SummaryBackgroundAfter the introduction of modern laboratory instruments and information systems, preanalytic phase is the new field of battle. Errors in preanalytical phase account for approximately half of total errors in clinical laboratory. The objective of this study was to share an experience of an education program that was believed to be successful in decreasing the number of rejected samples received from the Emergency Department (ED).MethodsAn education program about laboratory procedures, quality requirements in the laboratory, patient and health-care worker safety was planned by the quality team to be performed on 36 people who were responsible for sample collection in the ED. A questionary which included 11 questions about the preanalytic phase was applied to all the attendees before and after training. The number of rejected samples per million was discovered with right proportion account over the number of accepted and rejected samples to laboratory after and before the training period.ResultsMost of the attendees were nurses (n: 22/55%), with over 12 years of experience in general and 2–4 years experience in the ED. Knowledge level of the attendees was calculated before training as 58.9% and after training as 91.8%. While the total rate of sample rejection before training was 2.35% (sigma value 3.37–3.50), the rate after training was 1.56% (sigma value 3.62–3.75).ConclusionsIncreasing the knowledge of staff has a direct positive impact on the preanalytic phase. The application of a pre-test was observed to be a feasible tool to shape group specific education programs.

Ab stra ctIn tro duc tion: The na tu re of the re la tion ship be tween glu co se me ta bo li sm and oc cur ren ce of mig rai ne has not been elu ci da ted pre ci se ly. This stu dy in ves ti ga ted the sta tus of oxi da ti ve/antioxidative ba lan ce and its re la tion ship wi th the glu co se me ta bo li sm in mig rai neu rs to get new poin ts of view for the un der lyi ng oxi da ti ve mec ha nis ms. Ma te ria ls and met ho ds: Sixty mig rai neu rs and 46 con trol sub jec ts we re in clu ded in the stu dy. Oxi da ti ve stre ss in dex, to tal oxi da nt and an tioxi dant sta tus of bo th grou ps we re exa mi ned in ad di tion to the in su lin and HOMA-IR in dex le ve ls. Re sul ts: HOMA-IR in dex was sig ni fi can tly en han ced in mig rai neu rs (P = 0.038); si mi lar ly oxi da ti ve stre ss in dex and to tal oxi da nt sta tus we re hig her in pa tien ts com pa red to the con tro ls (P < 0.001 for bo th). Con clu sion: This pre li mi na ry stu dy shows that oxi da ti ve/antioxidative ba lan ce shif ts towar ds the oxi da ti ve sta tus in mig rai ne. Hig her to tal oxi da nt sta tus and ele va ted HOMA-IR in dex mig ht play a ro le in the po ten tial ear ly pat ho ge ne sis for mig rai ne. Key wor ds: mig rai ne; oxi da nt; an tioxi da nt; HOMA in dex; oxi da ti ve stre ss.

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Objectives An excessive inflammatory response to SARS-CoV-2 is thought to be a major cause of disease severity in COVID-19. The aim herein was to determine the prognostic value of IL-6, and demonstrate the comparison between IL-6 and related parameters in COVID-19. Methods Data were collected from 115 COVID-19 patients. Results The median age was 46.04 years in the mild group, 56.42 years in the moderate group, and 62.92 years in the severe group (p=0.001). There was a significant difference in the hospitalized clinic to intensive care unit ratio among the patients (p<0.001). The IL-6 values were significantly higher in the severe group than those in the mild (p=0.04) and moderate groups (p=0.043). The area under the receiver operating characteristic curve for IL-6, as predictor of severe clinical condition, was 0.864 (95% CI 0.765–0.963 p=0.000). The longitudinal analyses showed that the severe group presented with significantly increased IL-6 levels during hospitalization. Conclusions IL‐6 seemed to be a guide in the early diagnosis of severe COVID-19 and an ideal marker for monitoring negative outcome.

Objective: Patient safety, comprise all the precautions by the healthcare provider institutions and their staff in order to prevent possible harms during health service presentations. In this study we discuss our efforts of prevention and improvement and the results of our education program pertaining to the subject. Methods: In the monthly quality workshop of Antalya Education and Research Hospital (AERH) Central Laboratories, the problems occuring in the preanalytical phase, particularly concerning phlebotomy were determined. The rejected blood specimens between 01.5.2011 and 31.05.2012 were classified through the cause of rejection and the unit from where the specimens were sent. The corrective and preventive actions and educational interventions effects were evaluated during this period. Results: The most rejected specimens were the ones collected with tubes or syringes containing anticoagulant additives (blood gases and coagulation tests). Emergency department presented the highest rejection rate. The medical units with higher rates of rejected specimens were gastroenterology, internal medicine, cardiology, which had a high circulation of patients and critical care patients in common. Conclusion: Our finding clearly showed that laboratory specimen rejection rates were manageable. The results emphasized the pivotal role of education and follow-up..

Centrifugation separates particles within the specimen according to their shape, dimensions, and density and basically can be defined as a separation method. The centrifuge is an essential device in medical laboratories to prepare the serum, plasma, and urine samples for analysis. It is basically an electric device composed of the stationary (motor) and the motile (rotor) part. The centrifugation depends on two main variables: relative centrifugal force (RCF) and centrifugation time. The physical impact separating the specimen into its components in the centrifuge known as RCF is expressed as the multiples of gravitational acceleration (×g). RPM, defined as the number of rotations of the centrifuge per minute, shows the speed of the centrifuge. RCF value can be calculated by using RPM, and the centrifuge radius. Because models and sizes of centrifuges vary considerably, the use of gravity (g) forces instead of RPM is suggested. The centrifuges can be classified according to their usage, speed, technical specifications, and rotor type. An accurate and precise centrifugation process is essential to prevent errors in the preanalytical phase. The purpose of this document is to ensure the standardization of a good, precise protocol for the centrifugation process among the medical laboratories.

Özet Amaç: Bu çalışmanın amacı, bir hastanenin yoğun bakım ünitesinde çalışan hemşirelerin tüken-mişlik düzeylerini ve ilişkili bazı faktörleri belirlemektir. Gereç ve Yöntemler: Bu kesitsel araştırma bir hastanenin yoğun bakım ünitesinde çalışan 90 hemşire ile Haziran 2012'de gerçekleştirilmiştir. Araştırmanın verileri, katılımcıların bazı sosyodemografik özelliklerini irdeleyen birtakım sorulardan ve Maslach Tükenmişlik Ölçeği'nden (MTÖ) oluşan bir anket formuyla toplanmıştır. Veriler SPSS 16.0 programında yüzdelik, tek yönlü varyans analizi, post hoc testleri (Tukey [HSD] çoklu karşılaştırma testi) ve bağımsız örneklem t-testi kullanılarak analiz edilmiş, p<0,05 olan değerler anlamlı kabul edilmiştir. Bulgular: Bu çalışmada yer alan hemşirelerin %93,3'ü kadındır ve %60'ı 30-39 yaş aralığındadır. Meslekte çalışma süresi 6-10 yıl olan hemşirelerin kişisel başarı duygusundaki azalma puanlarının, meslekte çalışma süresi 1-5 yıl olan hemşirelere göre istatistiksel olarak anlamlı derecede yüksek olduğu saptanmıştır (p= 0,04). Vardiyalı çalışan hemşirelerin gündüz çalışanlara göre, meslek değiştirmeyi düşünen hemşirelerin diğer hemşirelere göre, ve iş yaşamından memnun olmayan hemşirelerin memnun olan hemşirelere göre duygusal tükenme puanlarının istatistiksel olarak anlamlı derecede yüksek olduğu saptanmıştır (sırasıyla, p=0,02; p<0,01; p<0,01). Tartışma ve Sonuç: Medeni durum, aylık gelir, çalışılan yıl sayısı, vardiyalı çalışma ve meslek değiştirmeyi düşünme yoğun bakım hemşirelerinin tükenmişlik düzeyini etkileyen önemli faktörler olarak belirlenmiştir. Anahtar Kelimeler: hemşire; yoğun bakım; tükenmişlik Abstract Aim: The aim of this study is to determine the level of burnout among the intensive care nurses working in a hospital and some of the related factors. Materials and Methods: This cross-sectional study was conducted with 90 nurses working in the intensive care unit of a hospital in June 2012. The data were collected with a questionnaire including a series of questions investigating the sociodemographic characteristics of the participants and the Maslach Burnout Inventory. The data were subjected to percentage analysis, one-way ANOVA, post hoc tests (Tukey's HSD test) and independent-samples t-test by using SPSS (Statistical Package for the Social Sciences) software, version 16.0. A p-value of <0.05 was considered statistically significant. Results: Of the nurses, 93.3% were female and 60% aged between 30 and 39 years. It was observed that the nurses who had worked for 6 to 10 years scored statistically significantly higher on the feeling of reduced personal accomplishment subscale than the nurses who had worked for 1 to 5 years (p=0.04). The nurses who worked in shifts compared to those who worked in the daytime, the nurses who were thinking about changing their jobs compared to those who were not, and the nurses who were satisfied with their careers compared to those who were not scored statistically significantly higher on the emotional exhaustion subscale (p=0.02, p<0

During pregnancy, the mother is potentially subjected to glucotoxicity as well as oxidative stress (OS) to help the foetus absorb more nutrients. Our results suggest that the Trx/TrxBP system may mediate a compensating mechanism. Reduced TrxBP levels and consequent enhanced Trx activity may alleviate OS and protect the foetus from hypoglycaemia. We hypothesise that the decrease in TrxBP levels is not a consequence of GDM, but rather is an instance of the active functional role of TrxBP in maternal development, unifying redox regulation and glucose metabolism.