Browsing by Author "Serteser, Mustafa"

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A new haematocytometric index: Predicting severity and mortality risk value in COVID-19 patients
(PUBLIC LIBRARY SCIENCE, 2021-01-01) Kilercik, Meltem; Demirelce, Ozlem; Serdar, Muhittin Abdulkadir; Mikailova, Parvana; Serteser, Mustafa
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) (<11.4 gr/dL) and monocyte to neutrophil ratio (MNR) (0.084) had the highest area under curve (AUC) values, respectively in discrimination critical patients than non-critical patients. In determining Group 3, MNR (<0.095), NLR (>5.2), Plateletcount (PLT) (>142 x10(3)/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.
A rare association: celiac disease and multiple myeloma in an asymptomatic young patient
(WALTER DE GRUYTER GMBH, 2016-01-01) Ongen, Belkiz; Aksungar, Fehime Benli; Tiftikci, Arzu; Coskun, Abdurrahman; Serteser, Mustafa; Usnsal, Ibrahim
Celiac Disease (CD) is a gluten-sensitive enteropathy, and an autoimmune disorder involving an innate and adaptive immune response that occurs in genetically predisposed patients who are exposed to gluten-containing foods and other environmental factors. Early diagnosis and treatment are essential in preventing complications of the disease. Symptoms may appear both in childhood or adulthood by the ingestion of gluten and are usually characterized by gastrointestinal symptoms
A Simple Method for Quantification of Five Urinary Porphyrins, Porphobilinogen and 5-Aminolevulinic Acid, Using Liquid Chromatography Tandem Mass Spectrometry
(SPRINGER INDIA, 2019-01-01) Dogan, Ozlem; Serdar, Muhittin A.; Murat, Koza; Sonmez, Cigdem; Ispir, Emre; Serteser, Mustafa; Unsal, Ibrahim
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 2nmol/L, where it was 5mol/L for ALA and 2mol/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.
ANALYSIS OF CHANGES IN PARATHYROID HORMONE AND 25 (OH) VITAMIN D LEVELS WITH RESPECT TO AGE, GENDER AND SEASON: A DATA MINING STUDY
(SCIENDO, 2017-01-01) Serdar, Muhittin A.; Can, Basar Batu; Kilercik, Meltem; Durer, Zeynep A.; Aksungar, Fehime Benli; Serteser, Mustafa; Coskun, Abdurrahman; Ozpinar, Aysel; Unsal, Ibrahim
Background: 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. Methods: 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. Results: Mean serum 25(OH) D levels showed a sinusoidal fluctuation throughout the year and were significantly (p < 0.01) higher in summer and autumn. On the other hand, PTH levels were significantly higher (p < 0.01) 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)(4.12-0.064{*}(sqrt)(25(OH) D)) (r=-0.325, R-squared=0.105, p < 0.001)) suggested that the cut-off for sufficient 25(OH) D should be 75 nmol/L. Conclusions: Our 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.
Association Between Serum Pregnancy-Associated Plasma Protein-A and Bicarbonate in Hemodialysis Patients
(JOHN WILEY \& SONS INC, 2014-01-01) Bicik, Zerrin; Coskun, Abdurrahman; Serteser, Mustafa; Bulur, Atilla; Mese, Meral; Unsal, Ibrahim
Background Acidosis is associated with protein-energy malnutrition, inflammation, and bone disease, and low bicarbonate levels have been implicated in higher mortality rates in chronic kidney disease. Recently, the concentration of serum pregnancy-associated plasma protein-A (PAPP-A) has become accepted as a prognostic marker in hemodialysis patients. This study determined the relationship between PAPP-A and bicarbonate levels in these patients. Methods The study enrolled 65 hemodialysis patients (41 males, 24 females) and 26 control subjects (11 males, 15 females). Serum PAPP-A, intact parathormone (iPTH), calcium, phosphorus (P), and bicarbonate levels were measured. Correlations between PAPP-A and bicarbonate, iPTH, calcium, and phosphorus were evaluated. Results Median PAPP-A levels were significantly higher in hemodialysis patients {[}15.1 (<0.03-158.8) ng/ml] than in control subjects {[}6.6 (<0.03-16.4) ng/ml] (P < 0.05). There were statistically significant correlations between serum PAPP-A and bicarbonate, iPTH, and P in hemodialysis patients but not in control subjects. Conclusion Elevation of serum PAPP-A has been found in hemodialysis patients and its significant correlation with bicarbonate suggests that it may be a prognostic factor.
Biological Variation Estimates Obtained from 91 Healthy Study Participants for 9 Enzymes in Serum
(AMER ASSOC CLINICAL CHEMISTRY, 2017-01-01) Carobene, Anna; Roraas, Thomas; Solvik, Una Orvim; Sylte, Marit Sverresdotter; Sandberg, Sverre; Guerra, Elena; Marino, Irene; Jonker, Niels; Barla, Gerhard; Bartlett, William A.; Fernandez-Calle, Pilar; Diaz-Garzon, Jorge; Tosato, Francesca; Plebani, Mario; Coskun, Abdurrahman; Serteser, Mustafa; Unsal, Ibrahim; Ceriottil, Ferruccio; Biological, E.F.L.M. Working Grp
BACKGROUND: We sought to develop estimates of biological variation (BV) for 9 enzymes in blood serum as part of the European Biological Variation Study. METHODS: Ninety-one healthy study participants (38 male and 53 female, 21-69 years old) were phlebotomized in each of 10 consecutive weeks at 6 European laboratories. The same preanalytical sample-handling protocol was followed at each center before transport to San Raffaele Hospital, Milan, Italy, for analysis. Sera were stored at -80 degrees C before analysis in duplicate within a single run on an ADVIA 2400 Clinical Chemistry System (Siemens Healthcare) following a protocol designed to minimize analytical imprecision. Assay traceability was established using frozen sera with target values assigned by reference methods. The results were subjected to outlier analysis before CV-ANOVA to deliver valid BV estimates. Results for 9 enzymes were subsequently partitioned for graphical display allowing visual assessment of the effects of country of origin, sex, and age on BV estimates. RESULTS: We found no effect of country upon the observed variation, but overall sex-related differences were evident for alanine amino transferase (ALT), gamma-glutamyl transferase (GGT), and creatine kinase (CK). The following estimates for within-subject BV (CVI) and between-subject BV (CVG), respectively, were obtained: ALT: 9.3\%, 28.2\%
Biological variations of ADAMTS13 and von Willebrand factor in human adults
(CROATIAN SOC MEDICAL BIOCHEMISTS, 2014-01-01) Kilercik, Meltem; Coskun, Abdurrahman; Serteser, Mustafa; Inan, Deniz; Unsal, Ibrahim
Background: The ultra-large von Willebrand factor (vWF) multimers are very active and must be degraded by ADAMTS13 for optimal activity. A severe functional deficiency of ADAMTS13 has been associated with thrombotic thrombocytopenic purpura. The correct interpretation of patient vWF and ADAMTS13 plasma levels requires an understanding of the biological variation associated with these analytes. In the present paper, we aimed to determine the biological variation of ADAMTS13 and vWF in human adults. Materials and methods: Blood samples were collected weekly from 19 healthy subjects for 5 consecutive weeks. vWF activity and antigenicity were determined using aggregometric and immunoturbidimetric methods. ADAMTS13 antigenicity and activity were determined by ELISA. Results: The within-subject biological variations for vWF activity and antigenicity were 8.06\% and 14.37\%, respectively, while the between-subject biological variations were 18.5\% and 22.59\%, respectively. The index of individuality for vWF activity was 0.44, while vWF antigenicity was 0.64. Similarly, ADAMTS13 activity and antigenicity within-subject biological variations were 12.73\% and 9.75\%, respectively, while between-subject biological variations were 9.63\% and 6.28\%, respectively. The ADAMTS13 indexes of individuality were 1.32 and 1.55, respectively. Conclusion: We report high biological variation and individuality in vWF antigenicity and activity levels. However, ADAMTS13 antigenicity and activity displayed high biological variation, but low individuality. Thus, population-based reference intervals may be useful for monitoring ADAMTS13 antigenicity and activity, but not for vWF, which displays high individuality. These findings should be considered when determining the reference interval and other clinical variables associated with ADAMTS13 and vWF levels.
CHALLENGES IN VITAMIN D ANALYSIS
(SCIENDO, 2012-01-01) Serteser, Mustafa; Coskun, Abdurrahman; Inal, Tamer C.; Unsal, Ibrahim
Vitamin D is an important determinant for the regulation of calcium and phosphorus levels and mineralization of the bone. The most reliable indicator of vitamin D status is the measurement of plasma or serum 25OH-D concentration. Several studies reported discrepancies between the results of assays. These high variabilities in 25OH-D measurements are due to used assay technologies and lack of standardization against the reference materials. Different assays have been employed for the measurement of 25OH-D levels: Competitive Protein Binding Assays, immunoassays, direct detection methods. Choosing an assay platform is important both for clinical laboratory professionals and researchers, and several factors affect this process. Recently, liquid chromatography and tandem mass spectrometry is an alternative method to traditional assays and provides higher specificity and sensitivity than many assays
Circulating C-Terminal Propeptide of Type I Collagen (CICP) Levels in Women with Polycystic Ovary Syndrome
(ORTADOGU AD PRES \& PUBL CO, 2012-01-01) Serteser, Mustafa; Fenkci, Ibrahim Veysel; Fenkci, Semin Melahat; Oztekin, Ozer
Objective: Collagen type I is abundant in the outer layers of capsular stroma and theca externa in the ovary. C-terminal propeptide of Type I collagen (CICP) is the measurable form of type I procollagen in serum. Circulating CICP levels are indicative of collagen production. This study was designed to determine the serum levels of CICP and tissue inhibitor of metalloproteinase-1 (TIMP-1) levels in women with Polycystic Ovary Syndrome (PCOS). Material and Methods: This study included twenty-five women with PCOS in the study group and twenty healthy women in the control group. Serum lipid sub-fractions, fasting glucose and insulin, hormone (gonadotropins, androgens), CICP and TIMP-1 levels were measured. Homeostasis model assessment (HOMA-IR) was used to estimate insulin resistance. Results: Serum luteinizing hormone (LH) and fasting insulin levels, LH/follicule stimulating hormone (FSH) ratio, free androgen index (FAI) and HOMA-IR values were higher in patients with PCOS compared with healthy women. A significant increase in CICP level was observed in subjects with PCOS, and TIMP-1 level was found to be significantly decreased. HOMA-IR value was positively correlated with CICP level, but inversely with TIMP-1 level. The best cut-off values for CICP and TIMP-1 were >49.94 ng/mL (sensitivity 92.6\% and specificity 65\%) and <275.99ng/ml (sensitivity 92.6\% and specificity 40\%) respectively. Conclusion: Elevated circulating CICP levels may be associated with thickened tunics albuginea in women with PCOS. However, the exact role of CICP in the pathogenesis of the disease remains to be elucidated.
Cofilin-1 as a potential biomarker to evaluate acute kidney injury
(WALTER DE GRUYTER GMBH, 2019-01-01) Coskun, Abdurrahman; Ucal, Yasemin; Berber, Ibrahim; Cakir, Ulkem; Serteser, Mustafa; Moldur, Derya Emel; Derelioglu, Ecenur Izzete; Yozgatli, Tahir Koray; Ozpinar, Aysel; Unsal, Ibrahim
Acute kidney injury (AKI) is a worldwide health problem and defined by rapid loss of excretory function of the kidney with the accumulation of metabolic end products. For effective treatment and prevent complications the early diagnosis of AKI is crucial. The current analytes used to diagnose AKI are not adequately sensitive and specific and therefore clinicians need new biomarkers. One of the new promising biomarker candidates of renal injury is cofilin-1. Previously, in our laboratory we isolated cofilin-1 in kidney preservation solution prior to transplantation and attempted to measure serum cofilin-1 in renal transplanted patients. However, cofilin-1 was not accurately measured in serum samples due to the methodological issues. In this mini-review, we summarized the current knowledge and concepts both in the literature and our experiences with cofilin-1 as a potential biomarker for the diagnosis and management of AKI.
Early Postnatal Metabolic Profile in Neonates With Different Birth Weight Status: A Pilot Study
(FRONTIERS MEDIA SA, 2021-01-01) Beken, Serdar; Abali, Saygin; Yildirim Saral, Neslihan; Guner, Bengisu; Dinc, Taha; Albayrak, Eda; Ersoy, Melike; Kilercik, Meltem; Halici, Muge; Bulbul, Ezgi; Kaya, Didem; Karabay, Melis; Ay, Zeynep Alize; Eksi, Gulten Zeynep; Benli Aksungar, Fehime; Korkmaz, Ayse; Serteser, Mustafa
Introduction: Restricted or enhanced intrauterine growth is associated with elevated risks of early and late metabolic problems in humans. Metabolomics based on amino acid and carnitine/acylcarnitine profile may have a role in fetal and early postnatal energy metabolism. In this study, the relationship between intrauterine growth status and early metabolomics profile was evaluated. Materials and Methods: A single-center retrospective cohort study was conducted. Three hundred and sixty-one newborn infants were enrolled into the study, and they were grouped according to their birth weight percentile as small for gestational age (SGA, n = 69), appropriate for gestational age (AGA, n = 168), and large for gestational age (LGA, n = 124) infants. In all infants, amino acid and carnitine/acylcarnitine profiles with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were recorded and compared between groups. Results: LGA infants had higher levels of glutamic acid and lower levels of ornithine, alanine, and glycine (p < 0.05) when compared with AGA infants. SGA infants had higher levels of alanine and glycine levels when compared with AGA and LGA infants. Total carnitine, C0, C2, C4, C5, C10:1, C18:1, C18:2, C14-OH, and C18:2-OH levels were significantly higher and C3 and C6-DC levels were lower in SGA infants (p < 0.05). LGA infants had higher C3 and C5:1 levels and lower C18:2 and C16:1-OH levels (p < 0.05). There were positive correlations between free carnitine and phenylalanine, arginine, methionine, alanine, and glycine levels (p < 0.05). Also, a positive correlation between ponderal index and C3, C5-DC, C14, and C14:1 and a negative correlation between ponderal index and ornithine, alanine, glycine, C16:1-OH, and C18:2 were shown. Conclusion: We demonstrated differences in metabolomics possibly reflecting the energy metabolism in newborn infants with intrauterine growth problems in the early postnatal period. These differences might be the footprints of metabolic disturbances in future adulthood.
Easy method for newborn screening of six lysosomal storage disorders using online solid-phase extraction with mass spectrometry
(WALTER DE GRUYTER GMBH, 2016-01-01) Serdar, Muhittin; Lay, Incilay; Coskun, Julide; Aslan, Berna; Aslan, Huseyin; Coskun, Abdurrahman; Serteser, Mustafa; Unsal, Ibrahim; Ozpinar, Aysel
Objective: A modified method for screening of six lysosomal storage disorders (LSDs) by tandem mass spectrometry was presented. Methods: The enzyme activities for six LSDs (Gaucher, Pompe, Krabbe, Fabry, Niemann-Pick A/B and Mucopolysaccharidosis Type I) was measured by using ultra-HPLC and mass spectrometry. After overnight incubation of dried blood spots with three distinct reaction cocktails containing substrates and internal standards, reactions were stopped and online trapping was performed with ultra-HPLC preceding to mass spectrometry. Ultra-HPLC was equipped with online solid phase extraction and Hypersil Gold C8 analytical columns and coupled with TSQ Quantum Access Max mass spectrometry. Results: Activities of acid-ss-glucocerebrosidase (ABG), acid glucosidase (GAA), galactocerebroside-ss-galactosidase (GALC), acid-galactosidase A (GLA), acid sphingomyelinase (ASM), and alpha-L-iduronidase (IDU) were obtained from DBSs of patients and healthy individuals. The intra- and inter-assay precisions were <20\% (CV). Conclusion: Our modified method, needing less DBS punches and only three reaction coctails, with the online trapping methodology, accurately differentiates newborns with LSDs from healthy newborns.
Exposure to Perchlorate in Lactating Women and Its Associations With Newborn Thyroid Stimulating Hormone
(FRONTIERS MEDIA SA, 2018-01-01) Ucal, Yasemin; Sahin, Ozlem N.; Serdar, Muhittin; Blount, Ben; Kumru, Pinar; Muhcu, Murat; Eroglu, Mustafa; Akin-Levi, Cansu; Keles, Z. Zeynep Yildirim; Turam, Cem; Valentin-Blasini, Liza; Morel-Espinosa, Maria; Serteser, Mustafa; Unsal, Ibrahim; Ozpinar, Aysel
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
Glutaric acidemia type II patient with thalassemia minor and novel electron transfer flavoprotein-A gene mutations: A case report and review of literature
(BAISHIDENG PUBLISHING GROUP INC, 2018-01-01) Saral, Neslihan Yildirim; Aksungar, Fehime Benli; Aktuglu-Zeybek, Cigdem; Coskun, Julide; Demirelce, Ozlem; Serteser, Mustafa
Glutaric acidemia type II (GA II), also known as multiple acyl-CoA dehydrogenase deficiency, is an auto-somal recessive inborn error of amino acid and fatty acid metabolism. We report a case of GA. with novel electron transfer flavoprotein (ETF)-A mutations in a 2-year-old female with thalassemia minor. The patient developed an episode of hypoglycemia and hypotonicity on the postnatal first day. Laboratory investigations revealed elevations of multiple acyl carnitines indicating glutaric acidemia type II in newborn screening analysis. Urinary organic acids were evaluated for the confirmation and revealed a high glutaric acid excretion. Genetic analysis revealed two novel mutations in the ETF-A gene, which are considered to be compound heterozygote. At the 8 mo of life ketone therapy was added, which significantly increased the neuromotor development. The patient had been closely followed for two years with carnitine, riboflavin, coenzyme Q10, and ketone supplementation in addition to a high carbohydrate diet. Although the patient had comorbidity like thalassemia minor, her neuromotor development was normal for her age and had no major health problems. This specific case expands the previously reported spectrum of this disease.
Hepatitis C virus positive patient diagnosed after detection of atypical cryoglobulin
(BAISHIDENG PUBLISHING GROUP INC, 2016-01-01) Ongen, Belkiz; Aksungar, Fehime Benli; Cicek, Bahattin; Akyar, Isin; Coskun, Abdurrahman; Serteser, Mustafa; Unsal, Ibrahim
A 60-year-old male patient presented with jaundice and dark urine for three days, icteric sclerae and skin rash on his legs for six months. Laboratory inves-tigations revealed an atypical cryoglobulinemia with high hepatitis C virus (HCV)-RNA levels. Imaging studies showed cholestasis was accompanying HCV. Capillary zone electrophoresis using immunosubtraction method revealed a polyclonal immunoglobulin G and immunoglobulin A (IgA) monoclonal cryoglobulin and that IgA lambda was absent in immu-nofixation electrophoresis. After a liver biopsy, chronic hepatitis C, HCV related mixed cryoglobulinemia and cryoglobulinemic vasculitis were diagnosed and antiviral therapy was initiated. Our HCV patient presented with cryoglobulinemic symptoms with an atypical cryoglobulinemia that was detected by an alternative method: Immunosubtraction by capillary electrophoresis. Different types of cryoglobulins may therefore have a correlation with clinical symptoms and prognosis. Therefore, the accurate immunotyping of cryoglobulins with alternative methods may provide more information about cryoglobulin-generated pathology.
HOW ISO-15189 LABORATORY ACCREDITATION ASSURES PATIENT SAFETY?
(SOC MEDICAL BIOCHEMISTS SERBIA, 2012-01-01) Serteser, Mustafa; Coskun, Abdurrahman; Inal, Tamer C.; Unsal, Ibrahim
Healthcare is a complex profession involving the state-of-art technology and sometimes leading to unintentional harm. Many factors contribute to the occurrence of medical errors. Patient safety is one of the most serious global health issues and defined as the absence of preventable harm to a patient during any process of medical care. The frequency of medical errors is higher than expected. It has been concluded that the majority of medical errors are not because of the individual attitudes but mainly caused by faulty systems or processes leading the staff to make mistakes or fail to prevent them. Patient safety is a shared responsibility comprised of many stakeholders such as society, patients, nurses, educators, administrators, researchers, physicians, government and legislative bodies, professional associations and accrediting agencies. Medical laboratory services are essential to patient care and need to be available to meet the needs of both patients and caregivers. ISO-15189:2007 Medical Laboratories-Particular requirements for quality and competence, an internationally recognized standard containing requirements necessary for diagnostic laboratories to demonstrate their competence to deliver reliable laboratory services. It applies quality system requirements to the clinical laboratories with a strong focus on responsiveness to the needs of patients and clinicians. Applying the performance improvement strategies focusing on different phases in total testing process will significantly reduce the errors and therefore will improve the patient safety. In this way, laboratory professionals contribute to improvement of safety and outcomes of care by working in interdisciplinary approach manner.
İdrar Yolu Enfeksiyonlarının Tanısında İdrar Akım Sitometrisi ve İdrar Kültürü Sonuçları Arasındaki İlişkiler
(Acıbadem Mehmet Ali Aydınlar Üniversitesi, 2012-01-01) Akyar, Işık; Serteser, Mustafa; Güldamlar, Gülçin; Kocagöz, Sesin; Kocagöz, Tanıl; Ünsal, İbrahim
Özet Amaç: İdrar yolu enfeksiyonlarının tanısında altın standart yöntem kül türdür. Bununla birlikte, erken ve uygun tedaviye başlamak için kısa süre de sonuç veren bir teste gerek duyulmaktadır. İdrar akım sitometrisinden bu konuda bilgi verici bir test olarak yararlanılabilir. Biz de çalışmamız da idrar yolu enfeksiyonlarında hızlı tanıya yardımcı olması açısından id rar akım sitometrisi ile kültür sonuçları arasındaki ilişkiyi incelemeyi he defledik. Gereç ve yöntemler: Hastaneye başvuran toplam 3418 hastanın idrar örnek lerinde UF-100 akım sitometrisi (Sysmex Corporation, Japan) ile bakteri ve lökosit incelenmiştir. UF- 100 ile elde edilen sonuçlar örneklerin kültürle ri ile karşılaştırılmıştır. Üreme saptanan kültürlerdeki mikroorganizmala rın tanımlanması ve antibiyotik duyarlılıkları Phoenix (Becton Dickinson, U.S.A.) ile çalışılmıştır. Bulgular: 3418 idrar kültürünün 739’u (% 22) pozitif olarak saptanmıştır. Akım sitometrisinde kültür ile en iyi uyumluluk gösteren eşik değeri bak teriler için 3000/μL (duyarlılık = % 19,37; özgüllük = % 97,76) ve lökosit ler için de 21/μL (duyarlılık = % 57,65; özgüllük = % 85,99) olarak saptan mıştır. Sonuç: Kısa sürede sonuçlanan bir teste gereksinim olmakla birlikte bu amaçla denenen UF-100 akım sitometrisinin kullanımı idrar kültür sonuç ları hakkında tam olarak fikir vermemektedir. İdrar akım sitometrisinde lökosit sayımı bakteri sayımı yapılmasına kıyasla daha güvenilir sonuç lar vermektedir. İdrar analizinin idrar akım sitometrisi kullanılarak yapıl ması zaman kazanılmasını sağlamakta ve bakteriyolojik kültür sonuçla rının elde edilmesi öncesinde hekimlere güvenilir bir lökosit sayım bilgi si vermektedir.
INCREASED MATERNAL LEPTIN LEVELS MAY BE AN INDICATOR OF SUBCLINICAL HYPOTHYROIDISM IN A NEWBORN
(SOC MEDICAL BIOCHEMISTS SERBIA, 2022-01-01) Karpuzoglu, Hande; Ucal, Yasemin; Kumru, Pinar; Muhcu, Murat; Eroglu, Mustafa; Serdar, Muhittin; Serteser, Mustafa; Ozpinar, Aysel
Background: 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. Methods: 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. Results: 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 than >5.5 mIU/L {[}13.2 mg/L (1.3-46.5) vs 19.7 mg/L (2.4-48.5), p<0.05]. Serum leptin levels showed a negative correlation with maternal fT4 (r=0.32, p<0.05), fT3 (r=0.23, p<0.05), and a positive correlation with BMI (r=0.30, p<0.05). Conclusions: 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.
Indirect Reference Intervals Estimated from Hospitalized Population for Thyrotropin and Free Thyroxine
(MEDICINSKA NAKLADA, 2010-01-01) Inal, Tamer C.; Serteser, Mustafa; Coskun, Abdurrahman; Ozpinar, Aysel; Unsal, Ibrahim
Aim To establish indirect reference intervals from patient results obtained during routine laboratory work as an alternative to laborious and expensive producing of their own reference range values according to international instructions. Methods All results for thyrotropin (TSH) and free thyroxine (T4) that were stored in our laboratory information system between 2004 and 2008 were included in this study. After a logarithmic transformation of the raw data, outliers were excluded. Non-parametric reference intervals were estimated statistically after visual observation of the distribution using stem-and-leaf plots and histograms. A standard normal deviation test was performed to test the significance of differences between sub-groups. Results There was no significant difference in serum TSH or free T4 concentrations between male and female participants. Because no differences were found within the time span of the study, combined reference intervals were calculated. Indirect reference values were 0.43- 3.93 mU/L for TSH and 11.98-21.33 pmol/L for free T4. Conclusion Using patient laboratory data values is a relatively easy and cheap method of establishing laboratory specific reference values if skewness and kurtosis of the distribution are not too large.
INHIBITION OF CHOLESTEROL BIOSYNTHESIS IN HYPERCHOLESTEROLEMIA - IS IT THE RIGHT CHOICE?
(DE GRUYTER POLAND SP ZOO, 2013-01-01) Coskun, Abdurrahman; Serteser, Mustafa; Unsal, Ibrahim
Cholesterol biosynthesis is a complex pathway comprising more than 20 biochemical reactions. Although the final product created in the pathway is cholesterol, the intermediate products, such as ubiquinone and dolichol, also provide vital metabolic functions. Statins are HGM-CoA reductase inhibitors that stop the production of cholesterol by directly inhibiting the mevalonate production. Mevalonate is a precursor of two additional vital molecules, squalene and ubiquinone (coenzyme Q10). We hypothesized that inhibiting the cholesterol biosynthesis with statins for an extended duration may potentiate the oxidative stress, neurodegenerative disease and cancer. Our recommendation was to measure muscle enzymes, antioxidant capacity, and ubiquinone to monitor patients receiving the statins for prolonged periods of time.