The relationship between epicardial fat thickness and gestational diabetes mellitus

Aim: Gestational diabetes mellitus (GDM) is associated with cardiovascular diseases; however, the relationship between epicardial fat thickness (EFT) and GDM remains unclear. The present study evaluates and compares EFT using transthoracic echocardiography in pregnant women with GDM. Materials and methods: This cross-sectional study included 129 pregnant women in the third trimester: 65 with GDM (GDM group) and 64 with uncomplicated pregnancies (control group). As defined by the World Health Organization, the diagnosis of GDM was based on an abnormal 2-h oral glucose tolerance test (OGTT) results. We used echocardiography to measure EFT in blood samples for all the participants. Results: The postprandial blood glucose level was significantly higher in the GDM group than in the control group (P < 0.001). There were no significant differences in BMI, heart rate, systolic and diastolic blood pressure or lipid parameters between the groups. In the GDM group, isovolumic relaxation time (IVRT) parameters were significantly higher than in the control group. EFT was significantly higher in the GDM group (P < 0.001) and was correlated with postprandial glucose, BMI, age, and heart rate in both the groups. Only postprandial glucose and BMI remained significantly associated with EFT after multiple stepwise regression analysis. Conclusion: Echocardiographically measured EFT was significantly higher in the patients with GDM. The findings show that EFT was strongly correlated with postprandial glucose. © 2014 Nar et al

Evaluation of urinary culture and urinalysis results of pediatric patients prediagnosed with urinary tract infection

Amaç:Bu çalışmada bölgemizde 0-16 yaş grubu çocuk hastalarda üriner sistem infeksiyonuna neden olan bakteriler ve antibiyotik direnç oranlarının belirlenmesi, çeşitli idrar analiz testlerinin kültür sonuçları ile birlikte tanısal uyumunun değerlendirilmesi amaçlanmıştır. Gereç ve yöntem:Mart 2015- Şubat 2016 tarihleri arasında üriner sistem infeksiyonu ön tanısı alan 0-16 yaş grubu çocuk hastalara ait hem kültür hem de idrar analizi istemi olan toplam 982 idrar örneğinin sonuçları retrospektif olarak incelenmiştir. Hastalara ait idrar kültürü sonuçları ile birlikte tam otomatik idrar analizatöründe incelenen lökosit (?10/mL) ve nitrit pozitifliği değerlendirilmiştir. Bulgular:İdrar kültürlerinde üreme tespit edilen 196 hastada rastlanan bakteriler sıklık sırasına göre Escherichia coli (%72), Klebsiella pneumoniae (%8.6), Proteus mirabilis (%7.6), Enterococcus spp (%7) ve diğer bakteriler (%4.8) türleri olmuştur. E.coli ve K. pneumoniae izolatlarında amikasin, fosfomisin, nitrafurontain ve imipeneme karşı direnç gözlenmemiştir ve en etkili antibiyotikler olarak tespit edilmiştir. Kültür sonuçları referans kabul edilerek idrar analiz testlerinden lökosit ve nitrit pozitifliğinin tanısal sensitivite, spesifite, pozitif prediktif değer, negatif prediktif değer ve doğruluk oranları hesaplanmıştır. Bu değerler lökosit için sırasıyla %64.3, %95, %76.4, %91, %88.4 ve nitrit için %17.1, %99, %86, %83.5, %69.8 olarak hesaplanmıştır. Sonuç:Bölgemizde, çocuk hastalarda antibiyotik direnç oranları diğer çalışmalara göre düşük bulunmuştur. Yaptığımız karşılaştırmaya göre idrar analiz sonuçlarının tek başına tanı koydurucu olmadığını, direnç gelişiminin önlenmesi amacı ile antibiyogramların yapılması ve takibi, hızlı tanı amacıyla kullanılan idrar analiz testlerinin kültürün daha verimli değerlendirilmesinde yararlı olacağını düşünmekteyiz.Purpose:The present study aimed to determine the bacteria causing urinary tract infection and their antibiotic resistance rates, and to assess the diagnostic compliance along with the culture results of several urine analysis tests in pediatric patients aged 0–16 years in the present region. Materials and methods:A retrospective analysis was performed to examine the results of a total of 982 urine samples received for both urine culture and analysis. These samples were of pediatric patients aged 0–16 years prediagnosed with urinary tract infection between March 2015 and February 2016. Along with the urine culture results of the patients, leukocyte (?10/mL) and nitrite positivity reviewed in the full automated urine analyzer was also evaluated. Results:The most common bacteria identified in 196 patients in whom growth was detected in urine cultures were Escherichia coli (72%), Klebsiella pneumoniae (8.6%), Proteus mirabilis (7.6%), Enterococcus spp. (7%), and other species (4.8%), as per the order of frequency. In E. coli and K. pneumoniae isolates, no resistance was observed to amikacin, phosphomycine, nitrofurantoin, and imipenem, which were also found to be the most effective antibiotics. Diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates of leukocyte and nitrite positivity were calculated from the urinalysis tests by taking the culture results as reference. These values were found to be 64.3%, 95%, 76.4%, 91%, 88.4% for leukocytes and 17.1%, 99%, 86%, 83.5%, 69.8% for nitrites, respectively. Conclusion:We can say that the antibiotic resistance rates in pediatric patients in our region are found to be lower compared to other studies. According to comparisons we have made, urinary analysis results are not diagnostic alone due to the low correspondence of culture results. The urinalysis tests used for rapid diagnosis will be useful for assessing the culture more efficiently by performing and following antibiograms to prevent the development of resistance

Evaluation of Analytical Process in Clinical Laboratories: Six Sigma Methodology

Amaç: Laboratuvarların analitik güvenilirliği iç kalite kontrol, dış kalite kontrol verilerinin istatistiksel yöntemlerle analiziyle kanıtlanır. Bu yöntemlerden Altı Sigma Metodolojisinde performans, süreç sigma değerleri ile belirlenir. Altı Sigma Metodolojisi sürecin mükemmellikten sapma derecesini gösterir. Bu çalışmada; laboratuvarımızda sık çalışılan testlerin analitik süreç performanslarını Altı Sigma Metodolojisine göre değerlendirmeyi amaçladık. Gereç ve Yöntem: Temmuz - Ekim 2014 iç kalite kontrol verileri laboratuvar bilgi sisteminden elde edildi. Seçilen testler için laboratuvar ortalama, standart sapma, varyasyon ve varyasyon katsayısı hesaplandı. Aylık süreç sigma seviyeleri "(% TEa -% Bias) / % CV" formülüne göre hesaplandı. Sonuçlar sigma değeri = 6 iyi olarak üç gruba ayrıldı. Bulgular: Süreç sigma değeri =6. Results: Tests having a process sigma level of <= 4; in July: level 1; Glucose, Creatinine, level 2; Urea, Glucose, Creatinine, Total Protein, in August: level 1; Alb, ALP, Urea, Glucose, Creatinine, Total Protein, level 2; Alb, ALT, Urea, Glucose, Creatinine, Total Protein September: level 1; Urea, Glucose, Total Protein, level 2; Glucose, Total Protein. Conclusion: This study showed that tests with low process sigma levels in our laboratory can be determined and these tests may ve evaluated as a whole with preanalytical and postanalytical processes. Six sigma methodology may provide a detailed assessment of measurement processes with problematic analytical process sigma levels and controlling the variables

Is CONUT score a prognostic index in patients with diffuse large cell lymphoma?

Background/aim: The aim of the study was to evaluate the effect of Controlling Nutritional Status (CONUT) score on the prognosis in patients with diffuse large B-cell lymphoma (DLBCL). Materials and methods: The present study was a retrospective study. The CONUT score was calculated based on serum albumin, total cholesterol and lymphocyte levels. This study included a total of 266 patients, 131 (49.2%) were female and 135 (50.8%) were male. The median follow-up period was 51 months (range: 1-190). Results: The median age was 64 years. The cut off CONUT was 1.5. There was a significant difference between patients with high (>_ 2) or low (_ 65 years (HR = 1.80, p = 0.028), Eastern Cooperative Oncology Group (ECOG) > 1 (HR = 2.04, p = 0.006), stage IIIA-IVB disease (HR = 2.75, p = 0.001) and the CONUT score (HR = 1.15, p = 0.003) were found statistically significant. In the multivariate analysis for PFS, age >_ 65 years (HR = 2.02, p = 0.007), stage IIIA-IVB disease (HR = 2.42, p = 0.002) and the CONUT score (HR = 1.19, p = 0.001) were found to be significant parameters. Conclusion: High CONUT score reduces OS and PFS in DLBCL. CONUT score is an independent, strong prognostic index in patients with DLBCL

The Relationship Between the Serum RNA Titers of Hepatitis C Virus and Biochemical Parameters in Chronic Hepatitis C Patients

WOS: 000381726500007Objective: Liver biopsy, as well as some non-invasive biochemical parameters are also used in monitoring patients with chronic hepatitis C (CHC). The aim of this study was to investigate the relationship between serum biochemical markers and HCV RNA titers in patients with previously untreated CHC. Materials and Methods: We performed a retrospective study on anti-HCV and HCV-RNA-positive 82 patients with CHC. Eighty two healthy subjects constituted the control group. Complete blood counts, total protein (TP), albumin (ALB), C-reactive protein (CRP), gamma-glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and HCV RNA levels were recorded for each patient and control subject. Neutrophil-lymphocytes ratio (NLR) and the fibrosis index based on the 4 factors (FIB-4 index) were calculated using formulas. Results: There was a significant difference in ALT, AST, GGT, TP, CRP, red cell distribution width (RDW), lymphocytes (LYM), platelets (PLT), FIB-4, and NLR between CHC patients and controls (p=<0.05). Values of HCV RNA viral load were correlated with ALT (r=0.271; p=0.014), TP (r=-0.256; p=0.02), WBC (r=-0.365; p=0.001), NEU (r=-0.362; p=0.001) and NLR (r=0.282; p=0.01) levels. Conclusion: We have shown that ALT, AST, GGT, TP, CRP, RDW, LYM, FIB-4, and NLR values are increased in CHC patients but, LYM and PLT levels were decreased. Also, levels of ALT and NLR have correlated with HCV RNA titers in CHC patients. These results have implied that noninvasive biochemical parameters may contribute to monitoring patients with CHC

Evaluation of urinary culture and urinalysis results of pediatric patients prediagnosed with urinary tract infection

Amaç:Bu çalişmada bölgemizde 0-16 yaş grubu çocuk hastalarda üriner sistem infeksiyonuna neden olan bakteriler ve antibiyotik direnç oranlarinin belirlenmesi, çeşitli idrar analiz testlerinin kültür sonuçlari ile birlikte tanisal uyumunun değerlendirilmesi amaçlanmiştir.Gereç ve yöntem:Mart 2015- Şubat 2016 tarihleri arasinda üriner sistem infeksiyonu ön tanisi alan 0-16 yaş grubu çocuk hastalara ait hem kültür hem de idrar analizi istemi olan toplam 982 idrar örneğinin sonuçlari retrospektif olarak incelenmiştir. Hastalara ait idrar kültürü sonuçlari ile birlikte tam otomatik idrar analizatöründe incelenen lökosit (>=10/mL) ve nitrit pozitifliği değerlendirilmiştir.Bulgular:İdrar kültürlerinde üreme tespit edilen 196 hastada rastlanan bakteriler siklik sirasina göre Escherichia coli (%72), Klebsiella pneumoniae (%8.6), Proteus mirabilis (%7.6), Enterococcus spp (%7) ve diğer bakteriler (%4.8) türleri olmuştur. E.coli ve K. pneumoniae izolatlarinda amikasin, fosfomisin, nitrafurontain ve imipeneme karşi direnç gözlenmemiştir ve en etkili antibiyotikler olarak tespit edilmiştir. Kültür sonuçlari referans kabul edilerek idrar analiz testlerinden lökosit ve nitrit pozitifliğinin tanisal sensitivite, spesifite, pozitif prediktif değer, negatif prediktif değer ve doğruluk oranlari hesaplanmiştir. Bu değerler lökosit için sirasiyla %64.3, %95, %76.4, %91, %88.4 ve nitrit için %17.1, %99, %86, %83.5, %69.8 olarak hesaplanmiştir.Sonuç:Bölgemizde, çocuk hastalarda antibiyotik direnç oranlari diğer çalişmalara göre düşük bulunmuştur. Yaptiğimiz karşilaştirmaya göre idrar analiz sonuçlarinin tek başina tani koydurucu olmadiğini, direnç gelişiminin önlenmesi amaci ile antibiyogramlarin yapilmasi ve takibi, hizli tani amaciyla kullanilan idrar analiz testlerinin kültürün daha verimli değerlendirilmesinde yararli olacağini düşünmekteyiz.Purpose:The present study aimed to determine the bacteria causing urinary tract infection and their antibiotic resistance rates, and to assess the diagnostic compliance along with the culture results of several urine analysis tests in pediatric patients aged 0-16 years in the present region.Materials and methods:A retrospective analysis was performed to examine the results of a total of 982 urine samples received for both urine culture and analysis. These samples were of pediatric patients aged 0-16 years prediagnosed with urinary tract infection between March 2015 and February 2016. Along with the urine culture results of the patients, leukocyte (>=10/mL) and nitrite positivity reviewed in the full automated urine analyzer was also evaluated.Results:The most common bacteria identified in 196 patients in whom growth was detected in urine cultures were Escherichia coli (72%), Klebsiella pneumoniae (8.6%), Proteus mirabilis (7.6%), Enterococcus spp. (7%), and other species (4.8%), as per the order of frequency. In E. coli and K. pneumoniae isolates, no resistance was observed to amikacin, phosphomycine, nitrofurantoin, and imipenem, which were also found to be the most effective antibiotics. Diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy rates of leukocyte and nitrite positivity were calculated from the urinalysis tests by taking the culture results as reference. These values were found to be 64.3%, 95%, 76.4%, 91%, 88.4% for leukocytes and 17.1%, 99%, 86%, 83.5%, 69.8% for nitrites, respectively.Conclusion:We can say that the antibiotic resistance rates in pediatric patients in our region are found to be lower compared to other studies. According to comparisons we have made, urinary analysis results are not diagnostic alone due to the low correspondence of culture results. The urinalysis tests used for rapid diagnosis will be useful for assessing the culture more efficiently by performing and following antibiograms to prevent the development of resistance

The Relationship Between the Serum RNA Titers of Hepatitis C Virus and Biochemical Parameters in Chronic Hepatitis C Patients

Amaç: Karaciğer biyopsisinin yanı sıra noninvaziv bazı biyokimyasal parametreler de kronik hepatit C (KHC) takibinde kullanılmaktadır. Bu çalışmanın amacı, daha önce tedavi edilmemiş kronik HCV hastalarında serum biyokimyasal belirteçler ve HCV RNA titreleri arasındaki ilişkiyi araştırmaktır.Gereç ve Yöntemler: Anti-HCV ve HCV-RNA pozitif 82 KHC hastası retrospektif olarak incelendi. Hastaneye başvurmuş herhangi bir hastalığı olmayan 82 sağlıklı birey kontrol grubu olarak belirlendi. Hasta ve kontrol grubundaki her bir bireyin, tam kan sayımı, total protein (TP), albumin (ALB), C-reaktif protein (CRP), ?-glutamil transpeptidaz (GGT), aspartat aminotransferaz (AST), alanin aminotransferaz (ALT) ve HCV RNA düzeyleri kaydedildi. Nötrofillenfosit oranı (NLR) ve 4 faktöre dayalı fibroz endeksi (FIB-4 endeksi) formüller kullanılarak hesaplandı.Bulgular: KHC hasta ve kontrol grubu arasında ALT, AST, GGT, TP, CRP, kırmızı hücre dağılım genişliği (RDW), lenfositler (LYM), trombositler (PLT), FIB-4 ve NLR değerlerinde anlamlı bir fark vardı (p<0.05). HCV RNA viral yük değerleri ile ALT (r=0,271; p=0,014), TP (r=-0,256; p=0,02), NEU (r=-0,365; p=0,01), WBC (r=-0,362; p=0,001) ve NLR (r=0,282; p=0,01) seviyeleri korelasyon gösterdi.Sonuç: ALT, AST, GGT, TP, CRP, RDW, LYM, FIB-4 and NLR değerlerinin CHC hastalarında arttığını, LYM ve PLT değerlerinin ise azaldığını bulduk. Ayrıca, ALT ve NLR seviyeleri KHC hastalarında HCV RNA titreleri ile korelasyon gösterdi. Bu sonuçlar noninvaziv biyokimyasal parametrelerin kronik hepatit C hastalığının takibine katkı sağlayabileceğini göstermektedir.Objective: Liver biopsy, as well as some non-invasive biochemical parameters are also used in monitoring patients with chronic hepatitis C (CHC). The aim of this study was to investigate the relationship between serum biochemical markers and HCV RNA titers in patients with previously untreated CHC.Materials and Methods: We performed a retrospective study on anti-HCV and HCV-RNA-positive 82 patients with CHC. Eighty two healthy subjects constituted the control group. Complete blood counts, total protein (TP), albumin (ALB), C-reactive protein (CRP), ?-glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and HCV RNA levels were recorded for each patient and control subject. Neutrophil-lymphocytes ratio (NLR) and the fibrosis index based on the 4 factors (FIB-4 index) were calculated using formulas. Results: There was a significant difference in ALT, AST, GGT, TP, CRP, red cell distribution width (RDW), lymphocytes (LYM), platelets (PLT), FIB-4, and NLR between CHC patients and controls (p=<0.05). Values of HCV RNA viral load were correlated with ALT (r=0.271; p=0.014), TP (r=-0.256; p=0.02), WBC (r=-0.365; p=0.001), NEU (r=-0.362; p=0.001) and NLR (r=0.282; p=0.01) levels.Conclusion: We have shown that ALT, AST, GGT, TP, CRP, RDW, LYM, FIB-4, and NLR values are increased in CHC patients but, LYM and PLT levels were decreased. Also, levels of ALT and NLR have correlated with HCV RNA titers in CHC patients. These results have implied that noninvasive biochemical parameters may contribute to monitoring patients with CHC

THE EVALUATION OF ANALYTICAL PERFORMANCE OF IMMUNOASSAY TESTS BY USING SIX-SIGMA METHOD

WOS: 000408878600002PubMed ID: 30581326Background: The Six-Sigma Methodology is a quality measurement method in order to evaluate the performance of the laboratory. In the present study, it is aimed to evaluate the analytical performance of our laboratory by using the internal quality control data of immunoassay tests and by calculating process sigma values. Methods: Biological variation database (BVD) are used for Total Allowable Error (TEa). Sigma values were determined from coefficient of variation (CV) and bias resulting from Internal Quality Control (IQC) results for 3 subsequent months. If the sigma values are >= 6, between 3 and 6, and 6 was found for TPSA and TSH for the both levels of IQC for 3 months. When the sigma values were analyzed by calculating the mean of 3 months, folate, LH, PRL, TPSA, TSH and vitamin B12 were found > 6. The mean sigma values of CA125, CA15-3, CA19-9, CEA, cortisol, ferritin, FSH, FT3, PTH and testosteron were > 3 for 3-months. However, AFP, CA125 and FT4 produced sigma values < 3 for varied months. Conclusions: When the analytical performance was evaluated according to Six-Sigma levels, it was generally found as good. It is possible to determine the test with high error probability by evaluating the fine sigma levels and the tests that must be quarded by a stringent quality control regime. In clinical chemistry laboratories, an appropriate quality control scheduling should be done for each test by using Six-Sigma Methodology

Assessment of dynamic thiol/disulfide homeostasis in patients with asthma

WOS: 000434799700005Background: Asthma is a chronic inflammatory lung disease and oxidative stress is an important component in airway inflammation. This study aims to investigate dynamic thiol/disulfide homeostasis in patients with asthma. Methods: A total of 103 subjects, including 56 patients with asthma and 47 healthy controls, of similar age and gender were included in the study. The native thiol, total thiol and disulfide levels and the disulfide-native thiol, disulfide-total thiol and native thiol-total thiol ratios were analyzed and compared between the asthma and control groups using a novel automatized spectrophotometric assay. Results: The levels of native thiol (p <0.001), total thiol (p <0.001) and disulfide (p <0.001) were significantly lower and the C-reactive protein (CRP) levels (p <0.001) were significantly higher in patients with asthma when compared with those in the control group. A negative correlation was detected between CRP levels and native thiol, total thiol and disulfide levels (p <0.05). A significant positive correlation was detected between forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) levels and native thiol and total thiol levels (p <0.01). Conclusions: The thiol/disulfide homeostasis parameters may be used as novel oxidative stress markers in asthma but further studies are needed to investigate the role of thiol/disulfide homeostasis in asthma.Ahi Evran University Research FundAhi Evran University [PYO. TIP. A4.17.006]This study was supported by Ahi Evran University Research Fund (Project No: PYO. TIP. A4.17.006)

Serum omentin-1 levels in hypertensive patients

Hypertension (HT) is a disease that can cause death due to multiple target organ damage and eventually related vascular system damage. High blood pressure is known increased inflammatory activity and to cause endothelial dysfunction has been showed in HT patients. Omentin-1 is a glucoprotein of the adiponectin family released from visceral adipose tissue, endothelial cells, and visceral fat stromal-vascular cells. It has anti-inflammatory effect and circulating omentin-1 concentration correlates negatively with waist circumference, insulin resistance, and body-mass index. Serum omentin-1 is used as a biomarker of coronary artery disease, obesity, cancer, metabolic syndrome, inflammatorydisease, atherosclerosis, and diabetes mellitus. The aim of our study is to investigate circulating omentin-1 levels in HT patients compared to healthy normotensive controls. Patients diagnosed with new essential HT (n = 61) and healthy normotensive individuals (n = 60) were enrolled in this study. The HT group was separated into two subgroups. There were 30 patients in stage 2 HT group and 31 patients in stage 1 HT group. Omentin-1 levels were significantly lower both in stage 1 and 2 HT subgroup as compared with the normotensive controls (72.19 +/- 54.33 ng/ml for stage 1 HT subgroup; 62.45 +/- 47.01 ng/ml for stage 2 HT subgroup; and, 147.84 +/- 58.55 ng/ml for healthy normotensive controls; overallP < 0.001). The present study demonstrated that serum Omentin-1 levels decreased in patients with HT compared with normotensive controls. These lower concentrations may be attributed to a combined outcome of endothelial dysfunction, renal injury, and inflammation in the setting of hypertension