Scandinavian Journal of Clinical & Laboratory Investigation最新文献

{"title":"Plasma levels of suPAR are inversely associated with absolute renal function and predict long-term outcomes in renal transplant recipients - a pilot study.","authors":"Lena Bøhnsdalen Nygaard, Veronica Krogstad, Karsten Midtvedt, Anna Varberg Reisæter, Anders Hartmann, Anders Åsberg","doi":"10.1080/00365513.2026.2749108","DOIUrl":"https://doi.org/10.1080/00365513.2026.2749108","url":null,"abstract":"<p><strong>Background: </strong>The effect of renal function on elimination of soluble urokinase-type plasminogen activator receptor (suPAR), has not been properly investigated. Initially we investigated change in suPAR concentration in the same patients before and after kidney transplantation. The primary aim was to assess the association between suPAR concentration and measured glomerular filtration rate (mGFR) in kidney transplant recipients. Secondly, investigate whether suPAR concentration, as a biomarker for inflammation, measured early post-transplant may serve as a biomarker of long-term patient and graft survival.</p><p><strong>Methods: </strong>Plasma suPAR concentrations were measured before and 8-weeks after kidney transplantation, absolute mGFR (iohexol serum clearance) was measured 8-weeks post-transplant. Long-term outcomes were obtained from the Norwegian Renal Registry.</p><p><strong>Results: </strong>suPAR concentrations (<i>n</i> = 121 paired samples) were significantly reduced by a mean of 56% (95% CI: 52-60%) from a mean of 9.7 ± 4.3 µg/L before to 3.9 ± 2.3 µg/L 8-weeks after transplantation <i>p</i> < 0.0001. At 8-weeks, higher suPAR concentrations were moderately associated with lower mGFR (r=-0.398, <i>p</i> < 0.001). Multivariable logistic regression revealed that pre-transplant suPAR concentrations, in addition to mGFR, plasma uric acid and albumin at 8-weeks were significant predictors of suPAR concentrations at 8-weeks. Patients with normal (cut-off: 4.0 µg/L), compared with elevated, suPAR concentrations 8-weeks post-transplantation experienced significantly better patient survival, but not death censored long-term graft survival.</p><p><strong>Conclusions: </strong>suPAR concentrations are closely associated with absolute mGFR indicating that renal filtration is a major elimination route for this biomarker. Our results indicate that suPAR concentrations early post-engraftment may be a relevant biomarker to consider for prediction of long-term outcomes after transplantation.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"1-9"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vancomycin therapeutic drug monitoring: trends and seasonal patterns.","authors":"Anders Larsson, Pär Hallberg, Jonathan Cedernaes, Anna-Karin Hamberg","doi":"10.1080/00365513.2026.2749100","DOIUrl":"https://doi.org/10.1080/00365513.2026.2749100","url":null,"abstract":"<p><p>Vancomycin is widely used for serious Gram-positive infections, but its narrow therapeutic index necessitates therapeutic drug monitoring (TDM). Over recent decades, monitoring has shifted from trough-based to AUC-guided dosing. This study investigated long-term trends in vancomycin concentrations, seasonal variation and the utility of patient medians as a laboratory quality tool. Serum vancomycin results (n = 59,445) from routine TDM at Akademiska Hospital, Uppsala, Sweden (2006-2024) were analyzed. Data included sampling date, age, sex and concentration. Measurements were performed using validated immunoassays (Architect ci8200 and Cobas Pro c503) with standard quality control. Annual medians and percentiles were calculated, and seasonal variation was assessed. The number of analyses increased from 2,263 (2006) to 4,164 (2015), then declined to 2,414 (2024). Median concentrations and distribution percentiles rose steadily from 2006 to 2015 and remained stable thereafter. Seasonal variation showed a ∼15% decrease in testing volume during July-August, while concentration percentiles remained consistent throughout the year. Vancomycin concentrations in routine TDM increased until 2015 and have since stabilized, despite seasonal variation in test volume. Patient medians were stable over time and may serve as a useful complement to traditional quality control, particularly when standard materials do not fully represent patient samples.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-normal and mildly elevated bilirubin levels in prefibrotic primary myelofibrosis patients are associated with lower thrombotic risk.","authors":"Marko Lucijanic, Davor Galusic, Vlatka Perisa, Ivan Zekanovic, Martina Moric Peric, Hrvoje Holik, Anica Sabljic, Rajko Kusec, Ivan Krecak","doi":"10.1080/00365513.2026.2749111","DOIUrl":"https://doi.org/10.1080/00365513.2026.2749111","url":null,"abstract":"<p><p>High-normal or mildly elevated bilirubin concentrations without apparent significance are commonly observed in clinical practice. Several observations in various chronic diseases associate them with reduced risk of metabolic and cardiovascular diseases, likely due to their antioxidant and anti-inflammatory activity. We aimed to investigate potential clinical and prognostic associations of high-normal to mildly elevated bilirubin in patients with prefibrotic primary myelofibrosis (pre-PMF), a chronic myeloproliferative neoplasm with high inflammatory and thrombotic burden. We retrospectively analyzed clinical and prognostic associations of bilirubin levels in a total of 82 pre-PMF patients diagnosed and treated in six Croatian hematology centers. Patients with apparent liver disease or hemolytic anemias were excluded from analysis. Among 82 evaluated patients, 54 (66.7%) were JAK2 mutated; 14 (17.5%) had prior thrombosis. Median age was 66 years. Incidence rates for thrombosis and bleeding were 2.02% and 1.26% patient-years, respectively. Median bilirubin levels were 11.9 µmol/L. Patients were stratified at a data-derived ≤11/>11 µmol/L cutoff for thrombotic risk evaluation. Although higher-bilirubin patients were more likely to belong to higher revised-IPSET-thrombosis categories, to be of male sex, and to have lower platelet and lymphocyte counts, they experienced significantly lower thrombotic risk compared to lower-bilirubin patients (0.47% and 3.81% patient-years, respectively). No significant association with major bleeding, nor with mortality, was observed. In the multivariate Fine and Gray regression model, higher-bilirubin (sHR 0.029 (0.006-0.13), <i>p</i> < 0.001) was independently associated with lower thrombotic risk, whereas older age (sHR 1.21 (1.04-1.41), <i>p</i> = 0.013) and male sex (sHR 6.75 (1.45-31.4), <i>p</i> = 0.015) were mutually independent predictors of higher thrombotic risk.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"1-6"},"PeriodicalIF":1.4,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149195448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement between lunar densitometers in the capital region of Denmark-a phantom study.","authors":"Marcus Bech Edelbo, Bo Zerahn","doi":"10.1080/00365513.2026.2738211","DOIUrl":"https://doi.org/10.1080/00365513.2026.2738211","url":null,"abstract":"<p><p>In clinical practice, patient follow-up requires scans to be performed on the same densitometer to ensure comparability. This study evaluated the agreement and equivalence between nine Lunar iDXA and four Lunar Prodigy scanners, assessing their interchangeability for longitudinal spine BMD monitoring. The manufacturer's encapsulated spine phantom was scanned 15 times on each of nine iDXA and four Prodigy densitometers under routine quality-control conditions by a single experienced operator. For each scanner, L2-L4 BMD repeatability was assessed using mean, SD, and coefficient of variation. Between-scanner equivalence was tested pairwise using two one-sided tests with ±1% equivalence bounds with Holm-Bonferroni correction. Exploratory method-comparison plots were used to assess agreement across vertebral regions. All iDXA scanners demonstrated low within-scanner variability (CV: 0.07-0.23%) and closely clustered mean BMD values, with a small negative bias relative to the phantom nominal value (mean -0.63%). All pairwise iDXA comparisons met the predefined ±1% equivalence criterion. Graphical analyses confirmed high agreement across all vertebral levels. In contrast, Prodigy scanners showed higher variability (CV: 0.17-0.33%), a positive bias (mean +1.5%), and failed to meet equivalence criteria in most pairwise comparisons. Under the conditions of this phantom study, the nine iDXA scanners in the region showed high agreement and may be sufficiently equivalent for longitudinal spine BMD monitoring across different sites. However, the Prodigy scanners did not demonstrate sufficient agreement for interchangeable use. These findings support regional harmonization of iDXA-based BMD measurements, although validation <i>in vivo</i>, including femoral and full-body measurements, is warranted.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"1-8"},"PeriodicalIF":1.4,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The reference intervals of PT, INR and APTT tests on the Cobas analyzer in Turkish pediatric population.","authors":"Berrak Guven, Ismail Benice, Bilgehan Acikgoz, Murat Can","doi":"10.1080/00365513.2025.2611810","DOIUrl":"10.1080/00365513.2025.2611810","url":null,"abstract":"<p><p>The aim of this study was to establish reference intervals (RIs) for prothrombin time (PT), international normalized ratio (INR) and activated partial thromboplastin time (APTT) in the Turkish pediatric population using the Cobas t511 analyzer. This retrospective study included preoperative laboratory results from 1065 healthy pediatric patients (aged 0-18 years) who underwent minor elective surgeries. RIs were established following Clinical and Laboratory Standards Institute (CLSI) guidelines and were summarized as 2.5th-97.5th percentile reference limits using nonparametric approach. The overall median (95% RI) values were 9.0 s [8.1-10.5] for PT, 1.02 [0.93-1.17] for INR, and 29.7 s [24.3-35.2] for APTT. Statistically significant differences were observed in PT, INR and APTT across age groups (<i>p</i> < 0.001). Accordingly, data were stratified into 18 age partitions, and reported for each group. In conclusion, our study provides pediatric-specific RIs for PT, INR and APTT using the Cobas t511 analyzer in a Turkish cohort. These age-stratified intervals can improve the interpretation of coagulation tests in clinical practice and contribute to more accurate pediatric diagnostics.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"36-41"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145934910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of two ELISA assays for the detection of anti-BP180 autoantibodies.","authors":"Jesper M Kivelä, Anne Toivonen","doi":"10.1080/00365513.2026.2613287","DOIUrl":"10.1080/00365513.2026.2613287","url":null,"abstract":"","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"86-88"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145945791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increase in mean corpuscular volume during treatment with hydroxyurea in patients with essential thrombocythemia and polycythemia vera does not predict clinical outcomes.","authors":"Ivan Krecak, Antonija Duzaic, Marko Skelin","doi":"10.1080/00365513.2026.2623607","DOIUrl":"10.1080/00365513.2026.2623607","url":null,"abstract":"","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"89-94"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking repeat testing: when analytical criteria tell different stories.","authors":"Özben Özden Işıklar, Evin Kocatürk, Zeynep Başoğlu, Cansu Manav, İbrahim Özkan Alataş","doi":"10.1080/00365513.2025.2605639","DOIUrl":"10.1080/00365513.2025.2605639","url":null,"abstract":"<p><strong>Background: </strong>Repeat testing in emergency clinical chemistry is common, often triggered by critical values, delta checks, or instrument flags. However, its clinical utility is uncertain, and unnecessary repeats may delay reporting and waste resources.</p><p><strong>Objective: </strong>To assess the necessity of repeat testing by applying three analytical criteria: laboratory-specific observed total allowable error (TEa_Obs), CLIA-based TEa (TEa_CLIA), and reference change values (RCV) to the same cohort.</p><p><strong>Methods: </strong>In this retrospective study, we analyzed 18,736 repeated result pairs across 23 analytes retrieved from the laboratory information system (LIS) of a tertiary-care emergency laboratory (Jan 2022 to Jun 2025). Each pair was classified as necessary or unnecessary under TEa_Obs, TEa_CLIA, and RCV; agreement between criteria was assessed using Cohen's kappa (κ). Necessary versus unnecessary TAT was compared within each criterion.</p><p><strong>Results: </strong>TEa_Obs classified 86.2% (16,143/18,736) of repeats as unnecessary, versus 93.7% (17,564/18,736) by TEa_CLIA and 96.7% (18,119/18,736) by RCV. Agreement was generally low to moderate, with κ ranging from <0.2 (e.g. creatinine, CRP, bilirubins) to >0.8 (magnesium). Necessary repeats were associated with longer TAT, although the statistical significance of these differences varied by criterion.</p><p><strong>Conclusions: </strong>Criterion selection is not neutral; it changes both clinical interpretation and operational outcomes. Rule-driven workflows that combine TEa_Obs, TEa_CLIA, and RCV within LIS-based auto verification may reduce unnecessary repeats, stabilize turnaround times, and optimize resource use without compromising patient safety.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"9-19"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145820593","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sigma metric performances of Capillarys 3 Tera and Premier Hb9210 HbA1c analysers and comparison of conventional laboratory quality control practice with risk-based statistical quality control procedure.","authors":"Zeynep Yildiz, Dilara Turanlı, Metin Alemdar, Asuman Orçun","doi":"10.1080/00365513.2026.2623604","DOIUrl":"10.1080/00365513.2026.2623604","url":null,"abstract":"<p><strong>Aim: </strong>This study was carried out to estimate sigma values of two HbA1c analysers and compare laboratory's quality control (QC) procedure with a patient risk based statistical quality control (SQC) strategy.</p><p><strong>Materials and methods: </strong>Internal quality control (IQC) and External quality control (EQC) results are downloaded from the laboratory data for different six-months' period when each analyser was used in the laboratory. Mean percent coefficient of variation (CV) and bias values of study period were calculated. Sigma values for each system were calculated. QC constellation program was used for risk-based QC parameters calculation and severity of harm level for HbA1c was taken as 'serious'.</p><p><strong>Results: </strong>Sigma values for Capillarys 3 Tera analyser (Captera) were 3.83 and for Premier Hb9210 analyser (Premier) were 2.95. Using ±2 standard deviation (SD) as control limits; on Captera with a run size of 110 samples, probability of false rejection rate (Pfr) was 8.89%, expected maximum unreliable patient results (Max E(Nuf)) was 0.78 and on Premier analyser with a run size of 800 samples Pfr was 8.89% and Max E(Nuf) was 40.73. Effective statistical quality control strategies for both systems with acceptable Pfr and affordable Max E(Nuf) are provided in the study.</p><p><strong>Conclusion: </strong>HbA1c is a key parameter in diabetes management and accurate methods are required for an efficient clinical use.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"72-78"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146093949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monocyte distribution width reference intervals in healthy Chinese adults: a study revealing the impact of anticoagulant choice.","authors":"Qimei Wei, Kun Luo, Shanshan Dong, Xin Li, Wen Jiang, Jun Yang, Cuihua Tao","doi":"10.1080/00365513.2026.2623606","DOIUrl":"10.1080/00365513.2026.2623606","url":null,"abstract":"<p><p>Monocyte distribution width (MDW) is a promising biomarker for early sepsis detection, but its use in Asian populations has been limited due to the lack of region-specific reference intervals (RIs). This study aimed to establish the first MDW RI for healthy Chinese adults using EDTA-K₂ anticoagulant, strictly following CLSI EP28-A3C guidelines. A total of 262 samples from healthy Chinese blood donors were analyzed using a Beckman Coulter DxH 900 analyzer. Statistical methods included Shapiro-Wilk tests for normality, t-tests, ANOVA for group differences, and Spearman correlation analysis, with RIs calculated using parametric, non-parametric, and robust methods. The parametric RI limits were determined to be 14.48 (90% CI 14.16-14.80) and 21.56 (90% CI 21.24-21.88), closely aligning with results from the robust method (14.41-21.55) and non-parametric method (14.70-21.52). Our findings are consistent with Spanish data obtained using EDTA-K₂ anticoagulant but differ from Italian data that used EDTA-K₃, highlighting the potential impact of anticoagulant type on MDW values. This RI is unaffected by gender or age, providing a critical diagnostic tool for early sepsis detection in Chinese clinical practice and emphasizing the need for further studies to investigate anticoagulant influences for global standardization.</p>","PeriodicalId":21474,"journal":{"name":"Scandinavian Journal of Clinical & Laboratory Investigation","volume":" ","pages":"79-85"},"PeriodicalIF":1.4,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146119889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}