Laboratuarda numune reddedilme nedenleri ve red oranlarının azaltılması

Objective: Sample rejection is an important step in the laboratory related with the patient safety. Periodical analysis of rejected samples is necessary to define the causes of rejection and follow-up the requirements for staff training. In this study, we aimed to put forth the efficiency of trainings by analyzing the amount of rejected samples in Yozgat State Hospital. Materials and methods: Taken from laboratory information system (LIS), rejected sample statistics related to 8 month-data before training was compared with 8-month data after training between 07.2015 and 10.2016 are examined. These datas were compared in itself and to each other. All statistical analyses were performed using the SPSS (V15). Results: Before training, the average number of patients for the analysis included months was 34,733 [standard deviation (SD) ± 4031], the number of rejected samples was 397.7 (SD ± 85.3) and the average rejection percentage was 1.13 (min-max: 1–1.29). The average number of patients for the after training months was 39,426 (SD ± 4779), the number of rejected samples was 343.2 (SD ± 57.7) and the average rejection percentage was 0.87 (min-max: 0.62–0.98), Rejected sample rates were significantly lower interms of statistics in the after-training group (p = 0.0001). Conclusion: Staff training takes a very important place preventing these mistakes. As it can be seen in our study, training helps decreasing rejection rates. It is suggested to schedule more trainings in order to decrease the rates to lower degrees.Amaç: Numune reddi, laboratuarda hasta güvenliği ile ilgili önemli bir önlemdir. Reddedilen örneklerin periyodik olarak analizi, personelin eğitimin ihtiyaçlarını belirlenmesi ve personele gerekli eğitimlerin verilerek numune güvenliğinin sağlanmasına hizmet eder. Bu çalışmada, Yozgat Devlet Hastanesinde reddedilen numunelerin analiz ederek eğitimlerin etkinliğini ortaya koymayı amaçladık. Materyal-Metod: Numune reddi ile ilgili bilgiler 07,2015 ve 10,2016 tarihleri arasını kapsayacak şekilde Laboratuvar bilgi sisteminden (LIS) alındı. Eğitimden önceki 8 aylık verilerle ile eğitimden sonraki 8 aylık veriler kendi içlerinde ve birbirleriyle karşılaştırıldı. Tüm istatistiksel analizler SPSS (V15) kullanılarak yapıldı. Sonuçlar: Eğitimden önceki sekiz aylık dönem de ortalama hasta sayısı 34.733 (SD ± 4031), reddedilen numune sayısı 397,7 (SD ± 85,3) ve ortalama reddedilme yüzdesi 1,13 (min-max: 1–1,29) olarak bulunmuştur. Egzersiz sonrası aylardaki ortalama hasta sayısı 39.426 (SD ± 4779), reddedilen numune sayısı 343,2 (SD ± 57,7) ve ortalama reddedilme yüzdesi 0,87 (min-max: 0,62–0,98) bulunmuştur. Reddedilen numune oranları, eğitim sonrası grupta istatistiksel olarak anlamlı ölçüde düşük bulundu (p = 0,0001). Tartışma: Personel eğitimi, laboratuvar hataları önlemede çok önemli bir yer tutmaktadır. Çalışmamızda görülebileceği gibi, eğitim numune reddedilme oranlarının düşürülmesine yardımcı olmaktadır. Numune red oranları düşürmek için daha fazla ve iyi planlanmış eğitimlerin yapılması önerilmektedir

The effect of high serum lipid level on benign gallbladder diseases

There is a positive correlation between serum lipid levels and benign gallbladder diseases. We wanted to evaluate whether there is a relationship between the preoperative lipid profiles results with the presence of cholesterolosis, cholesterol polyps and cholelithiasis in the pathological examination. Patients who presented with various symptoms and underwent cholecystectomy surgery in a tertiary university hospital were retrospectively analyzed. Pathological examination records of 331 patients who had undergone cholecystectomy between 2016 and 2020 were obtained retrospectively. The latest lipid profiles results before the cholecystectomy were recorded. Patients were divided into groups according to their lipid profiles periods before cholecystectomy. The cholecystectomy reports of the patients were examined in terms of cholesterolosis, cholesterol polyp, and cholelithiasis. There was no difference between lipid profiles and the pathological subtypes in the patients whose lipid profiles were measured between 0-30 days and 0-90 days preoperatively. There was a significant difference in triglyceride levels between patients with cholesterol polyps and those without polyps, whose lipid profiles were measured within 90-180 days before surgery (p=0.031). There were significant differences in total cholesterol, triglyceride, LDL, and non-HDL levels between patients with and without cholesterolosis (p=0.017, p=0.037, p=0.048, p=0.019, respectively). There was a significant difference in triglyceride levels between patients with cholesterol polyps and those without polyps, whose lipid profiles were was measured within 0-180 days before surgery (p=0.023). There was a significant difference in total cholesterol, LDL, and non-HDL levels between patients with and without cholesterolosis (p=0.017, p=0.021, p=0.03, respectively). There is a positive correlation between preoperative serum lipi

Increased serum concentration of netrin-1 after intravitreal bevacizumab injection: is it a compensatory mechanism to counteract drug side effects?

Background To evaluate alterations in the serum concentrations of vascular endothelial growth factor (VEGF) and netrin-1 after intravitreal bevacizumab (BCZ) injection for the treatment of diabetic macular edema (DME). Methods This prospective case-control study included a total of 50 participants assigned to one of three groups, including 10 individuals with DME and non-proliferative diabetic retinopathy (NPDR), 13 with DME, and proliferative diabetic retinopathy (PDR), and 27 healthy individuals as a control group. Serum VEGF and netrin-1 concentrations were measured by enzyme-linked immunosorbent assays (ELISAs) immediately before, as well as 1 week and 1 month after, intravitreal BCZ injection. Results The mean VEGF serum concentrations in the PDR and NPDR groups were 388.4 and 196.9 pg/mL at baseline, respectively. After 1 week, these concentrations changed to 193.41 and 150.23 pg/mL, respectively (P = 0.001 and P = 0.005, respectively); after 1 month, the concentrations were 97.89 and 76.46 pg/mL, respectively (P = 0.001 and P = 0.009, respectively). The mean netrin-1 serum concentrations in the PDR patients and NPDR groups were 318.2 and 252.7 pg/mL at baseline, respectively. After 1 week, these concentrations increased to 476.6 and 416.3 pg/mL, respectively (P = 0.033 and P = 0.005, respectively), and after 1 month, they were 676.6 and 747.5 pg/mL, respectively (P = 0.001 and P = 0.005, respectively). The correlation analysis revealed a significant inverse relationship between changes in serum VEGF and netrin-1 concentrations in both the PDR and NPDR groups (r = - 0.685, P = 0.029). Conclusions Intravitreal BCZ injections work systemically to significantly decrease serum VEGF levels, leading to a significant upregulation in the concentration of another angiogenic mediator, netrin-1

Assessment of Thiol/Disulphide Homeostasis in Patients with Knee Osteoarthritis

Our aim was to explore the thiol/disulphide homeostasis and the link with functional status in patients who have knee OA. Sixty knee OA patients and 50 healthy individuals were enrolled in this study. We measured serum levels of native thiol, total thiol and disulphide. In order to measure the alterations in functional status such tests as the Western Ontario, MacMaster steoarthitis index (WOMAC), walking test and Visual Analogue Scale (VAS) were utilized. The total thiol levels were higher in the control group than the knee OA patients (P< 0.05). Disulphide and disulphide/total thiol levels were significantly lower when control group were compared to knee OA patients (P< 0.05).Activity pain was negatively associated with native thiol levels (P< 0.05), walking test scores were negatively correlated with the native thiol levels (P< 0.05) and positively correlated with disulphide levels (P< 0.05) in knee OA patients. In knee OA patients, no correlation was observed between thiol/disulphide parameters and WOMAC scores. Conclusion, thiol/disulphide homeostasis is impaired in patients with knee osteoarthritis. Disulphide level increased and thiol level decreased due to oxidative stress. Thiol/ disulphide homeostasis had not noticeable impact on the on functional status. Thiol/disulphide homeostasis may help to explain the pathogenesis of osteoarthritis

Assessment of Thiol/Disulphide Homeostasis in Patients with Knee Osteoarthritis

21-26Our aim was to explore the thiol/disulphide homeostasis and the link with functional status in patients who have knee OA. Sixty knee OA patients and 50 healthy individuals were enrolled in this study. We measured serum levels of native thiol, total thiol and disulphide. In order to measure the alterations in functional status such tests as the Western Ontario, MacMaster Osteoarthitis index (WOMAC), walking test and Visual Analogue Scale (VAS) were utilized. The total thiol levels were higher in the control group than the knee OA patients (P0.05). Disulphide and disulphide/total thiol levels were significantly lower when control group were compared to knee OA patients (P0.05).Activity pain was negatively associated with native thiol levels (P0.05), walking test scores were negatively correlated with the native thiol levels (P0.05) and positively correlated with disulphide levels (P0.05) in knee OA patients. In knee OA patients, no correlation was observed between thiol/disulphide parameters and WOMAC scores. Conclusion, thiol/disulphide homeostasis is impaired in patients with knee osteoarthritis. Disulphide level increased and thiol level decreased due to oxidative stress. Thiol/ disulphide homeostasis had not noticeable impact on the on functional status. Thiol/disulphide homeostasis may help to explain the pathogenesis of osteoarthritis

Evaluation of thiol/disulfide homeostasis in bronchiectasis

Purpose. Thiols are sulfhydryl-containing organic compounds that have an important role in preventing cellular oxidative stress. This study compares the blood oxidative stress marker levels in bronchiectasis cases during their stable periods with healthy controls. Materials and Methods. Seventy-seven patients (49 patients with stable bronchiectasis/28 healthy controls), followed up by the chest disease clinic, were included in the study. Peripheral blood thiol-disulfide parameters (NT: native thiol (-SH); TT: total thiol (-SH + SS); SS: disulfide (-SS); SS-SH: disulfide/native thiol index; SS-TT: disulphide/total thiol index; SH-TT: native thiol/total thiol index), and ischemia-modified albumin (IMA) levels were examined in the stable bronchiectasis group and the control group. Thiol-disulfide homeostasis was evaluated using a novel and automated assay. Findings and Result. Blood native thiol levels in patients with stable bronchiectasis were found to be significantly higher compared with healthy controls. A positive correlation between the total airway disease score and IMA levels was present. Our findings revealed that native thiol levels, which constitute a part of the antioxidant defense system, are increased in patients with stable bronchiectasis

Evaluation of serum vascular endothelial growth factor and netrin-1 levels in patients with neovascular age-related macular degeneration: case-control study

Amaç: Bu çalışmanın amacı, neovasküler yaşa bağlı makula dejenerasyonu (n-YBMD) hastalarında serum vasküler endotelyal büyüme faktörü [vascular endothelial growth factor (VEGF)] ve netrin-1 düzeyini sağlıklı kontrol grubu ile karşılaştırarak, bu vasküler belirteçlerin düzeyindeki değişikliğin sistemik problemlerin belirtisi olup olmadığını araştırmaktır. Gereç ve Yöntemler: Kliniğimizde n-YBMD teşhisi almış ve intravitreal enjeksiyon planlanan 37 hasta ve kontrol grubu olarak katarakt cerrahisi planlanan 34 hasta dâhil edildi. Çalışma ve kontrol grubu hastalarında serum VEGF ve netrin-1 düzeyi enzime bağlı immünosorbent deney yöntemi kullanılarak ölçüldü. Bulgular: Çalışma grubunun medyan yaş değeri 77 (61-84) kontrol grubunun ise 75 (50-87) idi. N-YBMD grubunda serum netrin-1 ve netrin-1/VEGF oranı kontrol grubuna göre anlamlı olarak düşük ve serum VEGF oranı anlamlı olarak yüksek bulundu (tümü p<0,001). Alıcı işletim karakteristiği [receiver operating characteristic (ROC)] analizine göre netrin1 seviyesi n-YBMD’yi tahmin etmek için orta düzeyde bir kesinliğe sahipti. ROC eğrisi altında kalan alan %83,78 [%95 GA (güven aralığı), 68-93,8)] duyarlılık ve %85,29 (%95 GA, 68,9-95) özgüllük ile 0,883 (%95 GA, 0,797-0,970) olarak bulundu. Netrin-1 seviyeleri için en iyi kesim değeri ≤485,1 mg/mL idi ve bu istatistiksel anlamlı olarak değerlendirildi (p<0,001). Sonuç: N-YBMD hastalarında bulunan yüksek VEGF ve düşük netrin-1 serum düzeyi bu hastalığın sistemik ve inflamatuar bir hastalık olduğunu göstermektedir. Düşük serum netrin1/VEGF oranı ise bu hastalıkta birbiri ile ilişkili anjiyogenik mediyatörlerin sistemik dengesinin bozukluğunun göstergesidir.Objective: To compare serum vascular endothelial growth factor (VEGF) and netrin-1 levels in patients with neovascular age-related macular degeneration (n-AMD) with a healthy control group, to investigate whether changes in the level of these vascular markers are a sign of systemic problems. Material and Methods: In our clinic, 37 patients who were diagnosed with n-AMD and were scheduled for intravitreal injection, and 34 patients who were scheduled for cataract surgery as the control group were included in the study. Serum VEGF and netrin-1 levels were measured using the enzymelinked immunosorbent assay method in the study and control group. Results: The median age of the study group was 77 (61-84) and the control group was 75 (50-87). Serum netrin-1/VEGF ratio and netrin1 levels were significantly lower and VEGF levels were significantly higher in n-AMD patients compared to the control group (p<0.001 for all). According to the receiver operating characteristic (ROC) analysis, the netrin-1 level had a moderate precision to predict n-AMD. The area under the ROC curve was 0.883 [95% confidence index (CI), 0.797- 0.970] with a sensitivity of 83.78% (95% CI, 68-93.8) and a specificity of 85.29% (95% CI, 68.9-95). For netrin-1 levels, the best cut-off value was ≤485.1 mg/mL, with a statistically significant difference (p<0.001). Conclusion: Low serum netrin-1 and high VEGF levels detected in patients with neovascular AMD indicate a manifestation of systemic inflammatory disease. The low serum netrin-1/VEGF ratio indicates that the systemic balance of these biomarkers is impaired in this disease

Prognostic significance of C-reactive protein/albumin and neutrophil/lymphocyte ratios in patients with COVID-19

Introduction and aim. COVID-19 causes an uncontrolled and generalized inflammatory response of the host immune system. Early recognition of the disease and early prediction of the clinical course are of great importance. The aim of this study was to evaluate the predictive role of the C-reactive protein/albumin ratio (CAR) and the neutrophil/lymphocyte ratio (NLR) for mortality in patients hospitalized with the diagnosis of COVID-19. Material and methods. The patients, who were hospitalized for COVID-19 and whose CRP, albumin, neutrophil, and lymphocyte levels were documented within the first 24 hours after admission, were analyzed retrospectively. Patients were divided into survivors and non-survivors; the groups were compared. Univariate and multivariate Cox regression models were developed to evaluate the CAR and the NLR as risk factors for mortality in COVID-19 patients. Results. One hundred and thirty patients were included in this study. The mean age of the survivor group (n=114) was 60±16 and 52% were male. The mean age of the non-survivor group (n=16) was 75±13 and 56% were male. In the non-survivor group, the CAR detected at the time of admission to the hospital was significantly higher compared to patients in the survivor group (p=0.026). Conclusion. As a result, the CAR, the NLR and LDH are independent risk factor indicators of mortality in hospitalized patients

Oxidative stress and the importance of H. pylori eradication in patients with functional dyspepsia

Background: To investigage the thiol and disulphide levels in Helicobacter pylori-positive patients with non-ulcer dyspepsia and investigate the change in these levels with eradication therapy. Methods: This is a prospective observational study. A total of 320 patients diagnosed with dyspepsia according to Rome IV criteria were included in the study. First, blood samples were drawn from patients to determine their serum thiol and disulphide levels. Endoscopic biopsy was performed on all patients and the biopsy specimens obtained were examined pathologically. Patients positive for H. pylori were administered eradication therapy. Blood samples were drawn from these patients for the second time, and their serum thiol and disulphide levels were measured. The thiol–disulfide levels of the patients who were successful in H. pylori eradication treatment, with those who were not, were compared before and after the treatment. Results: The mean plasma disulphide level decreased significantly from 14.0 ± 6.6 to 10.9 ± 5.9 µmol/L in H. pylori-positive patients that responded to the H. pylori eradication treatment (P = 0.033). On the other hand, there was an insignificant increase in the mean serum thiol level (341.4 ± 30.5 vs. 342.6 ± 29.8 µmol/L; P = 0.273) and an insignificant decrease in the mean serum disulphide level (15.2 ± 2.5 vs. 14.8 ± 2.3 µmol/L; P = 0.163) in H. pylori-positive patients that did not respond to the H. pylori eradication treatment. Conclusion: The inflammation caused by H. pylori shifted the thiol–disulphide equilibrium in the cell redox system towards the direction of disulphide. The study findings suggest that the restoration of the said hemostatic balance with eradication therapy relieved the organism from oxidative stress

The relationship of serum asymmetric dimethylarginine concentrations and lung involvement in patients with COVID-19 infection

Aim: COVID-19 infections the tissue through angiotensin converting enzyme 2 receptor, which is also expressed on endothelial cells. Endothelial dysfunction may be associated with lung involvement. Asymmetric dimethylarginine (ADMA) is an indirect marker of endothelial dysfunction. The aim of our study was to evaluate ADMA concentrations and to identify its association with lung involvement in patients with COVID19 disease. Methods: We included 42 patients with COVID-19 infection and lung involvement (Group 1). Forty-two age and sex matched patients without pneumonia acted as the control group (Group 2). All patients gave blood samples for ADMA at the 1st month control visit after discharge. We compared C-reactive protein (CRP) and ADMA concentrations in addition to routine biochemical parameters between groups. Results: Patients with lung involvement had higher admission glucose, CRP, and ADMA concentrations, and displayed lower hemoglobin concentration and lymphocyte count compared to patients without lung involvement. Although patients with lung involvement had higher ADMA concentrations with respect to those without; plasma ADMA levels were also higher than normal values in control group. Multivariate analysis identified log CRP concentration (OR= 3.047, 95% CI=1.881-5.023, p<0.001) as the independent predictor for lung involvement. And, there was a correlation between ADMA and CRP (r: 0.318, p: 0.003). Conclusion: We revealed elevated ADMA concentrations as the surrogate of endothelial dysfunction in COVID-19 patients whether they have pneumonia or not