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Laboratory Medicine

Kyung-Hwa Shin, Hyun-Ji Lee, Duyeal Song, Sun-Min Lee, In Suk Kim, Hyunghoi Kim, Eu Jeen Yang, Kyung-Hee Park
Background: Hyperbilirubinemia, which is a sign of hemolytic disease of the newborn (HDN), can irreversibly damage the central nervous system. Objectives: To determine the etiology of HDN in affected patients and characterize the changing pattern of bilirubin using direct antiglobulin testing (DAT). Methods: We collected clinical data from newborns who underwent perinatal DAT and from their mothers, between August 2008 and July 2017. Results: Among 303 neonates, 37 (12...
September 6, 2018: Laboratory Medicine
Jeffrey S Mohlman, Jonathan R Genzen, Ronald L Weiss, Robert L Schmidt
Objectives: To determine whether different laboratory developed test (LDT) risk stratification proposals would assign differing levels of risk to selected LDTs as a measure of the validity of those proposals, and whether there would be differing interrater agreement rates as a measure of the reliability of those proposals. Methods: A total of 4 reviewers applied 6 proposals for risk stratification of 4 LDTs. Interrater agreement was calculated as a measure of the reliability of the proposals...
August 29, 2018: Laboratory Medicine
Sen Wang, Xian Wang, Shengnan Tang, Yuxin Chen, Jia Jia, Junhao Chen, Han Shen, Bing Bai
Background: The sensitivity of the commonly used immunochromatographic fecal occult blood test (iFOBT) is critical in the routine screening of digestive tract cancers. Objective: To determine whether the performance of the iFOBT might be improved by optimizing detergents and buffers in stool solution. Methods: We tested different buffers and detergents in stool solution. The specificity of the new solution condition was confirmed by dot immunoblotting...
August 28, 2018: Laboratory Medicine
Austin Adams, Joely A Straseski, Christopher M Lehman, Lauren N Pearson
Background: Chemistry testing is requested for body fluid (BF) specimens despite the lack of assays approved by the US Food and Drug Administration (FDA). The criteria for categorizing fluids as transudate or exudate are not validated across analyzers. Objective: To compare BF chemical analysis and classification by different analyzers. Methods: We analyzed 10 pleural and 18 peritoneal fluids with corresponding plasma specimens using the Vitros 5,1 FS; Abbott ARCHITECT ci8200; and Roche Modular P platforms...
August 24, 2018: Laboratory Medicine
Elizabeth M Staley, Sierra C Simmons, Alexander Z Feldman, Lance A Williams, Huy P Pham
Heparin-induced thrombocytopenia (HIT) is a not-uncommon adverse effect of heparin exposure, with potentially serious and/or fatal thrombotic consequences. Recent studies looking at the off-label use of fondaparinux for HIT show similar efficacy and adverse-effect profiles, as well as improved costs, compared with some commonly used direct thrombin inhibitors. Although routine laboratory monitoring of fondaparinux-specific anti-Xa levels typically is not recommended, we present a case report that suggests fondaparinux monitoring may be needed in patients with hepatic impairment causing acquired antithrombin deficiency...
August 24, 2018: Laboratory Medicine
Nipaporn Deejai, Suwannee Wisanuyotin, Choochai Nettuwakul, Sookkasem Khositseth, Nunghathai Sawasdee, Kiattichai Saetai, Pa-Thai Yenchitsomanus, Nanyawan Rungroj
Background: Two common mutations of the solute carrier family 4 member 1 (SLC4A1) gene, namely, Southeast Asian ovalocytosis (SAO) and band 3 Bangkok 1 (G701D), cause autosomal recessive distal renal tubular acidosis (AR dRTA) in ethnic Southeast Asian populations. In this study, we applied the high-resolution melting (HRM) method for screening of AR dRTA associated with SLC4A1 mutations in 10 new patients with unknown cause(s) of AR dRTA. Methods: We analyzed SAO and G701D mutations in the patients and their family members using HRM...
August 17, 2018: Laboratory Medicine
Ishwarlal Jialal, Richa Singh
Allergy to insulin occurs in approximately 2% of patients treated with insulin. However, major guidelines fail to emphasize this serious adverse effect. In this article, we report on a 61 year old ethnic Filipino man who developed urticaria and pruritus with a swollen tongue, which necessitated a visit to the emergency department. His clinical diagnosis was confirmed by a high titer of anti-insulin antibodies. His condition was successfully managed by discontinuing insulin and by treatment with oral hypoglycemic agents, with no additional adverse reactions...
August 17, 2018: Laboratory Medicine
Zahra Sepehri, Zohre Kiani, Farhad Kohan, Saeid Ghavami
Objective: To review the main Mycobacterium tuberculosis (Mtb) pathogen-associated molecular patterns (PAMPs) and the roles played by toll-like receptor (TLR)4 in determination of Mtb infection outcome. Methods: Several scientific databases, including Scopus, PubMed, and Google Scholar, were used for searching appropriate research articles from the literature for information on our topic. Results: TLR4 plays positive roles in induction of immune responses against Mtb and participates in eradication of the infection...
August 17, 2018: Laboratory Medicine
Frances B Compton, Reem Alrabeh, Lisa Q Nguyen, Elena Nedelcu, Amer Wahed, Nghia D Nguyen
Background: The PIFA PLUSS PF4 Rapid Assay (PIFA) is a rapid screening test used for the diagnosis of heparin-induced thrombocytopenia (HIT). Objective: To determine the usefulness of this assay as a screening method in our institution. Methods: A total of 159 specimens from patients with suspected HIT were included in our study. We simultaneously performed PIFA assay and confirmatory polyspecific enzyme-linked immunosorbent assay (ELISA)...
August 6, 2018: Laboratory Medicine
Caterina M Miraglia
Ebolaviruses have gained much attention recently due to the outbreak from 2014 through 2016. The related marburgviruses also have been responsible for large outbreaks with high case fatality rates. The purpose of this article is to provide the clinical laboratory scientist with a review of the most current developments in marburgvirus research. The PubMed database was reviewed using the keywords "Marburg virus," "Ravn virus," and "marburgviruses," with publication dates from January 1, 2015 through June 20, 2017...
August 6, 2018: Laboratory Medicine
Osman Evliyaoglu, Josef van Helden, Matthias Imöhl, Ralf Weiskirchen
Objective: To describe the reference intervals of folate, vitamin B12, vitamin B6, and vitamin B1 by sex and age. Methods: The study was performed by gathering data on 55,811 subjects from 57 medical centers. Groups were categorized based on age and grouped according to statistical significance values. The reference values for the different groups were determined using the Bhattacharya and Hoffmann methods. Results: Vitamin B1 and B6 values and folate (vitamin B9) levels between the sexes were statistically significantly increased in the group aged 0 to 10 years...
August 1, 2018: Laboratory Medicine
Najib Aziz, Joshua J Quint, Elizabeth C Breen, John Oishi, Beth D Jamieson, Otoniel Martinez-Maza, Roger Detels
Background: Clinicians often use population-based reference intervals (RIs) when interpreting patient results. However, this method can present problems if the analyte in question has wide variability from person to person. Methods: We examined the biological variation of routine hematologic markers in 82 white non-Hispanic men every 6 months during a 30-year period, to determine the usefulness of population-based RIs and age-related decline of hematological markers...
July 27, 2018: Laboratory Medicine
Dalia A Labib, Olfat G Shaker, Rasha M El Refai, Shada A Ghoniem, Alaa Elmazny
Single-nucleotide polymorphisms (SNPs) in microRNA-146a (miRNA-146a) can be associated with the development of immune-system dysfunctions.The aim of this work is to correlate SNPs of miRNA-146a and its target gene, IRAK1, with susceptibility, clinical manifestations, and diseases progression in patients with systemic lupus erythematous (SLE) and multiple sclerosis (MS). Genotyping for miRNA-146a (rs2910164) and its target gene IRAK1 (rs3027898) was performed using real-time polymerase chain reaction (RT-PCR) in 80 patients with SLE and 70 patients with MS, as well as 120 healthy control individuals...
July 27, 2018: Laboratory Medicine
Blaine A Mathison, Bobbi S Pritt
Zoonotic helminths are frequent human parasites that generally complete their natural life cycle in the absence of humans. This review encompasses 30 common or clinically relevant zoonotic helminth infections that are endemic to North America. For each organism or disease, the following information is briefly reviewed: taxonomy, biology, and life cycle, epidemiology, route of transmission for the human host, clinical manifestations, pathologic features, treatment, and laboratory diagnosis. Illustrations are provided for select parasites...
July 18, 2018: Laboratory Medicine
Burak Bahar, Stefan E Pambuccian, Güliz A Barkan, Yasemin Akdas
Background: The misuse of statistical methods in diagnostic accuracy studies has been criticized in many publications. Objective: To assess the use and misuse of statistical methods in medical journal articles. Methods: We reviewed 141 original articles from 6 cytopathology journals published in 2014. Results: In total, 16 articles used no descriptive statistics and 66 articles used no inferential statistics. Also, 82 articles did not report using any tests for diagnostic accuracy...
July 17, 2018: Laboratory Medicine
Egarit Noulsri, Sakkarin Ardsiri, Surada Lerdwana, Kovit Pattanapanyasat
Objective: To determine the number and intensity of phosphatidylserine (PS) expression of the red blood cells (RBCs), fragmented RBCs, and RBC-derived microparticles (RMPs) in patients with β-thalassemia/hemoglobin (Hb)E. Methods: We used flow cytometry to determine the number and levels of PS expression. Results: The number of PS-exposing RBCs was statistically significantly higher (P <.001) than that of PS-exposing fragmented RBCs or RMPs...
July 17, 2018: Laboratory Medicine
Chethan K Belludi, Edward T Qian, James J Tolle, Ryan M Brown, Mary Ann Thompson, Ridas Juskevicius
Anaplastic large cell lymphoma (ALCL) is a lymphoma of T-cell origin, characterized by the presence of large lymphoid cells with abundant cytoplasm and pleomorphic, often horseshoe-shaped nuclei (hallmark cells), as well as strong and uniform expression of cluster of differentiation (CD)30. Two distinct clinicopathologic categories of ALCL include primary cutaneous ALCL and systemic ALCL. Systemic ALCL is further classified into anaplastic lymphoma kinase (ALK)-positive, ALK-negative, and breast implant-associated ALCL...
July 17, 2018: Laboratory Medicine
Ashwin S Akki, Sun M Chung, Bryan J Rudolph, Michelle R Ewart
Background: We describe the differential diagnosis of an obese 12-year-old boy of Mexican origin who presented with a 6-year history of abnormal lipid profile and elevated liver transaminase levels. Methods: The patient underwent routine clinical testing, an abdominal ultrasound and, ultimately, a liver biopsy. Based on the histologic findings, a serum leukocyte lysosomal acid lipase (LAL) assay and DNA sequencing of the lipase A (LIPA) gene were performed. Results: Liver biopsy revealed diffuse microvesicular steatosis with clusters of foamy histiocytes in the lobules and portal areas...
July 4, 2018: Laboratory Medicine
Hoi-Ying Elsie Yu, Harold Lanzoni, Tracy Steffen, Warren Derr, Kim Cannon, Jeanene Contreras, Jordan Erik Olson
Background: To further improve workflow efficiency, our laboratory implemented a total laboratory automation (TLA) system that connected our preanalytic processing system with various testing (hematology, coagulation, and chemistry). Methods: Detailed time and motion studies were performed to create process flow maps before and after TLA. The before maps identified opportunities for workflow improvements. We used postimplementation studies to quantify efficiency gains...
June 29, 2018: Laboratory Medicine
Tingting Li, Haijian Zhao, Cuanbao Zhang, Wei Wang, Falin He, Kun Zhong, Shuai Yuan, Zhiguo Wang
Objective: To understand the reasons for proficiency testing (PT) failures, toward the goal of continuous improvement of laboratory services. Methods: Laboratories participating in PT of routine chemistry testing provided by the National Center for Clinical Laboratories (NCCL) of China were given 3 schemes for handling PT failures in 2016. If they had unsatisfactory PT performance, they were notified and requested to investigate failure errors and submit data regarding those errors...
June 28, 2018: Laboratory Medicine
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