INTRODUCTION: This study aimed to evaluate the impact of Total Laboratory Automation (TLA) with the implementation of the Beckman Coulter DxA Fit 5000 on laboratory workload and performance.
METHODS: A comparative analysis was conducted at the Biochemistry Laboratory of Zonguldak Bülent Ecevit Hospital, covering the pre-automation period (May 1–June 30, 2024) and the post-automation period (May 1–June 30, 2025). Key performance indicators included mean turnaround time (TAT), median TAT, 90th percentile TAT, the proportion of outliers at 60 and 120 minutes, and achievement of emergency department (ED) benchmarks (≤45 minutes). Test volumes were monitored to ensure stability as a covariate.
RESULTS: Following the introduction of TLA, mean TAT decreased by up to 20%, median TAT by 18%, and 90th percentile TAT by 25% across inpatient and outpatient tests. Outlier rates at 60 minutes declined from 12% to 10% in inpatients and from 83% to 55% in outpatients. For STAT testing, the proportion of samples meeting the 45-minute ED benchmark increased from 65% to 88%.Total test volumes remained largely stable between periods, indicating that observed TAT improvements were attributable to automation rather than changes in sample volume. Glucose exhibited the shortest mean TAT, whereas gamma-glutamyl transferase had the longest. In outpatient testing, C-reactive protein demonstrated the highest compliance with the 60-minute TAT benchmark, while human chorionic gonadotropin showed the lowest; however, all outpatient tests were completed within 120 minutes.
DISCUSSION AND CONCLUSION: The implementation of TLA significantly improved numerical TAT metrics, reduced outlier frequencies, and increased achievement of ED benchmarks, while maintaining stable test volumes, highlighting enhanced efficiency, predictability, and workflow stability in a high-volume university hospital laboratory setting.

INTRODUCTION: Brucella species are highly infectious organisms that can gain access to the human body through various routes, including the gastrointestinal and respiratory tracts, conjunctiva, and eroded skin. In some cases, they may also enter the bloodstream directly, as in transfusion-related cases or via transplacental transmission. The aim of this study was to evaluate the potential role of serum anti-inflammatory and antioxidant factors such as nuclear factor erythropoietin-2 (NRF2), heme oxygenase (HO-1), and neopterin in brucellosis and to investigate their relationship with serologic anti-Brucella antibody findings.
METHODS: A total of 90 patients with brucellosis and 30 healthy control individuals were included in the study. The patient group was divided into three subgroups according to antibody titers: 30 patients with a 1/160 titer, 30 patients with a 1/320 titer, and 30 patients with a 1/640 titer. Blood samples were collected and transferred into biochemistry tubes containing gel. The tubes were then centrifuged at 4000 rpm for 10 minutes to separate the serum. The separated serum samples were stored at -80°C. Serum levels of NRF2, HO-1, and neopterin were measured using the ELISA method.
RESULTS: No significant differences in biomarker levels were observed between gender or age groups. However, biomarker levels varied significantly according to antibody titer. Healthy controls exhibited the lowest levels of NRF2, HO-1, and neopterin, whereas the 1/640 titer group exhibited the highest levels. NRF2, HO-1, and neopterin levels in-creased progressively with rising anti-Brucella antibody titers (p<0.01).
DISCUSSION AND CONCLUSION: NRF2, HO-1, and neopterin levels were positively correlated with antibody titers, suggesting that these biomarkers may play a role in the immune response to brucellosis. Further studies with larger patient groups are needed to better understand and confirm these findings.

INTRODUCTION: This study aims to analyze the plasma free amino acid profiles pre and post dialysis in patients with chronic kidney failure (CRF), and to evaluate their potential utility in diagnosis and treatment by comparing them with profiles from a healthy control group.
METHODS: Plasma samples were collected from 46 healthy control and 46 patients diagnosed with CRF who applied to Şanlıurfa Harran University Medical Faculty Dialysis Department. Plasma free amino acid profiles were analyzed with LC-MS/MS.
RESULTS: Mean values of alanine, arginine, aspartic acid, citrulline, histidine, methionine, tyrosine, hydroxyproline, glycine, leucine, isoleucine, lysine, ornithine, phenylalanine, proline, serine glutamic acid, glutamine, valine, taurine, alloisoleucine, alphaaminoadipic acid, anserine, gammaaminobutyric acid, 1- methylhistidine, 3-methylhistidine, 5-hy-droxytryptophan levels in CRF patients exhibited higher levels compared to the control group. Phosphoethanolamine, cystine, alphaaminobutyric acid, betaaminoisobutyric acid and tryptophan were found to be lower in CRF patients than control group. When post-dialysis compared to pre-dialysis; there was an increase in citrulline, histidine, alanine, arginine, aspartic acid, glutamic acid, glycine, cystine, isoleucine, proline, phosphoethanolamine, taurine, alloisoleucin, alphaaminoadipic acid, ancerine, alphaaminobutyric acid, betaaminoisobutyric acid, beta alanin, 1-methylhistidine, 5-hydroxytryptophan levels; there was a decrease was observed in glutamine, leucine, lysine, ornithine, phenylalanine, serine, valine, asparagine, methionine, tryptophan, tyrosine, hydroxyproline, gammaaminobutyric acid, 3-methylhistidine levels. Citrulline, glycine, anserine, alphaaminobutyric acid, gammaaminobutyric acid, phosphoethanolamine and taurine levels were found to be significant in the Paired samples test, which was used to test the significance of the difference between the arithmetic means of the groups (p<0.05).
DISCUSSION AND CONCLUSION: More studies were needed to understand the role of amino acids in CRF.

INTRODUCTION: The proliferation of digital educational platforms has transformed medical education delivery, yet concerns regarding content quality persist. This study systematically evaluates clinical biochemistry educational content on YouTube and examines relationships between content characteristics and audience engagement.
METHODS: A systematic YouTube search was conducted August 1–15, 2025, using standardized clinical biochemistry education terms. Videos were evaluated using a validated 10-point quality assessment framework encompassing scientific accuracy, educational structure, producer credibility, and technical accessibility. Statistical analyses included descriptive statistics, correlation analysis, and linear regression modeling.
RESULTS: Of 152 identified videos, 69 met inclusion criteria (total views: 14,247,835; average of 206,491±167,420). Quality assessment revealed 65.2% (n=45) demonstrated high quality (8–10 points), 30.4% (n=21) moderate quality (5–7 points), and 4.4% (n=3) low quality (1–4 points). Pearson correlation identified robust positive association between quality scores and view counts (r=0.782, p<0.001), with quality accounting for 61.2% of viewership variance (r²=0.612). Corporate training channels (34.8%) demonstrated highest mean viewership (n=247,825).
DISCUSSION AND CONCLUSION: While YouTube is a valuable platform for clinical biochemistry education, quality standardization and accessibility improvements are needed. The analysis reveals the potential and diversity of digital educational tools in clinical biochemistry education.

INTRODUCTION: The relationship between polycythemia and hereditary hemochromatosis (HH) has been investigated in several studies. This study aimed to evaluate the association between iron parameters and Hemochromatosis Protein (HFE) gene mutations in patients with primary or secondary polycythemia, as well as in non-polycythemic patients with elevated iron parameters.
METHODS: A total of 106 patients who were evaluated for polycythemia or underwent HFE mutation testing due to elevated transferrin saturation (TS) and ferritin levels in the hematology department between 2015 and 2022 were retrospectively reviewed.
RESULTS: The median age of the 106 patients (77 male, 29 female) was 54 years (range, 19–83). HFE gene mutations were detected in 44 patients (41.5%; 31 male, 13 female). Thirty-seven patients (35%) with Myeloproliferative Neoplasms (MPNs) were classified as Group 1, 52 (49%) with secondary polycythemia as Group 2, and 17 (16%) who underwent HFE mutation testing due to elevated TS/ferritin levels without polycythemia as Group 3. The mean TS level in Group 1 was significantly higher than in Group 2 (p=0.032). Among HFE(+) patients, mean TS was significantly higher in Group 3 compared with Group 2 (p=0.023). When all polycythemic HFE(+) patients (primary + secondary) were compared with non-polycythemic HFE(+) patients, mean TS was significantly higher in non-polycythemic patients (p=0.026).
DISCUSSION AND CONCLUSION: The relatively high frequency of HFE positivity in patients with secondary polycythemia, together with its association with lower TS levels, suggests that the possibility of HH should not be overlooked in secondary polycythemia, even at lower TS levels.

INTRODUCTION: Oocyte quality and maturation are critical factors determining successful fertilization and embryo development in vitro. However, delays in processing ovarian tissues after animal slaughter or collection can negatively impact oocyte viability and developmental potential. This study investigated the effect of Quercetin on the maturation of bovine oocytes subjected to a field-relevant post-mortem delay.
METHODS: Oocytes were isolated from ovaries approximately six-hour delay post-collection, mimicking practical conditions encountered in tissue handling. Then, they were treated with hyaluronidase, mechanically denuded, and cultured with quercetin at concentration of 15 µg/mL, against a control group.
RESULTS: The results demonstrated that quercetin improved the extrusion of polar bodies compared to the control group. Additionally, pH variations were noted among control and quercetin treated group, potentially influencing maturation outcomes.
DISCUSSION AND CONCLUSION: These findings highlight that quercetin at 15 µg/mL significantly enhances the maturation of bovine oocytes, suggesting its potential to modulate oocyte quality in vitro.

INTRODUCTION: Although the C-reactive protein/albumin ratio is accepted as a current biomarker in many diseases, such as myocardial infarction, studies on its clinical relevance in patients diagnosed with non-ST elevation myocardial infarction (NSTEMI) are limited. This study aimed to evaluate the prognostic significance of the C-reactive protein/albumin ratio in patients with NSTEMI.
METHODS: This retrospective study included 300 patients diagnosed with NSTEMI. All patients were compared in terms of survival status and clinical, biochemical, and inflammatory markers. Logistic regression and receiver operating characteristic (ROC) curve analyses were used to determine the predictive value of CRP, albumin, and the CRP/albumin ratio.
RESULTS: The CRP/ALB ratio was significantly higher in the mortality group than in the survivor group (p=0.001), whereas albumin levels were significantly lower (p=0.001). This ratio had a strong positive correlation with the CHA₂DS₂–VASc score (ρ=0.711, p<0.001) and independently predicted in-hospital mortality (OR=1.485, p=0.046). ROC analysis revealed an area under the curve (AUC) of 0.891 for the CRP/albumin ratio, which was significantly better than that of CRP or albumin alone (p<0.001). Although the combined CRP-albumin model had a slightly higher AUC (0.894), it was not significantly different from the C-reactive protein/albumin ratio.
DISCUSSION AND CONCLUSION: The CRP/ALB ratio is a strong and independent predictor of in-hospital mortality in patients with NSTEMI. As an easily accessible and cost-effective biomarker, it provides valuable prognostic information and may improve early risk stratification and treatment strategies in clinical settings.

Alzheimer’s disease (AD) is a progressive neurodegenerative disorder and the most common cause of dementia world-wide. Traditionally diagnosed based on clinical syndromes, AD is now increasingly defined as a biologically identifiable disease, reflecting advances in fluid and imaging biomarkers. Contemporary diagnostic frameworks emphasize the integration of clinical assessment with biological confirmation and staging, primarily through biomarkers of amyloid-β deposition, tau pathology, and neurodegeneration. This review provides a structured overview of current clinical staging systems and biomarker-based diagnostic approaches in Alzheimer’s disease, with particular emphasis on analytical standardization, interpretive frameworks, and methodological limitations relevant to routine clinical practice. The revised 2024 Alzheimer’s Association criteria are discussed, including the numeric clinical staging model and the AT(N) biomarker classification, which together enable biologically grounded diagnosis independent of symptom severity. Core biomarkers are categorized into Core 1 biomarkers, used for biological confirmation of AD pathology, and Core 2 biomarkers, which characterize disease burden, neurodegeneration, and progression. Cerebrospinal fluid (CSF) biomarkers remain the reference standard for in vivo biological diagnosis, while blood-based biomarkers—enabled by ultrasensitive analytical platforms—have emerged as scalable and minimally invasive tools for screening, risk stratification, and longitudinal monitoring. Multimodal biomarker profiling further supports the identification of mixed or non-Alzheimer comorbid pathologies, which are common in older populations and critically influence clinical interpretation and therapeutic decision-making. Despite their clinical utility, significant challenges remain. Measurement variability related to pre-analytical handling, assay performance, inter-laboratory differences, and lot-to-lot reagent effects continues to limit universal cut-off definition and broad clinical implementation. International standardization initiatives, reference materials, external quality control programs, and automation-ready assays have substantially improved analytical performance, yet pre-analytical variability—particularly for amyloid-β—remains a key unresolved issue. In conclusion, Alzheimer’s disease biomarkers provide a powerful framework for biological diagnosis and staging, but their clinical value increasingly depends on rigorous standardization, harmonization, and context-aware interpretation rather than on the discovery of new markers alone.