The aim of the study was to evaluate thyroid-stimulating hormone (TSH) concentration in a reference group and to compare it with the TSH in subjects with high probability of thyroid dysfunction. The study population consisted of 852 subjects. The reference group consisting of 316 subjects was obtained by the exclusion of the subjects having thyroid disease, taking thyroid influencing drugs, having increased thyroid peroxidase (TPO) antibodies, or having abnormal thyroid ultrasound. 42 high probability of thyroid dysfunction subjects were defined by the association of increased TPO antibody concentration, changed echogenicity, and changed echosonographic structure of thyroid parenchyma. In the reference group TSH reference range was 0.45 mU/l (95% CI 0.39-0.56 mU/l) to 3.43 mU/l (95% CI 3.10-4.22 mU/l). To distinguish reference and high probability of thyroid dysfunction group a TSH threshold was calculated. At a threshold value of 3.09 mU/l (95% CI 2.93-3.38 mU/l), specificity was 95% and sensitivity 38.1%. Using 2 different approaches to find upper limit of the TSH reference range we obtained similar results. Using reference group only a value of 3.43 mU/l was obtained. Using both reference group and subjects with the high probability of thyroid dysfunction we obtained 95% CI for the upper reference limit between 2.93 and 3.38 mU/l. Based on these premises, it could be argued that conservative estimate of the TSH upper reference range should be 3.4 mU/l for both sexes.
SummaryBackgroundUp until now there have been contradictory data about the association between p.Val158Met catechol-O-methyltransferase (COMT) polymorphism and risk of preeclampsia (PE). The goal of this study was to assess the potential correlation between p.Val158Met COMT polymorphism and risk of early-onset PE, risk of a severe form of early-onset PE, as well as risk of small-for-gestational-age (SGA) complicating PE.MethodsThe study included 47 early-onset PE patients and 47 control cases. Forty-seven early-onset PE patients were grouped by disease severity (33 patients with a severe form and 14 patients without severe features) and secondly by size for gestational age (12 patients with appropriate-for-gestational-age (AGA) and 35 patients with SGA size). p.Val158Met polymorphism was genotyped by PCR-RFLP analysis.ResultsAllele analysis showed significant difference in COMT allele distribution between early-onset PE and control group as well as early-onset PE SGA and controls (p=0.04057 and p=0.0411 respectively). A statistically significant distribution difference between the severe form and form without severe features of early-onset PE patients was not observed (p>0.05). The highest difference observed was in the allele recessive model where COMT MetMet genotype was associated with decreased risk of early-onset PE (OR=0.281; 95%CI = 0.092–0.7836) and PE complications including severe early-onset PE (OR= 0.304; 95%CI=0.086–0.944) and SGA early-onset PE (OR=0.284; 95%CI=0.081–0.874).ConclusionsCOMT may be used as a candidate gene for early-onset PE and its severe form and SGA complications.
Introduction/Objective In the era of emerging antibacterial resistance, the major burden of resistant strains is on hospitalized patients. Although community factors are also important in the spread of resistance, less attention has been paid to non-healthcare settings. The aim of the study is to determine the prevalence of vancomycin-resistant enterococci (VRE) in the outpatient's urine culture and to perform phenotypic and genotypic characterization of VRE strains. Methods During an 18-month period, a total of 5,164 Enterococcus spp. strains were isolated from urine and identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antimicrobial susceptibility testing was performed by disk diffusion method and by gradient test for glycopeptideresistant strains. Genotypic characterization of VRE strains was done by multiplex polymerase chain reaction for the detection of the vancomycin resistance genes. Results Among the isolated enterococci, 5,060 (98%) were E. faecalis and 104 (2%) were E. faecium. E. faecalis strains were susceptible to all tested antibiotics except norfloxacin (33% of strains were resistant), while E. faecium showed high level of resistance to most of the tested agents (91.3% to ampicillin, 77% to norfloxacin, and 75% to nitrofurantoin), and 26% of strains were resistant to vancomycin and teicoplanin. VanA gene was detected in all vancomycin resistant E. faecium (VREfm) strains. Conclusion A high proportion of VREfm was noticed among outpatients in our country. All analyzed VREfm strains belonged to vanA genotype. Future surveillance studies of VRE are needed to follow up on this baseline study to monitor any possible changes in abundance and genotype of VRE in this population group.
Background/Aim. Preeclampsia (PE) belongs to the group of hypertensive disorders in pregnancy with the global average incidence of 2.16%. It is considered as one of the leading causes of maternal and neonatal morbidity and mortality worldwide. The goal of this study was to assess the potential association between Val158Met catechol-o-methyltransferase (COMT), tumor necrosis factor-alpha (TNF-α)-857 C>T, tumor necrosis factor receptor 1 (TNFR1) 36 A>G, interleukin-1alpha (IL-1α) 4845 G>T and interleukin-10 (IL-10)-1082 A>G polymorphisms and risk of early-onset preeclampsia (PE) and its complications. Methods. The study included 47 early-onset PE patients, which were grouped by disease severity and by size for gestational age and 47 control cases. The Val158Met polymorphism was genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis and inflammatory cytokine polymorphisms by the Sanger sequencing method. Results. The COMT Met allele as well as IL-1α T showed a protective role, decreasing the risk of early-onset PE after age and body mass index (BMI) adjustments. The detected interactions between the COMT Met and IL-10 A alleles, as well as between the COMT Met and TNF-α T alleles were insignificant after age and BMI adjustments. Conclusion. COMT and IL-1α may be used as candidate genes for early-onset PE and its severe form and small for gestational age (SGA) complications.
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