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Öğe Aktive Parsiyal Tromboplastin Zamanı, Protrombin Zamanı ve Fibrinojenin Diurnal Varyasyonu(2023) Semerci, Tuna; İhtiyar, Alperen; Arslan, Fatma Demet; Köseoğlu, Mehmet HicriAmaç: Bu çalışmada günlük rutinde en çok kullanılan koagulasyon testleri olan aktive parsiyal tromboplastin zamanı (APTT), protrombin zamanı (PT) ve plazma fibrinojeninin gün içindeki değişimlerinin incelenmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmaya alınan gönüllülerden 9.00, 12.00, 15.00, 18.00 ve 24.00 saatlerinde kan alındı. PT, APTT ve fibrinojen parametrelerin analizi için ACL Top 500 cihazında (Instrumentation Laboratory, Bedford, MA, USA) orjinal kitleriyle optik yöntem kullanıldı. Saat 09.00'da alınan örnekler bazal olarak kabul edildi. Günün değişik saatlerinde elde edilen plazmalardan APTT, PT ve fibrinojen sonucu, istatistiksel ve klinik olarak saat 09.00'da elde edilen bazal sonuçlarla karşılaştırılarak diurnal varyasyon araştırıldı. Bulgular: Çalışmamıza yaşları 18-50 yaş arasında olan toplam 15 (10 erkek, 5 kadın) sağlıklı gönüllü dahil edildi. Çalışmamızda PT değerlerinde bazal düzeye göre klinik ve istatistiksel olarak anlamlı farklılık saptanmadı (p< 0.0125). APTT de fibrinojen de saat 09.00’da en yüksek olup gün içindeki tüm sonuçlar bazal düzeyden klinik olarak anlamlı düşük bulundu (APTT saat 12.00 % değişim maksimum -%13.36, Fibrinojen saat 24.00 % değişim maksimum -%9.81) Bazal değer ile karşılaştırdığımızda APTT ve fibrinojen düzeyleri bazı saatlerde bazale göre istatistiksel olarak anlamlı düşük bulundu (p< 0.0125). Sonuç: Koagulasyon testlerinden PT gün içinde değişiklik göstermemiştir. APTT ve fibrinojen değerlerinde ise gün içinde farklılıklar tespit edilmiş olup, klinik değerlendirmede numune alım saatlerinin dikkate alınması önerilir.Öğe Assessment of mimicking by EBV-CMV immunoglobulin M of anti-HLA antibodies(Elsevier, 2023) Gulec, Rasime Derya; Arslan, Fatma Demet; Ozyilmaz, Berk; Yilmaz, Nisel; Hanci, Sevgi Yilmaz; Kose, SukranObjective: We aimed to show the cross-reactivity that may occur between immunoglobulin (Ig) M antibodies that form against Cytomegalovirus (CMV) and/or Epstein-Barr virus (EBV) and human leukocyte antigens (HLA).Methods: Complement-dependent cytotoxicity (CDC) cross-reactivity between serum samples of 57 patients with IgM positive CMV and/or EBV infections and T and B cells from 15 healthy donors were evaluated. Dithiothreitol was used to distinguish cross-reactivity caused by IgM antibodies from IgG.Results: The cross-reactivity ratio between pathogenic IgM antibodies with T cell of the 12th donor, and B cell of the 3rd, 4th, and 8th donors was significantly higher (p = 0.011, <0.001, <0.001 and 0.013, respectively). The ratio of B cell CDC cross-reactivity of all donors (26.4%) was higher than the ratio of T cell CDC cross-reactivity (5.2%) (p < 0.001). The ratio of T cell CDC cross-reactivity of sera containing both anti-CMV IgM and anti-EBV IgM antibodies was significantly higher than those of sera containing only anti-CMV IgM or only anti-EBV IgM antibodies (p = 0.002 and p < 0.001, respectively). There was no difference between B cell CDC cross-reactivity rates according to the presence of anti-CMV and/or anti-EBV IgM antibodies.Conclusion: Cross-reactivity may occur between anti-CMV and anti-EBV IgM antibodies with HLA molecules. Thus, in graft recipients, pathogenic IgMs can also act as de novo anti-HLA antibodies and aggravate the rejection process.Öğe Biological variation of plasma 25-Hydroxyvitamin D3, Serum vitamin B12, folate and ferritin in Turkish healthy subject(Taylor & Francis Ltd, 2023) Ozkanay, Hayat; Arslan, Fatma Demet; Narin, Figen; Koseoglu, Mehmet HicriBiological variation (BV) plays a crucial role in determining analytical performance specifications, assessing serial measurements of individuals, and establishing the use of population-based reference intervals. Our study aimed to calculate the BV and BV-based quality goals of 25-hydroxyvitamin D-3 (25-OH D-3), ferritin, folate and vitamin B12 tests. We included a total of 22 apparently healthy volunteers (9 women and 13 men) aged 18-55 years in the study that we conducted in Turkey. Blood samples were collected from the participants once a week for five weeks. Serum ferritin, folate and vitamin B12 levels were measured using immunochemical method, while plasma 25-OH D-3 levels were determined using the high-performance liquid chromatography method. Analysis of variance (ANOVA) was used to estimate analytical variation(CVA), within-subject BV(CVI) and between-subject BV(CVG). The individuality index (II) and reference change value (RCV) were calculated based on these data. The CVI of 25-OH D-3, ferritin, folate, and vitamin B12 were found to be 1.8% (0.6%-2.5%), 16.9% (14.4%-20.2%), 10.7% (9.2%-12.7%), and 8.6% (6.8%-10.5%), respectively. CVG were 44.2% (34.3%-69.9%), 132% (87.7%-238%), 19.4% (14.4%-28.8%), and 39.6% (29.8%-59.0%) for the same biomarkers, while CVA were 3.2% (2.81%-3.71%), 3.5% (3.1%-4.1%), 4.0% (3.5%-4.6%), and 7.5% (6.6%-8.6%), respectively. The II values for 25-OH D-3, ferritin, folate, and vitamin B12 were calculated as 0.04, 0.13, 0.55, and 0.22, respectively. The RCV were 10.2%, 47.8%, 31.7%, and 31.6%, respectively. Because the tests analyzed in this study exhibit high individuality, RCV should be preferred rather than population-based reference ranges in clinical interpretation of results.Öğe Biological variation of thyroid stimulating hormone, free triiodothyronine and free thyroxine in healthy subjects in Turkey(Biochemia Medica, Editorial Office, 2025) Yıldız, Raziye; Özkanay, Hayat; Arslan, Fatma Demet; Köseoğlu, MehmetIntroduction: Biological variation (BV) data are necessary for interpretation of test results and assessment of analytical performance. We aimed to determine the BV estimates for thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine(fT4) in healthy subjects in Turkey and compare them with the literature findings. Materials and methods: A total of 21 Turkish healthy volunteers (12 males and 9 females) were included in the study. Blood samples were collected once a week for five weeks, and the analysis was performed using the chemiluminescent immunoassay method on an Advia Centaur XP (Siemens Diagnostic, Tarrytown, USA). Analytical variation (CVA), within-subject BV (CVI) and between-subject BV (CVG) were calculated. Analytical goals, individuality index (II) and reference change value (RCV) were derived from these data. Statistical analysis was performed using BioVar: BV analysis tool v.1.0. Results: For TSH, fT3 and fT4, CVA (confidence interval, CI) were 3.3% (2.9 to 3.8), 1.7% (1.5 to 1.9) and 2.7% (2.4 to 3.1); CVI (CI) were 22.3% (19.3 to 26.3), 4.4% (3.8 to 5.3) and 5.1% (4.3 to 6.1); CVG (CI) were 26.6% (19.2 to 39.8), 9.2% (6.9 to 13.6) and 8.2% (6.1 to 12.1), respectively. For TSH, fT3 and fT4, desirable total errors were 27.1%, 6.2% and 6.6%; II values were calculated as 0.84, 0.48 and 0.61; and RCV% values (decrease; increase) were - 40.3;67.6, - 10.4;11.6 and - 12.7;14.5, respectively. Conclusions: Our study provides updated BV data for thyroid function tests (TFTs) in healthy subjects in Turkey. As TFTs have shown a high degree of individuality, RCV should be preferred rather than population-based reference ranges in the assessment of serum concentrations. Our BV estimates were compatible with European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) BV meta-analysis data obtained using different immunoassay methods in different populations. © by Croatian Society of Medical Biochemistry and Laboratory Medicine.Öğe THE EFFECT OF DIURNAL VARIATION ON LABORATORY TESTS(Dokuz Eylul Univ Inst Health Sciences, 2023) Ihtiyar, Alperen Halil; Koseoglu, Mehmet Hicri; Arslan, Fatma DemetPurpose: Commonly used biochemical tests in blood samples may be measured at any time of day. This study investigated the existence and clinical significance of diurnal variations in some of routine parameters to facilitate accurate and reliable decision-making in diagnosis and follow-up.Material and Methods: Blood samples were collected from 17 healthy volunteers who were 18-50 years of age (11 men, 6 women) on the same day at 9.00 am, 12.00 am, 3.00 pm, 6.00 pm, and 12.00 pm. Samples collected at 9.00 am were regarded as baseline. The results of 19 biochemical parameters in blood samples obtained at 12.00 am, 3.00 pm, 6.00 pm and 12.00 pm were statistically and clinically compared with the results at 9.00 am baseline sample.Results: Total protein, creatinine, aspartate transaminase, alanine transaminase, alkaline phosphatase and gamma glutamyl transferase showed no clinically significant variation within the day, but clinically significant changes were observed in levels of glucose, total cholesterol, HDL-cholesterol, triglyceride, total bilirubin (TBIL), direct bilirubin (DBIL), albumin, blood urea nitrogen, uric acid, sodium, potassium, chloride and amylase. Especially, BUN changed by maximum 20-30%, TBIL, DBIL and triglyceride maximum 40-50% within the day.Conclusion: The results of our study suggest that clinicians should consider the timing of blood sampling and the diurnal variations in BUN, TBIL, DBIL and triglyceride parameters during diagnosis and treatment follow-up. Sampling throughout the day seems to pose no problem for other tests with limited diurnal variation.Öğe Evaluation of D-dimer levels measured by different analytical methods in COVID-19 patients(Lippincott Williams & Wilkins, 2022) Arslan, Fatma Demet; Basok, Banu Isbilen; Terzioglu, Mustafa; Altan, Tuba Kansu; Karaca, Yeser; Senger, Suheyla Serin; Colak, AyferClinicians experience some challenges due to the lack of standardization of test, although D-dimer is a prognostic marker for COVID-19. We compared the clinical and analytical performances of D-dimer results obtained from different devices, kits and methods in patients with a diagnosis of COVID-19. Thirty-nine patients with a diagnosis of COVID-19 and 24 healthy individuals were included in the study. D-dimer levels were measured with Innovance D-DIMER kit (immunoturbidimetric method) on Sysmex CS-2500 and BCS XP and VIDAS D-Dimer Exclusion II kit (enzyme-linked fluorescence method) on mini VIDAS. The studies of precision, method comparison and clinic performance were performed. The variation coefficients in all systems were within the acceptable imprecision (7.8%). Bias%(12.5%) between BCS XP and Sysmex CS-2500 was lower than the acceptable Bias%(15.5%). Bias% values (19.2% and 33.3%, respectively) between Mini VIDAS with BCS XP and Sysmex CS-2500 were higher than the acceptable Bias%. The correlation coefficients among all systems were 0.89-0.98. For 500 ng/ml FEU, there was almost perfect agreement between BCS XP and Sysmex CS-2500, a moderate agreement between Mini VIDAS and BCS XP and Sysmex CS-2500. The cut-off values for distinguishing between individuals with and withoutCOVID-19 were Mini VIDAS, Sysmex CS-2500 and BCS XP 529, 380 and 390 ng/ml FEU, respectively. The immunoturbidimetric method can be used as an alternative to the enzyme-linked fluorescent method because of satisfactory agreement at the different thresholds proposed for venous thromboembolism. However, it is recommended to follow up COVID-19 with the D-dimer results obtained by the same assay system.Öğe HLA-B varıatıons and HLA-B*57:01 prevalence ın HIV-1 ınfected Turkısh patıent(2022) Güleç, Rasime Derya; Kurtuluş, Mustafa; Özyılmaz, Berk; Köse, Şükran; Arslan, Fatma Demetntroduction: Human Leukocyte Antigen (HLA)-B*57:01 is associated with a hypersensitivity reaction to abacavir used in antiretroviral therapy in patients infected with human immunodeficiency virus (HIV)-1. In this study, we aimed to investigate the prevalence of HLA-B*57:01 and HLA-B alleles that may pose a risk in the Turkish population. Material and Methods: In this retrospective study, 500 HIV-1 infected patients who applied to the Tissue Typing Laboratory and 500 healthy bone marrow donors as the control group were examined. HLA-B genotyping was performed before starting abacavir therapy. 451 (90.2%) of HIV-1 positive patients and 264 (52.8%) control group were male (p<0.001). HLA-B genotyping was performed using the sequence-specific primer (SSP) HLA-B kit or the HLA-B sequence-specific oligonucleotide probe hybridization (SSO) kit. The presence or absence of the HLA- B*57:01 specific allele in individuals with B*57 allele was detected using the HLA-B*57:01 SSP kit. Result: The HLA-B*57:01 allele frequency was found to be 1.5% (n=15) in HIV-1 positive patients and 1.6% (n=16) in controls. The prevalence of HLA-B*57:01 allele in the Turkish population was calculated as 3.1% (n=31). Also HLA-B*7 (p=0.013, OR: 1.761), HLA-B*14 (p=0.016, OR: 2.592), HLA-B*18 (p=0.001, OR: 2.106), HLA-B* 49 (p=0.035, OR: 1.626) alleles were associated with susceptibility to HIV-1. Conclusion: The prevalence of HLA-B*57:01, which we found as 3.1% in our society, is lower than the Caucasian ethnic group (5-8%) . Our results will shed light on the cost-effectiveness analysis studies to be conducted on HLA B*57:01 screening in HIV-1 positive patients and will contribute to the literature.Öğe Improving Phlebotomy Practices Through Small-Volume Blood Tubes: A Survey-Based Study(2024) Arslan, Fatma Demet; Van, Tuğba Öncel; Alpşen, Canan; Çınar, Sevgi; Koseoglu, MehmetAim: The blood collection for laboratory tests has been frequently performed due to evidence-based medicine. We aimed to conduct a survey on phlebotomy among phlebotomists and patients and to reduce unnecessary blood loss by using small-volume blood collection tubes. Material and Method: A survey among phlebotomists and patients was conducted to gather their opinions. Phlebotomists received training on the importance of the preanalytical process. The blood volume required for laboratory tests was reduced by 33.3%-50.0% in children and adults, and 63.0%-84.0% in newborns. Following this intervention, we investigated its effects on the blood transfusion ratio in the neonatal and adult intensive care unit (NICU and ICU) and the amount of laboratory medical waste generated. Results: A majority of phlebotomists (91.8%) reported difficulties in drawing blood from newborns, pediatric, oncology, hematology, and geriatric patients. Additionally, 68.9% of phlebotomists and 57.1% of patients expressed an opinion for reduced blood volume. Despite an increase in the number of laboratory tests (28.4%) and samples (15.7%), we observed a 17.8% reduction in the amount of laboratory medical waste. Although the number of patients in NICU increased statistically significant, the increase in transfusion rates was not significant. Although the number of patients in ICU increased, transfusion rates decreased, but neither was found to be statistically significant. Conclusion: Post-graduation, phlebotomists should be educated regularly about the preanalytical process. Based on the opinions of both phlebotomists and patients, using small-volume tubes in patients with difficult blood collection may increase their satisfaction. Generally, laboratory medical waste may be reduced.Öğe Kritik COVID-19 hasta prognozunun değerlendirilmesinde akut faz proteinlerinin önemi(2022) Güleç, Derya; Yılmaz, Nisel; Arslan, Fatma Demet; Çalışkan, Taner; Şenoğlu, NimetAmaç: Yoğun bakım ünitesine ilk kabulde kötü prognoz riskine sahip COVID-19 hastalarını belirlemenin çeşitli tanısal zorlukları vardır. Karaciğer tarafından sentezlenen akut faz proteinlerinin konsantrasyonu inflamasyon ve enfeksiyonu takiben serumda artar veya azalır. Bu çalışmada, kritik COVID-19 hastalarında akut faz proteinlerinin prediktif değerini belirleme ve yoğun bakım ünitesinde mortalite riskini öngörmede inflamatuar belirteçlerin etkinliğini değerlendirme amaçlanmaktadır. Gereç ve Yöntem: Retrospektif olarak tasarlanan bu çalışma yoğun bakım ünitesinde tedavi gören kritik COVID-19 hastalarında yapıldı. Çalışmaya yoğun bakım ünitesine kabulün ilk 24 saatinde ARDS ve/veya çoklu organ disfonksiyonu olan 123 hasta dahil edildi. Yoğun bakım ünitesindeki 28 günün sonunda sağ kalan (n=54) ve ölen (n=69) hasta grupları veya invaziv mekanik ventilasyon (n=83) uygulanan ve uygulanmayan (n =40) hasta grupları oluşturuldu. Gruplar arasında akut faz proteinleri olan serum amiloid A, C-reaktif protein, albümin ve prealbüminin yoğun bakım ünitesine kabulün ilk 24 saat içerisindeki değerleri karşılaştırıldı. Bulgular: Albümin ve prealbümin düzeyleri ölen (sırasıyla p=0.011, p<0.001) ve mekanik ventilasyon uygulanan (sırasıyla p=0.010, p=0.006) hastalarda anlamlı olarak azaldı. Mekanik ventilasyonlu hastalarda serum amiloid A düzeyleri anlamlı olarak arttı (p=0.022). Sonuç: Yoğun bakım ünitesine kabul sırasında düşük prealbümin ve albümin seviyeleri ve yüksek serum amiloid A seviyeleri, hastalık şiddeti ve mortalitenin prognostik bir belirteci olarak kullanılabilir.Öğe A retrospective study: the effect of sensitization events on anti-HLA antibody development(Wiley, 2023) Gulec, Rasime Derya; Arslan, Fatma Demet[Abstract Not Available]Öğe Shoulder Pain, Kinesiophobia, Emotional State and Muscle Strength in Breast Cancer Surgery Patients: A Cross-Sectional Study(University of Health Sciences, 2024) Sertpoyraz, Filiz Meryem; Akyol, Murat; Altaş, Elif Umay; Kebabçı, Eyüp; Beytorun, Ecem; Arslan, Fatma DemetBreast cancer is the most common type of cancer in women. The life expectancy of patients is increasing with advances in treatment. However, lymphovascular, musculoskeletal, and psychogenic complications are reported to be expected in the follow-up period after breast cancer surgery. Kinesiophobia is the behavior of avoiding movement for fear of increased pain. Research on the frequency and interrelationships of kinesiophobia and other complications in the follow-up period is limited. Aim: We aim to evaluate shoulder pain, kinesiophobia, emotional state and muscle strength in female patients who have undergone breast cancer surgery and are in the follow-up period and to examine the relationship between these factors. Materials and Methods: A total of 50 female patients who underwent unilateral breast cancer surgery and were using aromatase inhibitors were included in this cross-sectional descriptive study. Demographic data, details of the surgical procedure and medical treatment information were recorded from the patient files. Hand grip muscle strength was measured by hand dynamometer, the Beck Depression Scale assessed emotional state, and the Tampa Kinesiophobia Scale assessed fear of movement. A Beck Depression Scale score of 10 and above and a Tampa Kinesiophobia Scale of 37 and above were considered significant. Results: The mean age of 50 female patients was 59.31 ± 11.19 years. Sixty percent of the patients had undergone surgery on the right breast and 40% on the left breast. Shoulder pain (n:31) was present in 62%. There were statistically significant correlations between pain and the Tampa kinesiophobia scale and the Beck depression scale (p:0.042, p:0.038). Kinesiophobia was present in 74% of the patients, and 64% had moderate to severe depression. The mean of the Tampa Kinesiophobia scale was 42.86±8.81, and the mean of the Beck depression scale was 15.19±10.98. When the relationship between kinesiophobia and depression was evaluated, a statistically positive significant relationship was found between them (p=0.005, r=0.410). The hand grip strength was 22.16±5.00 kg on the right and 18.22±5.10 kg on the left in patients who underwent left-sided breast cancer surgery. A significant difference was found in the left- and right-hand grip strength of those who underwent left-sided surgery for breast cancer (pÖğe The Effect of Serum Cortisol and Vitamin D Levels on Mortality in Covid-19 Patients Admitted to the Intensive Care Unit(2023) Uzun, Ugur; Güneş, Murat; Arslan, Fatma Demet; Sahar, İsa; Çalışkan, Taner; Zincircioglu, Ciler; Rollas, KazımIntroduction: One of the ways to reduce deaths due to Coronavirus-19 disease is to identify the factors that increase the mortality of the disease. Deficiency of vitamin D, which supports the immune system, and corticosteroids administered to suppress excessive inflammatory response may be risk factors that may affect mortality. Methods: In our study, we evaluated serum vitamin D and cortisol levels in Covid-19 patients during their admission to the intensive care unit, together with the demographic data and comorbidities of the patients, and examined their effect on mortality and their relationship with intensive care unit (ICU) scoring systems. Results: In the study, 101 Covid-19 patients were examined. Serum vitamin D and cortisol levels did not affect mortality statistically. Intensive care unit admission was more common in patients with low vitamin D levels. Cortisol levels were also higher in patients who died. Discussion and Conclusion: Vitamin D deficiency increased the risk of admission to the intensive care unit, and serum vitamin D and cortisol levels during admission to the intensive care unit had no effect on the prediction of mortality.Öğe Tiroid fonksiyon testlerinde diürnal ritm ve postprandial değişim(2022) Ihtiyar, Alperen; Arslan, Fatma Demet; Köseoğlu, Mehmet HicriAmaç: Tiroid fonksiyon testleri (TFT) klinisyenler tarafından en sık istenen biyokimyasal parametrelerinden biridir ve günün herhangi bir saatinde analiz edilebilmektedir. Bu nedenle hastaların tanı ve takibinde doğru ve güvenilir bir karar vermek için diürnal varyasyon ve açlık-tokluk durumunun TFT üzerine etkisini değerlendirdik. Gereç ve Yöntem: 16 sağlıklı erişkin gönüllüden (11 erkek, 5 kadın), 9.00, 10.00, 11.00, 12.00, 15.00, 18.00 ve 24.00 saatlerinde kan alındı. Saat 09.00'da alınan örnekler bazal düzey olarak kabul edildi. Diğer saatlerdeki tiroid uyarıcı hormon (TSH), serbest triyodotironin (fT3) ve serbest tiroksin (fT4) düzeyler, bazal düzeyler ile istatistiksel ve klinik olarak karşılaştırıldı. Bulgular: Gün boyunca fT4 düzeylerinde istatistiksel ve klinik olarak anlamlı bir varyasyon bulunmazken, TSH düzeyleri bazale göre (-%27.37)-(%48.95) arasında klinik olarak anlamlı değişim gösterdi. fT3 düzeylerinin ise sadece saat 15.00 ve 18.00’deki değişimi (-%5.59) klinik olarak anlamlı bulundu. Sonuç: TSH ve fT3 test sonuçları değerlendirilirken diürnal varyasyonunun da göz önüne bulundurulması ve değilse sabah aynı saatlerde kan örneklemi yapılması gerektiği düşünüldü.Öğe Usefulness of laboratory parameters and chest CT in the early diagnosis of COVID-19(Inst Medicina Tropical Sao Paulo, 2022) Colak, Ayfer; Oncel, Dilek; Altin, Zeynep; Turken, Melda; Arslan, Fatma Demet; Iyilikci, Veli; Yilmaz, NiselIn the present study, the importance of laboratory parameters and CT findings in the early diagnosis of COVID-19 was investigated. To this end, 245 patients admitted between April 1st, and May 30th, 2020 with suspected COVID-19 were enrolled. The patients were divided into three groups according to chest CT findings and RT-PCR results. The non-COVID-19 group consisted of 71 patients with negative RT-PCR results and no chest CT findings. Ninety-five patients with positive RT-PCR results and negative chest CT findings were included in the COVID-19 group; 79 patients with positive RT-PCR results and chest CT findings consistent with COVID-19 manifestations were included in COVID-19 pneumonia group. Chest CT findings were positive in 45% of all COVID-19 patients. Patients with positive chest CT findings had mild (n=30), moderate (n=21) andor severe (n=28) lung involvement. In the COVID-19 group, CRP levels and the percentage of monocytes increased significantly. As disease progressed from mild to severe, CRP, LDH and ferritin levels gradually increased. In the ROC analysis, the area under the curve corresponding to the percentage value of monocytes (AUC=0.887) had a very good accuracy in predicting COVID-19 cases. The multinomial logistic regression analysis showed that CRP, LYM and % MONO were independent factors for COVID-19. Furthermore, the chest CT evaluation is a relevant tool in patients with clinical suspicion of COVID-19 pneumonia and negative RT-PCR results. In addition to decreased lymphocyte count, the increased percentage of monocytes may also guide the diagnosis.Öğe Vitamin D Levels and Their Relationship with Ambulation in Patients with Amyotrophic Lateral Sclerosis(Galenos Publ House, 2024) Sertpoyraz, Filiz Meryem; Arslan, Fatma DemetObjective: Vitamin D is a steroid hormone that exerts many effects on human health. Amyotrophic lateral sclerosis is a progressive neurodegenerative disease characterized by the loss of motor neurons. This can result in a number of complications, including muscle weakness, spasticity, difficulty swallowing, speech disturbances, and, in some cases, respiratory failure. A number of studies have reported an association between vitamin D and various neurological diseases. This study aimed to assess vitamin D levels in patients diagnosed with amyotrophic lateral sclerosis and compare them with those of a control group comprising healthy individuals. In addition, the correlation between vitamin D levels and functional ambulation levels will be examined. Materials and Methods: This retrospective cross-sectional study was conducted involving 29 male and female patients diagnosed with definite amyotrophic lateral sclerosis using the El Escorial criteria and 28 healthy controls from the physical medicine and rehabilitation clinic of medicine. The medical records of the patients were consulted to obtain relevant demographic, clinical, and vitamin D levels. Subsequently, vitamin D levels were compared with those of healthy controls. Results: The results are presented in the following section. The mean vitamin D level observed in the patient group with amyotrophic lateral sclerosis was 20.21 +/- 9.53, while in the healthy control group, it was 26.69 +/- 8.90. A statistically significant difference in vitamin D levels was observed between the two groups (p=0.034). No correlation was observed between patients' ambulation levels and vitamin D levels (p=0.202). Conclusion: It can be concluded that patients with amyotrophic lateral sclerosis are at risk of vitamin D deficiency or insufficiency. It is therefore recommended that regular vitamin D levels are measured and treatment plans are developed for these patients.
