Practical Laboratory Medicine最新文献

{"title":"Performance evaluation of influenza a rapid antigen test and PCR among nasopharyngeal and oropharyngeal samples","authors":"Xiaosong Su ,&nbsp;Jiaye Zhou ,&nbsp;Ling Liu ,&nbsp;Hongzhi Gao ,&nbsp;Yan Lin ,&nbsp;Zhile Wang ,&nbsp;Xin Zhang ,&nbsp;Baishen Pan ,&nbsp;Beili Wang ,&nbsp;Chunyan Zhang ,&nbsp;Wei Guo","doi":"10.1016/j.plabm.2024.e00416","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00416","url":null,"abstract":"<div><h3>Objectives</h3><p>Rapid antigen test (RAT) and polymerase chain reaction (PCR) using nasopharyngeal (NP) or oropharyngeal (OP) swab specimens are the two main testing techniques used for laboratory diagnosis of influenza in clinical practice. However, performance variations have been observed not only between techniques, but also between different specimens. This study evaluated the differences in performance between specimens and testing techniques to identify the best combination in clinical practice.</p></div><div><h3>Methods</h3><p>Both NP and OP samples from suspected influenza patients collected in the 2023/4–2023/5 Flu-season in Xiamen, China, were tested for RAT and quantitative PCR. The testing performance of the different specimens and testing techniques were recorded and evaluated.</p></div><div><h3>Results</h3><p>Compared to PCR, RAT showed 58.9 % and 10.3 % sensitivity for NP and OP swabs, respectively. The Limit of Detection (LoD) was 28.71 the Median Tissue Culture Infectious Dose (TCID₅₀)/mL. Compared with PCR using NP swabs, PCR with OP swabs showed 89.5 % sensitivity and 95.4 % specificity.</p></div><div><h3>Conclusions</h3><p>There were no significant differences in performance between the specimens when PCR was used to test for influenza. However, a decrease in sensitivity was observed when the RAT was used, regardless of the specimen type. Therefore, to avoid false-negative results, PCR may be a better choice when OP swabs are used as specimens. In contrast, NP swabs should be the recommended specimens for RAT.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00416"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000623/pdfft?md5=efeafd52dcb04891c8f51ab8d9ce74d1&pid=1-s2.0-S2352551724000623-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141323512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enzymatic detection of α-hydroxybutyrate, an important marker of insulin resistance, and comparison with LC-MS/MS detection","authors":"Beate Steiner ,&nbsp;Christian Leitner ,&nbsp;David Stadler ,&nbsp;Eva-Maria Prugger ,&nbsp;Christoph Magnes ,&nbsp;Peter L. Herzog","doi":"10.1016/j.plabm.2024.e00398","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00398","url":null,"abstract":"<div><h3>Aim</h3><p>The metabolite α-hydroxybutyrate (α-HB) is an important marker of insulin resistance and impaired glucose tolerance allowing to identify patients at risk of developing diabetes and related metabolic disorders before any symptoms become apparent. At present, its exact quantification requires mass spectrometry (LC-MS), which is not compatible with routine laboratory use. Accordingly, a simple enzymatic-based method was assessed and its applicability and measuring accuracy compared with LC-MS was investigated.</p></div><div><h3>Methods</h3><p>Standards, serum, and plasma samples containing α-HB were prepared with routine procedures and their α-HB contents measured with the XpressGT® enzymatic test kit photometrically or with LC-MS and multiple reaction monitoring.</p></div><div><h3>Results</h3><p>α-HB detection with XpressGT® yielded highly linear calibration curves and 102 % recovery of stocks added to commercial samples. Stability of the analyte in serum and plasma samples prepared with various anti-coagulants was &gt;90 % after 46 h for several widely used preparations and recovery after 3 freeze-thaw cycles was ≥95 % with these anti-coagulants. A direct comparison of 75 samples indicated very good agreement of α-HB levels determined by both methods, 86 % of XpressGT® samples being within ±20 % of LC-MS values and even 93 % within ±20 % considering only samples above 30 μM concentration.</p></div><div><h3>Conclusion</h3><p>XpressGT®-based detection of α-HB is an easily applicable method which can be used for accurate and reliable quantification of the metabolite in clinical practice. Routine α-HB determination in patients at risk of developing diabetes would allow early establishment of preventive measures or pharmacological intervention reducing the risk for the onset of serious diabetes-related health problems.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00398"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000441/pdfft?md5=f57563a55f17bbd1ce542cb6fe9fd18f&pid=1-s2.0-S2352551724000441-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140879997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPLC and flow cytometry combined approach for HbF analysis in fetomaternal haemorrhage evaluation","authors":"Benedetta Peruzzi ,&nbsp;Serena Guerrieri ,&nbsp;Tiziana Biagioli ,&nbsp;Luisa Lanzilao ,&nbsp;Sara Pratesi ,&nbsp;Sara Bencini ,&nbsp;Marinella Statello ,&nbsp;Alessia Carraresi ,&nbsp;Stefania Stefanelli ,&nbsp;Martina Tonelli ,&nbsp;Marco Brogi ,&nbsp;Manuela Capone ,&nbsp;Alessio Mazzoni ,&nbsp;Anna Maria Grazia Gelli ,&nbsp;Alessandra Fanelli ,&nbsp;Roberto Caporale ,&nbsp;Francesco Annunziato","doi":"10.1016/j.plabm.2024.e00401","DOIUrl":"10.1016/j.plabm.2024.e00401","url":null,"abstract":"<div><h3>Introduction</h3><p>Recently, a flow cytometric (FC) based test has been developed for detection of circulating fetal cells to replace the less accurate and reproducible Kleihauer-Betke test.</p><p>FC test is easier to perform, it can distinguish the origin of fetal cells, but it is expensive and available in highly specialized laboratories. We evaluated the introduction of high-performance liquid chromatography (HPLC) approach as initial screening to identify patients who need an additional FC test to better discriminate the nature of haemoglobin-F (HbF) positive cells.</p></div><div><h3>Methods</h3><p>Blood samples from 130 pregnant women suspected to have fetomaternal haemorrhage were analysed with HPLC and FC methods. The cut-off for HbF HPLC concentration was calculated. Statistical analyses for the evaluation of HPLC as a screening method were performed. The positivity cut-off of HbF to be used as decision-making value to continue the investigation was calculated.</p></div><div><h3>Results</h3><p>An excellent agreement (R² &gt; 0.90) was observed between the percentage of HbF obtained by HPLC and the percentage of fetal cells detected by FC. Results obtained from each assay were compared to define the HPLC threshold below which it is not necessary to continue the investigations, confirming the maternal nature of the HbF positive cells detected. Our study demonstrated that a cut-off of 1.0 % HbF obtained by HPLC was associated with the lowest rate of false negative results in our patient cohort.</p></div><div><h3>Conclusions</h3><p>This study provides a new FMH investigation approach that possibly leads to a reduction in times and costs of the analysis.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00401"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000477/pdfft?md5=8fe6e1a4d570fbec4024ab791d7c745f&pid=1-s2.0-S2352551724000477-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Italian external quality assessment program for Cystic Fibrosis sweat chloride test: CFTR modulators and the impact of a new sweat test report form","authors":"Natalia Cirilli ,&nbsp;Giovanna Floridia ,&nbsp;Annalisa Amato ,&nbsp;Rita Padoan ,&nbsp;Federica Censi ,&nbsp;Gianluca Ferrari ,&nbsp;Valeria Raia ,&nbsp;Giuseppe Castaldo ,&nbsp;Ettore Capoluongo ,&nbsp;Domenica Taruscio ,&nbsp;Marco Salvatore","doi":"10.1016/j.plabm.2024.e00403","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00403","url":null,"abstract":"<div><h3>Background</h3><p>The advent of CFTR modulators highlighted that the sweat test (ST) for CF can be used also as an outcome measure for the basic defect of CFTR. Despite the technological advances, ST still remains operator-dependent and its execution should be strongly paired with guidelines. In 2022, due to the advent of CFTR modulators, the Italian CF Society introduced a specific ST report. The aim of the present paper is to discuss the impact of this new report in the 2022-23 round of the Italian External Quality Assessment program for ST (I-EQA-SCT).</p></div><div><h3>Methods</h3><p>The scheme of the I-EQA-SCT is prospective, enrolment is voluntary, the payment of a fee is required and results are shared through a web-facility. Assessment covers analysis, interpretation, and reporting of results. In the 2022-23 round, 2 out of the 3 mock clinical information referred to patients who started modulators.</p></div><div><h3>Results</h3><p>Fourteen laboratories completed the 2022-23 I-EQA-SCT round. Three of them failed in the interpretation of results from these two mock cases and/or used a wrong report not consistent with the more recent Italian Sweat Test Recommendations.</p></div><div><h3>Conclusions</h3><p>The overall results obtained from the laboratories involved in the I-EQA-SCT program clearly showed that the laboratories’ qualitative and quantitative performance improved significantly. Results emerged from this round highlighted an issue in the report form used for monitoring patients on CFTR modulator therapy thus stressing the importance of these programs in improving both the performance of lab services and ameliorating the sweat test recommendations.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00403"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000490/pdfft?md5=0d971d899d8456940875725a0c6bb72f&pid=1-s2.0-S2352551724000490-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141083660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reference intervals of Cyfra21-1 and CEA in healthy adult Han Chinese population","authors":"Lidan Xing ,&nbsp;Shuai Zhao ,&nbsp;Shichao Gao,&nbsp;Xiaoqian Shi,&nbsp;Yaomeng Huang,&nbsp;Puhuan Bian,&nbsp;Jingna Sun","doi":"10.1016/j.plabm.2024.e00409","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00409","url":null,"abstract":"<div><h3>Objective</h3><p>This study aimed to establish the reference intervals of Cyfra21-1 and CEA for the local screening populations using a chemiluminescence method.</p></div><div><h3>Methods</h3><p>A total of 4845 healthy adults and 190 lung cancer patients were included from the First Hospital of Hebei Medical University. The levels of Cyfra21-1 and CEA were measured to establish the local reference intervals.</p></div><div><h3>Results</h3><p>The upper limit reference intervals for Cyfra21-1 and CEA were determined as 3.19 ng/ml and 3.13 ng/ml, respectively. Notably, both Cyfra21-1 and CEA levels were found to be higher in males than in females. Additionally, both biomarkers showed an increasing trend with age.</p><p>In terms of diagnostic efficacy, the receiver operating characteristic (ROC) curve areas for Cyfra21-1, CEA, and their combination in lung cancer were 0.86, 0.73, and 0.91, respectively.</p></div><div><h3>Conclusion</h3><p>Our study revealed that the reference intervals of Cyfra21-1 and CEA in the local population differed from the established reference intervals. Furthermore, both biomarkers exhibited gender-dependent variations and demonstrated a positive correlation with age. Combining the two biomarkers showed potential for improving the diagnosis rate of lung cancer.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00409"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000556/pdfft?md5=93f0cacdcc571aef9f87336ce0e449d5&pid=1-s2.0-S2352551724000556-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141239036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unified calibration of D-dimer can improve the uniformity of different detection systems","authors":"Kun Wang ,&nbsp;Xinwei Zang ,&nbsp;Wenjie Zhang ,&nbsp;Xiangyu Cao ,&nbsp;Huiru Zhao ,&nbsp;Chunyan Li ,&nbsp;Cuiying Liang ,&nbsp;Jun Wu","doi":"10.1016/j.plabm.2024.e00413","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00413","url":null,"abstract":"<div><h3>Background</h3><p>D-dimer at a low level is important evidence for excluding the onset and progression of thrombosis. It is readily detectable and yields rapid results, although significant variability exists among different detection systems. Our study aims to enhance the consistency across various detection systems.</p></div><div><h3>Methods</h3><p>Twelve detection systems were included in our study. We sought to address this inconsistency by using various calibrators (two supplied by manufacturers and two comprising pooled human plasma diluted with different diluents) to standardize D-dimer measurements. We categorized the data into three groups according to D-dimer concentration levels: low (≤0.5 mg/L), medium (&gt;0.5 mg/L - &lt;3 mg/L), and high (≥3 mg/L). We then analyzed the data focusing on range, consistency, comparability, negative coincidence rate, and false negative rate.</p></div><div><h3>Results</h3><p>Calibrating with pooled human plasma led to narrower result ranges in the low and medium groups (P &lt; 0.05). In the low group, consistency improved from weak to strong (ICC 0.4–0.7, P﹤0.05), while it remained excellent in the other groups and overall (ICC﹥0.75, P﹤0.05). The percentage of pairwise comparability increased in both the low and high groups. Additionally, there was an increase in the negative coincidence rate.</p></div><div><h3>Conclusion</h3><p>These findings demonstrate that uniform calibration of D-dimer can significantly enhance the consistency of results across different detection systems.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00413"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000593/pdfft?md5=df6911df6a73af616b3526357832c179&pid=1-s2.0-S2352551724000593-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141314733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance verification and clinical evaluation of the NAP-Fluo Cycler system for detecting five genital tract pathogens based on microfluidic technology","authors":"Ye Wang ,&nbsp;Qunshan Xu ,&nbsp;Jianguo Cai ,&nbsp;Lijin Zheng ,&nbsp;Weilun Zuo ,&nbsp;Jumei Liu ,&nbsp;Jiali Cao ,&nbsp;Mingxin Lin ,&nbsp;Hongli Liu ,&nbsp;Huiming Ye","doi":"10.1016/j.plabm.2024.e00417","DOIUrl":"10.1016/j.plabm.2024.e00417","url":null,"abstract":"<div><h3>Introduction</h3><p>Sexually transmitted infections (STIs) are among the most common infectious diseases worldwide, often leading to coinfections. Timely detection of genital tract pathogens in at-risk populations is crucial for preventing STIs. We evaluated the NAP-Fluo Cycler System, an innovative microfluidic nucleic acid detection platform, for its ability to simultaneously identify <em>Chlamydia trachomatis</em> (CT), <em>Neisseria gonorrhoeae</em> (NG), <em>Ureaplasma urealyticum</em> (UU), <em>Mycoplasma genitalium</em> (MG), and <em>Mycoplasma hominis</em> (MH) in urethral or cervical secretions.</p></div><div><h3>Materials and methods</h3><p>The limits of detection (LODs), repeatability, specificity, and interference resistance of the system were evaluated using standard strains, a panel of 24 pathogens, and seven interferents. We used the system to analyze 302 clinical samples and compared the results with those of five approved commercial reference kits.</p></div><div><h3>Results</h3><p>The system achieved LODs of 500 IFU/mL, 500 CFU/mL, and 500 CCU/mL for CT, NG, and UU/MG/MH, respectively, demonstrating high stability (coefficient of variation &lt;1.1 %), specificity, and resistance to interference. Among 302 clinical samples, 237 tested positive with single, dual, and triple infection rates of 35.6 %, 16.2 %, and 3.0 %, respectively. The reference kits detected 138 positive samples. The concordance rates with commercial reference kits were 100 % for UU, NG, and MH; 94.85 % for CT; and 80.00 % for MG.</p></div><div><h3>Conclusions</h3><p>This system offers a streamlined, rapid, and multiplex detection method that reduces testing time and complexity. Although it performs well with pure strains, it has limitations when using clinical samples of CT and MG, suggesting the need for further refinement before its widespread use in the clinic.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00417"},"PeriodicalIF":1.7,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000635/pdfft?md5=9d60cc521a3673d42c64982d4e1387a9&pid=1-s2.0-S2352551724000635-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seasonal variation of HbA1c levels in diabetic and non-diabetic patients","authors":"Sana Ahuja ,&nbsp;Sugandha Sugandha ,&nbsp;Rohit Kumar ,&nbsp;Sufian Zaheer ,&nbsp;Mukul Singh","doi":"10.1016/j.plabm.2024.e00396","DOIUrl":"10.1016/j.plabm.2024.e00396","url":null,"abstract":"<div><h3>Background</h3><p>Hemoglobin A1c (HbA1c) serves as a pivotal marker for long-term glycemic control. The Diabetes Control and Complications Trial (DCCT) established its relevance, yet gaps exist in understanding potential seasonal variations in HbA1c levels among diabetic patients. The study highlights the need to explore potential seasonal variations in HbA1c levels and their impact on diabetic patients.</p></div><div><h3>Materials and methods</h3><p>This is an observational study conducted in a tertiary care hospital from January to December 2019, the study analyzed HbA1c levels in 8138 patients. Blood samples were collected using Potassium EDTA-containing vials and processed with an automated analyzer. Seasonal variations were explored using time series analysis.</p></div><div><h3>Results</h3><p>Mean HbA1c levels peaked during the monsoon (June to September) and were lowest in autumn (October to November). Subgroup analysis revealed differences in patients with HbA1c values below and above 6.5 %. Those with controlled blood sugar showed higher levels in winter (December to February) and monsoon (June to September), while patients with HbA1c values ≥ 6.5 % exhibited significantly lower levels in monsoon (June to September) and autumn (October to November) compared to summer (March to May).</p></div><div><h3>Conclusion</h3><p>In contrast to global trends, Indian patients demonstrated distinct seasonal variations in HbA1c levels. The highest levels during the monsoon (June to September) may be linked to reduced outdoor activity and dietary changes. The study emphasizes the need for tailored diabetes management considering seasonal influences. Further extensive, longitudinal studies across diverse Indian regions are recommended to comprehensively grasp the impact of seasonal changes on diabetes outcomes.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00396"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000428/pdfft?md5=a43a21f9736fa93c86e41c9a472dd442&pid=1-s2.0-S2352551724000428-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140766439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A genetic condition that spans both extremes of the nutritional spectrum","authors":"Lisa M. Johnson","doi":"10.1016/j.plabm.2024.e00405","DOIUrl":"10.1016/j.plabm.2024.e00405","url":null,"abstract":"<div><p>Prader-Willi syndrome (PWS) is a complex genetic disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13 region, known as the Prader Willi critical region. Nutritional clinical manifestations change with age and are described in four different phases. The phases span both extremes of the nutritional spectrum, beginning with an infant with poor sucking reflexes and failure to thrive then progressing to an adolescent who may have hyperphagia and be at risk for obesity. The phenotype is likely due to hypothalamic dysfunction due to genetic changes in the Prader Willi critical region. Researchers are examining the pathological mechanisms that determine the disease course.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00405"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2352551724000519/pdfft?md5=64075e0dbc1febbf4adc097ce256d614&pid=1-s2.0-S2352551724000519-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond the fractures: A comprehensive Comparative analysis of Affordable and Accessible laboratory parameters and their coefficients for prediction and Swift confirmation of pulmonary embolism in high-risk orthopedic patients","authors":"Piotr Piech ,&nbsp;Mateusz Haratym ,&nbsp;Bartosz Borowski ,&nbsp;Robert Węgłowski ,&nbsp;Grzegorz Staśkiewicz","doi":"10.1016/j.plabm.2024.e00397","DOIUrl":"https://doi.org/10.1016/j.plabm.2024.e00397","url":null,"abstract":"<div><h3>Background</h3><p>Pulmonary embolism (PE) poses a significant challenge in diagnosis and treatment, particularly in high-risk patient populations such as those hospitalized for orthopedic reasons. This study explores the predictive and diagnostic potential of laboratory parameters in identifying PE among orthopedic patients.</p></div><div><h3>Objectives</h3><p>The purpose of this study was to determine whether selected (inexpensive and readily available) laboratory parameters and their coefficients can be used to diagnose pulmonary embolism and whether they are applicable in predicting its occurrence.</p></div><div><h3>Material and methods</h3><p>Selected laboratory parameters were determined twice in 276 hospitalized orthopedic patients with suspected PE: PLT, MPV, NEU, LYM, D-dimer, troponin I, age-adjusted D-dimer and their coefficients. Depending on the angio-CT results, patients were divided into groups. Selected popular laboratory coefficients were calculated and statistically analyzed. Optimal cutoff points were determined for the above laboratory tests and ROC curves were plotted.</p></div><div><h3>Results</h3><p>D-dimer/troponin I [p = 0.008], D-dimer [p = 0.001], age-adjusted D-dimer [p = 0.007], NLR/D-dimer [p = 0.005] and PLR [p = 0.021] are statistically significant predictors of PE. D-dimer/troponin I [p &lt; 0.001], troponin I [p = 0.005] and age-adjusted D-dimer [p = 0.001] correlated with the diagnosis of PE after the onset of clinical symptoms.</p></div><div><h3>Conclusions</h3><p>In the context of orthopedic patients, cost-effective laboratory parameters, particularly the D-dimer/troponin I ratio and age-adjusted D-dimer, exhibit considerable potential in predicting and diagnosing PE. These findings suggest that combining readily available laboratory tests with clinical observation can offer a viable and cost-effective diagnostic alternative, especially in resource-constrained settings. Further studies with larger and diverse patient populations are recommended to validate these results.</p></div>","PeriodicalId":20421,"journal":{"name":"Practical Laboratory Medicine","volume":"40 ","pages":"Article e00397"},"PeriodicalIF":1.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S235255172400043X/pdfft?md5=a58645a9794c537feaa7740f3ec07054&pid=1-s2.0-S235255172400043X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140823132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}