Ecem Baltan

Background/Objectives: Postoperative early hypocalcemia (PEH) is a key postoperative issue after parathyroidectomy in primary hyperparathyroidism. It often leads to long-lasting hypocalcemia, requiring more calcium and active vitamin D supplements. This study aimed to determine whether the extent of intraoperative parathyroid hormone (PTH) decline, measured 15 min after parathyroid tumor excision, could serve as a reliable intraoperative rule-out marker for PEH. Methods: We conducted a retrospective review of 88 adult patients who underwent surgical intervention for a solitary parathyroid tumor at a single institution. Postoperative early hypocalcemia (PEH) was defined as a total serum calcium level p < 0.001). Univariate logistic regression showed a significant association between the 15-min PTH decline and PEH (OR 1.22 per 1% increment; 95% CI 1.08–1.38). That said, when we added ALP and parathyroid tumor weight to the multivariate models, PTH decline no longer predicted independently. In contrast, ALP (OR 3.11 per 10 U/L; 95% CI 1.34–7.93; p = 0.011) and parathyroid tumor weight (OR 1.22 per 10 mg; 95% CI 1.10–1.48; p = 0.004) stayed significant. Thus, the incremental prognostic contribution of the 15-min PTH decline beyond ALP and parathyroid tumor weight appears limited. The ROC curve for the 15-min PTH decline produced an AUC of 0.883, with an optimal cutoff of 75% providing 100% sensitivity and 74.4% specificity. No patients with a PTH decline below 75% developed PEH. Conclusions: Preoperative ALP and parathyroid tumor weight showed the strongest independent associations with PEH following parathyroid tumor surgery. An intraoperative PTH decline of less than 75% at 15 min may serve as a practical rule-out tool for PEH, although further validation in larger patient populations is warranted.

OBJECTIVE: To investigate whether there is a relationship with serum decorin levels in second and third trimester pregnant women with PPROM. DESIGN: After this study was approved by the Clinical Research Ethics Committee of Sisli Hamidiye Etfal Training and Research Hospital all subjects included in the study signed informed consent forms that they agreed to participate in the study. SETTING: We collected all biochemical and demograpfic characteristics of patients. Decorin levels of plasma samples were measured using the Human Decorin Elisa Kit. POPULATION: 35 patients who were diagnosed with PPROM from the outpatient clinic with the complaint of sudden gush of amniotic fluid and 35 patients without any obstetric problem were included in our study. METHODS: This study is a prospective controlled study. All statistical analyzes were performed using IBM SPSS 26.0 statistical package program and Microsoft Excel V 2019. MAIN OUTCOME MEASURES: The mean plasma decorin level was 14.7 ng/ml in the PPROM group and it was not found to be statistically significantly lower than the control group with the mean plasma decorin level of 17.5 ng/ml (p=0.339). RESULTS: A significant correlation was found between plasma decorin levels and BMI in both groups (p<0.05). In the PPROM group, no significant correlation was found between the latent time from sampling to delivery of the pregnant woman (p=0.153). CONCLUSIONS: We concluded that the approach to diagnose or predict PPROM by determining the serum decorin levels that we aimed in our study is not currently possible.

Objectives: Studies have shown that fibrinolysis activity is insufficient in COVID-19 patients. Plasminogen activator inhibitor-1 (PAI-1) is an important antifibrinolytic molecule that plays a key role in the fibrinolytic system. In our study; we aimed to evaluate serum PAI-1 and other biochemical parameters of COVID-19 patients in terms of disease course and mortality. Methods: A total of 40 COVID-19 patients were hospitalized in the service and intensive care unit (ICU) of our hospital from October to December 2020 and 20 healthy volunteers were included in our study. The patients were grouped as those who transferred to the ICU from the service and transferred to service from the ICU. The first and second values of the same patients in both the service and the ICU were analyzed by SPSS. Results: The PAI-1 levels of the patients in the ICU were significantly higher than the levels of the same patients in the service and the healthy control group (p<0.001). IL-6, ferritin, and D-dimer levels in the ICU of the same patients were significantly higher than the levels of service and healthy control group (p<0.001). A positive correlation was found between initial serum PAI-1 and D-dimer levels in patients hospitalized in the service (p=0.039) and initial serum ferritin and IL-6 levels in the ICU (p=0.031). Conclusions: In our study, we found that PAI-1 levels increased significantly with the increase in mortality in COVID-19 patients.

Amaç: Tiroid stimülan hormon (TSH), serbest T4 (sT4) ve serbest T3 (sT3) testlerinin referans aralıklarını laboratuvarımızın sonuç verilerinden indirekt yöntem ile belirlemek ve belirlenen referans aralıkları kullanmakta olduğumuz kitlerin ve yöntemin üreticisi tarafından önerilen referans aralıklarla karşılaştırmaktır. Gereç ve Yöntem: Ocak – Ekim 2021 tarihleri arasında laboratuvarımızda çalışılmış olan 1-99 yaş aralığındaki 195205 kişiye ait eş zamanlı olarak istenen TSH, sT4 ve sT3 sonuçları çalışmaya dahil edildi. Uç değerlerin belirlenmesi ve dışlanmasında Tukey yöntemi kullanıldı. Ardından non-parametrik ve Bhattacharya yöntemleri ile TSH, sT4 ve sT3 referans aralıkları hesaplandı. Referans aralıklar arasındaki uyumluluğun değerlendirilmesinde CLIA 19 kabul edilebilir limitleri kullanıldı. Bulgular: Pediatrik yaş grubu (1-17 yaş) için referans aralıklar non-parametrik yöntem ile TSH (0,56 - 5,93 mIU/L), sT4 (8,9 - 16,1 ng/L) ve sT3 (2,74 - 5,39 ng/L) bulunurken; Bhattacharya yöntemi ile TSH (0,67 - 3,08 mIU/L), sT4 (9,2 - 16,1 ng/L) ve sT3 (2,72 - 5,46 ng/L) olarak bulundu. Erişkin yaş grubu (18-99 yaş) için referans aralıklar non-parametrik yöntem ile TSH (0,10 - 4,98 mIU/L), sT4 (8,7 - 16,1 ng/L) ve sT3 (2,01 - 4,09 ng/L) bulunurken; Bhattacharya yöntemi ile TSH (0,18 - 3,07 mIU/L), sT4 (9,1 - 16,2 ng/L) ve sT3 (2,05 - 4,13 ng/L) olarak bulundu. Sonuç: sT4 ve sT3 referans aralıklarımızın üreticinin referans aralıkları ile uyumlu olarak kabul edilebilir olduğunu ancak TSH testi için pediatrik gruptaki üst referans sınır ve erişkin gruptaki alt referans sınır ile üreticinin referans sınırları arasında farklılık olduğunu belirledik. Laboratuvarların kendi referans aralıklarını belirlemesinin, test sonuçlarının doğru yorumlanabilmesi açısından büyük önem taşıdığını düşünmekteyiz.