Neurotoxicity is an important side-effect of many chemotherapeutic agents, including doxorubicin (DXR). L-Theanine (LT) is a non-protein amino acid with a variety of beneficial health effects, involving anti-inflammatory, antimicrobial, anti-aging, antioxidant, antitumor, antihypertensive, and antistress properties. The aim of this study was to investigate the modulatory roles of LT on the electrophysiological, histopathological and biochemical effects of DXR on the rat hippocampus, cerebral cortex and cerebellum. Sixty-four male Wistar rats were randomly divided into four groups: Sham, DXR, DXR+LT200 and DXR+LT400. LT was administered via oral gavage at doses of 200 and 400 mg/kg/day for 21 days, while DXR was given cumulatively at 18 mg/kg (intraperitoneally on days 4, 11, and 18). Half the rats were used for brain electrophysiological assessments, and the remaining half for histological and biochemical analyses. DXR reduced total power in the electrocorticogram (ECoG) between 0.1 and 50 Hz, across all frequency ranges. The application of 400 mg/kg/day, but not 200 mg/kg/day, reduced the total power even further (p<0.05). Conversely, both doses of LT treatment significantly reduced DXR-induced cell degeneration in all regions (p<0.001). LT treatments also tended to reduce the levels of DXR-induced oxidative stress parameters, although these effects were not significant for every region of the brain. Considering the capacity of DXR to cause pathological conditions and the multifaceted effects of LT treatments on different regions of the brain, we conclude that the simultaneous administration of LT supplement with DXR treatment should be performed with caution.

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.

Objectives: Furin (Proprotein Convertase Subtilisin/Kexin Type 3, PCSK3) is a proprotein convertase involved in the processing of precursor proteins. Furin substrates play significant roles in the initiation and progression of atherosclerosis, which is the primary cause of coronary artery disease (CAD). This study aimed to investigate the serum furin concentrations in stable CAD patients and their relationship with disease severity. Methods: The study included 81 stable CAD patients and 50 subjects without coronary artery lesions. Coronary angiography was performed via the percutaneous femoral artery approach, and the severity of CAD was assessed using the Gensini score. Serum furin concentrations were measured using an enzyme-linked immunosorbent assay. Results: Serum furin concentrations were significantly higher in CAD patients compared to CAD-negative subjects (p=0.0001). The serum furin levels of mild, moderate, and severe CAD patients were 1.53 ng/mL, 2.01 ng/mL, and 3.03 ng/mL, respectively, which were significantly different from CAD-negative subjects (p=0.018, p=0.002, and p=0.0001, respectively). Furin levels were found to be an independent predictor of CAD and exhibited potential diagnostic value for CAD and severe CAD. Conclusion: The study concluded that serum furin concentrations could be considered a new risk factor for CAD, in addition to well-known biomarkers.

Estimation of cardiovascular (CV) individual risk over a 10 year period was provide benefit most from preventive action in individual at high risk of CVD, and it evaluated by SCORE2 predictive model. Oxidative stress plays a critical role in all stages of atherosclerosis. It was examined the relationship between oxidative stress and SCORE2, and to investigate whether one of the oxidative stress parameters may represent a potential risk marker permitting more accurate high-risk prediction for CV risk calculation models. The study groups consisted of 71 coronary artery disease (CAD)(−) patients (27 normocholesterolemic and 44 hypercholesterolemic) and 12 CAD(+) patients. Ox-LDL, MDA, OSI, 3-NT, 8-OHdG, and total thiols were measured as oxidative stress parameters and TNF-α and IL-6 as inflammatory factors. The oxidative stress parameters were showed significant changes among study groups. ROC analysis identified ox-LDL levels as one of the highest values (AUC:0.998, p < 0.001). ox-LDL exhibited the highest odds ratio at 1.68 (CI = 1.26–2.14) with SCORE2. ox-LDL levels increased significantly and gradually from the low- to high-risk groups of SCORE2 and exhibited the strongest correlation with SCORE2 (r = 0.48, p < 0.001). We suggest that circulating ox-LDL levels may be considered as a candidate marker for more accurate high-risk prediction with SCORE2.

Objective: Chronic Obstructive Pulmonary Diesase (COPD) is an inflammatory lung disease that progresses with attacks. Pneumonia is an infectious lung disease that progresses with lung infiltrations. Osteopontin (OP) is a cytokine which participates in inflammation. Neutrophil Gelatinase Associated Lipocalin (NGAL) is an antimicrobial peptide with neutrophil activation and antibacterial properties. In this study, serum OP and NGAL levels were assayed in COPD exacerbation, stabile COPD and pneumonia. The aim of our study is to assess the importance of NGAL and OP levels as biomarkers in the differential diagnosis of COPD and pneumonia. Material and Methods: One hundred twenty consecutive patients who were admitted to our department between May 2011 and August 2013 were included in the study. Serum OP and NGAL levels were measured with ELISA method within 24 hours following the determination of diagnosis. COPD acute exacerbation (AE-COPD) group was comprised of 95 patients (87 male and mean age 69.0±10.6), and the pneumonia group was comprised of 25 patients (16 male and mean age 57.5±22.9). Serum OP and NGAL levels of the patients in the AE-COPD group were re-measured within 30-45 days following acute exacerbation in stabile period. Results: Serum OP levels were higher in the pneumonia group compared to the AE-COPD group (93.47 ng/ml vs 53.10 ng/ml; p<0.001). Multivariate regression analyses indicated that OP levels to be >84 ng/ml is an independent predictor that increases risk for pneumonia more than 8-fold (95% CI, 2.43-26.59). Sensitivity and specificity of OP in the differentiation of pneumonias from AE-COPD were determined to 80% and 92%, respectively. Serum NGAL levels also increased as COPD severity increased and was found to be statistically significant (p: 0.032). Conclusion: It has been indicated that serum osteopontin level can be an independent predictor in differentiating COPD exacerbation from pneumonia. Additionally, as COPD severity (stage) increases, serum NGAL levels also increase, which may be helpful in assessing the severity of COPD.

Objectives: The Six Sigma methodology is also frequently used by clinical laboratories as an objective and quantitative way to measure quality. In our study, we aimed to evaluate the analytical performance of 80 tests using the Six Sigma methodology according to the CLIA (Clinical Laboratory Improvement Amendments) 2019, RICOS BV (Dr. Carmen RICOS Biological Variation) Desirable, and EFLM BV (European Federation of Clinical Chemistry and Laboratory Medicine Methods: The sigma values of 80 tests were calculated according to the TEa (Total Allowable Error) limits allowed by all three references using internal quality control and external quality control data. They were calculated monthly for 12 months, and the annual average was taken. Sigma values were calculated with the Six Sigma formula. Results: Considering the total number of goals reached, the highest success rate of 60% was achieved according to the CLIA goals, while the lowest success rate of 36% was obtained according to the EFLM BV Desirable criteria. Although exactly the same laboratory data are used, this gap between the sigma values obtained according to the selected refA1c), and Troponin T. Conclusion: The Six Sigma protocol is one of the effective and universal tools for evaluating the performance of clinical laboratories. However, one of its biggest limitations is the lack of standardization in tolerance limits. The obtained performance varies according to the preferred reference. Therefore, we think that in the Six Sigma methodology, it is more feasible to select Total Allowable Error criteria from different references according to their suitability for the test.

BACKGROUND:Post-ischemia reperfusion can lead to oxidative stress and an increase in oxidative markers. Employing preventive strategies and antioxidant agents may help mitigate ischemia-reperfusion injury (IRI). The use of a tourniquet in extremity surgery has been associated with IRI. This study aims to investigate the impact of three different approaches- brachial plexus block, total intravenous anesthesia (TIVA), and inhalation anesthesia-on IRI during upper extremity surgery using a tourniquet. METHODS:Patients aged 18 to 45 with American Society of Anesthesiologists (ASA) I-II scores were randomly assigned to one of three groups: Group A received an axillary block with bupivacaine; Group I underwent inhalation anesthesia with sevoflurane; and Group T received TIVA with propofol and remifentanil infusion. Blood samples were collected to measure glucose, lactate, total anti-oxidant status (TAS), total oxidant status (TOS), and ischemia-modified albumin (IMA) levels at various time points: before anesthesia (t1), 1 minute before tourniquet release (t2), 20 minutes after tourniquet release (t3), and 4 hours after tourniquet release (t4). RESULTS:In Group I, lactate levels at t3, and glucose levels at t2 and t3, were higher compared to the other groups. Group A exhibited lower IMA levels at t2, t3, and t4 than the other groups. Additionally, Group I had lower IMA levels at t2, t3, and t4 compared to Group T. TAS levels were higher in Group I at t2, t3, and t4 compared to the other groups. TOS levels at t2 and t3 were lower in Group A than in Group I. CONCLUSION:Axillary anesthesia results in a sympathetic block, promoting better perfusion of the upper extremity. This study demonstrated lower levels of oxidative stress markers with axillary plexus block. Therefore, these results suggest that the axillary block has the potential to mitigate IRI.

Paraoxonase-1 (PON1) is a high-density lipoprotein (HDL)-associated enzyme that exhibits paraoxonase, arylesterase, and lactonase activities. This multifunctional enzyme plays a crucial role in preventing atherosclerosis by inhibiting low-density lipoprotein (LDL) oxidation and reducing oxidized lipid levels. The present study aimed to investigate the affinities of various lipid-lowering drugs to PON1 and its polymorphic structures [(M/L)55 and (Q/R)192] using advanced molecular docking methods. The research utilized a comprehensive computational approach, including homology modeling, molecular dynamics simulation, and AutoDock 4 software to analyze the interactions between PON1 and several classes of lipid-lowering agents. These included statins (simvastatin, atorvastatin, lovastatin, mevastatin, fluvastatin, rosuvastatin, pravastatin), fibrates (fenofibrate, gemfibrozil, bezafibrate, ciprofibrate), niacin, ezetimibe, orlistat, sibutramine, probucol, and phytosterols (brassicasterol, campesterol, β-sitosterol, stigmasterol). The study revealed varying affinities of these drugs to PON1 and its polymorphic structures. Notably, brassicasterol showed the highest affinity for the normal PON1 structure, while sibutramine and stigmasterol demonstrated the highest affinities for the Q/R 192 and M/L 55 polymorphic structures, respectively. Conversely, orlistat exhibited the lowest affinity for both normal PON1 and the M/L 55 polymorphic structure, while atorvastatin showed the lowest affinity for the Q/R 192 polymorphic structure. These findings provide valuable insights into the potential interactions between lipid-lowering drugs and PON1, suggesting that consideration of PON1 affinity might be important in the selection of lipid-lowering therapies, particularly in individuals with different PON1 polymorphisms. However, further in vitro and in vivo studies are necessary to validate these computational results and establish their clinical relevance.

We hypothesized that the consumption of a 3-day standard diet (SD) prior to the oral fat tolerance test (OFTT), used to evaluate postprandial lipemia, may counteract the undesirable effects of individual dietary habits on the test results. The OFTT was applied to 22 healthy adults (11 females and 11 males), after their habitual diets (HDs) and following the consumption of a 3-day SD (45–60% energy from carbohydrate, 20–35% from fat, and 10–20% from protein). Plasma triglyceride (TG) concentrations were measured during fasting and at the fourth hour of the OFTT. A 3-day SD significantly reduced fasting and fourth-hour TG concentrations and delta TG values by 10%, 12.8%, and 22.7%, respectively. Decreases were observed in fasting and fourth-hour TG and delta TG values following the 3-day SD compared to the HD in subjects with fasting TG concentrations between 89 and 180 mg/dL (p = 0.062, p = 0.018, and 0.047, respectively). As a result, the consumption of a 3-day standardized diet prior to the OFTT may be useful to eliminate the false positive or negative effects of individual dietary habits on test results and to correctly identify individuals who should be administered the OFTT.

Background: Postprandial lipemia (PPL) causes endothelial dysfunction by causing endothelial damage to lipoproteins that remain rich in triglycerides. Endocan is a proteoglycan with increased tissue expression, endothelial activation, and neovascularization. The aim of the study was to examine circulating endocan levels in PPL subjects by considering the degree of PPL response according to a high-fat test meal. The other aim was to determine the association between endocan levels and endothelial and inflammatory factors. Method: Fifty-four hyperlipidemic subjects and 28 normolipidemic subjects consumed the high-fat meal. Endocan, sICAM-1, sVCAM-1, and VEGFA as endothelial factors and IL-6 and LFA-1α as inflammatory factors were evaluated. Results: Fasting serum endocan, VEGFA, sICAM-1, sVCAM-1 IL-6, and LFA-1α levels were increased in the PPL group compared to the control group. The PPL group was divided into tertiles based on mean AUC levels. Endocan levels in tertile 3 were at the highest and were increased significantly compared to tertiles 1 and 2. AUC and endocan levels were positively correlated with other endothelial and inflammation factors. ROC analysis showed endocan levels to be one of the highest values. Conclusions: Circulating endocan is seen at significantly higher levels and independently associated with endothelial and inflammatory factors in postprandial lipemia and dyslipidemia.

Background: Diabetes Mellitus (DM), a metabolic disease characterized by the increased blood glucose level, insulin deficiency or ineffectiveness, may cause structural and functional disorders in the brain. L- Theanine (LTN) has the relaxing, psychoactive, antidepressant, anti-inflammatory and antinecrotic properties, and regulates the functions of hippocampus (HP) in brain. In the present study, the aim was to identify the effects LTN on the levels of BDNF, insulin and adipocytokines (TNF-a, leptin, adiponectin and resistin) in both HP and serum of diabetic rats. Methods: 32 male Wistar rats were divided into four groups (n 1/4 8/group): Control, LTN, DM and DM thorn LTN. Diabetes was induced by by nicotinamide/streptozotocin. 200 mg/kg/day LTN treatment was applied for 28 days. The serum and hippocampal levels of the parameters were determined by using commercial ELISA kits. Additionally, HP tissues examined histopathologically. Results: LTN treatment significantly decreased leptin and adiponectin levels in HP tissues in diabetic rats (p < 0.05). Although it decreased the insulin level in both serum and HP, this was not statistically sig-nificant. No significant effect on other parameters was observed (p > 0.05). In histopathological analysis, although the damage was reduced by LTN in all sections of HP, this change was significant mainly in CA3 region (p < 0.05). Conclusion: It was concluded that LTN has the ability to reduce hippocampal degeneration and modu-lates adipocytokines in diabetic rats. (c) 2023 Elsevier Inc. All rights reserved.

Coronavirus disease 2019 (Covid-19) has caused one of the biggest pandemics of modern times, infected over 240 million people and killed over 4.9 million people, and continues to do so. Although many drugs are widely recommended in the treatment of this disease, the interactions of these drugs with an anti-atherosclerotic enzyme, paraoxonase-1 (PON1), are not well known. In our study, we investigated the interactions of 18 different drugs, which are claimed to be effective against covid-19, with the PON1 enzyme and its genetics variants L55M and Q192R with molecular docking, molecular dynamics simulation and free energy calculation method MM/PBSA. We found that ruxolitinib, dexamethasone, colchicine; dexamethasone, sitagliptin, baricitinib and galidesivir, ruxolitinib, hydroxychloroquine were the most effective compounds in binding PON1-w, PON1L55M and PON1Q192R respectively. Mainly, sitagliptin, galidesivir and hydroxychloroquine have attracted attention by showing very high affinity (<-300 kJ/mol) according to the MM/PBSA method. We concluded that the drug interactions should be considered and more attention should be paid in the use of these drugs.Communicated by Ramaswamy H. Sarma.

Background: The study aimed to identify the effects of L-theanine on kidney and heart tissues in diabetic rats. 24 male rats included in the study were divided into 4 groups (n 1/4 6/group): SHAM, LTEA, DM and DM thorn LTEA. For 28 days, drinking water was given to SHAM and DM, and LTEA (200 mg/kg/day) to LTEA and DM thorn LTEA groups, intragastrically. DM was induced by 120 mg/kg nicotinamide (NA) thorn 60 mg/kg streptozotocin (STZ). The levels of cystatin C (CysC) and angiotensin-converting enzyme 2 (ACE2) were determined by ELISA kits, homocysteine, electrolytes and iron by an autoanalyzer, the ratio of oxidized/ total reduced glutathione (GSSG/TGSH) by assay kits. The tissues were histopathologically analyzed.Results: LTEA alleviated histopathological degenerations. However, it decreased significantly serum iron and homocysteine levels (p < 0.05).Conclusion: LTEA did not exhibit significant protective effects on kidney and heart tissues; it may have affected the homocysteine and iron metabolisms in diabetics.(c) 2023 Elsevier Inc. All rights reserved.

Oxidative modifications of lipoproteins are crucial in the early stages of cardiovascular diseases (CVD) like hypercholesterolemia. The major aim is to determine the effects of hazelnut consumption on the resistance of low- and high-density lipoproteins to oxidation in hypercholesterolemic subjects. Fifteen hypercholesterolemic subjects (13 men, 2 women) who did not require drug treatment according to the National Cholesterol Education Program Adult Treatment Panel III criteria and had serum levels of TC˃200 mg/dL were included in the study. This study was designed as a dual control sandwich model intervention with a single group, isoenergetic three periods. The periods were; Control Diet I (30 days), Hazelnut-Enriched Diet (30 days), and Control Diet II (30 days). The susceptibility of LDL and HDL to copper-mediated oxidation was determined spectrophotometrically by following conjugated diene formation. The resistance of lipoproteins, mainly LDL, was increased by hazelnut consumption. It can be concluded that a hazelnut-enriched diet had protective effects against lipoprotein oxidation in hypercholesterolemic subjects. These changes may play important roles in reducing the development of the atherosclerotic process.

INTRODUCTION: Behçet's disease (BD) is a chronic multisystemic inflammatory disorder and is associated with many inflammatory processes. The present study aimed to examine the serum levels of proinflammatory cytokine soluble tumor necrosis factor-like weak inducer of apoptosis (sTWEAK) and its scavenger receptor soluble cluster of differentiation 163 (sCD163) simultaneously in patients with BD by considering their relationships with disease activity. METHODS: The study group included 53 patients with BD (29 females and 24 males) and 30 healthy individuals. Patients with a lesion or active organ involvement were defined as active (n=39) and those without were identified as inactive (n=14). Serum sTWEAK and sCD163 concentrations were determined by enzyme-linked immunosorbent assay. RESULTS: Serum sTWEAK and sCD163 levels were significantly increased in patients with BD compared with the healthy group (p=0.016 and p=0.003, respectively). Concentrations of these two molecules were also higher in active and inactive BD than the healthy individuals (p=0.043 for sTWEAK and p=0.010 for sCD163). Receiver operating characteristic curve analysis revealed that serum sCD163 and sTWEAK levels had a discriminating ability between patients with BD and healthy controls with area under the curve values of 0.706 and 0.661, respectively. DISCUSSION AND CONCLUSION: It was concluded that circulating sTWEAK and its scavenger receptor sCD163 levels were increased in BD, significantly predicted the disease, and might be significant molecules to assess inflammation.

Background and Objective Due to the frequency of meal ingestion, individuals spend the majority of the day, ~18 h, in a status of post-prandial (PP) stress. Remnant-like lipoprotein particles (RLPs) are predominant in PP phase playing an important role in the development of atherosclerosis. Endothelial progenitor cells (EPCs) have been suggested to play a role in vessel wall homeostasis and in reducing atherosclerosis. However, there is no information about peripheral blood EPCs number following PP stress. We investigated the association between circulating EPCs levels and extent of PP lipemia in healthy subjects following a high-fat meal. Materials and Methods A total of 84 healthy subjects (42 men, 42 women) aged 17–55 years were included in the study. PP lipemic response of subjects was determined by Oral Fat-Loading Test (OFLT). All the subjects were classified on the basis of their plasma TG levels after PP lipemic stressors in categories 1 (low), 2 (moderate), and 3 (high). Circulating EPCs numbers were measured by the flow cytometry method. Results There was a significant difference in terms of lipid parameters between men and women: high-density lipoprotein cholesterol (HDL-C) was significantly lower in men than in women (p < 0.001). Total cholesterol (TC) (p = 0.004), low-density lipoprotein cholesterol (LDL-C) (p < 0.001), triglyceride (TG) (p < 0.001), and TG-AUC (p < 0.001) were significantly higher in men than in women. There was no significant difference between the genders in terms of CD34+KDR+ and CD34+KDR+CD133+cell number and MMP-9 levels. Vascular endothelial growth factor (VEGF) levels were significantly higher in men than women (p = 0.004). TC, LDL-C, and TG were significantly higher in the 3rd category than 1st and 2nd categories (p < 0.001) in women. Age, body mass index (BMI), fat rate, TG, TC, and LDL-C were significantly higher in the 3rd category than 1st category (p < 0.001, p = 0.002, p = 0.002, p = 0.01, p = 0.007, p = 0.004; respectively), in men. Circulating numbers of EPCs in men were significantly higher in the PP hyperlipidemia group than in the low TG levels category, independently from age (p < 0.05). Circulating EPC levels showed a positive correlation with OFLT response in men (r = 0.414, p < 0.05). Also, OFLT response showed a strong positive correlation with fasting TG levels (r = 0.930, p < 0.001). EPC levels in categories of women were not different. Conclusion Increased EPCs levels in subjects with different PP hyperlipidemia may be associated with a response to endothelial injury, related to increased atherogenic remnant particles at the PP phase.

Background Metabolic syndrome (MetS) is closely related to lipid disorders and increased oxidant stress, and is associated with cardiovascular diseases. Objective The purpose of this research was to examine thiol/disulfide homeostasis and oxidative stress in MetS patients with postprandial lipemia (PPL) during fasting by considering time-dependent changes in the postprandial period. Methods Twenty-five patients with MetS and 25 healthy controls underwent a 6-h oral fat tolerance test. Dynamic thiol/disulfide homeostasis (native thiol, disulfide, and total thiol) values and total oxidant status (TOS), total antioxidant status (TAS), and Oxidative Stress Index (OSI): (TOS/TAS) were evaluated. Results Increased levels of disulfide, and higher disulfide/native thiol ratio, TOS, and OSI values were observed at fasting and in the postprandial period in MetS compared to the control group, peaking at the 4 th hour in both groups ( p < 0.05). ROC analysis showed that both fasting and 4 th hour disulfide/native thiol ratios exhibited the highest values. Higher disulfide/native thiol ratio values were observed at the 4 th hour and higher OSI in the 2 nd hour in the upper tertiles for MetS ( p < 0.05). Conclusions An increased disulfide/native thiol ratio and OSI level elevation in MetS may be closely associated with PPL. The disulfide/native thiol ratio in MetS subjects with PPL may play a role for evaluating oxidative stress, especially in postprandial 4 th hour.

Sepsis induces lung injury and respiratory distress syndrome and is therefore potentially fatal. L-theanine (LT), an amino acid found in tea, is a bioactive compound with an important antioxidant, anti-inflammatory, and antifibrotic properties. The purpose of this study was to evaluates whether, LT exhibits protective effects against lung tissue damage by determining its effect on oxidative stress, inflammation and mineral levels in an experimental model of cecal ligation and perforation (CLP)-induced sepsis in rats. Rats were randomly divided into three groups (n=6): sham, CLP, and CLP+LT. LT was administered intraperitoneally (750 mg/kg) in two equal doses immediately and 12 h after surgery. Malondialdehyde (MDA), advanced protein oxidation product (AOPP), myeloperoxidase (MPO), total antioxidant status (TAS), total oxidant status (TOS), oxidative stress index (OSI), and ischemia modified albumin (IMA) values were determined spectrophotometrically. Serum elements (Na, K, Mg, Ca, and Fe), albumin, glucose, triglyceride, and lactate levels were determined using an autoanalyzer. Lung tissues were also examined histopathologically. Treatment of septic rats with LT significantly reduced oxidative stress and inflammation in lung tissues and serum. LT also increased albumin and Na levels and reduced triglyceride levels in serum. In conclusion, LT treatment may exhibit a preventive effect against sepsis-induced lung injury by reducing oxidative stress and inflammation, and by regulating osmotic balance.

Evaluation of the analytical performance of tests in medical laboratories is important. Total Error (TE) and sigma analysis have been used as a quantitative indicator of quality for many years. The aim of this study is to evaluate the analytical performance of Beckman Coulter Access Estradiol (E2) and Sensitive E2 reagents. Analytical performance of two reagents were evaluated with TE, six sigma and measurement uncertainty values. Two Beckman Coulter Unicel DxI-800 autoanalyzers (A1 and A2) included in the study. Quality control data between December 2017 and December 2019 were used. CLIA-2019 values were used for total allowable error (TEa) limits. Uncertainty values were calculated with ISO/TS 20914. The median TE of the old generation and sensitive E2 reagent were 27.46% (between 13.49 and 48.88) and 11.16% (between 7.08 and 24.81), respectively (p < .005) The process sigma results were below 3 sigma in all months with the old reagent, whereas with the new reagents it was seen to be above 3 sigma in 11 of 12 months for both autoanalyzers. Uncertainty of old reagent is higher than new reagent. Imprecisions decrease as concentration increases with both reagents. The uncertainty values of low concentration levels are greater than high concentration levels. In conclusion, in both auto analyzers, Sensitive E2 reagent was found to have better performance than old reagent in terms of TE, process sigma and measurement uncertainty. We believe that the sensitive E2 reagent still needs further improvement for patients who have low E2 levels.