Tıbbi Biyokimya Uzmanlarının 1 Yıllık Covid-19 Pandemi Serüveni

Amaç: Devam eden koronavirüs hastalığı-2019 (COVID19) pandemisinde tıbbi biyokimya laboratuvarlarının önemi daha da artmıştır. Bu çalışmadaki amaç 2020 mart ayından 2021 mart ayına kadar 1 yıllık süreçte tıbbi biyokimya uzmanları ve tıbbi biyokimya laboratuvarlarının mevcut durumunu ortaya koymaktır. Materyal ve Metod: Hazırlanan anket internet aracılığı ile katılımcılara gönderilerek cevapları değerlendirilmiştir. Bulgular: Ankete katılan 210 tıbbi biyokimya uzmanından %32,4’ü erkek %67,6’sı kadın ve %62,2’si 40-60 yaş grubunda olup %47,8’si 11-20 çalışma yılındadır. En fazla katılım Marmara bölgesinden olup %78,6 kamu, %21,4 özel laboratuvarlarda çalışmaktaydı. Birlikte çalışan 2-5 uzmanın olduğu %46,4 kişi vardı. Pandemi kliniklerinde görev alan %46,4 uzman olmuş ve %42,3 tek uzman olduğundan devamlı görevde bulunmuştur. Katılımcıların %19,2’si COVID-19 hastalığı geçirmiş, aşılanan %92,3 uzman vardır. Polimeraz zincir reaksiyon (PCR) test çalışmalarına destek veren %20,4 tıbbi biyokimya uzmanı olmuştur. Sonuç: Tıbbi Biyokimya laboratuvarlarının salgınlara en hazırlıklı birimler olduğu ve gereken yönetsel becerileri derhal hazırlıklı bir şekilde uygulamaya koymuş olan tıbbi biyokimya uzmanlarının COVID-19 pandemi dönemindeki aktif rolü gözler önüne serilmiştir. Hekim olarak pandemi servis ve polikliniklerinde çalışarak ekiplere destek vermiş ve gerektiğinde verebileceklerini de ortaya koymuşlardır. Havalandırma, kişisel koruyucu ekipman, malzeme temini, katsayı eşitsizliği gibi sorunlar yaşanmasına rağmen, kliniklerle iş birliği, genel bilgilendirme, rehberlerin hazırlanması, numune transferleri eğitimleri tıbbi biyokimya uzmanları tarafından sağlanmıştır

Birinci Basamakta Evlilik Öncesi Hemoglobinopati Taramasına Farklı Bir Bakış

Objective: Despite the high prevalence of hemoglobinopathies (HBP), the most common single-gene disorders in Turkey, data in some regions are lacking. We aimed to evaluate the effectiveness of the hemoglobinopathy premarital screening program (PMS) and to investigate the contribution of efficient use of complete blood count (CBC) parameters on cost-effectivity. Methods: HMP diagnosed 49171 subjects in 4 years and CBC of subjects with HMP in a year were evaluated retrospectively. Results: The total incidence rate of HBP was 3.41%, ?-thalassemia trait (?-TT) was 1.98%, HMP incidence in the PMS group was 2.43%, ?-TT was 1.08%. Moreover, HbF, HbD, HbC, HbS, HbE and HbJ were detected with the incidences of 0.49%, 0.14%, 0.05%, 0.04%, 0.007% and 0.009%, respectively. RDW/MCH ratio compared to other indices was the most successful for both sexes in diagnostic efficiency of HBP (AUC: male:0.922 - female:0.961) and ?-TT (AUC: male;0.928 - female:0.961). Conclusions: PMS was found to be an effective application program in HMP screening. RDW/MCH ratio was the most useful and easy parameter in detecting HBP and ?-TT in PMS and in terms of reducing unnecessary test requests and cost-effectiveness in public health screenings.Amaç: Türkiye'de en sık görülen tek gen hastalıkları olan hemoglobinopatilerin (HBP) yüksek prevalansına rağmen, bazı bölgelerde veri bulunmamaktadır. Hemoglobinopati evlilik öncesi tarama programının (PMS) etkinliğini değerlendirmeyi ve tam kan sayımı (CBC) parametrelerinin etkin kullanımının maliyet-etkililiğe katkısını araştırmayı amaçladık. Gereç ve Yöntem: 4 yılda 49,171 HMP tanısı konan olgu ve bir yılda HMP’si olan olguların tam kan sayımları geriye dönük olarak değerlendirildi. Bulgular: HBP'nin toplam insidans oranı %3.41, ?-talasemi taşıyıcılığı (?-TT) %1.98 bulundu. PMS grubunda HMP insidansı %2.43, ?-TT %1.08 idi. Ayrıca HbF, HbD, HbC, HbS, HbE ve HbJ sırasıyla %0.49, %0.14, %0.05, %0.04, %0.007 ve %0.009 oranında tespit edildi. ROC analizinde diğer indekslere kıyasla RDW/MCH oranı, HBP (erkek:0.922- kadın:0.961) ve ?-TT (erkek;0.928- kadın:0.961) tanısal etkinliğinde her iki cinsiyet için de en başarılıydı. Sonuç: PMS, HBP taramasında etkili bir uygulama programı olarak bulundu. RDW/MCH oranı; HBP ve ?-TT'nin saptanmasında ve halk sağlığı taramalarında gereksiz test isteklerinin azaltılması ve maliyet etkinliği açısından en kullanışlı parametreydi

Assessment of intracellular zinc levels in infants with food protein-induced allergic proctocolitis

Background: Food protein-induced allergic proctocolitis (FPIAP) is characterized by bloody stools in well-appearing infants. Zinc is a micronutrient that plays a crucial role in immune modulation and is essential for cellular function during immune response. Although there are studies on the assessment of intracellular zinc levels in allergic diseases, no data is available on erythrocyte zinc levels of patients with FPIAP. Objective: This study aimed to assess the erythrocyte zinc levels of children with allergic proctocolitis and compare zinc levels with clinical and demographic characteristics. Methods: This was a case-control study that prospectively compared 50 patients with FPIAP and 50 healthy children without malnutrition. The erythrocyte zinc levels of children were determined using atomic absorption spectrophotometry. Results: Fifty patients with FPIAP, including 28 (51%) girls, with median age of 7.1 +/- 2.9 (3-14) months and 50 healthy children, including 26 (53.1%) girls, with median age of 7.7 +/- 2.8 (3-13) months were included in the study. Seventy percent (n = 35) of the patients with FPIAP started to have symptoms while they were exclusively breastfeeding. Offending allergen foods were cow's milk (78%), egg (40%), sesame (10%), hazelnut (8%), almond (6%), beef (6%), and peanuts (6%, n = 3). Intracellular (erythrocyte) zinc levels in patients with FPIAP were lower than in the healthy control group (495.5 +/- 134 mu g/dL, 567.3 +/- 154.4 mu g/dL, respectively, P = 0.01). Patients with FPIAP aged younger than 6 months had lower intracellular zinc levels compared with those aged above 6 months (457 +/- 137 mu g/dL; 548 +/- 112 mu g/dL, respectively, P = 0.01). There was no relationship between zinc levels and time of symptom onset, presence of concomitant disease, being allergic to multiple foods, and family history of atopy (P > 0.05). Conclusions: FPIAP is a food allergy with limited information on its pathogenesis. Considering the beneficial effects on gastrointestinal system epithelia, zinc may be involved in the patho-genesis of FPIAP. Future comprehensive prospective research on this subject is of importance. (c) 2023 Codon Publications. Published by Codon Publications

Cardiovascular disease risk prediction in scleroderma

OBJECTIVE: Cardiovascular disease risk prediction in scleroderma is important. In this study of scleroderma patients, the aim was to investigate the relationship between cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide and cardiovascular disease risk with the Systematic COronary Risk Evaluation 2 model of the European Society of Cardiology.METHODS: Systematic COronary Risk Evaluation 2 risk groups of 38 healthy controls and 52 women with scleroderma were evaluated. Cardiac myosin-binding protein-C, sensitive troponin T, and trimethylamine N-oxide levels were analyzed with commercial ELISA kits.RESULTS: In scleroderma patients, cardiac myosin-binding protein-C and trimethylamine N-oxide levels were higher than healthy controls but sensitive troponin T was not (p= 10.28 ng/mL) could predict high -moderate-Systematic COronary Risk Evaluation 2 risk 15 times higher than those with low trimethylamine N-oxide (= 8.29 ng/mL) levels could predict significantly higher Systematic COronary Risk Evaluation 2 risk than low cardiac myosin-binding protein-C (<8.29 ng/mL) levels (OR: 11.00, 95%CI 2.786-43.430).CONCLUSION: Noninvasive cardiovascular disease risk prediction indicators in scleroderma, cardiac myosin-binding protein-C, and trimethylamine N-oxide could be recommended to distinguish between high-moderate risk and low risk with the Systematic COronary Risk Evaluation 2 model

Serum Neudesin Levels in Obese Adolescents

Objective: Advances in knowledge of neurotrophic factors are now revealing the complex control of energy homeostasis and appetite, as well as the crucial role these factors play in nervous system function. The aim of this study was to assess serum levels of neudesin in adolescents with obesity and to examine the relationship between these levels and metabolic outcomes. Methods: Adolescents, aged 10-17 years were enrolled. Subjects were divided into normal weight, obese and morbidly obese subgroups. Serum neudesin concentrations were compared between the groups. Results: In total, 88 adolescents were recruited, of whom 30 (34.1%) were normal weight, 15 (17.0%) were obese and 43 (48.9%) were morbidly obese. Neudesin levels were significantly lower in obese adolescents than in the control group (p=0.013). A correlation analysis applied to the whole study group revealed a negative correlation between serum neudesin concentration and body mass index (BMI) z scores (r=-0.40, p<0.001). Serum neudesin levels tended to increase in adolescents with metabolic syndrome, insulin resistance, dyslipidaemia, and hypertension but the differences were not significant (p=0.259, p=0.246, p=0.259, and p=0.523, respectively). Conclusion: Serum neudesin levels were significantly correlated with BMI z score in obese adolescents. Generally, serum neudesin levels were low in obese and morbidly obese adolescents and tended to increase with the appearance of metabolic disorders. Both obesity and associated metabolic disorders have multifactorial causes. Therefore, we suggest that the role of the neudesin molecule in the regulatory mechanisms of obesity and metabolic disorders should be further investigated with well-designed studies enrolling larger groups

Diagnostic accuracy of adropin as a preliminary test to exclude acute pulmonary embolism: a prospective study

Background This study aims to investigate the diagnostic accuracy of adropin as a biomarker to exclude the diagnosis of acute pulmonary embolism (PE). Methods Patients admitted to the emergency department of a tertiary health centre between August 2019 and August 2020 and diagnosed with PE were included in this prospective cohort study. The amount of serum adropin was determined in patients with (PE) and compared with that of healthy volunteers. Receiver operating characteristic analysis was performed with the obtained data, and the area under the curve (AUC) with a 95% confidence interval was determined. The parameters of diagnostic accuracy for PE were determined. Results A total of 57 participants were included in the study (28 controls and 29 PE patients). The mean adropin level in the PE group was 187.33 +/- 62.40 pg/ml, which was significantly lower than that in the control group (524.06 +/- 421.68 pg/ml) (p < 0.001). When the optimal adropin cut-off value was 213.78 pg/ml, the likelihood ratio of the adropin test was 3.4, and the sensitivity of the adropin test at this value was 82% with specificity of 75% (95% CI; AUC: 0.821). Conclusion Our results suggest that adropin may be considered for further study as a candidate marker for the exclusion of the diagnosis of PE. However, more research is required to verify and support the generalizability of our study results

Long-lasting cognitive effects of COVID-19: is there a role of BDNF?

Coronavirus disease 2019 (COVID-19) affects numerous systems of the body during the illness, and there have been long-lasting effects. BDNF plays an important role in synaptic plasticity and synaptic communication. According to the inclusion and exclusion criteria, 54 patients who had COVID-19 infection participated in this study. Thirty-six age-, sex-, body mass index (BMI)-, education level- and smoking status-matched healthy controls were included in the present study. All participants were individually administered the Stroop test and Visual Aural Digit Span Test Form B (VADS-B). Serum BDNF levels were measured by ELISA. Stroop test word reading spontaneous correction number and reading time, word color saying wrong number, spontaneous correction number and reading time, box color speaking spontaneous correction number and reading time, Stroop interference and speed factor duration were significantly higher in the COVID-19 group than in the control group. All scores of the VADS-B test were found to be significantly lower in the COVID-19 group. The mean serum BDNF levels were found to be 10.9 +/- 6.9 ng/ml in the COVID-19 group and 12.8 +/- 6.4 ng/ml in the healthy control group. Two-way ANOVA showed that the serum mean BDNF level was significantly lower in the COVID-19 group than in the control group. Gender had a significant effect on BDNF levels (F = 12.21; p = 0.008). The present study is the first to demonstrate the association between the role of serum BDNF and cognitive decline in patients with COVID-19 infection. Additionally, there is a significant role of male gender in terms of lower BDNF level and cognitive decline

Investigation of Factors Affecting Viral Clearance Time by Real-Time Polymerase Chain Reaction Method in Nasopharyngeal Swab Samples of COVID-19 Patients

The coronavirus disease-2019 (COVID-19) pandemic continues to threaten the lives of millions of people. Viral shedding through the respiratory tract is the main risk factor for the transmission of the severe acute respiratory syndrome-2 (SARS-CoV-2) virus from sick individuals to healthy individuals. In this study, we aimed to investigate the viral clearance (VC) time in PCR tests of COVID-19 patients and the possible factors affecting this time. Seventy patients older than 18 years of age whose presence of SARS-CoV-2 virus was proven by real-time polymerase chain reaction (Rt-PCR) in nasopharyngeal swab samples were included in the study. The presence of SARS-CoV-2 RNA was investigated by RT-PCR in nasopharyngeal swab samples at 48-72 hour intervals, five days after the initial diagnosis. Demographic, physical examination, laboratory test, computed tomography (CT) results, concomitant diseases, and duration of VC were recorded. Of the cases, 41 were female and 29 were male. The mean age was 45.8 +/- 19.2 years. According to the CT results, in the group with no involvement, local involvement and widespread involvement, the duration of VC was 9.66 +/- 5.91 days, 9.99 +/- 4.68 days, and 10.94 +/- 5.34 days, respectively (p>0.05). While the duration of VC was determined as 8.93 +/- 4.33 days in the group without comorbidity, this period was found to be 12.26 +/- 5.69 days (p=0.025) in the group with the comorbidity. It was determined that the duration of VC was 9.55 +/- 6.37 days in women and 9.20 +/- 7.22 days in men (p=0.040). The duration of VC was found to be 10.18 +/- 7.1 days in patients over 50 years of age and 8.87 +/- 5.15 days under 50 years of age (p=0.03). A significant correlation was found between the laboratory test lactate dehydrogenase level and VC duration (p=0.007). However, a significant relationship could not be established between other laboratory test results and the duration of VC. In this retrospective observational study, the relationship between viral clearance duration in Rt-PCR and gender, age, CT results, comorbidities and laboratory results in nasopharyngeal swab samples was investigated and it was determined that the duration of VC was significantly prolonged in case of female gender, being over 50 years old and having a comorbid disease. The results obtained may contribute to predict the isolation times of the patients and to reveal the factors that may affect viral shedding

The association of TSH-receptor antibody with the clinical and laboratory parameters in patients with newly diagnosed Graves' hyperthyroidism: experience from a tertiary referral center including a large number of patients with TSH-receptor antibody-negative patients with Graves' hyperthyroidism

Introduction: Although the TSH-receptor antibody (TRAb) plays a central role in the pathogenesis of Graves' disease (GD), the association between TRAb at first diagnosis and clinical and laboratory parameters is not well known. On the other hand, a minority of patients with GD may be TRAb negative, and there is a lack of adequate evidence to demonstrate the clinical and laboratory characteristics of these patients. Therefore, we aimed to investigate the association of TRAb at the initial diagnosis of GD with the clinical and laboratory parameters in a large number of patients with GD and to compare the clinical and laboratory parameters between patients with high TRAb levels and TRAb-negative patients. Material and methods: This study included 440 patients [326 (74%) female, 114 (26%) male]. All patients were classified according to gender, age, smoking habit, and TRAb levels. Results: TRAb levels were significantly higher in male compared to female patients and in smokers compared to non-smokers. Smoking male patients had the highest TRAb levels. In regression analysis, goiter size, male gender, cigarette smoking, Graves' orbitopathy, fT3, and anti-TPO antibody levels were independently associated with high TRAb levels, while age at diagnosis and fT4 levels were not independently associated with high TRAb levels. TRAb-negative GD was diagnosed in 80 (18%) patients. TRA-negative patients had markedly less severe clinical and laboratory hyperthyroidism compared to patients with high TRAb levels. Moreover, the smoking habit was significantly lower in patients with TRAb-negative GD. Conclusions: According to our study results, TRAb levels at the initial diagnosis of GD are differently associated with clinical and laboratory parameters. Male patients and smoking patients with GD tended to have markedly higher TRAb levels and more severe clinical hyperthyroidism. Therefore, besides other contributing factors, male gender and smoking may affect TRAb levels and consequently the severity of hyperthyroidism in patients with GD. Furthermore, male gender and smoking may have a synergistic effect on TRAb levels and consequently on the severity of hyperthyroidism in patients with GD

Investigation of Serum Folate-Receptor-1 in Patients with Non- Small Cell Lung Cancer

Objective: Histopathological overexpression of folate receptor-1(FOLR1) involved in folate transport in cell growth has been reported in various cancers. Increased serum FOLR1 (sFOLR1) has also been reported in epithelial ovarian cancer. The aim was to investigate sFOLR1 levels in non-small cell lung cancer(NSCLC) patients and the response prediction of the standard chemotherapy targeting folic acid metabolism. Methods: In this prospective study, sFOLR1 levels were investigated in 30 healthy individuals and 60 patients with stage4 malign metastatic NSCLC before and after standard chemotherapy. The commercial immunoassay(ELISA) kit was used for the analysis of sFOLR1. Serum carcinoembryonic antigen(CEA), vitamin B12, and folate levels were also investigated. Results: In NSCLC patients sFOLR1 levels were significantly higher(p<0.001) than the healthy individuals. After 3 months of standard treatment, sFOLR1 was significantly lower than pre-treatment values in NSCLC patients(p<0.001). Diagnostic accuracy was strong in the differentiation of NSCLC patients from healthy individuals(AUC= 0.966). with the cut-off point of 82.45 pg/ml, the sFOLR1 level was performed with 95% sensitivity and 99% specificity. Pretreatment sFOLR1 levels were significantly lower in patients with-response to standard chemotherapy(p<0.01). The best predictive value was determined as 393.80 pg/ml. At the end of the 401 days, a significant difference was found in patients with high sFOLR1 predictive value. The median overall survival(OS) duration was 288 days for all patients (95% GA 198.13-377.87). Median progression-free survival(PFS) was 321 days(95% GA 211.90-430.10). Conclusions: For monitoring standard chemotherapy with drugs targeting folic acid metabolism, sFOLR-1 levels be an biomarker