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This study aimed to evaluate the subjective Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms with self-reported ratings and objective neurocognitive tests among medical students. Also, we examined to identify the psychological factors that predict ADHD reporting among medical students. Medical students (N=57) completed self-report questionnaires, and neurocognitive tests were conducted for attention measures. Participants had a mean age of 20.3 years, and 69.0% were female. High levels of perceived stress, state-trait anxiety, and current and childhood ADHD symptoms were possible risk factors; however, only higher perceived stress was a risk factor for the possibility of reporting themselves as ADHD in medical school students [odds ratio [OR] =1.184, 95% confidence interval [CI] = [1.015; 1.381]]. Higher perceived stress levels, the more reported ADHD subjectively in medical students. Objective attention measures had no impact on reporting ADHD subjectively. Screening for perceived stress is necessary for medical students, especially those with subjective ADHD symptoms.

Introduction The aim of this study was to evaluate the analytical performance of the Kite Biotechnology Oral fluid (OF) screening test device, which is used for roadside screening of cannabis, opiates, amphetamines , methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), cocaine and benzodiazepines by comparing samples with matched plasma samples, analysed via liquid chromatography–tandem mass spectrometry (LC-MS/MS) for confirmation. Methods OF and plasma samples were obtained simultaneously from a total of 100 subjects. OF samples were analysed by OF screening test based on immunochromatography . The OF screening test cut-off values were 50 ng/mL for amphetamines ( d -amphetamine) and methamphetamine/MDMA ( d -methamphetamine), 30 ng/mL for cocaine (benzoylecgonine), 40 ng/mL for opiates (morphine), 20 ng/mL for benzodiazepines (nordazepam), and 25 ng/mL for cannabis (Δ9-tetrahydrocannabinol). LC-MS/MS method validation was performed according to the CLSI C62-A recommendations with the following parameters: matrix effect, lower limit of quantification (LLOQ), linearity, intra-day and inter-day precision and accuracy. Results The overall specificity, accuracy and negative predictive values (NPV) were acceptable and met the DRUID standard of >80%. The OF screening test device showed good sensitivity for cocaine, amphetamines and opiates, whereas it indicated poor sensitivity for methamphetamine/MDMA (66.7%) and failed to detect cannabis and benzodiazepines. Conclusion The present study is the first report to evaluate the Kite Biotechnology OF screening test device. The diagnostic performance of the OF screening test device was acceptable for opiates, cocaine and amphetamines, but it was insufficient for methamphetamine/MDMA, benzodiazepines and cannabis because of sensitivity issues.

Lexical access and lexical diversity are often assumed to be vulnerable to first language (L1) attrition. They also differ between monolinguals and nonimmersed bilinguals. This raises the question whether lexical attrition can be ascribed to nonuse or to competition between the two languages. We compare two populations of late L2 learners of Dutch living in the Netherlands. One of them was largely monolingual prior to emigration (Turkish migrants), while the other comes from a highly multilingual society (Morocco). While both experimental populations should be affected by erosion due to nonuse, we expect competition effects to be more strongly pronounced when compared against a monolingual versus a multilingual baseline population. The results show that this is not the case with attrition effects being even stronger in the Moroccan group than in the Turkish group. Furthermore, there is no impact of individual measures of frequency of exposure or language attitudes among the attriters. We conclude that being immersed in an L2 environment leads to weakening of lexical access.

Objectives As one of the most widely used tests, the erythrocyte sedimentation rate (ESR) is a measurement of sedimentation reaction in blood samples. Although the recommended method for ESR measurement is the Westergren method, this method has some disadvantages in comparison with automated ESR systems. In this cross-sectional study, we aimed to compare Vision C with the Westergren method. Methods The Vision C automated ESR system and the modified Westergren method were compared using K3EDTA-containing tubes and citrated blood tubes from randomly selected 100 patients. Precision, bias, and interference calculations were performed. Results The mean difference between the Vision C (room temperature) and the modified Westergren method was 22.8 ± 26.6 mm/h (95% CI for the mean was 17.50–28.08 mm/h). The mean difference between the Vision C (18 °C) and the modified Westergren method was 27.4 ± 30.6 mm/h (95% CI for the mean was 21.3–33.5 mm/h). The calculated regression analysis equation was “y= 0.263 + 1.053x” and “y= −0.530 + 0.851x” for the Vision C (room temperature) and the Vision C (18 °C), respectively. The imprecision values ranged at 7.55–17.09%. According to our external quality control results, bias was 11.11 and 9.66 for the low- and high-level samples, respectively. Conclusions The Vision C automated ESR system has a comparable analytical performance with the modified Westergren method. The Vision C automated system may be utilized in ESR measurements with quality control evaluations. Nevertheless, temperature correction using Manley’s monogram causes an important negative bias and should be taken into consideration during the evaluation of the Vision C results.

Skin is the largest epithelial surface of the human body, with a surface area of 2 m2 for the average adult human. Being an external organ, it is susceptible to more than 3000 potential skin diseases, including injury, inflammation, microbial and viral infections, and skin cancer. Due to its nature, it offers a large accessible site for administrating several medications against these diseases. The dermal and transdermal delivery of such medications are often ensured by utilizing dermal/transdermal patches or microneedles made of biocompatible and biodegradable materials. These tools provide controlled delivery of drugs to the site of action in a rapid and therapeutically effective manner with enhanced diffusivity and minimal side effects. Regrettably, they are usually fabricated using synthetic materials with possible harmful environmental effects. Manufacturing such tools using green synthesis routes and raw materials is hence essential for both ecological and economic sustainability. In this review, natural materials including chitosan/chitin, alginate, keratin, gelatin, cellulose, hyaluronic acid, pectin, and collagen utilized in designing ecofriendly patches will be explored. Their implementation in wound healing, skin cancer, inflammations, and infections will be discussed, and the significance of these studies will be evaluated with future perspectives.

The healthcare system has a drastic paradigm shift from centralized care to home-based and self-monitoring strategies; aiming to reach more individuals, minimize workload in hospitals, and reduce healthcare-associated expenses. Particularly, wearable technologies are garnering considerable interest by tracking physiological parameters through motion and activities, and monitoring biochemical markers from sweat, saliva, and tears. Through their integrations with sensors, microfluidics, and wireless communication systems, they allow physicians, family members, or individuals to monitor multiple parameters without any significant disruptions to daily routine. Integrating flexible and smart materials with wearable platforms have already enabled facile operations. Especially, carbon nanomaterials hold unique features, including low density, high strength, good conductivity, outstanding flexibility, versatile integration with materials and sensors. In this manuscript, carbon nanomaterials are comprehensively reviewed with their tremendous assets utilized in wearable technologies. Further, their integration with ultrasonic, acoustic and energy harvesting devices, optical and electrochemical platforms, microfluidics, and wireless communication technologies are presented.

The purpose of this study is to evaluate anti-inflammatory and chondro-protective effects of 1,25(OH)2D3 in human chondrocytes and SW1353 cells via investigating expressions of MMPs, TIMPs, VDR, and intracellular signalling pathway mediators such as TLR-2 and -4. The HC and SW1353 cells were treated with 1,25(OH)2D3 at 10, 100, and 1000 nM concentrations in the absence/presence of TNF-α (20 ng/mL) for 48 h. The mRNA expressions of MMP-1, -2, -3, -9, and -13, TIMP-1 and -2, VDR, TLR-2 and -4 in HC and SW1353 cells were detected by qPCR after treatments. The cytotoxicity and cell proliferation analyses were assessed by LDH and WST-1 assay, respectively. Protein levels of MMPs, TIMPs, and VDR were analysed by immunocytochemistry and ELISA methods. TNF-α markedly increased cytotoxicity for 24, 48, 72 h (p

The spectrum of coronavirus disease 2019 (COVID-19) severity, related to cellular immune functions, has not been fully clarified yet. Therefore, this study aimed to investigate the alteration of peripheral blood cells in patients with COVID-19. The flow cytometric characterization of immune cell subset was performed on 69 COVID-19 patients and 21 healthy controls. These data were evaluated based on the disease severity. A total of 69 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were classified as asymptomatic infection (

It is important to determine the inflammatory biomarkers in the severity of coronavirus disease 2019 (COVID-19) with the emergence of the pandemic. Galectins and prostaglandins play important roles in the regulation of immune and inflammatory responses. Therefore, this study aimed to investigate Galectin-1 (Gal-1), Galectin-3 (Gal-3), and prostaglandin E2 (PGE2) levels in patients with COVID-19. Serum concentrations of Gal-1, Gal-3, and PGE2 were measured using enzyme-linked immunosorbent assay on 84 patients with COVID-19 (severe = 29 and nonsevere = 55) and 56 healthy controls. In this study, increased levels of Gal-1 (median, 9.86, 6.35, and 3.67 ng/mL), Gal-3 (median, 415.31, 326.33, and 243.13 pg/mL), and PGE2 (median, 193.17, 192.58, and 124.62 pg/mL) levels were found in patients with COVID-19 than in healthy controls (P < 0.001 for all). In the severe disease group, Gal-3 levels were higher, while no differences were noted in Gal-1 and PGE2 levels (P = 0.011, P = 0.263, and P = 0.921, respectively). Serum levels of Gal-1 were positively correlated with those of Gal-3 (P = 0.871 and P < 0.001). Gal-3, C-reactive protein, lymphocyte count, and age were found as independent predictors of disease severity (P = 0.002, P = 0.001, P = 0.007, and P = 0.003, respectively). With the emergence of effective drug needs in the COVID-19 pandemic, differentiation of severe disease is important. Therefore, Gal-3 could be a potential prognostic biomarker of COVID-19.

INTRODUCTION Low-density lipoprotein cholesterol (LDL) is an important risk factor for cardiovascular disease (CVD) and generally measured after 8-12 h fasting. However, some recent studies have pointed that non-fasting lipoproteins, especially LDL concentrations, are better indicators for demonstrating CVD risk and atherosclerosis. They asserted that nutrition is a negligible factor on changes in lipoprotein concentrations and claimed this difference as a result of hemodilution effect, caused from fluid intake and can be eliminated by applying some adjustments. We aimed to compare the fasting and non-fasting LDL values of the same individuals and discuss whether non-fasting and fasting LDL results can be used in place of each other, directly or after applying hemodilution correction models. MATERIAL AND METHODS Fasting and non-fasting blood samples of 248 apparently healthy participants were collected. Lipid panel tests, albumin and hemoglobin levels were studied in each sample. Results were evaluated in seven different models which were recommended to correct the hemodilution effect on fasting and non-fasting lipid concentrations of the same individual. Concordance of fasting and non-fasting risk group of the individual were calculated according to the National Cholesterol Education Program classification. RESULTS Fasting and non-fasting LDL and non-high density lipoprotein cholesterol (non-HDL) concentrations were significantly different in every model (p

After the first case has appeared in China, the COVID-19 pandemic continues to pose an omnipresent threat to global health, affecting more than 70 million patients and leading to around 1.6 million deaths. To implement rapid and effective clinical management, early diagnosis is the mainstay. Today, real-time reverse transcriptase (RT)-PCR test is the major diagnostic practice as a gold standard method for accurate diagnosis of this disease. On the other side, serological assays are easy to be implemented for the disease screening. Considering the limitations of today's tests including lengthy assay time, cost, the need for skilled personnel, and specialized infrastructure, both strategies, however, have impediments to be applied to the resource-scarce settings. Therefore, there is an urgent need to democratize all these practices to be applicable across the globe, specifically to the locations comprising of very limited infrastructure. In this regard, sensor systems have been utilized in clinical diagnostics largely, holding great potential to have pivotal roles as an alternative or complementary options to these current tests, providing crucial fashions such as being suitable for point-of-care settings, cost-effective, and having short turnover time. In particular, the integration of smart materials into sensor technologies leverages their analytical performances, including sensitivity, linear dynamic range, and specificity. Herein, we comprehensively review major smart materials such as nanomaterials, photosensitive materials, electrically sensitive materials, their integration with sensor platforms, and applications as wearable tools within the scope of the COVID-19 diagnosis.

This chapter provides an overview of the research on the attrition of native language (L1) in late bilinguals in relation to their second language (L2) development and integration into the L2 society. Despite lack of empirical evidence, it is often implicitly assumed that maintaining L1 knowledge impedes L2 learning. Furthermore, individuals whose L1 skills decline as a result of immersion in an L2 environment and become highly competent in the L2 are expected to achieve better cultural integration as opposed to those who prefer to preserve their mother tongue. We point to the fact that bilingualism and biculturalism have often been investigated independently and hence the lack of evidence for a straightforward association between the development of languages and cultural affiliation; and we call for in-depth studies that integrate language and culture in order to reveal their consequences for L1 development.

The purpose of this study is to evaluate anti-inflammatory and chondro-protective effects of 1,25(OH)

Quality by Design (QbD) emerged with quality guidelines issued by the International Council on Harmonization (ICH); is a concept that suggests the quality of product cannot be secured by the finish product tests; product quality should be ensured by starting from risk and scientific based work in process and product development through the whole product life cycle. Statistical studies, which are done by computer program, have important role in today’s pharmaceutical area. ANN (Artificial Neural Network) and GEP (Gene Expression Programming) are modelling techniques can be used for analyzing big amount of data, in understanding the relations between dependent and independent variables affecting product quality and optimizing the formulation variables and process parameters to get the desired product quality continuously. In this study, different etofenamate emulgel formulations were prepared, the quality characteristics determined to be critical were evaluated separately with the ANN, and GEP modeling techniques for the optimization of the formulations examined. During the modeling, the input values were oil type, oil ratio and polymer ratio and the outputs were pH, conductivity, viscosity and flow properties of the emulgels. According to results of pre-formulation studies both of the programs suggested two optimized formulations. Depending on the further studies, the viscosity and rheological behavior showed that both formulations were could apply on skin.

Background Familial Mediterranean fever (FMF) is an autosomal recessive inherited inflammatory disease. The gene responsible for the disease, called MEFV, encodes a protein called pyrin or marenostrin. According to recent data, MEFV mutations are not the only cause of FMF, but genetic analysis of MEFV gene is needed for confirming the diagnosis of FMF. In the present study, we aimed to evaluate the molecular testing results of MEFV mutations. Methods Molecular testing results of 1,435 patients were retrospectively evaluated over the last 4 years. These patients were identified as having FMF clinical symptoms. Patients were tested for 12 common mutations in the MEFV gene using a strip assay technique. Results From all 1,435 patients, MEFV mutations were found in 776 patients (54.08%) and 659 patients (45.92%) did not carry any mutations. Patients with mutations were classified as homozygotes (n = 148), compound heterozygotes (n = 197), heterozygous (n = 427), and complex genotypes (n = 4, patients with three mutations). Allelic frequencies for the four most common mutations in the mutation-positive groups were 48.79% (M694V), 14.86% (M680I G/C), 13.70% (E148Q), and 12.35% (V726A). The remaining alleles (10.3%) showed rare mutations that were R761H, P369S, A744S, K695R, F479L, and M694I. No patient showed a I692del mutation that is sometimes evident in other Mediterranean populations. Conclusion It was found that the most common four mutations (M694V, M680I [G/C], E148Q, V726A) were similar to those previously reported from different regions of Turkey and this study might add some knowledge to the mutational spectrum data on FMF.

Late bilinguals who spend (part of) their adult lives in an environment where a language other than the one they learned in childhood is spoken typically experience a range of language development phenomena. Most obviously, they will acquire some level of receptive and/or productive knowledge of the new, or second, language (L2). How basic or advanced that level will be is determined by a range of environmental, experiential, attitudinal and individual factors. Secondly, they will most likely find the knowledge of their native language (L1) beginning to diverge from that of monolingual speakers in their country of origin, a process known as language attrition. In the course of this developmental process, some L2 skills may eventually match or even overtake the corresponding skill in the L1. This shift in the balance between L1 and L2 is the focus of investigations of language dominance. The present study explores language dominance in four migrant populations (Germans in the Netherlands and Canada, Turks and Moroccans in the Netherlands). Investigating both the development of formal/controlled skills and more automatic aspects of lexical access and fluency, we aim to attain an understanding of how extralinguistic factors contribute to the development of both languages. We argue that an integrated perspective can contribute more profound insights into the predictors of this complex process of bilingual development. In particular, our findings show that statistical models based on linear relationships fall short of capturing the full picture. We propose an alternative method of analysing data, namely discriminant function analysis, based on a categorisation of the populations, and demonstrate how this can enhance our understanding. Our findings suggest that different aspects of the bilingual experience contribute differently to language development, regardless of language combination and type of skill measured. Contrary to what previous research suggests, measures relating to the intensity of informal use of both the L1 and the L2 in daily life are important in determining whether someone is a good or a poor L1 maintainer, while high vs. low success in acquisition appears to be predominantly associated with personal factors such as educational level.

AIM: To investigate whether single-dose intravitreal injections of bevacizumab and ranibizumab transfer into milk. METHODS: This study included lactating 12 sheep and a single 3-month old suckling lamb of each sheep. Two groups consisting of 6 sheep and their lambs were constituted; the ranibizumab group and the bevacizumab group before the administration of intravitreal injections, blood and milk samples were obtained from all sheep and, following the injections, blood and milk samples of all sheep and blood samples of all lambs were collected at regular time points. Serum and milk concentrations of bevacizumab and ranibizumab were measured using an enzyme-linked immunosorbent assay (ELISA) kit. The limit of determination was 0.9 ng/mL for bevacizumab and 0.62 ng/mL for ranibizumab. RESULTS: At 6h after intravitreal injections, bevacizumab concentration was above the limit of determination in the blood of all sheep. At 3wk, when the study was terminated, bevacizumab concentrations were high in 4 sheep. Even though bevacizumab concentrations in milk showed fluctuations, the drug transferred into the milk of all sheep at detectable concentrations. Ranibizumab drug concentrations in the blood and milk of sheep and those in the blood of lambs were below the limit of determination by the ELISA kit. CONCLUSION: This sheep model study demonstrate that intravitreal injection of ranibizumab, which did not transfer into the milk of sheep and suckling lambs, is safer than bevacizumab during lactation period.

Background Rapid and practical point-of-care testing (POCT) devices become more popular, especially in blood donation centers for determining predonation hemoglobin (Hb) concentrations. The purpose of this study was to evaluate accordance between the POCT methods and the venous method as the reference to Hb screening. Methods A total of 353 subjects with no known significant health problems were included in the study. Hb screening was performed by two different POCT methods, a noninvasive method (Haemospect, MBR, Germany) and an invasive method (HemoControl, EKF Diagnostic, Germany), and a venous method as the reference (Sysmex XE-2100, Sysmex Europe, Germany). The obtained results were compared. Results The sensitivity and the specificity values of the invasive POCT method (83.3%, 87.9%) were higher than the noninvasive POCT method (66.7%, 77.1%). The Bland-Altman analysis was evaluated for both sexes and the bias of the noninvasive POCT method of the males (−0.97 g/dL) was higher than the bias of the invasive POCT method of the males (−0.07 g/dL). We found a better correlation between the invasive POCT method (r = .908) compared with the venous method than the noninvasive POCT method (r = .634). Conclusion Predonation Hb measurements must be performed with accurate, precise, and practical methods. Although the noninvasive POCT method was practical and painless, it had lower levels of specificity and sensitivity, and more false deferral and pass rates than the invasive POCT method. The POCT methods agreeable to the venous method as the reference might be suitable for Hb screening especially for centers of excessive numbers of blood donation.

Background Psoriatic arthritis (PsA) is an immune-mediated disease affecting skin, joints, entheses, spine, and the vasculature [1,2]. Increased inflammatory mediators are held responsible for impacts on the skin and musculoskeletal system as well as comorbid situations including cardiovascular disease (CVD) and metabolic syndrome [3]. PTX 3 is an acute phase reactant that has prognostic value for rheumatoid arthritis (RA), vasculitis, and psoriasis that also stands out as a novel biomarker for CVD in new researches [4]. Objectives This study aims to assess the association between PTX 3 levels, disease activity and CVD risk in patients with PsA. Methods A total of 38 PsA patients applying to Ankara University Faculty of Medicine, Rheumatology Polyclinic and 32 age and sex-matched controls were enrolled in the study. tender and swollen joint counts, patient9s and doctor9s global assesment on VAS, ESR, CRP, fasting insulin, fasting glucose, total cholesterol, HDL, and LDL were noted. Also body mass index (BMI) and HOMA-IR score were calculated. Carotid intima media thickness (cIMT) was bilaterally assessed by Doppler ultrasound. Results The mean age was 49.5 in patients and 48.9 in controls. Sixty percent of the patients and 50% of controls were female. Of the patients, 15 (39%) used DMARD monotherapy, 8 (21%) used DMARD combination therapies, and 15 (39%) used anti TNF therapies. There was no statistically significant difference between groups in terms of hypertension, LDL levels, and smoking status (p:0.775, p:0.228, p:0.136 respectively). PsA patients had significantly higher BMI scores (p:0.03). Insulin levels and HOMA-IR scores were significantly higher among PsA patients compared to controls (p:0.001, p:0.005). There was statistically significant difference between groups in terms of PTX 3 (p Conclusions Elevated levels of PTX 3 may be associated with cardiovascular involvement in PsA patients independent from the disease activity. This marker might be used for risk prediction for CVD or may represent a target for new therapies. References Braun J. New targets in psoriatic arthritis. Rheumatology (Oxford). 2016 Dec;55(suppl 2). Egeberg A. Psoriasis and comorbidities. Epidemiological studies. Dan Med J.2016 Feb;63(2). Rutter MK, Kane K, Lunt M, et al. Primary care based screening for cardiovascular risk factors in patients with psoriasis. Br J Dermatol. 2016 Mar 1. Inoue K, Kodama T, Daida H. Pentraxin 3: a novel biomarker for inflammatory cardiovascular disease Int J Vasc Med. 2012;2012:657025. Disclosure of Interest None declared

The aim of this study was to investigate the effects of oral carbohydrate solution (CHO) on perioperative discomfort, biochemistry, hemodynamics, and patient satisfaction in elective surgery patients under general anesthesia. Sixty cases in ASA I-II group who were planned to have operation under general anesthesia were included in the study. The cases were randomly divided into two groups having 30 subjects in each. The patients in the study group were given CHO in the evening prior to the surgery and 2-3 hr before the anesthesia while routine fasting was applied in the control group. In the study group; 2-3 hr before the surgery; malaise, thirst, hunger, and weakness; just before the surgery malaise, thirst, hunger, and fatigue; 2 hr after the operation thirst, hunger, weakness, and concentration difficulty; 24 hr after the operation malaise and weakness were found significantly lower. Fasting blood glucose (FBG) level was found to be higher in the control group at the 90th min of the operation. Gastric volumes were higher in the control group; gastric pH values were found significantly higher in the study group. The level of anxiety and depression risk rate were found lower in the study group. In conclusion, preoperative CHO reduces perioperative discomfort and improves perioperative well being when compared to overnight fasting.

Background: The study aim was to compare the performance of three different methods used for determining urinary glycosaminoglycans (GAG) levels in spot and 24-h urine samples. Methods: Performance characteristics were studied for cetylpyridinium chloride (CPC), and manual and automated dimethylmethylene blue (DMB) methods. Results: For automated DMB method, within-run precisions were 9.10% and 1.98%, and between-day precisions were 13.0% and 5.81% in low- and high-urine pools, respectively. The method was linear up to 100 mg/L of GAG concentration. The detection limit of the method was 0.71 mg/L. Mean recovery was 95.7%. Conclusions: The automated DMB method was found to give better performance characteristics than cetylpyridinium chloride (CPC) and manual DMB methods. It is a fast, cheap, simple and reliable method and can be applied in many diseases in which GAG is used as a screening test.

The hypothesis of this study was that the extent of bone regeneration could be enhanced by using scaffolds with appropriate geometry, and that such an effect could be further increased by mimicking the natural timing of appearance of bone morphogenetic proteins BMP-2 and BMP-7 after fracture. Bioplotted poly(e-caprolactone) (PCL) disks with four different fibre organizations were used to study the effect of 3D scaffold architecture on the healing of bone defects in a rat pelvis model. Moreover, one PCL construct was further modified by introducing a nanoparticulate sequential BMP-2/BMP-7 delivery system into this scaffold. Scaffolds and functionalized construct along with free nanocapsules were implanted using a rat iliac crest defect model. Six weeks post-implantation, the defects were evaluated by CT scan and histology. Analysis revealed that the basic architecture, having the highest pore volume for tissue ingrowth, presented the highest bone formation as determined by the bone mineral density (BMD) within the defect (144.2 ± 7.1); about four-fold higher than that of the empty defect (34.9 ± 10.7). It also showed the highest histological analysis scores with a high amount of bone formation within the defect, within the scaffold pores and along the outer surfaces of the scaffold. The basic scaffold carrying the BMP-2/BMP-7 delivery system showed significantly higher bone formation than the growth factor-free basic scaffold at 6 weeks (BMD 206.8 ± 15.7). Histological analysis also revealed new bone formation in close to or in direct contact with the construct interface. This study indicates the importance of open and interconnecting pore geometry on the better healing of bone defects, and that this effect could be further increased by supplying growth factors, as is the case in nature.

Objectives It is clear that reproductive hormones modulate the brain activity and development in human. Studies about how the reproductive hormones fluctuations alter the brain waves during menstrual cycle are insufficient. The objective in this study to explore if reproductive hormones fluctuations in the menstrual and luteal phase of cycle alter the EEG delta response. Methods 10 healthy women participated in this study. EEG recordings on resting state and blood hormone analysis were performed in the menstrual and luteal phases. Reproductive hormone levels (estradiol, progesterone, FSH and LH) were measured with electrochemiluminescence immunoassay. The delta power values were analyzed by artifact-free 45 epochs lasting 2 s. We investigated the relationship between the hormone levels and delta power values in the two phases of menstrual cycle. Results The mean of estrodiol, progesterone, FSH and LH levels in the menstrual cycle were 26.01 pg/ml; 0.15 ng/ml; 6.33 mIU/ml and 5.28 mIU/ml, while the mean of estrodiol, progesterone, FSH and LH levels in the follicular phase were 130.7 pg/ml; 8.51 ng/ml; 3.48 mIU/ml and 7.19 mIU/ml, respectively. The mean of the delta power values in occipital region was 20.42 in menstrual phase while it was 27.21 in luteal phase. Therewithal, the mean of the delta power values in frontal region was 24.96 in menstrual phase while it was 25.42 in luteal phase. The highest difference was seen in occipital region whereas the lowest difference was in frontal region. Conclusion We obtained that increased blood levels of estradiol and progesterone in luteal phase enhance the delta power values in occipital region.

Familial Mediterranean fever (FMF) is an autosomal recessive disease which predominantly affects certain ethnic groups mainly Sephardic Jews, Turks, Arabs, and Armenians. Differential diagnosis of an attack of FMF with appendicitis could be difficult in patients presenting with acute abdomen. Circulating levels of resistin and visfatin have been shown to increase in several inflammatory conditions. In this study we aimed to investigate the role of resistin and visfatin in diseases activity by monitoring these adipokines' levels in patients with FMF (attacks and attack-free period) and acute appendicitis. The study involves four groups: group 1-31 FMF patients at attack (M/F, 14/17), group 2-27 FMF patients at attack-free period (M/F, 9/18), group 3-29 acute appendicitis patients (M/F, 16/13), and group 4-20 healthy controls (M/F, 10/10). Erythrocyte sedimentation rate, C-reactive protein, white blood cell count, fibrinogen, resistin, visfatin, interleukin-1β, interleukin-6, interleukin-10, TNF-α, and IFN-γ were evaluated concurrently. Resistin level could be a useful test in diagnosis of FMF patients in attacks period but not in acute appendicitis as differential diagnosis. Measuring visfatin levels would not give additional information neither for attacks and attack-free period nor FMF attack and appendicitis.

Celiac disease (CD) is a genetically based chronic inflammatory disorder of the small bowel induced by the dietary gluten and possibly other environmental cofactors. The objective of this study was to investigate the relation of adenosine deaminase (ADA), a cytoplasmic enzyme involved in the catabolism of purine bases, as an index of altered immune response, with adult CD patients. ADA has been shown to increase in several inflammatory conditions, but there is no literature data indicating an alteration in CD. Serum levels of ADA were investigated in newly diagnosed 20 CD patients. ADA levels were compared in patients with CD and in healthy controls. Correlation analysis was also performed between ADA and other serum markers of CD (anti‐gliadin and anti‐endomysial antibodies) Mean serum ADA levels were significantly elevated in CD patients compared with control group. ROC curve analysis suggested that the optimum ADA level cut‐off point for CD was 12.27 U/l. At a cut‐off value of 12.27 U/l, the sensitivity was 80% and specificity was 100%. There was no statistically significant correlation between ADA and anti‐gliadin and anti‐endomisium antibodies. Serum ADA levels elevated significantly in CD patients, suggesting a partial role in activated T‐cell response in the disease pathophysiology. ADA can be used as a supportive diagnostic marker in patients with CD. J. Clin. Lab. Anal. 24:323–326, 2010. © 2010 Wiley‐Liss, Inc.

Background: The mechanisms involved in the pathology of acute appendicitis (AA) and the factors affecting the progression have still been investigated. Oxidative stress is one of the factors of interest. Nitric oxide (NO) and its role in AA has not been studied previously. Methods: Thirty‐four patients who underwent operation with a perioperative diagnosis of AA and 16 age and sex‐matched controls were included in the study. Serum thiobarbituric acid reactive substances (TBARS), thiol groups (SH), NO metabolites (NO(x)), and conventional inflammation markers were determined. Results: NO(x), TBARS, C‐reactive protein (CRP) levels, white blood cell (WBC) count, and erythrocyte sedimentation rate (ESR) were significantly higher, and total SH was significantly lower in AA than in control group. NO(x), TBARS, and SH levels were comparable in acute phlegmonous appendicitis and advanced appendicitis. There was a significant positive correlation between NO(x) and TBARS, CRP, ESR, WBC and a significant negative correlation between NO(x) and SH. Conclusions : Serum NO(x) levels and oxidative stress elevate in AA independent from the extent of the lesion. Increased NO may play a role in the increased oxidative stress in AA. J. Clin. Lab. Anal. 24:63–66, 2010. © 2010 Wiley‐Liss, Inc.

In the present study, the effects of povidone iodine (PI) used during Caesarean operations on maternal thyroid hormones and urine iodine levels in the infant and the mother were investigated.Twenty-seven patients were allocated to the PI group I (Gr I), and 28 to the non-PI group (Group II). Maternal preoperative and 24th-h postoperative free T3 (fT3), freeT4 (fT4), TSH, and urine iodine levels were determined, as well as infant urine iodine values.In both groups, fT3 levels before and after the operation were found to be reduced (p 0.01, p = 0.01, respectively). However, the decrease in fT3 was approximately 1.5-fold higher in Gr I than in Gr II. TSH levels increased significantly in Gr I (p = 0.005). The urine iodine levels of the mothers increased 25% in Gr I, but only 2% in Gr II.The absorption of PI by the skin was found to lead to changes in fT3, TSH, and urine iodine excretion values in the mothers. The findings of this study of Caesarean operations, which have a short duration, might be a signal to be careful of thyroid hormone effects in operations lasting longer.

Background Familial Mediterranean Fever (FMF) is a systemic relapsing autoinflammatory disorder. Adenosine deaminase (ADA) is an enzyme widely distribute in tissues and body fluids. Circulating levels of ADA have been shown to increase in several inflammatory conditions. This study was designed to evaluate the serum ADA in patients with FMF during acute attacks and attack-free periods. Methods The study groups comprised 23 FMF patients in attack-free period (male/female: 11/12), 30 FMF patients in attack period (male/female: 11/19) and 20 healthy control (male/female:10/10). The groups were similar for age, gender and disease duration. Results The mean age of FMF patients in attack-free period, patient with acute attack were 34.3±11.7 and 29.4±11.1 respectively. The disease durations were 13.1±10.2 and 8.2±7.6 years for patients in attack-free periods and patients with acute FMF attack, respectively. Patients with acute attack had significantly higher ADA levels than both patients with attack-free periods and healthy controls (for each, p Conclusion In this study we demonstrated that FMF patients with acute attacks had higher serum ADA levels than attack-free periods and healthy controls. It is likely that ADA may have a role in the cytokine network of the inflammatory cascade of FMF. Also, elevated ADA levels may be a part of the activated Th1 response in the disease. ADA may be used as a supportive marker to differentiate FMF attacks from attack-free periods. Further larger-scale studies are needed to support this result.

Background: Cardiovascular diseases are important factors in mortality and morbidity of dialysis patients. Cardiovascular risk assessment is important in order to arrange the treatment strategies. The aim of the study was to investigate the relationship between carotid atherosclerosis and various CVD risk factors in dialysis patients. Methods: 22 HD and 54 PD patients were included in the study. Carotid artery intima media thickness (IMT) and plaque score (PS) were obtained by B-mode ultrasonography for each participant. Uric acid, albumin, bilirubin, lipid profile, apolipoprotein A-l (apo A-l), apolipoprotein B (apo B), lipoprotein(a) [Lp(a)], high-sensitivity CRP (hs-CRP), homocysteine (Hcy), vitamin A, vitamin E, sialic acid (SA) and thiobarbituric acid-reactive substances (TBARS) were determined. The differences of the cardiovascular risk factors between the patients according to the treatment modality and the comparison of the risk factors as indicators of IMT and PS were investigated. Results: There was no significant difference in IMT and PS between the two groups. SA, TBARS, hs-CRP, total, HDL- and LDL-cholesterol, white blood cell (WBC) and erythrocyte sedimentation rate (ESR) levels were significantly higher; albumin levels were significantly lower in PD group. In multiple regression analysis, only bilirubin for IMT and SA for PS were independent predictors. Conclusions: SA can be a superior marker to hs-CRP in PD patients; however, hs-CRP seems to be a more valuable marker than SA in HD patients according to the correlation analysis. This study provides information and opportunity for comparison of relatively new cardiovascular risk markers in hemodialysis and peritoneal dialysis patients using carotid atherosclerosis as an objective assessment criterion.

Background. Peritonitis is a major complication in continuous ambulatory peritoneal dialysis (CAPD) patients, and the mechanisms involved in the pathology are important if the success rate of treatment strategies is to increase. Material and methods. A total of 50 CAPD patients (25 with 25 episodes of peritonitis and 25 with no clinical or laboratory signs of infection) were included in the study. Malondialdehyde (MDA) and nitric oxide (NO) metabolites in serum and dialysate effluents were determined. Results. The dialysate/serum (D/S) ratio of the NO metabolites and serum NO metabolite concentrations were significantly higher in the peritonitis group. Serum and dialysate MDA concentrations were also significantly higher in the peritonitis group. The D/S ratio of MDA was significantly higher in the control group. Conclusions. Local peritoneal NO production and oxidative stress seem to increase in CAPD patients during the peritonitis attack.

Cardiovascular disease is a common cause of death for diabetic patients. High sialic acid levels (SA) and increased oxidative stress are important factors for cardiovascular diseases. We aimed to research whether SA and thiobarbituric acid reactive substances (TBARS) levels are associated with the degree of the diabetic regulation and investigate if SA and TBARS levels can be controlled with the regulation of the blood glucose levels. A total of 179 subjects were included in the study. Three groups, which were comprised of subjects with type 2 diabetes mellitus (DM) (DM group [DMG], n=149), impaired glucose tolerance (IGT) (IGT group [IGTG], n=15), and normal oral glucose tolerance (NGT) (NGTgroup [NGTG], n=15) were constituted. Glucose, cholesterol, high‐density lipoprotein (HDL) and glycated hemoglobin (HbA(1C)), SA, and TBARS were measured in the sera of the patients. SA and TBARS levels were significantly increased in subjects with type 2 DM (P

Amaç: D vitamini, kalsiyum absorbsiyonu ve kemik metabolizmasında etkilidir. Ayrıca düşük D vitamini düzeyleri DM, HT, kanser ve otoimmun hastalıkların yer aldığı çoğu kronik hastalık ile de ilişkilidir. Bu çalışmada laboratuvarımızda 2012 yılı Ocak-Aralık ayları arasında çalışılan D vitamini düzeylerinin incelenmesi amaçlandı.Materyal ve Metod: 2012 yılında Ocak-Aralık ayları arasındaki 4168 hasta değerlendirildi ve yaş, cinsiyet ve D vitamini düzeyleri aylara göre gruplara ayrıldı.Bulgular: Çalışmamızda 3242 (% 77,8) kadın ve 926 (%22,2) erkek yer aldı. Hastaların D vitamini düzeyleri ortalaması 22,80±13,27 ng/mL, kadınlarda 22,49±13,88 ng/mL, erkeklerde 23,75±10,57 ng/mL idi. Hastaların % 47’inde (kadınlarda % 50, erkeklerde %38) < 20 ng/mL D vitamini seviyeleri vardı (D vitamin yetersizliği için cut-off). D vitamini yetersizliğinde mevsimsel değişiklikleri incelemek için ortalama D vitamini düzeyleri karşılaştırıldığında tüm gruplar arasında istatiksel olarak anlamlı fark bulundu ( p

Objective To evaluate the efficacy of an anti-inflammatory and capillary regulator drug, micronized purified flavonoid fraction (MPFF), in the prevention of postoperative formation of adhesions. Design A double-blind, controlled study evaluated the efficacy of MPFF in reducing postoperative adhesion formation in a rat model. Setting Animal care facility of an academic research setting. Animal(s) Thirty Sprague-Dawley female rats randomly divided into three groups. Intervention(s) Starting on day of surgery, group 2 rats received oral MPFF (100 mg/kg per day for 7 days). Group 3 rats were intraperitoneally injected with 5 mL of saline (containing 200 mg/kg per day of MPFF for 3 days). Control rats received no medication. A standardized surgical trauma was applied in all animals. Three weeks after surgery, the rats were killed, and the adhesions were scored according to macroscopic and microscopic scales. Main Outcome Measure(s) Postoperative adhesions. Result(s) Both oral and intraperitoneal administration of MPFF reduced the scores of adhesions according to macroscopic and microscopic scales. There was no difference between the routes of administration. Conclusion(s) A statistically significant reduction in postoperative formation of adhesions was observed after oral and intraperitoneal administration of MPFF in our experimental animal model. However, further studies are required to reveal its mechanism of action.

Objectives It is known that sex hormones affect the brain in women. However, there are not enough studies that explain the relationship between sex hormone fluctuations during menstrual cycle and brain waves. Our aim in this study is to show the effects of sex hormone fluctuations on the EEG alpha response in menstrual phase and follicular phase. Methods EEG recordings on resting state was performed in 11 healthy volunteer women in two different phases (menstrual and follicular). The alpha power values were analyzed by artifact-free 45 epochs lasting 2 s. Blood samples of volunteers were drawn simultaneously and estradiol, progesterone, FSH and LH were analyzed with electrochemiluminesence immunoassay method. The assessment of alpha power values and its relationship with hormone levels were performed in two phases of menstrual cycle. Results The highest difference between the mean power value in the menstrual phase (46.06) and the follicular phase (36.08) was obtained from the parietal region of the brain. At the same time, the lowest difference between the mean power value (41.06) in the menstrual phase and the follicular phase (39.37) was obtained from the occipital region of the brain. Estrodiol, progesterone, FSH, LH mean levels were 30.2 pg/ml; 0.17 ng/ml; 6.7 mIU/ml; 5.43 mIU/ml in the menstrual cycle and 123.9 pg/ml; 0.23 ng/ml; 7.3 mIU/ml; 17.12 mIU/ml in the follicular phase, respectively. Conclusion We found that increased estradiol levels in response to the elevation of LH levels in blood during follicular phase resulted in a decrease in the power of the alpha waves from the parietal region. Sex hormone fluctuations in menstrual cycle has minimal effect on the EEG alpha response in occipital region.

Adenosine deaminase (ADA) is found in most tissues including lymphoid cells and lymph nodes. It is a marker of T lymphocyte activation. The role of type 1 and type 2 T helper cells in appendicitis has been investigated experimentally. Serum ADA levels in acute appendicitis have not previously been studied.To assess the serum levels of ADA in patients with acute appendicitis.Serum levels of ADA were investigated in 30 cases with acute appendicitis (mean age 26 years; male/female 17/13) and 21 healthy controls (mean age 40 years; male/female 11/10). Levels of ADA were compared in patients with acute appendicitis and healthy controls. Correlation analysis between ADA and other inflammatory markers (C-reactive protein (CRP), high-sensitivity CRP, erythrocyte sedimentation rate and white blood cell count) was also performed.Mean (SD) serum ADA levels were significantly higher in those with acute appendicitis than in the control group (13.41 (3.56) U/l vs 9.39 (1.22) U/l; p0.001). There was no correlation between ADA and the other inflammatory markers investigated.Although serum levels of ADA do not correlate with other known inflammatory markers, its serum level is increased in acute appendicitis and it has a higher positive predictive value.

Background 24-h urine measurements are used in the routine diagnosis and follow-up of many diseases in the clinical laboratory. Calcium (Ca 2+ ), magnesium (Mg 2+ ), phosphate (PO 4 3− ) and uric acid are frequently requested markers in 24-h urine samples. Because of the different solubilities of these parameters, different urine collection conditions – urine in base for uric acid and urine in acid for Ca 2+ , PO 4 3− and Mg 2+ measurements – are recommended. Methods We aimed to test the effect of addition of preservatives and heating of the urine specimen on the results obtained for Ca 2+ , Mg 2+ , PO 4 3− and uric acid by comparison with untreated samples results. Spot ( n = 20) and 24-h urine ( n = 50) samples were obtained from patients for routine urine analysis. A single spot urine sample was divided into five aliquots of 10 mL each: one containing 200 µL of HCl (6 N), another containing 200 µL of sodium bicarbonate, NaHCO 3 (5 g/L), two others in which the same preservative agents were added 24 h after the collection, and one without any preservative (untreated). Ca 2+ , PO 4 3− , uric acid and Mg 2+ were measured in triplicate and at three different time points during the study: at the time of sampling (0 h), 24 h after sampling, and after heating the samples. The 24-h urine samples were collected without preservatives and analytes were measured promptly before and after acidification/alkalinization. Results There was no statistically significant difference between untreated and treated samples ( p > 0.05). Heating also failed to show any difference in the results ( p > 0.05). Conclusion According to our results, addition of preservatives is not necessary for measurement of Ca 2+ , Mg 2+ , PO 4 3− and uric acid in promptly assayed 24-h urine samples.

Objectives Turbidimetric urine protein methods like Benzethonium Chloride (BTC) and Benzalkonium Chloride (BC) are previously reported to give falsely low protein results in very high protein concentrations (> 2000 mg/L). Design and methods BTC and BC assays were adapted to an Olympus AU 640 analyzer in order to investigate the effect of the secondary wavelength on the linearity of the assays. Pyrogallol red (PYR) was also adapted to the same analyzer and used as the comparative method. Results The linearity of BC was increased from 1500 mg/L to 3000 mg/L and the linearity of BTC was increased from 1500 mg/L to 2500 mg/L with the omission of the secondary wavelength. Conclusions We propose single-wavelength measurements for BC and BTC methods; however, urine samples with protein concentration > 2500 mg/L for BTC and > 3000 mg/L for BC should be diluted to appropriate concentrations.

Background: Peritonitis is an important complication in continuous ambulatory peritoneal dialysis (CAPD) patients. Procalcitonin (PCT) has recently been identified as an inflammation marker and recommended as a new potential marker in CAPD peritonitis. We aimed to study a card test for PCT and compare the results with the conventional markers such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and white blood cell (WBC) count. Patients and methods: A total of 40 CAPD patients; 20 patients with an episode of peritonitis and 20 patients without any clinical or laboratory sign of infection were included in the study. PCT, CRP, ESR, WBC and dialysate cell count were performed at the beginning of the clinical signs of peritonitis. Results: CRP and ESR had the highest sensitivities (100% for both) but lower specificities (55 and 10%; respectively) and PCT had the highest specificity with a relatively low sensitivity (100 and 70%) according to the calculated results. Conclusions: The card test for PCT seems to be suitable for the adjunctional use in CAPD peritonitis, with its shorter turn-around time, appropriateness for near-patient testing and high specificity.

BACKGROUND: In this study, we aimed to set levels of blood S100B and lactate and to determine any correlation with brain computerized tomography in minor head traumas in children and adults. METHODS: This clinical trial is a prospective study including 100 head trauma patients who applied to Ankara Training and Research Hospital emergency service. RESULTS: In this study, cut-off ranges of 0.0-0.15 ug/ml and 0.9-1.7 mmol/L for blood S100B and lactate levels, respectively, were used. S100B level was higher than the cut-off range in 42% of patients and lactate level was higher in 56% of patients. No significant differences were determined between age groups. When the relation between S100B and lactate levels with brain CT was evaluated, no statistically significant relation was determined. CONCLUSION: According to our results, in minor head traumas, the determination of elevated serum S100B and lactate levels cannot take the place of clinical examination and the use of cranial CT. Although the patients in our study group had minor head trauma, we do not consider S100B and lactate to be reliable markers for estimating progression.

Gestational diabetes (GDM) is a metabolic disease characterized by the impairment of glucose tolerance during pregnancy. Sialic acid (SA) is a component of glycolipid and glycoproteins found in hormone and enzymes in serum and tissues and high serum SA levels are observed in diabetic patients.Serum SA levels were investigated in three groups, namely 61 normal pregnant women with normal 50 gr glucose loading test (group 1: gr 1), 36 patients with high 50 gr test values and normal 100 gr test (group 2: gr 2: group with impaired glucose tolerance test, IGT), and 8 patients with diagnosis of GDM (group 3:gr 3).According to Kruskal-Wallis test, significant difference was observed in SA levels between gr1 and gr2-gr3 (p = 0.001). Difference was observed between groups with respect to age (p0.001), the number of pregnancies (p = 0.001), BMI (p = 0.001), and diabetes history in the family (p = 0.001) (Table 1). Table 1 Summary of results and statistical relationship Variable Group 1 (n = 61) Group 2 (n = 36) Group 3 (n = 8) p Age 24 (18-38) 28 (19-38) 31 (20-38)0.001 Pregnancy week 26 (24-29) 26 (24-32) 26,5 (24-29) 0.126 Pregnancy number 2 (0-6) 2 (1-5) 3.5 (1-5)0.001 BMI 23.7 (17.9-38.2) 27.6 (17.04-41.14) 30.8 (21.9-43.8)0.001 Weight taken 7 (1-13) 6 (2-12) 6 (4-10) 0.954 Sialic acids 2.66 (1.2-4.59) 3.22 (2.34-5.04) 3.05 (2.67-3.49)0.001 Fetal weight 3,380 (2,310-4,290) 3,400 (2,650-4,600) 3,655 (3,270-3,960) 0.092 Smoking 5 (%8.2) 2 (%5.6) 0 (%0) 1 Family history 22 (%36.1) 10 (%27.8) 8 (%100)0.001.Our study demonstrated that SA values are increased in GDM and IGT groups, which demonstrates that inflammatory disorders may occur also in IGT group, which is considered like normal pregnancy, and that this group may be considered in the same way as GDM.

BACKGROUND: Familial Mediterranean fever (FMF) is an autosomal recessive inherited inflammatory disease. The gene responsible for the disease, called MEFV, encodes a protein called pyrin or marenostrin. According to recent data, MEFV mutations are not the only cause of FMF, but genetic analysis of MEFV gene is needed for confirming the diagnosis of FMF. In the present study, we aimed to evaluate the molecular testing results of MEFV mutations. METHODS: Molecular testing results of 1,435 patients were retrospectively evaluated over the last 4 years. These patients were identified as having FMF clinical symptoms. Patients were tested for 12 common mutations in the MEFV gene using a strip assay technique. RESULTS: From all 1,435 patients, MEFV mutations were found in 776 patients (54.08%) and 659 patients (45.92%) did not carry any mutations. Patients with mutations were classified as homozygotes (n = 148), compound heterozygotes (n = 197), heterozygous (n = 427), and complex genotypes (n = 4, patients with three mutations). Allelic frequencies for the four most common mutations in the mutation‐positive groups were 48.79% (M694V), 14.86% (M680I G/C), 13.70% (E148Q), and 12.35% (V726A). The remaining alleles (10.3%) showed rare mutations that were R761H, P369S, A744S, K695R, F479L, and M694I. No patient showed a I692del mutation that is sometimes evident in other Mediterranean populations. CONCLUSION: It was found that the most common four mutations (M694V, M680I [G/C], E148Q, V726A) were similar to those previously reported from different regions of Turkey and this study might add some knowledge to the mutational spectrum data on FMF.

Objectives To investigate and discuss the total-, lipid-associated, and thrombocyte-sialic acid levels in chronic heart failure (CHF) patients. Design and methods Thirty-one chronic heart failure patients and 38 healthy controls were included in the study. Serum total sialic acid (TSA), lipid associated sialic acid (LASA), thrombocyte sialic acid (TrSA) were determined together with the traditional inflammation and prognostic markers. Results Serum TSA levels were significantly higher in patient group (3.08 ± 0.33 mmol/L) than control group (2.60 ± 0.17 mmol/L). Serum LASA, homocysteine, high-sensitivity CRP, brain natriuretic peptide and erythrocyte sedimentation rate were also significantly higher in patient group. TrSA levels were not significant between the groups. Conclusion TSA and LASA levels increase in CHF, independent from coronary artery disease. TrSA levels were not found to be a prognostic or valuable marker for CHF patients. Acute phase response and lipid associated portions of SA are thought to be responsible for SA rise in CHF.