Laboratory medicine最新文献

{"title":"Comparison of basic lymphocyte phenotype results between a diagnostic and a research laboratory.","authors":"Najib Aziz, Erik LaBelle, Beth D Jamieson, Matthew J Mimiaga, Roger Detels","doi":"10.1093/labmed/lmae091","DOIUrl":"10.1093/labmed/lmae091","url":null,"abstract":"<p><strong>Objective: </strong>Lymphocyte phenotyping is a valuable tool for monitoring the effects of antiretroviral therapy on individuals living with HIV-1. A switch study was conducted to compare T-cell subset quantification performed by a research laboratory and a diagnostic, laboratory to understand the impact on the retrospective and prospective results of a long-term study.</p><p><strong>Methods: </strong>Using FACSCanto II Flow Cytometers, EDTA anticoagulated peripheral blood from 73 males enrolled in the Multicenter AIDS Cohort Study/Women Interagency HIV Combined Cohort Study was analyzed by both a research (laboratory 1) and a diagnostics laboratory (laboratory 2) for quantification of cluster of differentiation (CD)3, CD4, and CD8 T-cells. There were 47 males living with and 26 living without HIV-1.</p><p><strong>Results: </strong>Bland-Altman (B-A) analysis was applied to assess the agreement between laboratory 1 and laboratory 2 results. There were 69 out of 73 CD3, 71 out of 73CD4, and 72 out of 73 CD8 T-cell results that fell within acceptable B-A limits of agreement. The mean differences between the 2 laboratories were -1.000, -0.945, and +0.685(%), respectively.</p><p><strong>Conclusion: </strong>The strong agreement between results from laboratory 1 and laboratory 2 for CD3, CD4, and CD8 T-cell percentage suggests that the difference between laboratories using the same instrumentation and methodology will have a minimal effect on long-term study results.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"271-278"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684010","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":"Analysis of platelet transfusion efficacy during extracorporeal membrane oxygenation (ECMO) treatment in pediatric patients post-cardiac surgery-a retrospective cohort study.","authors":"Xusheng Chen, Yongtao Yang","doi":"10.1093/labmed/lmae087","DOIUrl":"10.1093/labmed/lmae087","url":null,"abstract":"<p><strong>Background: </strong>Postoperative extracorporeal membrane oxygenation (ECMO) may be necessary for pediatric patients following cardiac surgery, with associated risks of thrombocytopenia and bleeding. Prophylactic platelet transfusions are utilized to mitigate these risks, but the effectiveness of platelet transfusion cannot be reliably predicted. The aim of this study was to investigate the effect of platelet transfusion during postoperative treatment with ECMO in children undergoing cardiac surgery and to explore the optimal transfusion thresholds to reduce the number of platelet transfusions in patients and reduce the risk of death.</p><p><strong>Methods: </strong>We included in our study patients from the Pediatric Cardiac Surgery Department at the First Affiliated Hospital of Tsinghua University who underwent cardiac surgery and received ECMO treatment from January 1, 2019, to December 31, 2023, and received platelets transfusion at least once during the ECMO therapy. The platelet counts were determined both before and 24 hours posttransfusion of the platelet product. The corrected count increment (CCI) was calculated for the effectiveness estimation of platelet transfusion. The research subjects were divided into 3 groups based on the platelet count before transfusion (pretransfusion platelet count ≤30×109/L was the low-threshold group, pretransfusion count 31-50×109/L was the medium-threshold group, and ≥51×109/L was the high-threshold group) and the effective rates of each group were calculated.</p><p><strong>Results: </strong>A total of 11 patients received 47 platelet transfusions, an average of 4.27 ± 1.67 per patient. According to the 24-hour postinfusion platelet (Plt) corrected critical control increase index (24-hour CCI) ≥4500, the infusion was considered to be effective, and ineffective when the CCI was <4500. Out of these, 22 transfusions (46.8%) proved effective, whereas 25 (53.2%) were deemed ineffective. The effective transfusion rates across the 3 groups were 69.2%, 50%, and 27.7%, respectively.</p><p><strong>Conclusion: </strong>The efficacy of platelet transfusion may be higher if a low threshold of platelet transfusion is chosen during ECMO treatment, on the premise of ensuring life safety.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"249-253"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142562964","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":"The importance of hemolysis detection among neonates for interpretation of potassium results.","authors":"Alan H B Wu","doi":"10.1093/labmed/lmae094","DOIUrl":"10.1093/labmed/lmae094","url":null,"abstract":"<p><p>Specimen hemolysis is a frequent finding when blood is collected from neonates. This produces artificially high results for some analytes, such as potassium. Testing samples for electrolytes using point-of-care (POC) blood gas analyzers is convenient and facile. However, unlike testing that is conducted on serum or plasma from a central laboratory, detection of hemolysis using POC analyzers cannot currently be achieved. As described in these cases, the presence of hemolysis can produce ambiguities and delays in the diagnosis and management of neonates.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"305-307"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824775","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":"Diagnostic approach for multiple sclerosis: optimizing algorithms for intrathecal synthesis of immunoglobulins.","authors":"Jorge Ferriz, Cristina Guallart, Pilar Timoneda, Marta Fandos, Javier Lopez-Arqueros, Antonio Sierra-Rivera, Marta Garcia-Hita, Goitzane Marcaida, Maria Carcelén-Gadea","doi":"10.1093/labmed/lmae101","DOIUrl":"10.1093/labmed/lmae101","url":null,"abstract":"<p><strong>Background: </strong>The kappa-free light chain (κFLC) index has shown its value in detecting the intrathecal synthesis of immunoglobulins. We aimed to evaluate the diagnostic performance of the κFLC index for multiple sclerosis (MS) and compare different algorithms proposed in the literature to optimize its use for our population.</p><p><strong>Methods: </strong>Based on the results of the oligoclonal bands (OCBs) and κFLC index of 255 patients with suspected MS different optimization strategies were evaluated, for which the optimal κFLC index cut-off thresholds were calculated.</p><p><strong>Results: </strong>The best diagnostic performance was achieved by using a reflexive algorithm, in which OCBs are only performed according to the κFLC index result. With a single cut-off (κFLC index = 7.9), an accuracy of 92.2% was obtained (sensitivity = 92.4%, specificity = 92%) with an OCB performance rate of 58.1%. When applying 2 cut-offs (κFLC index = 4.2 and 13), the accuracy was the same (92.2%, sensitivity = 89.6%, specificity = 94%), but the OCB performance rate dropped to 29.4%.</p><p><strong>Conclusion: </strong>The 2-step strategy proposed with κFLC determination followed by OCB analysis in the borderline cases appears to be the most suitable solution, further optimized by adjusting the decision thresholds to 4.2 < κFLC index < 13, resulting in high accuracy and the most saving of OCBs.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"291-296"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866823","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":"Advisory on delayed fading caused by the use of a xylene substitute for frozen tissue specimen staining in micrographic surgery.","authors":"Mitchell S Davis, Rini M Desai, Daniel B Baird, Cloyce L Stetson","doi":"10.1093/labmed/lmae099","DOIUrl":"10.1093/labmed/lmae099","url":null,"abstract":"<p><strong>Background: </strong>The use of xylene substitutes is becoming more common in the setting of micrographic surgery frozen tissue section staining, and dermatologic surgeons need to be aware of possible undesirable delayed effects of using these agents and the possibility of modifying H&E staining protocols to prevent delayed fading. This report demonstrates an undesirable outcome of using an isoparaffinic aliphatic hydrocarbon as a xylene substitute, implementation of a quality improvement intervention to eliminate frozen section slide fading in the setting of micrographic surgery tissue processing, and recommendations for the modification of protocol when using a xylene substitute.</p><p><strong>Clinical and laboratory information: </strong>Frozen section slides processed with xylene and xylene substitute were analyzed by histotechnicians, a dermatopathologist, and a micrographic surgery surgeon at 1-week and 1-month intervals. The use of a standard H&E protocol resulted in zero stains fading when using xylene as a clearing agent, but delayed fading when using a xylene substitute.</p><p><strong>Discussion: </strong>Using an isoparaffinic aliphatic hydrocarbon as a xylene substitute can lead to excess water carryover, which may result in delayed hematoxylin fading in micrographic surgery tissue staining, so using this xylene substitute likely requires modification to the dehydration phase and tap water immersion phase to prevent fading.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"308-311"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824686","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":"Correction to: Impact of COVID-19 pandemic on accredited programs and graduates who sat for the American Society for Clinical Pathology-Board of Certification Examination: program directors' perspective.","authors":"","doi":"10.1093/labmed/lmad103","DOIUrl":"10.1093/labmed/lmad103","url":null,"abstract":"","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"319"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72212411","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":"Ascorbic acid and glucose can cause significant interference on quantitative measurement of biochemistry analytes in urine.","authors":"Sara Mašković, Nora Nikolac Gabaj","doi":"10.1093/labmed/lmae089","DOIUrl":"10.1093/labmed/lmae089","url":null,"abstract":"<p><strong>Background and aims: </strong>Preanalytical errors due to interferences can lead to inaccurate results, necessitating an understanding of potential interferences for each test. This study explores the impact of elevated concentrations of ascorbic acid and glucose on urine analysis, a pivotal diagnostic tool.</p><p><strong>Methods: </strong>Conducted at the Clinical Institute of Chemistry, KBC Sestre milosrdnice, the research utilized a 24-hour urine sample. Parameters assessed included total proteins, albumin, amylase, sodium, potassium, chlorides, calcium, phosphates, magnesium, creatinine, urea, and uric acid. Various concentrations of added interferents were prepared for duplicate measurements using statistical analysis in Microsoft Excel.</p><p><strong>Results: </strong>No statistically significant interferences were found in albumin, amylase, sodium, potassium, or phosphate concentrations. However, ascorbic acid interfered with chloride, calcium, and magnesium determinations. Conversely, elevated glucose affected total protein, calcium, magnesium, creatinine, urea, and uric acid determinations. Interference of ascorbic acid with chloride and interference of glucose with total proteins and uric acid displayed a linear relationship.</p><p><strong>Conclusions: </strong>Results suggest cautious analysis interpretation from certain parameters in patients with elevated glucose and/or ascorbic acid in urine. Whereas ascorbic acid interference may go unnoticed due to its infrequent measurement, routine determination of glucose in urine is crucial, especially for diabetes patients.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"254-258"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645343","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":"Correlation of the abundance of MDSCs, Tregs, PD-1, and PD-L1 with the efficacy of chemotherapy and prognosis in gastric cancer.","authors":"Na Li, Yun Li, Jing Li, Shimin Tang, Hongbo Gao, Yong Li","doi":"10.1093/labmed/lmae090","DOIUrl":"10.1093/labmed/lmae090","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to investigate the relationship between tumor microenvironment markers (myeloid-derived suppressor cells [MDSCs], regulatory T cells [Tregs], programmed cell death 1 [PD-1], and programmed death ligand 1 [PD-L1]) and chemotherapy efficacy and prognosis in advanced gastric cancer, identifying potential monitoring indicators.</p><p><strong>Methods: </strong>Advanced gastric cancer patients' MDSC and Treg expression was measured by flow cytometry pre- and postchemotherapy; PD-1 and PD-L1 expression in cancer tissues was assessed by immunohistochemistry. Correlations with chemotherapy outcomes and prognosis were analyzed.</p><p><strong>Results: </strong>Postchemotherapy reductions in MDSC and Treg levels correlated with chemotherapy efficacy (P <.01). Negative PD-1 and PD-L1 expression in cancer tissues predicted better chemotherapy responses (P <.01). Patients with lower MDSC and Treg levels and negative PD-1 and PD-L1 had significantly longer median progression-free survival (PFS) and overall survival (OS) (P <.05).</p><p><strong>Conclusion: </strong>In advanced gastric cancer, reduced peripheral blood MDSC and Treg levels postchemotherapy and negative PD-1 and PD-L1 expression in tissues are associated with improved chemotherapy efficacy and are independent prognostic factors for PFS and OS.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"259-270"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142684012","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":"Anemia in patients with cartilage hair hypoplasia: a narrative review and recommendations.","authors":"Natalia Lewandowska, Michal Ordak","doi":"10.1093/labmed/lmae082","DOIUrl":"10.1093/labmed/lmae082","url":null,"abstract":"<p><p>Cartilage hair hypoplasia (CHH) can lead to the development of anemia as a possible complication of this rare genetic disease. Despite various publications on anemia in CHH patients, a comprehensive review on this topic has not been conducted. This article reviews publications on anemia in CHH patients published from 1981 to 2022. Most authors have reported macrocytic anemia and blood transfusion as a common treatment approach in this patient group. Recommended guidelines for managing anemia in CHH patients include iron chelation therapy for those requiring multiple blood transfusions, regular assessment of anemia symptoms, red blood cell parameters, and immune system function. Future studies should evaluate the erythroid system in a larger cohort of CHH patients, considering key factors such as concurrent illnesses, age, height, and weight.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"213-219"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335329","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":"Implementing laboratory internal audit to improve compliance and quality of care in the municipal public health system-based ambulatory care health clinics in New York city.","authors":"Faisal M Huq Ronny, Tshering Sherpa, Faisal N Saquib, Shana Ahmad","doi":"10.1093/labmed/lmae088","DOIUrl":"10.1093/labmed/lmae088","url":null,"abstract":"<p><strong>Introduction: </strong>System-wide laboratory internal audits are useful to help laboratories prepare for external audits in addition to being part of the ongoing program for compliance improvement and quality assurance in the laboratory to track and enhance care quality.</p><p><strong>Methods: </strong>A formal plan was developed and a modified audit checklist was prepared by our laboratory management team, applicable and uniquely tailored for our ambulatory care clinic settings to track operational, quality, and compliance metrics according to the New York State Department of Health Clinical Laboratory Evaluation Program. Two audits were conducted 6 months apart and the conformity documented.</p><p><strong>Results: </strong>An overall 84% increase in compliance and conformity was observed between first and second audits, which ranged from 63% to 100% across different categories, with 100% improvement (0% nonconformity) in 75% of the sites in the second audit.</p><p><strong>Conclusion: </strong>A system-wide laboratory internal audit was created and carried out. Staff shortages, rapid turnover, and lack of retraining were found to be contributing factors to sites that did not achieve 100% conformance. Continuous assessment and monitoring are key elements to success in the laboratory quality management system, and through this scheduled audit process, we were able to achieve continual laboratory quality improvement.</p>","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"115-117"},"PeriodicalIF":0.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142670174","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}