Appropriateness of thyroid function test requesting to the foreseen algorithm in Giresun province center

Amaç: Amerikan Tiroid Derneği (ATA), Amerikan Klinik Endokrinologlar Birliği (AACE) ve Türkiye Endokrinoloji ve Metabolizma Derneği gibi organizasyonların kılavuzlarında tiroid fonksiyonlarını değerlendirmede ilk yapılacak testlerin tiroid stimulan hormon (TSH) ve serbest T4 (fT4) olması gerektiği bildirilmektedir. Bu çalışmada Giresun İli Merkez'de tiroid fonksiyon test istemlerinin klinikte öngörülen algoritmaya uygunluğunun incelenmesi amaçlanmıştır. Gereç ve Yöntem: S.B. Giresun Prof. Dr. A. İlhan Özdemir Devlet Hastanesi Tıbbi Biyokimya Laboratuvarı'nda 01.01.2016-31.12.2016 tarihleri arasında çalışılıp raporlanmış TSH, serbest T3 (fT3) ve fT4 test sonuçları Laboratuvar Bilgi Sistemi kayıtlarından elde edildi. Tiroid fonksiyon testlerinin istemleri 4 grupta (yalnız TSH istemi, TSHfT4 istemi, TSHfT3 istemi, TSHfT3fT4 istemi) incelendi. Her bir grubun istem sonuçları Roche Immunoassay ölçüm sistemleri için bildirilen TSH referans aralığına göre (0,27-4,2 mIU/L) hipotiroidik, normotiroidik ve hipertiroidik olmak üzere 3 alt gruba ayrıldı. Bulgular: İçinde TSH'ın olduğu tiroid fonksiyon test paneli istemlerinin (n65.533) %47,8'ini TSHfT4 istemi,%34,3'nü yalnız TSH istemi, %17,8'ini TSHfT3fT4 istemi, %0,05'ini ise TSHfT3 istemi oluşturmakta idi. TSH referans aralığına göre (0,27-4,2 mIU/L) belirlenen normotiroidik gruplarda istenen toplam test sayısı (n120.308) içerisinde fazladan istenmiş fT3 ve fT4 test sayılarının (n44.025) yüzdesi %36,6 olarak hesaplandı. Sonuç: Tiroid fonksiyon test istemlerinde klinikte öngörülen algoritmaya göre yalnız TSH isteminin yapılması gereken vakalarda, TSH ile beraber fT3 ve fT4 test istemlerinin yaygın olmamakla beraber kullanıldığı saptandı. Ek olarak daha önce farklı merkezlerde yapılan sonuçlara kıyasla Giresun ili Merkez'de tiroid fonksiyon test istemlerinin klinikte öngörülen algoritmaya uygunluğunun daha kabul edilebilir düzeylerde olduğu görüldü.Objective: It is reported that the first tests to evaluate thyroid functions in the guidelines of American Thyroid Association (ATA), American Association of Clinic Endocrinologs (AACE) and Turkey Endocrinology and Metabolism Association are thyroid stimulated hormone (TSH) and free T4 (fT4). In this study, it was aimed to investigate the appropriateness of thyroid function test requests to the clinically foreseen algorithm in Giresun Province Center. Materials and Methods: TSH, fT3 and fT4 test results, which were worked and reported between 01.01.2016 and 31.12.2016 in the Ministry of Health Prof.Dr.A.İlhan özdemir State Hospital Medical Biochemistry Laboratory, were obtained from the Laboratory Information System records. Thyroid function tests were evaluated in 4 groups (Only TSH; TSH fT4; TSH fT3; TSH fT3 fT4). The results of each group were divided into three subgroups: hypothyroidism, normothyroidism and hyperthyroidism according to the reported TSH reference range (0.27-4.2 mIU / L). Results: Thyroid function test panel requests (n 65,533), TSH fT4 is the cause of 47.8%, TSH is the only cause of 34.3%, TSH fT3 fT4 is the 17.8% whereas TSH fT3 was the cause. The percentage of additional fT3 and fT4 test numbers (n 44,025) was calculated as 36.6% within the total number of tests (n 120,308) required in the normothyroidic groups determined according to the TSH reference range (0.27-4.2 mIU / L). Conclusion: According to the clinically foreseen algorithm for thyroid function tests, it was determined that fT3 and fT4 test requests together with TSH were used together with not being widespread when only TSH should be done. In addition, compared to the results obtained in different centers, it has been observed that the demand for thyroid function test in Giresun province center is more acceptable than that of the clinically prescribed algorithm

The relationship between vitamin D and the severity of COVID-19

AIM: Vitamin D, which has immunomodulatory effect, can reduce risk of infections and concentrations of pro-inflammatory cytokines. The aim of this study was to investigate the relationship between the levels of vitamin D and severity of COVID-19. METHODS: A total of 204 patients with COVID-19 disease were enrolled in the study. All patients had viral pneumonia, which was confirmed with chest computer tomography. All cases were divided in two groups-mild (outpatients); and serious (inpatients)- according to their clinical and laboratory data. Serum vitamin D levels were measured by chemiluminescence method. RESULTS: Vitamin D deficiency was found in 41.7 % (n = 85) of cases and insufficiency was found in 46.0 % (n = 94), while in 12.3 % (n = 25) of cases normal vitamin D levels were found. The odds of having a serious clinical outcome were increased for vitamin D insufficiency patients 5.604 times (%95 CI:0.633-49.584) and for vitamin D deficiency patients 38.095 times (%95 CI:2.965-489.50) for each standard deviation decrease in serum 25(OH)D. CONCLUSION: Adequate levels of vitamin D could suppress inflammation and reduce the severity of COVID-19. Vitamin D supplementation may have an important role in decreasing the impact of the pandemicWOS:0006376132000072-s2.0-85101946377PubMed: 3361852