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ABSTRACT In the present study, the importance of laboratory parameters and CT findings in the early diagnosis of COVID-19 was investigated. To this end, 245 patients admitted between April 1st, and May 30th, 2020 with suspected COVID-19 were enrolled. The patients were divided into three groups according to chest CT findings and RT-PCR results. The non-COVID-19 group consisted of 71 patients with negative RT-PCR results and no chest CT findings. Ninety-five patients with positive RT-PCR results and negativechest CT findings were included in the COVID-19 group; 79 patients with positive RT-PCR results and chest CT findings consistent with COVID-19 manifestations were included in COVID-19 pneumonia group. Chest CT findings were positive in 45% of all COVID-19 patients. Patients with positive chest CT findings had mild (n=30), moderate (n=21) andor severe (n=28) lung involvement. In the COVID-19 group, CRP levels and the percentage of monocytes increased significantly. As disease progressed from mild to severe, CRP, LDH and ferritin levels gradually increased. In the ROC analysis, the area under the curve corresponding to the percentage value of monocytes (AUC=0.887) had a very good accuracy in predicting COVID-19 cases. The multinomial logistic regression analysis showed that CRP, LYM and % MONO were independent factors for COVID-19. Furthermore, the chest CT evaluation is a relevant tool in patients with clinical suspicion of COVID-19 pneumonia and negative RT-PCR results. In addition to decreased lymphocyte count, the increased percentage of monocytes may also guide the diagnosis.

ABSTRACT Objective: In this study, we aimed to evaluate serum irisin and apelin levels in patients with subclinical hypothyroidism (SCH) when they were subclinical hypothyroid and become euthyroid after levothyroxine therapy and association of these adipokines with markers of atherosclerosis such as serum homocysteine levels and carotid intima-media thickness (IMT). Subjects and methods: The study included 160 patients with newly diagnosed subclinical hypothyroidism due to Hashimoto's thyroiditis and 86 euthyroid healty subjects. Serum glucose and lipid profile, insulin, HOMA, TSH, free T3, free T4, anti-thyroperoxidase and anti-thyroglobulin antibodies, homocysteine, apelin and irisin levels were measured in all study subjects. Thyroid and carotid ultrasound examinations were performed. The subclinical hypothyroid group was reevaluated after 12-weeks of levothyroxine therapy when they became euthyroid. Results: Clinical characteristics of the patient and control group were similar. Glucose, insulin and HOMA levels, lipid parameters and free T3 were similar between the two groups.. Serum homocystein was higher and apelin was lower in patients with SCH, but irisin levels were similar between the two groups. While thyroid volume was lower, carotid IMT was significantly greater in patients with SCH (pCarotidIMT:0,01). After 12-weeks of levothyroxine therapy, all the studied parameters remained unchanged except, serum freeT4, TSH, homocystein and apelin. While homocystein decreased (p: 0,001), apelin increased significantly (p = 0,049). In multivariate analysis, low apelin levels significantly contributed to carotid IMT (p = 0,041). Conclusions: Apelin-APJ system may play a role in vascular and cardiac dysfunction in patients with SCH and treatment of this condition may improve the risk of cardiovascular disease.

Ziel des Sprachunterrichts ist es, den Lernenden zu befähigen, eine gesunde Kommunikation mit seiner Umwelt aufzubauen, indem er seine vier grundlegenden Sprachfertigkeiten entwickelt. Das Zuhören, welches zu den rezeptiven Kompetenzbereichen gehört, bildet beim Fremdsprachenlernen die Grundlage für die Kommunikationsfähigkeit. Es ist wichtig, dass der Lernende versteht, was er hört, und dass er beim Sprachenlernen nicht auf Schwierigkeiten stößt. Für einen erfolgreichen Fremdsprachenunterricht, insbesondere im Fernunterricht, ist es notwendig, die Auswirkungen von Hörübungen in den verwendeten Lehrmaterialien auf das Hörverhalten und das Lernen der Lerner zu ermitteln. Diese Studie, welche erstellt wurde, um die Verhaltensweisen und Einstellungen der Studenten zu Hörverständniskompetenzen in Bezug auf das aktuelle Unterrichtsmaterial „Aussichten A1“ zu bestimmen, das Deutsch als Fremdsprache auf A1-Niveau lernen, basiert auf eine quantitative Forschungsmethode. Das Programm AMOS 24 und auch das Programm SPSS 22 wurden in der Untersuchung verwendet. Es wurden erklärende Faktorenanalysen (EFA) und Diskriminanzanalysen durchgeführt, um die Zuverlässigkeit der entwickelten Skalen-Items zu analysieren. Zur Bestimmung der internen Konsistenz der Skala wurden konfirmatorische Faktorenanalysen (CFA) verwendet und Cronbachs Alpha-Tests durchgeführt. In diesem Zusammenhang wurde im Wintersemester 2019-2020 ein Fragebogen mit einer eigens entwickelten Skala an 675 Studierende verschiedener Fernstudiengänge der Anadolu Universität angelegt. Während sich die Untersuchungsgruppe aus Fernstudierenden an der Universität zusammensetzt, besteht die Stichprobe aus Studierenden, die Deutsch als Fremdsprache lernen. Nach den Forschungsergebnissen kann gesagt werden, dass die Struktur der Lerninhalte des Fernunterrichts und ihr Einfluss auf die Entwicklung der Sprachfähigkeit und Haltungen der Lernenden zum Verstehen des Gehörten „teilweise“ wirken.

Objective: Gestational diabetes mellitus (GDM) is observed in pregnant women worldwide with a prevalence ranging between 1% and 14%. The oral glucose tolerance test (OGTT) is performed for diagnosis. We compared the diagnostic value of HbA1c with the OGTT test in the diagnosis of GDM. Methods: 24-28 weeks pregnant women whose HbA1c was studied on the same day between 2019- 2023 January and who had OGTT with 75 g oral glucose were included in the study. Age, HbA1c, and hemoglobin values of groups separated as GDM and non-GDM were compared with the Wilcoxon test. Logistic regression analysis was used to determine the relationship of fasting plasma glucose (FPG) and HbA1c values with the OGTT result. Finally, ROC analysis was performed to evaluate diagnostic performance. Results: According to the OGTT results, out of 81 patients included in the study, 28 (34.6%) were classified as non-GDM, and 53 (65.4%) were classified as GDM. The median HbA1c value of the non-GDM group is 5.05% and the GDM group is 5.3%, and the statistical difference between the two groups is significant (p=0.032). In the ROC analysis, the AUC was 0.65 for HbA1c, 0.94 for FPG and 0.94 for HbA1c + FPG. Conclusion: In the prediction of GDM, the diagnostic performance of ROC analysis alone or even together with the FPG value of HbA1c is low; It has been observed that HbA1c is not sufficient for diagnosis in patients with suspected GDM and OGTT study may be more effective.

Objective: In clinical laboratories, it is aimed to minimize the sources of error in pre- and postanalytical processes along with the analytical process. The most common errors are pre-analytical process errors, which are frequently encountered during sample collection. For quality and reliable test results, the validation of sampled tubes is important and helps reduce pre-analytical errors. This study aimed to compare the HbA1c results of the K2-EDTA BD Vacutainer tube that we currently use for HbA1c measurement in our laboratory and two different brands of EDTA tubes from another manufacturer. Methods: Blood was drawn simultaneously from 29 patients with diabetes mellitus, 20 with prediabetes, and 29 apparently healthy individuals into three different EDTA tubes (K2-EDTA BD Vacutainer, K2-EDTA Samplix, and K3-EDTA Vacuette). The bias% was calculated for clinical significance and evaluated according to the CLIA bias% target (1.5%). Results: The median (interquartile range) values of HbA1c levels of K2-EDTA BD Vacutainer, K2-EDTA Samplix, and K3-EDTA Vacuette tubes were the same and were 6.0% (5.5-7.6). There was no statistically significant difference between the HbA1c results of the BD Vacutainer, Samplix, and Vacuette tubes (p=0.980). The calculated bias% values were

INTRODUCTION: To determine the clinical significance of serum 25-hydroxy (OH) vitamin D levels in pediatric patients with multisystem inflammatory syndrome in children (MIS-C) and compare the vitamin D levels of these patients with those patients with Coronavirus disease-2019 (COVID-19) and healthy controls. METHODS: This study was designed for pediatric patients aged 1 month to 18 years and conducted between July 14 and December 25, 2021. Fifty-one patients with MIS-C, 57 who were hospitalized with COVID-19, and 60 controls were enrolled in the study. Vitamin D insufficiency was defined as a serum 25 (OH) vitamin D level of less than 20 ng/mL. Severe MIS-C was classified as necessitating intensive care due to cardiovascular instability, the necessity for non-invasive or invasive mechanical ventilation, and/or a diminishing Glasgow coma scale. World Health Organization definition criteria were used to describe the clinical stages of COVID-19 in children and patients were divided into four groups according to the clinical severity of COVID-19: asymptomatic, mild, moderate, and severe/critical. RESULTS: The median serum 25 (OH) vitamin D was 14.6 ng/mL in patients with MIS-C, 16 ng/mL in patients with COVID-19, and 21.1 ng/mL in the control group (p

INTRODUCTION: Measurement of blood zinc levels is frequently used in the diagnosis of a few conditions such as growth retardation, immunodeficiency, infertility, neurological disorder, and acrodermatitis enteropathica. The serum matrix is the most preferred one to determine zinc levels due to the ease of analysis with other tests and cost-effectiveness of blood collection tubes used to obtain serum samples. In our study, we aimed to compare serum and plasma zinc test results for accurate and reliable zinc measurement in plain tubes with clot activator and gel and in heparin-free tubes, which specifically produced for trace element analysis. METHODS: Twenty-seven randomly selected patients were included in the study. Blood samples drawn simultaneously from patients were pipetted into tubes with clot activator and gel (SST) (SST II Advance, Vacutainer, Becton Dickinson and Company, USA) as well as into trace element tubes with sodium heparin (NH) (NH Trace Elements Sodium Heparin, Vacuette, Greiner Bio-One GmbH, Austria). After the centrifugation process, zinc levels in serum and plasma samples were analyzed by colorimetric method using an autoanalyzer. Bias between serum and plasma zinc levels was evaluated according to the allowable bias criterion based on biological variation and regression analysis performed. RESULTS: The mean and standard deviation of serum and plasma zinc levels were 49.0+-11.5 μg/dL and 46.4+-12.0 μg/dL, respectively, and a statistically significant difference was determined (p=0.012) in between. Besides, the bias between serum and plasma was 6.8%, which was above the allowable bias (3.3%) and considered as clinically significant. No systematic or random errors detected. DISCUSSION AND CONCLUSION: When selecting a blood collection tube for trace element analysis, the structural differences between tubes and the matrix effect should be considered carefully.

Introduction:Acromegaly is a rare disease caused by overproduction of growth hormone (GH) secreted from a benign pituitary adenoma. It has been shown in many studies that the incidence of cancer is increased in patients with acromegaly with increased GH and insulin-like growth factor-1 (IGF-1). Especially, colon cancer is more common. Thrombospondin-1 (TSP-1) is a glycoprotein that is thought to play an important role in cancer formation. This study aimed to evaluate circulating TSP-1 levels in patients with acromegaly.Methods:This study was a case-control study. Fifty-two patients with active acromegaly with GH

INTRODUCTION: Although anemia is common in children, there isn't much study related with this issue. In this study, we aimed to investigate iron, folate and vitamin B12 status in children and adolescents in a single center study in the aegean region of our country. METHODS: We evaluated the children without chronic disease who were admitted to our hospital between 2008-2016 (n=7310), retrospectively. Ferritin, iron and iron binding capacity were measured by Olympus 2700 analyzer. Folate and vitamin B12 were measured by Immulite 2000 and Cobas E411 analyzer, respectively. MCV and hemoglobin were measured by Beckman Coulter LH750. Kruskal–Wallis and Mann-Whitney U test were used for comparison between groups. RESULTS: Children (2743 boys, 4567 girls) aged between 1-18 years old were screened. The percentage of iron, folate, vitamin B12 and combined iron and vitamin B12 deficiencies were found to be 21.7%, 8%, 16.9%, and 4.7% respectively. 18.8% of all participants were anemic. The incidence of combined iron and vitamin B12 in anemic group was found to be high (10.2%), although anemic and non-anemic groups were similar with respect to vitamin B12 and folate deficiencies. DISCUSSION AND CONCLUSION: Iron deficiency may mask the megaloblastic anemia caused by vitamin B12 and folate deficiency. Effective preventive social nutrition programs may be useful in preventing anemia.

INTRODUCTION[|]Diabetic nephropathy (DN) is the major cause of chronic renal failure, and proteinuria is an independent risk factor for the end stage renal disease. The random urine protein: creatinine ratio (P: C ratio) can accurately predict the amount of 24-hour urinary protein excretion. Apelin is thought to be associated with endothelial dysfunction, angiogenesis, and inflammation. This study investigated the apelin concentration and its association with the urine P: C ratio, and metabolic parameters in subjects with and without type 2 diabetes mellitus (T2D).[¤]METHODS[|]This study involved 86 subjects: 56 with newly diagnosed and untreated T2D and 30 non-diabetic controls. All subjects underwent a complete clinical examination that included anthropometric and laboratory measurements.[¤]RESULTS[|]Twenty-four males and sixty-two females participated in this study, and their mean age was 52.27+-11.34 years. There were no differences in age, thyrotropin-stimulating hormone (TSH), creatinine clearance, and apelin levels between groups. As expected, fasting plasma glucose, weight, body mass index, and HbA1C were higher in T2D subjects (p=0.001, p=0.02, p=0.03, and p=0.001, respectively). Although apelin levels were higher in the control group, the differences were not statistically significant (p=0.93). The P: C ratio levels were lower in the control group, and the differences were statistically significant (p=0.006). A Spearman correlation analysis revealed that serum apelin levels were not correlated with the urine P: C ratio.[¤]DISCUSSION AND CONCLUSION[|]Our study demonstrates that T2D is associated with decreased serum apelin levels and increased urine P: C ratios compared to those in non-diabetic subjects. This association may depend on impaired glucose homeostasis. Our results show that the serum apelin levels were not correlated with the urine protein: creatinine ratio and provide further evidence regarding the relationship between apelin and DN.[¤]

Background: Serum procalcitonin (PCT) and C-reactive protein (CRP) are markers of systemic inflammation and bacterial infection. We aimed to compare the usefulness of procalcitonin and CRP in patients with communityacquired pneumonia and exacerbations of chronic obstructive pulmonary disease (COPD). Methods: A total of 116 consecutive patients were included in the study: 76 with chronic obstructive pulmonary disease in group 1, and 40 with pneumonia in group 2. Results: Median serum CRP level was 44 mg/L in the COPD group and 132 mg/L in the pneumonia group. Median value of serum PCT was found to be 0.07 in the COPD group and 0.14 ng/mL in the pneumonia group. Serum PCT and CRP levels were significantly higher in the pneumonia group compared to the COPD group (p< 0.001). The area under the ROC curve was 0.788 (CI: 0.704-0.872) for CRP and 0.699 (CI: 0.599-0.800) for procalcitonin to identify pneumonia. Conclusions: Procalcitonin and CRP levels were significantly higher in patients with community-acquired pneumonia presenting to the emergency department with indications for hospitalization than in patients with exacerbations of chronic obstructive pulmonary disease. Serum CRP and procalcitonin concentrations were strongly correlated. CRP might be a more valuable marker in these patients with lower respiratory tract infections.