Laboratoriumsmedizin-Journal of Laboratory Medicine最新文献_第10页

Laboratory testing for systemic autoimmune diseases 系统性自身免疫性疾病的实验室检测

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-02-22 DOI: 10.1515/labmed-2015-0109

M. Diller, M. Fleck

{"title":"Laboratory testing for systemic autoimmune diseases","authors":"M. Diller, M. Fleck","doi":"10.1515/labmed-2015-0109","DOIUrl":"https://doi.org/10.1515/labmed-2015-0109","url":null,"abstract":"Abstract The detection of autoantibodies is well established in daily clinical practice for evaluation of systemic autoimmune diseases like rheumatoid arthritis (RA), connective tissue diseases and vasculitides. Rheumatoid factor (RF) or the anti-citrullinated protein antibody (ACPA) is only observed in approximately 80% of patients suffering from rheumatoid arthritis. Anti-CarP autoantibodies might serve as a novel marker, filling this gap. The detection of anti-nuclear antibody (ANA) facilitates the diagnosis of connective tissue diseases. Elevated levels of anti-centromer antibodies, anti-topoisomerase I [anti-Scl-70] antibodies and the anti-RNA polymerase III antibodies, which belong to the group of ANA, are frequently present in the serum of patients suffering from systemic sclerosis and are therefore incorporated into the new classification criteria. To establish the diagnosis of an antiphospholipid syndrome, the detection of the lupus anticoagulant and the aCL-/anti-β2GPI-antibodies of IgG, IgM and IgA isotypes plays a pivotal role. The anti-neutrophil cytoplasmic antibodies (ANCAs) are associated with vasculitides of small vessels. Screening with immunofluorescence testing (IFT) is established as the first step followed by additional immunoassays specific for proteinase 3 (PR3) and myeloperoxidase (MPO) autoantibodies. Novel bedside test procedures for these antibodies allow an early diagnosis in critically ill patients. New biomarkers for polymyalgia rheumatic and for spondyloarthritides are also described, but their clinical relevance remains uncertain and necessitates further studies.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79744190","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}

引用次数: 1

Referenzintervalle für eisenabhängige Blutparameter bei Kindern und Jugendlichen: Ergebnisse einer populationsgestützten Kohortenstudie (LIFE Child) 儿童与青年铁相关血型参考期:人口群体研究结果

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-02-01 DOI: 10.1515/labmed-2015-0093

K. Rieger, Mandy Vogel, C. Engel, U. Ceglarek, J. Thiery, J. Kratzsch, K. Harms, Fabian Glock, A. Hiemisch, W. Kiess

{"title":"Referenzintervalle für eisenabhängige Blutparameter bei Kindern und Jugendlichen: Ergebnisse einer populationsgestützten Kohortenstudie (LIFE Child)","authors":"K. Rieger, Mandy Vogel, C. Engel, U. Ceglarek, J. Thiery, J. Kratzsch, K. Harms, Fabian Glock, A. Hiemisch, W. Kiess","doi":"10.1515/labmed-2015-0093","DOIUrl":"https://doi.org/10.1515/labmed-2015-0093","url":null,"abstract":"Zusammenfassung Einleitung: Es werden pädiatrische Referenzintervalle zu eisenabhängigen Parametern kontinuierlich über das Alter unter Anwendung des, in der Laboratoriumsmedizin noch wenig bekannten, R-Pakets GAMLSS aus einer hoch standardisierten Probenpopulation ermittelt. Methoden: 2778 Blutproben von LIFE Child-Probanden im Alter von 2,5 bis 19 Jahren wurden mittels Sysmex XN-9000 für Hämoglobin und Retikulozyten, sowie mittels Roche cobas 8000 für Transferrin und Ferritin analysiert. Die Schätzung der Referenzintervalle erfolgte durch wiederholte Modellberechnungen unter Anwendung der LMS-Methode nach Cole mit spezifisch gewichteten Teilstichproben. Ergebnisse: Es wurden kontinuierliche und geschlechtsspezifische Referenzintervalle sowie geglättete Perzentilenkurven für Hämoglobin, Ferritin, Retikulozyten und Transferrin erstellt. Dabei konnten aufgrund der wiederholten Modellberechnungen Einzelkurven und durch Mittelung zusammengefasste Perzentilenkurven erstellt werden. Die Einzelkurven gaben einen Überblick über potentielle Schwankungen der einzelnen Parameterverläufe. Die gemittelten Kurven ermöglichten eine stabile Kurvenverlaufsbeurteilung der eisenabhängigen Parameter im Kindes- und Jugendalter. Schlussfolgerungen: Hiermit stehen erstmals mit dem GAMLSS-R-Paket und für die hier verwendeten Gerätetechniken eruierte aktuelle alters- und geschlechtsspezifische Referenzintervalle zur Verfügung. Verglichen zu bisherigen Studien können frühere Ergebnisse vervollständigt und Diskrepanzen, abhängig vom unterschiedlichen methodischen Vorgehen, verdeutlicht werden. Relevante Erkenntnisse für die Diagnostik der Eisenmangelanämie, wie eine geschlechtsabhängige Beurteilung des Hämoglobins ab dem 11. Lebensjahr statt wie bisher ab 15 Jahren (nach WHO), werden dargestellt.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"52 1","pages":"31 - 41"},"PeriodicalIF":0.0,"publicationDate":"2016-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90065633","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}

引用次数: 0

Schilddrüsenerkrankungen: Diagnostik und Therapiekontrolle 2015 甲状腺疾病:2015年的诊断和治疗

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-02-01 DOI: 10.1515/labmed-2015-0077

D. Führer

引用次数: 1

Influence of DIN EN ISO 15189 on the correctness of results in clinical virology DIN EN ISO 15189对临床病毒学结果正确性的影响

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-28 DOI: 10.1515/labmed-2016-0037

P. Späth, D. Hoffmann, F. Spitzenberger

{"title":"Influence of DIN EN ISO 15189 on the correctness of results in clinical virology","authors":"P. Späth, D. Hoffmann, F. Spitzenberger","doi":"10.1515/labmed-2016-0037","DOIUrl":"https://doi.org/10.1515/labmed-2016-0037","url":null,"abstract":"Abstract To date more than 400 medical laboratories in Germany are accredited based on DIN EN ISO 15189 (Medical laboratories – requirements for quality and competence). In Germany, a new version of the DIN EN ISO 15189 has been published in 2014. This standard includes overall criteria but no requirements specific for certain disciplines of laboratory medicine. The present study examined how technical requirements, mainly for quality assurance and analytic methods, influence the correctness of results in clinical virology. Experts from laboratories, industry, DAkkS (German Accreditation Body) and from standardization have been interviewed. The qualitative content analysis showed that fulfilling technical requirements increased the correctness of examination results and minimized the risks for patient care and safety. Furthermore, we studied how effective internal quality controls, assay-controls as well as additional controls, assure HIV-p24-antigen and anti-HBs results. Additional controls recommended by DIN EN ISO 15189 (so called “run controls”) clearly indicated inaccuracies of HIV antigen measurement that were undetected by manufacturer’s controls. Also for anti-HBs examination, such internal controls provided by the manufacturer did not guarantee correct results. Therefore, we conclude that fulfilling DIN EN ISO 15189, usually confirmed by accreditation, has a positive influence on correctness of results in clinical virology, ultimately improving patient care.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84748628","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}

引用次数: 1

Rational diagnostic work-up of anemia 贫血的合理诊断检查

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-26 DOI: 10.1515/labmed-2016-0017

J. Hastka, G. Metzgeroth

{"title":"Rational diagnostic work-up of anemia","authors":"J. Hastka, G. Metzgeroth","doi":"10.1515/labmed-2016-0017","DOIUrl":"https://doi.org/10.1515/labmed-2016-0017","url":null,"abstract":"Abstract Anemia is defined as a decrease in the hemoglobin concentration below the age- and sex-specific lower limit, established by WHO as 130 g/L in men and 120 g/L in women. In principle, there are many differential diagnoses which must be considered. The diagnostic evaluation furthermore is complicated by the fact that anemias are often multicausal. A rational evaluation of anemia should always take into account the epidemiological data and also the individual patient’s history. The classification according to the size and the hemoglobin content of the red blood cells based on the erythrocyte indices still plays a central diagnostic role. The worldwide most important cause of a hypochromic-microcytic anemia is iron deficiency. Anemia of chronic disease (ACD) and thalassemia are to be considered as differential diagnoses. Disorders of vitamin B12 and folic acid metabolism are clinically the most important causes of hyperchromic-macrocytic anemia. The normochromic-normocytic group includes most forms of anemias. In these cases one should not try to cover all possible causes by a fully comprehensive laboratory panel within the first blood sample already. It is more appropriate to proceed step-by-step to evaluate the most frequent and clinically most important reasons first. This especially applies to geriatric and multimorbid patients where the diagnostic effort must be adjusted to the individual needs and prognosis of the patient, not only from economical but also from ethical reasons. In unexplained anemias, consultation of a hematologist should be considered. In case of doubt, bone marrow biopsy is required to precisely evaluate the hematopoiesis and to exclude a hematological disorder.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"58 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80703745","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}

引用次数: 2

Thyroid disorders: diagnosis and therapeutic approaches 2015 甲状腺疾病:诊断和治疗方法2015

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-23 DOI: 10.1515/labmed-2016-0028

D. Führer

引用次数: 0

Simple estimation of reference intervals from routine laboratory data 从常规实验室数据中简单估计参考区间

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-22 DOI: 10.1515/labmed-2015-0104

Georg F. Hoffmann, R. Lichtinghagen, W. Wosniok

{"title":"Simple estimation of reference intervals from routine laboratory data","authors":"Georg F. Hoffmann, R. Lichtinghagen, W. Wosniok","doi":"10.1515/labmed-2015-0104","DOIUrl":"https://doi.org/10.1515/labmed-2015-0104","url":null,"abstract":"Abstract: According to the recommendations of the IFCC and other organizations, medical laboratories should establish or at least adapt their own reference intervals, to make sure that they reflect the peculiar characteristics of the respective methods and patient collectives. In practice, however, this postulate is hard to fulfill. Therefore, two task forces of the DGKL (“AG Richtwerte” and “AG Bioinformatik”) have developed methods for the estimation of reference intervals from routine laboratory data. Here we describe a visual procedure, which can be performed on an Excel sheet without any programming knowledge. Patient values are plotted against the quantiles of the standard normal distribution (so-called QQ plot) using the NORM. INV function of Excel. If the examined population contains mainly non-diseased persons with approximately normally distributed values, the respective dots form a straight line. Very often the values are rather lognormally distributed; in this case the straight line can be detected after logarithmic transformation of the original values. Values, which do not match with the assumed theoretical distribution, deviate from the linear shape and can easily be identified and eliminated. Using the reduced data set, the mean value and standard deviation are calculated and the reference interval (μ±2σ) is estimated. The method yields plausible results with simulated and real data. With the increasing number of results, which do not match with the model, it tends to underestimate the standard deviation. In all cases, where the QQ plot does not yield a substantial linear part, the proposed method is not applicable.","PeriodicalId":49926,"journal":{"name":"Laboratoriumsmedizin-Journal of Laboratory Medicine","volume":"192 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2016-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77630145","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}

引用次数: 20

Antwort auf A. von Meyer: Cadamuro et al. In-vitro Hämolyse verschiedener Blutabnahmesysteme sowie deren finanzielle Auswirkung a: Meyer的回复:Cadamuro等各种抗凝血系统的体外溶血及其财务影响

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-22 DOI: 10.1515/LABMED-2015-0103

J. Cadamuro, G. Fiedler, Cornelia Mrazek, T. Felder, Hannes Oberkofler, U. Kipman, Elisabeth Haschke-Becher, H. Wiedemann

引用次数: 0

Stepwise diagnostic procedure for the analysis of pathological changes of leukocytes 白细胞病理变化分析的逐步诊断方法

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-20 DOI: 10.1515/labmed-2015-0113

H. Diem, T. Nebe, P. Bettelheim

引用次数: 0

Diagnostic relevance of CSF interleukin-6 脑脊液白细胞介素-6的诊断意义

Laboratoriumsmedizin-Journal of Laboratory Medicine Pub Date : 2016-01-20 DOI: 10.1515/labmed-2015-0111

S. Gruber, Philipp Werner, R. Germann, P. Fraunberger

引用次数: 0