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Biyokimya Laboratuvarında Yeni Uygulamalar ve Klinisyenlerin Farkındalığı

Yıl 2019, Cilt: 4 Sayı: 2, 170 - 182, 30.06.2019
https://doi.org/10.26453/otjhs.459641

Öz

Çalışmamızın amacı, biyokimya
laboratuvarımızda yeni uygulanan ve hastane otomasyonu tarafından klinisyenlere
sunulan bazı parametrelerin farkındalık tespitinin yapılmasıdır. Yapılan
araştırmada klinisyenlere anket üzerinden HOMA-IR, eGFR ve dCa hakkında,
çeşitli bilgiler soruldu. Elde edilen veriler, istatistiksel açıdan
değerlendirildi ve klinisyenlerin farkındalığı ölçüldü. Anket çalışmamıza
değişik kliniklerden 100 doktor katıldı. Araştırmaya katılan kişilerin
ünvanlara göre dağılımı; 28 uzman doktor, 16 akademisyen ve 56 asistan şeklinde
oldu. Branşlara göre dağılım, dahili       65
ve cerrahi 35 hekim şeklinde idi. Klinisyenlerin ünvanlarına göre HOMA-IR den
haberdar olma dağılımları anlamlı farklılık gösterdi (p=0.007). En çok haberi
olan klinisyenlerin öğretim üyeleri (%75), en az haberi olanların ise asistanlar
oduğu görüldü (%33.9).  Öte yandan
haberdar olan hekimlerin sadece %21’i HOMA-IR’yi kullanmakta idi. eGFR için
durum şu şekildedir; 91 hekim haberdar, 9 hekim habersiz idi. eGFR kullanan
hekim sayısı 67 iken, 33 hekim kullanmadığını ifade etti. Katılımcıların %74’ü
eGFR’nin işe yaradığını, %11’i işe yaramadığını ve %15’i ise fikri olmadığını
ifade etti. İstatistiksel açıdan anlamlı çıkan bu durumda dikkat çeken detay
ise, cerrahi branşlarda görülen eGFR işe yarama oranının, HOMA-IR’ye göre
oldukça yüksek çıkmasıdır (p<0,001). dCa araştırmamızda ise, katılımcıların
%84’ü önemli olduğunu ifade etmişlerdir. Sonuç olarak yapılan çalışmamız
göstermektedir ki; biyokimya laboratuvarında yeni uygulamalardan klinisyenler
haberdar, ama kullanma noktasında yeterince aktif değillerdir.

Kaynakça

  • 1.Hill NR, Levy JC, Matthews DR. "Expansion of the homeostasis model assessment of β-cell function and insulin resistance to enable clinical trial outcome modeling through the interactive adjustment of physiology and treatment effects. Diabetes Care 2013; 36 (8): 2324–30.
  • 2.Port FK, Eknoyan G, The dialysis outcomes and practice patterns study (DOPPS) and the kidney disease outcomes quality initiative (K/DOQI): a cooperative initiative to improve outcomes for hemodialysis patients worldwide. Americanjournal of kidney diseases. 2004; 44(2): 1-6.2.
  • 3.Ma A, Liu F, Wang C, et al. Both insulin resistance and metabolic syndrome accelerate the progression of chronic kidney disease among Chinese adults: results from a 3-year follow-up study. Int Urol Nephrol. 2018 Sep 4. doi: 10.1007/s11255-018-1934-6.
  • 4.Kan WC, Chien CC, Wu CC, Su SB, Hwang JC, Wang HY. Comparison of low-dose deferoxamine versus standard-dose deferoxamine for treatment of aluminium overload among haemodialysis patients Nephrology Dialysis Transplantation, 2010; 25 (5): 1604–08.
  • 5.Yazar H, Kayhan B C. Adult hemodialysis patients, "paricalcitol" prescription, is there any difference between the corrected Ca and normal Ca? J. Chem. Pharm. Res., 2010; 2(4):594-601.
  • 6. Zhou W, Ye SD, Chen C, Wang W. Involvement of RBP4 in Diabetic Atherosclerosis and the Role of Vitamin D Intervention. J Diabetes Res. 2018; 2018:7329861.
  • 7. Castillo AR, Zantut-Wittmann DE, Neto AM, Jales RM, Garmes HM. Panhypopituitarism Without GH Replacement: About Insulin Sensitivity, CRP Levels, and Metabolic Syndrome. Horm Metab Res. 2018; 50(9): 690-695.
  • 8. Ma H, Lin H, Hu Y, et al. Serum ferritin levels are associated with insulin resistance in Chinese men and post-menopausal women: the Shanghai Changfeng study. Br J Nutr. 2018; 7:1-9
  • 9. Lee CK, Swinford RD, Cerda RD, Portman RJ, Hwang W, Furth SL. Evaluation of serum creatinine concentration-based glomerular filtration rate equations in pediatric patients with chronic kidney disease. Pharmacotherapy. 2012;32(7):642-8.
  • 10. Dogan E, Izmirli M, Ceylan K, et al. Incidence of renal insufficiency in cancer patients. Adv Ther. 2005;22(4):357-62.
  • 11 Libório AB, Barros RM, Esmeraldo RM, Oliveira ML, Silva GB Jr, Daher EF. Creatinine-based equations predicting chronic kidney disease after kidney donation. Transplant Proc. 2011;43(7):2481-6.
  • 12. Le Bricon T, Leblanc I, Benlakehal M, Gay-Bellile C, Erlich D, Boudaoud S. Evaluation of renal function in intensive care: plasma cystatin C vs. creatinine and derived glomerular filtration rate estimates.Clin Chem Lab Med. 2005;43(9):953-7.
  • 13. Hu Y, Zhang Y, Wang H, et al. Percutaneous renal artery stent implantation in the treatment of atherosclerotic renal artery stenosis. Exp Ther Med. 2018;16(3):2331-2336.
  • 14. van Rijn MHC, Metzger M, Flamant M, et al. Performance of creatinine-based equations for estimating glomerular filtration rate changes over time. Nephrol Dial Transplant. 2018 Sep 1. doi: 10.1093/ndt/gfy278. [Epub ahead of print]
  • 15.Miyaoka D, Imanishi Y, Ohara M, et al. Impaired residual renal function predicts denosumab-induced serum calcium decrement as well as increment of bone mineral density in non-severe renal insufficiency. Osteoporos Int. 2018 Sep 5. doi: 10.1007/s00198-018-4688-1. [Epub ahead of print]

New Applications in Biochemistry Laboratory And Awareness Of Clinicians

Yıl 2019, Cilt: 4 Sayı: 2, 170 - 182, 30.06.2019
https://doi.org/10.26453/otjhs.459641

Öz

The aim of our study is to assess the
awareness of clinicians on the parameters that are newly applied in our
biochemistry laboratory and presented to clinicians by hospital automation. The
researchers were asked about various questions on HOMA-IR, eGFR and corrected
Ca  (cCa) through the questionnaire. The
data obtained was evaluated statistically and the awareness of clinicians was
measured. 100 physicians from different clinics participated in the survey.
Distribution of the doctors participating in the research according to their
titles was as follows; 16 academician, 28 specialists and 56 assistant. The
distribution according to departments was 65 internal medicine physcians and 35
surgeons. The distributions of awareness of the HOMA-IR were found to be
significantly different according to the titles of the clinicians (p = 0.007).
The faculty members were found to be the best among the clinicians in terms of
their awareness of the HOMA-IR (75%), and the worst being the residents
(33.9%). On the other hand; only 21% of the informed physicians use HOMA-IR.
The situation for eGFR is as follows; 91 physicians were informed, 9 physicians
were unaware. While the number of physicians using eGFR was 67, 33 physicians
stated that they did not use it. 74% of the participants stated to find the
EGFR useful, 11% did not agree and 15% hesitated. The statistically significant
detail is that the rate of eGFR seen in the surgical branches is higher than
the HOMA-IR gore (p<0.001). In our study of cCa, 84% of the participants
stated that they were important. As a result, our study shows that; clinicians
are aware of new applications in the biochemistry laboratory, but they are not
seem to be as active in using them.

Kaynakça

  • 1.Hill NR, Levy JC, Matthews DR. "Expansion of the homeostasis model assessment of β-cell function and insulin resistance to enable clinical trial outcome modeling through the interactive adjustment of physiology and treatment effects. Diabetes Care 2013; 36 (8): 2324–30.
  • 2.Port FK, Eknoyan G, The dialysis outcomes and practice patterns study (DOPPS) and the kidney disease outcomes quality initiative (K/DOQI): a cooperative initiative to improve outcomes for hemodialysis patients worldwide. Americanjournal of kidney diseases. 2004; 44(2): 1-6.2.
  • 3.Ma A, Liu F, Wang C, et al. Both insulin resistance and metabolic syndrome accelerate the progression of chronic kidney disease among Chinese adults: results from a 3-year follow-up study. Int Urol Nephrol. 2018 Sep 4. doi: 10.1007/s11255-018-1934-6.
  • 4.Kan WC, Chien CC, Wu CC, Su SB, Hwang JC, Wang HY. Comparison of low-dose deferoxamine versus standard-dose deferoxamine for treatment of aluminium overload among haemodialysis patients Nephrology Dialysis Transplantation, 2010; 25 (5): 1604–08.
  • 5.Yazar H, Kayhan B C. Adult hemodialysis patients, "paricalcitol" prescription, is there any difference between the corrected Ca and normal Ca? J. Chem. Pharm. Res., 2010; 2(4):594-601.
  • 6. Zhou W, Ye SD, Chen C, Wang W. Involvement of RBP4 in Diabetic Atherosclerosis and the Role of Vitamin D Intervention. J Diabetes Res. 2018; 2018:7329861.
  • 7. Castillo AR, Zantut-Wittmann DE, Neto AM, Jales RM, Garmes HM. Panhypopituitarism Without GH Replacement: About Insulin Sensitivity, CRP Levels, and Metabolic Syndrome. Horm Metab Res. 2018; 50(9): 690-695.
  • 8. Ma H, Lin H, Hu Y, et al. Serum ferritin levels are associated with insulin resistance in Chinese men and post-menopausal women: the Shanghai Changfeng study. Br J Nutr. 2018; 7:1-9
  • 9. Lee CK, Swinford RD, Cerda RD, Portman RJ, Hwang W, Furth SL. Evaluation of serum creatinine concentration-based glomerular filtration rate equations in pediatric patients with chronic kidney disease. Pharmacotherapy. 2012;32(7):642-8.
  • 10. Dogan E, Izmirli M, Ceylan K, et al. Incidence of renal insufficiency in cancer patients. Adv Ther. 2005;22(4):357-62.
  • 11 Libório AB, Barros RM, Esmeraldo RM, Oliveira ML, Silva GB Jr, Daher EF. Creatinine-based equations predicting chronic kidney disease after kidney donation. Transplant Proc. 2011;43(7):2481-6.
  • 12. Le Bricon T, Leblanc I, Benlakehal M, Gay-Bellile C, Erlich D, Boudaoud S. Evaluation of renal function in intensive care: plasma cystatin C vs. creatinine and derived glomerular filtration rate estimates.Clin Chem Lab Med. 2005;43(9):953-7.
  • 13. Hu Y, Zhang Y, Wang H, et al. Percutaneous renal artery stent implantation in the treatment of atherosclerotic renal artery stenosis. Exp Ther Med. 2018;16(3):2331-2336.
  • 14. van Rijn MHC, Metzger M, Flamant M, et al. Performance of creatinine-based equations for estimating glomerular filtration rate changes over time. Nephrol Dial Transplant. 2018 Sep 1. doi: 10.1093/ndt/gfy278. [Epub ahead of print]
  • 15.Miyaoka D, Imanishi Y, Ohara M, et al. Impaired residual renal function predicts denosumab-induced serum calcium decrement as well as increment of bone mineral density in non-severe renal insufficiency. Osteoporos Int. 2018 Sep 5. doi: 10.1007/s00198-018-4688-1. [Epub ahead of print]
Toplam 15 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makalesi
Yazarlar

Hayrullah Yazar 0000-0001-9447-6322

Ömer Emre Öz 0000-0002-7662-5061

Elif Yıldız Köse 0000-0003-0399-3071

Yayımlanma Tarihi 30 Haziran 2019
Gönderilme Tarihi 13 Eylül 2018
Kabul Tarihi 25 Eylül 2018
Yayımlandığı Sayı Yıl 2019 Cilt: 4 Sayı: 2

Kaynak Göster

AMA Yazar H, Öz ÖE, Köse EY. Biyokimya Laboratuvarında Yeni Uygulamalar ve Klinisyenlerin Farkındalığı. OTSBD. Haziran 2019;4(2):170-182. doi:10.26453/otjhs.459641

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