Background: Pediatric headache is a common neurological condition that adversely affects quality of life. Vitamin B12 is involved in homocysteine (Hcy) and methylmalonic acid (MMA) metabolism, and nitric oxide (NO) plays a role in neurovascular signaling. This study evaluated vitamin B12-related biomarkers and NO in pediatric migraine and tension-type headache (TTH). Methods: The study included 39 migraine, 42 TTH and 29 control. Vitamin B12 and folic acid were measured using the Roche Cobas e601, Hcy were measured with the Shimadzu LC-20 HPLC, MMA were measured by a modified LC-MS/MS method, NO were measured using the Griess method. Results: Hcy levels differed significantly between the migraine and control, as well as between the TTH and control (p<0.05). For MMA, a significant difference was observed between the TTH and control groups (p<0.05). Total nitrite and nitrate concentrations were significantly higher in patients than in controls(p<0.05). Conclusions: Although serum vitamin B12 concentrations did not show a significant difference, median MMA values were elevated in the patient groups. MMA is recognized as a biomarker of subclinical vitamin B12 deficiency, and because oxidative stress may impair the cellular function of vitamin B12, MMA measurement provides valuable information even when serum B12 levels remain within the normal range. Furthermore, endothelial damage induced by Hcy, together with chronic oxidative stress associated with the Hcy-NO pathway, may contribute to the pathogenesis of pediatric migraine and TTH. Consistent with this, the significantly higher levels of NO metabolites in patients compared with controls suggest that NO may play a role in the development of migraine and TTH in the pediatric population.

A common food additive, monosodium glutamate (MSG), is a source of glutamate, the primary excitatory neurotransmitter in the central nervous system, and has been associated with neuronal damage at high levels. Taurine (TAU), a naturally occurring amino acid, is widely used in energy drinks alongside caffeine and sugar. Given the widespread consumption of these products, this study investigated the potential adverse effects of high levels of MSG, TAU, and their combination on systemic and brain oxidative stress/antioxidant balance, as well as cortical histology. Young male Wistar rats (10 weeks old) were randomly assigned to four groups: MSG (1 g/kg/day), TAU (300 mg/kg/day), MSG+TAU (1 g/kg/day + 300 mg/kg/day), and control (CON) group (saline), all administered via oral gavage for 21 days. While serum trace element levels (Cu, Zn, Se) remained unaffected, total oxidant status was significantly higher in the MSG and MSG+TAU groups compared to the TAU and control groups. Oxidative stress markers (8-OHdG and 4-HNE) were elevated in the serum, cortex, and hippocampus of all experimental groups, accompanied by increased total oxidant status and decreased total antioxidant status in these samples. Histological analysis revealed neuronal disorganization and pericapillary edema in the cerebral cortex. These findings indicate that excessive exposure to these compounds may disrupt redox balance and brain tissue integrity to varying degrees, with combined exposure producing more pronounced deleterious effects. Overall, these results suggest that frequent consumption of foods and beverages containing MSG and taurine, particularly at high levels, may pose significant health risks to young individuals.

This article aims to define a minimum panel of essential laboratory tests to be used in emergency and disaster settings through expert consensus. A structured survey was distributed to the 24 members of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Committee on Preparation of Laboratories for Emergencies (C-PLE). Participants were asked to rate a predefined list of diagnostic tests using a four-level priority scale (essential, critical, supportive, not recommended), with scores ranging from 1 to 4. Responses were collected over a two-week period, and mean scores with standard deviations were calculated to classify each test into priority categories. Additional test suggestions were also solicited and evaluated. A total of 20/24 members (83.3 %) completed the survey. Tests classified as essential (mean score 1.00-1.49) included complete blood count, electrolytes (sodium, potassium, chloride), blood glucose, lactate, blood gases (including ionized calcium), urinalysis, and ABO/RhD blood typing. Critical tests (mean score 1.50-2.49) comprised urea and/or creatinine, coagulation parameters such as prothrombin time/international normalized ratio (PT/INR) and activated partial thromboplastin time (APTT), aminotransferases (especially alanine aminotransferase; ALT), and cardiac troponins. Supportive tests (mean score 2.50-3.49) included C-reactive protein, D-dimer, rapid diagnostic tests for infectious diseases, and procalcitonin. Additional tests, such as urine pregnancy testing, bilirubin, and pancreatic enzymes, were proposed for potential inclusion based on clinical relevance. These findings establish a prioritized, consensus-based diagnostic framework tailored to resource-limited emergency contexts, emphasizing rapid, high-impact testing to support clinical decision-making and patient outcomes.

Background and objectives Migraine is a common primary headache disorder associated with neuroinflammation, with evidence implicating gut microbiota and metabolites in neurological mechanisms pathways. Since trimethylamine-N-oxide (TMAO), derived from dietary precursors by gut microbial metabolism, is associated with cardiovascular and neurodegenerative conditions, and its role in migraines is unclear, we aimed to evaluate whether serum TMAO level and related metabolites in migraine patients can be biomarkers. Methods A total of 106 participants were enrolled, consisting of healthy controls (n=46; mean age ± SD=39±8 yr old) and migraine patients (n=60). The migraine cohort was divided into migraine with aura (n=18; mean age±SD=33±11 yr old) and migraine without aura (n=42; mean age±SD=37±10 yr old), according to the International Classification of Headache Disorders, 3rd edition (ICHD-3). Blood samples were centrifuged, stored at -80°C, and analysed for TMAO, carnitine, betaine, and choline levels using liquid chromatography-mass spectrometry (LC-MS/MS). Results There were no significant differences between the groups for age, smoking, or body mass index (BMI). Serum TMAO levels were significantly higher in patients with migraine with aura [2.75 (1.98-3.91) ng/mL] and migraine without aura [2.85 (2.08-5.53) ng/mL] compared to controls [1.40 (1.00-3.01) ng/mL] (P<0.001). Serum choline, betaine, and carnitine levels were significantly higher in the migraine groups (all P < 0.01). Interpretation and conclusions These findings indicate elevated TMAO levels in patients with migraine, suggesting a possible involvement of TMAO in migraine-associated neuroinflammatory processes. Targeted studies and cohort-based investigations are needed to clarify its role in migraine and evaluate its potential as a biomarker.

The healthcare systems are a prime target for cyber-attacks due to the sensitive nature of the information combined with the essential need for continuity of care. Medical laboratories are particularly vulnerable to cyber-attacks for a number of reasons, including the high level of information technology (IT), computerization and digitization. Based on reliable and widespread evidence that medical laboratories may be inadequately prepared for cyber-terrorism, a panel of experts of the Task Force Preparation of Labs for Emergencies (TF-PLE) of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) has recognized the need to provide some general guidance that could help medical laboratories to be less vulnerable and better prepared for the dramatic circumstance of a disruptive cyber-attack, issuing a number of consensus recommendations, which are summarized and described in this opinion paper.

Objectives This study aimed to objectively assess the potential severity of harm associated with erroneous results in 195 laboratory tests by surveying 514 specialist physicians and medical biochemistry experts.Methods The survey obtained participants' (75 medical biochemists, 439 clinicians) opinions on severity of harm for the erroneous results of 195 tests. The comprehensive list of errors and their effects on test results were obtained from the literature, and then matched with severity of harm scores, from 1 (negligible effect) to 5 (life-threatening injury/death), obtained from the survey responses.Results Participants perceived tests such as cardiac biomarkers, blood gases, coagulation parameters (activated partial thromboplastin time, prothrombin time, international normalized ratio, and dimerized plasmin fragment D), critical ions (potassium, sodium), toxic trace elements (lead, mercury), and specific serum drug levels (lithium, digoxin) to have a greater potential for patient harm in case of errors. Medical biochemistry specialists assigned higher severity scores to some laboratory tests, including total bilirubin, pseudocholinesterase, platelet indices, and some drug levels (cyclosporine, methotrexate, vancomycin).Conclusions A substantial agreement (91%) was observed between medical biochemists and clinicians in terms of the most frequently chosen severity of harm score. The study provided objective severity scores and identified high-risk tests for targeted quality improvement.

Graphical abstract Highlights • After hemolysis and icterus, lipemia is one of the most common errors encountered in the preanalytical phase • Mimicking lipemia is more challenging than other interference types because of the heterogenous property of lipids • Intravenous lipid emulsions are not sufficient for mimicking lipemia • Since almost all companies use intravenous lipid emulsion in lipemia interference studies, the results of these studies must be interpreted carefully by the laboratory experts IntroductionThis study aimed to investigate the effects of lipemia on clinical chemistry and coagulation parameters in native ultralipemic (NULM) and intravenous lipid emulsion (IVLE) spiked samples. Materials and methodsThe evaluation of biochemistry (photometric, ion-selective electrode, immunoturbidimetric method), cardiac (electrochemiluminescence immunoassay method) and coagulation (the viscosity-based mechanical method for prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen and the immunoturbidimetric method for D-dimer) parameters were conducted. In addition to the main pools, five pools were prepared for both types of lipemia, each with triglyceride (TG) concentrations of approximately 2.8, 5.7, 11.3, 17.0 and 22.6 mmol/L. All parameters’ mean differences (MD%) were presented as interferographs and compared with the desirable specification for the inaccuracy (bias%). Data were also evaluated by repeated measures of ANOVA. ResultsProthrombin time and APTT showed no clinically relevant interference in IVLE-added pools but were negatively affected in NULM pools (P < 0.001 in both parameters). For biochemistry, the most striking difference was seen for CRP; it is up to 134 MD% value with NULM (P < 0.001) at the highest TG concentration, whereas it was up to - 2.49 MD% value with IVLE (P = 0.009). Albumin was affected negatively upward of 5.7 mmol/L TG with IVLE, while there was no effect for NULM. Creatinine displayed significant positive interferences with NULM starting at the lowest TG concentration (P = 0.028). There was no clinically relevant interference in cardiac markers for both lipemia types. ConclusionsSignificant differences were scrutinized in interference patterns of lipemia types, emphasizing the need for careful consideration of lipemia interferences in clinical laboratories. It is crucial to note that lipid emulsions inadequately replicate lipemic samples.

Objectives In this study, the aim is to provide a more detailed understanding of vitamin D metabolism by evaluating the correlation between 1,25-dihydroxyvitamin D (1,25(OH)2D) and 25-hydroxyvitamin D (25(OH)D) according to the variations in measurement methods and clinical conditions. Methods We searched PubMed, Embase, and Web of Science for studies reporting correlation results between 1,25(OH)2D and 25(OH)D. We performed a meta-analysis based on the correlation results of 1,25(OH)2D and 25(OH)D in different clinical conditions. We included a total of 63 studies and our laboratory's results in the meta-analysis. The studies were categorized into high-quality methods group (HQMG), medium-quality methods group (MQMG), and low-quality methods group (LQMG) based on the 25(OH)D and 1,25(OH)2D measurement. Results In the healthy, renal disease, and other disease groups, the highest correlation values were observed in the studies categorized as HQMG, with values of 0.35 (95 % CI; 0.23-0.48), 0.36 (95 % CI; 0.26-0.42), and 0.36 (95 % CI; 0.22-0.48), respectively. Significant statistical heterogeneity was observed in the healthy, renal disease, and other disease groups, with I2 values of 92.4 , 82.7, and 90.7 %, respectively (p<0.001). Both Funnel plots and the results of Egger's and Begg's tests indicated no statistically significant bias across all studies. Conclusions A significantly low correlation was found between 25(OH)D and 1,25(OH)2D. However, higher correlations were found in the studies categorized as HQMG. Various factors, including methodological inadequacies and disparities, might contribute to this. In the future, with more accurate and reproducible measurements of 1,25(OH)2D, a clearer understanding of vitamin D metabolism will be achieved.

Objectives The cardiovascular mortality risk is greatly increased in patients with chronic kidney disease (CKD), especially in dialysis patients, due to atherosclerosis. Platelet activating factor acetylhydrolase (PAF-AH) is an enzyme that hydrolyzes platelet activating factor (PAF). Valvular calcifications and PAF-AH are associated with atherosclerosis. However, little is known about the status of PAF-AH activity and valvular calcification in dialysis patients. Therefore, the aim of this study was to investigate the status of these parameters in CKD patients. Methods This study included 92 chronic renal failure (CRF) (dialysis group), and 86 CKD patients (non-dialysis group). Echocardiography was performed to assess valvular calcification. Results There was no significant difference between the dialysis and CKD groups in terms of PAF-AH activities. However, when comparisons were stratified according to the presence of valve calcification, higher PAF-AH activity and N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were evident in patients with calcification compared to those without. Additionally, the CRF group also exhibited elevated PAF-AH and NT-proBNP levels. While elevated NT-proBNP persisted in the CKD group, in contrast, changes in PAF-AH were not significant. Conclusions The results of this study suggest that high PAF-AH and NT-proBNP levels are associated with valvular calcification in dialysis patients. Both biomarkers may be used as a risk factor for calcification. Furthermore, inhibition of PAF-AH activity may be a treatment target to reduce calcification.

Homosistein vaskülotoksik ve trombojenik bir aminoasittir. Homosistein düzeyleri çeşitli nedenlere bağlı olarak yükseldiği zaman, homosistein metabolizmasında bir ara ürün olan, homosistein tiyolakton oluşumuna neden olur. Homosistein tiyolakton, reaktif oksijen türlerinin birikmesine ve proteinlerin posttranslasyonal modifikasyonlarına yol açarak ateroskleroz gibi zararlı etkilere sebep olabilir ve vasküler hastalıkların, özellikle koroner arter hastalığının ve inme riskinin bir belirteci olarak kabul edilmektedir. Paraoksonaz enzim ailesi homosistein tiyolaktonun ve diğer zararlı bileşiklerin detoksifikasyonunda yer alır. Paraoksonaz enzim ailesi, PON-1, PON-2 ve PON-3 olmak üzere üç izoformdan oluşur. Bu izoformların antioksidan, anti-enflamatuvar ve vasküloprotektif özellikleri bulunmaktadır. PON-1, HDL üzerinde taşınan özellikle organofosfatlı bileşiklerin ve lipitlerin peroksidasyonunu önleyen izoformdur. Ayrıca, homosistein tiyolaktonu detoksifiye eder ve homosisteinlenmiş proteinleri parçalar. PON-1 aktivitesi bireyler arasında değişkenlik gösterir ve bu değişkenliklerin kardiyovasküler hastalıklarla ilişkili olduğu gösterilmiştir. Paraoksonaz enzim ailesinin aktiviteleri arasında paraoksonaz, homosistein tiyolaktonaz ve aril esteraz bulunur. Bu aktiviteler, toksik maddelerin metabolize edilmesi, homosistein düzeylerinin düzenlenmesi ve oksidatif stresin azaltılması gibi birçok biyolojik süreçte kritik rol oynar. Genel olarak, homosistein tiyolakton ve paraoksonaz enzim ailesi, vasküler hastalıkların patofizyolojisinde ve tedavisinde önemli bir rol oynarlar. Bu nedenle, bu molekül ve enzimler üzerindeki araştırmalar, potansiyel olarak vasküler hastalıkların önlenmesi ve tedavisine ışık tutabilir. Homocysteine is a vasculotoxic and thrombogenic amino acid. When homocysteine levels increase due to various reasons, it causes the formation of homocysteine thiolactone, an intermediate product in homocysteine metabolism. Homocysteine thiolactone can lead to accumulation of reactive oxygen species and posttranslational modifications of proteins, causing harmful effects such as atherosclerosis, and is considered a marker of vascular diseases, especially coronary artery disease and stroke risk. The paraoxonase enzyme family is involved in the detoxification of homocysteine thiolactone and other harmful compounds. The paraoxonase enzyme family consists of three isoforms: PON-1, PON-2 and PON-3. These isoforms have antioxidant, anti-inflammatory and vasculoprotective properties. PON-1 is the isoform that prevents the peroxidation of especially organophosphate compounds and lipids carried on HDL. Additionally, homocysteine detoxifies thiolactone and breaks down homocysteinated proteins. PON-1 activity varies between individuals, and these variations have been shown to be associated with cardiovascular diseases. Activities of the paraoxonase enzyme family include paraoxonase, homocysteine thiolactonase, and arylesterase. These activities play critical roles in many biological processes, such as metabolizing toxic substances, regulating homocysteine levels and reducing oxidative stress. In general, homocysteine thiolactone and the paraoxonase enzyme family play an important role in the pathophysiology and treatment of vascular diseases. Therefore, research on these molecules and enzymes could potentially shed light on the prevention and treatment of vascular diseases.

Objectives Clinical Biochemistry Laboratories (CBL) are the most frequently utilized laboratory group in healthcare, and their significance in patient care is indisputable. This study investigated the frequency and pattern of test utilization rate in CBL at two large hospitals' outpatient and inpatient clinics.Methods A total of 43,732,428 CBL tests, including clinical chemistry, immunoassay, coagulation, specific proteins, CBC, and urinalysis, were conducted for 12,182,382 patients across two large hospitals in different settings between 2018 and 2022. These tests were analyzed alongside patient admissions data, with a focus on the distribution across various clinics.Results 94 and 93 % of those admitted to Hospitals 1 and 2 were outpatients. They had applied to CBL laboratories for 27.1-30.3 % of outpatients and 81.2-88.7 % of inpatients for at least one test. When analyzing the rates at which laboratory tests were requested for outpatients, it was found that emergency departments had the highest test-requesting rates, ranging from 19.99 to 45.36 %. This was followed by internal medicine clinics, with rates ranging from 13.77 to 14.8 %, and inpatient intensive care units, with rates between 24.31 and 30.14 %. Outpatients had 10-11 test requests for each patient and 16-31 for inpatients. The most frequently requested laboratory tests were CBC, glucose, creatinine, urea, AST and ALT in two hospitals.Conclusions Despite significant variations in location, structure, medical staff, and patient demographics, approximately one-third of outpatients and 85 % of inpatients at these hospitals undergo testing in CBL. CBLs are essential for screening, diagnosis, prognosis, and healthcare treatment.

Scientific knowledge should be based on evidence. However, some scientific studies can be carried out without sufficient evidence. And these studies may mislead subsequent studies. Ischemia-modified albumin (IMA) is a relatively newly proposed biomarker. It is used not only for myocardial ischemia but also used for other pathological conditions in the body. IMA is commonly measured by albumin cobalt binding (ACB) assay. ACB is a simple colorimetric assay performed in patients’ sera. It is claimed that because of the ischemia or ischemia-reperfusion, the molecular structure of the N-terminus of human serum albumin is changed and therefore it cannot bind metal ions and cobalt ions added into the reaction mixture react with dithiothreitol to give a brown color. The clinical performance of the ACB assay is poor and it has not a strong correlation with other ischemia biomarkers. There are many analytical uncertainties in ACB assay and IMA as well. Despite the uncertainties, the ACB assay is still commonly used for many research studies. Therefore the theory of the ACB assay should be questioned. In this opinion paper, we discussed these uncertainties. In conclusion, there is insufficient evidence for the existence of IMA as a biomarker. The ACB assay essentially measures serum albumin concentration. There are many other interfering factors with the ACB assay. Therefore, the measurement of IMA in any pathological condition is a useless effort.

AMAÇ: COVID-19 enfeksiyonu olan bireylerde, hastalığın şiddetini belirlemek, risk faktörlerini analiz etmek ve hastalığın prognozunu takip etmek için hematolojik ve enflamatuvar parametreler önemlidir. Bu parametreler yaş ve cinsiyete bağlı olarak değişim gösterebilir. Çalışmamızda COVID-19 enfeksiyonu olan hastaların Nötrofil/Lenfosit oranı (NLO), C-Reaktif Protein (CRP), Ferritin, Laktat Dehidrogenaz (LDH), D-Dimer ve Sistemik immün enflamasyon indeksi (Sİİ) parametrelerinin yaş ve cinsiyete göre değişimini incelemeyi amaçladık. YÖNTEM: Mart 2019 ve Ağustos 2021 tarihleri arasında Lokman Hekim Üniversitesi Ankara Hastanesi'ne başvuran ve PCR testi pozitif olan toplam 322 servis hastası (Kadın: 180, Erkek: 142) çalışmaya dahil edildi. Hastalar yaşlarına göre beş gruba ayrıldı (1.grup: 1-17 yaş; 2.grup: 18-30 yaş; 3.grup: 31-45 yaş; 4.grup: 46-60 yaş; 5.grup: 61-92 yaş). Hastaların laboratuvar sonuçları ve demografik bulguları retrospektif olarak incelendi. Gruplarda WBC, NLO, CRP, Ferritin, LDH, D-Dimer, Sİİ değerleri incelendi. BULGULAR: Yaş grupları arasında NLO, CRP, Ferritin, LDH, D-Dimer parametreleri değerlendirildiğinde; 1. ve 2. grup karşılaştırıldığında D-dimer seviyesinde, 1. ve 3. grup karşılaştırıldığında LDH, WBC, CRP seviyelerinde, 1. ve 4. grup karşılaştırıldığında CRP seviyesinde, 1. ve 5. grup değerlendirildiğinde Ferritin, NLO, CRP seviyelerinde anlamlı fark görüldü (p<0.05). NLO, CRP, Ferritin, LDH, D-Dimer değerlerinin yaş ile korelasyonları incelendiğinde CRP, LDH ve Ferritin düzeyleri orta düzeyde korelasyon gösterirken (sırasıyla r=0.557, r=0.408, r=0.400); NLO, D-Dimer ve WBC değerlerinde korelasyon görülmedi. Cinsiyete göre değerlendirildiğinde enfeksiyonla ilişkili parametrelerin (CRP, NLO, WBC ve Ferritin) erkek hastalarda daha yüksek olduğu görüldü (p<0.05). Sİİ değerleri yaşa ve cinsiyete göre değerlendirildiğinde anlamlı fark görülmedi (p>0.05). SONUÇ: Enflamatuvar ve hematolojik belirteçler COVID-19 enfeksiyonlu hastalarda değişiklik gösterdiğinden enfeksiyonun takibinde WBC, NLO, CRP, Ferritin, LDH, D-Dimer parametreleri ile demografik verilerin birlikte değerlendirilmesinin faydalı olacağını düşünmekteyiz.

Purpose Ghrelin has previously been proven to have anti-inflammatory and antioxidant properties in preventing cisplatin-induced ovarian damage. The aim of this study was to evaluate the potential effects of this hormone in preventing this damage in rats using histopathological and biochemical methods. Methods Twenty-eight Wistar-albino rats were randomly divided into four groups. While no drug was given to Group 1 (sham group), acylated ghrelin was intraperitoneally administered to Group 2 at 0.5 nmol/kg and Group 3 at 2 nmol/kg for 21 days. Group 4 received only saline solution. On the 15th day, a single dose of 5 mg/kg cisplatin was intraperitoneally administered to each rat in Groups 2, 3 and 4. Serum anti-Mullerian hormone (AMH) values were measured on days 0, 15 and 21. Then, laparotomy and bilateral oophorectomy were performed, and the ovaries were histopathologically examined. Results The number of primordial and primary follicles was significantly higher in Group 3 than in the saline solution + cisplatin group. In Group 4, cisplatin caused significantly higher follicle damage in the primordial, primary and secondary phases compared to the sham group. The AMH level of the SF + cisplatin group was significantly lower than that of the sham group and the high-dose ghrelin + cisplatin group, and the AMH level of the sham group was significantly higher than that of the low-dose ghrelin + cisplatin group. Conclusion High-dose ghrelin was effective in preventing cisplatin-induced ovarian damage by preserving the number of primordial and primary follicles. Larger randomized studies are needed to determine the optimal dosage and duration of ghrelin.

BACKGROUND:Obesity and overweight are significant public health problems because of higher risk for coronary artery disease (CAD). It is very important to determine new predictive markers to identify the CAD risk in obese and overweight. To aim this, we analysed HDL-C subgroups (HDL2-C and HDL3-C) and their paraoxonase-1 (PON-1) activity in obese, overweight and normal weight subjects.METHOD:71 obese, 40 overweight and 30 healthy subjects as a control group were enrolled the study. Serum lipids levels were determined with enzymatic colorimetric method. Further, PON-1 activities and HDL-C levels were determined by spectrophotometric methods. Non-HDL3-C concentrations were calculated with the subtraction of HDL3-C from total HDL-C.RESULTS:The mean serum levels of total HDL-C, HDL3-C, Non-HDL3-C and ApoA1 were higher in control group than obese and overweight groups. There were a statistically significant difference between obese and control group in terms of Lp(a), hsCRP and HOMA index. Higher total PON-1, non-HDL3 PON-1 and HDL3 PON-1 activities were found in the control group compared with obese and overweight groups. Total HDL was weakly negative correlated with the HOMA index, BMI and waist circumference. There was a weak negative correlation between non-HDL3-C and waist circumference.CONCLUSION:Altered HDL-subgroups pattern and decreased PON-1 activities may cause increased risk for CVD in obese and overweight individuals. Therefore determination of HDL subgroups and their PON-1 activity may improve risk prediction compared with measuring total HDL-C levels and its PON-1 activity alone. Body weight and insulin resistance appear to have a role in the decreased HDL-C levels and PON-1activity in obese. Further studies should be conducted to shed more light on impacts of these markers in CVD.

COVID-19 is the most devastating pandemic situation we have experienced in our age, affecting all systems. Although it affects all systems, it shows its most important effect through thrombophilia. Therefore, the possible cause of sudden death due to COVID-19 may be embolism caused by thrombophilia. D-dimer amounts increase due to COVID-19. The thrombosis is associated with sudden death in COVID-19 disease in populations. Since individuals with thrombophilia will be more prone to death due to COVID-19, it may be appropriate to administer low doses of Clexane (Enoxaparin sodium) or low-weight heparin for prophylactic purposes in order to consider these individuals at high risk and to prevent deaths. Moreover, in order not to risk the lives of healthcare professionals with thrombophilia, it would be appropriate to keep them away from individuals with COVID-19 disease and to employ them in different healthcare services according to their fields of expertise. It should also not be forgotten that different symptoms related to COVID-19 appear day by day, these different symptoms probably show that the virus has undergone mutations in order to survive, but no matter what, its effect on thrombophilia has not been eliminated yet. This compilation aims to present the reasons and causes of death due to COVID-19, possible treatment options, and thrombophilia panel tests and new parameters that may have a place in the meticulous interpretation of these tests and possible etiopathology in the light of current information. Therefore, presenting this information in a rational manner and keeping the parameters of the thrombophilia panel under strict control predict that the deaths due to the virus will be partially reduced.

Objectives: In our study, we investigated whether the undercarboxylated osteocalcin (ucOC) is an indicator of bone turnover for patients treated with hemodialysis (HD) or peritoneal dialysis (PD). Furthermore, we have examined the relationships between ucOC levels and other bone inidicators such as osteocalcin (OC), bone specific alkaline phosphatase (B-ALP), calcitonin, vitamin D, intact parathyroid hormone (iPTH), calcium (Ca), phosphate (P), magnesium (Mg) and bone mineral density (BMD). Methods: Study group was consisted of 24 HD, 30 PD patients and 30 control subjects. ucOC measurements were based on precipitation of carboxylated OC with barium sulfate. After precipitation, ucOC was measured in supernatant by ELISA. Results: In chronic kidney disease (CKD), increased ucOC levels were present both in HD and PD groups. The ucOC levels in HD group were higher than those of PD group. ucOC levels in samples after HD were lower than in samples before HD. But there is no difference between groups for ucOC% levels. We observed that ucOC levels for CRF were higher compared to that of control group and statistically significant. ucOC levels were positively correlated with OC, B-ALP, ALP, iPTH, P and Mg levels. There were negative and significant correlations between ucOC levels and BMD values. ucOC has a good discrimination power for both high and low turnover ROD groups. Conclusions: ucOC is a useful marker to evaluation of bone metabolism in patients undergone hemodialysis or peritoneal dialysis in end-stage renal disease.

INTRODUCTION:To interpret test results correctly, understanding of the variations that affect test results is essential. The aim of this study is: 1) to evaluate the clinicians' knowledge and opinion concerning biological variation (BV), and 2) to investigate if clinicians use BV in the interpretation of test results.MATERIALS AND METHODS:This study uses a questionnaire comprising open-ended and close-ended questions. Questions were selected from the real-life numerical examples of interpretation of test results, the knowledge about main sources of variations in laboratories and the opinion of clinicians on BV. A total of 399 clinicians were interviewed, and the answers were evaluated using a scoring system ranked from A (clinician has the highest level of knowledge and the ability of using BV data) to D (clinician has no knowledge about variations in laboratory). The results were presented as number (N) and percentage (%).RESULTS:Altogether, 60.4% of clinicians have knowledge of pre-analytical and analytical variations; but only 3.5% of them have knowledge related to BV. The number of clinicians using BV data or reference change value (RCV) to interpret measurements results was zero, while 79.4% of clinicians accepted that the difference between two measurements results located within the reference interval may be significant.CONCLUSIONS:Clinicians do not use BV data or tools derived from BV such as RCV to interpret test results. It is recommended that BV should be included in the medical school curriculum, and clinicians should be encouraged to use BV data for safe and valid interpretation of test results.