Our aim was to investigate the hemogram index parameters and their clinical significance in the evaluation of the inflammatory response of patients with male breast cancer, who are rarely observed in the literature. In total, 22 (n=22) healthy male and 28 (n=28) male breast cancer patients without synchronous/metachronous tumors were included in this study. They were grouped as the healthy male control group (Group 1) and the male breast cancer patient group (Group 2). The male breast cancer was divided into two subgroups, namely, early stage [(stage: 0/I/II) (Group 2A)] and late stage [(stage: III/IV) (Group 2B)], and their hemogram index parameters were compared. A significant (p>0.05) increase was observed in neutrophil/lymphocyte ratio (NLR) and·platelet/lymphocyte ratio (PLR) values in the late stage (Group 2B: stage III/IV) compared to the early stage (Group 2A: stage 0/I/II) and healthy control (Group 1) groups. In male breast cancer patients, neutrophil/lymphocyte ratio and platelet/lymphocyte ratio values were significantly higher as the stage of cancer increased. These readily available simple tests can be used to evaluate the host's inflammatory response in male breast cancer.

Objectives The utilization of reliable quality indicators (QIs) proven to be suitable for monitoring and improvement tools is one of the best choices to minimize of the risk of errors in all laboratory processes called as total testing process (TTP). In 2008, a Working Group “Laboratory Errors and Patient Safety” (WG-LEPS) established by International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) developed the Model of Quality Indicators (MQI) complying with requirements of the ISO 15189:2012 standard for laboratory accreditation. They have also been dealing with harmonizing the QIs in most laboratories worldwide since then. The present study was set out to investigate the frequency of using IFCC WG-LEPS’ pre-QIs by Turkish laboratories and to assess the conformity of them, by taking into account Turkey’s conditions. Methods A survey consisting nine questions was applied in 81 laboratories using SurveyMonkey. Results According to the survey results, most of the laboratories reported they have used pre-QIs in the quality standards of health prepared by Turkish Ministry of Health (MOH). A part of IFCC WG-LEPS’ pre-QIs were being utilized by more than 80% of the laboratories, the rest of which only used by 10% of laboratories. Conclusions The majority of the medical laboratories have been using the pre-QIs included in the guidelines of Quality Standards prepared by the MOH. The pre-QIs are partially compatible with IFCC WG-LEPS’ pre-QIs. The definitions of IFCC WG-LEPS’ pre-QIs may also be revised to make them more clear and understandable by IFCC WG-LEPS. The insufficiency of Health Information Management Systems (HIMS) limits the use of pre-QIs proposed by IFCC WG-LEPS. Finally, the education of relevant personnel about the use of HIMS and pre-QIs is very crucial to harmonize and to extend the use of IFCC WG-LEPS’ pre-QIs in Turkish medical biochemistry laboratories.

Background: Clinically important critical values must be readily available to the clinician. Repeating critical values may cause a delay. In this study, we evaluated the requirement of repeating critical values. Methods: We extracted initial and repeated critical values and reporting times for a six-month period via the hospital laboratory information management system. Ten parameters from our critical value list (glucose, urea, magnesium (Mg++), calcium (Ca++), sodium (Na+), potassium (K+), chloride (Cl-), white blood cells (WBC), platelets, hemoglobin) were evaluated. We assessed whether the difference between the first measurement of the initial critical value and the repeated measurement value exceeded total allowable error (TEa). Results: Repeated critical values of Mg++, Ca++, WBC, platelets, and hemoglobin did not exceed TEa. However, repeated critical values of glucose, urea, Na+, K+, and Cl- did exceed TEa. In addition, parameters such as glucose and urea did not affect the clinical decision although their critical values exceeded the TEa. This study showed that critical values for Na+, K+, and Cl- may need to be repeated. Conclusions: Each laboratory should assess the requirement of repeating critical values under its own operating conditions and, accordingly, establish and implement a suitable policy.

Objectives: The ‘Rational Laboratory Use Project’ (RLUP) was launched in 2018 by the Department of Examination and Diagnosis Services under the General Directorate of Health Services of the Republic of Turkey’s Ministry of Health. In this study, we aimed to determine the rate of implementation of RLUP in medical biochemistry laboratories, and to contribute to new regulations by collecting the information and opinions of the laboratory experts participating the survey. Methods: Thirty questions were uploaded to an online survey tool (SurveyMonkey ^® , San Mateo, ABD). The first five were descriptive for laboratories. Among the remaining 25 questions, one is open-ended and addresses the various topics encompassed by the project’s scope. Results: The questionnaire was completed by 202 medical biochemistry specialists, of whom 82.12 % reported that they did not implement autoverification. 55.65 % defined consultations in Hospital Management Information System (HIMS), but; 70.49 % were not using it actively. 57.69 % of the participants answered, “I agree” to the statement “I think RLUP is feasible”. It was observed that the specialists tried to implement rational laboratory practices partially depending on their laboratory capacity, hospital administration and Laboratory Information Management System (LIMS). Conclusions: Increasing clinicians’ awareness could increase the success of this project, which might provide more effective diagnosis and treatment for the patient. In our view, actively involving stakeholders of the information management system, which is not under the direct control of laboratory professionals, in the RLUP will accelerate the development of the project.

Introduction: The aim of the this study was to assess the biological variation and reference change value (RCV) for creatinine in healthy individuals aged 18 - 45 years using both Jaffe and enzymatic methods. Methods: Blood samples were collected from ten females and ten males, for four consecutive weeks in our laboratory between November and December 2018. Samples were stored at -80 degrees C before analysis and dissolved in one run and analyzed in duplicate in a single study with the Beckman Coulter AU2700 biochemistry analyzer. Data was evaluated using CV-ANOVA, and analytical (CVA), intra-individual (CVI), and inter-individual (CVG) variations were calculated. The RCV was calculated using the formula. Results: The average CVA calculated at 95% confidence interval for creatinine using Jaffe's method was 2.51%, CVI was 4.51%, and CVG was 14.17%. The same measures for creatinine were 2.43%, 4.21% and 13.69%, respectively, using the enzymatic method. The individuality index (II) was 0.32 for the Jaffe's method and 0.31 for the enzymatic method. The average RCV calculated bilaterally in the 95% confidence interval for the Jaffe's and enzymatic methods were 14.26 and 13.43, respectively. Conclusions: This manuscript has underlined the fact that the II of creatinine is less than 0.6 indicating that the use of population-based reference intervals is limited, and interpretation of the RCV and analysis might be a more objective approach. Taken together, these results suggest that it could be valuable to calculate biological variation correctly and increase clinical awareness.