Person: DİRİCAN, MELEHAT
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DİRİCAN
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MELEHAT
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Publication Analysis of inappropriate repeated laboratory testing(Walter De Gruyter Gmbh, 2022-05-09) Bozyiğit, Cengiz; Odabaşı, Merve Sena; Dirican, Melehat; DİRİCAN, MELEHAT; Tıp Fakültesi; Biyokimya Ana Bilim DalıObjectives Laboratory services are an important part of the healthcare system. However many requested tests may be considered inappropriate or unnecessary. We evaluated laboratory use in a period of 3 years in terms of the inappropriate test repeats. Methods We analyzed inappropriate repeat rate (IRR) of hemoglobin A1c (HbA1c), 25-OH vitamin D [25(OH)D], thyroid-stimulating hormone (TSH), free triiodothyronine (FT3), free thyroxine (FT4), anti-thyroid peroxidase antibody (anti-TPO), vitamin B12, folate, iron, ferritin and total cholesterol in the light of clinical guidelines. Results IRR of 3 year was found to be 10% on average (4.2-15.5%). In TSH, FT3, and FT4 parameters, IRR was between 4.2 and 5.3%, while it was between 12.9 and 15.5% for 25(OH)D, iron, ferritin, and total cholesterol. In all tests (except anti-TPO), IRRs were found to be higher in inpatients for each of the 3 years. Inappropriate repetition of total cholesterol, iron, and ferritin parameters were more frequent in men. Inappropriate repeats were performed in all parameters (except HbA1c) after a result that had been in the reference range. Conclusions Examined test repetitions were mostly inappropriate. To reduce the inappropriate laboratory test requests, it is important to analyze the causes and to ensure cooperation between laboratory specialists and clinicians.Publication Oxidative stress in common variable immunodeficiency(Sage Publications, 2021-03-01) Başaranoğlu, Sevgen Tanır; Çekiç, Şükrü; Kirhan, Emine; Dirican, Melahat; Kılıç, Sara Şebnem; ÇEKİÇ, ŞÜKRÜ; DİRİCAN, MELEHAT; KILIÇ GÜLTEKİN, SARA ŞEBNEM; Kirhan, Emine; Başaranoğlu, Sevgen Tanır; Tıp Fakültesi; Çocuk Sağlığı ve Hastalıkları Ana Bilim Dalı; 0000-0002-9574-1842; 0000-0001-8571-2581; 0000-0002-9416-1512; L-1933-2017; AAC-8665-2020; AAH-1658-2021; DBC-8927-2022; ESK-6562-2022Common variable immunodeficiency (CVID) is a heterogenous group of immunologic disorders of unknown etiology. Alterations of the normal cellular balance due to an increase in reactive oxygen species and/or decrease in antioxidant defense may lead to increased oxidative stress. We aimed to evaluate the levels of oxidative stress biomarkers in patients with CVID who had different presentations. We investigated the serum catalase (CAT), erythrocyte superoxide dismutase (SOD), erythrocyte reduced glutathione as antioxidants and serum malondialdehyde levels as lipid peroxidation marker in patients with CVID in Uludag University Hospital Department of Pediatric Allergy and Immunology's outpatient clinics. In the analysis, there were 21 patients and 27 matched healthy controls. The median levels of CAT in patients with CVID was significantly lower than in healthy controls (p = 0.04). Among the patients with CVID, 19% had autoimmune disease, one had Sjogren's syndrome, one had autoimmune alopecia, one had juvenile rheumatoid arthritis, and one had chronic inflammatory demyelinating polyneuropathy. Patients with autoimmune complications had significantly lower CAT levels compared to the ones without autoimmune diseases (p = 0.03). The patients without non-infectious complications (NICs) had lower SOD levels than the patients with NICs (p = 0.05). The analysis of oxidative stress markers in the patients with CVID suggested a series of abnormalities in the anti-oxidant system. The clinical syndrome associations may be a useful tool for future studies to set prediction markers for the prognosis of patients with CVID.Publication Short term effect of laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary ngal levels in diabetic and non diabetic obesity(Editura Acad Romane, 2019-07-01) Elbasan, Onur; Şişman, P.; Peynirci, Hande; Yabacı, Ayşegül; Dirican, Melehat; DİRİCAN, MELEHAT; Gül, Özen Öz; ÖZ GÜL, ÖZEN; Cander, Soner; CANDER, SONER; Ersoy, Canan; ERSOY, CANAN; Tıp Fakültesi; Biyokimya Ana Bilim Dalı; 0000-0001-8580-9471; AAH-8861-2021; AAG-6985-2021; AAI-1005-2021Background. Although diseases such as diabetes, hypertension, obstructive sleep apnea and hyperlipidemia are clearly documented as obesity associated diseases, it is not well-known whether obesity causes renal pathologies. The aim of the present study was to evaluate the effect of weight loss following laparoscopic sleeve gastrectomy on clinical, renal parameters and urinary Neutrophil gelatinase-associated lipocalin (NGAL) levels in diabetic and non-diabetic obese patients.Methods. Nineteen morbidly obese patients (10 diabetic and 9 non diabetic) who underwent laparoscopic sleeve gastrectomy were evaluated clinically (anthropometric measurements) and biochemically before surgery and at 6 months from surgery.Results. Significant decreases in weight, BMI, FPG, PPG and HbA1c levels were observed in the diabetic group when the baseline and 6th month parameters of the patients were compared. There was also a significant decrease in SBP and DBP. At 6th month following laparoscopic sleeve gastrectomy, renal parameters such as creatinine, mAlb/creatinine, NGAL/creatinine did not differ in the diabetic group. In the nondiabetic group, serum creatinine levels were significantly decreased, but other renal parameters such as mAlb/creatinine and NGAL/creatinine were not significantly different.Conclusions. Our findings revealed significant decreases in weight, body mass index and glycemic parameters after sleeve gastrectomy in diabetic and non-diabetic patients, while no significant alteration was noted in renal functions, urinary NGAL and microalbumin levels.Publication A multicenter nationwide reference intervals study for common biochemical analytes in turkey using abbott analyzers(Walter De Gruyter Gmbh, 2014-12-01) Ichihara, Kiyoshi; Aslan, Diler; Aybek, Hulya; Ari, Zeki; Taneli, Fatma; Coker, Canan; Akan, Pinar; Şişman, Ali Riza; Bahçeci, Onur; Sezgin, Nurzen; Demir, Meltem; Yücel, Gultekin; Akbas, Halide; Özdem, Sebahat; Polat, Gürbüz; Erbağci, Ayse Binnur; Örkmez, Mustafa; Mete, Nuriye; Evliyaoglu, Osman; Kıyıcı, Aysel; Vatansev, Hüsamettin; Ozturk, Bahadir; Yucel, Dogan; Kayaalp, Damla; Dogan, Kubra; Pinar, Asli; Gurbilek, Mehmet; Çetinkaya, Çiğdem Damla; Akın, Okhan; Serdar, Muhittin; Kurt, Ismail; Erdinç, Selda; Kadiceşme, Özgur; Ilhan, Necip; Atali, Dilek Sadak; Bakan, Ebubekir; Polat, Harun; Noyan, Tevfik; Can, Murat; Bedir, Abdulkerim; Okuyucu, Ali; Değer, Orhan; Agaç, Suret; Ademoğlu, Evin; Kaya, Aysem; Nogay, Turkan; Eren, Nezaket; Gunes, Yeliz; Kawano, Reo; Tezcan, Sehavet; Demirpençe, Özlem; Değirmen, Elif; Özarda, Yesim; ÖZARDA, YEŞİM; Dirican, Melahat; DİRİCAN, MELEHAT; Tuncer, Gül Özlem; Aykuş, Mehmet; Özmen, Sevda Ünalli; Tıp Fakültesi; Biyokimya Ana Bilim Dalı; KYR-0994-2024; AAL-8873-2021Background: A nationwide multicenter study was organized to establish reference intervals (RIs) in the Turkish population for 25 commonly tested biochemical analytes and to explore sources of variation in reference values, including regionality.Methods: Blood samples were collected nationwide in 28 laboratories from the seven regions (>= 400 samples/region, 3066 in all). The sera were collectively analyzed in Uludag University in Bursa using Abbott reagents and analyzer. Reference materials were used for standardization of test results. After secondary exclusion using the latent abnormal values exclusion method, RIs were derived by a parametric method employing the modified Box-Cox formula and compared with the RIs by the non-parametric method. Three-level nested ANOVA was used to evaluate variations among sexes, ages and regions. Associations between test results and age, body mass index (BMI) and region were determined by multiple regression analysis (MRA).Results: By ANOVA, differences of reference values among seven regions were significant in none of the 25 analytes. Significant sex-related and age-related differences were observed for 10 and seven analytes, respectively. MRA revealed BMI-related changes in results for uric acid, glucose, triglycerides, high-density lipoprotein (HDL)-cholesterol, alanine aminotransferase, and.-glutamyltransferase. Their RIs were thus derived by applying stricter criteria excluding individuals with BMI >28 kg/m(2). Ranges of RIs by non-parametric method were wider than those by parametric method especially for those analytes affected by BMI.Conclusions: With the lack of regional differences and the well-standardized status of test results, the RIs derived from this nationwide study can be used for the entire Turkish population.