This study aimed to establish the reference intervals of Cyfra21-1 and CEA for the local screening populations using a chemiluminescence method.
Methods
A total of 4845 healthy adults and 190 lung cancer patients were included from the First Hospital of Hebei Medical University. The levels of Cyfra21-1 and CEA were measured to establish the local reference intervals.
Results
The upper limit reference intervals for Cyfra21-1 and CEA were determined as 3.19 ng/ml and 3.13 ng/ml, respectively. Notably, both Cyfra21-1 and CEA levels were found to be higher in males than in females. Additionally, both biomarkers showed an increasing trend with age.
In terms of diagnostic efficacy, the receiver operating characteristic (ROC) curve areas for Cyfra21-1, CEA, and their combination in lung cancer were 0.86, 0.73, and 0.91, respectively.
Conclusion
Our study revealed that the reference intervals of Cyfra21-1 and CEA in the local population differed from the established reference intervals. Furthermore, both biomarkers exhibited gender-dependent variations and demonstrated a positive correlation with age. Combining the two biomarkers showed potential for improving the diagnosis rate of lung cancer.
方法 选取河北医科大学第一医院4845名健康成人和190名肺癌患者作为研究对象,采用化学发光法测定Cyfra21-1和CEA的含量,以确定当地筛查人群Cyfra21-1和CEA的参考区间。结果 Cyfra21-1和CEA的参考值上限分别为3.19 ng/ml和3.13 ng/ml。值得注意的是,男性的 Cyfra21-1 和 CEA 水平均高于女性。结论我们的研究表明,本地人群中 Cyfra21-1 和 CEA 的参考区间与既定的参考区间存在差异。此外,这两种生物标志物都表现出性别差异,并与年龄呈正相关。将这两种生物标志物结合起来,有望提高肺癌的诊断率。
{"title":"Reference intervals of Cyfra21-1 and CEA in healthy adult Han Chinese population","authors":"Lidan Xing , Shuai Zhao , Shichao Gao, Xiaoqian Shi, Yaomeng Huang, Puhuan Bian, Jingna Sun","doi":"10.1016/j.plabm.2024.e00409","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00409","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to establish the reference intervals of Cyfra21-1 and CEA for the local screening populations using a chemiluminescence method.</p></div><div><h3>Methods</h3><p>A total of 4845 healthy adults and 190 lung cancer patients were included from the First Hospital of Hebei Medical University. The levels of Cyfra21-1 and CEA were measured to establish the local reference intervals.</p></div><div><h3>Results</h3><p>The upper limit reference intervals for Cyfra21-1 and CEA were determined as 3.19 ng/ml and 3.13 ng/ml, respectively. Notably, both Cyfra21-1 and CEA levels were found to be higher in males than in females. Additionally, both biomarkers showed an increasing trend with age.</p><p>In terms of diagnostic efficacy, the receiver operating characteristic (ROC) curve areas for Cyfra21-1, CEA, and their combination in lung cancer were 0.86, 0.73, and 0.91, respectively.</p></div><div><h3>Conclusion</h3><p>Our study revealed that the reference intervals of Cyfra21-1 and CEA in the local population differed from the established reference intervals. Furthermore, both biomarkers exhibited gender-dependent variations and demonstrated a positive correlation with age. Combining the two biomarkers showed potential for improving the diagnosis rate of lung cancer.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000556/pdfft?md5=93f0cacdcc571aef9f87336ce0e449d5&pid=1-s2.0-S2352551724000556-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.plabm.2024.e00417
Ye Wang , Qunshan Xu , Jianguo Cai , Lijin Zheng , Weilun Zuo , Jumei Liu , Jiali Cao , Mingxin Lin , Hongli Liu , Huiming Ye
Introduction
Sexually transmitted infections (STIs) are among the most common infectious diseases worldwide, often leading to coinfections. Timely detection of genital tract pathogens in at-risk populations is crucial for preventing STIs. We evaluated the NAP-Fluo Cycler System, an innovative microfluidic nucleic acid detection platform, for its ability to simultaneously identify Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG), Ureaplasma urealyticum (UU), Mycoplasma genitalium (MG), and Mycoplasma hominis (MH) in urethral or cervical secretions.
Materials and methods
The limits of detection (LODs), repeatability, specificity, and interference resistance of the system were evaluated using standard strains, a panel of 24 pathogens, and seven interferents. We used the system to analyze 302 clinical samples and compared the results with those of five approved commercial reference kits.
Results
The system achieved LODs of 500 IFU/mL, 500 CFU/mL, and 500 CCU/mL for CT, NG, and UU/MG/MH, respectively, demonstrating high stability (coefficient of variation <1.1 %), specificity, and resistance to interference. Among 302 clinical samples, 237 tested positive with single, dual, and triple infection rates of 35.6 %, 16.2 %, and 3.0 %, respectively. The reference kits detected 138 positive samples. The concordance rates with commercial reference kits were 100 % for UU, NG, and MH; 94.85 % for CT; and 80.00 % for MG.
Conclusions
This system offers a streamlined, rapid, and multiplex detection method that reduces testing time and complexity. Although it performs well with pure strains, it has limitations when using clinical samples of CT and MG, suggesting the need for further refinement before its widespread use in the clinic.
{"title":"Performance verification and clinical evaluation of the NAP-Fluo Cycler system for detecting five genital tract pathogens based on microfluidic technology","authors":"Ye Wang , Qunshan Xu , Jianguo Cai , Lijin Zheng , Weilun Zuo , Jumei Liu , Jiali Cao , Mingxin Lin , Hongli Liu , Huiming Ye","doi":"10.1016/j.plabm.2024.e00417","DOIUrl":"10.1016/j.plabm.2024.e00417","url":null,"abstract":"<div><h3>Introduction</h3><p>Sexually transmitted infections (STIs) are among the most common infectious diseases worldwide, often leading to coinfections. Timely detection of genital tract pathogens in at-risk populations is crucial for preventing STIs. We evaluated the NAP-Fluo Cycler System, an innovative microfluidic nucleic acid detection platform, for its ability to simultaneously identify <em>Chlamydia trachomatis</em> (CT), <em>Neisseria gonorrhoeae</em> (NG), <em>Ureaplasma urealyticum</em> (UU), <em>Mycoplasma genitalium</em> (MG), and <em>Mycoplasma hominis</em> (MH) in urethral or cervical secretions.</p></div><div><h3>Materials and methods</h3><p>The limits of detection (LODs), repeatability, specificity, and interference resistance of the system were evaluated using standard strains, a panel of 24 pathogens, and seven interferents. We used the system to analyze 302 clinical samples and compared the results with those of five approved commercial reference kits.</p></div><div><h3>Results</h3><p>The system achieved LODs of 500 IFU/mL, 500 CFU/mL, and 500 CCU/mL for CT, NG, and UU/MG/MH, respectively, demonstrating high stability (coefficient of variation <1.1 %), specificity, and resistance to interference. Among 302 clinical samples, 237 tested positive with single, dual, and triple infection rates of 35.6 %, 16.2 %, and 3.0 %, respectively. The reference kits detected 138 positive samples. The concordance rates with commercial reference kits were 100 % for UU, NG, and MH; 94.85 % for CT; and 80.00 % for MG.</p></div><div><h3>Conclusions</h3><p>This system offers a streamlined, rapid, and multiplex detection method that reduces testing time and complexity. Although it performs well with pure strains, it has limitations when using clinical samples of CT and MG, suggesting the need for further refinement before its widespread use in the clinic.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000635/pdfft?md5=9d60cc521a3673d42c64982d4e1387a9&pid=1-s2.0-S2352551724000635-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.plabm.2024.e00401
Benedetta Peruzzi , Serena Guerrieri , Tiziana Biagioli , Luisa Lanzilao , Sara Pratesi , Sara Bencini , Marinella Statello , Alessia Carraresi , Stefania Stefanelli , Martina Tonelli , Marco Brogi , Manuela Capone , Alessio Mazzoni , Anna Maria Grazia Gelli , Alessandra Fanelli , Roberto Caporale , Francesco Annunziato
Introduction
Recently, a flow cytometric (FC) based test has been developed for detection of circulating fetal cells to replace the less accurate and reproducible Kleihauer-Betke test.
FC test is easier to perform, it can distinguish the origin of fetal cells, but it is expensive and available in highly specialized laboratories. We evaluated the introduction of high-performance liquid chromatography (HPLC) approach as initial screening to identify patients who need an additional FC test to better discriminate the nature of haemoglobin-F (HbF) positive cells.
Methods
Blood samples from 130 pregnant women suspected to have fetomaternal haemorrhage were analysed with HPLC and FC methods. The cut-off for HbF HPLC concentration was calculated. Statistical analyses for the evaluation of HPLC as a screening method were performed. The positivity cut-off of HbF to be used as decision-making value to continue the investigation was calculated.
Results
An excellent agreement (R2 > 0.90) was observed between the percentage of HbF obtained by HPLC and the percentage of fetal cells detected by FC. Results obtained from each assay were compared to define the HPLC threshold below which it is not necessary to continue the investigations, confirming the maternal nature of the HbF positive cells detected. Our study demonstrated that a cut-off of 1.0 % HbF obtained by HPLC was associated with the lowest rate of false negative results in our patient cohort.
Conclusions
This study provides a new FMH investigation approach that possibly leads to a reduction in times and costs of the analysis.
{"title":"HPLC and flow cytometry combined approach for HbF analysis in fetomaternal haemorrhage evaluation","authors":"Benedetta Peruzzi , Serena Guerrieri , Tiziana Biagioli , Luisa Lanzilao , Sara Pratesi , Sara Bencini , Marinella Statello , Alessia Carraresi , Stefania Stefanelli , Martina Tonelli , Marco Brogi , Manuela Capone , Alessio Mazzoni , Anna Maria Grazia Gelli , Alessandra Fanelli , Roberto Caporale , Francesco Annunziato","doi":"10.1016/j.plabm.2024.e00401","DOIUrl":"10.1016/j.plabm.2024.e00401","url":null,"abstract":"<div><h3>Introduction</h3><p>Recently, a flow cytometric (FC) based test has been developed for detection of circulating fetal cells to replace the less accurate and reproducible Kleihauer-Betke test.</p><p>FC test is easier to perform, it can distinguish the origin of fetal cells, but it is expensive and available in highly specialized laboratories. We evaluated the introduction of high-performance liquid chromatography (HPLC) approach as initial screening to identify patients who need an additional FC test to better discriminate the nature of haemoglobin-F (HbF) positive cells.</p></div><div><h3>Methods</h3><p>Blood samples from 130 pregnant women suspected to have fetomaternal haemorrhage were analysed with HPLC and FC methods. The cut-off for HbF HPLC concentration was calculated. Statistical analyses for the evaluation of HPLC as a screening method were performed. The positivity cut-off of HbF to be used as decision-making value to continue the investigation was calculated.</p></div><div><h3>Results</h3><p>An excellent agreement (R<sup>2</sup> > 0.90) was observed between the percentage of HbF obtained by HPLC and the percentage of fetal cells detected by FC. Results obtained from each assay were compared to define the HPLC threshold below which it is not necessary to continue the investigations, confirming the maternal nature of the HbF positive cells detected. Our study demonstrated that a cut-off of 1.0 % HbF obtained by HPLC was associated with the lowest rate of false negative results in our patient cohort.</p></div><div><h3>Conclusions</h3><p>This study provides a new FMH investigation approach that possibly leads to a reduction in times and costs of the analysis.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000477/pdfft?md5=8fe6e1a4d570fbec4024ab791d7c745f&pid=1-s2.0-S2352551724000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The advent of CFTR modulators highlighted that the sweat test (ST) for CF can be used also as an outcome measure for the basic defect of CFTR. Despite the technological advances, ST still remains operator-dependent and its execution should be strongly paired with guidelines. In 2022, due to the advent of CFTR modulators, the Italian CF Society introduced a specific ST report. The aim of the present paper is to discuss the impact of this new report in the 2022-23 round of the Italian External Quality Assessment program for ST (I-EQA-SCT).
Methods
The scheme of the I-EQA-SCT is prospective, enrolment is voluntary, the payment of a fee is required and results are shared through a web-facility. Assessment covers analysis, interpretation, and reporting of results. In the 2022-23 round, 2 out of the 3 mock clinical information referred to patients who started modulators.
Results
Fourteen laboratories completed the 2022-23 I-EQA-SCT round. Three of them failed in the interpretation of results from these two mock cases and/or used a wrong report not consistent with the more recent Italian Sweat Test Recommendations.
Conclusions
The overall results obtained from the laboratories involved in the I-EQA-SCT program clearly showed that the laboratories’ qualitative and quantitative performance improved significantly. Results emerged from this round highlighted an issue in the report form used for monitoring patients on CFTR modulator therapy thus stressing the importance of these programs in improving both the performance of lab services and ameliorating the sweat test recommendations.
背景CFTR调节剂的出现突出表明,CF的出汗试验(ST)也可用作CFTR基本缺陷的结果测量。尽管技术不断进步,但出汗试验仍依赖于操作者,其执行应严格遵循相关指南。2022 年,由于 CFTR 调节剂的出现,意大利 CF 协会推出了专门的 ST 报告。本文旨在讨论这一新报告在 2022-23 年度意大利 ST 外部质量评估计划(I-EQA-SCT)中的影响。方法 I-EQA-SCT 计划是前瞻性的,注册是自愿的,需要付费,结果通过网络设施共享。评估包括结果的分析、解释和报告。结果14家实验室完成了2022-23年度的I-EQA-SCT。结论参与I-EQA-SCT项目的实验室所获得的总体结果清楚地表明,实验室的定性和定量能力均有显著提高。这一轮得出的结果突出了用于监测接受 CFTR 调节剂治疗的患者的报告表中存在的一个问题,因此强调了这些计划在提高实验室服务质量和改善汗液检测建议方面的重要性。
{"title":"The Italian external quality assessment program for Cystic Fibrosis sweat chloride test: CFTR modulators and the impact of a new sweat test report form","authors":"Natalia Cirilli , Giovanna Floridia , Annalisa Amato , Rita Padoan , Federica Censi , Gianluca Ferrari , Valeria Raia , Giuseppe Castaldo , Ettore Capoluongo , Domenica Taruscio , Marco Salvatore","doi":"10.1016/j.plabm.2024.e00403","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00403","url":null,"abstract":"<div><h3>Background</h3><p>The advent of CFTR modulators highlighted that the sweat test (ST) for CF can be used also as an outcome measure for the basic defect of CFTR. Despite the technological advances, ST still remains operator-dependent and its execution should be strongly paired with guidelines. In 2022, due to the advent of CFTR modulators, the Italian CF Society introduced a specific ST report. The aim of the present paper is to discuss the impact of this new report in the 2022-23 round of the Italian External Quality Assessment program for ST (I-EQA-SCT).</p></div><div><h3>Methods</h3><p>The scheme of the I-EQA-SCT is prospective, enrolment is voluntary, the payment of a fee is required and results are shared through a web-facility. Assessment covers analysis, interpretation, and reporting of results. In the 2022-23 round, 2 out of the 3 mock clinical information referred to patients who started modulators.</p></div><div><h3>Results</h3><p>Fourteen laboratories completed the 2022-23 I-EQA-SCT round. Three of them failed in the interpretation of results from these two mock cases and/or used a wrong report not consistent with the more recent Italian Sweat Test Recommendations.</p></div><div><h3>Conclusions</h3><p>The overall results obtained from the laboratories involved in the I-EQA-SCT program clearly showed that the laboratories’ qualitative and quantitative performance improved significantly. Results emerged from this round highlighted an issue in the report form used for monitoring patients on CFTR modulator therapy thus stressing the importance of these programs in improving both the performance of lab services and ameliorating the sweat test recommendations.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000490/pdfft?md5=0d971d899d8456940875725a0c6bb72f&pid=1-s2.0-S2352551724000490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hemoglobin A1c (HbA1c) serves as a pivotal marker for long-term glycemic control. The Diabetes Control and Complications Trial (DCCT) established its relevance, yet gaps exist in understanding potential seasonal variations in HbA1c levels among diabetic patients. The study highlights the need to explore potential seasonal variations in HbA1c levels and their impact on diabetic patients.
Materials and methods
This is an observational study conducted in a tertiary care hospital from January to December 2019, the study analyzed HbA1c levels in 8138 patients. Blood samples were collected using Potassium EDTA-containing vials and processed with an automated analyzer. Seasonal variations were explored using time series analysis.
Results
Mean HbA1c levels peaked during the monsoon (June to September) and were lowest in autumn (October to November). Subgroup analysis revealed differences in patients with HbA1c values below and above 6.5 %. Those with controlled blood sugar showed higher levels in winter (December to February) and monsoon (June to September), while patients with HbA1c values ≥ 6.5 % exhibited significantly lower levels in monsoon (June to September) and autumn (October to November) compared to summer (March to May).
Conclusion
In contrast to global trends, Indian patients demonstrated distinct seasonal variations in HbA1c levels. The highest levels during the monsoon (June to September) may be linked to reduced outdoor activity and dietary changes. The study emphasizes the need for tailored diabetes management considering seasonal influences. Further extensive, longitudinal studies across diverse Indian regions are recommended to comprehensively grasp the impact of seasonal changes on diabetes outcomes.
{"title":"Seasonal variation of HbA1c levels in diabetic and non-diabetic patients","authors":"Sana Ahuja , Sugandha Sugandha , Rohit Kumar , Sufian Zaheer , Mukul Singh","doi":"10.1016/j.plabm.2024.e00396","DOIUrl":"10.1016/j.plabm.2024.e00396","url":null,"abstract":"<div><h3>Background</h3><p>Hemoglobin A1c (HbA1c) serves as a pivotal marker for long-term glycemic control. The Diabetes Control and Complications Trial (DCCT) established its relevance, yet gaps exist in understanding potential seasonal variations in HbA1c levels among diabetic patients. The study highlights the need to explore potential seasonal variations in HbA1c levels and their impact on diabetic patients.</p></div><div><h3>Materials and methods</h3><p>This is an observational study conducted in a tertiary care hospital from January to December 2019, the study analyzed HbA1c levels in 8138 patients. Blood samples were collected using Potassium EDTA-containing vials and processed with an automated analyzer. Seasonal variations were explored using time series analysis.</p></div><div><h3>Results</h3><p>Mean HbA1c levels peaked during the monsoon (June to September) and were lowest in autumn (October to November). Subgroup analysis revealed differences in patients with HbA1c values below and above 6.5 %. Those with controlled blood sugar showed higher levels in winter (December to February) and monsoon (June to September), while patients with HbA1c values ≥ 6.5 % exhibited significantly lower levels in monsoon (June to September) and autumn (October to November) compared to summer (March to May).</p></div><div><h3>Conclusion</h3><p>In contrast to global trends, Indian patients demonstrated distinct seasonal variations in HbA1c levels. The highest levels during the monsoon (June to September) may be linked to reduced outdoor activity and dietary changes. The study emphasizes the need for tailored diabetes management considering seasonal influences. Further extensive, longitudinal studies across diverse Indian regions are recommended to comprehensively grasp the impact of seasonal changes on diabetes outcomes.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000428/pdfft?md5=a43a21f9736fa93c86e41c9a472dd442&pid=1-s2.0-S2352551724000428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.plabm.2024.e00397
Piotr Piech , Mateusz Haratym , Bartosz Borowski , Robert Węgłowski , Grzegorz Staśkiewicz
Background
Pulmonary embolism (PE) poses a significant challenge in diagnosis and treatment, particularly in high-risk patient populations such as those hospitalized for orthopedic reasons. This study explores the predictive and diagnostic potential of laboratory parameters in identifying PE among orthopedic patients.
Objectives
The purpose of this study was to determine whether selected (inexpensive and readily available) laboratory parameters and their coefficients can be used to diagnose pulmonary embolism and whether they are applicable in predicting its occurrence.
Material and methods
Selected laboratory parameters were determined twice in 276 hospitalized orthopedic patients with suspected PE: PLT, MPV, NEU, LYM, D-dimer, troponin I, age-adjusted D-dimer and their coefficients. Depending on the angio-CT results, patients were divided into groups. Selected popular laboratory coefficients were calculated and statistically analyzed. Optimal cutoff points were determined for the above laboratory tests and ROC curves were plotted.
Results
D-dimer/troponin I [p = 0.008], D-dimer [p = 0.001], age-adjusted D-dimer [p = 0.007], NLR/D-dimer [p = 0.005] and PLR [p = 0.021] are statistically significant predictors of PE. D-dimer/troponin I [p < 0.001], troponin I [p = 0.005] and age-adjusted D-dimer [p = 0.001] correlated with the diagnosis of PE after the onset of clinical symptoms.
Conclusions
In the context of orthopedic patients, cost-effective laboratory parameters, particularly the D-dimer/troponin I ratio and age-adjusted D-dimer, exhibit considerable potential in predicting and diagnosing PE. These findings suggest that combining readily available laboratory tests with clinical observation can offer a viable and cost-effective diagnostic alternative, especially in resource-constrained settings. Further studies with larger and diverse patient populations are recommended to validate these results.
背景肺栓塞(PE)给诊断和治疗带来了巨大挑战,尤其是在高危患者人群中,如因骨科原因住院的患者。本研究探讨了实验室参数在识别骨科患者肺栓塞方面的预测和诊断潜力。目的本研究的目的是确定选定的(廉价且容易获得的)实验室参数及其系数是否可用于诊断肺栓塞,以及是否可用于预测肺栓塞的发生。材料和方法对 276 名疑似肺栓塞的住院骨科患者进行了两次选定实验室参数的测定:PLT、MPV、NEU、LYM、D-二聚体、肌钙蛋白 I、年龄调整后的 D-二聚体及其系数。根据血管造影 CT 的结果,将患者分为不同的组别。对选定的常用实验室系数进行计算和统计分析。结果 D-二聚体/肌钙蛋白 I [p = 0.008]、D-二聚体[p = 0.001]、年龄调整后的 D-二聚体[p = 0.007]、NLR/D-二聚体[p = 0.005]和 PLR [p = 0.021]是预测 PE 的有统计学意义的指标。结论 在骨科患者中,具有成本效益的实验室参数,尤其是 D-二聚体/肌钙蛋白 I 比值和年龄调整后的 D-二聚体,在预测和诊断 PE 方面具有相当大的潜力。这些研究结果表明,将现成的实验室检测与临床观察相结合,可提供一种可行且具有成本效益的诊断替代方法,尤其是在资源有限的情况下。为了验证这些结果,建议对更多不同的患者群体进行进一步研究。
{"title":"Beyond the fractures: A comprehensive Comparative analysis of Affordable and Accessible laboratory parameters and their coefficients for prediction and Swift confirmation of pulmonary embolism in high-risk orthopedic patients","authors":"Piotr Piech , Mateusz Haratym , Bartosz Borowski , Robert Węgłowski , Grzegorz Staśkiewicz","doi":"10.1016/j.plabm.2024.e00397","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00397","url":null,"abstract":"<div><h3>Background</h3><p>Pulmonary embolism (PE) poses a significant challenge in diagnosis and treatment, particularly in high-risk patient populations such as those hospitalized for orthopedic reasons. This study explores the predictive and diagnostic potential of laboratory parameters in identifying PE among orthopedic patients.</p></div><div><h3>Objectives</h3><p>The purpose of this study was to determine whether selected (inexpensive and readily available) laboratory parameters and their coefficients can be used to diagnose pulmonary embolism and whether they are applicable in predicting its occurrence.</p></div><div><h3>Material and methods</h3><p>Selected laboratory parameters were determined twice in 276 hospitalized orthopedic patients with suspected PE: PLT, MPV, NEU, LYM, D-dimer, troponin I, age-adjusted D-dimer and their coefficients. Depending on the angio-CT results, patients were divided into groups. Selected popular laboratory coefficients were calculated and statistically analyzed. Optimal cutoff points were determined for the above laboratory tests and ROC curves were plotted.</p></div><div><h3>Results</h3><p>D-dimer/troponin I [p = 0.008], D-dimer [p = 0.001], age-adjusted D-dimer [p = 0.007], NLR/D-dimer [p = 0.005] and PLR [p = 0.021] are statistically significant predictors of PE. D-dimer/troponin I [p < 0.001], troponin I [p = 0.005] and age-adjusted D-dimer [p = 0.001] correlated with the diagnosis of PE after the onset of clinical symptoms.</p></div><div><h3>Conclusions</h3><p>In the context of orthopedic patients, cost-effective laboratory parameters, particularly the D-dimer/troponin I ratio and age-adjusted D-dimer, exhibit considerable potential in predicting and diagnosing PE. These findings suggest that combining readily available laboratory tests with clinical observation can offer a viable and cost-effective diagnostic alternative, especially in resource-constrained settings. Further studies with larger and diverse patient populations are recommended to validate these results.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235255172400043X/pdfft?md5=a58645a9794c537feaa7740f3ec07054&pid=1-s2.0-S235255172400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dopamine is known to cause negative interference on enzymatic creatinine measurement. However, its effect on the Jaffe reaction, and its concentration required to interfere with enzymatic reactions, remain uncertain. This study was designed to study the interference of stable dopamine infusion on Jaffe and enzymatic creatinine assays, as well as the effect of dopamine infusion drip arm contamination on both creatinine assays.
b) Design and Methods
For the first part of the study, dopamine was spiked into pooled plasma samples at different concentrations to mimic the scenario of patients on dopamine infusion at an infusion rate between 2 and 20 μg/kg/min. For the second part, dopamine preparation of 2 g/L (same as the preparation used clinically) was mixed with pooled plasma samples at different proportions to mimic drip arm contamination. Creatinine concentrations were measured using Jaffe and enzymatic reactions.
c) Results
The first part showed that creatinine measurements were not interfered by dopamine infusion at an infusion rate between 2 and 20 μg/kg/min. The second part showed that dopamine could negatively interfere with enzymatic creatinine assays, even with minute drip arm contamination. The effect on the Jaffe reaction was less significant.
d) Discussion
Creatinine concentration could be reliably measured by Jaffe or enzymatic reactions if samples are from venous access sites other than the site of dopamine infusion. When dopamine interference on enzymatic creatinine assays is suspected, using the Jaffe reaction to cross-check may provide additional useful information.
{"title":"Dopamine infusion at typical infusion rates does not cause interference on plasma creatinine assays","authors":"Jenny Yeuk Ki Cheng , Shreenidhi Ranganatha Subramaniam , Stephanie C.Y. Yu , L.Y. Lois Choy , Jeffrey Sung Shing Kwok","doi":"10.1016/j.plabm.2024.e00399","DOIUrl":"10.1016/j.plabm.2024.e00399","url":null,"abstract":"<div><h3>a) Objectives</h3><p>Dopamine is known to cause negative interference on enzymatic creatinine measurement. However, its effect on the Jaffe reaction, and its concentration required to interfere with enzymatic reactions, remain uncertain. This study was designed to study the interference of stable dopamine infusion on Jaffe and enzymatic creatinine assays, as well as the effect of dopamine infusion drip arm contamination on both creatinine assays.</p></div><div><h3>b) Design and Methods</h3><p>For the first part of the study, dopamine was spiked into pooled plasma samples at different concentrations to mimic the scenario of patients on dopamine infusion at an infusion rate between 2 and 20 μg/kg/min. For the second part, dopamine preparation of 2 g/L (same as the preparation used clinically) was mixed with pooled plasma samples at different proportions to mimic drip arm contamination. Creatinine concentrations were measured using Jaffe and enzymatic reactions.</p></div><div><h3>c) Results</h3><p>The first part showed that creatinine measurements were not interfered by dopamine infusion at an infusion rate between 2 and 20 μg/kg/min. The second part showed that dopamine could negatively interfere with enzymatic creatinine assays, even with minute drip arm contamination. The effect on the Jaffe reaction was less significant.</p></div><div><h3>d) Discussion</h3><p>Creatinine concentration could be reliably measured by Jaffe or enzymatic reactions if samples are from venous access sites other than the site of dopamine infusion. When dopamine interference on enzymatic creatinine assays is suspected, using the Jaffe reaction to cross-check may provide additional useful information.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000453/pdfft?md5=391debd2fc9543daa5b8fd2edf9785b6&pid=1-s2.0-S2352551724000453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141027103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.plabm.2024.e00405
Lisa M. Johnson
Prader-Willi syndrome (PWS) is a complex genetic disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13 region, known as the Prader Willi critical region. Nutritional clinical manifestations change with age and are described in four different phases. The phases span both extremes of the nutritional spectrum, beginning with an infant with poor sucking reflexes and failure to thrive then progressing to an adolescent who may have hyperphagia and be at risk for obesity. The phenotype is likely due to hypothalamic dysfunction due to genetic changes in the Prader Willi critical region. Researchers are examining the pathological mechanisms that determine the disease course.
{"title":"A genetic condition that spans both extremes of the nutritional spectrum","authors":"Lisa M. Johnson","doi":"10.1016/j.plabm.2024.e00405","DOIUrl":"10.1016/j.plabm.2024.e00405","url":null,"abstract":"<div><p>Prader-Willi syndrome (PWS) is a complex genetic disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13 region, known as the Prader Willi critical region. Nutritional clinical manifestations change with age and are described in four different phases. The phases span both extremes of the nutritional spectrum, beginning with an infant with poor sucking reflexes and failure to thrive then progressing to an adolescent who may have hyperphagia and be at risk for obesity. The phenotype is likely due to hypothalamic dysfunction due to genetic changes in the Prader Willi critical region. Researchers are examining the pathological mechanisms that determine the disease course.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000519/pdfft?md5=64075e0dbc1febbf4adc097ce256d614&pid=1-s2.0-S2352551724000519-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.plabm.2024.e00400
Helena Kullenberg, Marie M. Svedberg
Insulin degrading enzyme (IDE) plays a critical role in degrading insulin and beta-forming proteins, implicating its significance as a biomarker in metabolic dysfunction and neurocognitive disorders, including Alzheimer's disease (AD). Understanding the impact of pre-analytic conditions of in vitro IDE levels is imperative for reliable biomarker assessment. This study explored the influence of freeze-thaw cycles, storage temperature, and storage time on IDE levels in human serum.
Serum samples from seven healthy volunteers were subjected to various storage conditions, including refrigeration (4 °C) and freezing (−20 °C and −80 °C) for 24 h and six months, with differing freeze-thaw cycles. In vitro IDE levels were measured at 24 h and after 6 months using ELISA.
Results indicate that while short-term storage at either −20 °C or −80 °C yielded similar IDE levels, prolonged storage and multiple freeze-thaw cycles significantly impacted IDE stability, with colder temperatures exhibiting better preservation.
Although further research with larger cohorts and longer storage time is warranted to establish clinical significance, our study suggests preferential use of unthawed samples or consistent freeze-thaw conditions for accurate IDE assessment. Thus, optimizing sample storage conditions is paramount for reliable IDE biomarker analysis in clinical and research settings.
胰岛素降解酶(IDE)在降解胰岛素和β-形成蛋白方面起着关键作用,它是代谢功能障碍和神经认知障碍(包括阿尔茨海默病)的重要生物标志物。要进行可靠的生物标记物评估,就必须了解分析前条件对体外 IDE 水平的影响。本研究探讨了冻融循环、储存温度和储存时间对人血清中IDE水平的影响。七名健康志愿者的血清样本被置于不同的储存条件下,包括冷藏(4 °C)和冷冻(-20 °C和-80 °C)24小时和6个月,冻融循环各不相同。结果表明,虽然在-20 °C或-80 °C条件下短期储存可获得相似的IDE水平,但长时间储存和多次冻融循环会显著影响IDE的稳定性,低温条件下的保存效果更好。因此,要在临床和研究环境中进行可靠的 IDE 生物标志物分析,优化样本储存条件至关重要。
{"title":"Exploring the in vitro stability of insulin degrading enzyme as a potential biomarker for neurocognitive disorders and Alzheimer's disease risk","authors":"Helena Kullenberg, Marie M. Svedberg","doi":"10.1016/j.plabm.2024.e00400","DOIUrl":"10.1016/j.plabm.2024.e00400","url":null,"abstract":"<div><p>Insulin degrading enzyme (IDE) plays a critical role in degrading insulin and beta-forming proteins, implicating its significance as a biomarker in metabolic dysfunction and neurocognitive disorders, including Alzheimer's disease (AD). Understanding the impact of pre-analytic conditions of in vitro IDE levels is imperative for reliable biomarker assessment. This study explored the influence of freeze-thaw cycles, storage temperature, and storage time on IDE levels in human serum.</p><p>Serum samples from seven healthy volunteers were subjected to various storage conditions, including refrigeration (4 °C) and freezing (−20 °C and −80 °C) for 24 h and six months, with differing freeze-thaw cycles. In vitro IDE levels were measured at 24 h and after 6 months using ELISA.</p><p>Results indicate that while short-term storage at either −20 °C or −80 °C yielded similar IDE levels, prolonged storage and multiple freeze-thaw cycles significantly impacted IDE stability, with colder temperatures exhibiting better preservation.</p><p>Although further research with larger cohorts and longer storage time is warranted to establish clinical significance, our study suggests preferential use of unthawed samples or consistent freeze-thaw conditions for accurate IDE assessment. Thus, optimizing sample storage conditions is paramount for reliable IDE biomarker analysis in clinical and research settings.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000465/pdfft?md5=86edc424a556b00332a388bf416f5f89&pid=1-s2.0-S2352551724000465-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141051406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-01DOI: 10.1016/j.plabm.2024.e00415
Murari Gurjar , K. Ambedkar Priyan , Priyanka Asia , Uday Kumar , Kajal Shukla , Bal Krishna Mishra , Akhil Kapoor , Pratibha Gavel
Background
The plasma concentration of 5-Fluorouracil (5-FU) is affected by numerous factors, thereby limiting its efficacy. The current therapeutic regimen's doses based on body surface area (BSA) are linked to increased toxicity and sometimes inadequate drug exposure.
Aim and objectives
The study aims to develop an in-vitro assay to monitor 5-Fluorouracil's therapeutic efficacy in cancer patients' blood samples, focusing on pharmacokinetics to improve therapy precision.
Materials and methods
Drug levels were determined from standards, quality controls, and experimental samples using protein precipitation, liquid-liquid extraction, and separation using a C18 analytical column with an isocratic program.
Result
In EXP-1A, the mean concentration of 5-Fluorouracil was 1.15 μg/ml; in EXP-1B, it was 1.16 μg/ml, while in EXP-1C, the mean concentration was 0.9 μg/ml. The percentage difference in mean 5-Fluorouracil concentration between the experiment sample containing a DPD inactivator and EXP-1C (without a DPD inactivator) was 21.5 % higher for EXP-1A and 0.68 % higher for EXP-1B. In the second phase of the experiment, the overall stability of 5-Fluorouracil in samples containing a DPD inactivator was 24.5 % superior compared to samples without a DPD inactivator.
Conclusion
A modified extraction technique has been developed to accurately measure 5-Flourouracil concentration in blood, preserving its stability and concentration by adding a DPD inactivator.
{"title":"Optimizing cancer patient care with a robust assay for 5-fluorouracil quantification and in-vitro stability in human blood for therapeutic drug monitoring","authors":"Murari Gurjar , K. Ambedkar Priyan , Priyanka Asia , Uday Kumar , Kajal Shukla , Bal Krishna Mishra , Akhil Kapoor , Pratibha Gavel","doi":"10.1016/j.plabm.2024.e00415","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00415","url":null,"abstract":"<div><h3>Background</h3><p>The plasma concentration of 5-Fluorouracil (5-FU) is affected by numerous factors, thereby limiting its efficacy. The current therapeutic regimen's doses based on body surface area (BSA) are linked to increased toxicity and sometimes inadequate drug exposure.</p></div><div><h3>Aim and objectives</h3><p>The study aims to develop an in-vitro assay to monitor 5-Fluorouracil's therapeutic efficacy in cancer patients' blood samples, focusing on pharmacokinetics to improve therapy precision.</p></div><div><h3>Materials and methods</h3><p>Drug levels were determined from standards, quality controls, and experimental samples using protein precipitation, liquid-liquid extraction, and separation using a C18 analytical column with an isocratic program.</p></div><div><h3>Result</h3><p>In EXP-1A, the mean concentration of 5-Fluorouracil was 1.15 μg/ml; in EXP-1B, it was 1.16 μg/ml, while in EXP-1C, the mean concentration was 0.9 μg/ml. The percentage difference in mean 5-Fluorouracil concentration between the experiment sample containing a DPD inactivator and EXP-1C (without a DPD inactivator) was 21.5 % higher for EXP-1A and 0.68 % higher for EXP-1B. In the second phase of the experiment, the overall stability of 5-Fluorouracil in samples containing a DPD inactivator was 24.5 % superior compared to samples without a DPD inactivator.</p></div><div><h3>Conclusion</h3><p>A modified extraction technique has been developed to accurately measure 5-Flourouracil concentration in blood, preserving its stability and concentration by adding a DPD inactivator.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000611/pdfft?md5=08e74907423f727ce6e12093e98c901f&pid=1-s2.0-S2352551724000611-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141312868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}