Open Journal of Clinical and Medical Case Reports, Jul 24, 2023
We present a 9 years old case with complicated Crush Syndrome rescued from dent at 57th hour in K... more We present a 9 years old case with complicated Crush Syndrome rescued from dent at 57th hour in Kahramanmaraş earthquake in Türkiye. We emphasized on the importance of laboratory support in all clinical stages of the patient; beginning from diagnosis through acute kidney injury and metabolic acidosis complications and follow-up of treatment in intensive care unit.
The capillary zone electrophoresis (CZE) and highperformance liquid chromatography (HPLC) methods... more The capillary zone electrophoresis (CZE) and highperformance liquid chromatography (HPLC) methods were compared in terms of HbA2 measurement for the assessment of hemoglobinopathies. Materials and Methods: CZE was compared with HPLC for the evaluation of patients without hemoglobinopathy (n=321), with β-thalassemia trait (n=113), and with common (HbD-Punjab, E, C, S/A, and S/S) and rare (HbS/D, O-Arap, Lepore, G-Coushata, Setif, Hamadan, Q-Iran, and H) variants (n=21). The reference range for HbA2 was determined by CZE. Results: Among patients without hemoglobinopathy, the median (2.5 th -97.5 th percentiles) values were 97.4% (97.0-98.0%) and 97.5% (96.6-98.4%) for HbA (p=0.060) and 2.4% (1.6-3.0%) and 2.5% (1.6-3.1%) for HbA2 (p<0.001) by HPLC and CZE, respectively. The reference range for HbA2 was 1.6-3.1% by CZE. In the comparison of methods for HbA2, there was a constant error of 0.255 (confidence interval: 0.062-0.448) and bias of 0.10% (limit of agreement: 0.33-0.53), and higher values were obtained with CZE. A strong correlation was observed between the methods (r=0.782). Interrater agreement was almost perfect for clinical diagnosis (κ=0.911). The two methods detected and identified the common variants similarly. All rare variants, except HbH by HPLC and HbS/D by CZE, were detected as separate peaks by both methods. The two methods were in agreement regarding the preliminary identification of β-thalassemia patients. Different Hb variants were detected by both methods but with possible methodological interference for HbA2 measurements. CZE is a reliable and simple alternative for the evaluation of hemoglobinopathies. The standardization of HbA2 measurements should be prioritized as more techniques become available in routine laboratory practice.
Background: The most common causes of microcytic anemias are Iron Deficiency Anemia (IDA) and Bet... more Background: The most common causes of microcytic anemias are Iron Deficiency Anemia (IDA) and Beta Thalassemia minor (BTm). Correct diagnosis is important to prevent unnecessary iron loading and to manage thalassemia states. In this study, we aimed to evaluate the performances of erythrocyte indices to support the differential diagnosis in a practical, quick and economic way. Materials and methods: We evaluated the premarital screening data and extracted microcytic anemic patients and classified as IDA and BTm according to Complete Blood Cell counts (CBC), ferritin, C-Reactive Protein (CRP) and HbA2 analysis results. 442 patients with IDA, 205 with BTm were enrolled in the study. Diagnostic performances of 23 indices were evaluated. The sensitivity, specificity, positive and negative predictive values, Youden’s index, Likelihood Ratios, Diagnostic Odds Ratios and Area Under Curve values out of Receiver Operating Characteristic curves were calculated. New cut-off values for each index was determined. Results: None of the indices had a 100 percent sensitivity or specificity. Sirdah Index (SI) had the best rank in overall performances followed by Mentzer Index (MI), England-Fraser (E-F), Ehsani Index (EI) and Green and King index (G&amp;K) while Telmissani MCHD, Bessman, Huber-Herklotz, Sirachainan, and Ricerca Index (RI) had the lowest performance. Conclusion: Indices are efficient enough for a preliminary differentiation of IDA and BTm before further diagnostic evaluation. Index performances differ among studies because of ethnic and genetic variations among study populations. Study settings as patient selection and cut-offs may also effect the performances of indices. Correct interpretation of performance criteria is also important in assessment of proper index.
Introduction. We evaluated the pattern of baldness and serum androgen levels in patients with ben... more Introduction. We evaluated the pattern of baldness and serum androgen levels in patients with benign prostate hyperplasia (BPH) and prostate cancer. BPH, prostate cancer and androgenic alopecia (AA) were somehow androgen dependent and affect large population of elderly men. Material and method. A total of 152 patients, 108 patients with BPH and 44 patients with prostate cancer were included in the study. We measured serum total, free and bioavailable testosterone, FSH, LH, prolactin, estradiol, albumin and SHBG levels. Baldness classification was based on Norwood's classification and we categorised baldness as vertex and frontal baldness. Result. The frequency of AA in BPH and prostate cancer groups were not different. We looked for some correlation between the two groups with respect to AA and hormone levels. We did not find any correlation between AA and total testosterone, free testosterone, bioavailable testosterone or SHBG levels in both groups. Conclusion. This prospective study with selected small group of patients showed that there is no difference of male pattern baldness in BPH and prostate cancer patients and also there is no correlation between pattern of baldness and serum androgen levels.
■ S p e c ia lis t, D e p a rtm e n t o f B io c h e m is try a n d C lin ic a l B io c h e m is ... more ■ S p e c ia lis t, D e p a rtm e n t o f B io c h e m is try a n d C lin ic a l B io c h e m is try , H a yd a rp a şa n u m u n e H o s p ita l, Is ta n b u l, T urke y. * * S p e c ia lis t, D e p a rtm e n t o f B io c h e m is try a n d C lin ic a l B io c h e m is try , K a rta l H o s p ita l, Is ta n b u l, T u rke y.
DOAJ (DOAJ: Directory of Open Access Journals), 2014
Background: The subjects with impaired glucose tolerance have an increased risk for future type 2... more Background: The subjects with impaired glucose tolerance have an increased risk for future type 2 diabetes (T2DM); however, a significant number of individuals who develop T2DM have normal glucose tolerance (NGT) at baseline. The study aims to compare glycated hemoglobin (HbA1C) and homeostasis model assessment (HOMA-IR) levels to 30, 60 and 90-min glucose levels in subjects with NGT. Methods: A 75-g oral glucose tolerance test (OGTT) at 0, 30, 60, 90 and 120-min was performed in 1118 subjects without known T2DM. Blood samples were also drawn for fasting insulin and HbA1C levels. Results: Forty percent of the subjects with NGT had increased post-challenge values above the determined optimal glucose levels (10.2, 10.3 and 8.9 mmol/L at 30, 60 and 90-min, respectively). Compared to the subjects with NGT whose glucose levels were below the determined optimal values at 30, 60 and 90-min, we found significantly elevated HbA1C and HOMA-IR levels in the subjects with NGT whose glucose levels were above the determined optimal values (p<0.001). Conclusions: We conclude that the subjects with NGT have different HbA1C and HOMA-IR levels considering glucose levels measured earlier than at 2-h during OGTT. Further well-designed prospective studies are needed to define the significance of 30-min, 60-min and 90-min glucose levels in the prediction of disease in subjects with T2DM.
Objective: The aim of this study is to evaluate the effect of ejaculation on serum total, free an... more Objective: The aim of this study is to evaluate the effect of ejaculation on serum total, free and complex prostate-specific antigen (PSA) levels and their effect on biopsy decisions. Material and methods: Our study includes 47 men older than 45 years with symptomatic benign prostatic hyperplasia (BPH). Patients' PSA levels were under 2.5 ng/mL, and there were no known conditions to preclude ejaculation. Eight patients with similar demographic, and clinical characteristics were chosen as a control group. With three days of sexual abstinence, blood samples were drawn for the measurement of baseline PSA levels, and then the patients were told to ejaculate. One, 5, 24 and 72 hours after ejaculation, serum total, free and complexed PSA levels were measured. Serum PSA sampling was performed at the same intervals in the control group without ejaculation. Results: The mean age of the patients was 59.13±1.38 years in the study group, and 63.75±3.13 years in the control group. The mean international prostate symptom scores (IPSS) were 11.78±1.12 and 11.63±3.32 in the study, and the control groups, respectively. The mean baseline total, free, and complexed PSA values were 1.07±0.09, 0.31±0.03, and 0.71±0.08 ng/mL, respectively. In the study group, total PSA value was found to be 1.29±0.12 ng/mL (p=0.008) at first hour after ejaculation, and this change was statistically significant when compared with baseline values. Mean total PSA level rose up to 1.28±0.13 ng/mL (p= 0.05) by the 5 th hour after ejaculation, but this change was not statistically significant relative to the baseline values. Mean free PSA level rose after the first hour postejaculation to 0.37±0.04 ng/mL (p= 0.01) and after the fifth hour postejaculation to 0.37±0.04 ng/mL (p= 0.002), and these changes were statistically significant relative to the baseline values. There were no statistically significant changes at the other sampled times as for the total, free or complexed PSA serum levels. When all three values were considered individually, in only 2.12% of the patients, biopsy decisions could be affected by the elevation in PSA levels. Conclusion: When the PSA value is borderline with respect to biopsy decisions, the effect of ejaculation on serum PSA levels may be clinically important. In these patients, ejaculation must be questioned, and repeated. PSA levels should be evaluated 24 hours after ejaculation. There were no statistically significant changes in the levels of complex PSA values. Further studies are needed to clarify the relationship between complexed PSA and ejaculation.
Journal of experimental and clinical medicine, Mar 14, 2021
To evaluate whether mirtazapine and mesna have protective effects on cisplatin-induced ovarian in... more To evaluate whether mirtazapine and mesna have protective effects on cisplatin-induced ovarian injury. A total of 32 female Wistar Albino rats were divided into 4 groups (8 rats per group) and included in the study. No medication was administered to the first group; only intervention was that their ovaries were removed and anti-mullerian hormone (AMH) values were measured. The second group received intramuscular cisplatin at a single dose of 7.5 mg/kg. The third group received a single dose of 200 mg/kg mesna intraperitoneally, and 30 minutes later, a single dose of 7.5 mg/kg intramuscular cisplatin was administered. The fourth group received oral 30 mg/kg mirtazapine, and 60 minutes later, a single dose of 7.5 mg/kg intramuscular cisplatin was administered. Oral 30 mg/kg mirtazapine was continued for ten days. Ovaries and AMH values of all groups were evaluated at the end of tenth day. In the cisplatin group when compared to normal ovarian tissue total histopathological damage score increased (p=0.037), preantral follicle count decreased (p=0.003) and AMH levels decreased (p<0.001). In the cisplatin + mesna group total ovarian damage score was also increased (p=0.005), preantral and antral follicles decreased (p<0.001 and p=0.001, respectively), and AMH levels decreased (p<0.001). In the cisplatin + mirtazapine group, total ovarian damage score (p<0.001), preantral follicle count (p=0.002) and AMH values were decreased (p<0.001). It was concluded that mesna and mirtazapine were not effective in preventing ovarian damage due to cisplatin.
In some studies, the prognostic and predictive significance of M30 and M65 has been reported to d... more In some studies, the prognostic and predictive significance of M30 and M65 has been reported to detect response to chemotherapy. In the present study, we aimed at determining the changes of serum M30 and M65 values after chemotherapy and the impact of these values on treatment response and progression-free survival (PFS) and overall survival (OS) of patients with advanced gastric cancer. A total of 31 patients with advanced gastric cancer was included. M30 and M65 values were measured by a quantitative enzyme-linked immunosorbent assay (ELISA) method in serum samples before and 48 h after the first chemotherapy cycle. Pre- and postchemotherapy values of M30 and M65 were compared. The difference between the mean values of serum M30 and M65 before and after chemotherapy was calculated and the prognostic significance of changes for survival was evaluated by univariate and multivariate analysis. Logistic regression analysis was performed to predict response to chemotherapy. Serum M30 and M65 levels were found to be increased significantly after chemotherapy (M30, 582.7 ± 111.5 U/l [pre mean] vs. 983.3 ± 214.1 U/l [post mean], p = 0.01; M65, 2,061.7 ± 431.2 U/l [pre mean] vs. 2,646.3 ± 433.1 U/l [post mean], p = 0.003). Means of the differences of M30 and M65 levels before and 48 h after chemotherapy were 400.5 ± 190 U/l ([M30-difference] M30-D) and 584.6 ± 335.4 U/l (M65-D), respectively. Patients with serum M30-D of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;400.5 U/l had better median PFS and OS times than patients with M30-D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;400.5 U/l (PFS, 9.9 vs. 4.3 months, p = 0.018 and OS, 13.6 vs. 8.1 months, p = 0.029). In addition, median PFS and OS intervals in patients with serum M65-D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 584.6 U/l were significantly worse than those of patients whose M65-D was lower than or equal to 584.6 U/l (4.1 vs. 11.4 months for PFS, p = 0.002 and 5.7 vs. 13.6 months for OS, p = 0.005). Patients with values above M30-D and M65-D had a better tumor response compared with patients with values below M30-D and M65-D (p = 0.02 and p = 0.006, respectively). In the logistic regression analysis, only M65-D was significantly found to be an independent factor in predicting response to chemotherapy (p = 0.018, OR:1.4). However, only M30 levels after chemotherapy were found to be an independent prognostic factor for PFS in the multivariate analysis. These results showed for the first time that both M30 and M65 in serum samples of patients with advanced gastric cancer were elevated 48 h after chemotherapy and these were poor prognostic factors for both PFS and OS of patients. Moreover, increased serum M65 levels after chemotherapy can be predict tumor response.
Medical Laboratory Technology Journal, Mar 16, 2020
To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian r... more To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (p<0.0167). The dehydroepiandrosterone supplementation, while did not have a significant effect on reducing ovarian damage induced by methotrexate, also was not shown to provide any considerable increase in AMH levels. However, prolonged usage of dehydroepiandrosterone by contributing to the antral follicle pool considered promising in increasing the AMH levels conceivably.
Objectives: The aim of this study was to compare the effects of sildenafil, vardenafil and tadala... more Objectives: The aim of this study was to compare the effects of sildenafil, vardenafil and tadalafil in treatment for ischemia/reperfusion injury which is created experimentally in rat ovaries. Material and methods: For this study, 30 female Wistar albino rats were used, and the rats were separated randomly into five groups consisting of six rats each: normal, torsion-detorsion, torsion-detorsion + sildenafil 1.4 mg/kg, torsion-detorsion + vardenafil 1.7 mg/kg and torsion-detorsion + tadalafil 5.0 mg/kg. The agents were given intraperitoneally 30 minutes before detorsion. An ovarian torsion procedure was implemented in all other groups for 3 hours with the exception of the normal group. Then, a detorsion procedure was implemented to the groups for 3 hours. Results: The sildenafil and vardenafil treatments showed protective effect by preventing significant increase in inflammation parameters. (p = 0.058, 0.138). The tadalafil treatment was only protective for cellular degeneration (p = 0.140). The vardenafil treatment was protective for edema (p = 0.238), vascular congestion (p = 0.111), inflammation (p = 0.138) and cellular degeneration (p = 0.532). Sildenafil, vardenafil and tadalafil inhibited the increase of atretic follicle. AMH levels were statistically different between torsion and detorsion and vardenafil group (p = 0.004, 0.004), whereas tadalafil and sildenafil groups were similar to normal group (p = 0.108, 0.108). Conclusions: PDE inhibitors were found to be effective in reducing ovarian ischemia/reperfusion injury. Sildenafil and tadalafil seem to be more effective than the vardenafil in protecting the ovarian reserve.
Although oncological treatments are improving, the prognosis of non-small-cell lung cancer (NSCLC... more Although oncological treatments are improving, the prognosis of non-small-cell lung cancer (NSCLC) patients has not. Several biomarkers related to prognosis have been evaluated, and M30 and M65 have been reported to be higher in patients with NSCLC than in healthy people. In the current study, we evaluated the clinical importance of the change in serum M30 and M65 values after chemotherapy in patients with NSCLC. Serum M30 and M65 values were measured before and 48 h after chemotherapy in thirty-two patients with advanced NSCLC. The importance of the change in the levels of these markers after chemotherapy was analyzed by univariate analysis. The median serum M65 and M30 values increased significantly after chemotherapy (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The median M30 value after chemotherapy was an important prognostic factor for both overall survival (OS) (p = 0.002) and progression-free survival (PFS) (p = 0.002). Stage and histopathological type were significant both for PFS and OS. Multivariate analysis showed that the median M30 value after chemotherapy was the only independent prognostic factor for PFS (p = 0.04, HR 5.4) and OS (p = 0.02, HR 11.49). Our results indicated that both serum M30 and M65 values increased after chemotherapy in patients with advanced NSCLC, and an elevated serum M30 value was an independent prognostic factor for both PFS and OS.
Background: The subjects with impaired glucose tolerance have an increased risk for future type 2... more Background: The subjects with impaired glucose tolerance have an increased risk for future type 2 diabetes (T2DM); however, a significant number of individuals who develop T2DM have normal glucose tolerance (NGT) at baseline. The study aims to compare glycated hemoglobin (HbA1C) and homeostasis model assessment (HOMA-IR) levels to 30, 60 and 90-min glucose levels in subjects with NGT. Methods: A 75-g oral glucose tolerance test (OGTT) at 0, 30, 60, 90 and 120-min was performed in 1118 subjects without known T2DM. Blood samples were also drawn for fasting insulin and HbA1C levels. Results: Forty percent of the subjects with NGT had increased post-challenge values above the determined optimal glucose levels (10.2, 10.3 and 8.9 mmol/L at 30, 60 and 90-min, respectively). Compared to the subjects with NGT whose glucose levels were below the determined optimal values at 30, 60 and 90-min, we found significantly elevated HbA1C and HOMA-IR levels in the subjects with NGT whose glucose levels were above the determined optimal values (p<0.001). Conclusions: We conclude that the subjects with NGT have different HbA1C and HOMA-IR levels considering glucose levels measured earlier than at 2-h during OGTT. Further well-designed prospective studies are needed to define the significance of 30-min, 60-min and 90-min glucose levels in the prediction of disease in subjects with T2DM.
BACKGROUND The effectiveness of aspiration and vacuum filling method with an adaptor in reducing ... more BACKGROUND The effectiveness of aspiration and vacuum filling method with an adaptor in reducing hemolysis was investigated. METHODS The study was conducted in the yellow zone of the Emergency department. Two different apparatuses that draw blood with two different techniques from an IV catheter were compared with our routine procedure. The first system drew blood with aspiration technique into 4.9 mL serum gel tube (Sarstedt S-Monovette®). The second was vacuum filling with a specific adaptor attached to the same catheter drawing the blood into vacuumed serum separator tubes (BD Vacutainer® SST™II and Luer-Lok™ Access Device (LLAD). In our routine, we use plastic syringes and deliver it into the same serum separator vacuum tubes. We measured the hemolysis index, AST, CK, potassium, and LDH. RESULTS Hemolysis rates of aspiration method vs. routine were 0.80% and 38.7% (p < 0.001) and of vacuum filling with adaptor vs. routine were 13.5% and 40.6%, respectively (p = 0.0001). The hemolysis rate of the aspiration method was lower than the vacuum filling adaptor method (p = 0.0004). Both techniques showed better performance when measured parameters were compared; aspiration technique being the superior (all p < 0.0001). CONCLUSIONS Aspiration method was more successful then vacuum filling methods in reducing hemolysis.
Cancer Chemotherapy and Pharmacology, Oct 22, 2010
Purpose M30 and M65 are different circulating fragments of cytokeratin 18. They release during ap... more Purpose M30 and M65 are different circulating fragments of cytokeratin 18. They release during apoptotic cell death, so it is believed that they reflect cell death of epithelial tumors. The aim of this study was to determine the prognostic value of plasma M30 and M65 levels in predicting of survival for patients with advanced gastric cancer compare with healthy controls. Methods Thirty-four patients with advanced gastric cancer and thirty-two healthy controls were included. Plasma M30 and M65 values were measured by quantitative ELISA method. Results The median age of patients and control groups was 60 and 56 years, respectively. No difference was detected between patient and control groups with respect to plasma median M30 values (390.4 vs. 270.7 U/l, respectively, P = 0.10). The median plasma M65 values of patients were significantly higher than those of control group (1232.1 vs. 580.1 U/l, P \ 0.001). The best cutoff values for plasma M30 and M65 for predicting progression-free survival (PFS) were 277.7 and 1434.9 U/l in ROC analysis. The patients whose plasma M30 values were higher than 277.7 U/l had worse PFS than patients with plasma M30 value \277.7 U/l (8.9 vs. 11.2, respectively, P = 0.01). The median PFS of patients whose M65 levels lower than or equal to 1434.9 U/l was better than that of patients whose M65 levels were [1434.9 U/l (12.4 vs. 10.4, respectively, P = 0.04). But plasma M30 and M65 level in patient group were not found to be an important prognostic factor for PFS in the multivariate analysis. Conclusions These results showed that plasma M65 values were significantly elevated in patients with advanced gastric cancer compared to healthy people. Moreover, both increased plasma M30 and M65 levels can predict PFS in patients with gastric cancer.
Open Journal of Clinical and Medical Case Reports, Jul 24, 2023
We present a 9 years old case with complicated Crush Syndrome rescued from dent at 57th hour in K... more We present a 9 years old case with complicated Crush Syndrome rescued from dent at 57th hour in Kahramanmaraş earthquake in Türkiye. We emphasized on the importance of laboratory support in all clinical stages of the patient; beginning from diagnosis through acute kidney injury and metabolic acidosis complications and follow-up of treatment in intensive care unit.
The capillary zone electrophoresis (CZE) and highperformance liquid chromatography (HPLC) methods... more The capillary zone electrophoresis (CZE) and highperformance liquid chromatography (HPLC) methods were compared in terms of HbA2 measurement for the assessment of hemoglobinopathies. Materials and Methods: CZE was compared with HPLC for the evaluation of patients without hemoglobinopathy (n=321), with β-thalassemia trait (n=113), and with common (HbD-Punjab, E, C, S/A, and S/S) and rare (HbS/D, O-Arap, Lepore, G-Coushata, Setif, Hamadan, Q-Iran, and H) variants (n=21). The reference range for HbA2 was determined by CZE. Results: Among patients without hemoglobinopathy, the median (2.5 th -97.5 th percentiles) values were 97.4% (97.0-98.0%) and 97.5% (96.6-98.4%) for HbA (p=0.060) and 2.4% (1.6-3.0%) and 2.5% (1.6-3.1%) for HbA2 (p<0.001) by HPLC and CZE, respectively. The reference range for HbA2 was 1.6-3.1% by CZE. In the comparison of methods for HbA2, there was a constant error of 0.255 (confidence interval: 0.062-0.448) and bias of 0.10% (limit of agreement: 0.33-0.53), and higher values were obtained with CZE. A strong correlation was observed between the methods (r=0.782). Interrater agreement was almost perfect for clinical diagnosis (κ=0.911). The two methods detected and identified the common variants similarly. All rare variants, except HbH by HPLC and HbS/D by CZE, were detected as separate peaks by both methods. The two methods were in agreement regarding the preliminary identification of β-thalassemia patients. Different Hb variants were detected by both methods but with possible methodological interference for HbA2 measurements. CZE is a reliable and simple alternative for the evaluation of hemoglobinopathies. The standardization of HbA2 measurements should be prioritized as more techniques become available in routine laboratory practice.
Background: The most common causes of microcytic anemias are Iron Deficiency Anemia (IDA) and Bet... more Background: The most common causes of microcytic anemias are Iron Deficiency Anemia (IDA) and Beta Thalassemia minor (BTm). Correct diagnosis is important to prevent unnecessary iron loading and to manage thalassemia states. In this study, we aimed to evaluate the performances of erythrocyte indices to support the differential diagnosis in a practical, quick and economic way. Materials and methods: We evaluated the premarital screening data and extracted microcytic anemic patients and classified as IDA and BTm according to Complete Blood Cell counts (CBC), ferritin, C-Reactive Protein (CRP) and HbA2 analysis results. 442 patients with IDA, 205 with BTm were enrolled in the study. Diagnostic performances of 23 indices were evaluated. The sensitivity, specificity, positive and negative predictive values, Youden’s index, Likelihood Ratios, Diagnostic Odds Ratios and Area Under Curve values out of Receiver Operating Characteristic curves were calculated. New cut-off values for each index was determined. Results: None of the indices had a 100 percent sensitivity or specificity. Sirdah Index (SI) had the best rank in overall performances followed by Mentzer Index (MI), England-Fraser (E-F), Ehsani Index (EI) and Green and King index (G&amp;K) while Telmissani MCHD, Bessman, Huber-Herklotz, Sirachainan, and Ricerca Index (RI) had the lowest performance. Conclusion: Indices are efficient enough for a preliminary differentiation of IDA and BTm before further diagnostic evaluation. Index performances differ among studies because of ethnic and genetic variations among study populations. Study settings as patient selection and cut-offs may also effect the performances of indices. Correct interpretation of performance criteria is also important in assessment of proper index.
Introduction. We evaluated the pattern of baldness and serum androgen levels in patients with ben... more Introduction. We evaluated the pattern of baldness and serum androgen levels in patients with benign prostate hyperplasia (BPH) and prostate cancer. BPH, prostate cancer and androgenic alopecia (AA) were somehow androgen dependent and affect large population of elderly men. Material and method. A total of 152 patients, 108 patients with BPH and 44 patients with prostate cancer were included in the study. We measured serum total, free and bioavailable testosterone, FSH, LH, prolactin, estradiol, albumin and SHBG levels. Baldness classification was based on Norwood's classification and we categorised baldness as vertex and frontal baldness. Result. The frequency of AA in BPH and prostate cancer groups were not different. We looked for some correlation between the two groups with respect to AA and hormone levels. We did not find any correlation between AA and total testosterone, free testosterone, bioavailable testosterone or SHBG levels in both groups. Conclusion. This prospective study with selected small group of patients showed that there is no difference of male pattern baldness in BPH and prostate cancer patients and also there is no correlation between pattern of baldness and serum androgen levels.
■ S p e c ia lis t, D e p a rtm e n t o f B io c h e m is try a n d C lin ic a l B io c h e m is ... more ■ S p e c ia lis t, D e p a rtm e n t o f B io c h e m is try a n d C lin ic a l B io c h e m is try , H a yd a rp a şa n u m u n e H o s p ita l, Is ta n b u l, T urke y. * * S p e c ia lis t, D e p a rtm e n t o f B io c h e m is try a n d C lin ic a l B io c h e m is try , K a rta l H o s p ita l, Is ta n b u l, T u rke y.
DOAJ (DOAJ: Directory of Open Access Journals), 2014
Background: The subjects with impaired glucose tolerance have an increased risk for future type 2... more Background: The subjects with impaired glucose tolerance have an increased risk for future type 2 diabetes (T2DM); however, a significant number of individuals who develop T2DM have normal glucose tolerance (NGT) at baseline. The study aims to compare glycated hemoglobin (HbA1C) and homeostasis model assessment (HOMA-IR) levels to 30, 60 and 90-min glucose levels in subjects with NGT. Methods: A 75-g oral glucose tolerance test (OGTT) at 0, 30, 60, 90 and 120-min was performed in 1118 subjects without known T2DM. Blood samples were also drawn for fasting insulin and HbA1C levels. Results: Forty percent of the subjects with NGT had increased post-challenge values above the determined optimal glucose levels (10.2, 10.3 and 8.9 mmol/L at 30, 60 and 90-min, respectively). Compared to the subjects with NGT whose glucose levels were below the determined optimal values at 30, 60 and 90-min, we found significantly elevated HbA1C and HOMA-IR levels in the subjects with NGT whose glucose levels were above the determined optimal values (p<0.001). Conclusions: We conclude that the subjects with NGT have different HbA1C and HOMA-IR levels considering glucose levels measured earlier than at 2-h during OGTT. Further well-designed prospective studies are needed to define the significance of 30-min, 60-min and 90-min glucose levels in the prediction of disease in subjects with T2DM.
Objective: The aim of this study is to evaluate the effect of ejaculation on serum total, free an... more Objective: The aim of this study is to evaluate the effect of ejaculation on serum total, free and complex prostate-specific antigen (PSA) levels and their effect on biopsy decisions. Material and methods: Our study includes 47 men older than 45 years with symptomatic benign prostatic hyperplasia (BPH). Patients' PSA levels were under 2.5 ng/mL, and there were no known conditions to preclude ejaculation. Eight patients with similar demographic, and clinical characteristics were chosen as a control group. With three days of sexual abstinence, blood samples were drawn for the measurement of baseline PSA levels, and then the patients were told to ejaculate. One, 5, 24 and 72 hours after ejaculation, serum total, free and complexed PSA levels were measured. Serum PSA sampling was performed at the same intervals in the control group without ejaculation. Results: The mean age of the patients was 59.13±1.38 years in the study group, and 63.75±3.13 years in the control group. The mean international prostate symptom scores (IPSS) were 11.78±1.12 and 11.63±3.32 in the study, and the control groups, respectively. The mean baseline total, free, and complexed PSA values were 1.07±0.09, 0.31±0.03, and 0.71±0.08 ng/mL, respectively. In the study group, total PSA value was found to be 1.29±0.12 ng/mL (p=0.008) at first hour after ejaculation, and this change was statistically significant when compared with baseline values. Mean total PSA level rose up to 1.28±0.13 ng/mL (p= 0.05) by the 5 th hour after ejaculation, but this change was not statistically significant relative to the baseline values. Mean free PSA level rose after the first hour postejaculation to 0.37±0.04 ng/mL (p= 0.01) and after the fifth hour postejaculation to 0.37±0.04 ng/mL (p= 0.002), and these changes were statistically significant relative to the baseline values. There were no statistically significant changes at the other sampled times as for the total, free or complexed PSA serum levels. When all three values were considered individually, in only 2.12% of the patients, biopsy decisions could be affected by the elevation in PSA levels. Conclusion: When the PSA value is borderline with respect to biopsy decisions, the effect of ejaculation on serum PSA levels may be clinically important. In these patients, ejaculation must be questioned, and repeated. PSA levels should be evaluated 24 hours after ejaculation. There were no statistically significant changes in the levels of complex PSA values. Further studies are needed to clarify the relationship between complexed PSA and ejaculation.
Journal of experimental and clinical medicine, Mar 14, 2021
To evaluate whether mirtazapine and mesna have protective effects on cisplatin-induced ovarian in... more To evaluate whether mirtazapine and mesna have protective effects on cisplatin-induced ovarian injury. A total of 32 female Wistar Albino rats were divided into 4 groups (8 rats per group) and included in the study. No medication was administered to the first group; only intervention was that their ovaries were removed and anti-mullerian hormone (AMH) values were measured. The second group received intramuscular cisplatin at a single dose of 7.5 mg/kg. The third group received a single dose of 200 mg/kg mesna intraperitoneally, and 30 minutes later, a single dose of 7.5 mg/kg intramuscular cisplatin was administered. The fourth group received oral 30 mg/kg mirtazapine, and 60 minutes later, a single dose of 7.5 mg/kg intramuscular cisplatin was administered. Oral 30 mg/kg mirtazapine was continued for ten days. Ovaries and AMH values of all groups were evaluated at the end of tenth day. In the cisplatin group when compared to normal ovarian tissue total histopathological damage score increased (p=0.037), preantral follicle count decreased (p=0.003) and AMH levels decreased (p<0.001). In the cisplatin + mesna group total ovarian damage score was also increased (p=0.005), preantral and antral follicles decreased (p<0.001 and p=0.001, respectively), and AMH levels decreased (p<0.001). In the cisplatin + mirtazapine group, total ovarian damage score (p<0.001), preantral follicle count (p=0.002) and AMH values were decreased (p<0.001). It was concluded that mesna and mirtazapine were not effective in preventing ovarian damage due to cisplatin.
In some studies, the prognostic and predictive significance of M30 and M65 has been reported to d... more In some studies, the prognostic and predictive significance of M30 and M65 has been reported to detect response to chemotherapy. In the present study, we aimed at determining the changes of serum M30 and M65 values after chemotherapy and the impact of these values on treatment response and progression-free survival (PFS) and overall survival (OS) of patients with advanced gastric cancer. A total of 31 patients with advanced gastric cancer was included. M30 and M65 values were measured by a quantitative enzyme-linked immunosorbent assay (ELISA) method in serum samples before and 48 h after the first chemotherapy cycle. Pre- and postchemotherapy values of M30 and M65 were compared. The difference between the mean values of serum M30 and M65 before and after chemotherapy was calculated and the prognostic significance of changes for survival was evaluated by univariate and multivariate analysis. Logistic regression analysis was performed to predict response to chemotherapy. Serum M30 and M65 levels were found to be increased significantly after chemotherapy (M30, 582.7 ± 111.5 U/l [pre mean] vs. 983.3 ± 214.1 U/l [post mean], p = 0.01; M65, 2,061.7 ± 431.2 U/l [pre mean] vs. 2,646.3 ± 433.1 U/l [post mean], p = 0.003). Means of the differences of M30 and M65 levels before and 48 h after chemotherapy were 400.5 ± 190 U/l ([M30-difference] M30-D) and 584.6 ± 335.4 U/l (M65-D), respectively. Patients with serum M30-D of &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;400.5 U/l had better median PFS and OS times than patients with M30-D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;400.5 U/l (PFS, 9.9 vs. 4.3 months, p = 0.018 and OS, 13.6 vs. 8.1 months, p = 0.029). In addition, median PFS and OS intervals in patients with serum M65-D &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 584.6 U/l were significantly worse than those of patients whose M65-D was lower than or equal to 584.6 U/l (4.1 vs. 11.4 months for PFS, p = 0.002 and 5.7 vs. 13.6 months for OS, p = 0.005). Patients with values above M30-D and M65-D had a better tumor response compared with patients with values below M30-D and M65-D (p = 0.02 and p = 0.006, respectively). In the logistic regression analysis, only M65-D was significantly found to be an independent factor in predicting response to chemotherapy (p = 0.018, OR:1.4). However, only M30 levels after chemotherapy were found to be an independent prognostic factor for PFS in the multivariate analysis. These results showed for the first time that both M30 and M65 in serum samples of patients with advanced gastric cancer were elevated 48 h after chemotherapy and these were poor prognostic factors for both PFS and OS of patients. Moreover, increased serum M65 levels after chemotherapy can be predict tumor response.
Medical Laboratory Technology Journal, Mar 16, 2020
To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian r... more To determine the possible detrimental effects of multiple methotrexate doses has on the ovarian reserve and to determine the beneficial effects of dehydroepiandrosterone supplementation. The rats (n:24) divided into three groups; Group 1: control group, Group 2: dehydroepiandrosterone and methotrexate group (6mg/kg dehydroepiandrosterone dissolved in 0.1 ml sesame seed oil subcutaneously for ten days and 1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th days) and Group 3: methotrexate group (1mg/kg intramuscular methotrexate at the 1st, 3rd, 5th and 7th day). The groups compared in regards to their histopathological ovarian damage scores and AMH values. It established that multiple methotrexate applications had a considerable effect on reducing vascular congestion in the ovarian tissue. Both in groups 2 and 3 AMH values found to be significantly lower. When this decline in the ovarian reserve examined comparatively; while both the group 2 and 3 reported having a considerable and continuous reduction in the AMH levels correlative to the control group; the primordial, primary and total follicle counts shown to stay statistically the same in the group 2 (p<0.0167). The dehydroepiandrosterone supplementation, while did not have a significant effect on reducing ovarian damage induced by methotrexate, also was not shown to provide any considerable increase in AMH levels. However, prolonged usage of dehydroepiandrosterone by contributing to the antral follicle pool considered promising in increasing the AMH levels conceivably.
Objectives: The aim of this study was to compare the effects of sildenafil, vardenafil and tadala... more Objectives: The aim of this study was to compare the effects of sildenafil, vardenafil and tadalafil in treatment for ischemia/reperfusion injury which is created experimentally in rat ovaries. Material and methods: For this study, 30 female Wistar albino rats were used, and the rats were separated randomly into five groups consisting of six rats each: normal, torsion-detorsion, torsion-detorsion + sildenafil 1.4 mg/kg, torsion-detorsion + vardenafil 1.7 mg/kg and torsion-detorsion + tadalafil 5.0 mg/kg. The agents were given intraperitoneally 30 minutes before detorsion. An ovarian torsion procedure was implemented in all other groups for 3 hours with the exception of the normal group. Then, a detorsion procedure was implemented to the groups for 3 hours. Results: The sildenafil and vardenafil treatments showed protective effect by preventing significant increase in inflammation parameters. (p = 0.058, 0.138). The tadalafil treatment was only protective for cellular degeneration (p = 0.140). The vardenafil treatment was protective for edema (p = 0.238), vascular congestion (p = 0.111), inflammation (p = 0.138) and cellular degeneration (p = 0.532). Sildenafil, vardenafil and tadalafil inhibited the increase of atretic follicle. AMH levels were statistically different between torsion and detorsion and vardenafil group (p = 0.004, 0.004), whereas tadalafil and sildenafil groups were similar to normal group (p = 0.108, 0.108). Conclusions: PDE inhibitors were found to be effective in reducing ovarian ischemia/reperfusion injury. Sildenafil and tadalafil seem to be more effective than the vardenafil in protecting the ovarian reserve.
Although oncological treatments are improving, the prognosis of non-small-cell lung cancer (NSCLC... more Although oncological treatments are improving, the prognosis of non-small-cell lung cancer (NSCLC) patients has not. Several biomarkers related to prognosis have been evaluated, and M30 and M65 have been reported to be higher in patients with NSCLC than in healthy people. In the current study, we evaluated the clinical importance of the change in serum M30 and M65 values after chemotherapy in patients with NSCLC. Serum M30 and M65 values were measured before and 48 h after chemotherapy in thirty-two patients with advanced NSCLC. The importance of the change in the levels of these markers after chemotherapy was analyzed by univariate analysis. The median serum M65 and M30 values increased significantly after chemotherapy (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001). The median M30 value after chemotherapy was an important prognostic factor for both overall survival (OS) (p = 0.002) and progression-free survival (PFS) (p = 0.002). Stage and histopathological type were significant both for PFS and OS. Multivariate analysis showed that the median M30 value after chemotherapy was the only independent prognostic factor for PFS (p = 0.04, HR 5.4) and OS (p = 0.02, HR 11.49). Our results indicated that both serum M30 and M65 values increased after chemotherapy in patients with advanced NSCLC, and an elevated serum M30 value was an independent prognostic factor for both PFS and OS.
Background: The subjects with impaired glucose tolerance have an increased risk for future type 2... more Background: The subjects with impaired glucose tolerance have an increased risk for future type 2 diabetes (T2DM); however, a significant number of individuals who develop T2DM have normal glucose tolerance (NGT) at baseline. The study aims to compare glycated hemoglobin (HbA1C) and homeostasis model assessment (HOMA-IR) levels to 30, 60 and 90-min glucose levels in subjects with NGT. Methods: A 75-g oral glucose tolerance test (OGTT) at 0, 30, 60, 90 and 120-min was performed in 1118 subjects without known T2DM. Blood samples were also drawn for fasting insulin and HbA1C levels. Results: Forty percent of the subjects with NGT had increased post-challenge values above the determined optimal glucose levels (10.2, 10.3 and 8.9 mmol/L at 30, 60 and 90-min, respectively). Compared to the subjects with NGT whose glucose levels were below the determined optimal values at 30, 60 and 90-min, we found significantly elevated HbA1C and HOMA-IR levels in the subjects with NGT whose glucose levels were above the determined optimal values (p<0.001). Conclusions: We conclude that the subjects with NGT have different HbA1C and HOMA-IR levels considering glucose levels measured earlier than at 2-h during OGTT. Further well-designed prospective studies are needed to define the significance of 30-min, 60-min and 90-min glucose levels in the prediction of disease in subjects with T2DM.
BACKGROUND The effectiveness of aspiration and vacuum filling method with an adaptor in reducing ... more BACKGROUND The effectiveness of aspiration and vacuum filling method with an adaptor in reducing hemolysis was investigated. METHODS The study was conducted in the yellow zone of the Emergency department. Two different apparatuses that draw blood with two different techniques from an IV catheter were compared with our routine procedure. The first system drew blood with aspiration technique into 4.9 mL serum gel tube (Sarstedt S-Monovette®). The second was vacuum filling with a specific adaptor attached to the same catheter drawing the blood into vacuumed serum separator tubes (BD Vacutainer® SST™II and Luer-Lok™ Access Device (LLAD). In our routine, we use plastic syringes and deliver it into the same serum separator vacuum tubes. We measured the hemolysis index, AST, CK, potassium, and LDH. RESULTS Hemolysis rates of aspiration method vs. routine were 0.80% and 38.7% (p < 0.001) and of vacuum filling with adaptor vs. routine were 13.5% and 40.6%, respectively (p = 0.0001). The hemolysis rate of the aspiration method was lower than the vacuum filling adaptor method (p = 0.0004). Both techniques showed better performance when measured parameters were compared; aspiration technique being the superior (all p < 0.0001). CONCLUSIONS Aspiration method was more successful then vacuum filling methods in reducing hemolysis.
Cancer Chemotherapy and Pharmacology, Oct 22, 2010
Purpose M30 and M65 are different circulating fragments of cytokeratin 18. They release during ap... more Purpose M30 and M65 are different circulating fragments of cytokeratin 18. They release during apoptotic cell death, so it is believed that they reflect cell death of epithelial tumors. The aim of this study was to determine the prognostic value of plasma M30 and M65 levels in predicting of survival for patients with advanced gastric cancer compare with healthy controls. Methods Thirty-four patients with advanced gastric cancer and thirty-two healthy controls were included. Plasma M30 and M65 values were measured by quantitative ELISA method. Results The median age of patients and control groups was 60 and 56 years, respectively. No difference was detected between patient and control groups with respect to plasma median M30 values (390.4 vs. 270.7 U/l, respectively, P = 0.10). The median plasma M65 values of patients were significantly higher than those of control group (1232.1 vs. 580.1 U/l, P \ 0.001). The best cutoff values for plasma M30 and M65 for predicting progression-free survival (PFS) were 277.7 and 1434.9 U/l in ROC analysis. The patients whose plasma M30 values were higher than 277.7 U/l had worse PFS than patients with plasma M30 value \277.7 U/l (8.9 vs. 11.2, respectively, P = 0.01). The median PFS of patients whose M65 levels lower than or equal to 1434.9 U/l was better than that of patients whose M65 levels were [1434.9 U/l (12.4 vs. 10.4, respectively, P = 0.04). But plasma M30 and M65 level in patient group were not found to be an important prognostic factor for PFS in the multivariate analysis. Conclusions These results showed that plasma M65 values were significantly elevated in patients with advanced gastric cancer compared to healthy people. Moreover, both increased plasma M30 and M65 levels can predict PFS in patients with gastric cancer.
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