The effect of Myrtus communis L. extract on nephrolithiasis model in rats.

OBJECTIVE: Nephrolithiasis is a common urological disease that can lead to renal failure. Oxidative stress has been shown to be a contributing factor for nephrolithiasis and many agents have been studied to prevent and treat oxidative stress-related nephrolithiasis and renal damage. Myrtus communis (MC) extract has been shown to be an important antioxidant in different animal models. In this study, MC extract was administered preventively or therapeutically to rats with kidney stones, and its effectiveness was investigated. METHODS: Wistar albino rats were divided into four groups (n=8); control (C), ethylene glycol (EG), EG+preventive MC, and EG+curative MC groups. The nephrolithiasis model was created by adding 0.75% EG to drinking water for 8 weeks. Ultimately, 24-hour urine was collected to measure calcium, citrate, and creatinine levels. After decapitation, kidney tissues were harvested for histological analyses, measurement of osteopontin and 8-hydroxydeoxyguanosine (8-OHdG) levels, and N-acetyl-ß-glucosaminidase (NAG), myeloperoxidase (MPO) and caspase-3 activities. RESULTS: In 24-hour urine samples, calcium, citrate and creatinine levels were decreased in the EG group, while oxalate levels were increased and in treatment groups these parameters returned to control levels. MPO, 8-OHdG, caspase-3 and NAG activity were significantly increased in tissue and these changes were reversed in both MC groups. Histological findings also supported the biochemical parameters. CONCLUSION: MC can reduce oxidative stress and histopathological changes in kidney tissues in rat nephrolithiasis model when used as either a preventive or therapeutic agent. If supported with further clinical trials, MC might have clinical implications in preventing oxidative renal cell injury and ultimately kidney stone formation.

Recommendations for blood sampling in emergency departments from the European Society for Emergency Medicine (EUSEM), European Society for Emergency Nursing (EuSEN), and European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for the Preanalytical Phase. Executive summary.

AIM: Blood Sampling Guidelines have been developed to target European emergency medicine-related professionals involved in the blood sampling process (e.g. physicians, nurses, phlebotomists working in the ED), as well as laboratory physicians and other related professionals. The guidelines population focus on adult patients. The development of these blood sampling guidelines for the ED setting is based on the collaboration of three European scientific societies that have a role to play in the preanalytical phase process: EuSEN, EFLM, and EUSEM. The elaboration of the questions was done using the PICO procedure, literature search and appraisal was based on the GRADE methodology. The final recommendations were reviewed by an international multidisciplinary external review group. RESULTS: The document includes the elaborated recommendations for the selected sixteen questions. Three in pre-sampling, eight regarding sampling, three post-sampling, and two focus on quality assurance. In general, the quality of the evidence is very low, and the strength of the recommendation in all the questions has been rated as weak. The working group in four questions elaborate the recommendations, based mainly on group experience, rating as good practice. CONCLUSIONS: The multidisciplinary working group was considered one of the major contributors to this guideline. The lack of quality information highlights the need for research in this area of the patient care process. The peculiarities of the emergency medical areas need specific considerations to minimise the possibility of errors in the preanalytical phase.

The Effect of Using a Normothermia Checklist on Awakening Time From Anesthesia and Coagulation Disorder: A Randomized Controlled Trial.

BACKGROUND: Inadvertent perioperative hypothermia (IPH) is a common issue in surgical patients. To avoid this issue, the patient should be monitored continuously throughout the perioperative process. Evidence-based practices in line with relevant guidelines are necessary to maintain normothermia. PURPOSE: This study was developed to determine the effect of using a control list developed for preventing IPH on time of awakening from anesthesia and coagulation disorder in surgical patients. METHODS: In this randomized controlled study, nursing interventions were applied to patients in accordance with the normothermia checklist (NC) developed by the researchers to prevent IPH. RESULTS: In this study, 30 patients were respectively assigned to the experimental and control groups. Conducting nursing interventions in accordance with the control checklist was found to be effective in preventing IPH. Moreover, time of awakening from anesthesia was significantly shorter in the experimental group (3.77 ± 1.10 minutes) than the control group (11.03 ± 2.51 minutes; p < .05). Furthermore, tendency to bleed was higher in the control group than the experimental group, and a statistically significant between-group difference in coagulation disorders was found ( p < .05). CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The results of this evidence-based study indicate that implementing nursing interventions in line with the developed NC is effective in preventing IPH. Preventing IPH, which increases the risk of numerous complications in surgical patients, is an important responsibility of nurses. Nurses may employ the NC proposed in this study to better secure the safety and minimize the risk of complications in surgical patients.

The Development of the Inadvertent Perioperative Hypothermia Knowledge Test (IPH-KT).

PURPOSE: This study aimed to develop the inadvertent perioperative hypothermia knowledge test (IPH-KT) for health care professionals and examine its validity and reliability. DESIGN: The methodological and cross-sectional study design was used. METHODS: The research was carried out with 326 nursing students in Turkey. Data for the study were collected using a demographic information form and the IPH-KT. FINDINGS: The item difficulty index and item distinctiveness index of the questions included in the draft form of the 25-item test ranged from 0.03 to 0.81 and from 0.25 to 0.99, respectively. After the analyses, 8 items were excluded from the draft test, and the final version of the test consisted of 17 questions. The item difficulty index of the final test ranged from 0.30 to 0.96, and the item distinctiveness index ranged from 0.33 to 0.81. The reliability of the test was determined using the Kuder-Richardson formula 20 and found to be 0.72, indicating high internal consistency. Therefore, the IPH-KT was accepted as a reliable test. CONCLUSIONS: The study revealed that the questions in the IPH-KT had varying difficulty levels and a high ability to discriminate between individuals with knowledge of IPH and those without. The results demonstrated that the test had good content and face validity and showed high reliability for measuring the IPH knowledge of nursing students.

A Retrospective Evaluation of the Laboratory Findings of Dermatology Patients Whose Biotin Levels Were Checked.

Objective Biotin is widely known to be beneficial for the hair, nails, and skin, but there are only a few studies on biotin. We evaluated whether there is a relationship between biotin levels and age, gender, and frequently observed laboratory findings. We also evaluated biotin levels according to the reason for checking biotin levels. Methods One hundred five patients applied to the dermatology outpatient clinic and had their biotin levels checked. Patient files were retrospectively analyzed. Results There were a weak positive (r=0.207) relationship between biotin levels and basophil count, a weak positive (r=0.201) relationship between biotin levels and creatinine, and a weak positive (r=0.314) relationship between biotin levels and cholesterol/triglyceride ratio. There were a weak negative (r=-0.216) relationship between biotin levels and mean platelet volume (MPV) and a moderately negative (r=-0.315) relationship between biotin levels and triglyceride levels. Conclusion Biotin levels do not significantly differ with gender but increase with age. Although a weak correlation was detected between hemogram parameters and biotin levels with basophil percentage and mean platelet volume values, biotin did not significantly change hemogram parameters. The relationship between biotin levels and triglyceride levels was the most critical finding of our study. We recommend examining biotin levels in the patients with high triglyceride levels. When we encounter dermatological side effects related to the use of epidermal growth factor receptor tyrosine kinase inhibitors, we recommend evaluating biotin levels. We recommend that biotin supplementation be made only in the patients with deficiencies and that biotin levels be measured in the follow-up.

Ethanolic extract of cotinuscoggygria leaves attenuates crystalluria and kidney damage in ethylene glycol-induced urolithiasis in rats.

OBJECTIVE: Nephrolithiasis is a common cause of kidney insufficiency. Nephrolithiasis is proven to be the result of various biochemical and inflammatory processes that result in crystal formation and subsequent aggregation. Cotinuscoggygria L. (CCog) is a plant extract which has been used as a Turkish remedy for kidney stones. With this study, we planned to evaluate the effects of CCog extract in ethylene glycol (EG)-induced nephrolithiasis model in rats. METHODS: The study group comprised 32 Wistar albino rats which were divided into Control (C), EG, CCog Prophylaxis (CC+EG+CC), and CCog Treatment (EG+CC) groups. Stone formation was induced by adding EG (0.75%) into rat's drinking water. Normal drinking water was given to Control group for 8 weeks. Throughout the study period of 8 weeks, EG group was given only EG (0.75%) and CC+EG+CC group was given both EG and CCog. In EG+CC group, EG (0.75%) was given for 8 weeks whereas CCog was given for the past 4 weeks. After the 8th week, 24-h urine samples were collected. Rats were then sacrificed and kidney tissue samples were harvested. RESULTS: Metabolites (calcium, citrate) and creatinine in 24 h urine samples were decreased in CC+EG+CC and EG+CC groups. While hyperoxaluria was observed in the EG group, oxalate levels were similar to control levels in the P-CCog and C-CCog groups. The N-acetyl-ß-glucosaminidase and myeloperoxidase activities were both increased in EG group and these parameters were significantly decreased on CCog treatment. CONCLUSION: We can conclude that C. coggygria extract can have beneficial effect on lowering concentration of stone-forming metabolites in urine and consequently protect renal tissues from damage due to nephrolithiasis. C. coggygria extract can be considered as a potential prophylactic and therapeutic option in high-risk stone formers. Furthermore, our data confirm ethnobotanical use of CC against nephrolithiasis.

Distribution of respiratory viruses: Evaluation of multiplex PCR results of 3074 patients.

OBJECTIVE: Early and accurate diagnosis of acute respiratory infections is important because these diseases negatively affect public health and can lead to loss of workforce and an increase in health expenditures. In this study, we aimed to determine the respiration panel multiplex polymerase chain reaction (PCR) test results and seasonal distribution in our region. METHODS: Three thousand and seventy-four patients samples multiplex PCR (Anatolia, Bosphore® Respiratory Pathogens Panel Kit v1) test results, which were sent to our laboratory, from 13 hospitals in our region between January 2018 and December 2018, were evaluated retrospectively. RESULTS: A total of 3074 patients samples, 1465 (48%) were positive and 1609 (52%) were negative test results. The most common factors were rhinovirus 30.2%, influenza A 23.1%, and respiratory syncytial virus (RSV) A/B 19.1%, respectively. When the distribution of these three most common viruses by months is examined, the most frequent months were determined as June for rhinovirus, November for influenza A, and February for RSV A/B. In the period between October and February, there was a significant increase in the positivity level of viral factors. CONCLUSION: The use of molecular methods in the diagnosis of respiratory infections will prevent unnecessary use of antibiotics and ensure correct and rapid treatment.

Direct cost analysis for 32,783 samples with preanalytical phase errors.

OBJECTIVE: Errors in the laboratory process often occur in the preanalytical phase (PA). The study aims to calculate the direct cost elements of PA errors, including material, logistics, transfer, personnel workforce, and medical waste. METHODS: Medical laboratory PA phase errors were retrospectively reviewed using the Laboratory Information Management System. We evaluated the whole 2019 laboratory data of the 836-bed Health Sciences University Umraniye Training and Research Hospital (UTRH). We assessed the direct cost elements of PA errors, such as those related to material, logistics, transfer, human resources, and waste. We performed the procedure for both samples analyzed in the hospital and transferred to the central laboratory. RESULTS: We analyzed 1,939,650 patient samples and 46,534,532 parameters studied in 2019 for UTRH. The rates for rejected tests and rejected samples (tube) for UTRH were noted as 0.32% and 1.7%, respectively. The total direct cost for PA errors was TRY 438,284.51 (68,918.07 euros) for 32,783 patient samples and 147,893 tests. We calculated the total cost for PA test errors detected in the hospital as TRY 390,238.06, while the total cost for PA test errors detected in the central laboratory was TRY 48,046.45. 89% of the total cost was for PA errors detected in the hospital, and 11% was for the errors detected in the central laboratory. The 2019 direct PA error cost we calculated based on our hospital's data was 0.153% of the 2019 hospital operating cost. We calculated the direct cost per rejected sample as TRY 13.37 (2.1 Euro). CONCLUSION: Providing reliable laboratory service with the least possible financial loss is one of the main goals in terms of laboratory medicine. In achieving this goal, the prevention of error costs is a priority. The direct cost elements for the PA phase, where laboratory errors are concentrated, can be easily identified. The amount of PA phase error direct cost will attract the attention of health policy decision-makers and field professionals and inspire further research. Therefore, we tried to determine a threshold cost regarding interventions and practices required to prevent PA phase errors.

Pre-Analytical Error Cost Analysis of 10,732 Contaminated Urine Culture Samples.

BACKGROUND: Unlike other pre-analytical (PA) phase errors, in our country Social Security Institution (SSI) reimburses urine samples rejected due to contamination in the form of a finalized test. The primary purpose was to estimate the direct financial loss created by contaminated urine sampling. We want to encourage its prioritization among corrective and preventive actions of laboratory PA management. METHODS: We examined the urine samples which were sent to Istanbul Anatolian North Central Laboratory retrospectively. The central laboratory serves the community of 6,400-bed hospitals. We made direct financial loss calculations with material-, labor-, and waste-related financial elements. RESULTS: We rejected 10,732 of 138,834 samples due to contamination. With the 2019 Euro Index, the cost for each urine sample rejected due to contamination was calculated as € 2.98. CONCLUSIONS: It is the first cost study where the prices are in human resources, material, waste cost, and the amount reimbursed by SSI as direct cost elements per rejection sample. Highlighting the cost elements in establishing health policies predicted due to their striking feature may contribute to their prioritization in corrective and preventive actions. The urine culture test is the most commonly performed bacterial culture test. The determination of financial loss predicted that it would also reduce antibiotic resistance in healthcare by providing financial resource threshold information to develop improved methods. In addition, it will inspire new additions to the existing few detailed pre-analytical error cost studies.

Association of blood groups on the risk of COVID-19 infection, morbidity, and mortality.

OBJECTIVE: We aimed to compare the effects of blood groups and Rh factor on the development of coronavirus-19 disease (COVID-19) with all aspects such as clinical course, inflammatory parameters, and organ-specific biochemical parameters with a significant number of patients. METHODS: This multicenter study was carried out retrospectively on 3551 patients hospitalized with the diagnosis of COVID-19 and whose blood groups were recorded during the time of hospitalization. As control groups, 22133 individuals' medical data who were admitted to the blood bank affiliated with our hospitals during the last year was used. The differences between the blood groups and clinical characteristics were analyzed. RESULTS: Of the 3551 patients, A Rh (+) blood group was found to be in a higher ratio in the case group than controls, with increased risk to be infected (case: 41.3% vs. control: 38.8%), (OR 1.113; 95% CI: 1.036-1.197; p=0.003). Meanwhile O Rh (+) blood group ratios were significantly lower in the case group than in the control group (case: 26% vs. control: 28.3%) (OR 0.862; 95% CI: 0.823-0.966; p=0.005). There was no significant difference between blood groups in terms of admission to the intensive care units and mortality, it was observed that patients with AB Rh (+) blood group have a greater risk for intubation than others (OR: 1.467; 95% CI: 1.040-2.071; p=0.028). CONCLUSION: We demonstrated that people with blood group A Rh (+) more susceptible to COVID-19, whereas blood group 0 Rh (+) have a protective effect against the infection. Once a person has been infected with severe acute respiratory syndrome coronavirus 2, we should be mindful that patients with blood group AB Rh (+) would be prone to intubation more than other blood groups.

[Joint EFLM-COLABIOCLI recommendation for venous blood sampling]. / Recommandations communes EFLM-COLABIOCLI relatives au prélèvement sanguin veineux.

This document provides a joint recommendation for venous blood sampling of the European federation of clinical chemistry and laboratory medicine (EFLM) Working Group for preanalytical phase (WG-PRE) and Latin American working group for preanalytical phase (WG-PRE-LATAM) of the Latin America confederation of clinical biochemistry (COLABIOCLI). It offers guidance on the requirements for ensuring that blood collection is a safe and patient-centered procedure and provides practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. The target audience for this recommendation are healthcare staff members directly involved in blood collection. This recommendation applies to the use of a closed blood collection system and does not provide guidance for the blood collection with an open needle and syringe and catheter collections. Moreover, this document neither addresses patient consent, test ordering, sample handling and transport nor collection from children and unconscious patients. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: 1) Pre-sampling procedures, 2) Sampling procedure, 3) Post-sampling procedures and 4) Implementation. A first draft of the recommendation was circulated to EFLM members for public consultation. WG-PRE-LATAM was also invited to comment the document. A revised version has been sent for voting on to all EFLM and COLABIOCLI members and has been officially endorsed by 33/40 EFLM and 21/21 COLABIOCLI members. We encourage professionals throughout Europe and Latin America to adopt and implement this recommendation to improve the quality of blood collection practices and increase patient and workers safety.

Joint EFLM-COLABIOCLI Recommendation for venous blood sampling

This document provides a joint recommendation for venous blood sampling of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE) and Latin American Working Group for Preanalytical Phase (WG-PRE-LATAM) of the Latin America Confederation of Clinical Biochemistry (COLABIOCLI). It offers guidance on the requirements for ensuring that blood collection is a safe and patient-centered procedure and provides practical guidance on how to successfully overcome potential barriers and obstacles to its widespread implementation. The target audience for this recommendation are healthcare staff members directly involved in blood collection. This recommendation applies to the use of a closed blood collection system and does not provide guidance for the blood collection with an open needle and syringe and catheter collections. Moreover, this document neither addresses patient consent, test ordering, sample handling and transport nor collection from children and unconscious patients. The recommended procedure is based on the best available evidence. Each step was graded using a system that scores the quality of the evidence and the strength of the recommendation. The process of grading was done at several face-to-face meetings involving the same mixture of stakeholders stated previously. The main parts of this recommendation are: 1) Pre-sampling procedures, 2) Sampling procedure, 3) Post-sampling procedures and 4) Implementation. A first draft of the recommendation was circulated to EFLM members for public consultation. WG-PRE-LATAM was also invited to comment the document. A revised version has been sent for voting on to all EFLM and COLABIOCLI members and has been officially endorsed by 33/40 EFLM and 21/21 COLABIOCLI members. We encourage professionals throughout Europe and Latin America to adopt and implement this recommendation to improve the quality of blood collection practices and increase patient and workers safety.

Patient's knowledge and awareness about the effect of the over-the-counter (OTC) drugs and dietary supplements on laboratory test results: a survey in 18 European countries.

Background Nowadays over-the-counter (OTC) drugs and dietary supplements are widely used. Their use can have a significant impact on the validity of laboratory results. The aim of this multicenter European study was to determine the frequency of consumption of various dietary products and OTC drugs among patients and explore their level of knowledge and awareness about the potential impact of various products on laboratory test results. Methods Eighteen European countries participated in this study. The survey was carried out anonymously on a subsequent series of outpatients (n=200) in each participating country. Included were patients who were referred to the laboratory for blood sampling and who voluntarily agreed to participate in the study. The survey included questions about the frequency of consumption of various products, awareness of the importance of informing physicians and laboratory staff about it and information about influence of preanalytical factors in general on laboratory test results. Results In total, 68% of patients were regularly taking at least one OTC drug or dietary supplement. The frequency of patients consuming at least one OTC drug or dietary supplement differed between countries (p=0.001). Vitamins (38%), minerals (34%), cranberry juice (20%), acetylsalicylic acid (ASA) (17%) and omega fatty acids (17%) were the most commonly used in our study. Conclusions The use of various OTC drugs and dietary supplements is highly prevalent in Europe and patients are often not willing to disclose this information to the laboratory staff and ordering physician. The education of both patients and healthcare staff is needed.

Evaluation of protein C and protein S levels in patients with diabetes mellitus receiving therapy with statins and ACE inhibitors or angiotensin II receptor blockers.

AIMS: To evaluate protein C, protein S level in patients with diabetes mellitus receiving statin and ACE inhibitor/ARB therapy. METHODS: 95 patients were included in the study and divided into four groups depending on the use of statin and ACE inhibitor/ARB therapy. Group 1 comprised of patients receiving statin therapy (n = 15), Group 2 comprised of patients receiving ACE inhibitor/ARB therapy (n = 31), Group 3 comprised of patients receiving statin and ACE inhibitor/ARB therapy (n = 23), and Group 4 comprised of patients who did not receive either statin or ACE inhibitor/ARB therapy (n = 26). These four groups were compared with respect to protein C, protein S, fibrinogen, D-dimer, INR, and aPTT levels. RESULTS: There were statistically significant differences with respect to protein C levels. Group 1 and group 2 had higher protein C levels compared with group 4. (p < .01). Similarly, Group 3 had higher protein C levels compared with group 4. (p < .01). There was no significant difference between the groups with respect to protein S, INR, aPTT, and D-dimer levels. CONCLUSIONS: Diabetic patients receiving statin or ACE inhibitor/ARB therapy had higher protein C levels. Use of statin and ACE inhibitor/ARB therapy in diabetic patients decrease hypercoagulability and therefore could reduce the occurrence of cardiovascular events.

A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood.

INTRODUCTION: A nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). MATERIALS AND METHODS: K2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. RESULTS: Analyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers' results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. CONCLUSIONS: With the novel use of a freshly prepared blood panel, manufacturer-specific RIs' were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude.

The Effects of Melatonin on Ethylene Glycol-induced Nephrolithiasis: Role on Osteopontin mRNA Gene Expression.

OBJECTIVE: To evaluate the protective effects of melatonin (Mel) on an ethylene glycol (EG)-induced nephrolithiasis model in rats. MATERIALS AND METHODS: Thirty-two Wistar albino rats were divided into 4 groups: control, EG, prevention Mel (Mel + EG + Mel), and therapeutic Mel (EG + Mel). EG (0.75%) was added to drinking water to create nephrolithiasis model. The EG group received EG and the Mel + EG + Mel group received both EG and Mel for 8 weeks. In the EG + Mel group, EG is given for 8 weeks and Mel is given for the last 4 weeks of the experiment. At the end of experimental period, urine, blood samples, and tissues were collected. RESULTS: In 24-hour urine samples, calcium, citrate, and creatinine levels were decreased and oxalate levels were increased in the EG group, whereas Mel prevention and Mel treatment reversed these parameters back to control levels. Malondialdehyde, glutathione activities, myeloperoxidase, superoxide dismutase levels, and caspase-3 activity showed improvements in the Mel-treated groups when compared with the EG group. 8-Hydroxydeoxyguanosine, matrix metalloproteinase 9 levels, N-acetyl-ß-glucosaminidase activity, and osteopontin mRNA expression were elevated in the EG group and decreased back to control levels in the Mel + EG + Mel and EG + Mel groups. Histological examination showed improvement in the Mel-treated groups when compared with the EG group. CONCLUSION: Mel can prevent crystalluria and kidney damage due to crystal formation and aggregation. It can be considered as a potential prophylactic and protective agent in high-risk patients with urinary stone formation or recurrence if supported by further clinical studies.

Compliance of blood sampling procedures with the CLSI H3-A6 guidelines: An observational study by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) working group for the preanalytical phase (WG-PRE).

BACKGROUND: An observational study was conducted in 12 European countries by the European Federation of Clinical Chemistry and Laboratory Medicine Working Group for the Preanalytical Phase (EFLM WG-PRE) to assess the level of compliance with the CLSI H3-A6 guidelines. METHODS: A structured checklist including 29 items was created to assess the compliance of European phlebotomy procedures with the CLSI H3-A6 guideline. A risk occurrence chart of individual phlebotomy steps was created from the observed error frequency and severity of harm of each guideline key issue. The severity of errors occurring during phlebotomy was graded using the risk occurrence chart. RESULTS: Twelve European countries participated with a median of 33 (18-36) audits per country, and a total of 336 audits. The median error rate for the total phlebotomy procedure was 26.9 % (10.6-43.8), indicating a low overall compliance with the recommended CLSI guideline. Patient identification and test tube labelling were identified as the key guideline issues with the highest combination of probability and potential risk of harm. Administrative staff did not adhere to patient identification procedures during phlebotomy, whereas physicians did not adhere to test tube labelling policy. CONCLUSIONS: The level of compliance of phlebotomy procedures with the CLSI H3-A6 guidelines in 12 European countries was found to be unacceptably low. The most critical steps in need of immediate attention in the investigated countries are patient identification and tube labelling.

Effects of the 810-nm diode laser on hair and on the biophysical properties of skin.

INTRODUCTION: Laser therapy is clinically effective in hair removal; however, despite the development of various strategies, laser procedures still present a risk of adverse effects due to the overheating of the skin. OBJECTIVE: To investigate the effects of 810-nm diode laser treatment on hair and on the biophysical properties of skin by using various non-invasive techniques on various parameters, including hair analysis, surface color changes, integrity of skin barrier, sebum production rate and pH level. METHODS: In this randomized, right-left comparison study, 35 women with axillary hair received single-session diode laser therapy. Hair analysis and biophysical properties of the skin were assessed before treatment and at weeks 2, 4 and 6 after the therapy. RESULTS: Hair density and thicknesses statistically significantly decreased after the first post-treatment evaluation. Regarding comparison of the biophysical properties of the skin, there was no statistically significant difference in the assessments, except for the increase determined during the second week in the erythema index in the laser-treated areas. CONCLUSION: The findings of this study showed that the diode laser can perform a significant reduction in the hair amount without significant epidermal damage, at least for a short period.

Relationship between low levels of high-density lipoprotein cholesterol and metabolic syndrome in Turkish patients.

OBJECTIVE: It is stated that high-density lipoprotein cholesterol (HDL-C) levels are low in Turkish people and that this may be related to genetic factors. Low HDL-C is a parameter of the metabolic syndrome (MetS). In this study, the relationship between low HDL-C levels and MetS has been investigated. METHODS AND RESULTS: A total of 720 successive patients, 20 years or older, were categorized into two groups, as those with low-HDL-C (in men < 40 mg/dl, in women < 50 mg/dl) and those without low-HDL-C levels (in men > or = 40 mg/dl, in women > or = 50 mg/dl). The groups were compared according to the frequency of the MetS and the averages of the MetS criteria other than HDL-C. Moreover, two groups were formed with normal (< 150 mg/dl) and high (> or = 150 mg/dl) triglyceride levels and they have been compared with the average HDL-C levels. The frequency of MetS was 70.8% in the group with low-HDL-C and 24.2% in the group without low HDL-C levels (p < 0.001). The averages of the MetS criteria other than the HDL-C were 2.17 +/- 1.19 in the group with low-HDL-C levels and 1.59 +/- 1.15 in the group without low-HDL-C levels (p < 0.001). Average HDL-C level was 48.90 +/- 13.40 mg/dl in the group with normal triglyceride levels and 44.41 +/- 10.26 mg/dl in the group with high triglyceride levels (p < 0.001). CONCLUSIONS: This study shows that low HDL-C is related to the MetS in our patients, a selected group of a population reported to have a low HDL-C average.