Pub Date : 2017-04-25DOI: 10.1515/labmed-2017-0013
S. Dasdelen, S.-O. Grebe
Zusammenfassung: Die Nierentransplantation stellt die Therapie der Wahl für eine bedeutende Zahl an Patienten mit terminaler Niereninsuffizienz dar. Dabei kommt der Prophylaxe, Diagnostik und Therapie von Infektionen eine besondere Bedeutung zu. Neben den bekannten nosokomial und ambulant erworbenen Infektionen bei hospitalisierten Patienten finden sich darüber hinaus im Kollektiv der Immunsupprimierten eine ganze Reihe opportunistischer und seltener Erreger, deren Kenntnis für eine optimierte und gezielte Behandlung erforderlich ist. Da das immunsuppressive Regime entsprechend der Phasen nach der Transplantation angepasst und reduziert wird und darüber hinaus erst mit einer gewissen Verzögerung latente Erkrankungen reaktiviert werden, kann in definierten Zeitintervallen nach der Transplantation mit dem Vorkommen bestimmter Infektionen gerechnet werden. Der vorliegende Übersichtsartikel soll dabei helfen, die häufigen und einige der seltenen Erkrankungen in dem breiten mikrobiologischen Spektrum der infektiologischen Transplantationsnachsorge zu erkennen und die Diagnostik und Therapie zu strukturieren.
{"title":"Infektionen nach Nierentransplantation","authors":"S. Dasdelen, S.-O. Grebe","doi":"10.1515/labmed-2017-0013","DOIUrl":"https://doi.org/10.1515/labmed-2017-0013","url":null,"abstract":"Zusammenfassung: Die Nierentransplantation stellt die Therapie der Wahl für eine bedeutende Zahl an Patienten mit terminaler Niereninsuffizienz dar. Dabei kommt der Prophylaxe, Diagnostik und Therapie von Infektionen eine besondere Bedeutung zu. Neben den bekannten nosokomial und ambulant erworbenen Infektionen bei hospitalisierten Patienten finden sich darüber hinaus im Kollektiv der Immunsupprimierten eine ganze Reihe opportunistischer und seltener Erreger, deren Kenntnis für eine optimierte und gezielte Behandlung erforderlich ist. Da das immunsuppressive Regime entsprechend der Phasen nach der Transplantation angepasst und reduziert wird und darüber hinaus erst mit einer gewissen Verzögerung latente Erkrankungen reaktiviert werden, kann in definierten Zeitintervallen nach der Transplantation mit dem Vorkommen bestimmter Infektionen gerechnet werden. Der vorliegende Übersichtsartikel soll dabei helfen, die häufigen und einige der seltenen Erkrankungen in dem breiten mikrobiologischen Spektrum der infektiologischen Transplantationsnachsorge zu erkennen und die Diagnostik und Therapie zu strukturieren.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"17 1","pages":"59 - 71"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82750676","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-2016-0089
Babette Hofmann, Cathleen Schröder, Niels Geisler, G. Stamminger
Zusammenfassung: Im Rahmen des Anbieterwechsels erfolgte im Zentrum für Diagnostik am Klinikum Chemnitz eine umfassende Validation des STA R Max® der Firma Stago. Neben der Ermittlung von Intra- und Interassay – Präzisionen wurden umfassende Vergleichsmessungen mit der bisherigen Routinemethode (BCS XP von Siemens) mit gepoolten Patientenplasmen durchgeführt. In dieser Publikation werden die Ergebnisse für Parameter der Basis – und Notfallversorgung vorgestellt. Die Ergebnisse waren gut bis sehr gut und ließen eine zügige Umstellung zu. Darüber hinaus wurden Anwenderfreundlichkeit von System und Reagenzien, die durchschnittliche Bearbeitungszeit sowie die allgemeine Störanfälligkeit des neuen Systems getestet. Nach verschiedenen Anpassungen im diagnostischen Prozess erfolgte die Überführung der neuen Geräte in die Routine.
{"title":"Evaluierung und Einführung des STA R Max® Hämostaseologie – Analysators im Zentrallabor eines Großkrankenhauses","authors":"Babette Hofmann, Cathleen Schröder, Niels Geisler, G. Stamminger","doi":"10.1515/labmed-2016-0089","DOIUrl":"https://doi.org/10.1515/labmed-2016-0089","url":null,"abstract":"Zusammenfassung: Im Rahmen des Anbieterwechsels erfolgte im Zentrum für Diagnostik am Klinikum Chemnitz eine umfassende Validation des STA R Max® der Firma Stago. Neben der Ermittlung von Intra- und Interassay – Präzisionen wurden umfassende Vergleichsmessungen mit der bisherigen Routinemethode (BCS XP von Siemens) mit gepoolten Patientenplasmen durchgeführt. In dieser Publikation werden die Ergebnisse für Parameter der Basis – und Notfallversorgung vorgestellt. Die Ergebnisse waren gut bis sehr gut und ließen eine zügige Umstellung zu. Darüber hinaus wurden Anwenderfreundlichkeit von System und Reagenzien, die durchschnittliche Bearbeitungszeit sowie die allgemeine Störanfälligkeit des neuen Systems getestet. Nach verschiedenen Anpassungen im diagnostischen Prozess erfolgte die Überführung der neuen Geräte in die Routine.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"23 1","pages":"81 - 87"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91321653","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-2017-0012
A. Isazadeh, S. Haj Azimian, Nazila Tariverdi, S. Rahmani, M. Esmaeili, Samaneh Karimkhanilouei, Milad Mohammadoo-khorasani
Abstract Background: Recurrent pregnancy loss (RPL) is a heterogeneous condition consisting of two or more consecutive abortions occurring before 20 weeks of gestation. One of the clotting factor genes encodes factor XIII (FXIII), which is involved in fibrin formation. The most common polymorphism in the FXIII genes is the conversion of G to T in exon 2 (val34leu) of the FXIIIA gene, which leads to the substitution of valine with leucine. The objective of this study was to investigate the association between RPL and FXIII val34leu polymorphisms in a sample population of Iranian Azeri women. Methods: A prospective case-control study was performed on a cohort of 310 RPL patients and 290 healthy controls. DNA was extracted from the whole blood and fragments of the Val34Leu polymorphism were amplified by polymerase chain reaction (PCR), followed by DNA sequencing. Genotyping was performed using the Sequenom MassArray system. Results: The genotype frequencies of FXIII in the case group were 60.64% GG, 34.83% GT, and 4.41% TT, whereas the frequencies in the control group were 58.96% GG, 36.5% GT, and 4.48% TT. T allele frequencies in the case and control groups were 78.06% and 21.93%, respectively, and G allele frequencies were 77.24% and 22.75%, respectively. Conclusions: No significant association was observed between the Val34Leu polymorphism and RPL among Iranian Azeri women.
{"title":"Effects of coagulation factor XIII (Val34Leu) polymorphism on recurrent pregnancy loss in Iranian Azeri women","authors":"A. Isazadeh, S. Haj Azimian, Nazila Tariverdi, S. Rahmani, M. Esmaeili, Samaneh Karimkhanilouei, Milad Mohammadoo-khorasani","doi":"10.1515/labmed-2017-0012","DOIUrl":"https://doi.org/10.1515/labmed-2017-0012","url":null,"abstract":"Abstract Background: Recurrent pregnancy loss (RPL) is a heterogeneous condition consisting of two or more consecutive abortions occurring before 20 weeks of gestation. One of the clotting factor genes encodes factor XIII (FXIII), which is involved in fibrin formation. The most common polymorphism in the FXIII genes is the conversion of G to T in exon 2 (val34leu) of the FXIIIA gene, which leads to the substitution of valine with leucine. The objective of this study was to investigate the association between RPL and FXIII val34leu polymorphisms in a sample population of Iranian Azeri women. Methods: A prospective case-control study was performed on a cohort of 310 RPL patients and 290 healthy controls. DNA was extracted from the whole blood and fragments of the Val34Leu polymorphism were amplified by polymerase chain reaction (PCR), followed by DNA sequencing. Genotyping was performed using the Sequenom MassArray system. Results: The genotype frequencies of FXIII in the case group were 60.64% GG, 34.83% GT, and 4.41% TT, whereas the frequencies in the control group were 58.96% GG, 36.5% GT, and 4.48% TT. T allele frequencies in the case and control groups were 78.06% and 21.93%, respectively, and G allele frequencies were 77.24% and 22.75%, respectively. Conclusions: No significant association was observed between the Val34Leu polymorphism and RPL among Iranian Azeri women.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"1 1","pages":"89 - 92"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89490826","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-2017-0011
Alexander Gaudl, Y. Bae, J. Kratzsch
Abstract: Quantitative steroid analysis via liquid chromatography-tandem mass spectrometry (LC-MS/MS) is applicable to clinical routine diagnostics by now, substituting immunoassays due to its superior selectivity and comparable sensitivity. Multiplexed assays covering a multitude of analytes represent the gold standard in this regard. There are commercially available kits which are easily adapted to individual LC-MS/MS systems required. Prior to and even after their appearance, in-house method development represented the flexible alternative in terms of solving specific analytical problems or focusing on a narrower steroid profile while maximizing sensitivity and high throughput applicability. In this work, commercial assays and in-house methods are discussed in relation to a benchmark LC-MS/MS method. Thereby, prerequisites and results are compared. Furthermore, the effect of concomitant medication on steroid assays was tested and requirements regarding quality assurance in routine steroid analysis are discussed. Most of the different commercially available or in-house LC-MS/MS methods for steroid analysis show a good or reasonable agreement of results. However, the harmonization in the methodology of mass spectrometric assays has to be improved to further reduce their variability. Such a procedure would facilitate the performance of diagnostic tests that involve the measurement of steroid hormones by the tremendous improvement of diagnostic sensitivity and specificity.
{"title":"Steroid analysis in clinical routine diagnostics – discussing crucial questions","authors":"Alexander Gaudl, Y. Bae, J. Kratzsch","doi":"10.1515/labmed-2017-0011","DOIUrl":"https://doi.org/10.1515/labmed-2017-0011","url":null,"abstract":"Abstract: Quantitative steroid analysis via liquid chromatography-tandem mass spectrometry (LC-MS/MS) is applicable to clinical routine diagnostics by now, substituting immunoassays due to its superior selectivity and comparable sensitivity. Multiplexed assays covering a multitude of analytes represent the gold standard in this regard. There are commercially available kits which are easily adapted to individual LC-MS/MS systems required. Prior to and even after their appearance, in-house method development represented the flexible alternative in terms of solving specific analytical problems or focusing on a narrower steroid profile while maximizing sensitivity and high throughput applicability. In this work, commercial assays and in-house methods are discussed in relation to a benchmark LC-MS/MS method. Thereby, prerequisites and results are compared. Furthermore, the effect of concomitant medication on steroid assays was tested and requirements regarding quality assurance in routine steroid analysis are discussed. Most of the different commercially available or in-house LC-MS/MS methods for steroid analysis show a good or reasonable agreement of results. However, the harmonization in the methodology of mass spectrometric assays has to be improved to further reduce their variability. Such a procedure would facilitate the performance of diagnostic tests that involve the measurement of steroid hormones by the tremendous improvement of diagnostic sensitivity and specificity.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"36 2 1","pages":"73 - 79"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77683416","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-2016-0086
Hanheng Zuo, Yinping Li, Peng Hao, Jing-Hua Liu
Abstract Background: Atherosclerosis (AS) is a vascular disease which causes cardiovascular diseases such as stroke, heart attack and acute coronary syndrome. It is a major cause of death worldwide, especially in developed countries. In AS, the artery walls become thickened due to the accumulation and invasion of white blood cells (foam cells) and form a fibro-fatty plaque. Hence, these investigations aim to identify the potential applications of herbal compounds targeting the AMPK signalling pathway for AS therapy. Methods: In this investigation, in vitro kinase activity was determined for a set of herbal compounds present in herbal plants and herbal medicines against 5′ AMP-activated protein kinase (AMPK). This enzyme plays a vital role in AS, having an effect on the invasion and accumulation of white blood cells, leading to the thickening of artery walls and vascular remodelling. In addition, a molecular docking simulation study was carried out for the AMPK enzyme (PDB ID: 3AQV) against the herbal compounds. Results: The in vitro kinase activity showed that 10 of the herbal compounds possessed IC50 values lower than 10 μM, which showed the potent inhibitory effect of the AMPK enzyme. In addition, a molecular docking simulation carried out on the AMPK enzyme (PDB ID: 3AQV) against the herbal compounds observed a positive correlation with IC50 values and docking scores of the docked compounds with an IC50 <10 μM. The subsequent protein-ligand interaction analyses for the best docking hits showed favourable interactions. Also, the molecular dynamics simulation enabled the generation of a trajectory file for the RMSD backbone, illustrating the stability of the docked protein-ligand complex without any structural fluctuations. Conclusions: The study concludes that baicalin, curcumin, campesterol, emodin and gingerol provide a promising lead for AS and can therefore be prescribed for the treatment of AS.
{"title":"Drug design targeting the AMPK signalling pathway with herbal medicines for atherosclerosis therapy","authors":"Hanheng Zuo, Yinping Li, Peng Hao, Jing-Hua Liu","doi":"10.1515/labmed-2016-0086","DOIUrl":"https://doi.org/10.1515/labmed-2016-0086","url":null,"abstract":"Abstract Background: Atherosclerosis (AS) is a vascular disease which causes cardiovascular diseases such as stroke, heart attack and acute coronary syndrome. It is a major cause of death worldwide, especially in developed countries. In AS, the artery walls become thickened due to the accumulation and invasion of white blood cells (foam cells) and form a fibro-fatty plaque. Hence, these investigations aim to identify the potential applications of herbal compounds targeting the AMPK signalling pathway for AS therapy. Methods: In this investigation, in vitro kinase activity was determined for a set of herbal compounds present in herbal plants and herbal medicines against 5′ AMP-activated protein kinase (AMPK). This enzyme plays a vital role in AS, having an effect on the invasion and accumulation of white blood cells, leading to the thickening of artery walls and vascular remodelling. In addition, a molecular docking simulation study was carried out for the AMPK enzyme (PDB ID: 3AQV) against the herbal compounds. Results: The in vitro kinase activity showed that 10 of the herbal compounds possessed IC50 values lower than 10 μM, which showed the potent inhibitory effect of the AMPK enzyme. In addition, a molecular docking simulation carried out on the AMPK enzyme (PDB ID: 3AQV) against the herbal compounds observed a positive correlation with IC50 values and docking scores of the docked compounds with an IC50 <10 μM. The subsequent protein-ligand interaction analyses for the best docking hits showed favourable interactions. Also, the molecular dynamics simulation enabled the generation of a trajectory file for the RMSD backbone, illustrating the stability of the docked protein-ligand complex without any structural fluctuations. Conclusions: The study concludes that baicalin, curcumin, campesterol, emodin and gingerol provide a promising lead for AS and can therefore be prescribed for the treatment of AS.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"110 1","pages":"105 - 112"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87700555","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-2017-0007
R. Haeckel, W. Wosniok, E. Gurr, T. Postma, T. Streichert
Abstract: The rapid increase to digitalize whatever is possible in human lives will lead to electronic storage of medical data probably during the whole life of most individuals. This requires standardization and condensation of an enormous amount of data. Most laboratory data are already reported in digitalized form, but they are far from being sufficiently standardized. Several attempts for standardization have been suggested. The most common standardizing approach is the z-transformation of laboratory data. It is proposed to modify the z-value to a quantity quotient in analogy to the intelligence quotient well known even to laymen.
{"title":"Quantity quotient reporting versus z-value for standardizing quantitative laboratory results","authors":"R. Haeckel, W. Wosniok, E. Gurr, T. Postma, T. Streichert","doi":"10.1515/labmed-2017-0007","DOIUrl":"https://doi.org/10.1515/labmed-2017-0007","url":null,"abstract":"Abstract: The rapid increase to digitalize whatever is possible in human lives will lead to electronic storage of medical data probably during the whole life of most individuals. This requires standardization and condensation of an enormous amount of data. Most laboratory data are already reported in digitalized form, but they are far from being sufficiently standardized. Several attempts for standardization have been suggested. The most common standardizing approach is the z-transformation of laboratory data. It is proposed to modify the z-value to a quantity quotient in analogy to the intelligence quotient well known even to laymen.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"57 1","pages":"93 - 97"},"PeriodicalIF":0.0,"publicationDate":"2017-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73543823","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 : 2017-02-01DOI: 10.1515/labmed-2016-0087
G. Hoffmann, F. Klawonn, R. Lichtinghagen, M. Orth
Zusammenfassung Hintergrund Im Zuge des deutschen E-Health-Gesetzes von 2016 wurde die DGKL aufgefordert, Vorschläge für die standardisierte Speicherung und Übermittlung von Labordaten zu erarbeiten. Wir schlagen dafür die in der Statistik weit verbreitete z-Transformation vor. Methoden Man erhält mit diesem Verfahren einen Relativwert, der angibt, um wie viele Standardabweichungen ein Messwert vom Mittelwert des Referenzkollektivs abweicht. Anhand realer Daten belegen wir die Annahme, dass die Werte gesunder Referenzpersonen durch logarithmische Transformation einer Normalverteilung angenähert werden können. Ergebnisse Kennt man somit die Unter- und Obergrenze UG und OG des Referenzintervalls, so kann man jedes Laborergebnis mit folgender Gleichung transformieren: zlog=(log(x)– (log(UG)+log(OG))/2)⋅3,92/(log(OG) – log(UG)) $eqalign{ & {rm{zlog}} = {rm{(log(x)}}-{bf{ }}{rm{(log(UG)}} + {rm{log(OG))/2)}} cdot {rm{3,92/(log(OG)}} cr & & -{bf{ }}{rm{log(UG))}} cr} $ Der zlog-Wert ist leicht interpretierbar: Sein Referenzintervall liegt methodenunabhängig stets zwischen –1,96 und +1,96; stark erniedrigte oder erhöhte Laborergebnisse führen zu zlog-Werten um –5 bzw. +5. Für eine intuitive Befunddarstellung kann man zlog-Werte auch in eine kontinuierliche Farbskala, z. B. von Blau über Weiß bis Orange umrechnen. Mithilfe der Umkehrfunktion lässt sich aus dem zlog-Wert auch das theoretische Resultat einer Messmethode mit einem anderen Referenzintervall berechnen: x=UG0,5 − zlog/3,92⋅OG0,5 + zlog/3,92 ${rm{x}} = {rm{U}}{{rm{G}}^{0,5{bf{ }} - {bf{ }}{rm{zlog}}/3,92}} cdot {rm{O}}{{rm{G}}^{0,5{bf{ }} + {bf{ }}{rm{zlog}}/3,92}}$ Schlussfolgerung Unser Standardisierungsvorschlag ist ein leicht realisierbarer und effektiver Beitrag zur Verbesserung der Datenqualität und Patientensicherheit im Rahmen des E-Health-Gesetzes. Es wird gefordert, dass alle Labore künftig zusätzlich zum Originalwert den zlog-Wert zur Verfügung stellen und dass in die Protokolle für die elektronische Labordatenübertragung (HL7, LDT) ein eigenes Feld für diesen zusätzlichen Wert eingefügt wird.
{"title":"Der zlog-Wert als Basis für die Standardisierung von Laborwerten","authors":"G. Hoffmann, F. Klawonn, R. Lichtinghagen, M. Orth","doi":"10.1515/labmed-2016-0087","DOIUrl":"https://doi.org/10.1515/labmed-2016-0087","url":null,"abstract":"Zusammenfassung Hintergrund Im Zuge des deutschen E-Health-Gesetzes von 2016 wurde die DGKL aufgefordert, Vorschläge für die standardisierte Speicherung und Übermittlung von Labordaten zu erarbeiten. Wir schlagen dafür die in der Statistik weit verbreitete z-Transformation vor. Methoden Man erhält mit diesem Verfahren einen Relativwert, der angibt, um wie viele Standardabweichungen ein Messwert vom Mittelwert des Referenzkollektivs abweicht. Anhand realer Daten belegen wir die Annahme, dass die Werte gesunder Referenzpersonen durch logarithmische Transformation einer Normalverteilung angenähert werden können. Ergebnisse Kennt man somit die Unter- und Obergrenze UG und OG des Referenzintervalls, so kann man jedes Laborergebnis mit folgender Gleichung transformieren: zlog=(log(x)– (log(UG)+log(OG))/2)⋅3,92/(log(OG) – log(UG)) $eqalign{ & {rm{zlog}} = {rm{(log(x)}}-{bf{ }}{rm{(log(UG)}} + {rm{log(OG))/2)}} cdot {rm{3,92/(log(OG)}} cr & & -{bf{ }}{rm{log(UG))}} cr} $ Der zlog-Wert ist leicht interpretierbar: Sein Referenzintervall liegt methodenunabhängig stets zwischen –1,96 und +1,96; stark erniedrigte oder erhöhte Laborergebnisse führen zu zlog-Werten um –5 bzw. +5. Für eine intuitive Befunddarstellung kann man zlog-Werte auch in eine kontinuierliche Farbskala, z. B. von Blau über Weiß bis Orange umrechnen. Mithilfe der Umkehrfunktion lässt sich aus dem zlog-Wert auch das theoretische Resultat einer Messmethode mit einem anderen Referenzintervall berechnen: x=UG0,5 − zlog/3,92⋅OG0,5 + zlog/3,92 ${rm{x}} = {rm{U}}{{rm{G}}^{0,5{bf{ }} - {bf{ }}{rm{zlog}}/3,92}} cdot {rm{O}}{{rm{G}}^{0,5{bf{ }} + {bf{ }}{rm{zlog}}/3,92}}$ Schlussfolgerung Unser Standardisierungsvorschlag ist ein leicht realisierbarer und effektiver Beitrag zur Verbesserung der Datenqualität und Patientensicherheit im Rahmen des E-Health-Gesetzes. Es wird gefordert, dass alle Labore künftig zusätzlich zum Originalwert den zlog-Wert zur Verfügung stellen und dass in die Protokolle für die elektronische Labordatenübertragung (HL7, LDT) ein eigenes Feld für diesen zusätzlichen Wert eingefügt wird.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"65 1","pages":"23 - 32"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83124672","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 : 2017-02-01DOI: 10.1515/LABMED-2017-0005
P. Schuff-Werner
{"title":"Laboratoriumsmedizin oder Journal of Laboratory Medicine – Gedanken zur zukünftigen strategischen Ausrichtung","authors":"P. Schuff-Werner","doi":"10.1515/LABMED-2017-0005","DOIUrl":"https://doi.org/10.1515/LABMED-2017-0005","url":null,"abstract":"","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"06 1","pages":"1 - 2"},"PeriodicalIF":0.0,"publicationDate":"2017-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86387345","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 : 2017-01-31DOI: 10.1515/labmed-2016-0079
E. Gurr, R. Haeckel, M. Orth, Thomas Streichert
Zusammenfassung: Kenntnisse zur Messunsicherheit sind für die diagnostische Bewertung quantitativer Messgrößen in der Laboratoriumsmedizin von Bedeutung. Die DIN EN ISO schreibt daher die Einschätzung und Validierung dieser Messunsicherheit vor. Die Arbeitsgemeinschaft „Richtwerte“ der Deutschen Vereinten Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL) hat ein Konzept zur Ableitung zulässiger Grenzen für die analytische Impräzision, und die systematische Messabweichung (Bias) aus der Größe der Referenzintervalle unter der Berücksichtigung technischer Standards entwickelt. Analytische Impräzision, systematische Messabweichung und kombinierte Messunsicherheit lassen sich demnach als Funktion der empirischen biologischen Variabilität ausdrücken. Das Konzept beschreibt zudem die Möglichkeit, systematische Messabweichunen durch die Verwendung der laborinternen Referenzintervalle zu vermeiden.
{"title":"Festlegung der zulässigen Messunsicherheit quantitativer Messgrößen in der Laboratoriumsmedizin","authors":"E. Gurr, R. Haeckel, M. Orth, Thomas Streichert","doi":"10.1515/labmed-2016-0079","DOIUrl":"https://doi.org/10.1515/labmed-2016-0079","url":null,"abstract":"Zusammenfassung: Kenntnisse zur Messunsicherheit sind für die diagnostische Bewertung quantitativer Messgrößen in der Laboratoriumsmedizin von Bedeutung. Die DIN EN ISO schreibt daher die Einschätzung und Validierung dieser Messunsicherheit vor. Die Arbeitsgemeinschaft „Richtwerte“ der Deutschen Vereinten Gesellschaft für Klinische Chemie und Laboratoriumsmedizin (DGKL) hat ein Konzept zur Ableitung zulässiger Grenzen für die analytische Impräzision, und die systematische Messabweichung (Bias) aus der Größe der Referenzintervalle unter der Berücksichtigung technischer Standards entwickelt. Analytische Impräzision, systematische Messabweichung und kombinierte Messunsicherheit lassen sich demnach als Funktion der empirischen biologischen Variabilität ausdrücken. Das Konzept beschreibt zudem die Möglichkeit, systematische Messabweichunen durch die Verwendung der laborinternen Referenzintervalle zu vermeiden.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"66 1","pages":"53 - 58"},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76062292","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 : 2017-01-31DOI: 10.1515/labmed-2016-0074
R. Dolscheid-Pommerich, Sarah Dolscheid, L. Eichhorn, B. Zur, S. Holdenrieder, B. Stoffel‐Wagner
Abstract Background: Since the introduction of luminescent oxygen channeling immunoassays (LOCI™)-based assays in the daily laboratory routine of tumor marker measurements, only a small number of method comparisons with established immunoassays have been published. We performed a method comparison between LOCI™-based tumor marker assays for Dimension™ VISTA and electrochemiluminiscent immunoassays (ECLIA) for Cobas™ e411, for α-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 125, CA 15-3, CA 19-9, prostate-specific antigen (PSA) and free PSA (fPSA). Methods: Tumor markers were assessed in 1088 sera from routine diagnostics on the Dimension™ VISTA 1500 and Cobas™ e411 analyzers. Results: Strong correlations were achieved for PSA (r=0.999), AFP (r=0.994) and CEA (r=0.993). Results were quite comparable as only minor slopes of 1.05 (PSA), 1.02 (AFP) and 0.94 (CEA), respectively, were found. However, correlations for CA 125 (r=0.976), CA 19-9 (r=0.960), fPSA (r=0.950) and CA 15-3 (r=0.940) were only moderate, and considerable slopes were observed for these markers with higher values for CA 19-9 (slope 1.50) and lower ones for CA 15-3 (0.76), fPSA (0.75) and CA 125 (0.64), for Dimension™ VISTA 1500. Conclusions: We found excellent correlations and comparable values for AFP, CEA and PSA, but only moderate correlations for fPSA, CA 125, CA 15-3 and CA 19-9. The slopes for CA 19-9, CA 15-3, fPSA and CA 125 have to be considered when analysis methods for tumor markers are changed.
{"title":"Method comparison of tumor markers assessed by LOCI™- and ECLIA-based technologies","authors":"R. Dolscheid-Pommerich, Sarah Dolscheid, L. Eichhorn, B. Zur, S. Holdenrieder, B. Stoffel‐Wagner","doi":"10.1515/labmed-2016-0074","DOIUrl":"https://doi.org/10.1515/labmed-2016-0074","url":null,"abstract":"Abstract Background: Since the introduction of luminescent oxygen channeling immunoassays (LOCI™)-based assays in the daily laboratory routine of tumor marker measurements, only a small number of method comparisons with established immunoassays have been published. We performed a method comparison between LOCI™-based tumor marker assays for Dimension™ VISTA and electrochemiluminiscent immunoassays (ECLIA) for Cobas™ e411, for α-fetoprotein (AFP), carcinoembryonic antigen (CEA), CA 125, CA 15-3, CA 19-9, prostate-specific antigen (PSA) and free PSA (fPSA). Methods: Tumor markers were assessed in 1088 sera from routine diagnostics on the Dimension™ VISTA 1500 and Cobas™ e411 analyzers. Results: Strong correlations were achieved for PSA (r=0.999), AFP (r=0.994) and CEA (r=0.993). Results were quite comparable as only minor slopes of 1.05 (PSA), 1.02 (AFP) and 0.94 (CEA), respectively, were found. However, correlations for CA 125 (r=0.976), CA 19-9 (r=0.960), fPSA (r=0.950) and CA 15-3 (r=0.940) were only moderate, and considerable slopes were observed for these markers with higher values for CA 19-9 (slope 1.50) and lower ones for CA 15-3 (0.76), fPSA (0.75) and CA 125 (0.64), for Dimension™ VISTA 1500. Conclusions: We found excellent correlations and comparable values for AFP, CEA and PSA, but only moderate correlations for fPSA, CA 125, CA 15-3 and CA 19-9. The slopes for CA 19-9, CA 15-3, fPSA and CA 125 have to be considered when analysis methods for tumor markers are changed.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"14 1","pages":"11 - 3"},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89138364","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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