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Several factors may influence newborn thyroid-stimulating hormone (TSH) concentrations and cause subclinical hypothyroidism in a newborn. A sufficient level of leptin signalling is needed for the normal production of TSH and thyroid hormones by the thyroid gland. Our study aimed to investigate the correlation between maternal serum leptin concentration during the third trimester of pregnancy and newborn screening-TSH levels.This prospective cross-sectional study was conducted in obstetrics and gynaecology clinics of a state hospital between June and August 2013. Maternal venous blood samples were collected from 270 healthy pregnant women in the third trimester just before delivery. Measurements of maternal fT3, fT4, TSH, anti-thyroid peroxidase (TPO), and anti-thyroglobulin (anti-Tg) antibodies from serum samples were performed by chemiluminescence immunoassay. Maternal serum leptin levels were determined by ELISA. Dried capillary blood spots were used to measure newborn TSH levels.Subjects were divided into two groups according to the neonatal TSH levels using a cut-point of 5.5 mIU/L. Median maternal serum leptin levels were significantly higher in newborns whose TSH levels were higher than5.5 mIU/L [13.2 μg/L (1.3 - 46.5) vs 19.7 μg/L (2.4 - 48.5), p0.05]. Serum leptin levels showed a negative correlation with maternal fT4 (r=0.32, p0.05), fT3 (r=0.23, p0.05), and a positive correlation with BMI (r=0.30, p0.05).Our results suggest that high leptin levels in the third trimester of pregnancy influence maternal thyroid functions and might cause an increase in newborn TSH levels. Detection of high maternal serum leptin levels may be a reason for subclinical hypothyroidism.Postoji nekoliko faktora koji mogu uticati na koncentraciju tiroidno-stimulišućeg hormona (TSH) kod novo - rođenčadi i na izazivanje subkliničkog hipotiroidizma. Da bi štitna žlezda normalno proizvodila TSH i tiroidne hormone potreban je dovoljan nivo signalizacije leptina. U našoj studiji smo želeli da istra'imo korelaciju između koncentracije serumskog majčinskog leptina tokom trećeg trimestra trudnoće i nivo TSH na skriningu kod novo rođenčadi.Ova prospektivna studija preseka sprovedena je na akušersko-ginekološkim klinikama jedne dr'avne bolnice u periodu od juna do avgusta 2013. Uzorci venske krvi majki prikupljeni su od 270 zdravih trudnica u trećem tromesečju neposredno pre porođaja. Merenje majčinskih fT3, fT4, TSH, antitireoidnih peroksidaza (TPO) i antitireoglobulinskih (anti-Tg) antitela iz serumskih uzoraka izvedeno je hemiluminiscentnim imunološkim testom. Nivo leptina u serumu kod majki je određen ELISA testom. Za merenje nivoa TSH kod novorođenčadi korišćene su suve kapilarne krvne tačke.Ispitanici su podeljeni u dve grupe prema neonatalnim nivoima TSH sa graničnom vrednošću od 5,5 mIU/L. Srednji nivo serumskog leptina je bio značajno veći kod novorođenčadi čiji su nivoi TSH bili veći od5,5 mIU/L [13,2 mg/L (1,3-46,5) naspram 19,7 mg/L (2,4-48,5), p0,05]. Nivo leptina u serumu je pokazao negativnu korelaciju sa majčinim fT4 (r = 0,32, p0,05), fT3 (r = 0,23, p0,05) i pozitivnu korelaciju sa BMI (r = 0,30 p0,05).Naši rezultati ukazuju da visoki nivoi leptina u trećem tromesečju trudnoće utiču na funkcije štitne žlezde majke i mogu izazvati i povećati nivo TSH kod novo - rođenčadi. Otkrivanje visokog nivoa majčinskog leptina u serumu mo'e biti razlog za subklinički hipotiroidizam.

The diagnostic performance of reverse transcriptase polymerase chain reaction (RT-PCR) decreases during the late acute stage of the corona virus disease (COVID-19) infection; hence, serological assays can be used for disease diagnosis in patients non-protected through vaccinations at this stage. The objective of this study was to assess the diagnostic accuracy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody tests in current/past infections, determine proper testing time, and check the accuracy of cutoff values. In this study, 18 Ig (immunoglobulin) G, IgM, IgA, and total antibody serological assays were performed using 839 samples. Positive sera (n=132) were collected during the first 5 months after the patients were symptomatic and tested positive for the SARS-CoV-2 RT-PCR test; they were grouped as 0-10, 10-15,15 days according to the symptom onset. Negative sera (N=707) were obtained from patients with lupus before the pandemic. The performance of IgG and total antibody assays was better than those of IgA, IgM, and IgA-IgM for all post-symptom groups except for 0-10 days, which showed lower Ig assay sensitivity. During 10-15 and15 days,70% sensitivity to IgA, IgM, IgM-IgA assays and lower sensitivity were noted, respectively. The sensitivities of IgG and total antibody assays for group C were slightly lower than that of group B. There were no significant differences, but there were higher correlations between the methods or antigenic structures. Receiving operating characteristics (ROC) analysis revealed better cutoff values. For the diagnosis of late acute/past SARS-CoV-2 infection, serological tests can be performed on unvaccinated patients showing symptoms for ≥10 days. SARS-CoV-2 IgG and total antibodies were better diagnostic markers than IgM, IgA, and IgM+IgA, which were restricted to group B.

Calculating the sample size in scientific studies is one of the critical issues as regards the scientific contribution of the study. The sample size critically affects the hypothesis and the study design, and there is no straightforward way of calculating the effective sample size for reaching an accurate conclusion. Use of a statistically incorrect sample size may lead to inadequate results in both clinical and laboratory studies as well as resulting in time loss, cost, and ethical problems. This review holds two main aims. The first aim is to explain the importance of sample size and its relationship to effect size (ES) and statistical significance. The second aim is to assist researchers planning to perform sample size estimations by suggesting and elucidating available alternative software, guidelines and references that will serve different scientific purposes.

Objective Hemoglobinopathies are a common public health problem in Turkey. In the screening of these disorders in population, cation-exchange high performance liquid chromatography (HPLC) is accepted as the gold standard method. In this study, the aim was to assess four different HPLC devices used in hemoglobinopathy screening. Materials and methods A total of 58 blood samples were analyzed with four different HPLC methods (Bio-Rad variant II, Agilent 1100, Tosoh G8 and Trinity Ultra2 trademarks). Results The comparison study demonstrated a good correlation between the results of each HPLC analyzer and the reference value obtained by averaging all the HbA2 results belonging to the methods tested in the study [ (Tosoh G8 (r=0.988), Bio-Rad variant II (r=0.993), Agilent 1100 (r=0.98) and Trinity Ultra2 (r=0.992) ]. HbA2 determination in the presence of HbE was interfered in both Bio-Rad variant II and Tosoh G8. Conclusion The analyzers were found to have compatible HbA2 results but with accompanying different degrees of proportional and systematic biases. HPLC analyzers may be affected by different hemoglobin variants at different HbA2 concentrations, which is an important point to take into consideration during the evaluation of HbA2 results in thalassemia screening.

Objectives Trace elements are essential in thyroid functioning as they incorporate into biologically important enzymes as cofactors. The placenta can either activate or inhibit the transfer of maternal trace elements to the unborn. An imbalance of maternal trace elements in pregnancy may affect both maternal and newborn thyroid function. Methods Blood samples from 315 lactating mothers were collected in the first 48 h after delivery and evaluated for selenium (Se), copper (Cu), manganese (Mn), and zinc (Zn) using flame atomic absorption spectroscopy (FAAS) and quadrupole inductively coupled plasma-mass spectrometer (ICP-MS). Thyroid hormones and auto-antibodies (thyroid-stimulating hormone (TSH), free T3 (fT3), free T3 (fT4), anti–thyroid peroxidase (anti-TPO), and antithyroglobulin (anti-TG)) were analyzed in maternal blood using an electro-chemiluminescence immunoassay (ECLIA). Between 48 and 72 postpartum hours, spot blood samples were used for newborn screening-TSH measurement. Correlation and multivariate analyses were performed to evaluate the effect of maternal trace element levels on newborn screening-TSH levels. Results The medians (min-max) of maternal Se (45.16 µg/L (21.28–79.04)), Cu (210.10 µg/dL (117.04–390.64)), Mn (2.11 µg/L (0.20–3.46)), and Zn (0.43 mg/L (0.24–0.66)) were determined. A positive correlation was detected between Zn and maternal TSH levels (r=0.12, p Conclusions There was no significant association between most of the maternal serum trace elements and maternal thyroid hormone parameters, with an only exception between maternal Zn and maternal serum TSH. Finally, the association between maternal serum Cu levels and newborn screening-TSH levels may highlight the importance of maternal Cu levels on the newborn thyroid health.

Objectives In this study, we aimed to compare modified Krauss polyacrylamide gradient gel electrophoresis (PAGGE) and high-performance liquid chromatography (HPLC) methods in classification, quantification, and separation of lipoproteins and determining low-density lipoprotein (LDL) size. Methods Blood specimens were obtained from eighty-seven volunteers. We measured LDL size using the PAGGE method and HPLC method with total cholesterol (TC) and triglyceride (TG) peaks. In the PAGGE method, Coomassie Brilliant Blue (CBB) staining was used instead of Sudan black staining, unlike the original method. The relationship between PAGGE and HPLC methods was evaluated by Pearson correlation test and Passing-Bablok regression analysis. Agreement between them was evaluated by Kappa analysis and Bland-Altman plots. Results Statistically significant correlation was found between the LDL size with PAGGE and HPLC methods under the cholesterol curve (HPLC-TC) (r=0.924, p Conclusions The PAGGE method can be a reliable method for measuring LDL size. HPLC method under cholesterol and triglyceride peaks may be used in clinical practice interchangeably, but clinical decision limits should be different. In addition, our study demonstrated that measurement methods for LDL size could be simplified with several modifications.

Objectives To obtain optimal immunoassay screening and LC-MS/MS confirmation cut-offs for opiate group tests to reduce false positive (FP) and false negative (FN) rates. Methods A total of 126 urine samples, −50 opiate screening negative, 76 positive according to the threshold of 300 ng/mL by CEDIA method – were confirmed by a full-validated in-house LC-MS/MS method. Sensitivity, specificity, FP, and FN rates were determined at cut-off concentrations of both 300 and 2,000 ng/mL for morphine and codeine, and 10 ng/mL for heroin metabolite 6-mono-acetyl-morphine (6-MAM). Results All CEDIA opiate negative urine samples were negative for morphine, codeine and 6-MAM. Although sensitivity was 100% for each cut-off; specificity was 54.9% at CEDIA cut-off 300 ng/mL vs. LC-MS/MS cut-off 300 ng/mL and, 75% at CEDIA cut-off 2,000 ng/mL vs. LC-MS/MS cut-off 2,000 ng/mL. False positive rate was highest (45.1%) at CEDIA cut-off 300 ng/mL. At CEDIA cut-off 2,000 ng/mL vs. LC-MS/MS cut-off 300 ng/mL, specificity increased to 82.4% and FP rate decreased to 17.6%. All 6-MAM positive samples had CEDIA concentration ≥2,000 ng/mL. Conclusions 2,000 ng/mL for screening and 300 ng/mL for confirmation cut-offs are the most efficient thresholds for the lowest rate of FP opiate results.

Introduction: Measurement of parathyroid hormone (PTH) is essential in the investigation and management of calcium metabolism disorders. To assess the significance of any assay result when clinical decision making biological variation (BV) of the measurand must be taken into consideration. The aim of the present study is determining the BV parameters for serum PTH. Materials and methods: Blood samples were taken at weekly intervals from 20 healthy subjects for ten weeks in this prospective BV study. Serum “intact PTH” concentrations were measured with electrochemiluminescence method. Biological variation parameters were estimated using the approach proposed by Fraser. Results: The values of within-subject biological variation (CVI), between-subject biological variation (CVG), analytical variation (CVA), reference change value (RCV) and individuality index (II) for serum PTH were 21.1%, 24.9%, 3.8%, 59.4% and 0.8%, respectively. Within-subject biological variation and CVG were also determined according to gender separately; 18.5% and 24.0%; 26.2% and 18.6% for male and female, respectively. Calculated desirable precision and bias goals were < 10.6% and < 6.3%, respectively. Conclusion: This study may contribute to BV data on serum PTH as it includes a sufficient number of volunteers from both genders over an acceptable period of time. We do not recommend the usage of population-based reference intervals for serum PTH concentrations. Reference change value may be helpful for the evaluation of serial serum PTH results. Nonetheless, evaluation of data according to gender is necessary when setting analytical performance specifications. © 2019, Biochemia Medica, Editorial Office. All rights reserved.

Background Several factors may influence newborn thyroid-stimulating hormone (TSH) concentrations and cause subclinical hypothyroidism in the newborn. A sufficient level of leptin signaling is needed for the normal production of TSH and the production of thyroid hormones by the thyroid gland. In our study, we aimed to investigate the correlation between maternal serum leptin concentration during the third trimester of pregnancy and newborn screening-TSH levels. Methods This prospective cross-sectional study was conducted in clinics of obstetrics and gynecology of a state hospital between June and August 2013. Maternal venous blood samples were collected from 270 healthy pregnant women in the third trimester just before delivery. Measurement of maternal fT3, fT4, TSH, anti-thyroid peroxidase (TPO) antibodies, and anti-thyroglobulin (anti-Tg) antibodies from serum samples were performed by chemiluminescence immunoassay. Maternal serum leptin levels were determined by ELISA. Dried capillary blood spots were used to measure newborn TSH levels. Results Subjects were divided into two groups according to the neonatal TSH levels using a cut-point of 5.5 mIU/L. Median leptin levels were significantly higher in newborns whose TSH levels were higher than > 5.5 mIU/L [13.2 µg/L (1.3–46.5) vs. 19.7 µg/L (2.4–48.5), p ]. Serum leptin showed a negative correlation with maternal fT4, fT3, and positive correlation with BMI, and newborn TSH levels. Conclusion Our results suggest that high leptin levels in the third trimester of pregnancy influence maternal thyroid functions and increase newborn TSH levels. High leptin levels may be a reason for subclinical hypothyroidism.

We assessed SARS-CoV-2 genome diversity and probable impact on epidemiology, immune response and clinical disease in Turkey.Complete genomes and partial Spike (S) sequences were accessed from the Global Initiative on Sharing Avian Influenza Data (GISAID) database. The genomes were analysed for variations and recombinations using appropriate softwares.Four hundred ten complete genomes and 206 S region sequences were included. Overall, 1,200 distinct nucleotide variations were noted. Mean variation count was 14.2 per genome and increased significantly during the course of the pandemic. The most frequent variations were identified as A23403G (D614G;92.9,%), C14408T (P323L, 92.2%), C3037T (89.8%), C241T (83.4%) and GGG28881AAC (RG203KR, 62.6%). The A23403G mutation was the most frequent variation in the S region sequences (99%). Most genomes (98.3%) belonged in the SARS-CoV-2 haplogroup A. No evidence for recombination was identified in genomes representing sub-haplogroup branches. The variants B.1.1.7, B.1.351 and P.1 were detected, with a statistically-significant time-associated increase in B.1.1.7 prevalence.We described prominent SARS-CoV-2 variations as well as comparisons with global virus diversity. Continuing a molecular surveillance in agreement with local disease epidemiology appears to be crucial, as vaccination and mitigation efforts are ongoing. (English) [ABSTRACT FROM AUTHOR] Turkiye kaynakli SARS-CoV-2 genomik dizi cesitliliginin ve epidemiyoloji, bagisik yanit ve hastalik seyri uzerine muhtemel etkili varyasyonlarin incelenmesi.“Global Initiative on Sharing Avian Influenza Data” (GISAID) veri tabaninda yer alan tum genom ve “Spike” (S) bolgesine ait verilere ulasilarak uygun yazilimlar yardimiyla varyasyon ve muhtemel rekombinasyonlar arastirildi.Toplam 410 tam genom ve 206 S bolgesi dizisi incelendi, 1200 farkli nukleotid duzeyinde varyasyon saptandi. Genom basina toplam varyasyon ortalamasi 14.2 olarak hesaplandi ve salginin ilerleyisi suresince istatistiksel olarak anlamli artis izlendi. En sik saptanan varyasyonlar A23403G (D614G;92.9,%), C14408T (P323L, 92.2%), C3037T (89.8%), C241T (83.4%) ve GGG28881AAC (RG203KR, 62.6%) olarak siralandi. S bolgesi dizilerinde de A23403G, en yaygin varyasyon (%99) seklinde izlendi. Incelenen genomlarin siklikla (%98.3) SARS-CoV-2 A haplogrubuna ait oldugu goruldu. Alt haplogruplari temsil eden genomlarda yapilan incelemelerde rekombinasyon bulgusu saptanmadi. Calisma grubunda B.1.1.7, B.1.351 ve P.1 varyantlari tespit edildi. B.1.1.7 prevalansinda izlenen zamanla iliskili artis, istatistiksel olarak anlamli bulundu.Calismada ulkemiz kaynakli SARS-CoV-2 genomlarinda belli basli varyasyonlar belirlenmis ve kuresel virus cesitliligi isiginda degerlendirilmistir. Kontrol ve asilama calismalari ile eszamanli olarak onemli varyantlarin tanimlanabilmesi icin, bolgesel epidemiyoloji ile uyumlu molekuler surveyans calismalari surdurulmelidir. (Turkish) [ABSTRACT FROM AUTHOR] Copyright of Turkish Journal of Biochemistry / Turk Biyokimya Dergisi is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Calculation of biological variation (BV) components is very important in evaluating whether a test result is clinically significant. The aim of this study is to analyze BV components for copper, zinc and selenium in a cohort of healthy Turkish participants. Methods A total of 10 serum samples were collected from each of the 15 healthy individuals (nine female, six male), once a week, during 10 weeks. Copper, zinc and selenium levels were analyzed by atomic absorption spectrometer. BV parameters were calculated with the approach suggested by Fraser. Results Analytical variation (CVA), within-subject BV (CVI), between-subject BV (CVG) values were 8.4, 7.1 and 4.3 for copper; 4.2, 9.1 and 13.7 for zinc; 7.6, 2.5 and 6.9 for selenium, respectively. Reference change values (RCV) were 30.46, 27.56 and 22.16% for copper, zinc and selenium, respectively. The index of individuality (II) values were 1.65, 0.66 and 0.36 for copper, zinc and selenium, respectively. Conclusions According to the results of this study, traditional reference intervals can be used for copper but we do not recommend using it for zinc and selenium. We think that it would be more accurate to use RCV value for zinc and selenium in terms of following significant changes in recurrent results of a patient. Amaç Biyolojik varyasyon (BV) bileşenlerinin hesaplanması, bir test sonucunun klinik olarak önemli olup olmadığını değerlendirmede çok önemlidir. Bu çalışmanın amacı, sağlıklı Türk katılımcılardan oluşan bir kohortta bakır, çinko ve selenyum için BV bileşenlerini analiz etmektir. Gereç ve Yöntem 15 sağlıklı bireyin (9 kadın, 6 erkek) her birinden 10 hafta boyunca haftada bir olmak üzere toplam 10 serum örneği alındı. Bakır, çinko ve selenyum seviyeleri atomik absorpsiyon spektrometresi ile analiz edildi. BV parametreleri Fraser tarafından önerilen yaklaşımla hesaplandı. Bulgular Birey içi BV (CVI), analitik varyasyon (CVA), bireyler arası BV (CVG) değerleri bakır için sırasıyla 8.4, 7.1 ve 4.3; çinko için sırasıyla 4.2, 9.1 ve 13.7; selenyum için sırasıyla 7.6, 2.5 ve 6.9 idi. Bakır, çinko ve selenyum için referans değişim değerleri (RCV) sırasıyla % 30.46, % 27.56 ve % 22.16 idi. Bakır, çinko ve selenyum için bireysellik indeksi (II) değerleri sırasıyla 1.65, 0.66 ve 0.36 idi. Sonuç Bu çalışmanın sonuçlarına göre geleneksel referans aralıklarının bakır için kullanılmasını ancak çinko ve selenyum için kullanılmaması öneriyoruz. Çinko ve selenyum için hastanın tekrarlayan sonuçlarındaki önemli değişiklikleri takip etmek açısından RCV değerinin kullanılmasının daha doğru olacağını düşünüyoruz.

Introduction Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 virus, is a major public health concern spanning from healthy carriers to patients with life-threatening conditions. Although most of COVID-19 patients have mild-to-moderate clinical symptoms, some patients have severe pneumonia leading to death. Therefore, the early prediction of disease prognosis and severity is crucial in COVID-19 patients. The main objective of this study is to evaluate the haemocytometric parameters and identify severity score associated with SARS-CoV-2 infection. Methods Clinical and laboratory records were retrospectively reviewed from 97 cases of COVID-19 admitted to hospitals in Istanbul, Turkey. The patient groups were subdivided into three major groups: Group 1 (Non-critical): 59 patients, Group 2 (Critical-Survivors): 23 patients and Group 3 (Critical-Non-survivors):15 patients. These data was tested for correlation, including with derived haemocytometric parameters. The blood analyses were performed the Sysmex XN-series automated hematology analyser using standard laboratory protocols. All statistical testing was undertaken using Analyse-it software. Results 97 patients with COVID-19 disease and 935 sequential complete blood count (CBC-Diff) measurements (days 0–30) were included in the final analyses. Multivariate analysis demonstrated that red cell distribution width (RDW) (>13.7), neutrophil to lymphocyte ratio (NLR) (4.4), Hemoglobin (Hgb) (5.2), Plateletcount (PLT) (>142 x103/L) and RDW (>14) were important haemocytometric parameters, and the mortality risk value created by their combination had the highest AUC value (AUC = 0.911, 95% CI, 0886–0.931). Trend analysis of CBC-Diff parameters over 30 days of hospitalization, NLR on day 2, MNR on day 4, RDW on day 6 and PLT on day 7 of admission were found to be the best time related parameters in discrimination non-critical (mild-moderate) patient group from critical (severe and non-survivor) patient group. Conclusion NLR is a strong predictor for the prognosis for severe COVID-19 patients when the cut-off chosen was 4.4, the combined mortality risk factor COVID-19 disease generated from RDW-CV, NLR, MNR and PLT is best as a mortality haematocytometric index.

Endocan, a 50 kDa soluble proteoglycan, also called endothelial cell-specific molecule-1 (ESM-1), is involved in many major cellular activities and has been reported to be overexpressed in inflammatory conditions. This study aims to determine ESM-1 levels in gingival crevicular fluid (GCF) samples from individuals with periodontitis to determine the correlation between the levels of lymphocyte-function-associated antigen-1 (LFA-1), intercellular adhesion molecule-1 (ICAM-1), and clinical findings of periodontitis. This study enrolled 27 individuals diagnosed with Stage III-Grade C generalized periodontitis and 16 individuals as healthy controls. Bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment loss (CAL) were calculated. Enzyme-linked immunosorbent assay (ELISA) test was used for detecting the levels of ESM-1, ICAM-1, and LFA-1 in GCF samples. PPD, BOP, CAL, and GCF volumes were significantly increased in patients with periodontitis in comparison to the control group (p < 0.001). The total amount of ESM-1, ICAM-1, and LFA-1 levels in GCF were increased in the periodontitis group (p < 0.001). ESM-1 level correlated with PPD, BOP, and CAL (p < 0.05). ICAM-1 level correlated with BOP and CAL (p < 0.05). LFA-1 level correlated with PPD and CAL (p < 0.05). Our data indicate that ESM-1, ICAM-1, and LFA-1 levels are increased in GCF of patients with periodontitis. These molecules could be associated with the pathogenesis and progression of periodontal disease.

Keles U, Iscan E, Yilmaz HE, Karakulah G, Suner A, Bal E, Tasdemir N, Cavga AD, Ekin U, Mutlu Z, Kahyaoglu S, Serdar MA, Atabey N, Ozturk M. Differential expression of full-length and NH2terminally truncated FAM134B isoforms in normal physiology and cancer. Am J Physiol Gastrointest Liver Physiol 319: G733-G747, 2020. First published October 14, 2020; doi:10.1152/ ajpgi.00094.2020.-Selective autophagy of the endoplasmic reticulum (ER), namely ER-phagy, is mediated by ER-localized receptors, which are recognized and sequestered by GABARAP/LC3B-decorated phagophores and transferred to lysosomes for degradation. Being one such receptor, FAM134B plays critical roles in cellular processes such as protein quality control and neuronal survival. FAM134B has also been associated with different cancers, although its exact role remains elusive. We report here that the FAM134B gene encodes not one but at least two different protein isoforms: the full-length and the NH2terminally truncated forms. Their relative expression shows extreme variation, both within normal tissues and among cancer types. Expression of full-length FAM134B is restricted to the brain, testis, spleen, and prostate. In contrast, NH2 terminally truncated FAM134B is dominant in the heart, skeletal muscle, kidney, pancreas, and liver. We compared wild-type and knockout mice to study the role of the Fam134b gene in starvation. NH2terminally truncated FAM134B-2 was induced in the liver, skeletal muscle, and heart but not in the pancreas and stomach following starvation. Upon starvation, Fam134b-/-mice differed from wild-type mice by less weight loss and less hyperaminoacidemic and hypocalcemic response but increased levels of serum albumin, total serum proteins, and a-amylase. Interestingly, either NH2terminally truncated FAM134B or both isoforms were downregulated in liver, lung, and colon cancers. In contrast, upregulation was observed in stomach and chromophobe kidney cancers. NEW & NOTEWORTHY We reported tissues expressing FAM134B-2 such as the kidney, muscle, heart, and pancreas, some of which exhibit stimulated expression upon nutrient starvation. We also demonstrated the effect of Fam134b deletion during ad libitum and starvation conditions. Resistance to weight loss and hypocalcemia, accompanied by an increase in serum albumin and a-amylase levels, indicate critical roles of Fam134b in physiology. Furthermore, the differential expression of FAM134B isoforms was shown to be significantly dysregulated in human cancers. © 2020 American Physiological Society. All rights reserved., National Institutes of Health, NIH National Institute of Mental Health, NIMH National Institute on Drug Abuse, NIDA National Heart, Lung, and Blood Institute, NHLBI National Human Genome Research Institute, NHGRI National Cancer Institute, NCI National Institute of Neurological Disorders and Stroke, NINDS Dokuz Eylül Üniversitesi: KB.SAG.047, This study is supported by Dokuz Eylul University, Department of Scientific Research Projects (with the Project code 2014.KB.SAG.047), and Izmir Biomedicine and Genome Center’s (IBG) institutional funds. The Genotype-Tissue Expression (GTEx) Project was supported by the Common Fund of the Office of the Director of the National Institutes of Health and by the National Cancer Institute, National Human Genome Research Institute, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, National Institute of Mental Health, and National Institute of Neurological Disorders and Stroke. The data used for the analyses described in this article were obtained from the GTEx Portal on 11/14/2018 and/or dbGaP Accession No. phs000424.v3.p1., This study is supported by Dokuz Eylul University, Department of Scientific Research Projects (with the Project code 2014.KB.SAG.047), and Izmir Biomedicine and Genome Center's (IBG) institutional funds. The Genotype- Tissue Expression (GTEx) Project was supported by the Common Fund of the Office of the Director of the National Institutes of Health and by the National Cancer Institute, National Human Genome Research Institute, National Heart, Lung, and Blood Institute, National Institute on Drug Abuse, National Institute of Mental Health, and National Institute of Neurological Disorders and Stroke. The data used for the analyses described in this article were obtained from the GTEx Portal on 11/14/2018 and/or dbGaP Accession No. phs000424.v3.p1. We thank the Izmir Biomedicine and Genome Center-Vivarium Rodent Facility and the optical imaging core facility for great support in the experimental procedures. We are also deeply grateful to Deniz Donmez for efforts in improving the manuscript's language. We also thank Christian Hu7die;bner for kind donation of Fam134b-/-animals.

Objective Data on bacterial diversity and microbiota alterations in acromegaly are currently lacking. The effects of somatostatin receptor analogs on gut microbiota remain unknown. The objective of this study was to determine microbiota alterations in patients with acromegaly and to assess the effects of somatostatin receptor analogs on gut microbiota. Methods The study was designed as a cross-sectional case-control research and three cohorts, comprising individuals with acromegaly without medical therapy (n=5), acromegaly receiving octreotide acetate (OCT) (n=8) and healthy controls (n=5), were evaluated. Results No statistically-supported changes in Bacteroidetes, Firmicutes, Proteobacteria and Actinobacteria abundance were observed. Bacteroidaceae, Odoribacteraceae, Porphyromonadaceae, Prevotellaceae and Alistipes families of Bacteroidetes and Bifidobacterium genus of the Actinobacteria phyla were detected, without overt differences. Variations in Clostridia, Erysipelotrichaceae and Veillonellaceae were not significant, while Lactobacillales were increased in individuals receiving OCT. Moreover, Akkermansia mucinophila was present in patients under OCT treatment. Conclusion Our preliminary results suggest that the bacterial community profile under OCT treatment may facilitate a colonic microenvironment for improved glucose metabolism. Alterations in the gut microbiota may be a factor affecting diabetes development during somatostatin analog treatment in acromegalic patients.

COVID-19 is the third spread of animal coronavirus over the past two decades, resulting in a major epidemic in humans after SARS and MERS. COVID-19 is responsible of the biggest biological earthquake in the world. In the global fight against COVID-19 some serious mistakes have been done like, the countries’ misguided attempts to protect their economies, lack of international co-operation. These mistakes that the people had done in previous deadly outbreaks. The result has been a greater economic devastation and the collapse of national and international trust for all. In this constantly changing environment, if we have a better understanding of the host-virus interactions than we can be more prepared to the future deadly outbreaks. When encountered with a disease which the causative is unknown, the reaction time and the precautions that should be taken matters a great deal. In this review we aimed to reveal the molecular footprints of COVID-19 scientifically and to get an understanding of the pandemia. This review might be a highlight to the possible outbreaks.

BACKGROUND Although the relationship between umbilical cord clamping time and various parameters such as hemoglobin (Hb) levels, iron deficiency, and risk of neonatal jaundice has previously been studied, to the best of our knowleadge there have been no studies investigating the relationship between cord clamping time and the risk of significant hyperbilirubinemia. We aimed to investigate the relationship between the time of umbilical cord clamping and transcutaneous bilirubin (TcB) measurements made on various postnatal hours, Hb and serum total bilirubin (STB) levels measured on postnatal 4th day, and the risk of development of significant hyperbilirubinemia requiring phototherapy treatment. METHODS Eligible newborns were divided into two groups on the basis of the time of cord clamping: those clamped late (60 seconds or more; Group I) and those clamped early (less than 60 seconds; Group II). Groups were compared with respect to the parameters of cord Hb, postnatal TcB measurements at 6th, 48th, 96th and 168th hours, and 96th hour Hb, STB and direct bilirubin levels. RESULTS TcB levels at the 96th and 168th hour were significantly higher in Group I when compared to Group II (p < 0.001 and p < 0.001, respectively). The 96th hour STB level was significantly higher in Group I when compared to Group II (p < 0.001). The need of phototherapy requirement was higher in Group I when compared to Group II (p=0.001). Increase in cord blood Hb for each 1 gr/dl caused a 3.94-fold increased risk in the requirement of phototherapy treatment. Cord clamping time showed statistically significant positive correlations with both cord blood and 96th hour venous Hb levels, with both 96th hour and 168th hour TcB levels, and with 96th hour STB levels. CONCLUSIONS Newborns whose cords are clamped late should be followed up closely with respect to high postnatal bilirubin levels and other risks associated with significant hyperbilirubinemia requiring phototherapy treatment.

SERDAR, Muhittin A./0000-0002-3014-748X; Ozpinar, Aysel/0000-0002-7399-4929; Ucal, Yasemin/0000-0001-9961-0711 WOS:000450447700017 Background: Assessment of thyroid function is important during postpartum period. However, measurements of total thyroxine (TT4) and total triiodothyronine (TT3) levels by immunoassays are mostly inaccurate during pregnancy and postpartum period, as immunoassays are interfered by hormone-binding proteins. LC-MS/MS is known to be selective and specific for the analysis of endocrine hormones and can be utilized for the analysis of TT4 and TT3. The aim of this study is to evaluate the reliability of TT4 and TT3 results measured by LC-MS/MS during postpartum period.Materials and Methods: Serum samples (n=358) were obtained within postnatal 48hr from participants. TT4 and TT3 levels were measured by LC-MS/MS method (TT4(MS) and TT3(MS)). Levels of free T4 (FT4), free T3 (FT3) and thyroid-stimulating hormone (TSH) were measured by immunoassay methods (FT3(IA), FT4(IA,) and TSHIA).Results: Statistically significant correlation was found between TSHIA and TT4(MS) (r=-0.13 and P=0.01), whereas no correlation was detected between TSHIA and FT4(IA,) TT3(MS) or FT3(IA).Conclusions: Significant negative correlation between TT4(MS) and TSHIA, and lack of correlation between FT4(IA) and TSHIA indicates that TT4(MS) measured by LC-MS/MS could be a more reliable parameter in the diagnosis of thyroid deficiency during postpartum period. [GRAPHICS] .

25 (OH) vitamin D3 (25(OH)D) and parathyroid hormone (PTH) are important regulators of calcium homeostasis. The aim of this study was to retrospectively determine the cut-off for sufficient 25(OH)D in a four-season region and the influence of age, seasons, and gender on serum 25(OH)D and PTH levels.Laboratory results of 9890 female and 2723 male individuals aged 38.8±22.1 years who had simultaneous measurements of 25(OH)D and PTH were retrospectively analyzed by statistical softwares. Serum 25(OH)D and PTH levels were measured by a mass spectrometry method and by an electrochemiluminescence immunoassay, respectively.Mean serum 25(OH)D levels showed a sinusoidal fluctuation throughout the year and were significantly (p0.01) higher in summer and autumn. On the other hand, PTH levels were significantly higher (p0.01) in women and showed an opposite response to seasonal effects relative to 25(OH)D. Lowest levels of 25(OH)D were detected in people aged between 20 and 40 years whereas PTH hormone levels were gradually increasing in response to aging. The significant exponential inverse relationship that was found between PTH and 25(OH)D (PTH=exp(4.12-0.064Our retrospective study based on large data set supports the suitability of the currently accepted clinical cut-off of 75 nmol/L for sufficient 25(OH)D. However, the issue of assessing Vitamin D deficiency remains difficult due to seasonal variations in serum 25(OH)D. Therefore, PTH measurements should complement 25(OH)D results for diagnosing Vitamin D deficiency. It is imperative that seasonally different criteria should be considered in future.25 (OH) vitamin D3 (25(OH)D) i paratireoidni hormon (PTH) imaju važnu ulogu u regulisanju homeostaze kalcijuma. Cilj ove studije bio je da se retrospektivno odrede cut-off vrednosti za dovoljan nivo 25(OH)D u regionu sa četiri godišnja doba, kao i uticaj starosti, godišnjeg doba i pola na nivoe 25(OH)D i PTH u serumu.Laboratorijski rezultati 9890 žena i 2723 muška rca starosti 38,8±22,1 godina kod kojih su istovremeno mereni 25(OH)D i PTH retrospektivno su analizirani statističkim softverom. Nivoi 25(OH)D i PTH u serumu mereni su metodom masene spektrometrije, odnosno elektrohemiluminiscencije.Srednji nivoi 25(OH)D pokazali su sinusoidnu fluktuaciju tokom cele godine i bili su značajno viši (p0,01) u leto i jesen. S druge strane, nivoi PTH bili su značajno viši (p0,01) kod žena i pokazali su suprotan odgovor na sezonske efekte u odnosu na 25(OH)D. Najniži nivoi 25(OH)D otkriveni su kod ljudi starosti između 20 i 40 godina, dok su hormonski nivoi PTH sa starenjem bili u postepenom porastu. Značajan eksponencijalni obrnut odnos koji je utvrđen između PTH i 25(OH)D (PTH=exp(4,12–0,064Naša retrospektivna studija zasnovana na velikim skupinama podataka potvrđuje da je trenutno prihvaćena klinička cut-off vrednost od 75 nmol/L prigodna za dovoljan nivo 25(OH)D. Međutim, utvrđivanje nedostatka vitamina D ostaje teško izvodljivo usled varijacija u serumskom nivou 25(OH)D zbog godišnjih doba. Stoga, merenje PTH trebalo bi da posluži kao komplement rezultatima 25(OH)D prilikom dijagnostikovanja nedostatka vitamina D. Najvažnije je da se u budućnosti razmotre različiti kriterijumi prilagođeni različitim godišnjim dobima.

Uncertainty is an inseparable part of all types of measurements, that is, in metrology a measurement without uncertainty is not possible. Calculation of uncertainty increases the awareness of the certainty of measurement results. Reporting measurement uncertainty is mandatory in almost all industrial sectors but not in laboratory medicine. Test results without analytical uncertainty increases the diagnostic uncertainty, causing errors that could seriously affect patients health. To improve diagnostic certainty, we should calculate and upon request report measurement uncertainty to laboratory users (ISO 15189). In this mini-review, we summarized the theoretical perspective of uncertainty concept, its relation to Six Sigma and finally compared it with Total Error Method.

Analysis of porphyrins and 5-aminolevulinic acid (ALA), porphobilinogen (PBG) in physiological liquids is required for diagnosis and follow-up of porphyrias. High performance liquid chromatography (HPLC) and liquid chromatography tandem mass spectrometry (LC–MS) methods with higher specificity and sensitivity have been developed. The major disadvantage of those methods is that they require longer extraction times due to their matrix effects. The present study suggests a simple, fast, sensitive, and specific assay for determination of Coproporphyrin, 5-carboxylporphyrin, 6-carboxylporphyrin, 7-carboxylporphyrin, Uroporphyrin I and ALA, PBG in urine sample by direct injection without sample pre-treatment using LC–MS. For the purposes of the present study LC–MS device was set to multiple reaction monitoring (MRM) and positive ion mode. Porphyrins and ALA, porphobilinogen were characterized by their MS/MS product ion, spectra. ALA, PBG and 5 porphyrins were detected simultaneously. Limit of detection for Coproporphyrin, 5-carboxylporphyrin, 6-carboxylporphyrin, 7-carboxylporphyrin, Uroporphyrin I were 2 nmol/L, where it was 5 μmol/L for ALA and 2 μmol/L for porphobilinogen. The present study suggests that the present method is very effective compared to many other available methods for it does not require pre-treatment, provides simultaneous results of ALA, PBG and 5 porphyrins quantitatively in a shorter span of time, and has suitable sensitivity and selectivity. LC–MS technique was used clinically for the determination of urine porphyrin levels.

ObjectiveMedical laboratories encounter critical obstacles in External Quality Assessment (EQA) practices that are key to assessment of the analytical period. Present study aims to unveil the challenges in nationwide inter-laboratory harmonization and suggest practical solutions.Materials and methodsEQA results of 1941 laboratories participating in 18 different EQA-programs between 2010 and 2017 were examined. Standard Deviation Index (SDI) of each program calculated using 801,028 sample data from 24 different clinical chemical tests were used to conduct a process assessment.ResultsThere is a significant discrepancy in unsatisfactory performance ratio among different EAQ-programs with an average of 3.4% (27,074 cases) between 2010 and 2017 and a decreasing trend (~40–50%) in 7-years. Programs with higher SDI display lower discrepancy rates. Reasons for unaccepted results appear to be data entry errors (8.27–22.2%), material dilution errors (5–11.4%), technical problems (3.76–7.9%); while random or unidentified causes account for a major of 44.9–59.5%. In 7-years, 15.7% reduction was observed in average SDI of all tests.ConclusionWith the launch of national EQA follow-up program, increased awareness of the analytical processes led to a decrease in unaccepted results and variances in the analytical period. Staff training is suggested as a significant measure. In addition, simultaneous assessment of SDI and allowable total error rates would reduce the variation between programs.

Background Analysis of steroid hormones rapidly and reliably remains a challenge in clinical laboratories as this plays an important role in evaluation of many endocrine disorders. The aim of this study was to create a steroid profiling panel by using a liquid chromatography tandem mass spectrometry (LC-MS/MS) method which was composed of the most commonly analyzed steroid hormones in clinical laboratories. Materials and methods Protein precipitation was performed for sample preparation. Ultra performance liquid chromatography (UPLC) system and an analytical column with C18 selectivity was chosen for chromatographic seperation. Atmospheric pressure chemical ionization (APCI) ion source was preferred for ionization, and tandem MS with triple quadrupole was used. MS scan was performed using the selected reaction monitoring mode in positive polarity. During the method validation process, test performance was evaluated for each steroid hormone, and 40 serum samples were used for method comparison with immunoassays available in our core laboratory. Results An isotope dilution (ID)-LC-MS/MS method was developed, in which 13 steroids can be analyzed in the same run. Test performance was quite good for the 11 steroids (cortisol, DHEA, DHEAS, total testosterone, progesterone, androstenedione, 11-deoxycortisol, cortisone, corticosterone and dihydrotestosterone) while estradiol and aldosterone performance was suboptimal considering the precision and trueness. Conclusion This ID-LC-MS/MS method would be useful in clinical laboratories, especially for the immunoassays having insufficient test performance and when checking for interferences in available immunoassays.

The aim of the present study was to determine the relation between the simultaneous fasting plasma glucose level and HbA1c in a large population of patients presenting to the hospital, based on various measurement methods available for HbA1c. HbA1c levels of 162,210 patients presenting to various hospitals and laboratories were measured based on seven different systems, and at the same time, eAG levels were calculated based on HbA1c levels. The correlation coefficients (r) between serum plasma glucose and HbA1c levels were found to be 0.809, 0.774, 0.779, 0.817, 0.704, 0.796, and 0.747 in Bio-Rad Variant II, Tosoh G8, ADAMS A1c, Trinity Boronate Affinity, Chromsystems HPLC, Roche Tina-quant, and Abbott Architect, respectively. The concordance correlation coefficients between the eAG levels as calculated with the formulas provided in the text and the eAG levels as calculated according to NGSP directions (where eAG = (28.7*HbA1c) - 46.7) were found to be between 0.9339 and 0.9866. Despite the progress made for the standardization of HbA1c measurements, the relation between serum glucose and HbA1c still demonstrated certain discrepancies pertaining to the differences in measurement methodologies. As a conclusion, each laboratory could determine different eAG levels depending on the data originated by their individual analyzer.

Objective The aim of this study was to identify probable intermediate biomarkers of disturbed pathways and their link between smoking. Methods Un-stimulated whole saliva and serum samples were collected from a total of 30 systemically healthy participants with periodontally healthy smokers (S) (n=15) and non-smokers (n=15). Periodontal indices (plaque index, gingival index, probing depth, bleeding on probing, clinical attachment level) were recorded to confirm periodontal health. Saliva was purified, and a total of 28 amino acids and metabolites were analyzed by liquid chromatography-mass spectrometry (LC-MS/MS). Smoking status was validated measuring serum cotinine levels. Intergroup comparisons were assessed using the Mann Whitney U test. Results When 28 amino acids were evaluated, smokers had statistically significantly higher cystathionine levels than non-smokers (p

Background: Perchlorate, thiocyanate, and nitrate can block iodide transport at the sodium iodide symporter (NIS) and this can subsequently lead to decreased thyroid hormone production and hypothyroidism. NIS inhibitor exposure has been shown to reduce iodide uptake and thyroid hormone levels; therefore we hypothesized that maternal NIS inhibitor exposure will influence both maternal and newborn thyroid function.Methods: Spot urine samples were collected from 185 lactating mothers and evaluated for perchlorate, thiocyanate, and nitrate concentrations. Blood and colostrum samples were collected from the same participants in the first 48 h after delivery. Thyroid hormones and thyroid-related antibodies (TSH, fT3, fT4, anti-TPO, anti-Tg) were analyzed in maternal blood and perchlorate was analyzed in colostrum. Also, spot blood samples were collected from newborns (n = 185) between 48 and 72 postpartum hours for TSH measurement. Correlation analysis was performed to assess the effect of NIS inhibitors on thyroid hormone levels of lactating mothers and their newborns in their first 48 postpartum hours.Results: The medians of maternal urinary perchlorate (4.00 μg/g creatinine), maternal urinary thiocyanate (403 μg/g creatinine), and maternal urinary nitrate (49,117 μg/g creatinine) were determined. Higher concentrations of all three urinary NIS inhibitors (μg/g creatinine) at their 75th percentile levels were significantly correlated with newborn TSH (r = 0.21, p < 0.001). Median colostrum perchlorate level concentration of all 185 participants was 2.30 μg/L. Colostrum perchlorate was not significantly correlated with newborn TSH (p > 0.05); however, there was a significant correlation between colostrum perchlorate level and maternal TSH (r = 0.21, p < 0.01). Similarly, there was a significant positive association between colostrum perchlorate and maternal urinary creatinine adjusted perchlorate (r = 0.32, p < 0.001).Conclusion: NIS inhibitors are ubiquitous in lactating women in Turkey and are associated with increased TSH levels in newborns, thus signifying for the first time that co-exposure to maternal NIS inhibitors can have a negative effect on the newborn thyroid function.

Background Vitamin D and intact parathyroid hormone (iPTH) play a crucial role in calcium homeostasis and bone health of children. Serum level of 25-hydroxyvitamin D (25-OHD) is considered to be the most accurate marker for vitamin D status. However, there have only been a few studies, with limited number of subjects, investigating the relationship between 25-OHD and parathyroid hormone (PTH) in children. The aim of this study was to evaluate the seasonal 25-OHD levels and its associations with intact parathyroid hormone (iPTH) in Turkish children at all pediatric ages; and then to define a critical decision threshold level for 25-OHD deficiency in Turkish children. Methods A retrospective record review of 90,042 children, was performed on serum 25-OHD and for 3525 iPTH levels. They were measured by mass spectrometry method and by electrochemiluminescence immunoassay simultaneously. Results 25-OHD levels showed a sinusoidal fluctuation througout the year; being significantly higher in summer and autumn (p

OBJECTIVE: Our aim was to investigate time effects in proinflammatory cytokines and the auditory brainstem response (ABR) thresholds of rat cochlea exposed to noise. MATERIALS and METHODS: Twenty-one rats were divided into two groups: the control group and the noise group. As high as 115 dB sound pressure of white noise was administered to the noise group of 16 rats for 3 h a day for 10 days. This group was further split into four subgroups based on the timing of sacrifice: 3rd hour group, 12th hour group, 24th hour group, and 28th day group. ABR thresholds were measured in all the rats, after the noise exposure and right before being sacrificed. Proinflammatory cytokine levels (IL-6, IL-1 beta, and TNF-alpha) at the cochlea were measured. RESULTS: We found a significant difference between the first ABR thresholds (5 dB nHL) and the post-exposure ABR thresholds in each group (25 dBnHL, 35 dBnHL, 15 dBnHL, and 17.50 dBnHL for the 3rd hour group, 12th hour group, 24th hour group, and 28th day group, respectively). The IL-1 beta levels in the 3rd hour group and 12th hour group were significantly higher than those in the control group and other noise subgroups. The TNF-alpha level in the 3rd hour group was significantly higher than that in the control group and other noise subgroups. CONCLUSION: It seems reasonable to point out a direct correlation between the cytokine levels and hearing threshold levels after the noise exposure. This correlation was the highest for IL-1 beta. This result suggested a significant role of proinflammatory cytokines in hearing deterioration after noise exposure.

Objective: There is an inverse log/linear relationship between TSH and FT4 due to the negative feedback of these hormones on the pituitary. The objective of our study was to compare this relationship of TSH and FT4 between four different immunoassay analyzers. Methods: In our study, four data sets obtained from the database of four different hospital laboratories each using only a single method of measurement was used to evaluate this relationship between TSH and FT4. These data sets with their assay methods include: 21.102 test results measured by Modular E170 Analyzer (Roche Diagnostics, Germany), 20.241 test results measured by Access DxI 800 Unicel (Beckman Coulter, USA), 22.444 test results measured by Architect i2000sr (Abbott Laboratories, Abbott Park, Illinois, U.S.A) and 20.200 test results measured by ADVIA Centaur XP (Siemens Diagnostics, Tarrytown, NY). Inverse logarithmic relationship were determined from each data sets and compared between analyzers. Results: The correlation coefficients were -0.439 {[}95\% CI, (-0.450)- (-0.428)], -0.488 {[}95\% CI, (-0.498)- (-0.478)], -0.353 {[}95\% CI, (-0.364)- (-0.342)], -0.430 {[}95\% CI, (-0.441)- (-0.419)] for DxI 800 Unicel, Modular E 170, Architect i2000sr and ADVIA Centaur XP, respectively. In our study, all immunoassay analyzers showed poor correlation in a concentration range of TSH between 1.0 to 10.0 uIU/mL and the inverse log/linear relationship was not observed. Inverse relationship between TSH and FT4 is the result of negative thyroid pituitary hypothalamic feedback mechanism and this relationship is important especially in the diagnosis and treatment of hypo and hyperthyroidism. In data sets obtained from four different immunoassay analyzers, poor and statistically different correlation was observed between analyzers at TSH values ranged from 1.0 to 10.0 uIU/mL compared with FT4. Conclusion: These variations between analyzers may affect the clinical decisions especially in the evaluation of subclinical hypothyroidism, clinicians and laboratory specialists should be aware of these situation.

Aspartate aminotransferase (AST) macroenzyme leads to an increase in AST without the presence of any disease. In present report, an isolated increase of AST was detected in a 6-year old girl following the investigations prior to tonsillectomy. As to her history, physical examination and other laboratory test results, no abnormal findings were detected. AST levels were measured as 591 IU/L and 585 IU/L after repeated tests. While found as

Background Health care programs for children with Down syndrome (DS) help improve the overall outcome and quality of life of these children. It is therefore very important to focus on the most common and serious problems of these patients, such as congenital heart defects and cardiac problems, and to keep medical guidelines updated with regard to these problems. Objectives The aim of this study was to evaluate aortic intima-media thickness (aIMT), lipid profiles and blood pressure in DS patients in comparison with a control group of ageand gender-matched neonates without DS. Material and methods Serum concentrations of lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglyceride), blood pressure and abdominal aIMT were measured in newborns with DS, and compared with the measurements from ageand gender-matched newborns without DS. Results No statistically significant differences between the 2 groups of newborns were detected with respect to aIMT, lipid levels or blood pressure. Conclusions This study represents the first investigation of aIMT - one of the most important indicators of atherosclerosis - in DS patients, but neither a significantly increased aIMT, nor any significant changes in lipid profiles or blood pressure were detected in this group of patients. Whether aIMT differs according to the type of congenital heart defect (such as atrial septal defect, ventricular septal defect, patent ductus arteriosus, and atrioventricular septal defect) among DS patients remains to be determined in future studies.

Background and purpose: Etiologic role, incidence, demographic, and response-to-treatment characteristics of urinary tract infection (UTI) among neonates, its relationship with significant neonatal hyperbilirubinemia, and abnormalities of the urinary system were studied in a prospective investigation in early (≤10 days) idiopathic neonatal jaundice in which all other etiologic factors of neonatal hyperbilirubinemia were ruled out. Patients and methods: Urine samples for microscopic and bacteriologic examination were obtained with bladder catheterization from 155 newborns with early neonatal jaundice. Newborns with a negative urine culture and with a positive urine culture were defined as group I and group II, respectively, and the 2 groups were compared with each other. Results: The incidence of UTI in whole of the study group was 16.7%. Serum total and direct bilirubin levels were statistically significantly higher in group II when compared with group I ( P = .005 and P = .001, respectively). Decrease in serum total bilirubin level at the 24th hour of phototherapy was statistically significantly higher in group I compared with group II ( P = .022). Conclusions: Urinary tract infection should be investigated in the etiologic evaluation of newborns with significant hyperbilirubinemia. The possibility of UTI should be considered in jaundiced newborns who do not respond to phototherapy well or have a prolonged duration of phototherapy treatment.

WOS: 000404924700004, PubMed ID: 28232367, Background: There have been studies focused on FokI, BsmI, ApaI and TaqI polymorphisms of the vitamin D receptor (VDR) gene and susceptibility to type 1 diabetes mellitus with controversial results. Methods: This present study is a meta-analysis investigating the association between FokI, ApaI, TaqI and BsmI polymorphisms of VDR gene and type 1 DM in children. A literature search was performed using Medline, EMBASE, Cochrane and PubMed. Any study was considered eligible for inclusion if at least one of FokI, ApaI, TaqI and BsmI polymorphisms was determined, and outcome was type 1 DM at pediatric age. Results: A total of 9 studies comprising 1053 patients and 1017 controls met the study inclusion criteria. The pooled odds ratios (ORs) of the FokI, ApaI, TaqI and BsmI polymorphisms were combined and calculated. Forest plots and funnel plots of the OR value distributions were drawn. Our meta-analysis has demonstrated statistically significant associations between DM1 and VDR genotypes, BsmIBB (P < 0.05), BsmIBb, (P < 0.05), BsmIbb (P < 0.05), TaqITT (P < 0.05) and TaqItt (P < 0.05) in children. Conclusion: The results indicated that BsmIBB, BsmIBb and TaqItt polymorphisms were associated with an increased risk of type 1 DM, whereas BsmIbb and TaqITT had protective effect for type 1 DM in children.

Introduction Delirium is a common and life-threatening neuropsychiatric syndrome. Diagnosing delirium can be challenging, which increases mortality and mortality rates and health care costs. The biologic model of delirium is not definite yet, but evidence supports a cholinergic deficiency model. Delirium may be the result of processes and drugs that trespass a compromised blood-brain barrier. We aimed to evaluate the possible diagnostic utilization and the role of certain biomarkers, such as C-reactive protein (CRP), tumor necrosis factor-alpha (TNF-α), and insulin like growth factor-1 (IGF-1), in delirium etiology. Methods A total of 93 inpatients that planned to undergo cardiovascular surgery were informed; 35 of them completed the study. Medical history and current cognitive status were evaluated pre-operatively. Participants were followed using Delirium Rating Scale-Revised-98 Turkish (DRS-R98-T) for delirium symptoms, and blood samples were collected post-operatively. Results Delirium was developed more in participants who had worse pre-operative cognitive status. Also, low pre-operative IGF-1 levels were detected in the delirium group. Pre-operative CRP and TNF-α levels were not different between groups. Conclusion Low IGF-1 levels can be used to predict delirium after surgery. However, the complex nature of cytokines and delirium itself make it difficult to utilize cytokines to predict delirium instead of psychometric tools.

Objective: Obesity is a risk factor for calcaneal spur (CS) formation. Diabetes mellitus may contribute to the risk of CS due to the decreased ability of tissue repair and peripheral neuropathy. Thus, we aimed to determine the frequency of CS in asymptomatic obese subjects with and without type 2 diabetes mellitus (T2DM). Also, we tried to find the related factors of CS in patients with T2DM. Material and Methods: Ninety-three obese patients with type-2 diabetes mellitus (T2DM) and 42 obese control subjects without glucose metabolism disturbances were enrolled in the study. A questionnaire was made about the duration of T2DM, age, and occupations of the participants. Physical, laboratory, and x-ray examinations of all cases were made. SPSS 15.0 was used for statistical analyses. Results: Patients with T2DM and control groups were similar in mean age and body mass index (BMI) (p=0.196, p=0.073, respectively). The existence of CS in the T2 diabetic group was significantly higher than in the control group (p=0.023). T2 diabetic patients with CS had significantly higher neuropathy existence, mean age, and BMI than T2 diabetic patients without CS (p=0.001, p=0.016, p=0.043, respectively). There was a positive correlation between the existence of CS and peripheral neuropathy and age (p=0.025, p=0.001, respectively). Conclusion: Increased ratio of CS in obese T2 diabetic patients may be important because of the relation between CS existence and complications of diabetes mellitus. Clinicians should pay more attention to increased frequency of CS in patients with T2DM, to avoid diabetic foot complications and other malformations.

SUMMARY Objective: The measurement of urinary 8-hidroxy- 2'deoxyguanosine (8-OHdG) level by liquid chromatographytandem mass (LC-MS/MS) method in order to determine whether there is an obvious oxidative deoxyribonucleic acid (DNA) damage in patients with polycystic ovary syndrome (PCOS) and its relationship with long term risks. Material and methods: Twenty-eight patients with PCOS diagnosis according to the criteria of 2003 Rotterdam Concensus Conference on PCOS were included in this study and twenty-seven healthy women were included as control group. After collecting first morning urine samples of patients and women in control group, the urinary 8-OHdG level were measured by LC-MS/MS method and the results were expressed as nmol/L. 8-OHdG/creatinine ratio (nmol/mol) was used to compensate the variation of all nucleoside concentration in urine. The patients with PCOS and the control group were compared in terms of the 8-OHdG/creatinine ratio. Results: Statistically, there was not a significant difference between the patients with PCOS and the control group in terms of the 8-OHdG/creatinine ratio (p= 0.533). Conclusion: According to our research, due to an increase of antioxidant and DNA repair capacity, the urinary 8OHdG/creatinine ratio as a determinant of oxidative stress in patients with PCOS was not different from the level analyzed in healthy women.

Soft tissue trauma is a type of acute traumatic ischemia. We investigated in this study whether the edema, inflammation and ischemia caused by the trauma could be affected positively by hyperbaric oxygen (HBO) and ozone therapy.Soft tissue trauma was generated in a total of 63 adult male Sprague-Dawley rats. Subsequently, rats were divided into three groups. The first group was treated with ozone, the second group with HBO, and the third group served as controls. Tissue and blood samples were taken at the end of the procedures. Tissue lipid peroxidation (LPO), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), inducible nitric oxide synthase (iNOS), heme oxygenase (HO)-1, and hypoxia-inducible factor (HIF)-1 levels were detected. Hematoxylin-eosin staining was used to determine the inflammation and edema histopathologically.We also detected HIF-1 activity, which decreases when the oxygen concentration increases, HO-1 activity, which has anti-inflammatory effects, and iNOS activity, which releases in any type of acute case. We determined a statistically significant reduction in iNOS and LPO levels in both the HBO and Ozone groups. A significant decrease in inflammation was detected in both the Ozone and HBO groups compared with the Control group, and a significant decrease in edema was detected in all three groups.We think that HBO and Ozone therapy have beneficial effects on biochemical and histopathological findings. Related clinical trials will be helpful in clarifying the effects.

Metabolic disorders and cardiovascular events are increased in hypogonadism. Serum HDL composition is a better cardiovascular predictor than the HDL counts. However, there is no information about the HDL subfractions in patients with hypogonadism. We designed a prospective study to investigate the HDL subfractions in treatment naïve subjects with hypogonadism and the effects of 2 different testosterone replacement regimens on the HDL subfractions. Seventy young male patients with congenital hypogonadotropic hypogonadism (CHH) and 70 age and BMI-matched healthy males were enrolled in the present study. The patients were assigned to receive intramuscular injections of testosterone esters 250 mg every 3 weeks and transdermal testosterone applications 50 mg daily. Biochemical investigations including HDL subfractions and insulin resistance were done. Patients with CHH had higher levels of insulin, HOMA-IR, WC, triglyceride, and diastolic blood pressure. Although, the HDL cholesterol concentrations were similar in both groups, hypogonadal patients had lower HDL2 and higher HDL3 levels. The total testosterone levels were independent determinants of the HDL2 subfractions. During the follow-up, a significant increase in the BMI and WC values and a significant decrease in the levels of total cholesterol, HDL cholesterol, and HDL3 were observed. No difference was present between the 2 treatment arms. These results show that patients with hypogonadism have unfavorable HDL compositions in addition to the other dysmetabolic features. However, testosterone replacement for about six months neither improves the metabolic problems nor the HDL composition. Mechanistic studies are warranted to better understand the cardiovascular effects of unfavorable HDL compositions in hypogonadism.

WOS: 000399955500030 PubMed ID: 27781272 Background and ObjectiveThe aim of this study was to evaluate the effect of nonsurgical periodontal therapy on clinical parameters and gingival crevicular fluid levels of tissue/blood vessel-type plasminogen activator (t-PA) and plasminogen activator inhibitor-2 (PAI-2) in patients with periodontitis, with or without rheumatoid arthritis (RA). Material and MethodsFifteen patients with RA and chronic periodontitis (RA-P), 15 systemically healthy patients with chronic periodontitis (H-P) and 15 periodontally and systemically healthy volunteers (C) were included in the study. Plaque index, gingival index, probing pocket depth, clinical attachment level, bleeding on probing, gingival crevicular fluid t-PA and PAI-2 levels, erythrocyte sedimentation rate, serum C-reactive protein and disease activity score were evaluated at baseline and 3 mo after mechanical nonsurgical periodontal therapy. ResultsAll periodontal clinical parameters were significantly higher in the RA-P and H-P groups compared with the C group (p < 0.001) and decreased significantly after treatment (p < 0.001). Pretreatment t-PA levels were highest in the RA-P group and significantly decreased post-treatment (p = 0.047). Pre- and post-treatment PAI-2 levels were significantly lower in controls compared with both periodontitis groups (p < 0.05). Gingival crevicular fluid volume and the levels of t-PA and PAI-2 were significantly correlated. ConclusionIn patients with periodontitis and RA, nonsurgical periodontal therapy reduced the pretreatment gingival crevicular fluid t-PA levels, which were significantly correlated with gingival crevicular fluid PAI-2 levels. The significantly higher t-PA and PAI-2 gingival crevicular fluid levels in periodontal patients, regardless of systemic status, suggest that the plasminogen activating system plays a role in the disease process of periodontitis. Ankara University Scientific Research Projects Office, Ankara, Turkey [08B3334005] This study was supported by the Ankara University Scientific Research Projects Office, Ankara, Turkey (08B3334005). The authors declare that they have no conflicts of interest.

OBJECTIVE We aimed to develop a transcutaneous bilirubin (TcB) nomogram for assessment of the risk of significant hyperbilirubinemia and prolonged jaundice during the first month of life in term and late-preterm Turkish newborns. METHODS On the basis of the daily (3rd, 7th, 15th and 30th days) TcB measurements, 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles, and 5 percentile tracks were obtained. TcB measurements were made by a transcutaneous bilirubinometer (JaundiceDetector JH20-1C). RESULTS We screened 729 healthy term and late-preterm Turkish infants 3-30 days old and developed a nomogram of TcB levels. TcB level was ≥5 mg/dl in 41.98% and 25.9% of infants at age 15.0 ± 2.1 days and 30.9 ± 2.6 days, respectively. The TcB measurement-based nomogram values of the 97th percentiles (cutoff values) at age 15.0 ± 2.1 and 30.9 ± 2.6 days were 11.4 (10.82-12.13) mg/dl and 10.0 (9.40-10.70) mg/dl, respectively. CONCLUSION This nomogram can be used to determine the risk status of Turkish newborns regarding significant hyperbilirubinemia and prolonged jaundice on the basis of TcB measurement in the first month of life.

SERDAR, Muhittin A./0000-0002-3014-748X; LUTFIOGLU, MUGE/0000-0003-1499-5902 WOS: 000377403000008 PubMed: 27088277 Objective: This study evaluated the impact of photobiomodulation (PBM) on the healing of the donor palatal area following free gingival graft (FGG) harvesting by examining changes in transforming growth factor (TGF)-beta(1), platelet-derived growth factor (PDGF)-BB, and interleukin (IL)-8 levels in palatal wound fluid (PWF). Material and methods: Thirty patients were selected and randomly assigned to receive PBM (laser group) or PBM sham (sham group) in the palatine area after FGG harvesting. Aneodymium-doped yttrium aluminumgarnet (Nd:YAG) laser (1064 nm) was applied to the test sites immediately after surgery and every 24 h thereafter for 4 days. PWF was collected on Days 7 and 12, and PWF TGF-beta(1), PDGF-BB, and IL-8 levels were analyzed by enzyme-linked immunosorbent assays (ELISA). Results: PWF TGF-beta(1), PDGF-BB, and IL-8 levels were significantly lower on Day 12 than on Day 7 for both groups. PWF TGF-beta(1), PDGF-BB, and IL-8 levels of the laser group were significantly higher than those of sham group on Day 7 (p < 0.05). PWF TGF-beta(1) levels were also significantly higher in laser group than in the sham group on Day 12; however, differences in PDGF-BB and IL-8 levels between groups on Day 12 were statistically nonsignificant. Conclusions: Observed increases in PWF TGF-beta(1), PDGF-BB, and IL-8 levels suggest that PBM may accelerate wound healing by stimulating production of selected mediators. Ondokuz Mayis UniversityOndokuz Mayis University [PYO.DIS.1901.13.003] The study was funded by Ondokuz Mayis University (PYO.DIS.1901.13.003).

Background In order to apply the right treatment for hemostatic disorders in pediatric patients, laboratory data should be interpreted with age-appropriate reference ranges. Objectives The purpose of this study was to determining age-dependent reference range values for prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen tests, and D-dimer tests. Materials and methods A total of 320 volunteers were included in the study with the following ages: 1 month - 1 year (n = 52), 2 - 5 years (n = 50), 6 - 10 years (n = 48), 11 - 17 years (n = 38), and 18 - 65 years (n = 132). Each volunteer completed a survey to exclude hemostatic system disorder. Using a nonparametric method, the lower and upper limits, including 95% distribution and 90% confidence intervals, were calculated. Results No statistically significant differences were found between PT and aPTT values in the groups consisting of children. Thus, the reference ranges were separated into child and adult age groups. PT and aPTT values were significantly higher in the children than in the adults. Fibrinogen values in the 6 - 10 age group and the adult age group were significantly higher than in the other groups. D-dimer levels were significantly lower in those aged 2 - 17; thus, a separate reference range was established. Conclusions These results support other findings related to developmental hemostasis, confirming that adult and pediatric age groups should be evaluated using different reference ranges.

Chronic kidney disease (CKD) is asymptomatic in the early stage. Kidney function might be lost 90% when the symptoms are overt. However, in case of early detection, progression of the disease can be prevented or delayed. If not detected it results in end stage renal disease. Therefore, the level of awareness about CKD should be increased. The role of medical laboratory is utmost important for the diagnosis and staging of CKD. In this paper, the main tasks of the laboratory specialists are described and the outlines are as follows.• Creatinine assays should be traceable to internationally recognised reference materials and methods, specifically isotope dilution mass spectrometry.• When reporting the creatinine result, eGFR should also be reported in adult (>18 years) population. A warning expression should be included in the report form if eGFR result is • eGFR values should be expressed quantitatively up to 90 mL/min/1.73 m• eGFR equations of the adult population should not be used for pediatric population. Different equations utilizing also patient height should be used. The enzymatic creatinine assay should be preferred. eGFR based on cystatin C can be used for confirmation in the pediatric population.• Cystatin C measurements, at least when eGFR based on creatinine is not reliable and for confirmation should be encouraged.• Proteinuria or albuminuria values should be measured in spot samples and reported in proportion to creatinine.