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Practical Laboratory Medicine

Ibrahim A Hashim, Mishkat Mohamed, Aileen Cox, Fernabelle Fernandez, Patricia Kutscher
Objectives: Deviation from manufacturers' pre-analytical sample handling recommendations necessitates extensive validation studies. This report uses plasma lactate testing, where a recommended 15 min room temperature sample handling limit cannot be met by the clinical laboratory, as an example for studies to bridge the gap with practice. Design and Methods: Triplicate blood samples were collected from patients (n = 51) with lactate requests by clinicians and from normal volunteers (n = 50)...
November 2018: Practical Laboratory Medicine
Karen Cravero, Arielle Medford, Aparna Pallavajjala, Jenna Canzoniero, Natasha Hunter, David Chu, Rory L Cochran, Ian Waters, Eric S Christenson, Kelly Kyker-Snowman, Berry Button, Alex J Cole, Ben Ho Park
Background: Genomic testing is often limited by the exhaustible nature of human tissue and blood samples. Here we describe biotinylated amplicon sequencing (BAmSeq), a method that allows for the creation of PCR amplicon based next-generation sequencing (NGS) libraries while retaining the original source DNA. Design and methods: Biotinylated primers for different loci were designed to create NGS libraries using human genomic DNA from cell lines, plasma, and formalin-fixed paraffin embedded (FFPE) tissues using the BAmSeq protocol...
November 2018: Practical Laboratory Medicine
Gurpreet S Bhalla, Manbeer S Sarao, Dinesh Kalra, Kuntal Bandyopadhyay, Arun Ravi John
Non-tuberculous mycobacteria (NTM) are composed of mycobacterial species other than the Mycobacterium tuberculosis complex. Initially thought to be mere contaminants when isolated from clinical specimens, literature is increasing by the day showing NTM as proven pathogens. Due to the difference in antimicrobial susceptibility of different species, it becomes imperative for the microbiology laboratory to identify them to the species level. Molecular methods are available for rapid and accurate identification, but in a resource limited nation, phenotypic methods, albeit time consuming, are of paramount importance...
November 2018: Practical Laboratory Medicine
Alexander S Gur'ev, Irina E Yudina, Anna V Lazareva, Alexey Yu Volkov
Objectives: Specialized analyzers are used to automate the diagnosis of bacteriuria in laboratory practice. They are based on analysis of microorganisms concentration in urine samples or recording the growth of urine microflora. Coherent fluctuation nephelometry (CFN) has high sensitivity and allows analyzing both parameters simultaneously. The aim of the study is to compare the effectiveness of CFN-based and flow cytometry based analyzers. Design and methods: Total 117 urine samples from children were studied in parallel using the CFN-analyzer and UF-1000i (Sysmex), the results were confirmed by conventional microbiological methods...
November 2018: Practical Laboratory Medicine
Shaik Fareeda Begum, Gutam Nagajothi, Kodidela Swarna Latha, G Sandeep, Bandi Sreekanth, Chitta Suresh Kumar, W Rajendra, Narendra Maddu
The aim of the study is to levels of nicotine and cotinine were elevated the oxidative stress malondialdehyde (MDA) and inflammation as nitric oxide (NO2 and NO3 ) may possibly be associated with decreased antioxidant enzyme activities and can sensitively indicate the production of reactive oxygen species (ROS). To evaluate the quantitative analysis of nicotine and cotinine levels and the alterations in the selected parameters of antioxidant metabolisms during nitroxidative stress in the saliva of smokeless tobacco consumers...
November 2018: Practical Laboratory Medicine
Ian Farrance, Tony Badrick, Robert Frenkel
Procedures for assessing the uncertainty in measurement and estimates of biological variation are currently available for many measurands capable of direct analytical measurement. However, not all measurands or quantity values determined in a medical laboratory are provided by direct analytical measurement. Estimated glomerular filtration rate (eGFR) is such a quantity value. In this situation, the result is calculated from other measurements through a functional relationship in which the output value (the calculated quantity value) is derived from one or more input quantities by applying a defined mathematical equation...
November 2018: Practical laboratory medicine
Mayu Onozato, Yuriko Tanaka, Michitsune Arita, Tatsuya Sakamoto, Hideaki Ichiba, Kiyomi Sadamoto, Motonari Kondo, Takeshi Fukushima
Objectives: Amino acid levels in serum or plasma are used for early detection and diagnosis of several diseases. The objective of this study was to analyze amino acid levels in serum exosomes, which have not been previously reported. Design and methods: We investigated the amino acid composition of exosomes from human serum using HPLC with fluorescence detection. Results: The composition ratios of His, Arg, Glu, Cys-Cys, Lys, and Tyr were significantly increased in the exosomes compared with those in the corresponding native serum...
November 2018: Practical Laboratory Medicine
Sheng Feng, Oneka Cummings, Gregory McIntire
Scheidweiler and colleagues have clinically tested and identified a reporting cutoff (10 ng/mL) of nicotine and cotinine in oral fluid that could reliably determine active smoking in patients. The results from that study were reevaluated using a large data set of oral fluid nicotine and cotinine results available from pain medication monitoring. Additionally, test results from patients using a nicotine transdermal patch delivery device are compared with those from smokers. Finally, oral fluid test results collected over a 2-year period were normalized and transformed to yield a near Gaussian distribution for nicotine...
November 2018: Practical Laboratory Medicine
Yuji Mano
Cross validation studies for bioanalytical methods are important to ensure that assay data from all study sites where sample analysis is performed can be compared throughout clinical trials. To support global clinical studies of lenvatinib, a novel multi-targeted tyrosine kinase inhibitor, seven bioanalytical methods by liquid chromatography with tandem mass spectrometry (LC-MS/MS) were developed at five laboratories. In this study, methods were initially validated at each laboratory according to bioanalytical guidelines...
November 2018: Practical Laboratory Medicine
Talita T Rocchetti, Suzane Silbert, Alicia Gostnell, Carly Kubasek, Robert Jerris, Jennifer Vong, Raymond Widen
The aim of this study was to develop a multiplex PCR test to detect Achromobacter xylosoxidans (AX), Burkholderia cepacia (BC), Pseudomonas aeruginosa (PSA) and Stenotrophomonas maltophilia (SM) directly from CF patient's respiratory samples using the open mode of the BD MAX™ System. A total of 402 CF respiratory samples were evaluated by culture and PCR. Specific sets of primers and probes for each target were designed in-house. Out of 402 samples tested, 196 were identified as negative and 206 as positive by culture for AX, PSA, BC and SM...
November 2018: Practical Laboratory Medicine
Rie Saito, Hisayuki Yokoyama, Kuniaki Meguro, Yusuke Ohba, Yoshihiko Izumi, Shinichiro Takahashi
A 38-year-old woman was suffering from back, right arm, and ankle joint pain, and visited our emergency department. Upon admission, the white blood cell (WBC) count was high (11,700/µL), and low numbers of red blood cells (2.21 × 106 /µL) and platelets (PLTs) (42,000/µL) were observed. A PLT histogram showed an abnormally shaped peak at around 20-30 fL, suggesting the presence of giant PLTs or PLT aggregation. The WBC histogram showed abnormal elevation at 35 fL and around 100 fL, suggesting abnormal cells including nucleated red blood cells...
November 2018: Practical Laboratory Medicine
Jeffrey Petersen, Darshana Jhala
Anti-A1 antibodies can be found as a usually clinically insignificant naturally occurring cold IgM antibody in A-subgroup patients. It is known from multiple prior case reports that warm-reactive anti-A1 that reacts at 37 °C can be clinically significant, and it has been previously reported that it could form after alloimmunization with donor A1 red blood cell (RBC) transfusion. In addition, the development of anti-A1 , often as an autoantibody, have been described in the setting of various malignancies, perhaps due to expressed subtle alterations of the ABO antigens provoking an immune response...
November 2018: Practical Laboratory Medicine
Aly Bernard Khalil, Bashir Taha Salih, Onismos Chinengo, Ma Remy D Bardies, Andrew Turner, Laila O Abdel Wareth
Background: The American Thyroid Association (ATA) recommended the establishment of population specific reference ranges for thyroid hormones during pregnancy. Initial studies conducted in the United Arab Emirates (UAE) in 2003 and 2004 on pregnant women published a considerably higher upper limit for thyroid stimulating hormone (TSH) than that proposed by ATA. The UAE was classified as a country with mild iodine deficiency at the time of this initial study. After the implementation of aggressive strategies to address iodine deficiency over the last decade, the UAE was recently declared as iodine sufficient...
November 2018: Practical Laboratory Medicine
Pia Bükmann Larsen, Ole Bjørn Skausig, Esther A Jensen
No abstract text is available yet for this article.
July 2018: Practical Laboratory Medicine
N Mallouk, J Varvat, A Berger, M Epinat, S Accassat, A Garcin, A Montmartin, G Li, P Garnier, P Mismetti, C Lambert
A recently released kit (PerFix EXPOSE) was reported to improve the measurement of the degree of phosphorylation of proteins in leukocytes by flow cytometry. We tested its adaptation for platelets to monitor vasodilator-stimulated phosphoprotein (VASP) phosphorylation, which is the basis of a currently used test for the assessment of the pharmacological response to P2Y12 antagonists (PLT VASP/P2Y12). The PerFix EXPOSE kit was compared to the PLT VASP/P2Y12 kit by using blood samples drawn at 24 h post clopidogrel dose from 19 patients hospitalized for a non-cardio-embolic ischemic stroke and treated with clopidogrel monotherapy for at least five days in an observational study...
July 2018: Practical Laboratory Medicine
Mahmoud Sirdah, Khaled Al Mghari, Ali H Abuzaid, Rami M Al Haddad
Background: β-thalassemia minor (BTM) and iron deficiency (ID) are common disorders characterized by microcytosis and/or hypochromasia, leading to a challenge in their discrimination during mass-screening programs especially in developing countries where resources are limited. It has been shown with varying reliability that quick exclusion of either disorder could be achieved mathematically using RBC-based indices and formulas. However, none of these proposed indices and formulas considered the sex-based hematological differences...
July 2018: Practical Laboratory Medicine
Camille Chenevier-Gobeaux, Louis Deweerdt, Anne-Valérie Cantero, Bertrand Renaud, Bruno Desmaizières, Sandrine Charpentier, Aline Leroy, Emmanuelle Adelaïde, Delphine Collin-Chavagnac, Eric Bonnefoy-Cudraz, Laurence Estepa, Akli Chekroune, Sylvie Basco, Stéphane Andrieu, Stéphane Bourgeois, Marie-Agnès Costa, Christine Vallejo, Tiphaine Robert, Siham Ouahabi, Bruno Baudin, Benedicte Beneteau-Burnat, Anne-Marie Gorce-Dupuy, Patrick Ray, Claire Gast, Monique Dehoux, Guillaume Lefèvre
Objectives: We aimed to compare the use of nine different cardiac troponin (cTn) assays (2 cTnT and 7 cTnI) for the diagnosis of NSTEMI in a single multi-centre population. Design and methods: One hundred and fifty-eight patients were included (mean age 60 years, SD 17 years), including 23 patients (14%) with NSTEMI. Results: The analytical comparison highlighted a large heterogeneity of cTn assays, as reflected by percentages of patients with detectable cTn, correlation coefficients, Passing-Bablok comparisons and concordance coefficients...
July 2018: Practical Laboratory Medicine
Shiro Mawatari, Seira Hazeyama, Tomomi Morisaki, Takehiko Fujino
Objectives: Ethanolamine ether phospholipids (ePE) and choline ether phospholipid (ePC) are present in human serum or plasma. Decreases in ether phospholipids (plasmalogens) in serum (plasma) have been reported in several diseases such as Alzheimer's disease, Parkinson's disease, metabolic syndrome, schizophrenia. Therefore, need for assay of ether phospholipids in plasma may increase in the future. Nowadays, measurement of the ether phospholipids in human plasma seem to depend on tandem mass spectrometry (LC/MS/MS), but a system for LC/MS/MS is too expensive for most of ordinary clinical laboratories, moreover, use and maintenance of the system are time consuming...
March 2018: Practical Laboratory Medicine
Charlotte Oris, Yoan Clavel, Matthieu Jabaudon, Annick Pialat, Hadj Abdelkader Mohamed, Frédérique Lioret, Vincent Sapin, Damien Bouvier
Background: Blood gas analyzers are o0.ften integrated into point-of-care testing provisions. International standards (ISO 22870 and 15189) as adapted to French COFRAC regulations make accreditation of point-ofta-care testintag obligatory. We installed and assessed 12 GEM PREMIER 4000 analyzers for pH, p CO2 , p O2 , Na+ , K+ , Cl- , Ca2+ , lactate, hemoglobin and oxyhemoglobin (O2 Hb) at Clermont-Ferrand Hospital. These instruments were distributed across 11 care sites in the hospital...
March 2018: Practical Laboratory Medicine
Ruth Natali, Cara Wand, Kelly Doyle, Jaime H Noguez
Objectives: Blood collections from peripheral intravenous catheters offer several benefits to patients, including reduced needle punctures and patient discomfort, but they risk reducing the quality of blood specimens analyzed by the laboratory. In an effort to balance analytical quality of test results with patient-centered care initiatives, a needle-less blood collection device called PIVO™ was evaluated at two institutions. The primary objective of this study was to assess the ability of the PIVO™ device to provide high-quality blood specimens for laboratory testing compared to current blood collection methods...
March 2018: Practical Laboratory Medicine
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