Journal of Clinical Laboratory Analysis最新文献_第2页

Serum Lipid Profile and Electrolytes Reference Intervals for Apparently Healthy Children and Adolescents in Addis Ababa, Ethiopia 埃塞俄比亚亚的斯亚贝巴健康儿童和青少年的血清血脂和电解质参考区间。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-21 DOI: 10.1002/jcla.25116

Ousman Mohammed, Melkitu Kassaw, Endalkachew Befekadu, Letebrhan G/Egzeabher, Yosef Tolcha, Feyissa Challa, Adisu Kebede, Genet Ashebir, Mehari Meles, Fatuma Hassen, Biruk Zerfu, Dessie Abera, Abiy Belay, Fikirte Aboneh, Daniel Hailu, Workabeba Abebe, Kassu Desta, Mistire Wolde, Aster Tsegaye

Background

Accurate reference intervals generated from an apparently healthy population and stratified by crucial variables such as age and gender are required to guarantee appropriate interpretation of test results. Since there were no local reference intervals in the study area, the present study aimed to establish reference intervals on serum lipid profiles and electrolytes for children and adolescents in Addis Ababa.

Methods

This community-based cross-sectional study was conducted from April to October 2019. Laboratory analysis was performed using the automatic biochemical analyzer Cobas 6000 (c501) from Roche. According to Clinical and Laboratory Standards Institute (CLSI) guidelines, reference intervals for lipid profile and electrolyte tests for apparently healthy children and adolescents were established. We used a non-parametric method to calculate the 2.5th and 97.5th percentiles with a 90% confidence interval.

Results

In children, the reference intervals for serum potassium, sodium, chloride, calcium, magnesium, and phosphate in mmol/L were 4.37–5.20, 137–145.50, 101.90–107.90, 2.34–2.70, 0.74–0.97, and 1.42–1.85, respectively; and for total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein, the respective values were 100.76–171.70, 44.16–126.36, 60.60–105.60, and 31.60–53.70 in mg/dL, for both genders. For adolescents, the reference intervals were 4.03–5.58, 137–146, 98.90–120.90, 2.39–2.70, 0.73–0.96, and 0.96–1.80 for serum potassium, sodium, chloride, calcium, magnesium, and phosphate in mmol/L, respectively; and 97.20–189.10, 40.50–143.60, 41.70–120.90, and 21.30–57.0 in mg/dL for total cholesterol, triglycerides, low-density lipoprotein, and high-density lipoprotein, respectively, for both genders.

Conclusion

The established reference intervals in the current study revealed that both the lower and upper limits contradicted the manufacturer values as well as the available literature. The study also discovered significant gender differences in reference values for TC, TG, LDL-C, potassium, phosphate, and chloride in the adolescent age groups.

背景：为了保证对检测结果做出正确的解释，需要从表面健康的人群中得出准确的参考区间，并根据年龄和性别等关键变量进行分层。由于研究地区没有当地的参考区间，本研究旨在为亚的斯亚贝巴的儿童和青少年建立血清脂质和电解质的参考区间：这项基于社区的横断面研究于 2019 年 4 月至 10 月进行。使用罗氏公司生产的自动生化分析仪 Cobas 6000（c501）进行实验室分析。根据临床和实验室标准协会（CLSI）指南，为表面健康的儿童和青少年确定了血脂和电解质检测的参考区间。我们采用非参数法计算了 2.5 百分位数和 97.5 百分位数，置信区间为 90%：结果：在儿童中，血清钾、钠、氯、钙、镁和磷酸盐的参考区间（单位：mmol/L）分别为 4.37-5.20、137-145.50、101.90-107.90、2.34-2.70、0.74-0.97 和 1.42-1.85；总胆固醇的参考区间（单位：mmol/L）为 1.42-1.85。以毫克/分升为单位，男女总胆固醇、甘油三酯、低密度脂蛋白和高密度脂蛋白的参考值分别为 100.76-171.70、44.16-126.36、60.60-105.60 和 31.60-53.70。对于青少年，血清钾、钠、氯、钙、镁和磷酸盐的参考区间分别为 4.03-5.58、137-146、98.90-120.90、2.39-2.70、0.73-0.96 和 0.96-1.80（单位：毫摩尔/升）；以及 97.总胆固醇、甘油三酯、低密度脂蛋白和高密度脂蛋白分别为 97.20-189.10、40.50-143.60、41.70-120.90 和 21.30-57.0（毫克/分升）：本次研究中确定的参考区间显示，其下限和上限均与生产商提供的数值以及现有文献相矛盾。研究还发现，在青少年年龄组中，TC、TG、LDL-C、钾、磷酸盐和氯化物的参考值存在明显的性别差异。

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引用次数: 0

Cutoff Values for Glycated Albumin, 1,5-Anhydroglucitol, and Fructosamine as Alternative Markers for Hyperglycemia 糖化白蛋白、1,5-脱水葡萄糖醇和果糖胺作为高血糖替代标记物的临界值。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-15 DOI: 10.1002/jcla.25097

Hui-Jin Yu, Chang-Hun Park, Kangsu Shin, Hee-Yeon Woo, Hyosoon Park, Eunju Sung, Min-Jung Kwon

Background

Glycated albumin (GA), 1,5-anhydroglucitol (1,5-AG), and fructosamine have attracted considerable interest as markers of hyperglycemia. This study aimed to evaluate the optimal cutoff values for GA, 1,5-AG, and fructosamine and to determine their respective diagnostic efficacies in relation to hyperglycemia.

Methods

We enrolled 6012 individuals who had undergone fasting blood glucose (FBG) and Hemoglobin A1c (HbA1c) tests along with at least one alternative glycemic marker. Receiver operating characteristic (ROC) curves and the upper or lower limit of the reference range (97.5 or 2.5 percentiles) were used to ascertain the optimal cutoff values. Follow-up data from healthy individuals were used to identify patients who developed diabetes mellitus (DM).

Results

The ROC cutoff values for GA, 1,5-AG, and fructosamine were 13.9%, 13.3 μg/mL, and 278 μmol/L, respectively, with corresponding area under the curve (AUC) values of 0.860, 0.879, and 0.834. The upper limits of the reference intervals for GA and fructosamine were 15.1% and 279 μmol/L, respectively, and the lower limit for 1,5-AG was 5.3 μg/mL. Among the GA cutoff values, the ROC cutoff had the highest sensitivity. Analyzing the follow-up data showed that lowering the GA cutoff from 16.0% to 13.9% identified an additional 40 people with DM progression.

Conclusions

Lowering the GA cutoff values significantly increased the sensitivity of DM diagnosis and enhanced its potential as a screening marker by identifying more individuals with diabetes progression. Conversely, modifications to the cutoff values for 1,5-AG and fructosamine did not confer any discernible diagnostic or predictive advantages.

背景：糖化白蛋白（GA）、1,5-脱水葡萄糖醇（1,5-AG）和果糖胺作为高血糖的标志物引起了广泛关注。本研究旨在评估 GA、1,5-AG 和果糖胺的最佳临界值，并确定它们各自对高血糖的诊断效果：我们招募了 6012 名接受过空腹血糖 (FBG) 和血红蛋白 A1c (HbA1c) 检测以及至少一种其他血糖标志物检测的患者。采用接收者操作特征曲线（ROC）和参考范围的上限或下限（97.5 或 2.5 百分位数）来确定最佳临界值。利用健康人的随访数据来确定糖尿病（DM）患者：GA、1,5-AG 和果糖胺的 ROC 临界值分别为 13.9%、13.3 μg/mL 和 278 μmol/L，相应的曲线下面积 (AUC) 值分别为 0.860、0.879 和 0.834。GA 和果糖胺的参考区间上限分别为 15.1% 和 279 μmol/L，1,5-AG 的下限为 5.3 μg/mL。在 GA 临界值中，ROC 临界值的灵敏度最高。对随访数据的分析表明，将GA临界值从16.0%降低到13.9%，可额外发现40名DM进展患者：结论：降低 GA 临界值可显著提高糖尿病诊断的灵敏度，并通过识别更多的糖尿病进展患者提高其作为筛查标志物的潜力。相反，1,5-AG 和果糖胺临界值的修改并没有带来任何明显的诊断或预测优势。

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引用次数: 0

The Bacterial Species Behind the Wound and Their Antibacterial Resistant Pattern: A Three-Year Retrospective Study at St. Dominic Hospital, Akwatia, Ghana 伤口背后的细菌种类及其抗菌模式：加纳 Akwatia 圣多米尼克医院的三年回顾性研究。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-14 DOI: 10.1002/jcla.25114

John Gameli Deku, Enoch Aninagyei, Israel Bedzina, Francisca Esenam Goloe, Vida Angmorkie Eshun, Eunice Agyei, Jonathan Maniye Nmoandor, Richard Vikpebah Duneeh, Kwabena Obeng Duedu

Background

Wound infections are often underestimated issues that can lead to chronic illnesses, and since the introduction of antibiotics, wound complications have become less common. However, due to the increased and irrational use of these antibiotics, the resistance in the bacterial isolates has become very common. This has led to reduced treatment options, delay in wound healing, and high treatment costs. This study aimed to investigate bacterial wound infections and their antibiotic resistance at St. Dominic Hospital, Ghana.

Methods

A total of 517 records of wound swab culture and susceptibility testing, and patient demographics from 2020 to 2022 were collected from the microbiology unit of St. Dominic Hospital in the Eastern Region of Ghana. The data were entered into Microsoft Excel 2019, cleaned, and exported into IBM SPSS v26 for the statistical analysis. p < 0.05 was considered statistically significant for all analyses.

Results

The overall prevalence of bacteriological agents causing wound infection in individuals who visited the St. Dominic Hospital from 2020 to 2022 was 70.21% (363/517), with S. aureus 79/363 (21.76%) being the most abundant isolate. Out of the 79 S. aureus isolated, 40 (50.63%) and 39 (49.37%) were resistant to ampicillin and cephalexin, respectively. More than 50% of the predominant Gram-negative isolate, K. pneumoniae, were resistant to clindamycin 45/72 (62.50%) but susceptible to levofloxacin 70/72 (97.22%), cefotetan 69/72 (95.83%), and chloramphenicol 67/72 (93.06%).

Conclusion

Antibacterial susceptibility patterns revealed significant resistance trends, particularly among Gram-negative isolates, emphasizing the urgent need for prudent antibiotic use and ongoing surveillance to combat resistance.

背景：伤口感染往往是一个被低估的问题，它可能导致慢性疾病，自从抗生素问世以来，伤口并发症已变得不那么常见。然而，由于这些抗生素使用的增加和不合理，细菌分离物的抗药性变得非常普遍。这导致治疗方案减少，伤口愈合延迟，治疗费用高昂。本研究旨在调查加纳圣多米尼克医院的细菌伤口感染及其抗生素耐药性：从加纳东部地区的圣多米尼克医院微生物室收集了 2020 年至 2022 年期间的 517 份伤口拭子培养和药敏试验记录以及患者人口统计数据。数据输入 Microsoft Excel 2019，经过清理后导出到 IBM SPSS v26 进行统计分析：2020 年至 2022 年期间，在圣多米尼克医院就诊的患者中，导致伤口感染的细菌病原体的总体流行率为 70.21%（363/517），其中金黄色葡萄球菌 79/363（21.76%）是最多的分离菌株。在分离出的 79 个金黄色葡萄球菌中，分别有 40 个（50.63%）和 39 个（49.37%）对氨苄西林和头孢菌素产生耐药性。超过 50%的主要革兰氏阴性分离菌肺炎双球菌对克林霉素 45/72 （62.50%）具有耐药性，但对左氧氟沙星 70/72 （97.22%）、头孢替坦 69/72 （95.83%）和氯霉素 67/72 （93.06%）具有敏感性：抗菌药敏感性模式显示出明显的耐药性趋势，尤其是在革兰氏阴性分离株中，这强调了谨慎使用抗生素和持续监测以消除耐药性的迫切需要。

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引用次数: 0

The Neutrophil Percentage-to-Albumin Ratio as a Biomarker for All-Cause and Diabetes-Cause Mortality Among Diabetes Patients: Evidence From the NHANES 1988–2018 中性粒细胞百分比与白蛋白比率作为糖尿病患者全因死亡率和糖尿病致死率的生物标志物：来自1988-2018年NHANES的证据。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-10 DOI: 10.1002/jcla.25110

Yuanyuan Jing, Bowen Tian, Wenzhen Deng, Ziyu Ren, Xunmei Xu, Dongmin Zhang, Jing Zeng, Dongfang Liu

Background

Neutrophil percentage-to-albumin ratio (NPAR) was significantly correlated with diabetes-related complications. There are little data about NPAR and mortality risk in individuals with diabetes.

Methods

This study included 3858 diabetes patients from the National Health and Nutrition Examination Survey (NHANES) conducted from 1988 to 2018. Using a restricted cubic spline (RCS), the relationship between the NPAR and mortality risk was shown. Multivariable Cox regression models were used to evaluate the relationship between the NPAR and diabetes-cause and all-cause death. An examination of the time-dependent receiver operating characteristic curve (ROC) was used to assess how well the NPAR predicted survival outcomes.

Results

Among 3858 diabetes individuals, a total of 1198 (31.1%) died over a mean follow-up of 7.86 years; of these, 326 (8.4%) had diabetes-related deaths and 872 (22.6%) had deaths from other causes. The RCS regression analysis showed a positive linear association between the NPAR and all-cause and diabetes-cause mortality. High NPAR group had a significantly higher risk of all-cause and diabetes-cause mortality in univariate and multivariate analysis. Compared with low NPAR group, high NPAR group had a low survival rate of diabetes cases in all-cause death and diabetes-cause mortality with area under the curve of the 3-, 5-, and 10-year ROC curve being 0.725, 0.739, and 0.734 for all-cause mortality and 0.754, 0.752, and 0.745 for diabetes-cause mortality, respectively.

Conclusion

In summary, we examined 3858 diabetes patients from NHANES database (1998–2018) and suggested NPAR as a biomarker for all-cause and diabetes-cause mortality prediction.

背景：中性粒细胞百分比与白蛋白比率（NPAR）与糖尿病相关并发症有显著相关性。有关 NPAR 和糖尿病患者死亡风险的数据很少：本研究纳入了 3858 名糖尿病患者，这些患者来自 1988 年至 2018 年进行的美国国家健康与营养调查（NHANES）。使用受限立方样条曲线（RCS）显示了NPAR与死亡风险之间的关系。多变量 Cox 回归模型用于评估 NPAR 与糖尿病病因死亡和全因死亡之间的关系。利用与时间相关的接收器操作特征曲线（ROC）来评估 NPAR 预测生存结果的能力：在 3858 名糖尿病患者中，共有 1198 人（31.1%）在平均 7.86 年的随访期间死亡，其中 326 人（8.4%）与糖尿病相关，872 人（22.6%）死于其他原因。RCS回归分析显示，NPAR与全因死亡率和糖尿病病因死亡率呈正线性关系。在单变量和多变量分析中，高 NPAR 组的全因和糖尿病原因死亡风险明显更高。与低NPAR组相比，高NPAR组糖尿病病例在全因死亡和糖尿病病因死亡中的存活率较低，3年、5年和10年ROC曲线下面积分别为：全因死亡0.725、0.739和0.734，糖尿病病因死亡0.754、0.752和0.745：综上所述，我们研究了NHANES数据库（1998-2018年）中的3858名糖尿病患者，并建议将NPAR作为预测全因死亡率和糖尿病病因死亡率的生物标志物。

{"title":"The Neutrophil Percentage-to-Albumin Ratio as a Biomarker for All-Cause and Diabetes-Cause Mortality Among Diabetes Patients: Evidence From the NHANES 1988–2018","authors":"Yuanyuan Jing, Bowen Tian, Wenzhen Deng, Ziyu Ren, Xunmei Xu, Dongmin Zhang, Jing Zeng, Dongfang Liu","doi":"10.1002/jcla.25110","DOIUrl":"10.1002/jcla.25110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Neutrophil percentage-to-albumin ratio (NPAR) was significantly correlated with diabetes-related complications. There are little data about NPAR and mortality risk in individuals with diabetes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 3858 diabetes patients from the National Health and Nutrition Examination Survey (NHANES) conducted from 1988 to 2018. Using a restricted cubic spline (RCS), the relationship between the NPAR and mortality risk was shown. Multivariable Cox regression models were used to evaluate the relationship between the NPAR and diabetes-cause and all-cause death. An examination of the time-dependent receiver operating characteristic curve (ROC) was used to assess how well the NPAR predicted survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 3858 diabetes individuals, a total of 1198 (31.1%) died over a mean follow-up of 7.86 years; of these, 326 (8.4%) had diabetes-related deaths and 872 (22.6%) had deaths from other causes. The RCS regression analysis showed a positive linear association between the NPAR and all-cause and diabetes-cause mortality. High NPAR group had a significantly higher risk of all-cause and diabetes-cause mortality in univariate and multivariate analysis. Compared with low NPAR group, high NPAR group had a low survival rate of diabetes cases in all-cause death and diabetes-cause mortality with area under the curve of the 3-, 5-, and 10-year ROC curve being 0.725, 0.739, and 0.734 for all-cause mortality and 0.754, 0.752, and 0.745 for diabetes-cause mortality, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In summary, we examined 3858 diabetes patients from NHANES database (1998–2018) and suggested NPAR as a biomarker for all-cause and diabetes-cause mortality prediction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"38 21","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142466713","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Detection of Rifampicin Resistance rpoB Gene Using GeneXpert MTB/RIF Assay in Pulmonary Tuberculosis Cases at Debre Tabor Comprehensive Specialized Hospital, Northwest Ethiopia 使用 GeneXpert MTB/RIF 检测法检测埃塞俄比亚西北部 Debre Tabor 综合专科医院肺结核病例的利福平耐药 rpoB 基因。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-10 DOI: 10.1002/jcla.25111

Bekele Sharew, Ayenew Berhan, Andargachew Almaw, Mulat Erkihun, Tegenaw Tiruneh, Teklehaimanot Kiros, Yenealem Solomon, Mitikie Wondmagegn, Etenesh Wondimu, Abay Teshager, Simegnew Bihonegn, Mihret Tilahun, Birhanu Getie

Background

Tuberculosis (TB) is a preventable and treatable disease leading to the second death globally. The evolution of drug resistance in Mycobacterium tuberculosis (MTB), particularly rifampicin resistance (RR), has hampered TB control efforts. Thus, this study aimed to provide information regarding the magnitude of MTB and rifampicin resistance among patients tested using the GeneXpert method.

Methods

A retrospective analysis was carried out at DTCSH. The study included TB registration logbook data from all patients who visited the hospital and were tested for MTB with the Xpert MTB/RIF assay from 2017 to 2024. The laboratory-based data were entered, cleaned, and analyzed using SPSS version 26 software. Multilogistic regression analysis was employed, and a p value ≤ 0.05 was considered statistically significant.

Results

A total of 12,981 patient results were included, of which 8.9% (1160/12,981) were MTB-positive and 7.1% (82/1160) were RR. Individuals aged 15–29 years (AOR = 2.13; 95% CI = 1.55–2.93, p < 0.001), living in rural areas (AOR = 1.23; 95% CI = 1.08–1.41, p = 0.003), and HIV+ (AOR = 1.79; 95% CI = 1.48–2.33, p < 0.001) had a higher risk of developing tuberculosis. While RR was identified in 63.4% (52/82) of new, 24.4% (20/82) of re-treated, and 12.2% (10/82) of failed presumptive TB patients.

Conclusion

In this study, MTB and RR trends were high. Productive age groups, rural populations, and HIV patients were at risk. To lessen the burden of this contagious and fatal disease, it is recommended to increase early diagnosis of drug-resistant TB and enhance infection control.

背景：结核病（TB）是一种可预防、可治疗的疾病，是全球第二大死亡病例。结核分枝杆菌（MTB）耐药性的演变，特别是利福平耐药性（RR），阻碍了结核病的控制工作。因此，本研究旨在提供有关使用 GeneXpert 方法检测的患者中 MTB 和利福平耐药性程度的信息：方法：在 DTCSH 进行了一项回顾性分析。研究包括2017年至2024年期间到医院就诊并接受Xpert MTB/RIF检测的所有患者的结核病登记日志数据。实验室数据使用 SPSS 26 版软件进行输入、清理和分析。采用多逻辑回归分析，P值≤0.05为具有统计学意义：共纳入 12981 例患者，其中 MTB 阳性患者占 8.9%（1160/12981），RR 患者占 7.1%（82/1160）。15-29 岁人群（AOR = 2.13；95% CI = 1.55-2.93，P 结论：MTB 和 RR 阳性率与年龄有关：在这项研究中，MTB 和 RR 呈上升趋势。生产年龄组、农村人口和艾滋病毒感染者面临风险。为了减轻这种传染性致命疾病的负担，建议增加耐药结核病的早期诊断并加强感染控制。

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引用次数: 0

Prognostic Nutritional Index is Related to All-Cause Mortality in Patients With Stage IV Colorectal Cancer Treated With Capecitabine: Single-Center 24-Month Observational Study in Vietnam 预后营养指数与接受卡培他滨治疗的 IV 期结直肠癌患者的全因死亡率相关：越南单中心 24 个月观察研究》。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-08 DOI: 10.1002/jcla.25112

Hung Nguyen Quang, Luan Nguyen Duc, Hieu Hoang Van, Hai Vu Anh, Kien Nguyen Trung, Thang Le Viet

Aim

To determine the mortality rate and the predictive value of the prognostic nutritional index (PNI) for all-cause mortality during the 24 months in patients with stage IV colorectal cancer treated with capecitabine.

Methods

We conducted a study on 87 stage IV colorectal cancer patients treated with capecitabine. Before the day of treatment, all patients were measured CEA and CRP-hs levels and calculated neutrophil/lympho ratio (NLR) and PNI. Patients were monitored and collected drug side effects and mortality for 24 months.

Results

The mortality rate of study subjects was 60.9%. CRP-hs, NLR, and PNI were independent factors associated with 24-month mortality in patients with stage IV colorectal cancer (p < 0.05 to p < 0.01). At a cut-off value of 38.51, PNI was a predictor for mortality, with the area under the curve (AUC) of 0.88 and p < 0.001.

Conclusions

PNI was a good predictor of all-cause mortality in patients with stage IV colorectal cancer treated with capecitabine for 24 months.

目的：确定接受卡培他滨治疗的 IV 期结直肠癌患者在 24 个月内的死亡率以及预后营养指数（PNI）对全因死亡率的预测价值：我们对87名接受卡培他滨治疗的IV期结直肠癌患者进行了研究。在治疗前一天，所有患者均测量了 CEA 和 CRP-hs 水平，并计算了中性粒细胞/淋巴细胞比率（NLR）和 PNI。对患者进行24个月的监测，并收集药物副作用和死亡率的数据：研究对象的死亡率为 60.9%。CRP-hs、NLR和PNI是与IV期结直肠癌患者24个月死亡率相关的独立因素（P 结论：PNI是预测IV期结直肠癌患者24个月死亡率的良好指标：PNI 是预测接受卡培他滨治疗 24 个月的 IV 期结直肠癌患者全因死亡率的良好指标。

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引用次数: 0

Clustering Based on Laboratory Data in Patients With Heart Failure Admitted to the Intensive Care Unit 基于实验室数据对重症监护室收治的心力衰竭患者进行分组。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-04 DOI: 10.1002/jcla.25109

Sepehr Nemati, Babak Mohammadi, Zahra Hooshanginezhad

Background

Heart failure (HF) is a common condition that imposes a significant burden on healthcare systems. We aimed to identify subgroups of patients with heart failure admitted to the ICU using routinely measured laboratory biomarkers.

Methods

A large dataset (N = 1176) of patients with heart failure admitted to the ICU at the Beth Israel Deaconess Medical Center in Boston, USA, between June 1, 2001, and October 31, 2012, was analyzed. We clustered patients to identify laboratory phenotypes. Cluster profiling was then performed to characterize each cluster, using a binary logistic model.

Results

Two distinct clusters of patients were identified (N = 679 and 497). There was a significant difference in the mortality rate between Clusters 1 and 2 (50 [7.4%] vs. 109 [21.9%], respectively, p < 0.001). Patients in the Cluster 2 were significantly older (mean [SD] age = 72.35 [14.40] and 76.37 [11.61] years, p < 0.001) with a higher percentage of chronic kidney disease (167 [24.6%] vs. 262 [52.7%], respectively, p < 0.001). The logistic model was significant (Log-likelihood ratio p < 0.001, pseudo R² = 0.746) with an area under the curve of 0.905. The odds ratio for leucocyte count, mean corpuscular volume (MCV), red blood cell (RBC) distribution width, hematocrit (HcT), lactic acid, blood urea nitrogen (BUN), serum potassium, magnesium, and sodium were significant (all p < 0.05).

Conclusion

Laboratory data revealed two phenotypes of ICU-admitted patients with heart failure. The two phenotypes are of prognostic importance in terms of mortality rate. They can be differentiated using blood cell count, kidney function status, and serum electrolyte concentrations.

背景：心力衰竭（HF）是一种常见疾病，给医疗系统带来了沉重负担。我们的目的是利用常规测量的实验室生物标记物确定入住重症监护室的心衰患者亚群：我们分析了 2001 年 6 月 1 日至 2012 年 10 月 31 日期间美国波士顿贝斯以色列女执事医疗中心重症监护室收治的大量心衰患者数据集（N = 1176）。我们对患者进行了聚类，以确定实验室表型。然后使用二元逻辑模型进行聚类分析，以确定每个聚类的特征：结果：确定了两个不同的患者群组（N = 679 和 497）。群组 1 和群组 2 的死亡率有明显差异（分别为 50 [7.4%] 对 109 [21.9%]，P 2 = 0.746），曲线下面积为 0.905。白细胞计数、平均血球容积（MCV）、红细胞（RBC）分布宽度、血细胞比容（HcT）、乳酸、血尿素氮（BUN）、血清钾、镁和钠的几率比均显著（均为 p 结论）：实验室数据显示，入住 ICU 的心力衰竭患者有两种表型。就死亡率而言，这两种表型对预后具有重要意义。可通过血细胞计数、肾功能状态和血清电解质浓度对它们进行区分。

{"title":"Clustering Based on Laboratory Data in Patients With Heart Failure Admitted to the Intensive Care Unit","authors":"Sepehr Nemati, Babak Mohammadi, Zahra Hooshanginezhad","doi":"10.1002/jcla.25109","DOIUrl":"10.1002/jcla.25109","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Heart failure (HF) is a common condition that imposes a significant burden on healthcare systems. We aimed to identify subgroups of patients with heart failure admitted to the ICU using routinely measured laboratory biomarkers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A large dataset (<i>N</i> = 1176) of patients with heart failure admitted to the ICU at the Beth Israel Deaconess Medical Center in Boston, USA, between June 1, 2001, and October 31, 2012, was analyzed. We clustered patients to identify laboratory phenotypes. Cluster profiling was then performed to characterize each cluster, using a binary logistic model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Two distinct clusters of patients were identified (<i>N</i> = 679 and 497). There was a significant difference in the mortality rate between Clusters 1 and 2 (50 [7.4%] vs. 109 [21.9%], respectively, <i>p</i> < 0.001). Patients in the Cluster 2 were significantly older (mean [SD] age = 72.35 [14.40] and 76.37 [11.61] years, <i>p</i> < 0.001) with a higher percentage of chronic kidney disease (167 [24.6%] vs. 262 [52.7%], respectively, <i>p</i> < 0.001). The logistic model was significant (Log-likelihood ratio <i>p</i> < 0.001, pseudo <i>R</i><sup>2</sup> = 0.746) with an area under the curve of 0.905. The odds ratio for leucocyte count, mean corpuscular volume (MCV), red blood cell (RBC) distribution width, hematocrit (HcT), lactic acid, blood urea nitrogen (BUN), serum potassium, magnesium, and sodium were significant (all <i>p</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Laboratory data revealed two phenotypes of ICU-admitted patients with heart failure. The two phenotypes are of prognostic importance in terms of mortality rate. They can be differentiated using blood cell count, kidney function status, and serum electrolyte concentrations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15509,"journal":{"name":"Journal of Clinical Laboratory Analysis","volume":"38 21","pages":""},"PeriodicalIF":2.6,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Evaluating Bacterial Viability in Faecal Microbiota Transplantation: A Comparative Analysis of In Vitro Cultivation and Membrane Integrity Methods 评估粪便微生物群移植中的细菌活力：体外培养和膜完整性方法的比较分析。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-10-03 DOI: 10.1002/jcla.25105

Ivana Cibulková, Veronika Řehořová, Marek Wilhelm, Hana Soukupová, Jan Hajer, František Duška, Helena Daňková, Monika Cahová

Background

Faecal microbiota transplantation (FMT) is a developing therapy for disorders related to gut dysbiosis. Despite its growing application, standardised protocols for FMT filtrate preparation and quality assessment remain undeveloped. The viability of bacteria in the filtrate is crucial for FMT's efficacy and for validating protocol execution. We compared two methods—in vitro cultivation and membrane integrity assessment—for their accuracy, reproducibility and clinical applicability in measuring bacterial viability in frozen FMT stool filtrate.

Methods

Bacterial viability in stool filtrate was evaluated using (i) membrane integrity through fluorescent DNA staining with SYTO9 and propidium iodide, followed by flow cytometry and (ii) culturable bacteria counts (colony-forming units, CFU) under aerobic or anaerobic conditions.

Results

Using different types of samples (pure bacterial culture, stool of germ-free and conventionally bred mice, native and heat-treated human stool), we refined the bacterial DNA staining protocol integrated with flow cytometry for assessment of bacterial viability in frozen human stool samples. Both the membrane integrity-based and cultivation-based methods exhibited significant variability in bacterial viability across different FMT filtrates, without correlation. The cultivation-based method showed a mean coefficient of variance of 30.3%, ranging from 7.4% to 60.1%. Conversely, the membrane integrity approach yielded more reproducible results, with a mean coefficient of variance for viable cells of 6.4% ranging from 0.2% to 18.2%.

Conclusion

Bacterial viability assessment in stool filtrate using the membrane integrity method offers robust and precise data, making it a suitable option for faecal material evaluation in FMT. In contrast, the cultivation-dependent methods produce inconsistent outcomes.

背景：粪便微生物群移植（FMT）是一种治疗肠道菌群失调相关疾病的新兴疗法。尽管其应用日益广泛，但用于 FMT 滤液制备和质量评估的标准化方案仍未制定。滤液中细菌的活力对于 FMT 的疗效和验证方案的执行至关重要。我们比较了体外培养和膜完整性评估两种方法在测量冷冻 FMT 粪便滤液中细菌存活率方面的准确性、可重复性和临床适用性：方法：粪便滤液中的细菌存活率通过以下两种方法进行评估：(i) 用 SYTO9 和碘化丙啶进行荧光 DNA 染色，然后用流式细胞术检测膜的完整性；(ii) 有氧或厌氧条件下的可培养细菌计数（菌落形成单位，CFU）：利用不同类型的样本（纯细菌培养物、无菌小鼠和常规饲养小鼠的粪便、原生和热处理的人类粪便），我们改进了细菌 DNA 染色方案，并将其与流式细胞术相结合，用于评估冷冻人类粪便样本中细菌的存活率。在不同的 FMT 滤液中，基于膜完整性的方法和基于培养的方法在细菌存活率方面都表现出显著的差异性，但没有相关性。基于培养的方法显示平均变异系数为 30.3%，范围从 7.4% 到 60.1%。相反，膜完整性方法得出的结果可重复性更高，可存活细胞的平均变异系数为 6.4%，范围在 0.2% 到 18.2% 之间：结论：使用膜完整性方法对粪便滤液中的细菌活力进行评估，可提供可靠而精确的数据，因此是 FMT 中粪便材料评估的合适选择。相比之下，依赖培养的方法产生的结果并不一致。

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引用次数: 0

Effects of Blood Collection Tubes on the Quantification of Catecholamines and Their O-Methylated Metabolites by Liquid Chromatography Coupled With Tandem Mass Spectrometry 采血管对液相色谱-串联质谱法定量儿茶酚胺及其 O-甲基化代谢物的影响

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-09-30 DOI: 10.1002/jcla.25107

Rong Su, Yanjie Wu, Qiuyi Huang, Shengchun Huang, Yao Li, Caifeng Chen, Wenchun Xie, Yan Li

Background

Catecholamines (epinephrine; norepinephrine; and dopamine) and their O-methylated metabolites (metanephrine; normetanephrine; and 3-methoxytyramine) are biomarkers for pheochromocytoma and paraganglioma. Liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS) was recommended by Endocrine Society for detecting these compounds. The influence of blood collection tubes on the analysis of the six analytes by LC-MS/MS was not thoroughly investigated, which we want to clarify in our study.

Methods

Blood samples of healthy individuals were collected into serum, lithium heparin, and K₂EDTA plasma tubes separately. Samples were subjected to solid phase extraction and then analyzed by LC-MS/MS. The retention behavior and assay performance of the six analytes were assessed for samples from different collection containers. The impacts of potassium and sodium as the counter ions of EDTA on the retention time and matrix effect were also studied.

Results

Compared with O-methylated metabolites, the results for catecholamines were more affected by the collection tubes, especially for norepinephrine, which displayed severely suppressed signal and very low extraction efficiency in K₂EDTA plasma. Changing the counter ion of EDTA from potassium to sodium dramatically changed the retention behavior and matrix effect of norepinephrine.

Conclusions

It is necessary to evaluate blood collection tubes for catecholamines and their O-methylated metabolites analyzed by LC-MS/MS. In addition, attention should also be paid when the anticoagulant counter ion was changed.

背景：儿茶酚胺（肾上腺素、去甲肾上腺素和多巴胺）及其 O 型甲基化代谢物（去甲肾上腺素、去甲肾上腺素和 3-甲氧基酪胺）是嗜铬细胞瘤和副神经节瘤的生物标记物。内分泌学会推荐使用液相色谱-串联质谱法（LC-MS/MS）检测这些化合物。采血管对 LC-MS/MS 分析这六种分析物的影响尚未得到深入研究，我们希望在本研究中澄清这一点：方法：将健康人的血样分别收集到血清、肝素锂和 K2EDTA 血浆管中。样品经固相萃取后进行 LC-MS/MS 分析。对来自不同收集容器的样本进行了六种分析物的保留行为和测定性能评估。此外，还研究了钾和钠作为 EDTA 的反离子对保留时间和基质效应的影响：结果：与 O 型甲基化代谢物相比，儿茶酚胺的检测结果受收集管的影响更大，尤其是去甲肾上腺素，在 K2EDTA 血浆中信号被严重抑制，提取效率非常低。将 EDTA 的反离子从钾改为钠，可显著改变去甲肾上腺素的保留行为和基质效应：结论：有必要对使用 LC-MS/MS 分析儿茶酚胺及其 O 型甲基化代谢物的采血管进行评估。此外，还应注意抗凝剂反离子的更换。

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引用次数: 0

Diagnostic Performance of CLEIA Versus FEIA for KL-6 Peripheral and Alveolar Concentrations in Fibrotic Interstitial Lung Diseases: A Multicentre Study 纤维化间质性肺病 KL-6 周围和肺泡浓度的 CLEIA 与 FEIA 诊断性能对比：一项多中心研究。

IF 2.6 4区医学 Q2 MEDICAL LABORATORY TECHNOLOGY

Journal of Clinical Laboratory Analysis

Pub Date : 2024-09-25 DOI: 10.1002/jcla.25108

Miriana d'Alessandro, Sara Gangi, Irene Paggi, Piera Soccio, Laura Bergantini, Tommaso Pianigiani, Giusy Montuori, Giorgia Moriondo, Giulio Natalello, Sofia Marrucci, Alfonso Brogna, Giulia Scioscia, Donato Lacedonia, Paolo Cameli, Elena Bargagli

Background

Interstitial lung diseases (ILD) is a group of lung disorders characterized by interstitial lung thickening due to inflammatory and fibrotic processes. Krebs von den Lungen-6 (KL-6) is a molecule secreted by damaged type II alveolar pneumocytes in the alveolar space. The goal of the present study was to compare two detection methods of KL-6 in both bronchoalveolar lavage (BAL) and serum from ILD patients at the moment of diagnosis.

Methods

Patients with suspicious of ILD and followed at two Italian referral centres for rare lung diseases were included in the study. BAL fluid and serum were collected and analysed by chemiluminescent enzyme immunoassay (CLEIA) and fluorescent enzyme immunoassay (FEIA) methods provided by Tosoh Biosciences.

Results

A total of 158 (mean age ± standard deviation, 61.5 ± 13.7, 65 females) patients were enrolled. A total of, 36 had diagnosis of idiopathic pulmonary fibrosis (IPF), 74 sarcoidosis, 15 connective tissue disease-ILD (CTD-ILD) and 33 other ILD. Diagnostic agreement between two methods was demonstrated for both BAL (r = 0.707, p < 0.0001) and serum (r = 0.816, p < 0.0001). BAL KL-6 values were lower than serum (p < 0.0001). IPF patients had higher serum KL-6 concentration than other ILDs (p = 0.0294), while BAL KL-6 values were lower in IPF than in non-IPF (p = 0.0023).

Conclusion

This study explored KL-6 concentrations through the CLEIA method in serum and BAL of patients with various ILDs, showing significant differences of biomarkers concentrations between IPF and other non-IPF ILDs. Our findings are promising as they provided further knowledge concerning KL-6 expression across different ILDs and may suggest its utility in differential diagnosis.

背景：间质性肺疾病（ILD）是一组以炎症和纤维化过程导致的肺间质增厚为特征的肺部疾病。Krebs von den Lungen-6 (KL-6) 是肺泡间隙中受损的 II 型肺泡气细胞分泌的一种分子。本研究的目的是比较两种检测方法，即在确诊 ILD 患者的支气管肺泡灌洗液（BAL）和血清中检测 KL-6：研究对象包括在意大利两家罕见肺病转诊中心就诊的疑似 ILD 患者。采集BAL液和血清，用东曹（Tosoh）生物科学公司提供的化学发光酶免疫分析法（CLEIA）和荧光酶免疫分析法（FEIA）进行分析：共招募了 158 名患者（平均年龄 ± 标准差，61.5 ± 13.7，女性 65 名）。其中，36 人被诊断为特发性肺纤维化（IPF），74 人被诊断为肉样瘤病，15 人被诊断为结缔组织病-ILD（CTD-ILD），33 人被诊断为其他 ILD。两种方法对 BAL 的诊断结果一致（r = 0.707，p 结论）：本研究通过 CLEIA 方法检测了各种 ILD 患者血清和 BAL 中的 KL-6 浓度，结果显示 IPF 和其他非 IPF ILD 之间的生物标志物浓度存在显著差异。我们的研究结果很有希望，因为它们提供了有关不同 ILD 中 KL-6 表达的进一步知识，并可能提示其在鉴别诊断中的作用。

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引用次数: 0