Pub Date : 2017-08-28DOI: 10.1515/labmed-2017-0077
U. Nydegger
Abstract With big data algorithms and artificial intelligence (AI) at stake the optimal assembly of the most appropriate lab assays selected to diagnose, treat and follow up patients suffering from well-delineated disease may get lost. The physician ordering a lab test, instead of asking for a good composition of screening tests is tempted to order a large number of assays, including genome sequencing hoping to find the diagnostic evidence for his/her patient at once. Four major specialities of medical laboratory assays, i.e. clinical chemistry, hematology, immunology and microbiology are embraced by genome sequencing techniques and have attained the degree of robotics, facilitating assays to such a degree, that the prescriber is free of concern as to how costly/complicated an investigation might become. Diagnostics with autoimmune diseases is not an exemption and autoantibody screening using multiplex assays or therapeutic drug monitoring to adjust treatments of inflammatory/autoimmune diseases is bound to become more and more informative even more so as the pharmacodynamics of modern pharmaceutical agents are explored. As the most appropriate therapeutical agents to monitor in the lab, biological response modifiers, immunosuppressants and monoclonal antibodies are at the forefront and we need to explore their efficacy and side effect profiles not only using phase III clinical studies but also by using postmarketing surveillance. Behind the profiles provided by big data and artificial intelligence, the therapeutically-induced regained immune balance can thus be traced to the single best lab assay. The next decade promises a series of new assays, e.g. inflammasome profiles, lymphocyte markers by fluorescence activated cell sorters as well as single cell secretome analysis.
{"title":"Medical laboratory in autoimmunity 2017","authors":"U. Nydegger","doi":"10.1515/labmed-2017-0077","DOIUrl":"https://doi.org/10.1515/labmed-2017-0077","url":null,"abstract":"Abstract With big data algorithms and artificial intelligence (AI) at stake the optimal assembly of the most appropriate lab assays selected to diagnose, treat and follow up patients suffering from well-delineated disease may get lost. The physician ordering a lab test, instead of asking for a good composition of screening tests is tempted to order a large number of assays, including genome sequencing hoping to find the diagnostic evidence for his/her patient at once. Four major specialities of medical laboratory assays, i.e. clinical chemistry, hematology, immunology and microbiology are embraced by genome sequencing techniques and have attained the degree of robotics, facilitating assays to such a degree, that the prescriber is free of concern as to how costly/complicated an investigation might become. Diagnostics with autoimmune diseases is not an exemption and autoantibody screening using multiplex assays or therapeutic drug monitoring to adjust treatments of inflammatory/autoimmune diseases is bound to become more and more informative even more so as the pharmacodynamics of modern pharmaceutical agents are explored. As the most appropriate therapeutical agents to monitor in the lab, biological response modifiers, immunosuppressants and monoclonal antibodies are at the forefront and we need to explore their efficacy and side effect profiles not only using phase III clinical studies but also by using postmarketing surveillance. Behind the profiles provided by big data and artificial intelligence, the therapeutically-induced regained immune balance can thus be traced to the single best lab assay. The next decade promises a series of new assays, e.g. inflammasome profiles, lymphocyte markers by fluorescence activated cell sorters as well as single cell secretome analysis.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"6 1-2 1","pages":"173 - 182"},"PeriodicalIF":0.0,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79181461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-08-28DOI: 10.1515/labmed-2017-0054
C. Gessner, P. Ruschpler, S. Fricke, A. Gillissen, Gerhard Hoheisel, J. Lehmann, U. Sack
Abstract Early non-invasive detection of lung cancer is a precondition for enabling better prognosis supported by new innovative therapy regimes. The aim of our study was to evaluate angiogenic and inflammatory proteins in exhaled breath condensate (EBC) as markers for lung cancer. Our report presents a diagnostic study of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and tumor necrosis factor-α (TNF-α) in EBC of 300 individuals, 84 patients with lung cancer, 111 patients with stable chronic obstructive pulmonary disease (COPD), and in 105 healthy controls. Detection of VEGF and bFGF in EBC was applicable to discriminate cancer patients from COPD patients as well as from healthy volunteers. Especially VEGF seems to be suitable to discriminate between non-small cell lung cancer (NSCLC) patients and control groups with highest VEGF values in EBC of patients with progressive NSCLC. The concentration of angiogenic factors correlated with disease progression as well as higher tumor stage. This study supports cytokine analysis in EBC as a suitable noninvasive diagnostic screening method for lung cancer detection and monitoring.
{"title":"Analyses of exhaled breath condensate cytokines for identification of lung cancer","authors":"C. Gessner, P. Ruschpler, S. Fricke, A. Gillissen, Gerhard Hoheisel, J. Lehmann, U. Sack","doi":"10.1515/labmed-2017-0054","DOIUrl":"https://doi.org/10.1515/labmed-2017-0054","url":null,"abstract":"Abstract Early non-invasive detection of lung cancer is a precondition for enabling better prognosis supported by new innovative therapy regimes. The aim of our study was to evaluate angiogenic and inflammatory proteins in exhaled breath condensate (EBC) as markers for lung cancer. Our report presents a diagnostic study of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF) and tumor necrosis factor-α (TNF-α) in EBC of 300 individuals, 84 patients with lung cancer, 111 patients with stable chronic obstructive pulmonary disease (COPD), and in 105 healthy controls. Detection of VEGF and bFGF in EBC was applicable to discriminate cancer patients from COPD patients as well as from healthy volunteers. Especially VEGF seems to be suitable to discriminate between non-small cell lung cancer (NSCLC) patients and control groups with highest VEGF values in EBC of patients with progressive NSCLC. The concentration of angiogenic factors correlated with disease progression as well as higher tumor stage. This study supports cytokine analysis in EBC as a suitable noninvasive diagnostic screening method for lung cancer detection and monitoring.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"32 1","pages":"187 - 194"},"PeriodicalIF":0.0,"publicationDate":"2017-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83112604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2017-0068
F. Erden, Hatice Karagoz, A. Avcı, D. Avcı, A. Çetinkaya, A. Erden
Abstract Background: Behçet’s disease (BD) is a systemic vasculitis of all types of vessels of both the venous and arterial sites. Mean platelet volume (MPV) is the most commonly used measure of platelet (Plt) size and is also a potential marker of Plt activity. In this study, we wanted to evaluate the MPV value and the MPV/Plt ratio in patients with deep venous thrombosis (DVT) in BD. Methods: Overall, 228 patients – 49 BD patients with a thrombotic complication and 179 BD patients without a thrombotic complication (as the control group) – were included the study. Results: Of the 49 patients with thrombosis, there was a very significant difference between the genders: 41 (83.6%) were males while only eight (16.4%) were females (p<0.0001). There was a statistically significant difference among the patients with and without thrombosis according to the median MPV value and the MPV/Plt ratio (p<0.0001). Conclusions: Increased MPV can predict the risk of DVT development as well as the male sex among BD patients. The MPV/Plt ratio may also be used for predicting DVT.
{"title":"The values of mean platelet volume and the mean platelet volume/platelet ratio for predicting deep venous thrombosis in Behçet’s disease","authors":"F. Erden, Hatice Karagoz, A. Avcı, D. Avcı, A. Çetinkaya, A. Erden","doi":"10.1515/labmed-2017-0068","DOIUrl":"https://doi.org/10.1515/labmed-2017-0068","url":null,"abstract":"Abstract Background: Behçet’s disease (BD) is a systemic vasculitis of all types of vessels of both the venous and arterial sites. Mean platelet volume (MPV) is the most commonly used measure of platelet (Plt) size and is also a potential marker of Plt activity. In this study, we wanted to evaluate the MPV value and the MPV/Plt ratio in patients with deep venous thrombosis (DVT) in BD. Methods: Overall, 228 patients – 49 BD patients with a thrombotic complication and 179 BD patients without a thrombotic complication (as the control group) – were included the study. Results: Of the 49 patients with thrombosis, there was a very significant difference between the genders: 41 (83.6%) were males while only eight (16.4%) were females (p<0.0001). There was a statistically significant difference among the patients with and without thrombosis according to the median MPV value and the MPV/Plt ratio (p<0.0001). Conclusions: Increased MPV can predict the risk of DVT development as well as the male sex among BD patients. The MPV/Plt ratio may also be used for predicting DVT.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"29 1","pages":"153 - 157"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74904918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2017-0036
Matthias Weber, Julia J. M. Eekels
Abstract Background: About 2/3 of the hemoglobin (Hb) variants do not show a charge difference to the wildtype entity but most of them differ in hydrophobicity. In addition to cation exchange chromatography, globin differentiation by liquid chromatography-tandem mass spectrometry (MS) was introduced. Hb Ullevaal was chosen as one example to demonstrate the performance of the approach. Methods: Screening for Hb variants was performed using cation exchange HPLC. For globin separation reversed phase-LC/MS was performed. Tryptic digests of variants were separated on RP-HPLC with or without CID-fragmentation and database search for identification of mutation bearing fragments. Sequencing of the β-globin gene has been performed. Results: HbS, HbC, HbE, Hb South Florida and Hb Ullevaal show typical and distinct patterns in the globin LC/MS according to the theoretical protein data. The tryptic digest of Hb Ullevaal resulted in the identification of the respective mutated peptide βT9, which was confirmed by genetic sequencing. Conclusions: By the application of globin-LC/MS two more dimensions for the Hb identification are added, hydropathicity and protein mass. With this workflow as screening procedure for Hb variants it is expected to be able to detect and identify the majority of variants with the exception of highly unstable variants, which cannot be determined in the peripheral blood at all. A negative result makes the presence of a significant Hb variant in the peripheral blood improbable.
背景:大约2/3的血红蛋白(Hb)变体与野生型实体不表现出电荷差异，但它们中的大多数在疏水性上不同。除阳离子交换色谱法外，还介绍了液相色谱-串联质谱(MS)鉴别珠蛋白的方法。以Hb Ullevaal为例，验证了该方法的有效性。方法:采用阳离子交换高效液相色谱法筛选Hb变异。珠蛋白的分离采用反相液相色谱/质谱法。采用RP-HPLC分离变异的色氨酸酶切，并通过数据库检索鉴定携带突变的片段。已进行β-珠蛋白基因测序。结果:HbS、HbC、HbE、Hb South Florida和Hb Ullevaal在珠蛋白LC/MS中表现出典型的、不同的模式，符合理论蛋白数据。Hb Ullevaal的胰蛋白酶消化鉴定出相应的突变肽βT9，并通过基因测序证实了这一点。结论:通过珠蛋白- lc /MS的应用，增加了血红蛋白鉴定的两个维度:亲水性和蛋白质量。将此工作流程作为Hb变体的筛选程序，预计能够检测和识别除高度不稳定的变体外的大多数变体，这些变体根本无法在外周血中确定。阴性结果表明外周血中不可能存在显著的Hb变异。
{"title":"The use of LC tandem mass spectrometry as part of a workflow for the screening and identification of hemoglobin variants. Characterization of Hb Ullevaal as an example","authors":"Matthias Weber, Julia J. M. Eekels","doi":"10.1515/labmed-2017-0036","DOIUrl":"https://doi.org/10.1515/labmed-2017-0036","url":null,"abstract":"Abstract Background: About 2/3 of the hemoglobin (Hb) variants do not show a charge difference to the wildtype entity but most of them differ in hydrophobicity. In addition to cation exchange chromatography, globin differentiation by liquid chromatography-tandem mass spectrometry (MS) was introduced. Hb Ullevaal was chosen as one example to demonstrate the performance of the approach. Methods: Screening for Hb variants was performed using cation exchange HPLC. For globin separation reversed phase-LC/MS was performed. Tryptic digests of variants were separated on RP-HPLC with or without CID-fragmentation and database search for identification of mutation bearing fragments. Sequencing of the β-globin gene has been performed. Results: HbS, HbC, HbE, Hb South Florida and Hb Ullevaal show typical and distinct patterns in the globin LC/MS according to the theoretical protein data. The tryptic digest of Hb Ullevaal resulted in the identification of the respective mutated peptide βT9, which was confirmed by genetic sequencing. Conclusions: By the application of globin-LC/MS two more dimensions for the Hb identification are added, hydropathicity and protein mass. With this workflow as screening procedure for Hb variants it is expected to be able to detect and identify the majority of variants with the exception of highly unstable variants, which cannot be determined in the peripheral blood at all. A negative result makes the presence of a significant Hb variant in the peripheral blood improbable.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"30 2 1","pages":"137 - 145"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80399734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2017-0055
M. Steiner, J. Lüdemann
Zusammenfassung Ausgehend von der kasuistischen Beobachtung einer zweigipfligen Albuminbande in der Serumproteinelektrophorese wird die Bisalbuminämie als angeborene oder erworbene Proteinanomalie nach Durchsicht der Literatur in einer Kurzübersicht dargestellt. Nach einer Einführung zur Bisalbuminämie werden deren Nachweismethoden, funktionelle und klinische Bedeutung sowie Befundinterpretation behandelt. Bei der Bisalbuminämie handelt es sich um eine seltene neutrale Normvariante ohne Symptom- bzw. Krankheitswert, die keiner weiteren Abklärung bedarf.
{"title":"Bisalbuminämie: Normvariante oder pathologischer Befund?","authors":"M. Steiner, J. Lüdemann","doi":"10.1515/labmed-2017-0055","DOIUrl":"https://doi.org/10.1515/labmed-2017-0055","url":null,"abstract":"Zusammenfassung Ausgehend von der kasuistischen Beobachtung einer zweigipfligen Albuminbande in der Serumproteinelektrophorese wird die Bisalbuminämie als angeborene oder erworbene Proteinanomalie nach Durchsicht der Literatur in einer Kurzübersicht dargestellt. Nach einer Einführung zur Bisalbuminämie werden deren Nachweismethoden, funktionelle und klinische Bedeutung sowie Befundinterpretation behandelt. Bei der Bisalbuminämie handelt es sich um eine seltene neutrale Normvariante ohne Symptom- bzw. Krankheitswert, die keiner weiteren Abklärung bedarf.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"57 1","pages":"113 - 116"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86318561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2017-0052
Marina Pijanović, A. Stefanović, M. Miljkovic, Snežana Marić-Krejović, S. Spasić
Abstract Background: Leptin and adiponectin play an important role during normal gestation; they are implicated in energy metabolism, glucose utilization and inflammation. Osteocalcin is released into circulation during bone formation; it also affects glucose metabolism by regulating insulin secretion and sensitivity, possibly mediated by adiponectin. The aim of this study was to explore the longitudinal changes of leptin and adiponectin in pregnancy, and their associations with lipid profile, insulin and bone formation parameters in late pregnancy. Methods: Leptin, adiponectin, lipid status parameters, C-reactive protein (CRP), insulin, 25-hydroxyvitamin D, osteocalcin and procollagen type 1 aminoterminal propeptide (P1NP) were measured in the sera of 38 healthy pregnant women. The samples were obtained in the 1st, 2nd, early and late 3rd trimester, and post-partum. Results: Leptin was significantly increased in the 3rd trimester. The decrease of adiponectin was significant only in postpartum. Osteocalcin and P1NP increased in the late 3rd trimester and postpartum. Leptin was significantly positively correlated with body mass index (BMI), uric acid, insulin, osteocalcin, P1NP and CRP in the 3rd trimester; adiponectin was positively correlated with high-density lipoprotein (HDL) cholesterol, and negatively with BMI, glucose, osteocalcin, triglycerides and insulin. Multiple regression analysis showed that only HDL is independently associated with adiponectin. Conclusions: The results of our study suggest complex interactions of leptin and adiponectin with glucose, lipid and bone metabolism during pregnancy. Adiponectin might be part of the protective systems that counterbalance a transient proatherogenic state observed in pregnancy mainly by improving the HDL levels. The exact mechanisms and potential implications in pathological states of pregnancy remain unexplained and require further investigation.
{"title":"Longitudinal changes in leptin and adiponectin concentrations through uncomplicated pregnancy","authors":"Marina Pijanović, A. Stefanović, M. Miljkovic, Snežana Marić-Krejović, S. Spasić","doi":"10.1515/labmed-2017-0052","DOIUrl":"https://doi.org/10.1515/labmed-2017-0052","url":null,"abstract":"Abstract Background: Leptin and adiponectin play an important role during normal gestation; they are implicated in energy metabolism, glucose utilization and inflammation. Osteocalcin is released into circulation during bone formation; it also affects glucose metabolism by regulating insulin secretion and sensitivity, possibly mediated by adiponectin. The aim of this study was to explore the longitudinal changes of leptin and adiponectin in pregnancy, and their associations with lipid profile, insulin and bone formation parameters in late pregnancy. Methods: Leptin, adiponectin, lipid status parameters, C-reactive protein (CRP), insulin, 25-hydroxyvitamin D, osteocalcin and procollagen type 1 aminoterminal propeptide (P1NP) were measured in the sera of 38 healthy pregnant women. The samples were obtained in the 1st, 2nd, early and late 3rd trimester, and post-partum. Results: Leptin was significantly increased in the 3rd trimester. The decrease of adiponectin was significant only in postpartum. Osteocalcin and P1NP increased in the late 3rd trimester and postpartum. Leptin was significantly positively correlated with body mass index (BMI), uric acid, insulin, osteocalcin, P1NP and CRP in the 3rd trimester; adiponectin was positively correlated with high-density lipoprotein (HDL) cholesterol, and negatively with BMI, glucose, osteocalcin, triglycerides and insulin. Multiple regression analysis showed that only HDL is independently associated with adiponectin. Conclusions: The results of our study suggest complex interactions of leptin and adiponectin with glucose, lipid and bone metabolism during pregnancy. Adiponectin might be part of the protective systems that counterbalance a transient proatherogenic state observed in pregnancy mainly by improving the HDL levels. The exact mechanisms and potential implications in pathological states of pregnancy remain unexplained and require further investigation.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"1 1","pages":"129 - 136"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85519476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2016-0059
A. Aydın, A. Varoğlu
Abstract Background: We aim to determine the relationships among vitamin B12, folic acid, homocysteine (Hcy), and methylenetetrahydrofolatereductase (MTHFR) C677T polymorphism, as well as the clinical importance of these relationships, in patients using valproic acid (VPA), carbamazepine (CBZ), and levetiracetam (LEV) as monotherapy and polytherapy. Methods: We enrolled 37 patients on VPA, 30 on CBZ, 31 on LEV, 30 on multidrug therapy, and 60 control subjects. We compared the levels of vitamin B12, folic acid, Hcy and polymorphism. Results: Vitamin B12 was low in patients on CBZ (p=0.02) and in combined CBZ and VPA (p=0.02). B12 was low in combined CBZ and VPA (p=0.05). In patients without polymorphism, Hcy was high on VPA (p=0.02), and folic acid was the low on CBZ (0.005). In patients with polymorphism, vitamin B12 was low on CBZ (p=0.02), and folic acid was low on VPA (p=0.04). Vitamin B12 was low in combined CBZ and VPA (p=0.05). Conclusions: Vitamin B12 therapy is necessary on CBZ and on combined CBZ and VPA. VPA should not be used in the presence of other thrombophilic risk factors because of hyperhomocysteinemia. Polytherapy does not increase hyperhomocysteinemia risk in comparison to monotherapy. Vitamin B12, folic acid, Hcy do not effect on seizure frequency.
{"title":"Methylenetetrahydrofolate reductase gene polymorphism and clinical importance in epilepsy patients using valproic acid, carbamazepine and levetiracetam","authors":"A. Aydın, A. Varoğlu","doi":"10.1515/labmed-2016-0059","DOIUrl":"https://doi.org/10.1515/labmed-2016-0059","url":null,"abstract":"Abstract Background: We aim to determine the relationships among vitamin B12, folic acid, homocysteine (Hcy), and methylenetetrahydrofolatereductase (MTHFR) C677T polymorphism, as well as the clinical importance of these relationships, in patients using valproic acid (VPA), carbamazepine (CBZ), and levetiracetam (LEV) as monotherapy and polytherapy. Methods: We enrolled 37 patients on VPA, 30 on CBZ, 31 on LEV, 30 on multidrug therapy, and 60 control subjects. We compared the levels of vitamin B12, folic acid, Hcy and polymorphism. Results: Vitamin B12 was low in patients on CBZ (p=0.02) and in combined CBZ and VPA (p=0.02). B12 was low in combined CBZ and VPA (p=0.05). In patients without polymorphism, Hcy was high on VPA (p=0.02), and folic acid was the low on CBZ (0.005). In patients with polymorphism, vitamin B12 was low on CBZ (p=0.02), and folic acid was low on VPA (p=0.04). Vitamin B12 was low in combined CBZ and VPA (p=0.05). Conclusions: Vitamin B12 therapy is necessary on CBZ and on combined CBZ and VPA. VPA should not be used in the presence of other thrombophilic risk factors because of hyperhomocysteinemia. Polytherapy does not increase hyperhomocysteinemia risk in comparison to monotherapy. Vitamin B12, folic acid, Hcy do not effect on seizure frequency.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"29 1","pages":"147 - 151"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84928215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2017-0002
Serdar Gülşen, Y. Çekmez, I. Ulu, Şebnem Garip, F. Aksoy, S. B. Türkmen, G. Gök, G. Kıran
Abstract Background: Endocan was shown to be a possible predictor of vascular endothelium related diseases. Due to this fact we aimed to investigate the role of maternal serum endocan levels in preeclampsia presence and severity. Methods: A total of 70 patients, including 25 normal pregnant women and 45 patients with preeclampsia (consists of 25 mild and 20 severe preeclamptic women), were included in this study. Maternal serum endocan concentrations were measured and compared among groups and subgroups. Results: Levels of endocan were detected statistically higher in the preeclamptic group than the control group. Endocan levels were lower in the severe preclampsia group than the mild preeclampsia group but this was not detected statistically significant. Conclusions: Maternal serum endocan levels can be used as a biomarker for preeclampsia presence.
{"title":"Investigation of the relation of maternal serum endocan levels to preeclampsia presence and severity","authors":"Serdar Gülşen, Y. Çekmez, I. Ulu, Şebnem Garip, F. Aksoy, S. B. Türkmen, G. Gök, G. Kıran","doi":"10.1515/labmed-2017-0002","DOIUrl":"https://doi.org/10.1515/labmed-2017-0002","url":null,"abstract":"Abstract Background: Endocan was shown to be a possible predictor of vascular endothelium related diseases. Due to this fact we aimed to investigate the role of maternal serum endocan levels in preeclampsia presence and severity. Methods: A total of 70 patients, including 25 normal pregnant women and 45 patients with preeclampsia (consists of 25 mild and 20 severe preeclamptic women), were included in this study. Maternal serum endocan concentrations were measured and compared among groups and subgroups. Results: Levels of endocan were detected statistically higher in the preeclamptic group than the control group. Endocan levels were lower in the severe preclampsia group than the mild preeclampsia group but this was not detected statistically significant. Conclusions: Maternal serum endocan levels can be used as a biomarker for preeclampsia presence.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"122 1","pages":"117 - 121"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82839678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-07-26DOI: 10.1515/labmed-2016-0045
Anil Yalcin, A. Baydın, Ö. K. Tunçel, A. K. Erenler, C. Çokluk, M. Güzel, L. Tomak
Abstract Background: The primary aim of this study was to investigate the diagnostic values of serum S100 calcium-binding protein B (S100B) and proenkephalin (P-ENK) levels in brain damage caused by traumatic brain injury (TBI). Methods: We prospectively collected serum blood samples of 58 adult patients admitted to our emergency department due to TBI. Serum S100B and P-ENK levels were measured and compared according to clinical findings and outcomes of the patients. Results: When patients with brain injury were compared to controls, statistical significance was determined in both S100B and P-ENK levels. According to the receiver operating characteristic (ROC) analysis, cut-off values for serum S100B and P-ENK levels for the differential diagnosis of patients with and without brain damage were found to be 785.944 ng/mL and 2.445 ng/mL, respectively. There was a statistical significance in both S100B and P-ENK levels when patients who were discharged and those who died were compared. Conclusions: Serum S100B and P-ENK levels are found to be elevated in patients with TBI when compared to controls. Additionally, serum levels of both markers are found to be elevated in patients with multiple lesions when compared to patients with a single lesion. Serum S100B and P-ENK levels may also be used as predictors of mortality in patients with TBI.
{"title":"Diagnostic values of proenkephalin and S100B protein in traumatic brain injury","authors":"Anil Yalcin, A. Baydın, Ö. K. Tunçel, A. K. Erenler, C. Çokluk, M. Güzel, L. Tomak","doi":"10.1515/labmed-2016-0045","DOIUrl":"https://doi.org/10.1515/labmed-2016-0045","url":null,"abstract":"Abstract Background: The primary aim of this study was to investigate the diagnostic values of serum S100 calcium-binding protein B (S100B) and proenkephalin (P-ENK) levels in brain damage caused by traumatic brain injury (TBI). Methods: We prospectively collected serum blood samples of 58 adult patients admitted to our emergency department due to TBI. Serum S100B and P-ENK levels were measured and compared according to clinical findings and outcomes of the patients. Results: When patients with brain injury were compared to controls, statistical significance was determined in both S100B and P-ENK levels. According to the receiver operating characteristic (ROC) analysis, cut-off values for serum S100B and P-ENK levels for the differential diagnosis of patients with and without brain damage were found to be 785.944 ng/mL and 2.445 ng/mL, respectively. There was a statistical significance in both S100B and P-ENK levels when patients who were discharged and those who died were compared. Conclusions: Serum S100B and P-ENK levels are found to be elevated in patients with TBI when compared to controls. Additionally, serum levels of both markers are found to be elevated in patients with multiple lesions when compared to patients with a single lesion. Serum S100B and P-ENK levels may also be used as predictors of mortality in patients with TBI.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"17 1","pages":"123 - 128"},"PeriodicalIF":0.0,"publicationDate":"2017-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82905845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-04-25DOI: 10.1515/labmed-2016-0077
M. Salinas, M. López-Garrigós, E. Flores, C. Leiva-Salinas
Abstract Background: The aim was to study the regional variability in the request of the ten most frequently ordered laboratory tests in primary care in Spain. Methods: Spain is divided into autonomous communities (AACC), first level health care divisions. Every AACC is divided into health departments (HDs). A laboratory attends the needs of every HD inhabitant. Laboratories from different HDs participated in the study. They reported the request of the ten most commonly requested laboratory tests in primary care during the year 2014 according to prior evidence: alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, creatinine, γ-glutamyl transpeptidase (GGT), glucose, HDL-cholesterol, triglycerides, uric acid and urinalysis. Test-utilization rates were calculated as tests per 1000 inhabitants. Laboratories were grouped in the different AACC and the results for each region were compared using the coefficient of quartile dispersion (CQD), calculated using the first (Q1) and third (Q3) quartiles for each data set, as follows: (Q3−Q1)/(Q3+Q1). Results: One hundred and ten laboratories participated, corresponding to 27,798,262 inhabitants (59.8% Spanish population) from 15 AACC. 82,710,869 tests were requested. AST, GGT and uric acid showed the greatest variation. Conclusions: There were significant regional differences in how the most common laboratory tests were ordered in Spain.
{"title":"Evaluating regional variability in the use of the most commonly requested laboratory tests in primary care in Spain: data from the multi-center national scale REDCONLAB initiative","authors":"M. Salinas, M. López-Garrigós, E. Flores, C. Leiva-Salinas","doi":"10.1515/labmed-2016-0077","DOIUrl":"https://doi.org/10.1515/labmed-2016-0077","url":null,"abstract":"Abstract Background: The aim was to study the regional variability in the request of the ten most frequently ordered laboratory tests in primary care in Spain. Methods: Spain is divided into autonomous communities (AACC), first level health care divisions. Every AACC is divided into health departments (HDs). A laboratory attends the needs of every HD inhabitant. Laboratories from different HDs participated in the study. They reported the request of the ten most commonly requested laboratory tests in primary care during the year 2014 according to prior evidence: alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, creatinine, γ-glutamyl transpeptidase (GGT), glucose, HDL-cholesterol, triglycerides, uric acid and urinalysis. Test-utilization rates were calculated as tests per 1000 inhabitants. Laboratories were grouped in the different AACC and the results for each region were compared using the coefficient of quartile dispersion (CQD), calculated using the first (Q1) and third (Q3) quartiles for each data set, as follows: (Q3−Q1)/(Q3+Q1). Results: One hundred and ten laboratories participated, corresponding to 27,798,262 inhabitants (59.8% Spanish population) from 15 AACC. 82,710,869 tests were requested. AST, GGT and uric acid showed the greatest variation. Conclusions: There were significant regional differences in how the most common laboratory tests were ordered in Spain.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"603 1","pages":"104 - 99"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83785310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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