Laboratory medicine最新文献

{"title":"Diagnostic Role of Circulating miRNAs in the Grading of Chronic Hepatitis B-Related Liver Fibrosis: A Systematic Review and Meta-Analysis.","authors":"Ting Jiang,&nbsp;Wenying Leng,&nbsp;Sen Zhong","doi":"10.1093/labmed/lmac151","DOIUrl":"https://doi.org/10.1093/labmed/lmac151","url":null,"abstract":"<p><strong>Objective: </strong>miRNAs are considered potential biomarkers that can be used for the grading of chronic hepatitis B (CHB)-related liver fibrosis. This meta-analysis aims to elucidate the diagnostic performance of miRNAs.</p><p><strong>Methods: </strong>Databases were used to search for meta-analyses. A bivariate model was used to calculate pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). In addition, the area under the summary receiver operating characteristic curve (AUC) and 95% confidence intervals (CIs) were calculated.</p><p><strong>Results: </strong>A total of 9 studies with 1159 patients with CHB-related liver fibrosis were assessed. For diagnosis of significant liver fibrosis, the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.73 (95% CI, 0.68-0.78), 0.78 (95% CI, 0.70-0.84), 3.32 (95% CI, 2.52-4.37), 0.34 (95% CI, 0.30-0.39), 9.70 (95% CI, 7.10-13.24), and 0.81 (95% CI, 0.77-0.84), respectively.</p><p><strong>Conclusion: </strong>miRNAs are potential biomarkers of CHB-related liver fibrosis.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"479-488"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10148192","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}

{"title":"Laboratory Diagnosis of Primary Amoebic Meningoencephalitis.","authors":"Juan U Rojo,&nbsp;Rajkumar Rajendran,&nbsp;Jose H Salazar","doi":"10.1093/labmed/lmac158","DOIUrl":"https://doi.org/10.1093/labmed/lmac158","url":null,"abstract":"<p><p>Primary amebic meningoencephalitis (PAM) is a fulminant fatal human disease caused by the free-living amoeba Naegleria fowleri. Infection occurs after inhalation of water containing the amoeba, typically after swimming in bodies of warm freshwater. N. fowleri migrates to the brain where it incites meningoencephalitis and cerebral edema leading to death of the patient 7 to 10 days postinfection. Although the disease is rare, it is almost always fatal and believed to be underreported. The incidence of PAM in countries other than the United States is unclear and possibly on track to being an emerging disease. Poor prognosis is caused by rapid progression, suboptimal treatment, and underdiagnosis. As diagnosis is often performed postmortem and testing is only performed by a few laboratories, more accessible testing is necessary. This article reviews the current methods used in the screening and confirmation of PAM and makes recommendations for improved diagnostic practices and awareness.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"e124-e132"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156114","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}

{"title":"A rare occurrence of Anaplasma-associated peritonitis.","authors":"Valerie Bush,&nbsp;Jitendra Chaudhary,&nbsp;Devarajan Manu,&nbsp;Charles Hyman","doi":"10.1093/labmed/lmad016","DOIUrl":"https://doi.org/10.1093/labmed/lmad016","url":null,"abstract":"<p><p>Anaplasmosis or human granulocytic anaplasmosis is a tick-borne illness caused by the bacteria, Anaplasma phagocytophilum, resulting from an infected tick bite. Examination of a blood smear within the first week of exposure may show microcolonies of anaplasmae (morulae) in the cytoplasm of neutrophils that are highly suggestive of anaplasmosis but not definitive. We present the first case describing Anaplasma-related peritonitis and morulae in peritoneal fluid granulocytes in a peritoneal dialysis patient who developed anaplasmosis.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"e152-e156"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156598","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}

{"title":"Lipoprotein-Associated Phospholipase A2 Correlates with Reduced Left Ventricle Ejection Fraction in Hemodialysis Patients.","authors":"Chen Jun-Feng,&nbsp;Jin Xiao-Ping,&nbsp;Zhang Juan,&nbsp;Yang Man-Li,&nbsp;Liu Fan,&nbsp;Fu Peng,&nbsp;Wu Qi-Shun,&nbsp;Shu Yang,&nbsp;Si Bo-Lin,&nbsp;Hu Yu-Wen,&nbsp;Chen Liang","doi":"10.1093/labmed/lmac162","DOIUrl":"https://doi.org/10.1093/labmed/lmac162","url":null,"abstract":"<p><strong>Objective: </strong>Reduced left ventricular ejection fraction (LVEF) is common in hemodialysis (HD) patients. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered an important determinant of cardiovascular events. The aim of the study was to evaluate the relationship between Lp-PLA2 and LVEF in HD patients.</p><p><strong>Methods: </strong>Fifty-seven HD patients with coronary heart disease were enrolled. Predialysis and postdialysis venous whole blood samples were collected. The patients were divided into preserved and reduced LVEF groups. The relationship between Lp-PLA2 and LVEF was assessed.</p><p><strong>Results: </strong>A significant difference in C-reactive protein (CRP) and Lp-PLA2 was observed, with higher levels noted in patients with reduced LVEF (P ≤ .001). Both Lp-PLA2 and CRP were negatively correlated with LVEF in the HD patients. Only Lp-PLA2 remained associated with LVEF in multiple regression analysis.</p><p><strong>Conclusion: </strong>Lipoprotein-associated phospholipase A2 levels are associated with LVEF and could potentially be used to evaluate chronic heart failure with reduced LVEF in HD patients for risk stratification management.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"523-526"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10164197","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}

{"title":"Thyroid-Stimulating Hormone Levels within the Trimester-Specific Reference Intervals Are Correlated with Non-High-Density Lipoprotein Cholesterol and Remnant Cholesterol Concentrations in Pregnant Women.","authors":"Guocheng Wang,&nbsp;Feng Jin,&nbsp;Limin Xie,&nbsp;Xiaofen Zhang,&nbsp;Yawei Zhang,&nbsp;Xin Ni,&nbsp;Wei Li,&nbsp;Guojun Zhang","doi":"10.1093/labmed/lmac150","DOIUrl":"https://doi.org/10.1093/labmed/lmac150","url":null,"abstract":"<p><strong>Objective: </strong>Thyroid-stimulating hormone (TSH) levels are associated with serum lipid concentrations in the general nonpregnant population. Here, we aimed to establish trimester-specific reference intervals and to explore the associations of their variations within the specific reference intervals during pregnancy.</p><p><strong>Methods: </strong>Trimester-specific reference intervals were established according to the Clinical and Laboratory Standard Institute EP28-A3c guidelines using a direct sampling method based on a large prospective cohort. After making one-to-one matches, correlation analyses between TSH and lipid index levels, especially within the reference intervals, were conducted.</p><p><strong>Result: </strong>A total of 1648 pregnant women for TSH and 2045 subjects for lipids were recruited to establish the trimester-specific reference intervals. The upper reference limit (90% confidence interval) of TSH for pregnant women in the first trimester is 3.95 (3.66-4.29) mIU/L, which is very close to the default value (4.0 mIU/L) recommended by the American Thyroid Association in 2017. Apart from triglyceride and high-density lipoprotein cholesterol, TSH levels were positively associated with the serum concentrations of total cholesterol, low-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), and remnant cholesterol (RC) either in the entire range or within the specific reference intervals. Of note, the positive correlations between TSH and non-HDL-C and RC were, albeit similarly weak (r < 0.25), relatively more robust (P < .001).</p><p><strong>Conclusion: </strong>In this study, we showed positive correlations between TSH and lipid components within trimester-specific reference intervals, highlighting the need for the integrated management of pregnant women over age 35 and with nonoptimal lipid status in China.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"449-456"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10212910","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}

{"title":"Urine Protein Immunofixation Electrophoresis: Free Light Chain Urine Immunofixation Electrophoresis Is More Sensitive than Conventional Assays for Detecting Monoclonal Light Chains and Could Serve as a Marker of Minimal Residual Disease.","authors":"Gurmukh Singh,&nbsp;Nkechi Arinze,&nbsp;David M Manthei,&nbsp;Frederick V Plapp,&nbsp;Roni J Bollag","doi":"10.1093/labmed/lmac155","DOIUrl":"https://doi.org/10.1093/labmed/lmac155","url":null,"abstract":"<p><strong>Background: </strong>Immunoglobulin monoclonal light chains (MLCs) in serum and urine are markers for monoclonal gammopathy and could serve as markers of minimal residual disease (MRD) in multiple myeloma (MM). Excretion of MLCs in urine is known to result in renal damage and shorter survival in patients with LC-predominant MM.</p><p><strong>Methods: </strong>Retrospective review of urine immunofixation in 1738 specimens at 3 medical centers was conducted to assess the utility of urinalysis for diagnosis and monitoring of monoclonal gammopathy. We tested 228 stored urine specimens via the modified urine immunofixation method, using antisera to assay free LCs (FLCs).</p><p><strong>Results: </strong>Our review of urine immunofixation results and medical records validated the theory that the only meaningful value-added finding was detection of monoclonal free light chains. Examination of 228 urine specimens using our novel method revealed 18.4% additional positive results. The rate of incremental findings for lambda LCs was nearly 3-fold higher than for kappa LCs.</p><p><strong>Conclusions: </strong>The new method of urine immunofixation is significantly more sensitive and more efficient than the conventional method for detecting MLCs in urine. The new assay appears to be sensitive enough to prove that MLCs serve as a marker of MRD in MM.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"527-533"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10510918","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}

{"title":"Association between Serum α-Klotho Levels and Behçet Disease.","authors":"Mohammad Reza Jafari Nakhjavani,&nbsp;Amir Ghorbanihaghjo,&nbsp;Aida Malek Mahdavi,&nbsp;Negin Nemati,&nbsp;Nadereh Rashtchizadeh,&nbsp;Sima Abedi Azar,&nbsp;Alireza Khabbazi","doi":"10.1093/labmed/lmac146","DOIUrl":"https://doi.org/10.1093/labmed/lmac146","url":null,"abstract":"<p><strong>Background: </strong>Endothelial dysfunction (ED) has a well-known role in promoting vascular inflammation in Behçet disease (BD). α-klotho is involved in regulation of endothelial function, and its reduction has been reported to be associated with ED.</p><p><strong>Objective: </strong>To assess serum α-klotho in patients with BD, compared with healthy control individuals.</p><p><strong>Methods: </strong>In a cross-sectional study, 55 patients with BD and 30 age- and sex-matched healthy controls were enrolled, and their serum levels of α-klotho were measured.</p><p><strong>Results: </strong>Common clinical symptoms in patients with BD were oral aphthous ulcers, uveitis, and genital ulcers. Median (IQR) serum α-klotho levels in the BD and control groups were 0.30 (0.20-0.70) and 1.00 (0.70-2.52) ng/mL, respectively. The difference was statistically significant (P = .005). No significant correlation was observed between serum α-klotho and age (r = 0.194; P = .14). Serum α-klotho levels in patients with uveitis were significantly lower.</p><p><strong>Conclusion: </strong>α-klotho may have a role in the pathogenesis of ED and is a potential biomarker for uveitis in BD.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"469-472"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156115","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}

{"title":"Biclonal Gammopathies in South Tunisia: Clinical and Biological Characteristics.","authors":"Ameni Jerbi,&nbsp;Hend Hachicha,&nbsp;Aida Charfi,&nbsp;Faten Kallel,&nbsp;Sawsan Feki,&nbsp;Mourad Ben Ayed,&nbsp;Faten Ayadi,&nbsp;Rim Akrout,&nbsp;Faten Frikha,&nbsp;Ali Amouri,&nbsp;Khaoula Kammoun,&nbsp;Moez Mdhaffar,&nbsp;Mohamed Ben Hmida,&nbsp;Nabil Tahri,&nbsp;Zouheir Bahloul,&nbsp;Sofien Baklouti,&nbsp;Moez Elloumi,&nbsp;Hatem Masmoudi","doi":"10.1093/labmed/lmac153","DOIUrl":"https://doi.org/10.1093/labmed/lmac153","url":null,"abstract":"<p><strong>Objective: </strong>Biclonal gammopathies (BGs) are rare situations characterized by the production of 2 monoclonal proteins. There are no available data on BGs in North Africa. We aimed to estimate the prevalence of BGs in our population and describe their clinical and laboratory features.</p><p><strong>Methods: </strong>We conducted a 31-year retrospective study including patients with persistent double monoclonal bands based on the results of immunofixation/immunoelectrophoresis.</p><p><strong>Results: </strong>A total of 35 patients with available clinical data (sex ratio, M/F = 1.53; mean age, 70 ± 10.87 years [range, 45-90 years]) were included. The main associated conditions were multiple myeloma (MM) (40%), BG of undetermined significance (BGUS) (34%), and lymphoproliferative diseases (23%). Only one-third of the patients had 2 monoclonal spikes on serum protein electrophoresis. The most common paraprotein combinations were immunoglobulin (Ig)G-IgG (25%) and IgG-IgA (23%) with different light chains in one-half of the cases. The mean follow-up was 25.6 months (median, 12 months). No BGUS evolved into a malignant disease.</p><p><strong>Conclusion: </strong>BGs are rare in clinical laboratory routine but must be accurately identified by the pathologist. Our cohort is characterized by a high prevalence of BGUS compared with MM.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"464-468"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10510460","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}

{"title":"Evaluation of Antinuclear Antibody and Subserology Reflex Testing for the Diagnosis of Systemic Autoimmune Rheumatic Disorders in an Academic Teaching Hospital.","authors":"Delicia Duff,&nbsp;Niti Vyas,&nbsp;Janet Enderle,&nbsp;Rajkumar Rajendran","doi":"10.1093/labmed/lmac157","DOIUrl":"https://doi.org/10.1093/labmed/lmac157","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to examine appropriate utilization of antinuclear antibody (ANA) screening tests with follow-up subserology tests (reflex testing) for diagnosing systemic autoimmune rheumatic disorder (SARD).</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 3003 SARD-test orders at an academic teaching hospital from January to December 2019. Testing patterns were categorized as American College of Rheumatology (ACR)-recommended reflex testing, panel testing, or single subserology testing. We described testing patterns, assessed their diagnostic accuracy, and explored factors associated with reflex testing.</p><p><strong>Results: </strong>Reflex testing accounted for 79.7% of SARD test-ordering, whereas improper testing (panel or single subserology) accounted for the other 20.3%. Reflex testing was associated with significantly more SARD diagnoses than improper testing (P = .004). Testing patterns were significantly associated with race/ethnicity (P = .008), with reflex testing being less frequent than improper testing in Hispanics and Whites.</p><p><strong>Conclusion: </strong>In summary, one-fifth (20.3%) of testing patterns for suspected SARD did not follow the ACR-recommended guidelines for using reflex testing. Use of reflex testing was associated with an increased frequency of SARD diagnosis.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"489-494"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156583","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}

{"title":"Clinical Educators' Teaching Approaches and Attributes in Laboratory Medicine.","authors":"Heather L Phillips,&nbsp;Eleanor K Jator,&nbsp;Shelley R Latchem,&nbsp;Timothy A Catalano","doi":"10.1093/labmed/lmad001","DOIUrl":"https://doi.org/10.1093/labmed/lmad001","url":null,"abstract":"<p><p>The quality of clinical experiences for students in health care professions relies heavily on clinical educators. Hence the quest to be informed on qualities that make great clinical educators in medical laboratory professions as well as teaching methods. A 48-question survey was developed, validated, and distributed to laboratory professionals in the American Society for Clinical Pathology database. Four questions pertaining to teaching and evaluation as well as clinical educators' attributes were evaluated in the study. Responses were analyzed using the Statistical Package for the Social Sciences. Descriptive statistics were performed with the P value set at .05. The results revealed that communication and motivation to teach were most valued among clinical educators and empathy was the least valued attribute. Educators reported on different approaches to teaching and evaluating students. Clinical educators could benefit from training that highlights these attributes and teaching methods for great clinical experiences both for educators and students.</p>","PeriodicalId":17951,"journal":{"name":"Laboratory medicine","volume":"54 5","pages":"e134-e140"},"PeriodicalIF":0.0,"publicationDate":"2023-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10156599","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}