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

Retinol binding protein 4 levels relate to the presence and severity of coronary artery disease

Background: The previous studies have showed that serum retinol binding protein 4 (RBP4) levels increase in metabolic disorders which are closely associated with cardiovascular diseases (CVD). However, the human studies investigating the role of RBP4 in CVD are conflicted. Therefore, we aimed to evaluate the relationship between RBP4 with the presence and severity of coronary artery disease (CAD) in this study. Methods: 55 patients with presenting acute coronary syndrome (ACS) and 43 control subjects who had various cardiovascular risk factors with normal coronary artery on coronary angiography were included in this study. The serum RBP4 concentrations were measured using ELISA method, clinically and anatomically score models were used to assess the severity of coronary lesion. Results: Serum RBP4 levels were significantly higher in patients with ACS compared to the without ACS (68.40 +/- 47.94 mg/L vs. 49.46 +/- 13.64 mg/L; p = 0.014). RBP4 was correlated with GENSINI and SYNTAX I score (r = 0.286 p = 0.034; r = 0.403 p = 0.002 respectively). However, there was no relationship between RBP4 and GRACE score. Conclusions: The serum RBP4 levels increase in patients with CAD and its increased levels may be correlated with CAD severity

Relationship between circulating serum omentin-1 levels and nascent metabolic syndrome in patients with hypertension

The prevalence of metabolic syndrome (MetS) is more common in patients with hypertension and is associated with an increased risk of target organ damage and/or cardiovascular disease (CVD). Omentin-1 is a beneficial adipokine considered to play a role in MetS and MetS-related states such as obesity, diabetes, and coronary artery disease. The aim of this study was to determine the relationship between circulating omentin-1 levels and MetS uncomplicated by diabetes or CVD (nascent MetS) in patients with hypertension. In this study, 110 patients (54 men, 49%; average age: 49.72 +/- 11.32 years) treated for hypertension but without overt diabetes and/or CVD were enrolled. 66 patients were stratified into MetS (+) (group 1) and 44 patients into MetS (-) (group 2) according to the American Heart Association/National Heart, Lung, and Blood Institute criteria. The triglyceride glucose (TyG) index was used to assess insulin resistance. Circulating omentin-1 levels in venous blood samples were measured by an ELISA kit. Circulating omentin-1 levels in patients with MetS were significantly lower than in patients without MetS (46.35 ng/mL (42.70-57.70 ng/mL) vs 130.95 ng/mL (62.83-236.48 ng/mL), p0.001). Omentin-1 was inversely correlated with TyG index (r=-0.204, p=0.033). In a multivariate logistic regression analysis, omentin-1, TyG index, and body mass index were independent predictors of MetS. A receiver operating characteristic curve analysis determined that the best cut-off value for omentin-1 in predicting MetS was 62.20 ng/mL and the area under the curve was 0.880 (95% CI 0.817 to 0.942, p0.001). The findings of this study suggest that circulating omentin-1 levels are inversely related to the presence of MetS and may be a reliable marker to predict the development of MetS in patients with hypertension

Evaluation of vitamin D status and the relationship with thyroid disease

Objectives: Vitamin D is known to be an essential element for calcium metabolism and bone health. Recent studieshave also identified vitamin D deficiency as a risk factor for cancers, autoimmune diseases, and cardiovascular disorders.The aim of this study was to investigate the relationship between vitamin D status and thyroid disease.Methods: A total of 1197 adults aged 18-45 years were enrolled in this retrospective study. Data of serum levels ofvitamin D, free triiodothyronine, free thyroxine, and thyroid-stimulating hormone were retrieved and analyzed. Theindividuals were divided into 3 groups: euthyroid state (n=940), hypothyroidism (n=206), and hyperthyroidism (n=51).The vitamin D status of the groups was compared.Results: The study population had a mean serum vitamin D concentration of 18.33±14.53 ng/mL. The mean vitamin Dlevel was 16.01±14.37 ng/mL in females (n=921) and 26.04±12.26 ng/mL in males (n=276) (p0.001). The mean vitaminD level in the euthyroid, hypothyroidism, and hyperthyroidism groups was 8.79±15.04 ng/mL, 15.72±11.71 ng/mL,and 20.4±14.23 ng/mL, respectively. There was a statistically significant difference in the vitamin D level between thehyperthyroidism and hypothyroidism groups (p0.05).Conclusion: Vitamin D deficiency/insufficiency is an important public health problem in Turkey, especially in females.The hypothyroid patients had significantly lower vitamin D levels compared with the other groups. Vitamin D supplementationmay be considered in the treatment of thyroid disease; however, additional prospective studies with a largernumber of subjects are needed

Determination of serum YKL-40 levels in patients with brucellosis

Aim: To determine serum YKL-40 levels in patients diagnosed with brucellosis.Material and Methods: This study included 40 Brucellosis patients with positive serum agglutination tests and 41 healthy control subjects. The two groups were compared with regard to their serum YKL-40, hematological parameters, and C-reactive protein (CRP) values.Results: The brucellosis patient group presented YKL-40 values of 15.0 ± 8.8 ng/mL, CRP values of 0.2 ± 0.1 mg/dL, a Neutrophil/Lymphocyte ratio (NLR) of 1.5 ± 1.0, and a Platelet/Lymphocyte ratio (PLR) of 109.3 ± 46.4. The control group presented YKL-40 values of 12.7 ± 6.1ng/mL, CRP values of 1.48 ± 2.1mg/dL, a Neutrophil/Lymphocyte ratio (NLR) of 2.1 ± 0.7, and a Platelet/Lymphocyte ratio (PLR) of 147.8 ± 59.0.Conclusion: No significant differences were determined between the YKL-40 levels of the patient and control groups. The patient group manifested significantly higher levels of CRP compared to the control group, and YKL-40 was determined to be positively correlated with CRP, PLT, PLR, NLR and age. However, further studies are needed for the role of YKL-40 in infectious diseases to be understood more clearly

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