The reference range verification analyses revealed that the manufacturer ranges were acceptable. The verification studies of the CS-2500 coagulation system were acceptable; however, in the comparison studies, there were small differences between STA-Compact. Overall, we propose that these differences could be eliminated in future standardization studies performed to use the same reference ranges for all systems.

Background: Automatic coagulation analyzers have been used in the last 50 years and have been developed considerably. Newly developed tests and methods cannot be conducted in routine laboratories without evaluating their performance. Therefore, their performance must be evaluated and approved before being used routinely. The aim of this study is to evaluate the analytical performance of Sysmex Coagulation System-2500 (CS-2500) and Sekisui CP-3000 automatic coagulation analyzer (CP-3000). Methods: For APTT, PT, and D-dimer tests, reference range verification study, a method comparison study was performed in both analyzers in accordance with CLSI protocols, and precision and accuracy were evaluated using internal and external quality control samples. In the evaluation of precision and accuracy, CV% and bias% values were calculated. Bland-Altman, Passing-Bablok regression analysis, and correlation coefficient were used in the comparison study. Results: The CV% values calculated for APTT and PT in both analyzers were found to be below the CLSI recommendation of 5%. D-dimer test results meet the quality criteria recommended by CLSI. Accuracy for both analyzers was within the acceptable limits. The reference ranges recommended by the manufacturer have been veryfied. Regression equations for APTT, PT, and D-dimer are y = -3.313 + 1.188x, y = -0.0399 + 1.048x, and y = 0.155 + 0.655x, respectively, and r values were 0.904, 0.978, and 0.974, respectively. Conclusions: CS-2500 and CP-3000 analyzers are suitable for laboratory use for routine coagulation. Since the CP-3000 device is newly used in our country, it needs to be supported by more comparison studies.

Objectives: Sarcoidosis is a multisystem granulomatous disorder characterized by an oxidative imbalance and inflammatory activation. Paraoxonase-1 (PON1) is a high-density lipoprotein–associated antioxidant enzyme that plays a protective role against oxidative stress. This study aimed to evaluate the serum PON1 activity in patients with sarcoidosis, its relationship with disease stage, and its association with pulmonary function and routine biochemical parameters. Materials and methods: A total of 45 patients with sarcoidosis and 45 age- and sex-matched healthy controls were included. Complete blood counts, biochemical parameters, and pulmonary function test results were evaluated. Serum PON1 activity was colorimetrically determined using a commercial kit. Statistical analyses included correlation, logistic regression, receiver operating characteristic (ROC) curves, and partial least squares discriminant analysis (PLS-DA). Results: Serum PON1 activity was significantly lower in patients with sarcoidosis than in the healthy controls (p<0.001). PON1 levels showed strong positive correlations with FEV ₁ (r=0.835), FVC (r=0.807), and DLCO (r=0.905), indicating that decreased antioxidant capacity parallels impaired pulmonary function. ROC analysis demonstrated that PON1 effectively differentiated patients from controls (AUC = 0.838; sensitivity, 75%; specificity, 82% at ≤210.53 U/L). PON1 levels declined progressively with increasing disease stages (p<0.05). Logistic regression analysis revealed that higher BMI and reduced FEV ₁ were independent predictors of sarcoidosis, whereas PON1 lost significance after adjusting for covariates. Conclusion: Serum paraoxonase activity is markedly reduced in sarcoidosis and is correlated with disease severity and pulmonary dysfunction, suggesting increased oxidative stress. Although not an independent predictor, PON1 may serve as a useful adjunctive biomarker, particularly for evaluating disease severity in Stage II and advanced stages, rather than for early diagnosis.

Annexin A3 (ANXA3) is a calcium-binding protein that plays a role in membrane phospholipid metabolism and inflammation, and significant alterations have been shown in some psychotic disorders. Because its association with major depressive disorder (MDD) is unclear, we aimed to compare serum ANXA3 levels in patients with MDD and healthy controls and to investigate their relationship with depression severity. Serum ANXA3 concentrations in 90 patients diagnosed with MDD and 90 healthy controls were measured by ELISA. Depression severity was assessed using the Beck Depression Inventory (BDI). Serum ANXA3 levels were significantly lower in patients with MDD compared to controls (p < 0.001). ANXA3 showed negative correlations with neutrophil count, platelet count, neutrophil-to-lymphocyte ratio (NLR), glucose, creatinine, and ALT levels, and positive correlations with lymphocyte and red blood cell counts. We found that low ANXA3 levels, high NLR, and glucose dysregulation predicted greater depression severity. Using ROC analysis, we demonstrated that ANXA3 has high discriminatory power in distinguishing moderate to severe cases of MDD (AUC > 0.90). ANXA3 may serve as a biomarker of depression severity. Further studies are needed to clarify its clinical utility and confirm whether ANXA3 alterations represent state or trait markers of depression.

Dear Editor, We carefully read the recent study published in your esteemed journal, "Comparison of Maternal Serum Vitamin D Levels in Preeclamptic and Healthy Pregnant Women," by Demir Özkan et al. The authors emphasize that significantly lower serum 25-hydroxyvitamin D (25-OH D) levels were found in pregnant women diagnosed with preeclampsia compared to normotensive pregnant controls, and they believe that vitamin D deficiency may be a factor playing a role in the pathogenesis of preeclampsia. This finding is clinically significant in reducing the increasing incidence of maternal morbidity and mortality worldwide. It is also an important observation for public health concerns, as it may reduce infant mortality. The evidence provided by this study and all the studies mentioned above highlights the need to integrate vitamin D screening into routine prenatal checkups, especially for pregnant women at higher risk of preeclampsia. Randomized controlled trials are needed to clearly demonstrate whether vitamin D supplementation can reduce the incidence and severity of preeclampsia. However, the lack of risk, low cost, and numerous potential benefits of vitamin D supplementation make it a valuable preventive strategy (Haugen et al., 2009; Andersen et al., 2015; Holick et al., 2011). Furthermore, public health measures such as dietary supplementation, awareness campaigns for both healthcare providers and pregnant women, and targeted supplementation programs can address this deficiency at the community level, thus preventing many adverse maternal and fetal complications. In conclusion, the important data obtained by Demir Özkan et al. from the Turkish population contributes substantially to the current body of evidence linking maternal vitamin D deficiency and preeclampsia. Further large-scale, multicenter studies are needed to determine optimal screening times, supplementation timing, and doses. Screening for vitamin D deficiency in pregnancy could be a simple yet effective policy to reduce the incidence of preeclampsia, improve maternal and fetal health outcomes worldwide, and reduce treatment costs.