BackgroundSubclinical hypothyroidism is a situation in which the thyroid-stimulating hormone (TSH) value exceeds the upper limit of normal, but the free triiodothyronine (T3) and thyroxine (T4) values are within the normal range. The etiology is similar to overt hypothyroidism.Case presentationAn 18-year-old female patient was referred to our endocrinology clinic due to elevated TSH levels detected during a routine examination. She was clinically euthyroid and had a normal thyroid ultrasound pattern. The TSH concentration was measured twice independently, giving values of 5.65 μIU/mL and 5.47 μIU/mL. The polyethylene glycol (PEG) method for TSH measurement was used to determine the concentration of macro-TSH (m-TSH), a macromolecule formed between TSH and immunoglobulin (Ig). Using the same blood samples for which the TSH levels were found to be high, the PEG method found TSH levels to be within a normal range, with values of 1.50 μIU/mL (5.65–1.50 μIU/mL measured; a decrease of 75%) and 1.26 μIU/mL (5.47–1.26 μIU/mL measured; a decrease of 77%), respectively. The TSH values determined by the PEG precipitation test were markedly low, with PEG-precipitable TSH ratios greater than 75%.ConclusionsThe cause of 55% of subclinical hypothyroidism is chronic autoimmune thyroiditis. However, it is necessary to exclude other TSH-elevated conditions for diagnosis. One of these conditions is m-TSH, which should be kept in mind even though it is rarely seen. m-TSH should be considered especially in patients who have a TSH value above 10 μIU/mL without hypothyroidism symptoms or who require a higher levothyroxine replacement dose than expected to make them euthyroid.

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Objectives: Vitamin D is a well-known hormone and important for many metabolic pathways and different health outcomes. The physiology of vitamin D is very complex. Multiple factors like ethnicity, age, sex, diseases, and medication influence vitamin D concentrations. In this study, our aim was to determine the prevalence of vitamin D deficiency among adults in Turkey. Materialmethods: The 25(OH) vitD3 test results of 2007 patients admitted to Selçuk University Medicine Faculty hospital between the years of 2015 and 2016 were analyzed, retrospectively. Patients using any vitamin D consisting drug, having chronic disease and inflammatory disorders were excluded. Vitamin D levels were measured by a chromatographic method (LC/MS/MS) with API3200 which is the gold standard to measure 25(OH)D3. Results: Our results show that the prevalence of vitamin D deficiency is about 67.9% in our society. The mean value of vitamin D was 16,87 ng/mL and females had significantly lower 25(OH)D3 levels compared to males (p<0.001).The 25(OH)D3 levels were higher in summer and in fall than in winter and spring. (p<0.001) Conclusıons: The results indicate that vitamin D deficiency is prevalent in this study population despite high levels of sunshine and UV radiation throughout the year. Preventive treatments should be planned.

Objectives: Urine dipstick is the first step laboratory test to diagnose a urinary tract infection (UTI) which is a common infectious disease diagnosed in the laboratories. Early treatment of UTI is very important in order to prevent long-term complications. The gold standard to diagnose UTI is urine culture so there are a number of unnecessary urine culture requests. However, urine culture results are not available earlier than 24-36 hours. Besides, urine culture is expensive and causes time-consuming of treatment. Our aim in this study was to compare urine leukocyte esterase test and nitrite test of urine dipstick with urine culture to determinate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV). Methods: Urine culture results and urine dipstick test results of patients who admitted to Selçuk University Hospital between May 2016 and May 2017 were collected retrospectively. The study included 11.169 patients and 3299 of them have positive urine cultures. Results: In total, 3299 (29.5%) patients have positive urine culture. Out of these culture positive samples, positive dipstick results' ratios for leukocyte esterase and nitrite were 82.8% (n = 2733) and 22.4% (n = 774). Leukocyte esterase had 82.8% sensitivity and 68.1% specificity, with PPVs and NPVs of 52.1% and 90.5%, respectively. Conclusions: The NPVs are found significantly higher than PPVs and it shows that urinary dipstick is more reliable to exclude disease than to diagnose the disease. Clinicians should not order urine culture from all patients without ant clinic signs.

Objectives Micro- and macrovascular endothelial deterioration has been mentioned in diabetic pregnants with critical clinical outcome for the fetus. Our aim was to measure serum and cord blood concentrations of methylated arginines in patients with gestational diabetes and find a relationship with endothelial dysfunction. Materials and methods Methylated arginines were detected with high performance liquid chromatography mass spectrometry via electrospray ionization positive technique with a chromatographic C18 column. Results Although gestational diabetes mellitus (GDM) groups’ asymmetric dimethylarginine (ADMA) levels were higher compared to control group, this difference was not significant. Control cord blood ADMA and N-monomethylarginine levels were significantly higher than insulin-regulated GDM cord blood ADMA and N-monomethylarginine levels (p=0.001; p=0.003, respectively). Diet-regulated GDM group’s cord blood N-monomethylarginine was significantly higher than insulin-regulated GDM group’s cord blood N-monomethylarginine (p=0.045). A negative correlation was found between cord blood symmetric dimethylarginine and oral glucose tolerance testing 0h glucose values (r=−0.453, p=0.002). Conclusions According to this study’s results, methylated arginine levels may not be associated with endothelial deterioration in GDM otherwise with preeclampsia risk.