Clinical laboratory最新文献

Background: Viral gastroenteritis is a significant global health concern. An effective, rapid, and easy-to-use diagnostic tool is essential for screening causative viruses.

Methods: Forty-eight samples, known to be infected with one of the following viruses: norovirus, group A rotavirus, astrovirus, adenovirus, and sapovirus determined by reverse transcription-PCR and nucleotide sequencing, were evaluated by the Fast Track Diagnostics (FTD) viral gastroenteritis assay.

Results: The assay demonstrated 100% specificity for all viruses and matched the RT-PCR sensitivity for norovi-rus GI, classic human astrovirus, adenovirus, and sapovirus. It identified norovirus GII and rotavirus with 87.5% and 85.7% sensitivity, respectively. However, its sensitivity for detecting novel human astrovirus MLB and VA was lower, at 35%.

Conclusions: The FTD viral gastroenteritis assay can effectively screen simultaneously for norovirus GI, GII, group A rotavirus, adenovirus, and sapovirus in clinical settings. The study also suggests that improved detection methods are necessary for novel astrovirus strains.

Background: Except host and environmental factors influencing individual human cytokine responses, pre-analytical handling procedures and detection methods also affect cytokine levels.

Methods: In this study, we used cytometric bead array (CBA) and chemiluminescence (ECL). These two methods were used to test serum and plasma samples from 50 healthy adult volunteers and 50 rheumatoid arthritis (RA) patients' cytokine levels. We evaluated the impact of storage temperature, collection times, and additives in collection tubes on the measurement of IL-6, IL-8, and TNF-α.

Results: The finding of this study first indicated that the CBA assay for IL-6 and IL-8 showed excellent agreement with ECL for the same analysis, but the CBA assay and ECL for TNF-α measurement showed less agreement. Furthermore, we used two detection methods to find plasma cytokines showing more stability than serum cytokines, when the samples were stored at 4°C. Additionally, IL-8 concentration was affected by the storage conditions of whole blood from the time of collection until further processing at room temperature. We also found heparin tubes showed higher levels of IL-6 and TNF-α than other tubes at room temperature.

Conclusions: In general, the best values for IL-6, IL-8, and TNF-α were found in EDTA samples, stored at 4°C, and centrifuged quickly within 2 hours. The effect of pre-analytical handling procedures and detection methods on cytokine levels we identified would provide a basis for clinical cytokine detection.

Background: Hemoglobin G-Siriraj is a rare hemoglobin variant caused by a β-globin gene mutation (HBB: c.22G>A). The focus of this paper is aimed mainly at the chromatographic and electrophoretic properties of hemoglobin G-Siriraj for a presumptive identification. Notably, this is the first documented case of hemoglobin G-Siriraj in Morocco.

Methods: This hemoglobin variant was discovered in a 44-year-old Moroccan patient while measuring HbA1c with high-performance liquid chromatography. The discrepancies between capillary electrophoresis and the acid agarose electrophoresis led to suspicion of heterozygous hemoglobin G-Siriraj. Only the globin gene analysis can identify definitively this rare hemoglobin variant.

Conclusions: Rare hemoglobin variants represent a diagnostic challenge. Contextualizing cytological and biochemical explorations based on clinical data is essential for effectively guiding diagnosis.

Background: Candidiasis can be present as a cutaneous, mucosal, or deep-seated organ infection, which is caused by more than 20 types of Candida spp., with C. albicans being the most common. Hence, this work aimed to estimate some virulence factors, including phospholipase and biofilm formation, in some Candida spp.

Methods: A total of eighty-six specimens were collected from patients with oral and vaginal candidiasis and subjected into different examinations, including cultural characteristic (on Sabouraud Dextrose Agar SDA and chromogenic Candida agar) and microscopic examination and germ tube formation (GT)to isolate Candida spp. In addition, the egg-yolk agar plate method was used to determine the extracellular phospholipase production, and the microtiter plate method was used to determine biofilm formation of Candida spp. Vitek Compact equipment was used to identify the highest phospholipase and biofilm-producers of Candida spp.

Results: As a result of all examinations, 58.1% (n = 50/86) of isolates of Candida spp. were obtained, including 26.7% (n = 23/86) isolates of Candida spp. from oral cavity and 31.3% (n = 27/86) isolates of Candida spp. from vaginal cavity. These isolates included 58% (n = 29/50) C. albicans, 10% (n = 5/50) C. glabrata, 6% (n = 3/50) C. parasilosis, 6% (n = 3/50) C. krusei, 6% (n = 3/50) C. lusitaniae, 6% (n = 3/50) C. kefyr, 6% (n = 3/50) C. tropicalis, and 2% (n = 1/50) C. ciferrii. To quantify extracellular phospholipase production, the egg-yolk agar plate method was utilized. The results indicated that the majority of isolates (n = 33; 66%) were phospholipase-strong producers, 18% (n = 9) of isolates were phospholipase-moderate producers, 5% (n = 10) were phospholipase-weak producers, and 6% (n = 3) were non-phospholipase producers. Microtiter plate method was utilized to estimate formation of biofilm by Candida spp. obtained from vaginal and oral cavities. The majority of Candida spp. isolates (n = 32; 64%) were biofilm-strong producers, followed by 30% (n=15) moderate-biofilm producers and 6% (n = 3) weak-biofilm producers. The results of VITEK 2 system indicated that the probability of C. albicans, C. krusei, C. kefyr, C. tropicalis, C. lusitaniae, C. glabrata, and C. ciferrii was 98, 95, 94, 91, 85, 93, and 85 %, respectively.

Conclusions: Candida albicans was the most frequent isolate among all isolates.

Background: Platelets are correlated with myeloid leukemia (ML), but to date, there have been no studies confirming the causal relationship between them.

Methods: Platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) data were obtained from the GWAS catalog database as exposure factors. Acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) data were obtained from the FinnGen database as outcome indicators. The causal relationship between exposure and outcome was explored using the inverse variance weighted, MR-Egger, weighted median, and simple mode methods of dual-sample Mendelian randomization (MR). The stability and reliability of the results were assessed using Cochran's test, MR-Egger regression, and MR-PRESSO methods.

Results: An elevated PCT is positively associated with the risk of CML [ORMR-Egger = 2.591, 95% CI (1.089 - 6.166), p = 0.032; ORSimple mode = 9.873, 95% CI (1.112 - 87.646), p = 0.040]. There was no evidence of heterogeneity or plei-otropy at the gene level. However, there were no causal associations between other indices and CML, and none of the four platelet indices were causally associated with AML.

Conclusions: An increase in PCT significantly increases the risk of developing CML, making it a candidate biomarker for clinical screening of CML.

Background: Epidemics and pandemics have been shown to have widespread effects on health systems. Diabetes is a condition of particular risk during national emergencies such as the COVID-19 pandemic. The aim of this study is to determine the influence of COVID-19 in the patient's diabetes quality management.

Methods: We conducted a retrospective multicenter cohort study. Data from type 2 diabetes patients living in Sevilla were included into the study. The study was divided into two observation periods, before and during COVID-19. Metabolic status was assessed using the levels of hemoglobin A1c (A1C) measured during the pre- and CO-VID-19 period. The time interval between sequential A1C tests were also measured. We as well identified the loca-tions where the burden of diabetes quality management is clustered and their relation with demographic and economic factors.

Results: We included a total of 106,336 patients from four different hospitals. A significant number patients have worsened their quality management during COVID-19. During the first year of the pandemic, 72,235 patients did not have any hemoglobin A1c (A1C) control. By the time of data extraction, the time between A1C controls was significantly increased by 309 days (from 211 to 520). In addition, 34,001 patients who had A1C control during the COVID-19 period did not reveal a deterioration of their metabolic status. They showed a small but significant metabolic improvement indicated by reduced A1C levels from 52 mmol/mol to 51 mmol/mol. Just like the other group, these patients showed a significant increase of 29 days (from 195 to 224) between A1C controls. COVID-19 increased the substantial clustering for diabetes quality management in specific locations, mostly along the rural southeastern area of Sevilla and these variations were associated with economic and socio-demographic variants.

Conclusions: Our study highlighted the great impact of the COVID-19 in diabetes quality management exacerbating the previous inequities and disparities. Our results highlight the need for urgent patient intervention in the areas with high burdens of poorer quality management.

Background: The aim of this study was to explore the clinical value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in evaluating complications after endoscopic retrograde cholangiopancreatography (ERCP) in patients with common bile duct (CBD) stones.

Methods: Patients who were diagnosed with CBD stones and underwent ERCP from December 2021 to December 2023 were selected as the study subjects. According to whether postoperative complications occurred, they were divided into complication group (n = 28) and non-complication group (n = 132). The general clinical data, biochemical indexes, serum PCT, and CRP levels before ERCP and 4 hours and 24 hours after ERCP were compared. The changes of serum PCT and CRP levels in patients with different types of complications at 4 hours and 24 hours after ERCP were analyzed. The value of serum PCT, CRP levels, and combined indicators in distinguishing postoperative complications was analyzed.

Results: The proportion of previous pancreatitis and complications (hypertension and diabetes) in the complication group was higher than that in the non-complication group. Serum PCT and CRP levels of patients in the complication group were significantly higher than those in the non-complication group at 24 hours after ERCP (p < 0.001). Stratified according to the main types of complications, CRP level of patients with postoperative pancreatitis continued to increase at 4 hours and 24 hours after ERCP, while serum PCT increased only after 24 hours. When serum PCT and CRP levels were higher than 2.61 μg/mL and 68.18 mg/mL, respectively, at 24 hours after ERCP, the patients with postoperative complications could be well distinguished. The combination of the two indicators had a higher value in distinguishing patients with postoperative complications than the serum indicators alone.

Conclusions: The increase of serum PCT and CRP levels after ERCP is related to the complications after ERCP in patients with CBD stones. For patients with a high risk of complications after ERCP, the possibility of complications occurring can be evaluated by combined examination of serum PCT and CRP levels, and prevention and treatment measures can be taken as soon as possible.

Background: Alloantibodies for the Rh blood group are the most immunogenic antibodies found in the Chinese population, typically causing acute or delayed hemolytic transfusion reactions and fetal and neonatal hemolytic diseases. Autoantibodies are generally considered nonspecific, and approximately 50% of warm antibodies are secondary to a variety of diseases, especially hematologic tumors. In this case report, a rare autoantibody that mimics anti-C and anti-e specificity was identified.

Methods: A 17-year-old adolescent with aplastic anemia was awaiting transfusion due to anemia. Routine laboratory testing before transfusion revealed that antibody screening was positive. Antibody identification and blood group antigen typing were performed to identify antibody specificity.

Results: Antibodies in the patient's plasma and red blood cell release solution were identified as anti-C and anti-e specific. The patient's proximal red blood cells were separated by capillary centrifugation to identify the Rh blood group as DCeEe. Antibodies in the patient's plasma were suspected of being autoantibodies, a rare type of antibody. Screened C and e antigen-negative blood for transfusion was effective, and the patient's anemia was re-lieved. The patient was discharged after transfusion.

Conclusions: Finding suitable blood for transfusion in patients with hemolytic anemia caused by warm autoantibodies is a challenge. Managed mimic antibodies are the same as alloantibodies, and matching-related antigen-negative blood is the first choice for transfusion in patients with mimic warm autoantibodies. However, C and e antigen-negative blood is rare among the Chinese population.

Background: Due to the unique geographical and climatic conditions in Nagqu (Tibet), the blood station laboratory was only fully established and accredited by 2020. This study validated the performance of the laboratory's blood screening system and analyzed recent trends in blood donation and screening effectiveness.

Methods: Various serum samples were used to assess the performance of hepatitis B, hepatitis C, HIV, and syphilis tests, both serological and nucleic acid tests. Donation data were also collected and analyzed.

Results: Serological testing demonstrated excellent sensitivity, specificity, and reproducibility (all 100%), with detection limits for HBsAg, HCV Ab, HIV-1 Ab, HIV-1 p24, and TP Ab of 0.2 IU/mL, 0.013 NCU/mL, 0.25 NCU/mL, 1.25 U/mL, and 1.5 mIU/mL, respectively. Nucleic acid testing systems also achieved 100% reproducibility with precision below 5%. PROBIT analysis revealed the 95% detection limits for HBV DNA, HCV RNA, and HIV-1 RNA as 8.29, 97.14, and 40.52 IU/mL, respectively. The study also found a high rate of unqualified donations for local markers such as ALT, HBsAg, syphilis, and HBV DNA.

Conclusions: The validation confirmed the screening system's high sensitivity, specificity, and reproducibility, highlighting the importance of effective predonation checks to ensure a safe blood supply in high-altitude areas.

Background: Cytolytic vaginosis (CV) is a condition characterized by an increase in lactobacilli in the vaginal flora, causing complaints of discharge, itching, dyspareunia, and dysuria. Since there are no antimicrobials in the treatment protocols of CV, the diagnostic and therapeutic criteria of which were first defined by Cibley, differential diagnosis of CV from other vaginitis agents will prevent unnecessary use of antimicrobials and recurrent com-plaints. In our study, we aimed to determine the frequency of CV in patients presenting with vaginitis complaints and the diagnostic accuracy of the diagnostic criteria.

Methods: In total, 140 women, 103 with vaginitis complaints and 37 without vaginitis complaints, were examined for bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), Trichomonas vaginalis (Tv), and CV. For the diagnosis of CV, vaginal pH ≤ 4.5, the presence of a large number of lactobacilli in Gram staining, the presence of false clue cells, cytolysis in vaginal epithelial cells, leukocyte deficiency or absence, absence of Tv, BV, or VVC were used.

Results: Out of 103 patients, 30 (29.1%) had BV, 20 (19.4%) had VVC, 20 (19.4%) had CV, 5 (4.9%) had BV and VVC, and 4 (3.9%) had Tv. The sensitivity and specificity of the diagnostic criteria were 80% and 99% for epithelial cytolysis, 70% and 99% for false clue cells, 100% and 86% for pH ≤ 4.5, and 100% and 56% for numerous lactobacilli, respectively.

Conclusions: In Turkey and worldwide, CV is not considered in vaginitis cases. In our study, the high rate of 19.4% in vaginitis cases shows the need for comprehensive research on this subject.