ABSTRACT Objective In response to the nuanced glycemic challenges faced by women with iron deficiency anemia (IDA) associated with diabetes, this study uses advanced machine learning algorithms to ...redefine hemoglobin (Hb)A1c measurement values. We aimed to improve the accuracy of glycemic interpretation by recognizing the critical interaction between erythrocytes, iron, and glycemic levels in this specific demographic group. Methods This retrospective observational study included 17,526 adult women with HbA1c levels recorded from 2017 to 2022. Samples were classified as diabetic, prediabetic, or non‐diabetic based on HbA1c and fasting blood glucose (FBG) levels for distribution analysis without impacting model training. Support Vector Machines, Linear Regression, Random Forest, and K‐Nearest Neighbor algorithms as machine learning (ML) methods were used to predict HbA1c levels. Following the training of the model, HbA1c values were predicted for the IDA samples using the trained model. Results According to our results, there has been a 0.1 unit change in HbA1c values, which has resulted in a clinical decision change in some patients. Discussion Using ML to analyze HbA1c results in women with IDA may unveil distinctions among patients whose HbA1c values hover near critical medical decision thresholds. This intersection of technology and laboratory science holds promise for enhancing precision in medical decision‐making processes.
Background/objective
The aim was to evaluate the left and right ventricular functions concurrently by two-dimensional speckle tracking echocardiography (STE) in systemic sclerosis (SSc) patients ...without overt cardiac disease.
Methods
A total of 47 patients with SSc and 36 age- and sex-matched controls were evaluated cross-sectionally. Two-dimensional STE was used to assess the longitudinal peak systolic strains (PSS) of both ventricles including apical long-axis (APLAX), apical four-chamber (4-CH), apical two-chamber (2-CH), and global longitudinal measurements. Any association of metabolic, cardiac, and inflammatory biomarkers with PSS was investigated.
Results
The longitudinal PSS of the left ventricle APLAX, 4-CH, 2-CH and global were significantly lower in SSc patients than controls (− 18.2 ± 3.2 vs − 19.8 ± 2.7%
p
= 0.02; − 17.8 ± 3.5 vs. − 20.3 ± 3.3%
p
= 0.001; − 18.6 ± 3.1 vs. − 21.8 ± 3%
p
< 0.001; − 17.5 ± 5.7 vs. − 20.6 ± 2.7%
p
= 0.003, respectively). No difference was found between the groups for right ventricular strains. The longitudinal PSS-4CH correlated positively with CRP and ESR (r = 0.349,
p
= 0.016; r = 0.356,
p
= 0.014, respectively) and negatively with serum Galectin-3 (
r
= − 0.362,
p
= 0.012). Global longitudinal PSS-left ventricle (LV) correlated positively with CRP and homocysteine (
r
= 0.297,
p
= 0.043;
r
= 0.313,
p
= 0.041, respectively) and negatively with serum Galectin-3 (
r
= −0.314,
p
= 0.041). After multivariable adjustment, CRP remained the only predictor of longitudinal PSS-4CH (95% CI 0.35, 0.70,
p
= 0.028) and global longitudinal PSS of left ventricle (95% CI 0.004, 0.22,
p
= 0.043).
Conclusions
Biventricular evaluation of patients with SSc by two dimensional STE revealed reduced left ventricular longitudinal strains, despite preserved right ventricular strain, and no diastolic dysfunction. In SSc without overt cardiac disease, global cardiac assessment with 2DSTE is a promising method which seems to contribute to the detection of patients without clinical findings.
Key Points
•
Two dimensional STE revealed reduced left ventricular longitudinal strains, despite preserved right ventricular strain in SSc patients without overt cardiac disease
.
•
CRP was the predictor of decreased longitudinal strains
.
•
Cardiac assessment in SSc should be made globally
.
Introduction: Ischaemic preconditioning is the most effective method for the prevention of ischaemic-reperfusion injury; however, no study has examined the question of the ideal time for ischaemic ...preconditioning.
Patients and Methods: The patients were divided into five groups, each group including of 20 patients. The precondition was applied as 1, 5, 10 and 15 min in Groups I, II, III and IV and Group V was the control group. Repeated blood samples were taken to measure the total antioxidant status (TAS), total oxidant status and oxidative stress index (OSI) values, just before insufflation, at the end of the operation and at 6 and 24 h of the post-operative period.
Results: A significant difference was observed between the TAS values at the end of the operation and at the sixth post-operative time of the four groups (P = 0.001, 0.000, 0.001, 0.019 and 0.033, respectively). Furthermore, a significant difference was observed between TAS values at the post-operative 24th h of Group III and Group V, and also a significant difference was observed between the OSI values at the post-operative 6th h of Groups III and V.
Conclusion: The low OSI and TAS values may interpret as a low degree of oxidative damage. The OSI values at the post-operative 6 h of Groups I and II were lower than those of other groups. We accept this result as low oxidative damage.
: Measurement of blood bilirubin levels is a crucial analysis because of the toxic effects of bilirubin on brain tissue, particularly in preterm neonates. The aim of this study was to investigate the ...consistency of the total bilirubin values obtained by the blood gas analyzer and the autoanalyzer.
: In this study, we used total bilirubin data of 407 pediatric patients from Kocaeli University Medical Faculty Education and Research Hospital Central Laboratory System. Total bilirubin data, provided that it was measured simultaneously, was obtained from ABL 735 blood gas analyzer and Roche Cobas C8000 chemistry analyzer. Pediatric patients (neonates, infant and children under 17 years old) were selected retrospectively by year between 2015-2017.
: Under a cut-off value (14.6 mg/dL) ABL 735 blood gas analyzer and Roche COBAS C8000 chemistry analyzer had strong correlation (r = 0.939) for total bilirubin measurements. It was found that 2-15 days old neonates give more scattered total bilirubin data by Bland Altman analysis in two measurements. Statistical analysis performed to compare whole total bilirubin data identity between two measurements: correlation coefficient was found r = 0.949 a statistically significant positive correlation (p < 0.001).
: According to our analysis which was supported by previous studies in the literature, we can say that the compatibility between the blood gas analyzer (multi-wave-length spectrophotometric technique) and the chemistry analyzer becomes weaker when the total bilirubin levels exceed 14.6 mg/dL.
Diabetes is one of the risk factors for the development of vascular dementia (VD), leading to endothelial dysfunction and cognitive impairment. Resveratrol has been shown to have antioxidant, ...antiinflammatory, and neuroprotective effects. The previous studies have also reported that resveratrol improves cognitive and vascular endothelial functions in several pathological conditions. In the present study we aimed to evaluate the effect of resveratrol on cognitive and vascular endothelial function and to explore the mechanisms of its effects in the streptozotocin-induced diabetic rat model of VD. Male Wistar rats were divided into 3 groups (n = 10 in each group): Control, diabetes (DM), DM + resveratrol (DM + RSV) groups. Rats from the DM + RSV group received resveratrol (20 mg/kg/day, ip) for 4 weeks after induction of diabetes and then cognitive functions of the rats were tested by the Morris water maze and a passive avoidance tests. After behavioral tests, endothelial function of thoracic aorta (the endothelium-dependent and -independent vasorelaxant responses) was investigated. To explore the mechanisms of resveratrol, endothelial eNOS, aortic superoxide dismutase (SOD), NADPH oxidase, heme oxygenase-1 (HO-1) levels, TNF-α and IL-1β expressions; serum SOD and NADPH oxidase levels and, hippocampal BDNF, TNF-α and IL-1β expressions were measured. It was shown that DM resulted in severe learning and memory deficits associated with endothelial dysfunction, increased expression of TNF-α and IL-1β, increased oxidative stress levels and decreased expression of eNOS and BDNF. In contrast, resveratrol treatment improved the cognitive decline. It was also found that chronic treatment with resveratrol ameliorated the impaired vascular reactivity. Reveratrol significantly reversed diabetes-induced changes of protein expression. Our data suggest that resveratrol prevents memory deficits, endothelial dysfunction, increased oxidative stress, inflammation and impairment of neurotrophin expression in a VD rat model. Thus, the vasculoprotective and neuroprotective effects of resveratrol may be beneficial in DM patients.
The aim of the study was to investigate the association of paraoxonase 1 (PON1) polymorphism, PON1/arylesterase (ARE) activity and oxidative stress index (OSI) in breast cancer (BC) patients with ...type 2 diabetes (DM).
Our study group consisted of 30 healthy women (HV group) and 66 female BC patients. The BC patients were divided into two groups: those with (n=37) and without DM (n=29) (BDM and NBDM group). Genotyping of PON1 Q192R and L55M polymorphisms were done by polymerase chain reaction (PCR) - restriction fragment length polymorphism (RFLP) method. Serum PON1/ARE enzyme activities, total oxidant status (TOS) and total antioxidant status (TAS) were analysed by spectrophotometric method. The ratio of TOS to TAS was accepted as the oxidative stress index (OSI).
PON1 Q192R genotype frequency distribution was significantly different in the BDM group compared to the NBDM group (p=0.021). When alleles distribution was examined, R and L alleles were significantly lower, Q and M alleles were significantly higher in the BDM group than in the NBDM group (p<0.001). TOS and OSI were statistically higher in BC patients than HV group (p<0.001).
Our results suggest that PON1 gene Q and M alleles may be the risk factors predisposing formation of BC due to increased oxidant damage seen in DM. However, these statements require further confirmation with screening PON1 polymorphism in a greater number of patients with DM, and also wide range follow-up studies are necessary for the same purpose.
Objective: Montelukast, an asthma drug, has an anti-inflammatory effect on tissues. We aimed to investigate therapeutic effect of montelukast (MK) on acetaminophen (APAP) - induced renal damage in ...rat models. Material and Methods: Twenty-four rats were randomly divided into four groups of six animals each. APAP was administered intraperitoneally as a single dose of 1000 mg/kg/day. In the treatment group, MK dose was 10 mg/kg and administered by oral gavage after APAP. The other groups were APAP + Saline group and the control group. We measured tissue malondialdehyde (MDA), reduced glutathione (GSH), and Nitric oxide (NO) levels to determine the nephrotoxicity. Results: Serum Blood Urea Nitrogen (BUN) and creatinine levels were measured significantly higher in APAP group than rats in the control and APAP + MK groups. The level of GSH was significantly diminished in APAP-treated rats. However, the administration of MK significantly increased the level of GSH in the MK treatment group. Tissue MDA levels in rats treated with APAP alone were significantly higher compared to the control group and APAP + MK group. The level of NO was measured as elevated in APAP treated group. However, NO levels in the MK treatment group were significantly lower than APAP treated group. Furthermore, some morphological recoveries were observed in the MK treatment group compared to APAP alone group. Conclusion: MK has beneficial effects on APAP-induced renal toxicity and dysfunction. However, clinical studies are needed to demonstrate appropriate use and effects. Keywords: acetaminophen, kidney, montelukast, nephrotoxicity, oxidative stress
Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) belongs to the tumor necrosis factor (TNF) superfamily and is reported to play a role in autoimmune diseases. In this study, we aimed ...to measure serum TRAIL receptor 1 (TRAIL-R1) concentration and assess any phenotypic relationship in patients with ankylosing spondylitis (AS).
Fifty-three patients with AS were recruited from August 2014 to December 2014 cross-sectionally. Fifty-three sex- and age-matched healthy controls were also recruited. Serum TRAIL-R1 concentrations were measured using an enzyme-linked immunosorbent assay. The association between serum TRAIL-R1, TNF-α, disease activity indices, markers of systemic inflammation, and clinical features were evaluated.
Serum TRAIL-R1 and TNF-α levels were increased in patients with AS compared with healthy controls (4.5 ± 2.3 vs 3.5 ± 2.3 pg/mL, p = 0.036; 3.8 1.6-7.7 vs 2.0 0.21-5.7 pg/mL, p = 0.048, respectively). Serum TRAIL-R1 displayed a medium positive correlation with serum TNF-α concentrations (r = 0.412; p = 0.002). Serum TRAIL-R1 concentration was higher in human leucocyte antigen (HLA)-B27-positive patients compared with non-HLA-B27 patients (5.5 ± 2.2 vs 3.1 ± 1.6 pg/mL, p < 0.001). No relationship was found between serum TRAIL-R1 concentration and disease activity scores.
This study confirms that serum TRAIL-R1 levels are higher in AS patients than healthy controls. The persistence of significantly elevated serum TRAIL-R1 levels, even in patients with low disease activity or after excluding biologic treatment, and the association with HLA-B27 positivity, warrants further investigation due to the unclear role of TRAIL-R1 in the pathophysiology of AS.
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