Serum fetuin-A and RANKL levels in patients with early stage breast cancer

Background: Breast cancer (BC) is the primary cause of mortality due to cancer in females around the world. Fetuin-A is known to increase metastases over signals and peroxisomes related with growing. Receptor activator of nuclear factor-kB ligand (RANKL) takes part in cell adhesion, and RANKL inhibition is used in the management of cancer. We aimed to examine the relationship between serum fetuin-A, RANKL levels, other laboratory parameters and clinical findings in women diagnosed with early stage BC, in our population. Methods: Women having early stage BC (n=117) met our study inclusion criteria as they had no any anti-cancer therapy before. Thirty-seven healthy women controls were also confirmed with breast examination and ultrasonography and/or mammography according to their ages. Serum samples were stored at -80 °C and analysed via ELISA. Results: Median age of the patients was 53 (range: 57-86) while it was 47 (range: 23-74) in the healthy group. Patients had lower high-density lipoprotein levels (p=0.002) and higher neutrophil counts (p=0.014). Fetuin-A and RANKL levels did not differ between the groups (p=0.116 and p=0.439, respectively) but RANKL leves were found to be lower in the favorable histological subtypes (p=0.04). Conclusions: In this study, we found no correlation between serum fetuin-A levels and clinical findings in patients diagnosed with early stage BC. However, RANKL levels are found to be lower in subgroups with favorable histopathologic subtypes such as tubular, papillary and mucinous BC and there was statistically significant difference

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Hypercalciuria in Postmenopausal Osteoporosis

Women aged between 35 to 75, termed as postmenopausal at least for one year, not smoking and not drinking alcohol, not using any medicine related with menopause and osteoporosis made up our patient and control groups. We investigated serum calcium, phosphorus, alkaline phosphatase, creatinine levels and urinary calcium level, calcium to creatinine ratio in post-menopausal women with osteoporosis (n = 25) and without osteoporosis (n =25). In our study hypercalciuria was found in 68% of women with osteoporosis and in 36% of women without osteoporosis. It was also found that there was a significant difference in calcium to creatinine ratio between the two groups (p<0,05). We also found that serum phosphorus level in women with osteoporosis was significantly higher than the other group (p<0,05). The results were compared with similar studies in literature

Koagülasyon testlerinin referans aralıklarının indirekt belirlenmesinde kalite kontrol prosedürleri olarak bhattacharya ve hoffmann yöntemlerinin karşılaştırılması

Amaç: Klinik laboratuvarlarda tüm testler için güvenilir referans aralıklarının belirlenmesi önemlidir, ancak çoğu zaman kullanışlı ve gerekli klinik veriler elde etmekte zorluk çekilir. Referans aralıklarının hasta test sonuçlarından faydalanarak indirekt belirlenmesi prosedürü herhangi bir klavuzda belirtilmemiş olmasına rağmen, yapılan birçok çalışmada referans aralıklarının indirekt olarak hesaplanabileceği gösterilmiştir. Bu çalışmada protrombin zamanı (PT) ve aktive parsiyel tromboplastin zamanı (APTT) için referans aralığının doğrulanmasında, birikmiş test verileri kullanımına dair bir model oluşturmayı amaçladık. Gereç ve Yöntem: Ameliyat öncesi cerrahi polikliniklerinden test istemi yapılan, 18-45 yaşları arasında ayaktan hastaların 2008 yılı PT (N11.363) ve APTT (N7.034) test sonuçları elektronik kayıtlardan elde edildi. Belli klinikler çalışma dışı bırakıldı. Testler Thromborel S ve Actin (Dade Behring, Germany) kitleri ile Sysmex CA-1500 cihazında çalışılmıştı. Her çalışma haftası için geriye dönük bir kalite kontrol prosedürü olarak Bhattacharya ve Hoffmann yöntemleri kullanıldı. Bulgular: İnternal kalite kontrol ve hasta test sonuçları arasında uyumun olmadığı haftaları belirledik ve hesaplamada bu haftalarda çalışılmış hasta test sonuçlarını dışladık. Bu iki yöntemin (Bhattacharya ve Hoffmann) duyarlılığı karşılaştırıldığında benzer olduğu görüldü. Belli kliniklerin dışlanması ve iç kalite kontrol sonuçlarının geriye dönük değerlendirmesiyle elde edilen birikmiş hasta test sonuçlarını kullanarak hesapladığımız indirekt referans aralıkları kit prospektüsündeki belirtilen aralıklarla örtüşmekteydi. Sonuç: Birikmiş test sonuçlarını kullanarak oluşturduğumuz model, laboratuvarın referans aralıklarının teyidi ve temsil ettiği toplumda sonuçların değerlendirilmesi için uygun olabilir.Objective: Its important to determine reliable reference intervals for all the test parameters of the clinical laboratory, but its usually hard to obtain useful and necessary clinical data. Although the procedure of indirect determination of reference intervals using stored data is not defined in any guide, it was showed that the reference intervals could be estimated by indirect method in lots of studies. We aimed to constitute a model of using stored data in verifying the reference intervals of prothrombin time (PT) and activated partial thromboplastin time (APTT) with exclusion of certain clinics in this study. Materials and Methods: Results of PT (N11,363) and APTT (N7,034) test requests of ambulatory patients aged 15 to 80 made from outpatient clinics of surgical departments before surgical interventions in 2008 were retrieved from the electronic medical record. Certain clinics were excluded. Thromborel S and Actin (Dade Behring, Germany) were used for the tests which we done on the Sysmex CA-1500. We used Bhattacharya and Hoffmann methods as a retrospective quality control procedure for each study week. When we compared the sensivities of these methods, the results were similar. Results: We determined the weeks where there was disagreement between the results of internal quality control and patients tests and excluded the results of these weeks in estimation. When we compared the sensivities of these methods (Bhattacharya and Hoffmann), the results were similar.The indirect reference intervals estimated by using the stored data with the exclusion of certain clinics and the retrospective evaluation of the internal quality conrol results were overlapping with the data stated in the insert. Conclusion: The model which we constituted using stored data, may be particularly suitable for confirming reference intervals of the laboratory and evaluation of the results of the presenting population

SARS-CoV-2 Pneumonia Affects Male Reproductive Hormone Levels: A Prospective, Cohort Study

Background: SARS-CoV-2 which causes coronavirus disease 2019 (COVID-19) binds to angiotensinconverting enyzme 2 (ACE2) and enters the host cell. ACE2 protein is expressed highly in the testis

Vitamin D levels in children with familial Mediterranean fever

Background: This study aimed to determine whether vitamin D deficiency is more common in children with familial Mediterranean fever (FMF) than in healthy individuals

Anti-CCP Antibodies Are Not Associated with Familial Mediterranean Fever in Childhood

Objective. Anticyclic citrullinated peptide antibodies (anti-CCP) testing is useful in the diagnosis of rheumatoid arthritis (RA) with high specificity. Arthritis is a very common clinical manifestation in children with familial Mediterranean fever (FMF). The aim of the study was to show the presence of anti-CCP antibodies in child individuals diagnosed with FMF. Material and Methods. The study groups comprised one hundred and twenty-six patients (126) diagnosed with FMF (female/male (n): 66/60) and 50 healthy controls (female/male (n): 25/25). Clinical and laboratory assessments of the FMF patients were performed during attack-free periods. Erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), fibrinogen, and anti-CCP antibody levels were measured. Results. Anti-CCP was negative in healthy controls and also in all FMF patients. There was not a significant difference in anti-CCP between the patient and the control groups. Our study has shown that anti-CCP was correlated moderately with age (rs=0.271; P=0.0020), duration of illness (rs=0.331; P<0.0001), and colchicine therapy (rs=0.259; P=0.004). Conclusion. Our data show that anti-CCP antibodies are not associated with FMF. Anti-CCP does not have a priority for identifying FMF arthritis from the other inflammatory arthritis

Clinical Study Anti-CCP Antibodies Are Not Associated with Familial Mediterranean Fever in Childhood

Objective. Anticyclic citrullinated peptide antibodies (anti-CCP) testing is useful in the diagnosis of rheumatoid arthritis (RA) with high specificity. Arthritis is a very common clinical manifestation in children with familial Mediterranean fever (FMF). The aim of the study was to show the presence of anti-CCP antibodies in child individuals diagnosed with FMF. Material and Methods. The study groups comprised one hundred and twenty-six patients (126) diagnosed with FMF (female/male ( ): 66/60) and 50 healthy controls (female/male ( ): 25/25). Clinical and laboratory assessments of the FMF patients were performed during attack-free periods. Erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), fibrinogen, and anti-CCP antibody levels were measured. Results. Anti-CCP was negative in healthy controls and also in all FMF patients. There was not a significant difference in anti-CCP between the patient and the control groups. Our study has shown that anti-CCP was correlated moderately with age (rs = 0.271; = 0.0020), duration of illness (rs = 0.331; &lt; 0.0001), and colchicine therapy (rs = 0.259; = 0.004). Conclusion. Our data show that anti-CCP antibodies are not associated with FMF. Anti-CCP does not have a priority for identifying FMF arthritis from the other inflammatory arthritis