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Objectives: The thiol-disulphide (TDH) homeostasis was investigated in a number of disorders. The aim of the present study is to investigate the dynamic thiol-disulphide homeostasis in patients diagnosed with obstructive jaundice and to compare the dynamic thiol-disulphide homeostasis with ischemia-modified albumin. Materials and Methods: A total of 146 participants who were admitted to the emergency department and who consisted of 69 patients and 77 healthy volunteers were included in the study. Detailed blood samples were obtained from the patients at the time of admission. Thiol/disulphide levels were examined using a brand-new method developed by Erel and Neselioglu on the patients diagnosed with obstructive jaundice during the admission. Data were evaluated in the computer system. Results: The levels of total thiol (p =0.025) and native thiol (p =0.023) were statistically significantly lower in the patient with obstructive jaundice than in the control group. It was observed that there was a significant negative correlation between the native thiol levels and the ALP (r =-0.262, p<0.01), urea (r =-0.313, p<0.01), total bilirubin (r =-0.388, p<0.01), direct bilirubin (r =-0.351, p<0.01) levels. At the same time, the level of disulphide (p = 0.235) was lower in the patient group than in the control group but not statistically significant. It was found that the ischemia modified albumin (IMA) values were lower in the control group than the obstructive jaundice group (p = 0.03). Conclusion: Total thiol and native thiol levels decrease in obstructive jaundice pathogenesis. Thiol-disulphide homeostasis may be a new biomarker of oxidative stress in obstructive jaundice. [ABSTRACT FROM AUTHOR]

Background: Acute cholecystitis (AC) is caused by chemical and bacterial inflammation of the gallbladder. The use of Tokyo guidelines is recommended in determining the diagnosis of AC and its clinical severity. In the early stages of AC, many cytokines are secreted due to the local inflammatory cell activation, leading to exacerbation of inflammation and organ failure. Ischemia modified albumin (IMA) is a type of albumin that occurs in ischemia and oxidation and is used as a marker of hypoperfusion and oxidative stress. This study aims to investigate the effectiveness of ischemia modified albumin, C-reactive protein (CRP), and some other inflammation parameters in predicting the severity of the AC on admittance. Methods: Forty-two patients diagnosed with AC and 30 healthy individuals in the control group were included in the study. The severity assessment of the patients was performed based on the revised Tokyo guidelines (TG 13). The patients were divided into 3 groups according to severity of the disease. Blood samples were taken from the subjects on admittance. Serum IMA levels were studied using an ELISA kit. SPSS 22.00 package program was used for statistical analysis. Results: Thirty (71.4%) of the participants were in the mild group, while 12 (28.6%) were in the moderate group. There were no patients in the severe group. Leukocyte, CRP, and IMA values in the patient group were higher than those of the control group (p > 0.05). According to the Tokyo classification, a significant difference was found between the groups with mild and moderate grades in terms of CRP and IMA values (p < 0.001 and p < 0.05, respectively). When the cutoff value of IMA was 84 ng/mL, the sensitivity was found to be 76% and specificity was determined to be 40% (AUC: 0.665, p = 0.017, 95% Confidence Interval). Conclusions: It is considered that IMA could be useful in predicting the clinical severity of TG13-based acute cholecystitis and, therefore, could be used in the management of treatment by the clinician such as medical treatment, early surgery, and interval surgery. [ABSTRACT FROM AUTHOR]

Serum ischemia-modified albumin (IMA) is higher in patients with cerebral infarction (CI). In this study, we aimed at studying the association between IMA and CI. Patients with CI were divided to severe stenosis group and mild stenosis group according to the stenosis of vertebrobasilar artery. Digital subtraction angiography (DSA) and magnetic resonance imaging (MRI) were used for diagnosis. Cobalt-combined with Albumin test was used to determine the serum IMA levels. Serum IMA levels in patients with CI and healthy volunteers were compared by t test. Receiver operating characteristic (ROC) curve was performed for evaluating the diagnostic efficiency of serum IMA for CI. The correlation between IMA level and the National Institute of Health Stroke Scale(NIHSS) score after treatment was analyzed. Serum IMA levels in patients with CI was increased compared to healthy volunteers(P <.05). Patients in severe stenosis group had a higher serum IMA level than mild stenosis group(P <.05). Serum IMA level at admission was associated with NIHSS score on the 7th day after treatment(P <.05). Serum IMA level was correlated with vertebrobasilar artery stenosis and short-term prognosis in patients with acute CI. [ABSTRACT FROM AUTHOR]

Copyright of Viral Hepatitis Journal / Viral Hepatit Dergisi is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The early detection and treatment of sepsis and septic shock patients in emergency departments are critical. Ischemia modified albumin (IMA) is a biomarker produced by ischemia and oxygen free radicals which are related to the pathogenesis of sepsis-induced organ dysfunction. This study aimed to investigate whether IMA was associated with short-term mortality in quick sequential organ failure assessment (qSOFA)-positive sepsis or septic shock patients screened by the sepsis management program.Method: From September 2019 to April 2020, patients who arrived at the emergency departments with qSOFA-positive sepsis or septic shock were included in this retrospective observational study.Results: Among 124 patients analyzed, IMA was higher in the non-surviving group than in the surviving group (92.6 ± 8.1 vs. 86.8 ± 6.2 U/mL, p < 0.001). The area under the receiver operating characteristics curve was 0.703 (95% CI: 0.572-0.833, p < 0.001). The optimal IMA cutoff was 90.45 (sensitivity 60.9%, specificity 79.2%). IMA values were independently associated with 28-day mortality in the multivariate Cox proportional hazard model (adjusted hazard ratio (aHR) = 1.16, 95% CI: 1.06-1.27, p < 0.01).Conclusions: In this study, we showed that IMA in the emergency departments was associated with 28-day mortality in qSOFA-positive sepsis and septic shock patients. Further studies are needed to evaluate the clinical value of IMA as a useful biomarker in large populations and multicenter institutions. [ABSTRACT FROM AUTHOR]

Ischemic infarctions occur under the influence of genetic and environmental factors. In our study, the role of ischemia-modified albumin and thiol balance, which are new markers in determining oxidative damage together with MTHFR gene polymorphisms and homocysteine levels, in the development of SBI was investigated. White matter lesions in the magnetic resonance imaging (MRI) results of the patients were evaluated according to the Fazekas scale and divided into groups (Grade 0, 1, 2, and 3). Homocysteine, folate, B12, IMA, total thiol, and native thiol were measured by biochemical methods. The polymorphisms in MTHFR genes were investigated by the RT-PCR method. According to our results, a significant difference was found between the groups in age, homocysteine, folate, IMA, total thiol, and native thiol parameters (p < 0.05). When we compared the groups in terms of genotypes of the C677T gene, we found a significant difference in TT genotype between grades 0/3 and 1/3 (p < 0.05). We determined that homocysteine and IMA levels increased and folate levels decreased in CC/TT and CT/TT genotypes in the C677T gene (p < 0.05). Considering our results, the observation of homocysteine and IMA changes at the genotype level of the MTHFR C677T gene and between the groups, and the deterioration of thiol balance between the groups suggested that these markers can be used in the diagnosis of silent brain infarction. [ABSTRACT FROM AUTHOR]

Copyright of Mersin Üniversitesi sağlık Bilimleri Dergisi is the property of Mersin University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tissue hypoxia remains a leading cause of morbidity and mortality in preterm infants. Current biomarkers often detect irreversible hypoxic cellular injury (i.e. lactate) and are non-specific. A new biomarker is needed which detects tissue hypoxia before irreversible damage occurs. To investigate the relation between serum ischemia modified albumin (IMA), a marker of hypoxia; and analytic variables, patient related variables and conditions associated with hypoxia, in preterm infants. Retrospective cohort study. Infants with a gestational age < 30 weeks and/or birth weight < 1000 g. We collected two remnant blood samples in the first week after birth and measured IMA. IMA/albumin ratio (IMAR) was used to adjust for albumin. We assessed correlations between IMA(R) and analytic variables (albumin, lipemia- and haemolysis index); mean-2 h SpO 2 ; mean-2 h variability of regional splanchnic oxygen saturation (r s SO 2), measured using near-infrared spectroscopy; and patent ductus arteriosus (PDA). Sixty-five infants were included. Albumin, the lipemia- and haemolysis index correlated negatively with IMA (r:-0.620, P <0.001; r:-0.458, P <0.001; and r:-0.337, P =0.002). IMAR correlated negatively with SpO 2 (rho:-0.614, P <0.001). Lower r s SO 2 variability correlated with higher IMAR values (rho:-0.785, n =14, P =0.001 and rho:-0.773, n =11, P =0.005). Infants with a hemodynamic significant PDA (hsPDA) had higher IMAR values than infants without PDA (0.13 [0.11–0.28], n =16 vs. 0.11 [0.08–0.20], n =29, P =0.005 and 0.11 [0.09–0.18], n =13 vs. 0.09 [0.06–0.17], n =37, P =0.026). When adjusted for albumin, the lipemia- and haemolysis index, IMAR has potential value as a marker for systemic hypoxia in preterm infants, considering the associations with SpO 2 , variability of r s SO 2 , and hsPDA. • IMA is negatively associated with arterial oxygen saturation in preterm infants. • IMA is negatively associated with variability of splanchnic oxygen saturation. • IMA is higher in neonates with a hemodynamic significant patent ductus arteriosus. • IMA is a potential objective marker of (tissue) hypoxia in preterm infants. [ABSTRACT FROM AUTHOR]

Amaç: Bu çalışmanın amacı akut mezenterik sikeminin (AMİ) erken tanısında ortalama trombosit hacminin (MPV) ve iskemi modifiye albümin (IMA) dğzeylerinin rolünü belirlemekti.Gereç ve Yöntem: Bu çalışmada, 18 Wistar Albino cinsi sıçan, her grupta 6 sıçan olacak şekilde 3 deney grubuna rasgele olarak ayrıldı; laparotomisiz şam grubu, laparotomi yapılan control grubu ve mezenterik iskemi grubu. Trombosit sayısı, MPV ve IMA, AMI grubunda 120. dk.lık superior mezenterik arter tıkanıklığının sonunda ve aynı zamanda diğer gruplarda çalışıldı.Bulgular: AMI grubunda MPV ve IMA değerleri diğer 2 gruba göre anlamlı derecede yüksekti; trombosit sayısı anlamlı olarak düşüktü. Kontrol ve şam grupları arasında bu parametreler açısından istatistiksel olarak anlamlı bir fark yoktu.Sonuç: AMI hızlı tanı konulmazsa oldukça mortal olabilen bir hastalıktır. Bu nedenle erken tanıda bu parametrelerin rolünü tanımlamak için daha fazla klinik çalışma gereklidir.

Purpose: Ovarian torsion, being a gynecological emergency, requires to be rapidly diagnosed and treated with minimal consequences on ovarian function after the removal of torsion. As ischemia modified albumin (IMA) is considered a good biomarker in diverse ischemic diseases, the aim of our study was to determine the effect of different ovarian torsion/detorsion models on serum and ovarian homogenates levels of IMA in an experimental study.

Background: Oxidative damage is of great importance for patients with breast cancer. Thus, studies were performed to identify the relationship between breast cancer and oxidative stress biomarkers.

Background: Oxysterols have been shown to play a role in plaque formation while ischemia modified albumin (IMA) is widely accepted as an acute marker for ischemia. The effort test is one of the methods used to identify the presence of coronary artery disease. Thus, there may be a relationship between effort test result and the levels of IMA, 7-ketocholesterol (7-KC) and cholestane-3β,5α,6β-triol (C-triol). Methods: Thirty patients who underwent effort test and 30 healthy subjects were included in the study. IMA levels were determined with the albumin-cobalt binding test, 7-KC and C-triol levels were determined with LC-MS/MS. Among the patients, two subgroups were identified according to the results of the effort test, group 1 consisted of patients with a positive effort test (n = 12), and group 2 consisted of patients who had a negative effort test (n = 18). Results: 7-KC levels of patients were significantly higher compared to healthy subjects (39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL; p=0.001). In patients, post-test 7-KC levels were significantly lower than pre-test levels (posttest vs. pre-test: 37.73 ± 2.44 ng/mL vs. 41.07 ± 2.18 ng/mL; p

Objective: Ischemia modified albumin (IMA) is an altered type of albumin produced due to exposure to hypoxia, acidosis, inflammation, or oxidative stress. In this study, we aimed to evaluate the serum IMA levels in newly diagnosed and medication-naive generalized anxiety disorder (GAD) and panic disorder (PD) patients. Method: This cross-sectional study included medication-naive 23 GAD, 25 PD patients, and 28 healthy controls. The participants were evaluated with a sociodemographic form, the Beck Depression Inventory (BDI), and the Beck Anxiety Inventory (BAI). Venous blood samples were collected from all participants, and IMA levels and routine biochemical parameters were measured. Results: There was no statistically significant difference between three groups in terms of age, gender, body mass index (BMI) and routine biochemical markers of the participants (p>0.05). The GAD and PD groups had significantly higher serum IMA levels than healthy controls (p<0.01), whereas there was no statistically significant difference in IMA levels between GAD and PD groups (p=0.994). Additionally, correlation analysis showed a positive correlation between IMA levels with BDI and BAI scores (r=0.449 and r=0,632, respectively, p<0.001). Discussion: Higher IMA levels in patients with GAD and PD may indicate metabolic stress on these patients. Anxiety disorders may tend to various biochemical disturbances, and IMA could be an important new marker that indicates global metabolic risk in such patients. This research is the first study that evaluates IMA levels in anxiety disorders. [ABSTRACT FROM AUTHOR]

In the general population Thyroid dysfunctions are common after DM as the most well-known situation to influence the endocrine system. Diabetic patients are at increased danger of thyroid sickness, particularly persons with poor glycaemic control. Ischemia Modified Albumin IMAis novel marker of oxidative stress and tissue ischemia . The pathophysiological occasions of ischemia, including free oxygen radicals and hypoxia, bring about a conformational change of albumin in the N-terminus. The study included 120 subjects, divided into four groups; the first group included 30 patients type2 diabetes mellitus T2DM with newly diagnosed hyperthyroidism HprT, the second group includes 30 patients T2DMwith newly diagnosed hypothyroidism HpoT, the third group included 30 patients diagnosed with T2DM, and the fourth group included 30 healthy control subjects. The concentration of (fasting blood glucose FBG, Glycated hemoglobin HbA1c,Total cholesterol TC, Triglyceride TG,high density lipoprotein HDL, Free Triiodothyronin FT3,Free Thyroxin FT4 and thyroid-stimulating hormone TSH). The results show high significant differences in level of IMA between all studied groups that including diabetic patient with newlydiagnosed hyperthyroidism, diabetic patient with newlydiagnosed hypothyroidism, DM only, and control group [(2.60±1.11), (2.41±1.23), (2.57±5.50), (2.10±0.61)] respectively. Conclusion: Biomarkers IMA could be helpful early diagnosis in monitoring T2DM with newlydiagnosed thyroiddisorders. [ABSTRACT FROM AUTHOR]

Objectives: We aimed to evaluate the potential effects of heart positioning during off-pump CABG (OPCAB) without a cardiac stabilizer device on serum levels of ischemia modified albumin (IMA) and cardiac output (CO). Materials and Methods: This was a prospective study in which consecutive patients who underwent isolated OPCAB were included. Data including electrocardiography and intraarterial hemodynamic monitoring parameters were recorded. Arterial pressure waveform was analyzed. CO was measured for circumflex coronary artery (Cx), diagonal coronary artery (D1), left anterior descending coronary artery (LAD), and right coronary artery (RCA) positions. Preoperative and postoperative 1st, 2nd, 4th, and 12th-hour blood samples were taken for serum ischemia modified albumin measurements. Results: Forty patients who underwent OPCAB were included in the study. The mean age was 60.3±10.2 years. Hospital mortality, stroke, postoperative myocardial infarction, acute kidney injury, sternal infection, and re-operation for bleeding/tamponade were not observed postoperatively. Six patients (15%) who developed postoperative atrial fibrillation (AF) had a significantly higher mean serum IMA level compared with patients who did not. There was no statistically significant difference in preoperative and postoperative mean serum IMA levels (p=0.925). Mean CO values measured at four different heart positions were not significantly different from each other except for a difference between LAD and Cx (p=0.002). Conclusion: Our results showed that when the heart was in the Cx anastomosis position, the CO was significantly lower than the LAD position; however, there was no significant serum IMA raise despite CO decrease. IMA levels did not change significantly from baseline values. Patients who developed postoperative AF had higher IMA levels than patients who did not develop AF. [ABSTRACT FROM AUTHOR]

Non-ST elevated myocardial infarction (NSTEMI)) diagnosis is difficult when the electrocardiography (ECG) normal and troponin parameters are slightly higher than the normal reference range. This study aimed to assess the IMA (ischemia modified albumin), MDA (malondialdehyde), SOD (superoxide dismutase), and catalase in patients with NSTEMI. The present study included 55 patients with NSTEMI and 55 healthy subjects prospectively. IMA, MDA, SOD, and catalase levels were measured from venous blood obtained from each patient within twelve hours after the onset of symptoms. Differences between the two groups were evaluated with Student's unpaired t -test for parameters with a normal distribution. IMA (3.14 ± 0.06 vs. 1.49 ± 0.03) and MDA (3.14 ± 0.06 vs. 1.49 ± 0.03) were higher, and SOD (1.10 ± 0.03 vs. 2.31 ± 0.02) and catalase (0.54 ± 0.02) vs. 0.22 ± 0.02) were lower in NSTEMI patients than control subjects. There was a significant correlation among IMA, MDA, SOD and catalase. Our data reveal that levels of MDA and IMA were increased, and SOD and catalase levels were decreased significantly in patients with NSTEMI. Blood concentrations of oxidant and antioxidant parameters could assess the oxidative state in patients with NSTEMI. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the changes in cardiac functions by echocardiography and oxidative stress markers in pregnant women with iron deficiency anemia. A total of 100 patients (pregnant women with IDA n = 34, healthy pregnant women n = 33, non-pregnant control group n = 33) were enrolled. Demographic data, serum thiol-disulfide and ischemia modified albumin levels, and echocardiographic parameters were compared. Native thiol (NT) (p <.001) and Total Thiol (TT) (p <.001) levels as antioxidant markers; left ventricular ejection fraction (LVEF) (p <.001), tricuspid annular plane systolic excursion (TAPSE) (p <.001) were significantly decreased in the IDA group compared to healthy pregnant women and non-pregnant controls. Adjusted IMA ratios were significantly increased in the IDA group (p =.001). A significant negative correlation was determined between adjusted IMA and LVEF (r = −0,4226; p =.016), a significant positive correlation was determined between thiol levels and TAPSE (r = 0.361; p =.041) in IDA group, no correlation was observed in healthy pregnant women and healthy non-pregnant control group. Anemia in pregnanc may trigger oxidative stress and increased OS may be related to changes in cardiac functions. The possible cardiovascular impact should be considered in pregnant women with anemia and clinicians should not neglect to refer these patients to cardiology in clinical practise. [ABSTRACT FROM AUTHOR]

Objective: To investigate cord blood ischemia-modified albumin (IMA) levels in pregnancies with intrauterine growth restriction (IUGR) and to determine its association with abnormal fetal Doppler findings.Methods: Umbilical cord IMA levels were assessed in 34 pregnant women with IUGR and 32 pregnancies with normal fetal development. Associations of IMA with abnormal umbilical artery Doppler findings, preeclampsia, and oligohydramnios were investigated. IMA was measured using a colorimetric test based on a decrease in cobalt binding.Results: No significant between group differences in maternal age, body mass index, gravida, and parity were identified. The mean gestational age at delivery was earlier in the IUGR group than in the control group (35.7 ± 3.2 versus 38.4 ± 1.2, respectively). The mean cord blood IMA values for the IUGR group were significantly increased compared to those in the control group (0.565 ± 0.22 versus 0.250 ± 0.12, respectively, p = .001). There was a significant positive correlation between umbilical artery pulsatility index and IMA levels in the IUGR group. Patients with preeclampsia, oligohydramnios, and abnormal nonstress test results in the IUGR group had significantly higher IMA levels. Patients with systolic to diastolic ratios >3 and pulsatility index (PI) above the 95th percentile in the IUGR group had significantly higher cord blood IMA levels (p = .001 and p = .007, respectively).Conclusions: Cord blood IMA values may be a useful marker for perinatal asphyxia. Abnormal Doppler findings are associated with increased IMA levels in complicated pregnancies with IUGR. [ABSTRACT FROM AUTHOR]

Copyright of Van Tip Dergisi is the property of Yuzuncu Yil University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: Growing evidence shows that oxidative stress plays an important role in the development and progression of nephrotic syndrome (NS). In this study, we aimed to examine serum IMA levels as an indicator of oxidative stress in children with steroid-sensitive NS (SSNS) in remission and relapse. Methods: This cross-sectional study was carried out at the Pediatric Nephrology Unit of Sanliurfa Training and Research Hospital, Sanliurfa, Turkey, from April 2019 to December 2019. In this study Serum IMA and albumin levels were determined in 70 children with SSNS and 45 healthy controls. Among the children with SSNS, 50 were in remission and 20 were in relapse. Then, adjusted IMA levels were calculated from the IMA/albumin ratio. Results: IMA and adjusted IMA levels significantly increased and albumin significantly decreased in children with SSNS in relapse and remission compared with those of the healthy controls. Moreover, these alterations were more prominent in the relapse group than in the remission group. IMA was inversely correlated with albumin in children with SSNS (r= -0.881, p= <0.001). Conclusions: Our findings demonstrated that elevated IMA and adjusted IMA levels observed in patients with SSNS were associated with increased oxidative stress and could indirectly reflect the degree of oxidative damage in glomerular structures. [ABSTRACT FROM AUTHOR]

Aim: The evaluation of dynamic thiol‐disulfide homeostasis among patients with the cancer of the uterine cervix. Methods: The study was conducted in 62 cervical cancer patients and 61 healthy women who had been followed up in an obstetrics and gynecology clinic between September 2018 and April 2020. Serum disulfide, native thiol, total thiol, ischemia modified‐albumin, total antioxidant and oxidant capacities, and oxidative stress index values were measured in all participants. Results: The mean plasma disulfide levels of the cervical cancer group was statistically significantly higher than that of the control group (25.79 ± 6.90 μmol/L, 22.31 ± 6.11 μmol/L, respectively) (P = 0.004). Plasma native thiol and total thiol levels were lower in cervical cancer patients (299.27 ± 99.05 μmol/L and 350.86 ± 102.72 μmol/L, respectively) compared to controls, but no statistically significant difference was observed (318.00 ± 93.75 μmol/L and 376.44 ± 98.51 μmol/L, respectively) (P = 0.284, P = 0.161). With respect to the ischemia modified‐albumin level, no statistically significant difference was observed between two groups. There were statistically significant positive association between disulfide level and both the stage of cervical cancer (r = 0.278, P = 0.029) and total oxidant capacity level (r = 0.256, P = 0.046). Conclusion: Dynamic thiol‐disulfide homeostasis may participate in the pathophysiological mechanisms of cervical cancer and may be a potential biomarker for early identification of cervical cancer in future. [ABSTRACT FROM AUTHOR]

Abdurrahman Sahin,1 Semra Turkoglu,2 Nurettin Tunc,1 Deccane Duzenci,3 Ozgen Arslan Solmaz,4 Ibrahim Halil Bahcecioglu,1 Mehmet Yalniz1 1Medicine Faculty, Department of Gastroenterology, Firat University, Elazig, Turkey; 2Department of Nutrition and Dietetics, Health Sciences Faculty, Firat University, Elazig, Turkey; 3Department of Internal Medicine, Elazig Education and Training Hospital, Elazig, Turkey; 4Department of Pathology, Elazig Education and Training Hospital, Elazig, Turkey Purpose: Oxidative stress has been implicated in several disorders, including acute pancreatitis (AP). Ischemia-modified albumin (IMA), which reflects the ability to bind cobalt, has been found to be elevated in conditions of oxidative stress and tissue hypoxia. This study examined IMA and adjusted IMA levels in patients with AP, and examined the associations of IMA and adjusted IMA levels to the severity of AP.Patients and methods: A total of 42 consecutive patients with AP and 43 age- and sex-matched control subjects were enrolled. Serum samples were obtained from patients with AP on admission as well as 48–72 hours after hospitalization, and from the controls, at the time of enrollment. Adjusted IMA was calculated by multiplying the IMA value of each patient with the ratio of the patient’s albumin value and the median albumin value of the study population. The severity of AP was assessed according to the modified Atlanta classification, and the patients were divided into 2 groups: mild AP and severe AP.Results: The serum IMA and adjusted IMA values of patients with AP on admission and those of the controls did not differ (p=0.86 and p=0.99, respectively). The second measurements of IMA and adjusted IMA in the AP group were higher than the first measurements of both the AP group and controls (for all, p

Objective: Ischaemia-modified albumin (IMA) has frequently been studied in recent years in ischaemia-based studies. In this study, IMA changes and postoperative pain were investigated in patients who underwent tourniquet and non-tourniquet knee arthroplasty, and the effect of the tourniquet on pain was investigated quantitatively. Methods: After obtaining institutional review board approval, 64 patients who underwent total knee arthroplasty were divided into two groups: tourniquet and non-tourniquet using the block randomisation technique. Blood was collected at the 15th minute and 24th hour postoperatively. A visual analogue scale (VAS) was used by patients to evaluate their pain. Results: According to the results, a significant correlation was found between VAS scores and IMA levels in the blood taken at the postoperative 15th minute (p<0.001). In addition, IMA levels were significantly higher in the tourniquet group (p<0.001). Conclusion: Less frequent loss of quadriceps muscle strength, less postoperative pain and avoidance of ischaemia-related complications are the main advantages of non-tourniquet knee arthroplasty. IMA is effective in demonstrating these advantages and can be used for problems such as compartment syndrome, which may be accompanied by muscle damage in the extremity. [ABSTRACT FROM AUTHOR]

Aim: In the present study, we aimed to evaluate serum IMA, IMA/albumin ratio, and DTDH levels in patients with early- and late-onset PE compared to healthy controls. Impaired homeostasis between oxidant and antioxidant mechanisms, inflammatory processes, and endothelial dysfunction play a key role in the pathogenesis of preeclampsia (PE). Serum ischemia modified albumin (IMA) and dynamic thiol/disulfide homeostasis (DTDH) levels are elevated in the presence of inflammation, oxidative stress, and endothelial dysfunction. Material and Methods: A total of 24 patients with early-onset PE and 62 patients with late-onset PE were included. The control group consisted of 46 healthy controls with similar gestational weeks. Serum samples were collected and IMA, albumin, and native, total, and disulfide thiol levels analyzed. Corrected IMA/albumin ratios were also calculated. Results: Disulfide levels, disulfide/native and disulfide/total thiol levels were higher in patients with early-onset PE compared to lateonset patients(p=0.008, p=0.022, and p=0.021, respectively). However, there was no significant difference between the late-onset PE patients and late-onset PE controls. Although there was no significant difference in the IMA levels between the patient and control groups, the IMA/albumin ratio was higher in the early-onset and late-onset PE patients, compared to the control group. However, there was no significant difference between the early-onset and late-onset PE patients. Conclusion: Our study results showed increased disulfide levels, disulfide/native thiol, disulfide/total thiol and IMA/albumin ratio in the early-onset PE patients, indicating increased oxidative stress in the pathogenesis of PE. In the late-onset PE patients, there was an increase only in the IMA/albumin ratio. However, further large-scale, prospective studies are needed to confirm the diagnostic value of these markers in the clinical practice [ABSTRACT FROM AUTHOR]

Background/aim: This study aimed to determine plasma thiol, disulphide, and serum ischemia-modified albumin (IMA) levels and ferroxidase activity in patients with ascending aorta dilatation (AAD) in comparison to those without AAD and to evaluate the predictive value of these oxidative stress parameters for AAD. Materials and methods: This study was designed as a cross-sectional study of 184 patients who applied to our cardiology clinic. Our study population consisted of patients with AAD (n = 85) and without AAD (n = 99). A spectrophotometric method was used to determine plasma thiol, disulphide, and serum IMA levels and ferroxidase activity. Results: The native thiol and the total thiol levels were significantly higher in the control group than the AAD group (P < 0.001), whereas the disulphide and IMA levels and the ferroxidase activity were similar between the groups. The native thiol and the total thiol levels were inversely and significantly correlated with ascending aortic diameter (r = –0.38, P < 0.001; r = –0.39, P < 0.001; respectively). The left ventricle mass and the total thiol levels were independent predictors of ascending aortic diameter (β= 0.223, P = 0.02; β= –0.340, P < 0.001; respectively). Conclusion: Among oxidative stress parameters including thiols, disulphide, IMA, and ferroxidase activity, only the lower total thiol levels appear to confer a high risk for AAD development. Along with the proven diagnostic imaging methods, thiol levels may be helpful to diagnose and stratify patients with AAD. [ABSTRACT FROM AUTHOR]

Background: Birth asphyxia is a leading cause of neonatal mortality. Ischemia-modified albumin (IMA) levels may have a predictive role in the identification and prevention of hypoxic disorders, as they increase in cases of ischemia of the liver, heart, brain, bowel, and kidney. Purpose: This study aimed to assess the value of IMA levels as a diagnostic marker for neonatal hypoxic-ischemic encephalopathy (HIE). Methods: Sixty newborns who fulfilled 3 or more of the clinical and biochemical criteria and developed HIE as defined by Levene staging were included in our study as the asphyxia group. Neonates with congenital malformation, systemic infection, intrauterine growth retardation, low-birth weight, cardiac or hemolytic disease, family history of neurological diseases, congenital or perinatal infections, preeclampsia, diabetes, and renal diseases were excluded from the study. Sixty healthy neonates matched for gestational age and with no maternal history of illness, established respiration at birth, and an Apgar score =7 at 1 and 5 minutes were included as the control group. IMA was determined by double-antibody enzymelinked immunosorbent assay of a cord blood sample collected within 30 minutes after birth. Results: Cord blood IMA levels were higher in asphyxiated newborns than in controls (250.83±36.07 pmol/mL vs. 120.24±38.9 pmol/mL). Comparison of IMA levels by HIE stage revealed a highly significant difference among them (207.3±26.65, 259.28±11.68, 294.99±4.41 pmol/mL for mild, moderate, and severe, respectively). At a cutoff of 197.6 pmol/mL, the sensitivity was 84.5%, specificity was 86%, positive predictive value was 82.8%, negative predictive value was 88.3%, and area under the curve was 0.963 (P<0.001). Conclusion: IMA levels can be a reliable marker for the early diagnosis of neonatal HIE and can be a predictor of injury severity. [ABSTRACT FROM AUTHOR]

Background: The objective of this study was to determine the levels of serum ischemia-modified albumin (IMA), fibrinogen (FIB) and high sensitivity C-reactive protein (hs-CRP) in type 2 diabetes mellitus (T2DM) patients with hypertension (HT) (DMT2HTN) and without HT (DMT2). Also, their association with certain biochemical and physical factors were studied to identify possible risk factors that lead to cardiovascular complications. Methods: Fasting blood samples were collected from 35 DMT2 or DMT2HTN patients each to analyze differences in serum and plasma levels of IMA, hs-CRP, FIB, total cholesterol (TC), high and low density lipoproteins (HDL and LDL), triglyceride (TG), hemoglobin A1c (HbA1C), glycated hemoglobin and creatinine. Results: In DMT2 and DMT2HTN patients, IMA, hs-CRP, FIB, TC, TG, HDL, LDL, glycated hemoglobin and creatinine levels, including body mass index (BMI) and waist-to-hip ratio (WHR), were significantly higher relative to healthy controls. In addition, the levels of IMA, hs-CRP and FIB levels showed a strong link to BMI, WHR, TC, TG, LDL and glycated hemoglobin. Lastly, both DMT2 and DMT2HTN patients demonstrated a significant reduction in HDL. Conclusions: DMT2 and DMT2HTN patients have a greater risk of developing cardiovascular related complications. This study suggests that quantifying hs-CRP, IMA and FIB levels can help diagnose the risk of developing complications during the early stages of metabolic and cardiovascular disease. Overall, the specific risk factors may be used for early identification of cardiovascular complications to decrease mortality and morbidity in T2DM patients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate whether urinary neutrophil gelatinase-associated lipocalin (NGAL) and serum ischemia-modified albumin (IMA) levels could serve as early biomarkers of contrast-induced acute kidney injury (CI-AKI) in patients with normal serum creatinine values who undergo coronary angiography (CAG). Methods: This study was conducted in 78 patients undergoing CAG. Urinary NGAL and serum IMA values which measured prior to and 6 hours after CAG were compared with creatinine values that measured prior to and 48 hours after CAG. Results: IMA and NGAL values obtained 6 hours after CAG differed significantly from those obtained at baseline. Statistically significant differences were found between the baseline and 6th-hour values of urinary NGAL and serum IMA (p<0.001). There was no significant difference between baseline and 48th hour serum creatinine levels (p=0.081). In addition, a statistically significant positive correlation was found between pre-processing and 6th-hour NGAL and IMA levels, (r=0.277, p=0.014; r=0.407 and p<0.001, respectively). Conclusion: An increase in urinary NGAL and serum IMA levels were detected without an increase in serum creatinine values which is routinely used in determining CI-AKI. When compared to serum creatinine, urinary NGAL and serum IMA may be early and sensitive biomarkers for predicting CI-AKI. [ABSTRACT FROM AUTHOR]

O objetivo principal do estudo foi investigar o efeito de exposição à radiação ionizante de baixa dose nos níveis de homeostase tiol/dissulfeto e de albumina modificada por isquemia. O objetivo secundário foi comparar os níveis de homeostase tiol/dissulfeto e albumina modificada por isquemia entre indivíduos expostos à radiação ionizante de baixa dose nas áreas de procedimentos anestésicos, dentro e fora da sala de cirurgia. O estudo incluiu um total de 90 voluntários com idades entre 18 e 65 anos, 45 profissionais que trabalhavam em ambiente de exposição potencial a radiação (Grupo Exposto) e 45 profissionais que trabalhavam em ambiente sem exposição à radiação (Grupo Controle). Foram medidos os níveis de tiol nativo, tiol total, dissulfeto, albumina e albumina modificada por isquemia. O Grupo Exposto era constituído por profissionais expostos a radiação fora da sala de cirurgia – Grupo sala de cirurgia (‐) e na sala de cirurgia – Grupo sala de cirurgia (+). Os níveis de albumina, tiol nativo e total foram significantemente mais baixos nos participantes expostos à radiação em área de realização de anestesia, e nenhuma diferença estatisticamente significante foi encontrada para os níveis de dissulfeto e albumina modificada por isquemia. No Grupo exposto sala de cirurgia (‐), os valores de tiol nativo e tiol total foram significantemente mais baixos quando comparados ao Grupo sala de cirurgia (+). Os profissionais expostos à radiação em área de realização de anestesia devem ser conscientizados quanto ao perigo do estresse oxidativo após exposição à radiação ionizante de baixa dose e medidas cabíveis devem ser instituídas. The primary objective of this study was to investigate the effect of low dose ionizing radiation exposure on thiol/disulfide homeostasis and ischemia modified albumin levels. The secondary objective is to compare thiol/disulfide homeostasis and ischemia modified albumin levels among the personnel exposed to low dose ionizing radiation in anesthesia application areas, in and out of the Operation room. The study included a total of 90 volunteers aged between 18 and 65 years old, with 45 personnel working in a setting with potential for radiation exposure (Exposed Group) and 45 personnel in a setting without radiation exposure (Control Group). Their native thiol, total thiol, disulphide, albumine and IMA levels were measured. Exposed group included personnel who were exposed to radiation outside the operating room – Operation room (‐) Group and inside the Operating room – Operation room (+) Group. Albumin, native and total thiol levels were significantly lower in the participants exposed to radiation in the anesthesia application area, no statistically significant difference was found in terms of disulfide and ischemia modified albumin levels. In the Operation room (‐) group exposed to radiation, native thiol and total thiol values were significantly lower compared to the Operation room (+) groups. Awareness of being in danger of oxidative stress should be established in personnel exposed to radiation in the anesthesia application area following low dose ionizing radiation exposure, and the necessary measures should be taken. [ABSTRACT FROM AUTHOR]

Background: Acute coronary syndrome (ACS) can be classified to ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI) and unstable angina. The challenging in acute coronary syndrome remains, as it does not detect the myocardial ischemia by cardiac troponin and creatine kinase-MB. Pro brain-type natriuretic peptide (pro-BNP) was released when the heart need to hard works, which leads of retention fluid and expansion of veins and arteries. Therefore, this hormone release in the response of the changes of pressure in the heart especially for patients with ACS, which be benefit to use as an indicator to evaluate health problem that related with heart. Ischemia modified albumin (IMA) is a form of human serum albumin in which the N-terminal amino acids have been modified by ischemia as the result of acidosis, damaging occurs by free radicals, fatty acids releasing, exposures to free copper and iron, and disturbance of calcium pump. The aim of this study was to estimate the brain natriuretic peptide (Pro-BNP) and Ischemia Modified Albumin (IMA) Levels as early diagnostic markers and correlated with conventional cardiac markers at admission to the emergency department in Acute Coronary Syndrome Patients with ST segment elevation myocardial infarction (STEMI) and Non ST segment elevation myocardial infarction (NSTEMI). Methods: Eighty ACS patients who arrived at the emergency department ED within 6h of clinical symptoms divided to STEMI and NSTEMI, and another 40 of noncardiac chest pain patients (NCCP) as control were enrolled in this study. pro-BNP was measured using a Cobas e 411 Roche, Germany, and IMA was measured using enzymelinked immunosorbent assay (ELISA) kits. Tukey HSD Post hoc ANONA test and One-way ANOVA were used to compare differences of mean between groups. Pearson Correlation was calculated to assess the relation between the biomarkers of this study. Receiver Operating Characteristics (ROC) curve was calculated to estimate the sensitivity and specificity for the use of pro-BNP and IMA as biomarker in the diagnosis and discriminatory ability of ACS. Results: pro-BNP and Ischemia modified albumin were significantly higher in acute coronary syndrome patients (STEMI & NSTEMI) compared to NCCP as controls (1359.82±995.00 and 2698.22±1604.69 vs 180.07±90.24) (p<0.01) for pro-BNP and (96.79±16.03 and 86.00±15.14 vs. 69.42±10.65) for IMA. There were a significant differences in mean of each pr0-BNP and IMA values between two categories of acute coronary syndrome were seen (p<0.01). The correlation of IMA with CK-MB in NSTEMI patients was peak negative (r=-0.41, p<0.01). Receiver operator characteristics (ROC) curve was calculated to define the optimal cut-off values for the use of each pro-BNP and IMA as biomarkers in early diagnostic and distinguish of patients with STEMI and NSTEMI at admission to ED within 6h of clinical signs. ROC curve revealed to the optimal cutoff value for pro-BNP in STEMI was 231 pg/ml and NSTEMI was 400 pg/ml with sensitivity of 85% and 87.5% and specificity of 82.5% and 87.5% with area under curve AUC of 91.9% and 95.7%. The optimal cutoff value for IMA in STEMI was 89 U/ml and NSTEMI was 80.9 U/ml with sensitivity of 85% and 82.5% and specificity of 90.0% and 75.0% with AUC of 88% and 87.5%. Conclusions: We conclude pro-BNP together with IMA assay as promising biochemical markers for the early diagnosis of ACS, and complement together as a good discriminator between STEMI patients and NSTEMI patients. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

To explore the changes of heat shock protein 70(HSP70) and ischemic modified albumin(IMA) in patients with polycystic ovary syndrome(PCOS) and their correlation with sex hormones and oxidative stress. Methods: 87 patients with untreated initial diagnosed PCOS admitted to Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from June 2017 to June 2018 were selected as PCOS group. A total of 87 healthy women who underwent physical examination at the same time were randomly selected as the control group. The serum levels of HSP70, IMA, sex hormones and oxidative stress indexes were compared between the two groups, the correlation between serum HSP70, IMA levels and sex hormones,oxidative stress indexes were analyzed. Results: The levels of serum follicular stimulating hormone(FSH), luteinizing hormone(LH),testosterone(T), 8-isoprostaglandin F2α(8-iso PGF2α), malondialdehyde(MDA), HSP70 and IMA in the PCOS group were significantly higher than those in the control group, the differences were statistically significant(P<0.05). The serum levels of superoxide dismutase(SOD) and glutathione peroxidase(GSH-Px) in the PCOS group were lower than those in the control group, the differences were statistically significant(P<0.05). There were no significant differences in serum estradiol(E2) and prolactin(PRL) levels between the PCOS group and the control group(P>0.05). Serum HSP70 and IMA levels in PCOS patients were positively correlated with serum FSH,LH, T, 8-iso PGF2α and MDA levels, negatively correlated with SOD and GSH-Px levels(P<0.05), but there were no significant correlation with E2 and PRL levels(P>0.05). Conclusion: The levels of serum HSP70 and IMA in the PCOS patients are abnormally high,and the level changes of the serum are closely related to the sex hormones and oxidative stress. It is suggested that HSP70 and IMA may be involved in the pathological process of PCOS. Clinical detection of HSP70 and IMA may provide an effective predictive role for PCOS diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Background: We suggested a relationship between increased serum IMA (ischemia-modified albumin) levels and cartilage degeneration. We proposed that the increased serum levels of IMA was due to the oxidative stress mechanism against ongoing cartilage degeneration in osteoarthritis (OA) and thus may be associated with the progression of OA. We aimed to investigate serum IMA levels in OA patients and determine whether any changes in IMA levels are useful as a marker in increased OA. Methods: A prospective case-control study was carried out, which included 110 patients (55 patients with OA and 55 healthy controls). Serum samples obtained from all participants and IMA levels were determined by spectrophotometric method. Results: Compared with controls, OA had significantly higher IMA and IMA/albumin (IMAR) levels (0.732 ± 0.078 vs. 0.773 ± 0.080, p = 0.008; 0.188 ± 0.20 vs. 0.176 ± 0.21; p = 0.011). Multivariable logistic regression analysis revealed rising IMA and IMAR levels were independently associated with OA (OR: 1.755, 95% CI: 0.655 - 4.700, p = 0.009 and OR = 3.021, 95% CI: 0.258 - 3.525, p = 0.015). Conclusions: The current study suggests that increased levels of IMA are associated with OA and are a probable predictive risk marker for the progression of OA. [ABSTRACT FROM AUTHOR]

Copyright of Online Turkish Journal of Health Sciences (OTJHS) / Online Türk Sağlık Bilimleri Dergisi is the property of Oguz KARABAY and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: Healthy life is sustained by maintaining the balance between oxidative and antioxidant homeostasis in the living organism. During oxidation process free radical products lead to cellular damage and death. It is well known that oxidative stress plays role in the etiology of many diseases. We aimed to study the relationship between oxidative stress and short term fasting by measuring the serum levels of ischemia modified albumin, thiol, and disulphide in pediatrics patients admitted for radiological imaging. Material and Method: Our study was carried out between April and November 2018. We included children between 6 months and 6 years. Children who were fasting for more than 5 hours were assigned as the study group. Children who were not fasting were assigned as the control group. Serum ischemia modified albumin, thiol and disulfide were calculated using the colorimetric method of Erel's. Results: In the study group, the mean± SD serum level of ischemia modified albumin, native thiol, total thiol and disulphide were 0.72± 0.12 ABSU, 559.15± 58.98 μmol/L, 606.83± 61.35 μmol/L and 23.83± 5.58 μmol/L respectively. In the control group, the mean ± SD serum level of ischemia modified albumin, native thiol, total thiol and disulphide were 0.77± 0.15 ABSU, 528.80± 54.45 μmol/L, 580.17± 63.41 μmol/L and 25.68± 8.07 μmol/L respectively. The disulphide /native thiol and disulphide / total thiol ratios were lower in the study group than the controls, but there were no significant differences between the two groups. Conclusion: Short term fasting does not change serum levels of oxidative stress biomarkers and dose not lead to inbalance in the oxidative stress hemeostasis in pediatric patients. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to investigate the potential early diagnostic value of ischemia modified albumin (IMA) and D-dimer in testicular torsion.Material and Methods: A total of 42 prepubertal Wistar-Hannover rats (26-30 days old, weighing 75-125 grams) were used in the study. They were randomly divided into 2 groups as torsion (21 rats) and control (21 rats). Both torsion and control groups were subdivided into three subgroups as 30th, 120th and 240th minutes. Intraperitoneal injection of 70 mg/kg ketamine (Ketalar, Pfizer, Istanbul, Turkey) plus 10 mg/kg of xylazine (Rompun, Bayer, Istanbul, Turkey) were used for general anesthesia. In the control group, scrotal incision was made and the left testis gently extracted. Then, intracardiac blood and testicular tissue were obtained at 30th, 120th and 240th minutes. In torsion group, testicular ischemia was achieved by rotating left testis 720° clockwise and maintained by fixing the testis. Blood and testicular samples were obtained at 30th, 120th and 240th minutes. All animals were sacrificed after completion of the study.Results: There was a statistically significant difference between the IMA and D-dimer levels at 30th, 120th and 240th minutes of torsion group when compared with the control group (p = .001). When compared in terms of pathological changes at 30th, 120th and 240th minutes, significant difference was found for all 3 periods (p = 0.039, p = 0.014, p = 0.03, respectively). The D-dimer and IMA estimated torsion with reasonable accuracy [Area under the curve (AUC)= 0.771 (p = 0.003, 95% confidental interval: 0.620-0.922) and AUC = 0.706 (95% confidental interval: 0.549-0.863, p = 0.022), respectively.Conclusion: The elevated D-dimer and IMA serum levels observed in the experimental testicular torsion modelseem to have a potential role as a serum marker in the early diagnosis of testicular torsion. [ABSTRACT FROM AUTHOR]

Acute myocardial ischemia is the most common cause of sudden cardiac death. The diagnosis of early myocardial ischemia is a hot point in forensic medicine, which is also an early and important part for a prevention against myocardial infarction. This paper conducts a comprehensive discussion of the structure, function, clinical value and forensic medicine application prospect of ischemia modified albumin （IMA） and heart-type fatty acid binding protein （H-FABP), aiming to determine whether the two proteins can be used as biochemical detection indicators of early myocardial ischemia for the diagnosis of sudden cardiac death in forensic medicine.

Introduction: Stroke is the leading cause of mortality and morbidity worldwide. Diabetes mellitus (DM) is most commonly associated with the acute stroke. Abnormalities in serum albumin are known to occur in acute stroke patients. Ischemia-modified albumin (IMA) is a novel marker of acute stroke and hence, it is important to know the factors affecting IMA estimation. The objective of this study was to find out the correlation between serum albumin and IMA in acute stroke with or without DM. Subjects and Methods: This cross-sectional study comprised sixty acute stroke patients (thirty with DM, thirty without DM) and thirty healthy controls. The blood sample was collected from the patients soon after the clinical diagnosis of stroke. IMA and albumin were measured. IMA concentration was expressed in absorbance units. Pearson′s correlation coefficient was estimated. Results: In stroke with DM (r = -0.103, P = 0.58) and control (r = -0.007, P = 0.96) groups, there was a negative correlation between IMA and serum albumin which was statistically not significant. In stroke without DM group, there was a positive correlation between IMA and serum albumin which was again statistically insignificant (r = 0.111, P = 0.56). Discussion and Conclusion: There was no statistically significant correlation between IMA and serum albumin levels in all the three groups. Hence, it can be concluded that IMA concentration is independent of serum albumin concentration and probably, it depends on the severity and duration of ischemia or oxidative stress in acute stroke patients.

Aim: The aims of the study are to investigate serum neopterin and ischemia modified albumin (IMA) levels in patients with immunoglobulin A vasculitis (IgAV) and evaluate the association of these markers with disease activity and relapse. Method: Thirty‐four consecutive adult patients (24 male and 10 female) admitted to the rheumatology clinic and met the IgAV American College of Rheumatology (ACR) criteria were enrolled in this cross‐sectional study. Demographic and clinical features of IgAV and a control group were recorded into a predefined protocol. Disease activity was categorized as "remission" or "active" according to Birmingham Vasculitis Activity Score (BVAS). BVAS ≥ 1 was accepted as "active". Serum neopterin levels, high‐sensitivity C‐reactive protein (hsCRP) and IMA were evaluated according to BVAS and compared to the healthy control group. Results: Serum median (interquartile range) neopterin, IMA levels and hsCRP were higher in the study group than in control group (2.01 [12.5] ng/mL vs 1.77 [1.37] ng/mL, 0.67 [0.2] ng/mL vs. 0.43 [0.17] ng/mL, 5.6 [17.1] mg/L vs. 1.55 [1.6] mg/L, P = .095, P < .001 and P = .002, respectively). When evaluated according to BVAS, IMA and hsCRP levels were significantly higher in the group with active disease (0.77 [0.12] vs 0.61 [0.13] and 14.85 [4.6], P = .009 and P = .03, respectively). Serum neopterin levels were significantly higher in the active group compared to BVAS (18.95 [32.36] vs 1.63 [1.48], P < .001). Conclusion: Oxidative stress is important in IgAV pathogenesis. Roles of hsCRP, neopterin and IMA as potential markers of diagnosis and disease activity seem to be worth studying in future studies with larger study groups. [ABSTRACT FROM AUTHOR]

Acute myocardial chest pain is one of the most common diagnostic challenges in emergency medicine. Diagnosis principally focuses on identifying patients with acute coronary syndrome (ACS), who are at significant risk of adverse outcome and have the potential to benefit from inpatient care. The electrocardiography ECG provides a quick, cheap and simple way of identifying patients with ST segment changes, who are likely to benefit from admission and is therefore an essential tool for evaluating any patient with suspected ACS. However, some patients with chest pain and a normal or non-diagnostic ECG may also be at significant risk of adverse outcome. Biochemical cardiac markers, particularly troponins, can identify, which patients with a normal or non-diagnostic ECG are at higher risk. For selected patients, treadmill exercise testing can provide further prognostic information. Chest pain is the initial symptom of many life-threatening disease processes. Pain may arise from any structure located in the thoracic cavity. Cardiac causes of chest pain usually have anginal symptoms. Noncardiac causes have a variety of chest pain characteristics. Diseases that require immediate attention and intervention are myocardial infarction/unstable angina, dissecting aortic aneurysm, pericarditis, pulmonary embolism, pneumothorax, pneumonia, and acute chest syndrome (Fallon and Roques, 1997). Early identification of patients with acute myocardial infarction is of prime importance due to the associated very high mortality. A number of biochemical tests like CKMB and Troponin-T/I have been introduced for early detection of the coronary syndrome (ACS). Ischemia modified albumin (IMA) has been introduced as a marker of myocardial ischemia. IMA appears to be developing into a new and very potent marker of cardiac ischemia (Chawla et al, 2006). [ABSTRACT FROM AUTHOR]

Purpose: We aimed to determine the alterations in thiol/disulphide homeostasis and ischemia-modified albumin (IMA) levels in patients with different subtypes of age-related cataract by comparing these values with control cases. Material and Method: Totally 198 eyes of 99 consecutive patients diagnosed with age-related cataract and 188 eyes of 94 control cases were included in the study. In cataract group disease subtypes were recorded as nuclear cataract, cortical cataract, posterior subcapsular cataract or mixed cataract. Results: Native thiol and total thiol levels were significantly lower in cataract group while disulphide, disulphide/native thiol and disulphide/total thiol ratios were significantly higher. IMA and adjusted IMA levels were also significantly higher in cataract group. When patients with different subtypes of cataract were analyzed; there was not any significant difference between patients with different subtypes of cataract regarding the thiol/disulphide homeostasis parameters or adjusted IMA levels. Conclusion: Serum dynamic thiol/disulphide homeostasis is altered in age-related cataract patients in the favor of oxidative stress and there was a significant increase in serum IMA and adjusted IMA levels in cataract patients. However, we did not determine any significant difference in dynamic thiol/disulphide homeostasis parameters or IMA levels between patients with different subtypes of cataract. Since age-related cataract is a common disease that can only be treated with surgery; to prevent or slow down its development is critical. The parameters of dynamic thiol/disulphide homeostasis or IMA may be regarded as new targets for the new treatment modalities in cataract. [ABSTRACT FROM AUTHOR]

Aim: Glaucoma is an optic neuropathy causing progressive impairment of visual functions. We aimed to assess the alterations in thiol–disulfide homeostasis and serum ischemia modified albumin (IMA) levels, which are the determinants of antioxidant status, in patients with primary open-angle glaucoma (POAG). Material and Method: A total of 140 eyes from 70 patients with POAG and 174 eyes of 87 healthy, control cases were included in the study. All study participants underwent a complete ophthalmic evaluation. Alterations in serum thiol–disulfide homeostasis and IMA levels were measured in all participants. Results: IMA levels were significantly higher in glaucoma group (p:0.001). Native thiol, Total thiol and Native/Total thiol ratio were significantly decreased while Disulfide, Disulfide/Native thiol, and Disulfide/Total thiol ratios were significantly higher in glaucoma group (p:0.001). There was no significant difference regarding central corneal thickness (CCT), iridocorneal angle, albumin, IMA and adjusted IMA levels in patients with different stages of glaucoma. In correlation analysis, there was a negative correlation between Native thiol, Total thiol and Native/Total thiol ratio and disease period, number of daily drops required and stage of the disease in glaucoma patients. There was also a positive correlation between Disulfide, Disulfide/Native thiol and Disulfide/Total thiol levels and the disease activity. Conclusion: In patients with POAG, thiol–disulfide homeostasis is disturbed in the favor of pro-oxidant molecules and IMA levels are increased, indicating the presence of augmented oxidative stress. In that aspect, systemic and local anti-oxidant treatments may be new targets in glaucoma treatment. Larger, prospective studies about the role of anti-oxidants in prevention and treatment of POAG are warranted. [ABSTRACT FROM AUTHOR]

Oxysterols have been shown to play a role in plaque formation while ischemia modified albumin (IMA) is widely accepted as an acute marker for ischemia. The effort test is one of the methods used to identify the presence of coronary artery disease. Thus, there may be a relationship between effort test result and the levels of IMA, 7-ketocholesterol (7-KC) and cholestane-3β,5α,6β-triol (C-triol). Thirty patients who underwent effort test and 30 healthy subjects were included in the study. IMA levels were determined with the albumin-cobalt binding test, 7-KC and C-triol levels were determined with LC-MS/MS. Among the patients, two subgroups were identified according to the results of the effort test, group 1 consisted of patients with a positive effort test (n = 12), and group 2 consisted of patients who had a negative effort test (n = 18). 7-KC levels of patients were significantly higher compared to healthy subjects (39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL; p=0.001). In patients, post-test 7-KC levels were significantly lower than pre-test levels (post-test vs. pre-test: 37.73 ± 2.44 ng/mL vs. 41.07 ± 2.18 ng/mL; p<0.001). There was a significant difference in post-test 7-KC levels among all study groups (negative, positive and healthy: 37.73 ± 2.44 ng/mL, 39.87 ± 2.13 ng/mL, 20.26 ± 1.35 ng/mL, respectively). There was no significant difference in IMA levels. Patients with positive effort test had significantly higher levels of 7-KC. Additionally, after the effort test, the 7-KC value was reduced. 7-KC is a biomarker of oxidative damage and its value or changes before and after the effort test may be used as a biomarker in the diagnosis and follow-up of coronary artery disease. [ABSTRACT FROM AUTHOR]

Objective: We searched thiol/disulphide homeostasis and ischemia modified albumin (IMA) in patients with and without endometrial polyp (EP) to evaluate whether there is an association between serum oxidative stress markers and EPs. Methods: A total of 87 women were enrolled into this study. All patients were evaluated with office hysteroscopy, and then those with EPs underwent operative hysteroscopy. 43 of these women had pathologically confirmed EPs (study group) and 44 had not (control group). Fasting blood samples were obtained from the antecubital vein before the procedure in all women. Thiol/disulphide levels were analyzed with a newly developed method by Erel et al. IMA measurement was performed using an indirect method based on the colorimetric assay as previously defined. Results: There were no significant differences between the 2 groups in terms of demographic characteristics including age, body mass index, and past obstetric history. Similarly no significant difference was observed regarding infertility ratio and smoking status. Native thiol, total thiol, and disulphide levels were found to be 263.6±63.3 µmol/l vs. 280.9±63.8 µmol/l (p:0.208), 296.9±64.9 µmol/l vs. 315.2±67.3 µmol/l (p:0.202), and 16.6±6.5 µmol/l vs.17.1±7.8 µmol/l (p:0.759) in the study and control groups, respectively. There was also no significant difference with regard to serum IMA level (46.5±12.1 vs. 44.9±12.6; p: 0.539). Conclusion: Serum thiol/disulphide homeostasis and IMA levels have no significant effect in the pathogenesis of EPs. [ABSTRACT FROM AUTHOR]

Background: Ectopic pregnancies constitute about 2% of all pregnancies which are the leading cause of pregnancy-related deaths and a considerable cause of maternal morbidity. Oxidative stress can lead to a number of pregnancy related diseases including miscarriage, eclampsia and preterm labor. Ischemia modified albumin (IMA) which reflects the oxidative stress may be used as a marker for ectopic pregnancy. Our aim was to compare the levels of IMA and total antioxidant status (TAS) in ectopic and normal pregnancies and to understand if IMA can be used as a marker to diagnose ectopic pregnancy. Materials and methods: Our case-control study consisted of 38 women with ectopic and 42 women with normal pregnancy. IMA and TAS levels were determined in serum samples with an albumin-cobalt binding test and by commercially available kits, respectively. IMA levels were adjusted according to serum albumin levels. Index of oxidation (IOS) was calculated by dividing adjusted IMA (A-IMA) levels with TAS. A receiver operating characteristics (ROC) curve analysis was made and cut-off values for the biomarkers were investigated in SPSS 21.0 program (SPSS, Chicago, IL). Data were presented as mean ± standard deviation and a p value < .05 was accepted as statistically significant. Results: There was a statistically significant difference in IMA, A-IMA, and IOS levels between ectopic and normal pregnancies. Although TAS level was not different statistically, it was lower in ectopic pregnancy. According to ROC curve analysis, IOS had the largest area under curve. A cut-off value of 0.545 for IOS had 81.6% sensitivity and 59.5% specificity. Conclusions: According to our study, oxidative stress plays an important role in ectopic pregnancy and either A-IMA or IOS can be evaluated as a marker of ectopic pregnancy after further studies. [ABSTRACT FROM AUTHOR]

We investigated the change of IMA levels as biochemical markers, especially in the postmortem diagnosis of early MI. Also, histological investigation has been performed in cases of cardiac deaths and in non-cardiac cases. To the best of our knowledge, this is the first study to investigate the levels of IMA in the postmortem diagnosis of early MI. A series of medicolegal autopsy cases (n=139; 6-24 h postmortem, with a median of 16 h) were examined at our institute. The cases comprised 112 males and 27 females, between 16 and 89 years of age. Subjects were divided into six groups depending upon their final cause of death according to medical data, autopsy reports, biochemical and histological findings. The groups were as follows: cardiovascular disease, blunt trauma, asphyxia, pathological cerebral hemorrhage, bleeding due to a sharp object and gunshot injuries, and poisoning. IMA levels in the cardiovascular disease group were found to be significantly higher than the blunt trauma, asphyxia, pathological cerebral hemorrhage, and bleeding groups (p < 0.05). It is known that after MI, if less than 4-6 hours pass before death, the histopathology of the heart does not reveal significant findings. Our results demonstrated that IMA might be a valid biochemical marker, especially in the postmortem diagnosis of early MI. [ABSTRACT FROM AUTHOR]

Aim: Hyperbilirubinemia causes oxidative stress. Method: We evaluated three oxidative stress markers in hyperbilirubinemic neonates (native/total thiol levels, serum ferroxidase activity and ischemia modified albumin (IMA), comparing these levels to levels in a control group to determine which indicators were the most sensitive. Results: Serum from 124 term infants (67 with pathologic jaundice and 57 controls) were evaluated. Native/total thiol ratio was significantly lower (p:0.021) while disulfide levels were significantly higher (p:0.001) in the jaundiced group. There was no significant difference in ferroxidase (p:0.603) or IMA (p:0.251) levels. Conclusion: Altered thiol/disulfide homeostasis in the favor of disulfide indicates augmented oxidative stress in jaundiced term infants. The lack of alteration in ferroxidase or IMA levels suggests these latter alterations take more time or more severe oxidative stress to become altered or are not as sensitive as the thiol/disulfide ratio to detect oxidative stress states. [ABSTRACT FROM AUTHOR]

Aim: The cardiovascular system is susceptible to thyroid hormones. Many studies show that hypothyroidism is associated with increased cardiovascular risk, functional abnormalities, atherosclerosis, and increased arterial stiffness. Pulse wave velocity (PWV) and augmentation index (AI) are regarded as indexes of arterial stiffness. Oxidative free radicals that occur during ischemic events cause certain chemical changes in the albumin molecules. The ischemia-modified albumin (IMA) has been suggested as an indicator of oxidative stress. Evaluation of oxidative stress markers and parameters of arterial stiffness can shed light on the mechanism of increased cardiovascular risk in patients with hypothyroidism. Material and Methods: For this study, PWV, AI measurements, and IMA levels of 20 untreated patients with overt hypothyroidism (OH), 21 untreated patients with subclinical hypothyroidism (SH), and 30 healthy controls (control-CNT) were evaluated. Patients and the healthy controls' gender, age, weight, height, body mass index, waist circumference, smoking habit and blood biochemical results were recorded. Results: PWV was found to be increased in patients with overt hypothyroidism; however, there was no difference in between subclinical hypothyroidism and control group(p=0,881). Also, PWV had a significant positive correlation with; age, BMI, waist circumference, blood glucose, uric acid, pulse pressure and systolic and diastolic blood pressures. IMA levels were not different in between the groups. Conclusion: Hence the increased CV risk in patients with hypothyroidism is a multifactorial state; the interplay of many factors determines it. Future studies with larger sample sizes are needed to evaluate the possible relationship among IMA levels, arterial stiffness parameters and cardiovascular risk factors in patients with hypothyroidism. [ABSTRACT FROM AUTHOR]