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To evaluate the radioprotective effect of spirulina (SP) on the lacrimal glands after RAI treatment. A total of 30 rats were separated into control, RAI and SP group. The radioprotective effect of SP on lacrimal glands was evaluated with histopathological and cytopathological analysis. Lacrimal glands were analyzed for tumor necrosis factor alpha (TNF-α), interleukin-2 (IL-2), IL-4, IL-6, IL-10, nuclear factor-kappa B (NF-κB), total oxidant status (TOS) and total antioxidant capacity (TAC) levels. RAI increased TNF-α (p =.001), IL-6 (p =.018), and NF-κB levels (p <.0005). Following the administration of SP, TNF-α (p <.0005), IL-4 (p =.026), and IL-6 (p =.006) levels decreased. RAI decreased the TAC levels (p =.001), and co-administration of SP increased the TAC level, but was not statistically significant. SP decreased the TOS level after RAI (p =.022). SP protects lacrimal glands from RAI-induced damage. [ABSTRACT FROM AUTHOR]

Objective: Metabolic syndrome (MS) was independently associated with increased risk of incident heart failure and coronary artery disease. In this study, we sought to identify whether there is an association between metabolic syndrome components and left ventricular diastolic functions and brain natriuretic peptide (BNP) levels. Methods: This study is a cross-sectional, observational study. Two hundred consecutive patients with MS were selected to form the study population. Echocardiographic parameters and BNP were determined. Mann-Whitney U test and Kruskal-Wallis test were used to compare BNP levels in categorical variables. Spearman rank correlation analysis was used to investigate the correlation between BNP level and other numerical variables. Linear regression analysis was used to find the variables affecting the BNP level. Results: BNP level was higher in females than males [11.14 (0.12-87) vs 7.49 (0.01-99) pg/dl, p=0.04]. None of the MS parameters affects the BNP level in MS patients. MS criteria number that the patient had was not related to BNP level. Sixty seven percent of patients had left ventricular (LV) diastolic dysfunction. BNP was independent from LV diastolic function. Multiple linear regression analysis demonstrated that having diabetes mellitus increases BNP level by 7.73 unit (β=7.73, 95% CI - 2.321 - 13.149, p=0.006). Conclusion: None of the MS parameters affects the BNP level in MS patients. Diastolic dysfunction existence did not affect the BNP level of MS patients. There is an association between diabetes mellitus and BNP, independent of left ventricle diastolic functions. [ABSTRACT FROM AUTHOR]

Study design: 2-amino-5-phosphonovaleric acid (APV) is an N-methyl-D-aspartate (NMDA) receptor blocker and has neuroprotective properties. This study is aimed at evaluating the effect of APV treatment on oxidative status after spinal cord injury (SCI). Methods: The experiment was carried out on the following five groups: Group1: sham operated, non-traumatized; Group2: with injured spinal cord, no treatment; Group3: with SCI, injected with 100 μg kg−1 APV; Group4: with SCI, injected with 200 μg kg−1 APV; and Group5: with SCI, injected with 400 μg kg−1 APV. SCI was inflicted by epidural compression with a cerebral vascular clip after T9–11 laminectomy. The experiments were completed after 12 h of trauma. Spinal cords were excised for evaluation of superoxide dismutase (SOD), catalase, reduced glutathione (GSH) and malonyldialdehyde (MDA) levels. Results:After SCI, SOD and GSH levels decreased and the MDA level increased significantly. APV treatment decreased the MDA level and increased SOD, catalase and GSH levels. The maximum decrease in MDA was detected in the group treated with 100 μg kg−1 APV compared with the other groups. The GSH level was significantly increased in the group treated with 200 μg kg−1 APV. The SOD level was significantly increased in the group treated with 200 μg kg−1 APV. Conclusion: The results of this study have shown that APV treatment creates a dose-dependent antioxidant effect in rats with SCI and may be used for the treatment of SCIs. [ABSTRACT FROM AUTHOR]

Purpose: Parkinson's Disease (PD), a neurodegenerative disorder, is associated with substantial morbidity. α-Klotho, an anti-aging protein known for its neuroprotective properties, has gained attention. This study aims to assess serum levels of α-Klotho in PD patients., Methods: This study is a cross-sectional case-control study. PD was diagnosed according to UK Parkinson Disease Society Brain Bank criteria. Serum α-Klotho level was measured using a commercially available enzyme-linked immunosorbent assay., Results: Of the 314 participants in the study, 157 were patients with PD and 157 were controls. Lower levels of α-Klotho were observed in PD (0.85 nmol/L) in comparison to the controls (1.47 nmol/L, p < 0.001). α-Klotho levels were also significantly lower among PD patients with dementia compared to PD patients without dementia. In logistic regression analysis, α-Klotho (OR: 0.04, p < 0.001) demonstrated a significant relationship between PD. A significant correlation was identified between α-Klotho levels and Mini-Mental State Examination scores in PD patients. The sensitivity and the specifity of α-Klotho were 90% and 65% for predicting PD., Conclusions: Our findings suggest that α-klotho could potentially serve as a biomarker. However additional studies are needed to confirm our findings., Competing Interests: Declarations. Declaration of Generative AI and AI-assisted technologies in the writing process: During the preparation of this work the author(s) used Bard/Google Services in order to grammer checking. After using this tool, the author(s) reviewed and edited the content as needed and take(s) full responsibility for the content of the publication. Competing interests: There is no conflict of interest among authors., (© 2024. Fondazione Società Italiana di Neurologia.)

Background: Parkinson's disease (PD) is characterized by the inability of dopamine production from amino acids. Therefore, changes in amino acid profile in PD patients are very critical for understanding disease development. Determination of amino acid levels in PD patients with a cumulative approach may enlighten the disease pathophysiology., Methods: A systematic search was performed until February 2023, resulting in 733 articles in PubMed, Web of Science and Scopus databases to evaluate the serum amino acid profile of PD patients. Relevant articles in English with mean/standard deviation values of serum amino acid levels of patients and their healthy controls were included in the meta-analysis., Results: Our results suggest that valine, proline, ornithine and homocysteine levels were increased, while aspartate, citrulline, lysine and serine levels were significantly decreased in PD patients compared to healthy controls. Homocysteine showed positive correlations with glutamate and ornithine levels. We also analyzed the disease stage parameters: Unified Parkinson's Disease Rating Scale III (UPDRS III) score, Hoehn-Yahr Stage Score, disease duration and levodopa equivalent daily dose (LEDD) of patients. It was observed that LEDD has a negative correlation with arginine levels in patients. UPDRS III score is negatively correlated with phenylalanine levels, and it also tends to show a negative correlation with tyrosine levels. Disease duration tends to be negatively correlated with citrulline levels in PD patients., Conclusion: This cumulative analysis shows evidence of the relation between the mechanisms underlying amino acid metabolism in PD, which may have a great impact on disease development and new therapeutic strategies.

Non-alcoholic Fatty Liver Disease (NAFLD) is both a cause and a consequence of metabolic disturbances. Consequently, the disease term has recently changed to Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). Turkiye is one of the leading countries with high incidences of diseases such as diabetes, obesity, metabolic syndrome, and fatty liver. This study aims to identify the metabolic parameters and MASLD potential of NAFLD in Turkiye. All NAFLD studies conducted in Turkiye were systematically searched using the keywords "fatty liver disease" AND " Turkiye " on PubMed, Scopus, and Web of Science databases. A total of 2653 articles were scanned, and 120 studies were eligible for meta-analysis. The metabolic parameters were meta-analyzed from a broad perspective. According to the meta-analysis results, there were significant increases in waist circumferences (mean difference: 10.90, p<0.00001), HOMA-IR (mean difference: 2.13, p<0.00001), aspartate aminotransferase (AST) (mean difference: 17.82, p<0.00001), systolic blood pressure (SBP) (mean difference: 5.86, p<0.00001), and C-reactive protein (CRP) levels (mean difference: 0.95, p<0.00001). These parameters are representative biochemical findings of disturbed glucose metabolism, lipid profile, blood pressure, and acute phase response mechanisms. Furthermore, the analysis of all related parameters commonly found among the articles confirmed these metabolic dysfunctions. NAFLD is a metabolic disease that encompasses multiple pathways related to glucose and lipid metabolism, vascular function, inflammation, and acute phase responses. Additionally, our results suggest that Turkish NAFLD patients identified in previous studies mostly have MASLD. This is the first meta-analysis study indicating changes in metabolism-related parameters with a cumulative meta-analysis of all Turkish NAFLD studies., Competing Interests: The authors have no conflict of interest to declare.

Objective: Our study aimed to differentiate patients with placenta accreta spectrum (PAS) from those with placenta previa (PP) using maternal serum levels of vascular endothelial growth factor (VEGF), tumor necrosis factor-alpha (TNF-alpha), interleukin-4 (IL-4), and IL-10., Methods: The case group consisted of 77 patients with placenta previa, and the control group consisted of 90 non-previa pregnant women. Of the pregnant women in the case group, 40 were diagnosed with PAS in addition to placenta previa and 37 had placenta previa with no invasion. The maternal serum VEGF, TNF-alpha, IL-4, and IL-10 levels were compared between the case and control groups. Then the success of these markers in differentiating between PP and PAS was evaluated., Results: We found the VEGF, TNF-alpha, and IL-4 levels to be higher and the IL-10 level to be lower in the case group compared to the control group (p < 0.001). We observed a statistically significantly lower IL-10 level in the patients with PAS than those with PP (p = 0.029). In the receiver operating characteristic analysis, the optimal cut-off of IL-10 in the detection of PAS was 0.42 ng/mL). In multivariate analysis, the risk of PAS was significant for IL-10 (odds ratio (OR) 0.45, 95 % confidence interval (CI) 0.25-0.79, p = 0.006) and previous cesarean section (OR 2.50, 95 % Cl 1.34-4.66, p = 0.004). The model's diagnostic sensitivity and specificity, including previous cesarean section, preoperative hemoglobin (Hb), TNF-alpha, and IL-10 were 75 % and 72.9 %, respectively., Conclusion: The study showed that the IL-10 level was lower in patients with PAS than in those with PP. A statistical model combining risk factors including previous cesarean section, preoperative Hb, TNF-alpha, and IL-10 may improve clinical diagnosis of PAS in placenta previa cases. Cytokines may be used as additional biomarkers to the clinical risk factors in the diagnosis of PAS., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to investigate maternal serum vascular endothelial growth factor (VEGF) C and D levels in patients with intrahepatic cholestasis of pregnancy (ICP)., Methods: A total of 83 patients, including 41 patients with ICP and 42 healthy pregnant women, were included in the study. We first compared the maternal serum VEGF-C and VEGF-D levels between the ICP and control groups and then examined the correlation between the serum VEGF-C level and the bile acid level in patients with severe ICP., Results: We observed statistically significantly higher serum VEGF-C levels and lower VEGF-D levels in the ICP group compared with the healthy controls (P < 0.001 and P = 0.015, respectively). According to receiver operating characteristic analysis, the optimal cutoff value for ICP was 147 ng/mL in the determination of the VEGF-C level (specificity and sensitivity: 76%). In patients with severe ICP, the serum VEGF-C statistically significantly correlated with the bile acid level (P = 0.019)., Conclusion: This study showed that the maternal serum VEGF-C level was higher and the VEGF-D level was lower in patients with ICP compared with healthy pregnant women. We also found that the VEGF-C level was correlated with the serum bile acid level in patients with severe ICP. Serum VEGF-C level can be used in the diagnosis and follow-up of intrahepatic pregnancy cholestasis., (© 2023 International Federation of Gynecology and Obstetrics.)

Purpose: To assess the potential influencing effects of Dexmedetomidine on impaired lacrimal glands after high-dose radioiodine treatment (RAI)., Methods: Thirty-six rats were arbitrarily separated into 3 groups: Sham, RAI, and Dexmedetomidine. Dexmedetomidine group was given Dexmedetomidine and RAI, the Sham group was given the same millimeters of saline, and the RAI group was given RAI only. All forms of lacrimal glands, including harderian glands (HG), extraorbital (EG), and intraorbital (IG) lacrimal glands, were evaluated for immunohistochemical, histopathologic assessments and also for tissue cytokines, oxidant and antioxidant levels., Results: Dexmedetomidine significantly ameliorated histopathologic changes such as periacinar fibrosis, acinar atrophy, lymphocytic infiltration, ductal proliferation, lipofuscin-like accumulation, and nucleus changes caused by RAI in all lacrimal gland forms (p < 0.05 for all of the parameters). However, periductal fibrosis was improved significantly only in EG (p = 0.049), and mast cell infiltration was improved significantly only in IG (p = 0.038) in Dexmedetomidine groups. There was a significant decrease in the elevated caspase-3 and TUNEL levels after RAI administration in the Dexmedetomidine group in all lacrimal gland forms (p < 0.05 for all parameters). Dexmedetomidine attenuated NF-kb, TNF-α, and IL-6 levels significantly diminished total oxidant status and raised total antioxidant status levels (p < 0.05 for all parameters)., Conclusions: The results of this study demonstrated that following RAI, Dexmedetomidine diminished inflammation, tissue cytokine levels, and apoptosis and ameliorated impaired histopathologic patterns of the lacrimal glands., (© 2024. The Author(s), under exclusive licence to Springer Nature B.V.)

We aimed to examine the relationship between serum midkine levels and placental invasion in pregnant women with placenta previa. The study group consisted of 43 pregnant women diagnosed with placenta previa, whereas the control group consisted of 60 healthy pregnant women. Serum midkine levels were compared between pregnant women with placenta previa and the control group in this study's first part. Thereafter, the utility of midkine in the prediction of the abnormally invasive placenta (AIP) was investigated and optimal cutoff values were calculated. Significantly higher serum midkine level was observed in placenta previa cases than in the controls (1.16 ng/mL vs. 0.18 ng/mL, P  < 0.001). Serum midkine level was also significantly higher in the AIP group among the placenta previa cases ( P  = 0.004). In the receiver operating characteristic analysis, the cutoff value of the midkine level in predicting AIP was 1.19 ng/mL. This study revealed that the serum midkine level is higher in pregnant women with AIP. Maternal serum midkine level may be used as a complementary biomarker to the radiological and clinical findings for the prediction of the AIP in placenta previa cases.

Introduction: To estimate the possible role of VEGF-A in predicting poor early pregnancy outcomes including threatened abortion and early pregnancy loss., Methods: We conducted a prospective case-control study with three groups of pregnant women diagnosed with threatened abortion, early pregnancy loss, and uncomplicated healthy pregnancies between 01 March 2023 and 15 March 2023. Maternal serum VEGF-A concentration was measured using the Sandwich-ELISA method in accordance to the commercial kit's instructions. There were 30 patients in each 3 group and the gestational age of the patients was between 6 and 14 weeks. The Kruskal-Wallis test was performed for comparing the median values between the groups. Mann-Whitney U test was conducted for pairwise comparisons., Results: VEGF-A levels were compared between 3 groups and a statistically significant difference was found (p = 0.007). There was a moderately significant correlation between VEGF-A levels and poor early pregnancy outcomes. For poor early pregnancy outcomes, the area under the curve (AUC) was 0.75 (95% CI: 0.64-0.85). The best balance of sensitivity/specificity in ROC curves was 0.60 (63.3% sensitivity, 74.3% specificity)., Discussion: In conclusion, this study pointed out the increased VEGF concentrations in pregnant women with threatened miscarriage and early pregnancy loss. VEGF-A may be a potential biomarker for the indication of poor early pregnancy outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: To evaluate changes in maternal serum midkine levels in pre-eclampsia., Methods: This study included 40 pregnant women with pre-eclampsia and 66 healthy pregnant women in the control group. Demographic data, laboratory results, and midkine levels were compared between the groups., Results: The pre-eclampsia and control groups were similar in terms of demographics. The midkine level of pregnant women with pre-eclampsia was significantly higher than that of the controls (0.54 ± 0.23 and 0.31 ± 0.19 ng/mL, respectively, P < 0.001). According to the receiver operating characteristic analysis, the optimal cut-off value of midkine was determined as 0.37 ng/mL, at which it had 75% sensitivity and 74% specificity (area under the curve: 0.815, 95% confidence interval 0.73-0.89, P < 0.001)., Conclusion: The serum midkine level was significantly higher in pregnant women with pre-eclampsia. Midkine seems to be associated with complicated inflammatory processes leading to pre-eclampsia. Further study protocols can be planned to investigate the role of midkine in the prediction of pre-eclampsia as a novel marker., (© 2023 International Federation of Gynecology and Obstetrics.)

Sometimes it can be difficult to chorionicity determination in twin pregnancies. This study aimed to compare maternal serum midkine levels between twin and singleton pregnancies. We also evaluated the relationship between chorionicity and maternal serum midkine level in twin pregnancies. The present prospective cohort study included 16 patients with monochorionic diamniotic twin pregnancies, 38 with dichorionic diamniotic twin pregnancies, and 66 healthy singleton pregnancies admitted to Ankara City Hospital Perinatology Clinic between June 2021 and June 2022. Demographic features, clinical characteristics, and serum midkine levels were compared between the groups. Additionally, a receiver operator characteristics (ROC) analysis was performed to assess the performance of midkine for detecting chorionicity. The median maternal serum midkine level was found to be 0.64 ng/ml in twin pregnancies and 0.26 ng/ml in singleton pregnancies (p < 0.001). When twin pregnancies were compared in terms of chorionicity, serum midkine level was determined as 1.20 ng/ml in the monochorionic diamniotic group and 0.50 ng/ml in the dichorionic diamniotic group (p = 0.034). An optimal cut-off value of 1.03 ng/ml was found for the determination of chorionicity (AUC: 0.68, p = 0.03, 95% CI: 0.53-0.83, %56.3 sensitivity, 76.3% specificity). In advanced weeks of pregnancy, biomarkers can be used as helpful parameters for ultrasonography in the diagnosis of twin pregnancies. Maternal serum midkine levels might be used to determine chorionicity in equivocal cases., Competing Interests: Declaration of Competing Interest No., (Copyright © 2023 Elsevier B.V. All rights reserved.)

The parathyroid glands are localized at the back of the thyroid glands in the cervical region and are responsible for regulation of the calcium level in the blood, through specialized cells that sense Ca 2+ and secrete parathyroid hormone (PTH) in response to a decline in its serum level. PTH stimulates the skeleton, kidneys and intestines and controls the level of Ca 2+ through specialized activities. Iatrogenic removal of the parathyroid gland, as well as damage to its vascular integrity during cauterization are some of the common complications of thyroid surgery. Therefore, regeneration and/or replacement of malfunctioning parathyroid tissue is required. Tissue engineering is an emerging and promising field for patients with organ failure with recent pioneering clinical applications. The success of tissue engineering strategy depends on the use of proper cells, bioactive factors that stimulate the activities of these cells and scaffolds that are produced to recapitulate the tissue structure and support the function of the engineered tissues. 3D printing is a developing strategy for the production of these scaffolds by providing a delicate control over their structure and properties. In this study, human primary parathyroid cells were successfully isolated and their viability and ability to secrete PTH upon stimulation with different levels of Ca 2+ were shown in vitro . These cells were then seeded onto 3D printed alginate scaffolds and 3D bioprinted within alginate bioink, and cell viability as well as the ability to secrete PTH upon stimulation were also demonstrated. Therefore, functional hormone-active parathyroid tissue substitute was engineered in vitro through 3D printed hydrogels and autologous cells., (Creative Commons Attribution license.)

Objective: To assess midkine (MK) levels in pregnant women with preterm premature rupture of membranes (PPROM) and compare them to healthy pregnant women. We also assessed the performance of the maternal serum MK level in predicting neonatal intensive care unit (NICU) requirement in the PPROM group., Methods: Forty pregnant women who presented to our clinic at 24-37 gestational weeks and were diagnosed with PPROM were included in the study group. During the same period, 40 healthy pregnant women at similar gestational weeks were randomly selected as the control group. Clinical characteristics, inflammatory markers, and serum MK levels were compared between the groups. The same parameters were then compared between the PPROM cases with and without NICU requirement. Finally, the receiver operating characteristic (ROC) analysis was performed to assess the predictive value of MK for NICU requirement., Results: The PPROM and control groups were similar in terms of demographics. The MK level of the pregnant woman with PPROM was significantly higher than that of the controls. No statistically significant difference was found between the MK levels of the cases with and without NICU requirement in the PPROM group. In the ROC analysis, the optimal cut-off value of was found to be 0.287, at which it had 63 % sensitivity and 65 % specificity (area under the curve(AUC): 0.78, 95 % confidence interval(CI): 0.683-0.881, p < 0.001) for the prediction of NICU requirement in cases with PPROM. In the same analysis performed for the prediction of PPROM, when the optimal cut-off value was taken as 0.298, MK had 56 % sensitivity and 60 % specificity (AUC: 0.65, 95 % CI: 0.522-0.770, p = 0.037)., Conclusion: Serum MK seems to be associated with complicated inflammatory processes leading to PPROM, and this novel marker has the potential to predict NICU requirement in PPROM cases., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: To compare umbilical cord blood pro-B-type natriuretic peptide (BNP) levels in newborns of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) positive pregnancies to those of SARS-COV-2 negative pregnancies., Methods: Prospectively cord blood samples from newborns of 42 SARS-COV-2 positive women, and 42 negative pregnant were collected at birth and analyzed for pro-BNP levels., Results: The mean cord blood pro-BNP level was significantly higher in newborns of SARS-COV-2 positive women than in controls. Furthermore, the pro-BNP level was an independent predictor of NİCU admission in both SARS-COV-2 positive and control patients., Conclusion: Cord blood pro-BNP level may be a parameter that can predict the under-stress fetus and adverse perinatal outcomes especially, in cases where placental involvement is present as in SARS-COV-2 infection., (© 2023 International Federation of Gynecology and Obstetrics.)

Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease and is significantly associated with obesity, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. NAFLD has become the most prevalent chronic liver disease in Western countries, and the proportion of NAFLD-related cirrhosis among patients on liver transplantation waiting lists has increased. In light of the accumulated data about NAFLD, and to provide a common approach with multi-disciplines dealing with the subject, it has become necessary to create new guidance for diagnosing and treating NAFLD. This guidance was prepared following an interdisciplinary study under the leadership of the Turkish Association for the Study of the Liver (TASL), Fatty Liver Special Interest Group. This new TASL Guidance is a practical application guide on NAFLD and was prepared to standardize the clinical approach to diagnosing and treating NAFLD patients. This guidance reflects many advances in the field of NAFLD. The proposals in this guidance are meant to aid decision-making in clinical practice. The guidance is primarily intended for gastroenterology, endocrinology, metabolism diseases, cardiology, internal medicine, pediatric specialists, and family medicine specialists., Competing Interests: The authors have no conflict of interest to declare., (© Copyright 2023 by Hepatology Forum.)

Aim: We compared maternal serum and fetal cord blood proBNP levels in healthy pregnancies to those with intrauterine growth restriction (IUGR). Methods: Prospectively, maternal and cord blood samples at childbirth of 40 pregnant women with isolated IUGR and 40 healthy pregnant women were evaluated for ProBNP levels. Results: The mean serum ProBNP level was significantly higher in newborn cord blood with IUGR than in the control group (181.28 ± 145.37 vs. 91.41 ± 49.77 pg/mL, p = <0.01). Mean serum ProBNP level trended higher in women with IUGR compared to the controls, but was not statistically significant (124.21 ± 113.32 vs. 88.73 ± 85.18 pg/mL, p = >0.05). Conclusion: Third trimester mean proBNP in fetal cord blood are increased in IUGR fetuses at term birth compared to pregnancies with normal fetal growth.

Objectives: To compare maternal serum midkine (MK) level in pregnant women with idiopathic fetal growth restriction (FGR) and healthy. In addition, we assessed the value of maternal serum MK level in predicting neonatal intensive care unit (NICU) admission., Methods: A total of 144 pregnant women were included, 72 with idiopathic FGR and 72 healthy in this study. The control group was matched for the mother's age, parity, gestational age, and pre-pregnancy body mass index (BMI) with the idiopathic FGR group at the time of recruitment into the study and sample collection., Results: Serum MK level is higher in the idiopathic FGR than the control group (0.24 ng/mL (0.19-0.32) vs. 0.18 ng/mL (0.14-0.23), p<0.001). In addition, we compared the maternal serum MK level of those with and without NICU admission in the FGR group (0.25 ng/mL (0.19-0.37) vs. 0.21 ng/mL (0.18-0.28), p=0.014). We performed ROC curve analysis to serum MK level predicting NICU admission in the FGR group (AUC: 0.668, %95 CI [0.550, 0.785], p=0.014). A sensitivity of 63% and a specificity of 62% for the serum MK level were achieved with a cut-off value of 0.22 for NICU admission., Conclusions: To the best of our knowledge, this study is the first to compare maternal serum MK level in pregnant women with idiopathic FGR and healthy. We showed that maternal serum MK level was significantly elevated in pregnant women with FGR than healthy., (© 2022 Walter de Gruyter GmbH, Berlin/Boston.)

Objective: We aimed to compare maternal serum midkine level in pregnant women with different types of diabetes mellitus (DM) and healthy pregnant women. We also assessed maternal serum midkine level performance to predict adverse neonatal outcomes in the DM group., Methods: The study included 57 pregnant women diagnosed with gestational diabetes mellitus (GDM) and 41 pregnant women with preexisting DMThe control group consisted of 98 healthy pregnant women., Results: Serum midkine level is higher in the DM group than healthy ones (0.93 ± 0.8 vs. 0.23 ± 0.2, p <.001). When the diabetic groups were compared, the highest serum midkine level was found in GDM, followed by Type 1 DM and Type 2 DM (1.33 ± 0.9 ng/ml, 0.58 ± 0.5 ng/ml vs. 0.30 ± 0.2, respectively). Maternal serum midkine level was higher in the DM group with adverse perinatal outcomes than those without adverse outcomes, but there was no statistical difference (0.97 ± 0.91vs. 0.87 ± 0.73, p =.571)., Conclusions: Serum midkine level was significantly higher in pregnant women with GDM, Type 1, and 2 DM than healthy ones. Serum midkine level did not predict adverse neonatal outcomes in the DM group.

Purpose: Developing a vaccine with improved immunogenicity is still a growing priority for many diseases. Different types of adjuvants may be beneficial to initiate and maintain the long-lasting immunogenicity of vaccines. Evidence has shown that polysaccharide adjuvants are efficient in improving immunological mechanisms with their biocompatibility and biodegradability characteristics. In this study, we aimed to investigate the safety and efficacy of Advax TM an adjuvant derived from delta inulin., Methods: A systematic research was performed in Pubmed, Web of Science, and Scopus databases for the following keywords; "Advax TM " OR "delta inulin" until December 14th, 2020. RevMan 5.4.1 software was used for cumulative meta-analysis and bias analysis. We also used GraphPad Prism 6 software for the figures., Results: In the cumulative meta-analysis, it was found that seroconversion and geometric mean titers (GMT) levels significantly increased in Advax TM -adjuvanted group (mean difference: 12.31, 95% Cl [4.14, 20.47], p ​= ​0.003; 17.10, 95% Cl [4.35, 29.85], p ​= ​0.009, respectively). We also observed that Advax TM could be effective in improving immunogenicity by inducing T-cell responses and plasmablast generation in viral vaccines., Conclusions: In this study, it was shown that Advax TM is a safe and well-tolerated adjuvant. Advax TM could be a potent adjuvant in increasing the protection and immunogenicity of different vaccines without safety issues. However, further studies are needed to verify these effects of Advax TM adjuvant., Competing Interests: Declaration of competing interest The authors declare no conflict of interests., (Copyright © 2021 Medical University of Bialystok. Published by Elsevier B.V. All rights reserved.)

Background and Aim: Zinc and copper are essential trace elements for cell growth and proliferation. Their deficiency may contribute to intrauterine growth restriction (IUGR). We aimed to determine the zinc and copper status of maternal serum and placenta samples of pregnant women with fetal IUGR and age-matched pregnant women without IUGR., Method: Serum and placenta samples obtained from 37 IUGR and 21 healthy pregnant women were analyzed at delivery., Results: Placenta zinc concentrations and placenta zinc/copper ratio were significantly lower in the IUGR group compared to controls (p < 0.05). Placenta zinc concentrations correlated with birth weight (p: 0.01, r: 0.31). Maternal levels of zinc and copper were similar between pregnant women with IUGR and controls., Conclusions: Lower placental zinc and zinc/copper ratio levels in pregnancies with IUGR may indicate that placenta zinc and placental zinc/copper status might be involved in IUGR.

Background: New biomarkers for diagnosis and monitoring the COVID-19 disease are the most important topics to be studied recently. We aimed to investigate the association between midkine levels and disease severity in pregnant women with COVID-19., Methods: Totally 186 pregnant women were participated in this study. 96 of them were healthy pregnant women, 90 of them were pregnant women with COVID19. Pregnant women were evaluated according to their trimesters. Serum midkine level, biochemical profile clinical and disease severity outcomes of pregnant women were obtained., Results: Our results showed that pregnant women with COVID19 have significantly increased serum midkine level compared to healthy pregnant women (1.801 ± 0.977 vs 0.815 ± 0.294 ng/dL). According to the data among each trimester, it was shown that there were significant increase in serum midkine level during all pregnancy trimesters (1st trimester Control Group: 0.714 ± 0.148, COVID-19 group 1.623 ± 0.824, p < 0.0001; 2nd trimester Control Group: 0.731 ± 0.261, COVID-19 group 2.059 ± 1.146, p < 0.0001; 3rd trimester Control Group: 1.0 ± 0.35, COVID-19 group 1.723 ± 0.907, p = 0.001). Serum midkine levels were significantly different between disease severity subgroups of pregnant women with COVID19; moderate and severe/critic groups had significantly higher serum midkine level than mild group. There was also significant correlation between serum midkine level and severity status (p:0.0001, r: 0.468). The most striking results of serum midkine levels were corelation between length of hospitalization (p: 0.01, r: 0.430) and O 2 saturation (p < 0.0001, r: -0.521). ROC curve analysis showed that serum midkine level might be a tool for predicting COVID-19 in pregnant women with COVID-19 (AUC: 0.912, 95% CI: [0.871, 0.952], p < 0.0001) CONCLUSION: Our data showed that there is an obvious relation between COVID19 progression and serum midkine level for the first time which might be used for monitoring the disease process., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

The objective of this study was to evaluate the utility of first trimester maternal serum afamin levels together with vitamin E and various elements (zinc, copper, selenium, and magnesium) for the prediction of gestational diabetes mellitus (GDM). All pregnant women between 11th and 14th weeks of gestation admitted for combined test were asked to participate in the study. A total of 797 women gave permission to participate in the study between January and September 2019. Serum was obtained by centrifugation and samples were frozen and kept at - 80 °C. For final analysis, forty-three GDM patients and forty-four healthy controls were selected. Levels of afamin, vitamin E, zinc, copper, selenium, and magnesium were compared between groups. The mean levels of afamin were found to be higher in women with GDM without statistical significance (63.69 ± 82.33 vs 44.25 ± 32.25 mg/L, p = 0.149). Vitamin E levels were found to be higher in women with GDM compared to controls without any statistical significance (5.04 ± 5.33 vs 4.47 ± 3.83 μg/mL, p = 0.568). While first trimester copper concentrations were higher among diabetic women (187.26 ± 34.78 vs 175.17 ± 30.40 μg/L, p = 0.088), this was not statistically significant. The other element levels (zinc, selenium, and magnesium) were found to be similar between the two groups (p = 0.624, p = 0.088, p = 0.254, p = 0.872, respectively). The results of our study demonstrated that mean levels of afamin, vitamin E, and copper were higher in women with GDM compared to controls. Additionally, first trimester maternal zinc, selenium, and magnesium levels were similar between diabetic and healthy pregnant women. However, more studies are needed to clarify the relationship between blood trace concentrations and GDM., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)

SARS CoV-2 is a novel coronavirus which has caused many deaths in the recent pandemic. This study aimed to determine zinc, copper and magnesium status on pregnant women with COVID-19. 100 healthy (33/32/35) and 100 SARS-CoV-2 positive (34/33/33) pregnant women were included in the study according to their trimesters. Blood samples were obtained from the patients along with the initial laboratory tests for clinical outcomes upon their first admission to hospital. In the first and third trimesters serum zinc level was lower (p:0,004 and p:0,02), serum copper level was higher (p:0,006 and p:0,008), the Zn / Cu ratio decreased(p < 0.0001 and p < 0.0001) and the serum magnesium level was higher(p < 0.0001 and p < 0.0001) in the COVID-19 group.In the second trimester COVID-19 patients had lower serum zinc (p:0,05) and copper levels (p:0,0003) compared to controls. Disease severity correlated with zinc/copper ratio in COVID19 patients (p:0.018, r:-0.243). Serum zinc and Zn/Cu ratio levels had a negative relationship with acute phase markers such as IL-6, Erythrocyte Sedimentation Rate, procalcitonin and C-reactive Protein. Also, increased serum magnesium level may play a role in decreased white blood cell, neutrophil, lymphocyte cell count and increased CRP levels in the third trimester. This study indicated that trace element status changed in pregnant women with COVID-19. The effect of trace elements on pregnant women diagnosed with COVID-19 infection was investigated in comparison with healthy pregnant women for the first time. This effect will be revealed better in more comprehensive studies to be planned in the future., (© 2020. Springer Science+Business Media, LLC, part of Springer Nature.)

Adequate maternal selenium level is essential for immune response and healthy pregnancy. This study aimed to shed light on the selenium status of pregnant women with COVID-19 and the effects of potential deficiency in serum selenium levels. Totally 141 pregnant women, 71 of them were COVID-19 patients, in different trimesters were included in the study. Maternal serum selenium levels, demographic and clinical parameters were determined. Serum selenium levels of pregnant women in the second (p: .0003) and third (p: .001) trimesters with COVID-19 were significantly lower than in the healthy group. Maternal selenium level was found to be negatively correlated with gestational week (p < .0001, r: -.541), D-dimer (p: .0002, r: -.363) and interleukin-6 (IL-6) level (p: .02, r: -.243). In the second trimester, serum selenium level positively correlated with white blood cell (p: .002, r: .424), neutrophil (p: .006, r: .39), lymphocyte (p: .004, r: .410) count and hemoglobin (p: .02, r: .323), hematocrit (p: .008, r: .38) status. In the third trimester, it was found that maternal selenium level positively correlated with monocyte (p: .04, r: .353) and negatively correlated with C-reactive protein level (p: .03, r: -.384). Serum selenium level was gradually decreased during the pregnancy period, however, this natural decrease was enhanced together with COVID-19 infection. The reason might be increased selenium needs depended on the immune response against infection. The decrease in maternal selenium level was found to be related to IL-6 and D-dimer levels, which indicate selenium's role in disease progression., (© 2021 Wiley Periodicals LLC.)

Background: This study aimed to investigate the prognostic value of N-terminal B-type natriuretic peptide (NT-proBNP) in pregnancies with isolated chronic hypertension (HT). Method: 34 pregnant women with chronic HT and 40normotensive controls were enrolled. The association between plasma NT-proBNP levels obtained in the first trimester and perinatal complications were evaluated. Results: NT-proBNP levelsstrongly predicted low birth weight (AUC=0.842, p<0.001). NT-proBNP and birth weight were negatively correlated (r= -0.323, p=0.005). NT-proBNP was found to be an individual determinant of low birth weight in univariate analysis (OR:1.03; 95%CI:1.01-1.04). Conclusion: NT-proBNP levels can be useful to predict low birth weight in pregnancies with chronic HT.