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1.
Clin Pediatr (Phila) ; : 99228231225164, 2024 Jan 19.
Article in English | MEDLINE | ID: mdl-38240073

ABSTRACT

We aimed to investigate clinical and laboratory characteristics of acute alcohol intoxication (AAI) in adolescents who presented to the pediatric emergency department (ED) at a tertiary referral center from 2006 to 2019. All consecutive adolescents with AAI (n = 335) and their sex- and age-matched control subjects (n = 335) with undetectable ethanol levels were included in this case-matched study. Mean serum ethanol level was 156.4 ± 58.4 (range: 50.8-341.2) mg/dL in the acute alcohol intoxication (AAI) group. Glasgow coma scores were lower in AAI group (14 [14-15] vs 15 [15-15], P < .001). Acidosis (16.3%), hyperlactatemia (60.9%), hypoglycemia (1.7%), hypernatremia (2.2%), hypokalemia (12.3%), hyperchloremia (20.4%), hypocalcemia (13.9%), hypermagnesemia (9.7%), and hyperalbuminemia (10.4%) were significantly more common in the AAI group than the control group. Blood pH, lactate, Na+, K+, Ca++, Mg++, albumin, blood urea nitrogen (BUN), and uric acid levels were correlated with serum ethanol levels. This study shows that AAI frequently leads to mild to moderate metabolic/biochemical derangements in adolescents.

2.
Hum Antibodies ; 31(1-2): 1-8, 2023.
Article in English | MEDLINE | ID: mdl-37248894

ABSTRACT

BACKGROUND: Lupus anticoagulant (LA) may be a cause of poor obstetric outcome. OBJECTIVE: To search the association of LA with risk factors for obstetric complications and adverse gestational outcome. METHODS: This retrospective cohort was consisted of 2 groups of pregnancies with poor obstetric history; 1) LA (+) gestations (Study Group, n= 20) and 2) LA (-) gestations (Control Group, 78). All patients were admitted to a special antenatal care program and were examined in terms of risk factors for thrombotic events, placenta-related obstetric complications, and poor gestational outcomes. Patients were administered low-dose low-molecular-weight heparin (LMWH), low-dose salicylic acid and low-dose corticosteroid (if necessary) within the framework of a prophylaxis protocol in addition to their already existing medications. RESULTS: We have shown that adverse gestational outcome was 1.7-fold more frequent in LA (+) pregnancies with poor obstetric history (p= 0.039, 70% vs. 41%). Higher rates of autoimmune diseases and hereditary thrombophilia were observed among LA (+) patients compared to LA (-) gestations (35% vs. 10.3%, p< 0.012 and 55% vs. 19.2%, p< 0.003, respectively). To identify the effectiveness of low-dose LMWH prophylaxis protocol, we compared gestational outcomes and demonstrated that the miscarriage rate was significantly decreased to half in current pregnancies compared to the previous gestations (73.6% vs. 35%, p= 0.003). CONCLUSIONS: Autoimmune diseases and hereditary thrombophilia are more frequent in LA (+) pregnancies, and these women are prone to obstetric problems. Low-dose LMWH and salicylic acid prophylaxis are critical in the management of LA (+) pregnant women.


Subject(s)
Antiphospholipid Syndrome , Pregnancy Complications, Hematologic , Thrombophilia , Female , Humans , Pregnancy , Heparin, Low-Molecular-Weight/therapeutic use , Lupus Coagulation Inhibitor , Retrospective Studies , Pregnancy Complications, Hematologic/drug therapy , Pregnancy Complications, Hematologic/etiology , Antiphospholipid Syndrome/complications , Antiphospholipid Syndrome/drug therapy , Thrombophilia/drug therapy , Risk Factors , Salicylic Acid/therapeutic use
3.
Acta Neurol Belg ; 122(5): 1313-1321, 2022 Oct.
Article in English | MEDLINE | ID: mdl-35790678

ABSTRACT

BACKGROUND: Intensive care unit-acquired weakness (ICUAW) defines generalized muscle weakness seen in critically ill patients in the absence of other causative factors. Herein, we aimed to evaluate ICUAW in stroke patients by electrodiagnostic testing, histopathology, and assessment of respiratory complex activities (RCA), to define the frequency of ICUAW in this patient group, and to reach new parameters for early prediction and diagnosis. METHODS: We prospectively recruited twenty-four severe acute stroke patients during a sixteen-month period. In addition to serial nerve conduction studies (NCS), we performed muscle biopsy and RCA analysis on the non-paretic side when ICUAW developed. Patients undergoing orthopedic surgery without metabolic and neuromuscular diseases constituted the control group for RCA. Survival and longitudinal data were analyzed by joint modeling to determine the relationship between electrophysiological parameters and ICUAW diagnosis. RESULTS: Eight patients (33%) developed ICUAW, and six of them within the first two weeks. Extensor digitorum brevis, abductor digiti minimi (ADM), rectus femoris and vastus medialis (VM) compound muscle action potential (CMAP) amplitudes showed a significant decrease in the ICUAW group. VM CMAP amplitude (BIC = 358.1574) and ADM CMAP duration (BIC = 361.1028) were the best-correlated parameters with ICUAW diagnosis. The most informative electrophysiological findings during the entire study were obtained within the first 11 days. Muscle biopsies revealed varying degrees of type 2 fiber atrophy. Complex I (p = 0.003) and IV (p = 0.018) activities decreased in patients with ICUAW compared to controls. CONCLUSION: VM CMAP amplitude and ADM CMAP duration correlate well with ICUAW diagnosis, and may aid in the early diagnosis.


Subject(s)
Intensive Care Units , Stroke , Humans , Muscle Weakness/diagnosis , Muscle Weakness/etiology , Muscle, Skeletal , Stroke/complications
4.
Turk J Med Sci ; 52(1): 175-187, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34544218

ABSTRACT

BACKGROUND: The presence of atrial fibrosis has already been known as a risk factor for atrial fibrillation (AF) development. We aimed to evaluate atrial fibrosis with previously defined three different methods, which were cardiac magnetic resonance imaging (C-MRI), echocardiographic strain imaging, and biomarkers and show the relationship between these methods in patients with AF scheduled for cryoballoon ablation. METHODS: A total of 30 patients were enrolled. Atrial T1 relaxation durations were measured using C-MRI before the procedure of atrial fibrillation catheter ablation. Fibroblast growth factor-21 (FGF-21) and fibroblast growth factor-23 (FGF-23) levels were measured at serum derived from the femoral artery (Peripheral FGF 21 and 23) and left atrium blood samples (Central FGF 21 and 23) before catheter ablation. Preprocedural transthoracic echocardiography was performed. The median follow-up duration for atrial tachyarrhythmia (ATa) recurrence was 13 (12-18 months) months. RESULTS: The mean ages of the study group were 55.23 ± 12.37 years, and there were 17 (56.7%) female patients in study population. There were negative correlations between post contrast T1 relaxation durations of both posterior and posterosuperior atrium, and central FGF-23 (r: - 0.561; p = 0.003; r:-0.624; p = 0.001; Posterior T1 vs. central FGF-23 levels and Posterosuperior T1 vs central FGF-23 levels, respectively). The positive correlations were observed between postcontrast posterior T1 relaxation durations and left ventricle ejection fraction (r:0.671; p = 0.001); left atrial emptying fraction (r:0.482; p = 0.013); peak atrial longitudinal strain (r:0.605; p = 0.001), and peak atrial contraction strain (r:0.604; p = 0.001). Also negative correlation was observed between postcontrast posterior T1 relaxation durations, and left atrial volume index (r: - 0.467; p = 0.016).


Subject(s)
Atrial Fibrillation , Catheter Ablation , Humans , Female , Adult , Middle Aged , Aged , Male , Atrial Fibrillation/diagnostic imaging , Heart Atria/diagnostic imaging , Catheter Ablation/methods , Fibrosis , Ventricular Function, Left , Treatment Outcome
5.
Turk J Med Sci ; 51(3): 1267-1272, 2021 06 28.
Article in English | MEDLINE | ID: mdl-33705647

ABSTRACT

Background/aim: Renal function of patients with hypothyroidism increases after reaching euthyroid state. There is no data regarding geriatric age group. The aim of the study was determined to investigate whether renal function of geriatric patients with hypothyroidism increases after they become euthyroid. Materials and methods: Patients who were sixty-five years or older were retrospectively screened in two centers. TSH, T3, T4, creatinine, and eGFR calculated by CKD-EPI formula were recorded under the presence of accompanying hypothyroidism. The same variables were recorded after the patients became euthyroid. Results: 285 patients were included in the study, the median age was 73(65­84), and 234 patients were female. Patients were examined in four groups according to TSH values. There were 160 (56.1%) patients with TSH 5­9.9 uIU/mL, 60(21.1%) patients with TSH between 10­19.9 uIU/mL, 41(14.4 %) patients with TSH between 20­49.9 uIU/mL and 24(8.4%) patients with TSH> 50uIU/mL. There was a significant and negative correlation between the initial TSH values and the first calculated eGFR values (p: 0.001; r: ­0.191). The median eGFR of the patients in hypothyroid cases was 66.59 (14.62­116.07), while the median eGFR value of patients was 69.6 (12.91­109.31) in the euthyroid state. This value obtained after thyroid replacement was significantly improved when compared to the first eGFR (p: 0.001). In logistic regression analysis, pretreatment TSH value was found to independently affect eGFR (p: 0.009; Exb: 1.017). Conclusion: It has been observed that hypothyroidism treatment increases eGFR in geriatric patients. Similar results were obtained after studies with younger patients in the literature. This study is a study in which only geriatric age group patients were examined. It should be kept in mind that hypothyroidism which is not corrected in geriatric patients may also contribute to a decrease in eGFR.


Subject(s)
Hypothyroidism , Aged , ErbB Receptors , Female , Glomerular Filtration Rate , Humans , Hypothyroidism/drug therapy , Hypothyroidism/epidemiology , Retrospective Studies , Thyrotropin , Thyroxine
6.
Curr Stem Cell Res Ther ; 16(7): 809-823, 2021.
Article in English | MEDLINE | ID: mdl-32321410

ABSTRACT

Telomeres are the protective end caps of eukaryotic chromosomes and they determine the proliferative lifespan of somatic cells, as the protectors of cell replication. Telomere length in leucocytes reflects telomere length in other somatic cells. Leucocyte telomere length can be a biomarker of human ageing. The risk of diseases associated with reduced cell proliferation and tissue degeneration, including aging or aging-associated diseases, such as dyskeratosis congenita, cardiovascular diseases, pulmonary fibrosis and aplastic anemia, is correlated with an increase in the shortening of telomeres. On the other hand, the risk of diseases that are associated with increased proliferative growth, including major cancers, is correlated with long telomeres. In most of the cancers, a telomere maintenance mechanism during DNA replication is essential. The reactivation of the functional ribonucleoprotein holoenzyme complex (telomerase) starts the cascade from normal and premalignant somatic cells to advanced malignant cells. Telomerase is overexpressed during the development of cancer and embryonic stem cells, through controlling genome integrity, cancer formation and stemness. Cancer cells have mechanisms to maintain telomeres to avoid initiation of cellular senescence or apoptosis, and halting cell division by critically short telomeres. Modulation of the human telomerase reverse transcriptase is the rate-limiting step for the production of functional telomerase and telomere maintenance. The human telomerase reverse transcriptase promoter promotes its gene expression only in tumor cells, but not in normal cells. Some cancers activate an alternative expansion of telomeres maintenance mechanism via DNA recombination to reduce the shortening of their telomeres. Not only heritability but also oxidative stress, inflammation, environmental factors, and therapeutic interventions have an effect on telomere shortening, explaining the variability in telomere length across individuals. There have been a large number of publications, which correlate human diseases with progressive telomere shortening. Telomere length of an individual at birth is also important to follow up telomere shortening, and it can be used as a biomarker for healthy aging. On the other hand, understanding of cellular stress factors, which affect stem cell behavior, will be useful in regeneration or treatment of cancer and age-associated diseases. In this review, we will understand the connection between stem cell and telomere biology, cancer, and aging-associated diseases. This connection may be useful for discovering novel drug targets and improve outcomes for patients having cancer and aging-associated diseases.


Subject(s)
Embryonic Stem Cells , Telomerase , Telomere Shortening , Cellular Senescence , Embryonic Stem Cells/enzymology , Humans , Telomerase/metabolism , Telomere
7.
J Glaucoma ; 29(7): 593-597, 2020 07.
Article in English | MEDLINE | ID: mdl-32287143

ABSTRACT

PRéCIS:: Apelin and asymmetric dimethylarginine (ADMA) concentrations, affecting the nitric oxide pathway, were different in the patient group compared with the control subjects. These 2 molecules may have potential effects in vascular pathologies and their possible role in predisposition to vascular comorbidities in exfoliation syndrome (XFS) or exfoliative glaucoma (XFG). PURPOSE: To evaluate apelin and ADMA levels in serum samples from patients with XFS or XFG compared with healthy control subjects. METHODS: Serum ADMA and apelin concentrations were evaluated from 36 and 32 XFS patients; 27 and 24 XFG patients; and 34 and 30 healthy controls, respectively. Subjects without systemic disease (including diabetes mellitus, hypertension, coronary artery disease, obesity) were included in the study and body mass index was calculated in all participants. An enzyme-linked immunosorbent assay and high-performance liquid chromatography were used to determine serum apelin and ADMA concentrations. Independent sample t test, χ test, analysis of variance test, and Pearson test were used for statistical analysis. RESULTS: Mean serum apelin levels of XFG, XFS, and control group were 1063.3±373.4, 1196.7±433.7, and 1343.3±405.1 ng/mL, respectively. Patients with XFG demonstrated significantly lower level of apelin versus controls (P=0.034). Mean serum ADMA concentration was significantly greater in XFS subjects (2.05±0.98 µmol/L) compared with normal controls (1.57±0.58 µmol/L) (P=0.042). No association was detected between ADMA and apelin concentrations and age, sex, and body mass index for both XFS and XFG groups. CONCLUSIONS: Significant alterations in serum levels of apelin and ADMA may suggest potential effects in vascular pathologies and a possible role in predisposition to vascular comorbidities in XFS/XFG.


Subject(s)
Apelin/blood , Arginine/analogs & derivatives , Enzyme Inhibitors/blood , Exfoliation Syndrome/blood , Glaucoma, Open-Angle/blood , Aged , Aged, 80 and over , Arginine/blood , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Exfoliation Syndrome/diagnosis , Female , Glaucoma, Open-Angle/diagnosis , Humans , Intraocular Pressure/physiology , Male , Middle Aged , Ophthalmoscopy , Prospective Studies , Slit Lamp Microscopy , Tonometry, Ocular
8.
Clin Appl Thromb Hemost ; 25: 1076029619858409, 2019.
Article in English | MEDLINE | ID: mdl-31218883

ABSTRACT

Bleeding has been reported in patients with chronic myeloid leukemia (CML) using tyrosine kinase inhibitors (TKIs). In this study, we aimed to evaluate platelet functions and associated bleeding symptoms in patients with CML using TKIs. A standardized questionnaire that was developed for inherited bleeding disorders (ISTH/SSC Bleeding Assessment Tool) was used to score bleeding symptoms in 68 chronic phase patients with CML receiving imatinib (n = 47), dasatinib (n = 15), or nilotinib (n = 6). Light transmission aggregometry was used for platelet function testing. None of the patients had major bleeding (score > 3). Minor bleeding was observed in 25.6% and 20% of the patients in imatinib and dasatinib treatment groups. Impaired/decreased platelet aggregation was observed in 29.8% of imatinib treatment group, 50% of nilotinib group, and 40% of dasatinib group. A secondary aggregation abnormality compatible with the release defect was observed in 26% of patients with CML; 25.5%, 33.3%, and 16.7% of patients receiving imatinib, dasatinib, and nilotinib, respectively. No correlation was found between bleeding symptoms and the impaired platelet function. We can conclude that TKIs may impair in vitro platelet aggregation but this impairment is not associated with bleeding diathesis.


Subject(s)
Blood Platelet Disorders/chemically induced , Hemorrhage/etiology , Leukemia, Myeloid, Chronic-Phase/pathology , Protein Kinase Inhibitors/adverse effects , Adolescent , Adult , Aged , Dasatinib/therapeutic use , Female , Humans , Imatinib Mesylate/therapeutic use , Leukemia, Myeloid, Chronic-Phase/drug therapy , Male , Middle Aged , Platelet Aggregation/drug effects , Pyrimidines/therapeutic use
9.
Turk J Med Sci ; 48(2): 237-245, 2018 Apr 30.
Article in English | MEDLINE | ID: mdl-29714434

ABSTRACT

Background/aim: Myoglobin, cardiac troponin T, B-type natriuretic peptide (BNP), and creatine kinase isoenzyme MB (CK-MB) are frequently used biomarkers for evaluating risk of patients admitted to an emergency department with chest pain. Recently, time- dependent receiver operating characteristic (ROC) analysis has been used to evaluate the predictive power of biomarkers where disease status can change over time. We aimed to determine the best set of biomarkers that estimate cardiac death during follow-up time. We also obtained optimal cut-off values of these biomarkers, which differentiates between patients with and without risk of death. A web tool was developed to estimate time intervals in risk. Materials and methods: A total of 410 patients admitted to the emergency department with chest pain and shortness of breath were included. Cox regression analysis was used to determine an optimal set of biomarkers that can be used for estimating cardiac death and to combine the significant biomarkers. Time-dependent ROC analysis was performed for evaluating performances of significant biomarkers and a combined biomarker during 240 h. The bootstrap method was used to compare statistical significance and the Youden index was used to determine optimal cut-off values. Results : Myoglobin and BNP were significant by multivariate Cox regression analysis. Areas under the time-dependent ROC curves of myoglobin and BNP were about 0.80 during 240 h, and that of the combined biomarker (myoglobin + BNP) increased to 0.90 during the first 180 h. Conclusion: Although myoglobin is not clinically specific to a cardiac event, in our study both myoglobin and BNP were found to be statistically significant for estimating cardiac death. Using this combined biomarker may increase the power of prediction. Our web tool can be useful for evaluating the risk status of new patients and helping clinicians in making decisions.

11.
J Assist Reprod Genet ; 34(5): 599-605, 2017 May.
Article in English | MEDLINE | ID: mdl-28185121

ABSTRACT

PURPOSE: This study seeks to evaluate the association between follicular fluid (FF) coenzyme Q10 (CoQ10) levels, embryo morphokinetics, and pregnancy rate. METHODS: Sixty infertile patients who underwent intracytoplasmic sperm injection (ICSI) cycles were included in the study. For each patient, CoQ10 level of the follicular fluid was measured by high-performance liquid chromatography system. After the ICSI of each oocyte, the relationship between the level of CoQ10 content of each follicular fluid, the subsequent embryo quality, and embryo morphokinetics was investigated. The relationship between the level of CoQ10 content of each follicle and optimal time-lapse parameters for the embryos of these follicles including t5, s2, and cc2 was also analyzed. The embryos were further classified into four categories, namely, grades A, B, C, and D, according to morphokinetic parameters using t5-t2 and t5-t3 (cc3). Each follicular fluid analysis was performed for a single oocyte of a single embryo which was transferred to the patients. Additionally, follicular fluid CoQ10 levels and pregnancy rates were evaluated. RESULTS: Follicular fluid CoQ10 levels were significantly higher in grades A and B than grades C and D embryos (p < 0.05). The concentration of CoQ10 levels was significantly higher in the pregnant group (p < 0.05). There was no significant correlation between optimal t5 and s2 morphokinetic parameters and CoQ10 levels. However, CoQ10 levels were significantly higher in follicular fluid of embryos which had optimal cc2 (p < 0.05). CONCLUSION: High follicular fluid CoQ10 level is associated with optimal embryo morphokinetic parameters and higher pregnancy rates.


Subject(s)
Follicular Fluid/enzymology , Infertility, Female/enzymology , Reproductive Techniques, Assisted , Ubiquinone/analogs & derivatives , Adult , Blastocyst/metabolism , Embryo Transfer , Embryonic Development , Female , Humans , Infertility, Female/pathology , Oocytes/metabolism , Pregnancy , Pregnancy Rate , Sperm Injections, Intracytoplasmic , Ubiquinone/isolation & purification , Ubiquinone/metabolism
12.
J Matern Fetal Neonatal Med ; 30(24): 2911-2917, 2017 Dec.
Article in English | MEDLINE | ID: mdl-27915495

ABSTRACT

OBJECTIVES: Mitochondrial oxidative phosphorylation is the key energy source for placental functions and fetal growth. The purpose of this study was to investigate the function of placenta in high risk pregnancies by measuring mitochondrial respiratory chain complex (RCC) activities, and to evaluate the correlation between double test risk ratio and RCC activities. METHODS: The placenta samples were collected from 50 pregnant women. The controls consisted of 20 normal uncomplicated pregnancies and the study group (n = 30) consisted of preeclampsia (PE), intrauterin growth restriction (IUGR), advanced maternal age (AMA), twins and preterm deliveries. Complexes I, II-III, IV and citrate synthase (CS) activities were measured by spectrophotometric assays. RESULTS: Complexes I, II-III and IV activities were significantly lower in the study group than the controls (p < 0.05). Complexes I and II-III activities were significantly reduced in placenta of preterm deliveries compared with the controls (p < 0.003). Double test risk ratio was above the cut-off limit (1:300) in 43% of the study group in which decreased complexes I and II-III activities were observed. CONCLUSIONS: Impaired placental mitochondria RCC functions can lead to adverse pregnancy outcomes. Pregnant women with high risk in double test should be monitored carefully in terms of PE, IUGR and preterm delivery.


Subject(s)
Electron Transport Complex II/metabolism , Electron Transport Complex I/metabolism , Mitochondria/metabolism , Placenta/metabolism , Pregnancy, High-Risk/metabolism , Adult , Case-Control Studies , Electron Transport , Female , Humans , Infant, Newborn , Pregnancy , Pregnancy Outcome/epidemiology , Pregnancy, High-Risk/blood , Young Adult
13.
Clin Chem Lab Med ; 54(8): 1377-83, 2016 Aug 01.
Article in English | MEDLINE | ID: mdl-26751895

ABSTRACT

BACKGROUND: Thyroid function tests are frequently assessed during pregnancy to evaluate thyroid dysfunction or to monitor pre-existing thyroid disease. However, using non-pregnant reference intervals can lead to misclassification. International guidelines recommended that institutions should calculate their own pregnancy-specific reference intervals for free thyroxine (FT4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH). The objective of this study is to establish gestation-specific reference intervals (GRIs) for thyroid function tests in pregnant Turkish women and to compare these with the age-matched non-pregnant women. METHODS: Serum samples were collected from 220 non-pregnant women (age: 18-48), and 2460 pregnant women (age: 18-45) with 945 (39%) in the first trimester, 1120 (45%) in the second trimester, and 395 (16%) in the third trimester. TSH, FT4 and FT3 were measured using the Abbott Architect i2000SR analyzer. RESULTS: GRIs of TSH, FT4 and FT3 for first trimester pregnancies were 0.49-2.33 mIU/L, 10.30-18.11 pmol/L and 3.80-5.81 pmol/L, respectively. GRIs for second trimester pregnancies were 0.51-3.44 mIU/L, 10.30-18.15 pmol/L and 3.69-5.90 pmol/L. GRIs for third trimester pregnancies were 0.58-4.31 mIU/L, 10.30-17.89 pmol/L and 3.67-5.81 pmol/L. GRIs for TSH, FT4 and FT3 were different from non-pregnant normal reference intervals. CONCLUSIONS: TSH levels showed an increasing trend from the first trimester to the third trimester, whereas both FT4 and FT3 levels were uniform throughout gestation. GRIs may help in the diagnosis and appropriate management of thyroid dysfunction during pregnancy which will prevent both maternal and fetal complications.


Subject(s)
Pregnancy/physiology , Thyroid Function Tests/methods , Thyroid Gland/physiology , Adolescent , Adult , Female , Humans , Middle Aged , Pregnancy/blood , Pregnancy Trimester, First/blood , Pregnancy Trimester, First/physiology , Pregnancy Trimester, Second/blood , Pregnancy Trimester, Second/physiology , Pregnancy Trimester, Third/blood , Pregnancy Trimester, Third/physiology , Reference Values , Thyroid Function Tests/standards , Thyrotropin/blood , Thyroxine/blood , Triiodothyronine/blood , Turkey , Young Adult
14.
J Med Biochem ; 35(2): 123-129, 2016 Apr.
Article in English | MEDLINE | ID: mdl-28356871

ABSTRACT

BACKGROUND: Biotin, a water-soluble vitamin, is used as a co-factor by enzymes involved in carboxylation reactions. Biotinidase (BTD) catalyzes the recycling of biotin from endogenous and dietary sources. Biotinidase deficiency (BD) is an autosomal recessively inherited disorder of biotin recycling that is associated with neurologic and cutaneous consequences when untreated. The aim of the study was to compare the results of spectrophotometric and fluorimetric methods, as well as to evaluate the advantages and disadvantages of both methods in current research practices. METHODS: Study group was chosen among the BD suspected newborn, children and parents (n = 52) who applied to Hacettepe University Pediatric Metabolism Unit. RESULTS: BTD activity is stable for 2 hours at room temperature and at 4 °C, and for 4 months at -20 °C and -80 °C. Genetic and clinical results showed that 25% of the total number of patients had complete BD which was treated with 10 mg/day biotin, while 15.38% of the patients had partial BD, and they were prescribed biotin 5 mg/day. The area under the ROC curve was 0.960±0.25 and 0.927± 0.41 for the fluorimetric and spectrophotometric method, respectively. Fluorimetric method showed 100% sensitivity and 97% specificity, whereas spectrophotometric method showed 90.5% sensitivity and 93.7% specificity. CONCLUSIONS: Fluorimetric method is superior to the spectrophotometric method due to higher sensitivity and specificity.

15.
Biochem Med (Zagreb) ; 25(3): 377-85, 2015.
Article in English | MEDLINE | ID: mdl-26527231

ABSTRACT

INTRODUCTION: The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. MATERIALS AND METHODS: The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. RESULTS: Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. CONCLUSIONS: We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety.


Subject(s)
Clinical Laboratory Techniques/standards , Emergency Service, Hospital/standards , Laboratories, Hospital/standards , Patient Safety , Specimen Handling/standards , Blood Chemical Analysis/standards , Blood Chemical Analysis/statistics & numerical data , Blood Specimen Collection/standards , Clinical Laboratory Techniques/statistics & numerical data , Drug Monitoring/standards , Drug Monitoring/statistics & numerical data , Emergency Service, Hospital/statistics & numerical data , Hospital Departments/statistics & numerical data , Hospitals, University/standards , Hospitals, University/statistics & numerical data , Humans , Laboratories, Hospital/statistics & numerical data , Medical Errors/prevention & control , Patient Safety/standards , Quality Improvement , Quality Indicators, Health Care , Total Quality Management , Turkey , Urinalysis/standards , Urinalysis/statistics & numerical data
16.
Clin Chem Lab Med ; 53(12): 1961-6, 2015 Nov.
Article in English | MEDLINE | ID: mdl-26041876

ABSTRACT

BACKGROUND: Medicine is a highly professionalized endeavour, by tradition centred on the authority of physicians. Better education and the advent of the information age cater for increased demands on society in general and on health care in particular to enable people to make informed decisions regarding themselves. Participation in medical decisions requires informed knowledge which is hard to obtain without substantial and time consuming professional help. METHODS: We performed a survey amongst the member organizations of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in order to investigate the recognition and preparedness of providing help to patients in interpreting their laboratory results. RESULTS: Out of 40 EFLM Member Societies, 27 sent their responses to the survey. In most cases the first line delivery of laboratory results to physicians is by computer link (63%). Patients receive their laboratory results on demand from their physician in 60% of cases. However, 34% of laboratory specialists showed a negative attitude for delivering laboratory results to patients. Yet, in 48% of countries 1-5 patients per day ask a laboratory specialist about the significance of laboratory results outside the reference range. When patients are informed about the purpose of laboratory testing, they seek information primarily from their physician, followed by the internet and the Specialist in Laboratory Medicine. CONCLUSIONS: Changing practices increasingly enabling patient access to their records are on the increase facilitated by recent innovations in information technologies. Successful transfer of some of the responsibilities of physicians, demands a mutual triangular dialogue between the patient, their physician and laboratory medicine.


Subject(s)
Clinical Laboratory Information Systems , Patient Access to Records , Patient Education as Topic , Europe , Humans , Medical Informatics , Physician-Patient Relations , Physicians , Surveys and Questionnaires
17.
Vet Res Commun ; 38(1): 59-62, 2014 Mar.
Article in English | MEDLINE | ID: mdl-24307458

ABSTRACT

Beta-cryptoxanthin (b-Cr) is a pro-vitamin A and one of the major carotenoids that can be commonly found in mammalian serum and tissues. Foods rich in certain fatty acids are known to be effective to gain a healthy immune system. In the present study, we evaluated the effect of b-Cr on rabbit humoral and cellular immune responses to have a better vision about the mechanism of effect of carotenoids on immune system. Twenty rabbits were randomly divided into five groups (4 per group): Groups consisted of: 1) control group (normal saline; 2) b-Cr (control); 3) vaccine control; 4) 5 mg/kg b-Cr o.p. + vaccine; 5) 10 mg/kg b-Cr o.p. + vaccine. Blood samples were obtained from the marginal ear artery at three time points: days 0, 14 and 21 of the study. Blood CD4+ and CD8+ lymphocytes and Serum Immunoglobulin and Cytokines content were evaluated. Results show that b-Cr administration increased the blood CD4+ lymphocytes count (P > 0.01). Serum IgG, IgM and IgA levels increased (P > 0.05) following b-Cr administration. b-Cr treatment increased serum IL-4 levels (P > 0.05). According to presented results, b-Cr may increase the humoral immunity in mammals. So, it would possible has a potentially beneficial effect on health and on prevention of the immunity related diseases.


Subject(s)
Immunity, Cellular/drug effects , Immunity, Humoral/drug effects , Rabbits/immunology , Xanthophylls/pharmacology , Animals , CD4-Positive T-Lymphocytes/drug effects , CD8-Positive T-Lymphocytes/drug effects , Cryptoxanthins , Immunoglobulins/blood , Interferon-gamma/blood , Interleukin-4/blood , Male , Myxoma virus/immunology , Random Allocation , Viral Vaccines/immunology
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