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Laboratory Medicine

Egarit Noulsri, Dinar Abudaya, Surada Lerdwana, Kovit Pattanapanyasat
Objective: To determine whether a corrected lymphocyte percentage could reduce bias in the absolute cluster of differentiation (CD)4+ T lymphocyte counts obtained via dual-platform (DP) vs standard single-platform (SP) flow cytometry. Methods: The correction factor (CF) for the lymphocyte percentages was calculated at 6 laboratories. The absolute CD4+ T lymphocyte counts in 300 blood specimens infected with human immunodeficiency virus (HIV) were determined using the DP and SP methods...
March 13, 2018: Laboratory Medicine
Fred Rodriguez, Rajeevan Selvaratnam, Peggy Mann, Rina Kalariya, John R Petersen
Although laboratories may be able to rely on a comprehensive Hurricane Plan during a hurricane, alarming and unanticipated events frequently occur. To minimize disruption of lab operations, it is important to try to mitigate the impact of these unexpected events as quickly as possible, in the quest to minimize negative outcomes. In this article, we discuss approaches to dealing with unanticipated events during and after hurricanes, based on our personal experiences.
March 10, 2018: Laboratory Medicine
HebatAllah Abd El Monaem Bassiouny, Somaya Mohamed Hussein, Laila Ahmed El-Attar, Amira Ezzat Khamis Amine
Background: A bilayered medium (BLM) seemed to indicate a rapid recovery time from Mycobacterium tuberculosis (M. tuberculosis) for the patients in question, namely, 48 hours. Method: Sputum specimens collected from 112 patients with clinically suspected pulmonary tuberculosis were subjected to Ziehl-Neelsen staining and inoculation on Löwenstein-Jensen medium (LJM) and BLM. Results: BLM grew all the 36 (100%) smear positive samples, while LJM grew only 20 (55...
March 8, 2018: Laboratory Medicine
Andrea Tesija Kuna, Kristina Dukic, Nora Nikolac Gabaj, Marijana Miler, Ines Vukasovic, Sanja Langer, Ana-Maria Simundic, Nada Vrkic
Objective: To compare the analytical performances of the enzymatic method (EM) and capillary electrophoresis (CE) for hemoglobin A1c (HbA1c) measurement. Methods: Imprecision, carryover, stability, linearity, method comparison, and interferences were evaluated for HbA1c via EM (Abbott Laboratories, Inc) and CE (Sebia). Results: Both methods have shown overall within-laboratory imprecision of less than 3% for International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) units (<2% National Glycohemoglobin Standardization Program [NGSP] units)...
March 8, 2018: Laboratory Medicine
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March 2, 2018: Laboratory Medicine
Gemlyn George, Wuttiporn Manatasahit, Manjula Balasubramanian, Victor Navarro
Background: Thromboelastography (TEG) has become the standard of care in liver-transplant surgery to identify real-time abnormalities in the coagulation cascade. To our knowledge, no studies have been performed to measure the intrasubject reproducibility of TEG parameters in cirrhotic patients. Objective: To perform a validation study to determine the reproducibility of TEG in cirrhosis. Methods: We recruited 30 patients with stable cirrhosis and tested 25 of them...
February 24, 2018: Laboratory Medicine
Fred H Rodriguez, John Petersen, Rajeevan Selvaratnam, Peggy Mann, Jonathan B Hoyne
Severe weather events such as hurricanes have the potential to cause significant disruption of laboratory operations. Comprehensive planning is essential to mitigate the impact of such events. The essential elements of a Hurricane Plan, based on our personal experiences, are detailed in this article.
February 22, 2018: Laboratory Medicine
Vladimira Rimac, Ivana Lapic, Kresimir Kules, Dunja Rogic, Marijana Miler
Objective: Autovalidation algorithm should be properly designed with clearly defined criteria and any data that do not meet the criteria, must be reviewed and manually validated. The aim was to define the rules for autovalidation in our laboratory information system (LIS), and validate the algorithm prior to its implementation in routine laboratory work. Methods: Autovalidation was implemented for all routine serum biochemistry tests. The algorithm included analytical measurement ranges (AMR), delta check, critical values, serum indices and all preanalytical and analytical flags from the analyzer...
February 8, 2018: Laboratory Medicine
Adam M Szewc, Steve Taylor, Gary D Cage, Jeffery Jacobsen, Ozlem Pinar Bulut, Daphne E de Mello
A previously healthy 11-year-old Caucasian boy presented with a 2-week history of nonspecific symptoms of nausea and nonbilious, nonbloody emesis. He developed significant jaundice and hepatic encephalopathy within 1 week of beginning symptoms and was discovered to have fulminant liver failure. Extensive work-ups for underlying etiologies included serologic evaluation for underlying chronic liver diseases, toxicology screening, inborn errors of metabolism, and infectious diseases. The results of the entire assessment were negative except for human herpesvirus 6B, which was detected in the liver by quantitative real-time polymerase chain reaction and immunohistochemical analysis...
January 30, 2018: Laboratory Medicine
Tanya Tacheva, Dimo Dimov, Elina Aleksandrova, Monika Bialecka, Maya Gulubova, Tatyana Vlaykova
A characteristic feature of inflamed lungs in bronchial asthma (BA) is airway remodeling. Due to limited information on this topic in the literature, we aimed to explore the possible role of polymorphisms in the promoter region of the macrophage elastase gene MMP12 82A>G (rs2276109) as a predisposing factor for BA in an ethnic Bulgarian population. Using restriction fragment length polymorphism analysis of polymerase chain reaction-amplified fragments (PCR-RFLP), we performed genotype analysis of 58 patients and 119 control individuals...
January 30, 2018: Laboratory Medicine
Vishuda Laengsri, Usanee Kerdpin, Chotiros Plabplueng, Lertyot Treeratanapiboon, Pornlada Nuchnoi
Gynecologic malignant neoplasms are a severe health problem among female patients, of which cervical cancer (CC), in particular, is a common disease leading to high mortality rates. Despite extensive attempts by researchers to solve the molecular mystery of CC, the mechanisms of its pathogenesis remain unclear. Tumor markers used in the clinical laboratory, such as squamous cell carcinoma (SCC), cancer antigen (CA)-125, and CA19-9, provide some help in diagnosing patients with CC. However, finding new molecular markers with high sensitivity and specificity is necessary...
January 25, 2018: Laboratory Medicine
Elise Schapkaitz
Background: New erythrocyte and reticulocyte parameters provide improved classification of anemia and monitoring of erythropoeitic activity. Parameters available on the Sysmex XN analyzers include the percentage of microcytic red blood cells (%Micro-R), percentage of macrocytic red blood cells (%Macro-R), percentage of hypochromic red blood cells (%Hypo-He), percentage of hyperchromic red blood cells (%Hyper-He), reticulocyte hemoglobin content (Ret-He), and immature reticulocyte fraction (IRF)...
January 22, 2018: Laboratory Medicine
Sierra C Simmons, Laura J Taylor, Marisa B Marques, Lance A Williams
Rat poisoning should be considered in the differential diagnosis of a patient presenting with signs and symptoms of vitamin K deficiency without a more likely explanation. However, confirming this diagnosis may be difficult due to the varying sensitivities of available assays. A 40-year-old Caucasian woman presented to our hospital with chronic abdominal pain, hematuria, and a history of diarrhea of unknown etiology, despite an extensive work-up. Her laboratory evaluation results were consistent with vitamin K deficiency...
January 22, 2018: Laboratory Medicine
Emil Lou, Rachel I Vogel, Deanna Teoh, Spencer Hoostal, Aaron Grad, Matthew Gerber, Minnu Monu, Tomasz Lukaszewski, Jaai Deshpande, Michael A Linden, Melissa A Geller
Background: The clinical assessment of circulating tumor cells (CTCs) as a blood-based biomarker is FDA-approved for use in breast, colorectal, and prostate cancers. The objective of this prospective clinical study was to determine whether pretreatment CTCs are a useful diagnostic biomarker in women with complex pelvic masses. Methods: Whole blood was collected from 49 women with newly diagnosed pelvic masses. The presence of CTCs was compared between women with and without ovarian cancer histopathologic diagnosis after surgery using a Chi-squared test...
January 19, 2018: Laboratory Medicine
Xiaoling Chen, Jinbiao Wu, Lisa Ying, Dan Su, Yu Chen
Background: Inflammatory response is known to play a vital role in carcinogenesis and cancer progression. The prognostic relevance of monocyte-to-lymphocyte ratio (MLR), as a biomarker of inflammatory response has been demonstrated in patients with hematologic cancers. Objectives: In this study, we assessed the prognostic relevance of MLR in patients with resectable lung carcinoma. Methods: Clinical records of 705 lung cancer patients who underwent radical resection at our hospital between October 2006 and January 2011 were retrospectively reviewed...
January 19, 2018: Laboratory Medicine
Adolfo Romero, Juan Gómez-Salgado, José Andrés Domínguez-Gómez, Carlos Ruiz-Frutos
Background: Reducing errors in the preanalytical phase is difficult, which suggests the issue may be multidimensional. As such, qualitative research may be truly innovative in this context. Method: We carried out a descriptive study using a qualitative method incorporating 4 focus groups. Data analysis followed the principles of Grounded Theory. Results: We queried in each of the 4 focus groups collectively to identify weaknesses in the system...
January 13, 2018: Laboratory Medicine
Sakorn Pornprasert, Nur-Afsan Salaeh, Monthathip Tookjai, Manoo Punyamung, Panida Pongpunyayuen, Kallayanee Treesuwan
Objectives: To compare hematological parameters between deletional and nondeletional HbH diseases, and to investigate the correlation between HbH levels and hematological parameters within these 2 groups. Methods: Samples of 43 deletional HbH diseases, which included 39 --SEA/-α3.7, 4 - -SEA/-α4.2, and 22 nondeletional HbH diseases (- -SEA/αcsα), were used in this study. Correlations between HbH levels and hematological parameters within these 2 groups were analyzed...
January 13, 2018: Laboratory Medicine
Upasana Joneja, Gene Gulati, Alina Dulau Florea, Jerald Gong
Background: Microcytic erythrocytosis is an underrecognized and underevaluated complete blood count (CBC) finding. The literature pertaining to the determination of its etiology specifically by hemoglobin variant analysis is limited. Methods: We performed hemoglobin variant analysis by high performance liquid chromatography on 137 patients who revealed microcytic erythrocytosis on CBC, and reviewed the results for the diagnosis of hemoglobin-associated disorders...
January 13, 2018: Laboratory Medicine
John P Lee, Michael Tansey, Jennifer G Jetton, Matthew D Krasowski
Background: Interest in vitamin D has increased during the past 2 decades, with a corresponding increase in laboratory testing of 25-hydroxyvitamin D [25(OH)D]. The vast majority of specimens tested display normal or deficient levels of 25(OH)D; concentrations rarely fall in the potentially toxic range. Methods: We performed a retrospective investigation of elevated 25(OH)D levels during a 16-year period at the University of Iowa Hospitals and Clinics (UIHC), a 734-bed tertiary-/quaternary-care academic medical center in the midwestern United States...
January 13, 2018: Laboratory Medicine
Lixia Zhang, Jian Xu, Li Gao, Shiyang Pan
Spurious thrombocytopenia is a well-known phenomenon observed with the widespread use of hematology analyzers (HAs). In this study, 355 specimens with pseudo-thrombocytopenia (PTCP) were evaluated via epidemiology, identification, remedies, and platelet (PLT) count. Data showed that anticoagulants such as citrate and/or heparin-dependent PTCP (16.0%) became increasingly common, whereas ethylenediaminetetraacetic acid (EDTA)-induced PTCP (49.1%) remained the most frequent. We note that that nearly half of the patients with PTCP had veritable decreased PLT counts, even after PLT levels had been corrected...
January 13, 2018: Laboratory Medicine
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