Background: Auto-approval (also known as autoverification ) is the task of automatically evaluating the consistency of a test result throughout the laboratory information system rather than its ...manual evaluation by the biochemists. Most of the existing auto-approval systems rely on a rule-based solution obtained from expert knowledge. However, it is a challenging issue to produce a complete and general rule-base for every single test type. To that end, the studies have relied only on a small subset of laboratory tests. Methods: The rule-based auto-approval process was re-investigated in this study, and the rules predetermined by human experts were utilized as a pre-filtering step for grouping the laboratory test result via some common criteria. Subsequently, a machine learning-based approval method, smart-approval, was proposed to approve the tests more precisely. At this point, the expert knowledge in the rule-based pre-filtering was extended by the tendency to imitate the experts' behavior in the smart-approval step. Two novel datasets (entitled with plot and real-time datasets) containing human experts' responses to previously studied tests have been used to train the machine learning models. Results: Experiments have been handled on several machine learning models on plot dataset to obtain the trained models based on cross-validation. Here, the random forest classifier provided the best approval performance while also outperforming the approval success of existing studies in the literature. To observe the real-time performance of these trained models, they were also evaluated on real-time unseen data for 4 months. Here, random forest reaffirmed that it was the best approval model. Conclusions: The proposed auto-approval system relying on random forest can provide convincing classification performance on both of the obtained datasets. With the correct approval rate of 98.51%, it surpasses many powerful approval methods in the literature.
Background and objective Intrahepatic cholestasis of pregnancy (ICP) is the most common pregnancy-related liver disease. G-protein-coupled bile acid receptor 1 (TGR5) agonists might be beneficial in ...ICP treatment. In this study, we aimed to investigate the relationship of serum TGR5 levels with ICP and associated itching. Methods Sixty-three pregnant women diagnosed with ICP based on a serum bile acid level of >10 µmol/L (patient group) and 47 healthy pregnant women as a control group were included in the study. In the patient group, ursodeoxycholic acid (UDCA) therapy was given at a dose of 15 mg/kg from the time of diagnosis until the termination of pregnancy. Serum transaminase levels were measured at the beginning and within 15 days after the onset of treatment, and the dose was increased in patients who were unresponsive to treatment. Results Bile acid level was found to be between 10-39 µmol/L in 61.9% of the ICP patients, and it was ≥40 µmol/L in 38.1% of the patients. The majority of the patients responded well to the treatment with UDCA. The mean TGR5 level was significantly higher in the patient group compared to the control group (0.98 ±0.95 ng/mL vs. 0.74 ±0.23 ng/mL, p=0.032). In the patient group, TGR5 level showed negative correlations with age and red cell distribution width and a positive correlation with lactate dehydrogenase level and lymphocyte count. Conclusions Based on our findings, it can be suggested that TGR5 may have a role in the pathogenesis but has no impact on the prognosis of the condition.
Down syndrome (DS) is one of the main genetic abnormalities of newborns. Therefore, prenatal diagnosis of this syndrome is of paramount importance to the family and the community. The microbiota ...system is important in early brain development. We tried to study and compare gut microbiota (GM) composition in pregnancies that resulted in DS neonates with pregnancies that resulted in healthy children. The study population consisted of 21 pregnant women having delivered DS newborns (group 1) and 22 pregnant women who had given birth to healthy newborns (group 2). The GM composition was determined and compared between the two groups. There were no significant age and gestational age differences between the two groups (p>0.005 both). Regarding GM analysis, microorganisms of the families
Clostridiaceae
and
Pasteurellaceae
were more abundant in the group of women having delivered DS neonates than the group of women having delivered healthy newborns (p<0.05). The results of our pilot study showed that the GM system might have a role in the pathophysiology of DS. The GM changes may be used in the prenatal diagnosis and prevention of this syndrome. Further studies are needed in this field.
We aimed to develop a simple, rapid urine test based on the level of foaming that occurs in the urine sample due to the excretion of peptide structures containing amino acids specific to the ...antigenic structure of COVID-19. In this study, we present the preliminary results of the first clinical study with a newly developed urine foaming test (UFT).
This study was conducted in a tertiary hospital in Istanbul. After obtaining the approval of the ethics committee, urine samples were taken from three groups of patients whose informed consent was obtained. The groups were created according to the COVID-19 Diagnostic Guide of Ministry of Health: A: outpatients with suspected COVID-19, B: inpatients for follow-up and treatment, C: patients treated in intensive care unit (ICU). Also, 30 healthy volunteers were included as the control group D. Urine samples taken from all groups were delivered to the laboratory. 2.5 ml urine sample was added to the test tube and shaken for 15 seconds and the level of foam formed was visually evaluated according to the color scale. Other data of the patients were obtained from the hospital information management system and the physician caring for the patient. The clinical status, PCR test results, computed tomography (CT), if any, laboratory tests, and UFT results were compared and the level of statistical significance was expressed as p≤0.05 in the 95% confidence intervals (CI). Performance characteristics, such as sensitivity, specificity, positive and negative predictive value of the UFT, were statistically calculated according to the RT-PCR result and/or CT.
A statistically significant difference was observed between UFT distributions of the control, outpatient, inpatient and ICU patients (p=0.0001). The results of UFT orange and red in inpatients and ICU patients were statistically significantly higher than in the control and outpatient groups. The diagnostic accuracy of UFT was detected in all group, the pooled sensitivity was 92% (95% CI: 87-95%) and specificity was 89% (95% CI: 80-98%).
Our preliminary results suggest that the UFT is useful, particularly in predicting the clinical severity of COVID-19. The UFT could be recommended as a point of care test, rapid and non-invasive method in the diagnosis and follow-up of COVID-19.
Highlights
It is best to store COVID‐19 swab samples in VTM to get the most reliable PCR results.
Positive COVID‐19 swab samples can be stored for at least 5 days at both room temperature and 4°C ...without loss of positivity.
Samples with high viral loads with CTs below 25 can be stored at both room temperature and 4°C without loss of positivity for up to 12 days.
Reliable and rapid detection of severe acute respiratory syndrome coronavirus 2 in laboratory setting is critical to control the pandemic. We aimed to an evaluated polymerase chain reaction (PCR) efficiency of nasopharyngeal swabs stored in viral transport medium (VTM) in different temperatures. Ninety swabs taken into VTM were analyzed at the first hour, then divided into two groups with similar numbers of positive and negative samples. Positive samples of each group were also subgrouped according to Fam CT values as low CT (<25), medium CT (25–32), and high CT (32–38) groups. One group was stored at 4°C, while the other was stored at room temperature, PCR analyses were repeated every 24 h for 5 days and on Day 12. There was a total of 30 positive samples (12 low CT, 11 medium CT, and 7 high CT). The CT values of both groups remained unchanged in first 3 days while the CT values of the room temperature group increased after the third day. All of the positive samples remained positive in both groups for the first 5 days. On the 12th day, the total number of positives decreased to 8 in the room temperature group and 11 in the 4°C groups. All the low CT samples remained positive in both groups. In conclusion, it is safe to store positive samples in room temperature for up to 5 days. Only samples with high viral loads remain positive for 12 days, regardless of whether stored at room temperature or 4°C. Negative samples don't turn to invalid if stored in VTM.
Objective: The systemic immune-inflammation index (SII), predicated on peripheral platelet, neutrophil, and lymphocyte counts, has been shown to be an effective predictive tool in different ...illnesses. We examined the role of the baseline SII in predicting short-term outcomes in patients hospitalized in the intensive care unit (ICU). Methods: The data of patients followed in the ICU between January 01, 2019 and December 31, 2019, were included in the study. Demographic data, the length of stay in the ICU, additional diseases, Acute Physiology and Chronic Health Evaluation-II score, presence of comorbidity and mortality, and complete blood count test results were recorded from electronic files. The SII was calculated as platelet x neutrophil/lymphocyte counts. The predictive value of SII on the clinical outcomes (length of stay, and 30-day mortality) were investigated retrospectively. Results: Based on the inclusion and exclusion criteria, 201 patients (104 female and 97 male) were selected to be included. The median age interquartile range (IQR): 61-82 was 73. The median length of stay in the hospital was 19 days (IQR: 8-32). Fifty- nine (n=59) patients (29.3%) died, leaving 142 patients (70.64%) who were discharged alive. Non-survivors had significantly higher SII values, (median; 1,566; IQR: 812-3,455 vs. 1,019; IQR 599-1,771, p=0.037) compared to survivors. The hazard ratio (95% confidence interval) for the high-SII group compared with the low-SII group for 30-day all-cause mortality was 2.61 (1.33-4.79), and 1.23 (0.71-2.61) respectively. Conclusion: In ICU patients, a high SII was linked to higher mortality. Consequently, SII is a predictive biomarker of patients that may be valuable. Additional research should be conducted to assess our findings using prospective trials with longer follow-ups. Keywords: Systemic immune inflammation index, intensive care, predictivity Amac: Periferik kanda, trombosit, notrofil ve lenfosit sayilarina dayanan sistemik immun-enflamasyon indeksinin (SII) farkli hastaliklarda etkili bir ongoru araci oldugu gosterilmistir. Bu calismanin amaci, yogun bakim unitesinde (YBU) yatan hastalarda kisa donem sonuclari tahmin etmede baslangic SII'nin rolunu arastirmaktir. Gerec ve Yontem: 01 Ocak ile 31 Aralik 2019 tarihleri arasinda YBU'de izlenen hastalarin verileri calismaya dahil edildi. Demografik veriler, YBU'de kalis suresi, ek hastaliklar, Akut Fizyoloji ve Kronik Saglik Degerlendirmesi-II skoru, komorbidite ve mortalite varligi ve tam kan sayimi test sonuclari elektronik dosyalardan kaydedildi. SII, trombosit x notrofil/lenfosit sayilari olarak hesaplandi. SII'nin klinik sonuclar (kalis suresi ve 30 gunluk mortalite) uzerindeki prediktif degeri geriye donuk olarak arastirildi. Bulgular: Dahil etme ve haric tutma kriterlerine gore, dahil edilmek uzere toplam 201 hasta (104 kadin ve 97 erkek) secildi. Medyan yas 73 ceyrekler acikligi (IQR): 61-82 bulundu. Hastanede ortalama kalis suresi 19 gundu (IQR: 8-32). Elli dokuz (n=59) hasta (%29,3) oldu, 142 hasta (%70,64) sag olarak taburcu edildi. Olen hastalar, hayatta kalanlara kiyasla onemli olcude daha yuksek SII degerlerine sahipti (medyan; 1.566; IQR: 812-3.455 ve 1.019; IQR 599-1771, p=0,037). Otuz gunluk tum nedenlere bagli olum icin dusuk SII grubuna kiyasla yuksek SII grubu icin risk orani (%95 guven araligi) sirasiyla 2,61 (1,33-4,79) ve 1,23 (0,71-2,61) idi. Sonuc: YBU hastalarinda yuksek SII, daha yuksek mortalite ile baglantiliydi. Sonuc olarak, SII, yogun bakim hastalarinin sonuclari icin ongorucu bir biyobelirtec olabilir. Ancak, bulgularimizi dogrulamak icin daha uzun takip sureli, prospektif ek arastirmalara ihtiyac vardir. Anahtar Kelimeler: Sistemik immun enflamasyon indeksi, yogun bakim, prediktivite
Fibroblast growth factor 19 (FGF19) and small heterodimer partner (SHP) are molecules responsible for controlling serum bile acid levels. We designed this study for evaluating the effects of FGF 19 ...and SHP in intrahepatic cholestasis of pregnancy (ICP). Fifty-six pregnant women having ICP and 20 healthy pregnant women were included in the study. The patients were followed up until delivery in terms of pregnancy-related morbidity/mortality. Serum FGF 19 and SHP levels were determined by enzyme-linked immunosorbent assay (ELISA). Serum FGF 19 and SHP levels were significantly higher in the patient group compared to the control group (p: .04, p: .003, respectively). In ROC analysis, SHP level above 1995 ng/L was found effective in predicting the need for neonatal intensive care unit (ICU) follow-up with 53.8% sensitivity and 77.8% specificity. High SHP levels were correlated with perinatal morbidity, mortality and neonatal ICU hospitalisation.
Impact Statement
What is already known on this subject? Itching, elevated serum transaminase and serum total bile acid (TBA) levels are the most important clinical and biochemical findings of intrahepatic cholestasis of pregnancy (ICP). Fibroblast growth factor 19 (FGF19) and small heterodimer partner (SHP) are molecules - responsible for controlling serum bile acid levels. ICP is associated with preterm labour, asphyxia, foetal distress, stillbirth and preeclampsia.
What do the results of this study add? Serum FGF 19 and SHP levels were significantly higher in the patient group compared to the control group. High SHP level was found effective in predicting the need for neonatal intensive care unit and showed a negative correlation with birth week and birth weight.
What are the implications of these findings for clinical practice and/or further research? Checking SHP levels can help to predict perinatal mortality and morbidity. Treatments to be developed through the mechanism of action of FGF 19 and SHP can be promising in the treatment of ICP and other cholestatic liver diseases.
OBJECTIVEThe aim of our study is to determine the risk of coinfection with COVID-19 due to the high prevalence of viral agents in Istanbul in autumn (September, October, and November) and winter ...(December and January) and to investigate the effects of age, gender, season and clinical features on the development of coinfection with COVID-19. METHODSIn the routine studies of our hospital, COVID-19, reverse transcriptase polymerase chain reaction (RTA kit, Turkiye) and Multiplex PCR Bio-Fire (Bio Merieux Company, France) methods were studied from the nasopharyngeal swab sample and the data were recorded. A total of 400 people with a mean age (7.91±17.80) were included in the study by retrospective scanning. RESULTSConsidering the virus distribution, Respiratory syncytial virus (RSV), COVID-19, rhino/entero virus did not show a significant difference in autumn and winter, while H. metapneumovirus, adeno virus, influenza A significantly higher rates were observed in winter months. Parainfluenza (1, 2, 3, 4) and Corona OC43 were detected at a higher rate in autumn compared to other viruses. Double and triple coinfection rates with other viral agents were high for 2 years and younger. CONCLUSIONThe risk of coinfection of COVID-19 with influenza A, RSV, parainfluenza, and rhino/entero virus was found to be higher than other viral agents. Especially in winter, the risk of coinfection with influenza A and COVID-19 increases. In terms of treatment management, coinfection should be investigated in risky patients and influenza a vaccine should be offered to risky groups.
Introduction: The importance of academic equipment in biochemical and microbiological evaluations of SARS-CoV-2 is increased. In this context, different techniques have been developed in the ...diagnosis and treatment of COVID-19 disease as qRT-PCR, rapid antigen tests and vaccine technology. The first known example of vaccine technology is the CoronaVac (Sinovac, China) inactivated vaccine throughout pandemic. In the presented study, the sensitivity of CoronaVac in the community would be positively increased and this data would be strengthened. In addition, antibody sensitivity of the CoronaVac between two doses, as well as the hemogram and biochemical analyzes were evaluated. The focus will be on increasing the sensitivity of the society to the vaccine.
Materials and methods: The immunoglobulin, biochemical analyzes, hemogram, and iron-iron binding capacities were evaluated after vaccinated person in a vaccine administration center in Istanbul, Türkiye.
Results: RBDIgG level was significantly higher after second dose (p<0.05). Mon#, Bas#, IMG#, Mon, Hgb, MCH, MCHC, RDWCV, RDWSD, and PDW levels were higher at 28th day. RBDIgG, Fe, WBC, Neu#, Lym#, Eos#, and PLT levels were higher at 42nd day. All other parameter means were higher at 56th day. RBDIgG, Fe, WBC, RDWCV, RDWSD and PDW differences between 28th and 42nd days were significant (p<0.05). RBDIgG, HCT, MCV, MCH, MCHC, and RDWCV differences between 28th and 56th days were statistically significant (p<0.05). RBDIgG, MCV and MCH differences between 42nd and 56th days were statistically significant (p<0.05).
Discussion and conclusion: The 60 volunteers in our study were laboratory, emergency service staffes and hospital personnel working at high risk of COVID-19. There was no differentiation in blood values related to the vaccine. It has been shown as an example of the phase-1 and the side effects of the CoronaVac, were also evaluated, and all our volunteers were followed for 60 days, and no possible serious side effects were observed. In groups with statistical significance in blood results, a vaccine related observation is not clearly revealed. We see that CoronaVac vaccine offers a positive confidence interval in antibody responses after the 2nd dose. These data are great importance in terms of better monitoring of the data by the anti-vaccine groups in Türkiye. It is beneficial to remove the vaccine mistrust against the anti-vaccination and pave the way for social immunization. This study contributes to the accuracy of the ministry and the vaccination strategy implemented in Türkiye. The result of this study provides preliminary information for the studies that will result from the application of the 3rd and 4th dose of vaccines.
Background: Nowadays, people have faced with a pandemic called COVID-19. The reliable detection of the virus is important to prevent transmission of the virus. RT-PCR is a gold standard method for ...the diagnosis of the disease used at all over the world. The highest number of sample size (1,461,258 patient sample) and differing results are reported with our study regarding the PCR positivity rates. Method/Study Design: The study was aimed to evaluate the positivity and negativity of the patients with RT-PCR from all the samples studied between March 25, 2020 and March 25, 2021, when the pandemic was declared and started to be seen in Turkey, and to investigate its contribution to the total test capacity of our country. Results/Conclusions: 1,461,258 patient is observed, and this frequency male is 58% and female is 42% of the population. The maximum number of admissions is noticed during the Autumn-2020 involved age ranged from 25 to 35. 14.6% positive result is got while the 85.4% negative result is observed. When the age distribution of COVID-19 (+) patients is evaluated, COVID-19 (+) rate is highest in the 6-15 age range, followed by the 66-75 age range and the highest COVID-19 (+) rate are November and October, respectively. Additionally, the highest COVID-19 (+) rate is in Autumn. According to the test results, it was determined that 7.5% of the male participants were COVID-19 (+) and 7.1% of the female participants were COVID-19 (+).
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