Objectives Determining low-density lipoprotein (LDL) is a costly and time-consuming operation, but triglyceride value above 400 (TG>400) always requires LDL measurement. Obtaining a fast LDL forecast by accurate prediction can be valuable to experts. However, if a high error margin exists, LDL prediction can be critical and unusable. Our objective is LDL value and level prediction with an error less than low total acceptable error rate (% TEa).Methods Our present work used 6392 lab records to predict the patient LDL value using state-of-the-art Artificial Intelligence methods. The designed model, p-LDL-M, predicts LDL value and class with an overall average test score of 98.70 %, using custom, hyper-parameter-tuned Ensemble Machine Learning algorithm.Results The results show that using our innovative p-LDL-M is advisable for subjects with critical TG>400. Analysis proved that our model is positively affected by the Hopkins and Friedewald equations normally used for (TG <= 400). The conclusion follows that the test score performance of p-LDL-M using only (TG>400) is 7.72 % inferior to the same p-LDL-M, using Hopkins and Friedewald supported data. In addition, the test score performance of the NIH-Equ-2 for (TG>400) is much inferior to p-LDL-M prediction results.Conclusions In conclusion, obtaining an accurate and fast LDL value and level forecast for people with (TG>400) using our innovative p-LDL-M is highly recommendable.

Background:In COVID-19 patients, besides changes in leucocyte count, morphological abnormalities of circulating blood cells have been reported. Aim:This study aims to investigate the relationship between the morphological and functional properties of leucocytes and the severity of the disease in COVID-19 patients. Materials and Methods:Blood samples were collected from COVID-19 patients (n = 130) at the time of admission. The patients were stratified according to the comorbidity, age, LDH, lymhocyte count score as mild, moderate, and severe. Complete blood count and the cell population data were analyzed by the Volume, conductivity, scatter (VCS) technology on Beckman Coulter LH-780 hematology analyzer. Kruskal-Wal'lis test was used to assess the differences between the groups with subsequent Bonferroni correction. Results:Neutrophil count was increased, and lymphocyte count was decreased in severe patients compared to mild patients. The increase in the percent of neutrophils and the neutrophil/lymphocyte ratio in the severe patient group was significant in comparison to both the moderate and the mild group. The dispersion of the neutrophil volume and conductivity showed significant changes depending on the severity of the disease. The lymphocyte volume, lymphocyte-volume-SD and lymphocyte-conductivity as well as the monocyte-volume and monocyte-volume-SD were significantly increased in severe patients in comparison to mild patients. The increase of lymphocyte and monocyte volume in severe patients was also significant in comparison to moderate patients. Conclusions:COVID-19 infection leads to important changes in cell population data of leucocytes. The volumetric changes in lymphocytes and monocytes are related to the severity of the disease.

Background: In patients with coronavirus disease 2019, the gastrointestinal symptoms have been reported increasingly in addition to the respiratory system symptoms. The studies show that the prevalence of gastrointestinal system symptoms and how the gastrointestinal system contributes to the severity and prognosis of the disease is still not clear. This study aims to find the prevalence of gastrointestinal symptoms and the correlation between the gastrointestinal symptoms and the clinical results in hospitalized patients diagnosed with coronavirus disease 2019. Methods: This study retrospectively analyzes patients diagnosed with coronavirus disease 2019 and hospitalized in the pandemic unit between March 2020 and August 2020 and compares their demographic and clinical characteristics, laboratory and radiologic findings, coronavirus disease 2019 treatments received, the clinical course of the disease, and the gastrointestinal symptoms. Results: In our study, we included 322 patients diagnosed with coronavirus disease 2019 and hospitalized; 39 patients (12.1%) were admitted to the hospital with at least one gastrointestinal symptom (nausea and vomiting, diarrhea, abdominal pain, and the loss of taste). Nausea and vomiting are the most common gastrointestinal symptoms with a prevalence of 7.1%, followed by diarrhea with 2.8%, the loss of taste with 2.2%, and abdominal pain with 1.5%. The mean age and D-dimer levels of the patients showing gastrointestinal symptoms were lower than those who did not have any gastrointestinal symptoms. We did not find a significant correlation between the presence of the gastrointestinal symptoms and the severity of the disease, treatment received, risk of acute respiratory distress syndrome and septic shock, admission to the intensive care unit, the need for mechanical ventilation, the mortality rate or the length of hospitalization in the medical floor or the intensive care unit. Conclusion: In this study, we observed that 12.1% of coronavirus disease 2019 patients apply to the hospital due to gastrointestinal symptoms. Furthermore, the gastrointestinal symptoms do not seem to affect the severity and the course of the disease, it is important to identify coronavirus disease 2019 patients showing unusual symptoms such as the gastrointestinal symptoms at an early stage to protect healthcare professionals from infection risk.

There is extensive research related to the changes in the hematological and biochemical tests in COVID‐ infection. The complete blood count, especially leucocyte, lymphocyte and thrombocyte counts became prominent among the routine clinical chemistry tests since this is an infectious process and these tests are easy to perform. Besides, interleukins, C‐reactive protein, erithrocyte sedimentation rate, procalcitonin, ferritin were used widely to assess the inflammatory process and the “cytokine storm”. Some parameters are used to evaluate the complications related to the liver, kidneys and the heart. Hypercoagulopathy and thrombosis were common in this infection and the major reason for many complications seen in COVID‐19. Creatine kinase, cardiac troponins, myoglobin were used to assess cardiac status; aspartat aminotransferase, albumin, lactate dehydrogenase were used broadly to assess liver function and fibrin degradation products, activated partial thromboplastin time and D‐dimer were used to determine the thrombotic state. S72 COVID-19 ve laboratuvar bulguları

Summary Background: The aim of this study is to establish the contribution of blood cells subtypes on hemolysis. Methods: Separated blood cell subtype suspensions prepared with blood from 10 volunteers were serially diluted to obtain different concentrations of cell suspensions. The cells were fully lysed and cell hemolysates were added (1:20) to aliquots of serum pool. Thus, seven serum pools with different concentrations of interferent were obtained for each blood cell subtype. Biochemical parameters and serum indices were measured by an autoanalyzer. As cell lysis markers, free hemoglobin was measured by spectrophotometry while myeloperoxidase and b-thromboglobulin were measured by enzyme immunoassay. The percent changes in analyte levels of the serum pools were evaulated by Wilcoxon Signed Rank Test and compared with clinical thresholds defined for each test. Results: The clinical thresholds were exceeded in lactate dehydrogenase, potassium, aspartate aminotransferase, creatine kinase, magnesium, total protein, total cholesterol, inorganic phosphate, glucose for red blood cells (RBC); lactate dehydrogenase, aspartate aminotransferase, total protein, inorganic phosphate and glucose for platelets (PLT). Free hemoglobin was significantly correlated with RBC (r=0.999; p=0.001), while myeloperoxidase and b thromboglobulin showed no significant correlation to white blood cells (WBC) and PLT, respectively. Conclusion: The effect of RBC hemolysis in serum on the routine biochemical tests are clearly established, yet, additional studies are required in order to verify this kind of effects of PLT and WBC hemolysis.

Objective This study aimed to assess the possible association of high breast milk sodium levels with postpartum depression and anxiety.Methods A total of 150 mothers and their healthy, exclusively breastfed newborns aged 8 to 15 days were recruited. Mothers were asked to complete scales for evaluation of postnatal depression and anxiety following an interview for consent and sociodemographic data collection. Breast milk samples were obtained to measure sodium and potassium (K) levels.Results Forty-nine mothers had higher than expected breast milk Na concentrations and a high Na/K ratio. These mothers scored significantly higher on the scales of postnatal depression and state anxiety (P=0.018 and P=0.048, respectively).Conclusions This study shows that compared to normal breast milk Na levels and Na/K ratio, high breast milk Na and high Na/K ratio, with possible serious consequences in infants, are associated with maternal depressive and anxious symptoms in the postpartum period.

In Alzheimer's disease (AD), which is the most common cause of dementia, the accumulation of amyloid beta (AB) peptides has a causal role in the neurodegeneration process. AB peptides can induce synthesis of dehydroepiandrosterone (DHEA), which is a precursor of various steroids. Neurosteroids are modulators of neuronal survival and may have different effects depending on whether they are free or sulfa-conjugated.Nitrophenols can inhibit the aggregation of AB peptides at relatively low concentrations. 2,4-dichloro- 6-nitrophenol (DCNP) is a small water-soluble derivative of nitrophenols, and it is also known as the inhibitor of steroid sulfotransferase enzyme. However, the effects of DCNP on levels of distinct steroids and cell viability is not yet clearly known. This work aimed to investigate the effects of DCNP on various steroid levels and AB-induced cell death.SH-SY5Y cells were treated with DCNP (1 mu M) and aggregates of AB 1-42 peptides (10 mu M) for 72 hours. Cell viabilities were evaluated using MTT reduction and immune-fluorescence microscopy. The cellular changes of DHEA, DHEA sulfate, and sex steroids were determined using liquid chromatography-mass spectrometry (LC-MS/MS). The effect of DCNP on ultrastructure of AB aggregates was also examined with transmission electron microscopy.Seventy-two-hour treatment with DCNP significantly decreased DHEA sulfate and increased DHEA levels. Treatment with AB 1-42 aggregates decreased cell viability to approximately 50% and significantly changed DHEA and estradiol levels in SH-SY5Y cells. The ratio of cell death induced by AB 1-42 was reduced with DCNP treatment. When the AB aggregates were incubated in the aqueous solution with DCNP, the size of the aggregates became significantly smaller compared with the initial size. According to our literature knowledge, this is the first study to show the beneficial effects of DCNP on AB toxicity.

Introduction A nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). Materials and methods K2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. Results Analyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers’ results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. Conclusions With the novel use of a freshly prepared blood panel, manufacturer-specific RIs’ were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude.

Objective: In this study, levels of sodium (Na) and sodium/potassium ratio (Na/K), which are considered as indicators of successful lactation, and their relationships with the mothers and their babies' sociodemographic features, psychosocial risk factors of mothers and their adult type attachment styles were aimed to be investigated. Method: The mothers' of 150 consecutive, exclusively breastfed, healthy babies that presented to Dokuz Eylul University School of Medicine and Tepecik State Hospital Healthy Children Outpatient Unit were included in the study. Data about babies' and their mothers were collected during a semi-structured interview with the mother. The mothers were requested to complete Relationship Scale Questionnaire (RSQ) to identify the adult type attachement styles of the mothers. Ten millilitres of breast milk were obtained from the mothers by manual self-milking. Results: Fourty-nine (32.7%) mothers had higher than expected breast milk Na levels and high Na/K ratios. Mothers with higher levels of Na in their breast milk were mothers that thought they were not appropriate to have a child at significance limits (p=0.059). There were no statistically significant differences between two groups of mothers, one with high mean breast milk Na and Na/K ratio, other with expected levels, regarding their adult attachment styles. Conclusion: According to the results of this study it can be speculated that the some psychosocial risk factors of the mothers have an effect on the breast milk electrolytes. But these results should be shown in other studies with a large sample size.

Our aim was to determine the effects of resistance training on cardiovascular risk factors in postmenopausal women. Forty-five women were included in the study. Resistance exercises were done with an intensity of 60% of 1-Repetition Maximum, for 12 weeks. Heart rate, blood pressure, estimated peak VO(2), lipid profiles, and homocysteine levels were evaluated. There were significant time and group interactions for body mass index (p = .02), heart rate (p = .04), systolic blood pressure (p = .03), estimated mean peak VO(2) (p = .00), and total cholesterol (p = .00), but there were no interactions with other evaluated parameters. Resistance training has beneficial effects on particular cardiovascular risk factors in postmenopausal women.

Purpose: To investigate the influences of regular sub-maximal aerobic and resistance exercise trainings for 3 months on plasma homocystenie level and other CVD risks (lipid profile, body mass index, etc.) and compare the effects of these two different types of exercise training on these parameters. Method: Thirty-eight individuals mean aged 21.68±1.38 years were included. Participants were divided into three groups as aerobic exercise (AE) (n=13), resistance exercise (RE) (n=13) and control group (CT) (n=12). Exercises were done four times a week during 12 weeks. CT (n=12) didn’t do any exercise. Blood analyses (plasma homocystenie, vitamin and lipid levels) and anthropometric measurements were performed, maximum aerobic capacity was assessed. Results: It was found that plasma homocystenie level and lipid profile didn’t change in exercise groups and CT group after 12 weeks (p>0.05). Body mass index and waist circumference decreased in both exercise groups (p 0.05). Homocystenie level has positive correlation with waist circumference (r=0,392,p=0.22) and waist-to-hip ratio (r=0,501,p=0.02),and has negative correlation with folic acid level (r=-0,447,p=0.01). Folic acid level was the essential factor for homocystenie level respect to multiple regression analysis (p=0.03,R 2 =0.60). Conclusion: Sub-maximal aerobic or resistance exercise training didn’t change homocysteine level when folic acid level at normal values in blood. Independent from the type of exercise, chronic exercise didn’t considerably change lipid profiles in normolipidemic individuals. Aerobic capacity didn’t change after 12 weeks exercise training whereas body composition improved.

Objectives: Paraoxonase (PON1) is a high density lipoprotein bound serum esterase that is synthesized by the liver which has ability to metabolize lipid peroxides hence playing an important role in protection against atherosclerosis. Our aim was to evaluate the effect of acute and chronic hyperglycemia on PON1 activity in order to clarify the effect of glucose homeostasis. Besides, the relation of hemoglobin A(1c) with triglyceride, total cholesterol, low density lipoprotein-cholesterol, high density lipoprotein-cholesterol and PON1/high density lipoprotein-cholesterol ratios which play role in the development of atherosclerosis was also evaluated.Design and methods: Chronic effects were investigated in Type 2 diabetes patients (n=290) divided into three groups according to their HbA(1c) levels (group 1: <7%, group 2: 7-8.9%, group 3: >= 9%). Oral glucose tolerance test applied 192 subjects were evaluated for acute effects.Results: No significant difference was observed in PON1 activities between the groups (p>0.05) and there was no correlation between PON1 activity, PON1/HDL-C ratio and HbA(1c). PON1 activities decreased during OGTT (p<0.05) and were insignificantly lower in the subjects with normal glucose tolerance.Conclusion: Our findings indicate that although there is a tendency of lowered PON1 activity in long term hyperglycemia, the difference was not significant between different HbA(1c) levels. However, acute hyperglycemia leads to significant decreases in PON1 activity.

IntroductionStudies have found that mothers normally have high sodium concentrations in their colostrum which shows a rapid decrease in the third day postpartum. A drop in breast milk sodium concentration is highly predictive for successful lactation.Objectives and aimsIn this study, the relationship between mammary gland permeability and the factors related to mothers and their babies were aimed to be investigated.MethodThe case group consisted of 150 consecutive healthy babies at postpartum 8–15 days. Edinburgh Postnatal Depression Scale, State and Trait Anxiety Inventory and Relationship Scale Questionnaire were applied to the mothers. Milk samples from all mothers were collected. Weights of babies at first month were recorded.ResultsIn babies with higher Na concentrations and Na/K ratio in their mothers’ milk, were found to gain less weight at the end of first month and also they were the first babies of the families included in the study. Mothers with higher concentrations of Na in their milk thought they were not appropriate to have a child, had poorer relationships with their own mothers, stated that they had no close friendships and had a past history of mental disorders at significance limits. The EPDS and STAI-I scores of mothers with elevated milk Na concentrations found to be higher.ConclusionRegarding this study's results, the risk factors causing an increase in the permeability of the mammary glands were determined as thoughts of not being suitable for motherhood, symptoms of postpartum depression and high levels of anxiety for the mothers.

Objective: Ischemia reperfusion (IR) injury can cause severe organ failures. Remote and direct ischemic preconditioning can be used to prevent ischemia-reperfusion injury. Present study compares the effects of remote and direct ischemic preconditioning in the rat model of hepatic ischemia-reperfusion injury. Material and Methods: Four groups, each including seven rats were included. In the sham group only laparotomy was performed. In the ischemia reperfusion group 25 minutes of total hepatic ischemia was induced followed by 120 minutes of reperfusion. The leg was subjected to three cycles of ischemic preconditioning (IP) before hepatic ischemia reperfusion in the remote IP + IR group. One cycle of hepatic ischemic preconditioning was performed before hepatic ischemia reperfusion in the direct IP+IR group. The length of the experiment was the same in all groups. At the end of the experiment blood and Liver samples were collected. Results: Levels of serum aspartate transaminase (AST) and alanine transaminase (ALT) were significantly lower in the sham group compared to other groups (p<0.001). Levels of serum AST and ALT in the remote IP + IR group were significantly lower than in the direct IP + IR (p<0.001, p<0.001, respectively) and IR groups (p<0.001, p=0.002, respectively). Hepatic tissue malondialdehid level and the histological score of liver injury were significantly lower than in the direct IP + IR group (p<0.001, p=0.002, respectively). Conclusion: Present study showed that when serum AST-ALT levels and hepatic histological score are considered, remote ischemic preconditioning protects the liver from ischemia reperfusion injury better than direct ischemic preconditioning. The effects and mechanisms of these two preconditioning methods must be compared in clinical and experimental studies.

SuleymanDemirel Universitesi TIP FAKULTESI DERGISI: 1996 Mart; 3(1) Myokard Infarktuslu Olgularda Serum Bakir ve Seruloplazmin Duzeyleri Mehmet H. Koseoglu, Meral Fadiloglu, Diler Aslan, Bunyamin Kaptanoglu, Murat Ormen Ozet Bu calismada, miyokard infarktusu (MI) gecirmis hastalarda serum bakir ve seruloplazmin duzeylerinin bu hastalik ile ilisldsim saptamayi amacladik. Onaltisi akut MI (AMI) (yag 54±7) ve 31 'i eski miyokard Infarktuslu (yas 55±8) olmak uzere iki grup (yas: 40-70, erkek) olusturuldu. Ayni yag gruplarinda, soygecmis ve ozgecmislerinde koroner arter hastaligi bulunmayan, saglikli 35 kisi kontrol grubu (yas: 48±7) olarak secildi. Bu kisilerde, aclik serum glukoz, trigliserid, total kolesterol, bakir ve seruloplazmin duzeyleri spektrofotometrik olarak olculdu. Bu degerler sirasiyla, AMI'de 110±41 mg/dl, 197±90 mg/dl, 216±36 mg/dl, 148±16 ng/dl, 34.2±6.5 mg/dl, MI'de 103±34 mg/dl, 2I4±133 mg/dl, 207±41 mg/dl, 142±15 jug/dl, 31.3±4.5 mg/dl, kontrol grubunda ise 97±8 mg/dl, 146±71 mg/dl, 19I±33 mg/dl, 138±14 ng/dL, 29.0±4.3 mg/dl olarak saptandi. Serum bakir duzeyleri, kontrol grubuna gore AMI'de p< 0.05 duzeyinde, seruloplazmin duzeyleri ise AMI'de (p< 0.01) ve MI'de (p< 0.05) anlamli yuksek belirlendi. Sonuc olarak, yuksek serum bakir ve serulopltizmin duzeylerinin koroner arter hastaliginin gelisiminde katkida bulunabilecegi, bu konuyu daha iyi aydinlatabilmek icin hucre kulturleri uzerinde kontrollu deneyler ve epidemiyolojik calismalarin yapilmasi gorusune varildi. Anahtar Kelimeler: Miyokard infarktusu, bakir, seruloplazmin. Abstract Serum Copper and Ceruloplasmin Levels in Myocardial Infarction Thepurpose ofthis study is to evaluate the serum levels of ceruloplasnun and copper in myocardial infarction (MI). Patient groups: Acute MI (AMI) (male, N=16, age 54±7), Old MI (male, N=31, age 55±S), Control group (healthy male people, N=35, age 48±7). in these groups, we determined the fasting serum glucose, triglycerides, total cholesterol, copper and ceruloplasmin. These valiies are 110±41 mg/dl, 197±90 mg/dl, 216±36 mg/dl, 148±16 ftg/dl, 34.2±6.5 mg/dl in AMI, 103±34 mg/dl 214±133 mg/dl, 207±41 mg/dl, 142±15 fjg/dl, 31.3±4.5 mg/dl in MI, 97±8 mg/dl, 146±71 mg/dl, 191±33 mg/dl, 138±14 {lg/dl, 29.0±4.3 mg/dl in controlgroup respectively. Ih comparasion with control group, there is a significant increase of senim copper (p< 0.05) and ceruloplasnun (p< 0.01) levels in AMI, and also a significant increase of serum ceruloplasmin (p< 0.05) levels in MI. We concluded that the high serum ceruloplasmin and copper levels could be a risk factor far coronary heart diseases. On the other hand experimental and epidemiologic studies can give more information in this subject. Key Wordss Myocardial infarction, copper, ceruloplasmin.