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Introduction: We investigated the interference of haemolysis on ethanol testing carried out with the Synchron assay kit using an AU680 autoanalyser (Beckman Coulter, Brea, USA). Materials and methods: Two tubes of plasma samples were collected from 20 volunteers. Mechanical haemolysis was performed in one tube, and no other intervention was performed in the other tube. After centrifugation, haemolysed and non-haemolysed samples were diluted to obtain samples with the desired free haemoglobin (Hb) values (0, 1, 2, 5, 10 g/L). A portion of these samples was then separated, and ethanol was added to the separated sample to obtain a concentration of 86.8 mmol/L ethanol. After that, these samples were diluted with ethanol-free samples with the same Hb concentration to obtain samples containing 43.4, 21.7, and 10.9 mmol/L. Each group was divided into 20 equal parts, and an ethanol test was carried out. The coefficient of variation (CV), bias, and total error (TE) values were calculated. Results: The TE values of haemolysis-free samples were approximately 2-5%, and the TE values of haemolysed samples were approximately 10- 18%. The bias values of haemolysed samples ranged from nearly - 6.2 to - 15.7%. Conclusions: Haemolysis led to negative interference in all samples. However, based on the 25% allowable total error value specified for ethanol in the Clinical Laboratory Improvement Amendments (CLIA 88) criteria, the TE values did not exceed 25%. Consequently, ethanol concentration can be measured in samples containing free Hb up to 10 g/L.

Objectives The utilization of reliable quality indicators (QIs) proven to be suitable for monitoring and improvement tools is one of the best choices to minimize of the risk of errors in all laboratory processes called as total testing process (TTP). In 2008, a Working Group “Laboratory Errors and Patient Safety” (WG-LEPS) established by International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) developed the Model of Quality Indicators (MQI) complying with requirements of the ISO 15189:2012 standard for laboratory accreditation. They have also been dealing with harmonizing the QIs in most laboratories worldwide since then. The present study was set out to investigate the frequency of using IFCC WG-LEPS’ pre-QIs by Turkish laboratories and to assess the conformity of them, by taking into account Turkey’s conditions. Methods A survey consisting nine questions was applied in 81 laboratories using SurveyMonkey. Results According to the survey results, most of the laboratories reported they have used pre-QIs in the quality standards of health prepared by Turkish Ministry of Health (MOH). A part of IFCC WG-LEPS’ pre-QIs were being utilized by more than 80% of the laboratories, the rest of which only used by 10% of laboratories. Conclusions The majority of the medical laboratories have been using the pre-QIs included in the guidelines of Quality Standards prepared by the MOH. The pre-QIs are partially compatible with IFCC WG-LEPS’ pre-QIs. The definitions of IFCC WG-LEPS’ pre-QIs may also be revised to make them more clear and understandable by IFCC WG-LEPS. The insufficiency of Health Information Management Systems (HIMS) limits the use of pre-QIs proposed by IFCC WG-LEPS. Finally, the education of relevant personnel about the use of HIMS and pre-QIs is very crucial to harmonize and to extend the use of IFCC WG-LEPS’ pre-QIs in Turkish medical biochemistry laboratories.

The European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) have recommended an algorithm based on the reference change value (RCV) to evaluate hemolysis. We utilized this algorithm to analyze hemolysis-sensitive parameters.Two tubes of blood were collected from each of the 10 participants, one of which was subjected to mechanical trauma while the other was centrifuged directly. Subsequently, the samples were diluted with the participant's hemolyzed sample to obtain the desired hemoglobin concentrations (0, 1, 2, 4, 6, 8, and 10 g/L). ALT, AST, K, LDH, T. Bil tests were performed using Beckman Coulter AU680 analyzer. The analytical and clinical cut-offs were based on the biological variation for the allowable imprecision and RCV. The algorithms could report the values directly below the analytical cut-off or those between the analytical and clinical cut-offs with comments. If the change was above the clinical cut-off, the test was rejected. The linear regression was used for interferograms, and the hemoglobin concentrations corresponding to cut-offs were calculated via the interferograms.The RCV was calculated as 29.6% for ALT. Therefore, ALT should be rejected in samples containing5.9 g/L hemoglobin. The RCVs for AST, K, LDH, and T. Bil were calculated as 27.9%, 12.1%, 19.2%, and 61.2%, while the samples' hemoglobin concentrations for test rejection were 0.8, 1.6, 0.5, and 2.2 g/L, respectively.Algorithms prepared with RCV could provide evidence-based results and objectively manage hemolyzed samples.Radna grupa za preanalitičku fazu (WG-PRE) Evropske Federacije za kliničku hemiju i laboratorijsku medicinu (EFLM) preporučila je algoritam koji se zasniva na promeni referentne vrednosti (RCV) za procenu hemolize. Mi smo koristili ovaj algoritam za analiziranje osetljivih hemolizovanih parametara.Uzete su dve epruvete krvi od svakog od 10 učesnika, jedna koja je bila predmet mehaničke traume a druga je direktno centrifugirana. Istovremeno uzorci su bili razblaženi sa hemolizovanim uzorcima učesnika da bi se dobile željene koncentracije hemoglobina (0, 1, 2, 4, 6, 8 i 190 g/L). Analiziranje ALT, AST, K, LDH, T. Bil je izve deno primenom Beckman Coulter AU680 analizatora. Analitičke i kliničke cut-off vrednosti bile su zasnovane na biološkoj varijaciji za dozvoljivu nepreciznost i RCV. Algo ritmi su odgovarali direktno vrednostima ispod kliničke cut-off ili one između analitičke i kliničke cut-off. Ako je pro mena bila iznad kliničke cut-off test je odbačen. Linearna regresija je korišćena na interferograme i koncentracije hemo globina koje su odgovarale cut-off vednostima izračunatih preko interferograma.RCV je izračunat kao 29,6% za ALT. Prema tome potrebno je odbaciti uzorke za ALT koji su imali5,9 g/L hemoglobina. RCV za AST, K, LDH i T. Bil izračunati su kao 27,9%, 12,1%, 19,2% i 61,2%, dok su uzorci sa koncentracijom hemoglobina za odbacivanje testa bili 0,8, 1,6, 0,5 i 2,2 g/L.Algoritimi pripremljeni sa RCV mogu da obezbe rezultate zasnovane na dokazima i objektivno procene hemolizovane uzorke.

Along with vitamin D deficiency, a common global health problem in developed and developing countries, zinc deficiency also remains one of the most common micronutrient deficiencies-related public health problems in some parts of the world. Determination of vitamin D and Zn status is important for the growth, development, and health of school-age children, as well as their intellectual achievement and academic performance. In this study, we aimed to evaluate serum 25(OH)D and Zn levels and the relationship between them in a nationally representative sample of Turkish children and adolescents.A total of 541 children and adolescents aged 1 - 16 years were included in our study whose vitamin D and zinc test levels were measured and who applied to the Basaksehir Cam and Sakura City Hospital Pediatric Outpatient Clinic. Cases were examined by dividing them into subgroups according to their vitamin D levels (≤ 15 ng/mL deficiency; 15 - 20 ng/mL insufficiency; ≥ 20 ng/mL sufficiency) and age (5 years preschool; 5 - 10 years middle childhood; 11 - 16 years adolescence).The levels of 25(OH)D were lower than 20 ng/mL in 33% of the children. There was deficiency in 80 (15%) and insufficiency in 99 (18%) cases. A statistically significant difference was found in 25(OH)D and Zn levels in groups separated by 25(OH)D level and age (p0.001). A positive significant correlation was found between serum 25(OH)D and Zn levels (r = 0.468; p0.001). A negative correlation was found between 25(OH) D levels and age (r = -0.261; p0.001) and body mass index (BMI) (r = -0.308; p0.001).In our study, we found high levels of vitamin D deficiency and insufficiency and a significant positive correlation between serum 25(OH)D and Zn levels in the pediatric population. Based on this possible contribution, we think that providing vitamin D support to children of all ages, including adolescents, and thus improving zinc levels may be beneficial in protecting from diseases that lead to morbidity and mortality as a result of reducing the rate of growth and development retardation, regulating of bone development, and contributing to the development of the immune system.

Background The number of confirmed cases of COVID-19 continues to increase worldwide and threatens public health. Our aim in this study is to examine the relationship between some laboratory parameters and hematological ratios with the severity of the disease and hospital mortality. Methods This study was designed as a retrospective cohort. The clinical data of 743 COVID-19 diagnosed patients who were eligible for hospitalization between March 16, and May 15, 2020 analyzed, retrospectively. The patients were separated into two groups as discharged from hospital (n = 681) and dead in hospital (n = 62). ROC curves and cutoff values of NLR (Neutrophil/Lymphocyte Ratio), PLR (Platelet/Lymphocyte Ratio), MLR (Monocyte/ Lymphocyte Ratio), CRP, and ferritin upon admission to hospital were calculated for the two groups. Binary Logistic Regression used to determine independent risk factors for mortality. Results The difference between both groups for age, duration in hospital, WBC, neutrophil, lymphocyte, NLR, PLR, MLR, CRP, and ferritin values were statistically significant. NLR had the highest area under the curve with a cutoff of 5.5 in the ROC curve [(AUC: 0.892, 95% CI: 0.844 - 0.939); Sensitivity = 85%, Specificity = 84%]. NLR, MLR, PLR, CRP and Ferritin groups have significant effects on the survival times of the Covid-19 patients. According to logistic regression analysis, increments of NLR (OR = 18.1, 95% CI: 6.4 - 51.4), CRP (OR = 5.5, 95% CI: 2.5 - 12.2), and age (OR = 2.7 95% CI: 1.3 - 5.5) values proportionally increase the death probability. Conclusions NLR, CRP, and age are independent risk factors for mortality from COVID-19. We believe that evaluating these parameters together during diagnosis will be important in predicting the prognosis of the disease and in treatment approaches.

Centrifugation separates particles within the specimen according to their shape, dimensions, and density and basically can be defined as a separation method. The centrifuge is an essential device in medical laboratories to prepare the serum, plasma, and urine samples for analysis. It is basically an electric device composed of the stationary (motor) and the motile (rotor) part. The centrifugation depends on two main variables: relative centrifugal force (RCF) and centrifugation time. The physical impact separating the specimen into its components in the centrifuge known as RCF is expressed as the multiples of gravitational acceleration (×g). RPM, defined as the number of rotations of the centrifuge per minute, shows the speed of the centrifuge. RCF value can be calculated by using RPM, and the centrifuge radius. Because models and sizes of centrifuges vary considerably, the use of gravity (g) forces instead of RPM is suggested. The centrifuges can be classified according to their usage, speed, technical specifications, and rotor type. An accurate and precise centrifugation process is essential to prevent errors in the preanalytical phase. The purpose of this document is to ensure the standardization of a good, precise protocol for the centrifugation process among the medical laboratories.

Multidisipliner bir alan olan adli bilimler, adaletin toplum ve toplumu olusturan bireyler arasinda esit olarak saglanabilirligine hizmet eden saglik, fen ve sosyal bilimler gibi egitsel, teknolojik ve pozitif bilimler toplulugunu kapsar. Bu bilimsel alanda teorik ve uygulamanin birbirleriyle ortusen ve ortusmeyen bircok noktasi bulunmaktadir. Teorik bilgilerin havada ucustugu cagimizda bu bilgilerin adli bilimlerin uygulama alanina yansimasi cok onemlidir. Adli tip, hukuk, psikoloji, sosyal hizmet, cocuk gelisimi, kriminoloji, antropoloji, ogretmenlik, medya, polis ve jandarma gibi guvenlik birimlerini de iceren toplumun cok genis bir alaninda birlikte calismaya ve uretmeye gereksinim bulunuyor. Egitim ve ogretimin en onemli parcasini deneyimlerimiz ve uygulama alanlari yani “olgu temelli” yaklasim belirliyor. Olgu, bilgiyi dogru kullanim, gelisim ve degisimin temeli olma yaninda egitim ve ogretimin ayrilmaz bir parcasidir. Bu paradigma ile elinizde tutugunuz “Olgularla Adli Tip & Adli Bilimler” kitabinin tip fakultesi ogrencileri, adli tip asistanlari, adli tip uzmanlari, adli bilimlerin farkli alanlarinda lisans, yuksek lisans ve doktora ogrencileri basta olmak uzere tip, hukuk, psikoloji, dis hekimligi, kriminoloji, sosyal hizmet, antropolojigibi cok cesitli adli bilimler alaninda calisanlara en son guncel literatur bilgileri yaninda olgularla yeni perspektifler de kazandiracagi kanisindayim. Kitabin okuyucuya multidisipliner bir yaklasim yaninda evrensel etik ilkelere de bagli bir adli tip/adli bilimler yaklasimi kazandirmasini diliyorum. Kitabin yaziminda katkilari olan bolum yazari hocalarimiza, meslektaslarimiza, asistanlarimiza, ogrencilerimize ve destek ve katkilari icin Akademisyen Yayinevi sahibi Yasin Dilmen’e sonsuz tesekkur ediyorum. Bilimselligin ve liyakatin gelecegin adli bilimlerini insa etmede tek gercek oldugu bilinciyle kitabin alanimizin bilimsel niteligini daha da yukseklere tasinmasina aracilik etmesi dilegiyle… Prof. Dr. Halis DOKGOZ Mersin, 2020

Objective: In this study, we firstly aimed to determine components of biological variations (BVCs) in levels of glucose and glycated hemoglobin (HbA1c) in detail based on guidance from relevant organizations and experts. We also investigated whether reference intervals for both analytes were useful for evaluations, particularly consecutive test results. Methods: The study group consisted of 36 healthy volunteers. Samples were collected from each individual 4 times every 2 weeks for 45 days. All samples were assayed in duplicate within a single run. Finally, we estimated BVCs and the analytical performance specifications of both analytes. Results: Our results were fairly compatible with current biological variations (BVs) in both analytes reported in a database. It was calculated as within biological variation (CVI)=4.2% and between-subject variation (CVG)=5.3% for glucose while calculating as CVI=1.7% and CVG=4.5% for HbA1c. According to these results, the index of individuality (II) of glucose was higher than 0.6 while HbA1c’s II was lower than this value. Conclusion: We thought that guidelines from relevant international organizations should be followed to standardize the study design and to appropriately calculate BVCs for any analyte in BV studies. Finally, reference change value should be used to evaluate meaningful differences in HbA1c levels instead of reference interval.

Objective:In this study, we investigated the correlation between coronary lesion complexity as characterized by syntax score (SS) with circulating adiponectin and adipocyte-fatty acid binding protein (A-FABP4) concentrations in the presence of stable coronary artery disease affecting three coronary vessels (three-vessel stable CAD).Methods:The study groups consisted of 41 control subjects (28 males and 13 females, non-CAD group) and 115 affected subjects (79 males and 36 females, three-vessel stable CAD group). We divided into tertiles the three-vessel stable CAD group according to SS and estimated circulating concentrations of adiponectin and A-FABP4.Results:We did not find any correlation between the coronary lesion complexity with either the adiponectin and/or A-FABP4. We found lower the A-FABP4 of the non-CAD group than those of the groups with three-vessel stable CAD (pConclusion:Adiponectin is not a suitable parameter for demonstrating the existence of CAD or predicting coronary lesion complexity. A-FABP4 is more useful for the proof of the presence of CAD but A-FABP4 are not correlated with the severity of CAD.

Introduction:The aim of our study was to investigate the vascular endothelial growth factor levels in joint swelling-positive and joint swelling-negative rheumatoid arthritis patients and to then examine the relationship between conventional parameters such as the erythrocyte sedimentation rate and the levels of C-reactive protein, rheumatoid factor, and anti-cyclic citrullinated protein.Methods:Fifty-nine (52 women and seven men) rheumatoid arthritis patients and 25 (20 women and five men) healthy individuals volunteered for this study. The patient group was divided into two sub-groups based on whether or not they exhibited joint swelling.Results:The levels of vascular endothelial growth factor in the joint swelling-negative group were significantly different from those in the joint swelling-positive group, but they were not different from those in the control group (p=0.001 and p=0.72, respectively). We investigated the correlation between vascular endothelial growth factor and C-reactive protein levels (r=0.37, p=0.001). We also evaluated the diagnostic adequacy of vascular endothelial growth factor and created a ROC curve. The area under the curve was calculated to be 0.767.Conclusion:Vascular endothelial growth factor is an adequate diagnostic biomarker and can successfully be used to predict the occurrence of rheumatoid synovitis based on local inflammation.

WOS: 000456923400005 Objective: Asymmetric dimethylarginine (ADMA) is known as a non-traditional risk factor for cardiovascular disease. Considering the increased prevalence of hypervolemia and heart failure in patients with peritoneal dialysis (PD), we aimed to investigate the relationship of ADMA with other biochemical parameters, echocardiographic findings, and results of bioimpedance analysis, which is a method for the determination of body fluid distribution in detail. Methods: The study was conducted on 21 patients with chronic PD. Bioimpedance was evaluated by Body Composition Monitor H02.201.1 (R). ADMA level was analyzed by an ELISA kit. Results: The mean ADMA level was 87.6 +/- 58.2 (18.54-247.34) mu mol/L. The mean ADMA level in patients with hypertension was significantly higher than those with normal blood pressure (95.8 +/- 58.8 mu mol/L and 41.0 +/- 27.9 mu mol/L, respectively; p=0.045). In univariate analysis, the parameters associated with serum ADMA levels were uric acid (r=0.681, p=0.001), left ventricular end-systolic diameter (LVESD) (r=0.509, p=0.019), intracellular water (ICW) (r=0.606, p=0.004), extracellular water (r=0.471, p=0.031), dialysate-to-plasma (D/P) creatinine ratio (r=0.452, p=0.04), body surface area (r=0.52, p=0.016), total body water (r=0.581, p=0.006), and lean tissue mass (r=0.528, p=0.014). In multivariate analysis, only uric acid level, ICW, LVESD, and D/P creatinine were found to be significantly associated with ADMA. Conclusion: Serum ADMA level may be a useful marker to detect cardiovascular risk in patients with PD. Serum uric acid and LVESD are important parameters related to ADMA levels in patients with PD. Bioimpedance spectroscopy findings support the association of ADMA with body fluid volume. Amaç: Kardiyovasküler hastalıklar diyaliz hastalarında mortalitenin en sık nedenidir. Asimetrik dimetilarginin (ADMA) düzeyleri ile aterogenezin ilk basamağı olan endotelyal disfonksiyon arasındaki ilişki gösterilmiş olup, ADMA kardiyovasküler hastalıklar için geleneksel olmayan bir risk faktörü olarak kabul edilmektedir. Periton diyalizi (PD) hastalarında hipervolemi ve kalp yetmezliği prevalansının yüksek olduğunu göz önüne alarak, çalışmamızda ADMA ile diğer biyokimyasal parametreler, ekokardiyografi bulguları ve vücut sıvı dağılımının belirlenmesinde geçerli bir yöntem olan biyoimpedans analizi sonuçları ile ilişkisini araştırmayı hedefledik. Yöntemler: Kronik PD tedavisi gören 21 hasta çalışmaya alındı. Biyoimpedans analizi için BCM (Body Composition Monitor H02.201.1®) cihazı kullanıldı. ADMA düzeyleri ELISA kiti ile çalışıldı. Bulgular: Yirmi bir hastanın 13’ü kadın 8’i erkek idi. PD modalitesi 12 hastada CAPD, 5 hastada APD ve 4 hastada CCPD idi. Hastaların 18’i (%85) hipertansif, 9’u ise (%42) dislipidemik idi. Son dönem böbrek yetmezliğinin etyolojisi 8 hastada (%38) diyabetik nefropati idi. 13 hastanın günlük idrar volümLeri ortalama 1402±636 mL iken, geri kalan 8 hasta ise anürik idi. Ortalama sistolik ve diyasyolik kan basınçları sırasıyla 124,5±36,8 mmHg ve 79,8±11,7 mmHg idi. Hastaların ortalama ADMA düzeyi 87,6±58,2 μmol/L (18,54-247,34 μmol/L) bulundu. Ortalama ADMA seviyesi hipertansif hastalarda normotensif olanlara göre istatistiksel açıdan anlamLı olarak daha yüksek tespit edildi (95,8±58,8 μmol/L ve 41,0±27,9 μmol/L; p=0,045). Tek değişkenli analizde ADMA düzeyi ile ilişkili bulunan parametreler, ürik asit (r=0,681, p=0,001), sol ventrikül diyastol sonu çapı (LVESD) (r=0,509, p=0,019), intrasellüler sıvı miktarı (r=0,606, p=0,004), ekstrasellüler sıvı miktarı (r=0,471, p=0,031), diyalizat/plazma kreatinin oranı (r=0,452, p=0,04), vücut yüzey alanı (r=0,52, p=0,016), total vücut suyu (r=0,581, p=0,006) ve yağsız vücut kitlesi (r=0,528, p=0,014) olarak saptandı. Çok değişkenli analizde ise sadece ürik asit düzeyi, intrasellüler su, LVESD ve diyalizat/plazma kreatinin oranı istatistiksel olarak ADMA düzeyi ile ilişkili bulundu. Sonuç: PD hastalarında kardiyovasküler riskin belirlenmesinde ADMA düzeyi yararlı bir marker olarak kullanılabilir. Serum ürik asit düzeyi ve LVESD, ADMA düzeyi ile yakından ilişkilidir. Biyoimpedans analizi sonuçları ADMA düzeyi ile total vücut sıvısı arasındaki ilişkiyi desteklemektedir.

The researchers have attempted to compare muscle damage in soccer players after matches played on artificial and natural turf fields. The study was performed on 16 male soccer players. A match was played on an artificial turf field, and another one was played on a natural turf field. Visual analogue scale scores, myoglobin, creatine kinase, aspartate transaminase and lactate dehydrogenase levels were measured before the match, after the match and at the 72nd hour. The 2x3 repeated measure ANOVA test was performed for statistical analysis. Comparing the artificial turf and natural turf field values, the post-match and 72nd hour visual analogue scale scores for artificial turf field were found to be statistically significant and higher than the natural turf field values. Based on these findings, the researchers claim that muscle damage is not significantly different when comparing matches played on both fields.

Objective We sought to simply demonstrate how levels of soluble human epoxide hydrolase-2 show changes in both temporal the cortex and hippocampal complex in patients with temporal lobe epilepsy. Methods A total of 20 patients underwent anterior temporal lobe resection due to temporal lobe epilepsy. The control group comprised 15 people who died in traffic accidents or by falling from a height, and their autopsy findings were included. Adequately sized temporal cortex and hippocampal samples were removed from each patient during surgery, and the same anatomic structures were removed from the control subjects during the autopsy procedures. Each sample was stored at −80°C as rapidly as possible until the enzyme assay. Results The temporal cortex in the epilepsy patients had a significantly higher enzyme level than did the temporal cortex of the control group (P = 0.03). Correlation analysis showed that as the enzyme level increases in the temporal cortex, it also increases in the hippocampal complex (r2 = 0.06, P = 0.00001). More important, enzyme tissue levels showed positive correlations with seizure frequency in both the temporal cortex and hippocampal complex in patients (r2 = 0.7, P = 0.00001 and r2 = 0.4, P = 0.003, respectively). The duration of epilepsy was also positively correlated with the hippocampal enzyme level (r2 = 0.06, P = 0.00001). Conclusions Soluble human epoxy hydrolase enzyme-2 is increased in both lateral and medial temporal tissues in temporal lobe epilepsy. Further studies should be conducted as inhibition of this enzyme has resulted in a significant decrease in or stopping of seizures and attenuated neuroinflammation in experimental epilepsy models in the current literature.

Objective:Gastric cancer is one of the most common malignancies worldwide. The risk factors for gastric cancer include environmental and genetic factors. Inflammation and the immune system are known to contribute to the development of the gastric cancer. We examined the influence of critical polymorphisms of CTLA-4 and CD28 genes and circulating protein levels on the etiology of gastric cancer.Methods:Genotyping of SNPs was performed in 55 gastric cancer patients and 105 healthy individuals using the PCR-RFLP method, and circulating levels of sCTLA-4 and sCD28 were measured.Results:There were no significant differences in the genotype and allele distributions of the evaluated SNPs [CTLA-4-318 C>T (rs5742909), CTLA-4+49 A>G (rs231775), CD28 C>T (rs3116496)] between gastric cancer patients and controls (p=0.36, p=0.78, and p=0.80, respectively). The circulating levels of sCTLA-4 and sCD28 were significantly different between the gastric cancer group and the control group (pConclusion:The present results suggest that the CTLA-4 and CD28 gene polymorphisms that were evaluated do not play an important role in Turkish patients with gastric cancer. However, sCTLA4 and sCD28 levels were higher in cancer patients and may be useful as an auxiliary parameter in the diagnosis and monitoring of gastric cancer.

mATeRIAl and meTHOdS: We investigated antierythropoietin antibodies in chronic hemodialysis patients and compared the results with healthy controls by means of establishing an ELISA method. A total of 121 chronic hemodialysis patients receiving recombinant erythropoietin were included in the study. The patients were subdivided according to the type of recombinant erythropoietin (erythropoietin-α or erythropoietin-β) they had been treated with in the last six months.

Objective:At the present time viral hepatitis and HIV infection are important global health problems. The aim of this study was to investigate the rates of HAV, HBV, HCV and HIV seropositivity in people those admitted to Batman State Hospital between Macrh 2010 and March 2011.Materials and Methods:Blood samples were searched for HAV IgG, HBsAg, AntiHBs, Anti-HCV and Anti-HIV with CMIA (Chemiluminescent Microparticle Immunoassay) method (Architect İ2000 SR, USA).Results:For anti-HBs, 10957 samples were analyzed and 5266 (48.06%) of these samples were positive. For anti-HCV 9666 samples were analyzed and 186 (1.9%) of these samples were positive. For HAV IgG 2606 samples were analyzed and 2447 (93.9%) of these samples were positive. For anti-HIV 1/2 6442 samples were analyzed and only 1 sample was positive (0.015%).Conclusion:In conclusion; despite the relatively lower rate of HIV seropositivity, hepatitis viruses, particularly HBV remains to be a significant health problem in our province. Effective vaccination coverage and public awareness about infection control measures would be expected to decrease the emergence of new cases.

Bone Alkaline Phosphatase (BAP) reflects the biosynthetic activity of the osteoblasts. End-stage renal disease and renal transplantation have effects on bone metabolism. The aim of this study was to evaluate serum BAP levels in pre-transplantation (pre-tx) and post-transplantation (post-tx) samples obtained from patients who underwent a renal transplantation. Forty end-stage renal disease patients (16 male and 24 female) undergoing transplantation and 40 healthy individuals (20 female and 20 male) volunteered for this study. The serum samples were obtained before the onset of immunosuppressive treatment and two months after renal transplantation. Serum BAP levels were measured by Ostease Kit (Beckman Coulter, California, USA) at DXI 800 immunoassay autoanalyzer. There were significant differences between control group and pre-tx group (p=0.015) and between control group and post-x group (P

Bu çalışmanın konusunu, psikolojik danışma ilişkisinin hukuksal boyutu kapsamında psikolojik danışmanın psikolojik danışma sözleşmesine dayalı hukuksal sorumluluğu oluşturmaktadır. Önce psikolojik danışmanın etik kurallara dayalı mesleki sorumluluğu ile hukuksal sorumluluğu arasındaki ilişki açıklanmış; sonra da kuruluşundan sona ermesine kadar, psikolojik danışmanın sözleşmeye dayalı sorumluluğunun temelini oluşturan Borçlar Kanunun m.386-398. maddeleri arasında düzenlenen vekalet sözleşmesi niteliğindeki psikolojik danışma sözleşmesi ele alınmıştır. Yine bu sözleşme çerçevesinde psikolojik danışmanın ve danışanın borçları, psikolojik danışmanın hukuksal sorumluluğunun şartları ve sonuçları ile psikolojik danışma merkezlerinin sorumluluğu da incelenmiştir. Ayrıca, bu çalışmanın kapsamına danışmanın sır saklama yükümlülüğü genel olarak Türk Ceza Kanununun ilgili maddelerine göre ele alınarak açıklanmıştır

The presence of a chronic inflammatory state has also been widely documented in end-stage renal disease patients receiving maintenance hemodialysis (HD). It is commonly attributed to the constantly renewed activation of circulating neutrophils and monocytes following blood passage through dialysis circuits and subsequent generation of activated complement components due to contact of plasma with bioincompatible membranes and/or transfer of endotoxins from the dialyzate to the blood compartment. This conjunction leads to a massive generation of reactive oxygen species (ROS), for example, superoxide anion, hydrogen peroxide, hydroxyl radical, and chlorinated oxidants, such as hypochlorous acid by activated neutrophils. The exquisite vulnerability of proteins to ROS is now well documented. Oxidation of amino acid residues, such as tyrosine, leads to the formation of dityrosine, protein aggregation, cross-linking, and fragmentation. Dityrosine-containing protein cross-linking products in the plasma of dialysis patients are named as advanced oxidation protein products (AOPP). In addition, advanced glycation end-products (AGE) is a protein carbonyl compound and produced by protein–ROS interaction. We investigated both the effect of the renewed activation of the immune cells, due to blood–dialyzer interaction over protein oxidation products like AOPP and AGE, among chronic renal failure (CRF) patients receiving maintenance HD, and choice of dialyzers like high flux or the other group on protein oxidation product levels.

Estimation of the postmortem interval (PMI) is one major area of interest in forensic medicine. We investigated changes of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and malondialdehyde (MDA) levels in rat brain and renal tissues in the PMI and examined the potential changes which may be useful for an estimation of time of death.Forty albino female rats were used in this study. The rats were sacrificed and divided into five groups: Group 1: 0 hour, Group 2: 6 hours, Group 3: 12 hours, Group 4: 24 hours, and Group 5: 48 hours. The rats were housed at room temperature (22 degrees C ± 2 degrees C) for the defined period for each group, and their brains and kidneys were excised.The postmortem MDA levels were significantly different between groups for both renal and brain tissues (p = 0.003; p = 0.007). The diagnostic adequacy of MDA was calculated. Regarding SOD and GSH-Px, we were not able to obtain any date that would be useful for the prediction of PMI.According to this study, it is possible that an estimation of the PMI can be made using postmortem MDA levels. Regarding SOD and GSH-Px, we were not able to obtain any data that would be useful for the prediction of PMI.

BACKGROUND Estimation of the postmortem interval (PMI) is one major area of interest in forensic medicine. We investigated changes of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities and malondialdehyde (MDA) levels in rat brain and renal tissues in the PMI and examined the potential changes which may be useful for an estimation of time of death. METHODS Forty albino female rats were used in this study. The rats were sacrificed and divided into five groups: Group 1: 0 hour, Group 2: 6 hours, Group 3: 12 hours, Group 4: 24 hours, and Group 5: 48 hours. The rats were housed at room temperature (22 degrees C ± 2 degrees C) for the defined period for each group, and their brains and kidneys were excised. RESULTS The postmortem MDA levels were significantly different between groups for both renal and brain tissues (p = 0.003; p = 0.007). The diagnostic adequacy of MDA was calculated. Regarding SOD and GSH-Px, we were not able to obtain any date that would be useful for the prediction of PMI. CONCLUSIONS According to this study, it is possible that an estimation of the PMI can be made using postmortem MDA levels. Regarding SOD and GSH-Px, we were not able to obtain any data that would be useful for the prediction of PMI.

Amaç: Bu çalışmada Tunceli ilinde yaşayıp, devlet hastanesine başvuran bireylerde Hepatit B virüsü (HBV) ve hepatit C virüsü (HCV) seroprevelansını değerlendirmek amaçlandı. Yöntem: Tunceli Devlet Hastanesinde, Hepatit B yüzey antijeni (HBsAg, n: 3640), hepatit B yüzey antikoru (anti-HBs, n: 3941) ve HCV antikoru (anti-HCV, n: 3489) seropozitiflik oranları retrospektif olarak, Temmuz 2013 ve Ocak 2015 arasında incelendi. Veriler Tunceli Devlet hastanesi veri tabanından toplandı ve SPSS 15.00 programı kullanılarak analiz edildi. Bulgular: HBsAg testi çalışılan 3640 hasta bu çalışmaya dahil edildi. 154 hasta (%4.23) HBsAg pozitif bulunmuştur. 3489 hastanın 33'ü (%0.94) anti-HCV pozitif; 3941 hastanın 1829'u (46.41%) anti-HBs pozitif bulunmuştur. Sonuç: Daha önceki çalışmada da Tunceli ilinde benzer sonuçlar olmasına rağmen, HBV ve HCV seroprevalansı hala yüksek düzeydedir. Bu nedenle, HBV ve HCV enfeksiyonlarının bulaşması ve korunma konusunda toplumun bilinçlendirilmesi, sağlık eğitimi ile güçlendirilmelidir., Objective: The aim of this study was to investigate the seroprevalance of the Hepatitis B (HBV) and Hepatitis C (HCV) viruses among patients living in Tunceli province who had been admitted to the Tunceli State Hospital. Method: The seropositivity rates of hepatitis B surface antigens (HBsAg, n:3640), antibodies to hepatitis B surface antigen (anti-HBs, n:3941) and HCV antibodies (anti-HCV, n:3489) were retrospectively studied at the Tunceli StateHospital for the period between July 2013 and January 2015. Data was collected from the database of Tunceli State Hospital and analyzed using SPSS 15.00. Results: A total of 3640 patients tested for HBsAg were included in this study. 154 patients (4.23 %) were found HBsAg positive. 33 (0.94 %) of 3489 patients were found anti-HCV positive and 1829 (46.41%) of 3941 patients were found anti-HBs positive. Conclusions:While an earlier study had produced similar results to the current study in Tunceli province, the seroprevalence of HBV and HCV are still high. Therefore, community awareness should be raised through health education about transmission and prevention of HBVand HCV infections.

Bu çalışmanın konusunu, psikolojik danışma ilişkisinin hukuksal boyutu kapsamında psikolojik danışmanın psikolojik danışma sözleşmesine dayalı hukuksal sorumluluğu oluşturmaktadır. Önce psikolojik danışmanın etik kurallara dayalı mesleki sorumluluğu ile hukuksal sorumluluğu arasındaki ilişki açıklanmış; sonra da kuruluşundan sona ermesine kadar, psikolojik danışmanın sözleşmeye dayalı sorumluluğunun temelini oluşturan Borçlar Kanunun m.386-398. maddeleri arasında düzenlenen vekalet sözleşmesi niteliğindeki psikolojik danışma sözleşmesi ele alınmıştır. Yine bu sözleşme çerçevesinde psikolojik danışmanın ve danışanın borçları, psikolojik danışmanın hukuksal sorumluluğunun şartları ve sonuçları ile psikolojik danışma merkezlerinin sorumluluğu da incelenmiştir. Ayrıca, bu çalışmanın kapsamına danışmanın sır saklama yükümlülüğü genel olarak Türk Ceza Kanununun ilgili maddelerine göre ele alınarak açıklanmıştır, The subject of this study is the legal responsibility of counselor in the extent of its legal dimension of counseling relation. First, the relationship between the professional responsibility based on the ethic codes and the legal responsibility of counselor has been explained; then, in the framework of the contract which forms the basics of the contractual responsibilities of counseling, the obligations of the counselor and the client, and the lawful conditions and their results from the arrangement of the contract to its termination, and the responsibilities of the counseling centers have been focused on as it is embodied in the Articles 386-389 of The Turkish Code of Obligations for a contract for counseling arranged as a procuracy. In addition, confidentiality is crucial issue for the counselors, the related articles of the Turkish Penal Code have been held

The definition of the uncertainty of measurement used in the International Vocabulary of Basic and General Terms in Metrology (VIM) is a parameter associated with the result of a measurement, which characterizes the dispersion of the values that could reasonably be attributed to the measurand. Uncertainty of measurement comprises many components. In addition to every parameter, the measurement uncertainty is that a value should be given by all institutions that have been accredited. This value shows reliability of the measurement. GUM, published by NIST, contains uncertainty directions. Eurachem/CITAC Guide CG4 was also published by Eurachem/CITAC Working Group in the year 2000. Both of them offer a mathematical model, for uncertainty can be calculated. There are two types of uncertainty in measurement. Type A is the evaluation of uncertainty through the statistical analysis and type B is the evaluation of uncertainty through other means, for example, certificate reference material. Eurachem Guide uses four types of distribution functions: (1) rectangular distribution that gives limits without specifying a level of confidence (u(x)=a/ radical3) to a certificate; (2) triangular distribution that values near to the same point (u(x)=a/ radical6); (3) normal distribution in which an uncertainty is given in the form of a standard deviation s, a relative standard deviation s/ radicaln, or a coefficient of variance CV% without specifying the distribution (a = certificate value, u = standard uncertainty); and (4) confidence interval.