Laboratory medicine最新文献_第6页

Assessment of appropriate use of amylase and lipase testing in the diagnosis of acute pancreatitis at an academic teaching hospital. 评估一家学术教学医院在诊断急性胰腺炎时对淀粉酶和脂肪酶检测的合理使用。

Laboratory medicine Pub Date : 2024-09-04 DOI: 10.1093/labmed/lmae008

Valerie Ryholt, Julie Soder, Janet Enderle, Rajkumar Rajendran

{"title":"Assessment of appropriate use of amylase and lipase testing in the diagnosis of acute pancreatitis at an academic teaching hospital.","authors":"Valerie Ryholt, Julie Soder, Janet Enderle, Rajkumar Rajendran","doi":"10.1093/labmed/lmae008","DOIUrl":"10.1093/labmed/lmae008","url":null,"abstract":"Objective: Despite evidence-based guidelines stating that lipase alone should be used in the diagnosis of suspected acute pancreatitis, health care providers continue to order amylase or amylase and lipase together. The purpose of this study was to assess the utilization of appropriate laboratory testing related to the diagnosis of acute pancreatitis.Methods: The study used a retrospective cross-sectional design. The timeframe was from January 1, 2020, to December 31, 2020. A retrospective chart review was used to collect data for the following: patient-provider encounter notes, patient demographics, provider demographics, differential and final diagnosis, and laboratory test results. Data analysis include stratification of categorical variables and calculation of cost savings.Results: For the 12-month period, this study found 2567 (9.3%) of all amylase and lipase tests to be unnecessary. Amylase tests (1881; 73.2%) made up the most unnecessary tests followed by lipase tests (686; 26.7%). An analysis of test-ordering behavior by providers revealed that 81.5% of all unnecessary tests were ordered by MDs. Finally, this study estimated a total cost savings of $128,350 if all unnecessary tests were eliminated.Conclusion: Our study demonstrated that amylase and lipase tests have been overutilized in the diagnosis of acute pancreatitis.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"566-570"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934881","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

Microbiological profile of long COVID and associated clinical and radiological findings: a prospective cross-sectional study. 长 COVID 微生物特征及相关临床和放射学结果：一项前瞻性横断面研究。

Laboratory medicine Pub Date : 2024-09-04 DOI: 10.1093/labmed/lmae010

Monalisa Dey, Baijayantimala Mishra, Prasanta Raghab Mohapatra, Sudipta Mohakud, Bijayini Behera

{"title":"Microbiological profile of long COVID and associated clinical and radiological findings: a prospective cross-sectional study.","authors":"Monalisa Dey, Baijayantimala Mishra, Prasanta Raghab Mohapatra, Sudipta Mohakud, Bijayini Behera","doi":"10.1093/labmed/lmae010","DOIUrl":"10.1093/labmed/lmae010","url":null,"abstract":"Objective: To study the frequency of microbiological etiology of respiratory infections in patients with long COVID and their associated clinical and radiological findings.Methods: Nasopharyngeal swabs and sputum specimens were collected from 97 patients with respiratory illness stemming from long COVID. The specimens were assessed for their microbiological profile (bacteria and virus) and their association with the overall clinical and radiological picture.Results: In total, 23 (24%) patients with long COVID had viral infection (n = 12), bacterial infection (n = 9), or coinfection (n = 2). Microorganisms were detected at significantly higher rates in hospitalized patients, patients with moderate COVID-19, and patients with asthma (P < .05). Tachycardia (65%) was the most common symptom at presentation. A statistically significant number of patients with long COVID who had viral infection presented with cough and myalgia; and a statistically significant number of patients with long COVID who had bacterial infection presented with productive coughing (P < .05). Post-COVID fibrotic changes were found in 61% of cohort patients (31/51).Conclusion: A decreasing trend of respiratory pathogens (enveloped viruses and bacteria) was found in long COVID. An analysis including a larger group of viral- or bacterial-infected patients with long COVID is needed to obtain high-level evidence on the presenting symptoms (cough, myalgia) and their association with the underlying comorbidities and severity.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"595-601"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140195387","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

The identification of a novel compound heterozygous mutation in hereditary human coagulation factor VII deficiency following a bamboo leaf green snake bite. 在被竹叶青蛇咬伤后，鉴定出遗传性人类凝血因子 VII 缺乏症的新型复合杂合突变。

Laboratory medicine Pub Date : 2024-09-04 DOI: 10.1093/labmed/lmae012

Chuanghua Qiu, Chunxiu Huang, Xueyan Chen, Dayong Gu

引用次数: 0

Cystic fibrosis-related diabetes screening at a large pediatric center. 大型儿科中心的囊性纤维化相关糖尿病筛查。

Laboratory medicine Pub Date : 2024-09-04 DOI: 10.1093/labmed/lmae009

Anil K Chokkalla, Pamela Tuley, Miray Kurtca, Herda Ona, Fadel E Ruiz, Sridevi Devaraj

{"title":"Cystic fibrosis-related diabetes screening at a large pediatric center.","authors":"Anil K Chokkalla, Pamela Tuley, Miray Kurtca, Herda Ona, Fadel E Ruiz, Sridevi Devaraj","doi":"10.1093/labmed/lmae009","DOIUrl":"10.1093/labmed/lmae009","url":null,"abstract":"Objective: Cystic Fibrosis Foundation guidelines recommend annual diabetes screening by oral glucose tolerance test (OGTT) in pediatric patients with cystic fibrosis (CF) starting at the age of 10 years. Adherence to these guidelines proves to be challenging, and the nationwide screening rates are still considered suboptimal. The aim of this study was to assess and improve the screening rates at our large pediatric center.Methods: A 4-year retrospective audit of OGTT completion among pediatric patients with CF of age ≥10 years who are not yet diagnosed with diabetes was conducted. A collaborative working group was formed to identify the barriers to screening and formulate a quality improvement plan, which was monitored and evaluated for a 9-month period.Results: Diabetes screening rates determined by OGTT completion at our center showed a gradual decline during the COVID-19 pandemic from 2019 to 2022. Following the implementation of the quality improvement plan during the summer of 2023, there was a marked increase in OGTT ordering compliance by providers as well as test completion by patients. Notably, the fractional OGTT completion rate rose from 45% during the preintervention phase (January-April 2023) to 70% during the postintervention phase (May-September 2023).Conclusion: Diabetes screening in pediatric patients with CF can be effectively improved by refining practices related to patient experience, care coordination, and laboratory testing strategies.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"580-584"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139934882","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

Evaluation of some nonroutine cardiac biomarkers among adults and children with beta-thalassemia major. 评估重型地中海贫血成人和儿童的一些非常规心脏生物标志物。

Laboratory medicine Pub Date : 2024-09-04 DOI: 10.1093/labmed/lmae007

Abdulkareem M Jewad, Ameer J Shwayel

{"title":"Evaluation of some nonroutine cardiac biomarkers among adults and children with beta-thalassemia major.","authors":"Abdulkareem M Jewad, Ameer J Shwayel","doi":"10.1093/labmed/lmae007","DOIUrl":"10.1093/labmed/lmae007","url":null,"abstract":"Background: Cardiac injury caused by iron overload is the leading cause of mortality and morbidity in patients with beta-thalassemia, owing to frequent blood transfusion, increased iron overload, and blood hemolysis.Objective: This research aimed to assess several novel cardiac biomarkers in the blood samples of children and adult patients with beta-thalassemia major (βTM), along with their respective control groups. These biomarkers included endothelin 1 (ET-1), N-terminal pro-brain natriuretic peptide (NT-proBNP), atrial natriuretic peptide (ANP), growth differentiation factor-15 (GDF-15), and renalase (RNLS).Methods: This case-control study was done on 46 patients with βTM (23 children <18 years, and 23 adults ≥18 years) from the Genetic Hematology Center in Thi-Qar province, Iraq, and 42 comparable controls in 2 groups (21 for each group) in the period from February to April 2023.Results: Levels of ET-1, NT-proBNP, ANP, GDF-15, RNLS, and ferritin were higher in the children and adults with βTM than in the control subjects.Conclusion: Elevations of the novel cardiac biomarkers ET-1, NT-proBNP, ANP, GDF-15, and RNLS in the sera of children and adult patients with βTM when compared with comparable control subjects confirm that the majority of patients with βTM are at risk of cardiac and cardiovascular complications even when there are no obvious symptoms, especially in children, which gives suitable predictive biomarkers.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"559-565"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992241","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

Differences in the levels of the appetite peptides ghrelin, peptide tyrosine tyrosine, and glucagon-like peptide-1 between obesity classes and lean controls. 肥胖症与瘦弱对照组之间食欲肽胃泌素、肽酪氨酸酪氨酸和胰高血糖素样肽-1水平的差异。

Laboratory medicine Pub Date : 2024-09-04 DOI: 10.1093/labmed/lmae004

Gülşah Alyar, Fatma Zühal Umudum

{"title":"Differences in the levels of the appetite peptides ghrelin, peptide tyrosine tyrosine, and glucagon-like peptide-1 between obesity classes and lean controls.","authors":"Gülşah Alyar, Fatma Zühal Umudum","doi":"10.1093/labmed/lmae004","DOIUrl":"10.1093/labmed/lmae004","url":null,"abstract":"Objective: This study was designed to compare basal concentrations of the gastrointestinal appetite modulators ghrelin, peptide tyrosine tyrosine (PYY), and glucagon-like peptide 1 (GLP-1) between obesity classes and obesity classes and controls.Methods: The study included 49 healthy controls with body mass index (BMI) between 18.5 and 29.9 kg/m² and 62 individuals with obesity with BMI ≥30 kg/m². Basal ghrelin, PYY, and GLP-1 concentrations of the samples were analyzed by an enzyme-linked immunosorbent assay commercial kit (SunRed Human). Other biochemical parameters were measured by a clinical chemistry autoanalyzer (Beckman Coulter AU 5800) in the biochemistry laboratory.Results: Compared with the control group, ghrelin, PYY, and GLP-1 levels were significantly lower in the obese group (P < .05). The PYY concentration was significantly different between obese groups (P < .05). The PYY and GLP-1 levels were significantly different between obesity class I and obesity class III. In addition, ghrelin levels were significantly different between obesity class II and obesity class III. Correlation analysis revealed a negative correlation between BMI and serum ghrelin, GLP-1, and PYY concentrations.Conclusion: Low basal ghrelin, GLP-1, and PYY hormones in the obese group compared with the control group indicate impaired appetite regulation in this population. The significant difference in PYY levels between obese groups was associated with increasing obesity grade.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":"553-558"},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992240","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

Difference in activated partial thromboplastin time values with two different reagents according to C-reactive protein values. 根据 C 反应蛋白值，两种不同试剂的活化部分凝血活酶时间值的差异。

Laboratory medicine Pub Date : 2024-08-30 DOI: 10.1093/labmed/lmae053

Yuya Ishihara, Hiroki Doi, Seiko Sato, Hiroyasu Ito

{"title":"Difference in activated partial thromboplastin time values with two different reagents according to C-reactive protein values.","authors":"Yuya Ishihara, Hiroki Doi, Seiko Sato, Hiroyasu Ito","doi":"10.1093/labmed/lmae053","DOIUrl":"https://doi.org/10.1093/labmed/lmae053","url":null,"abstract":"Background: Activated partial thromboplastin time (APTT) is susceptible to reagent composition. This study aimed to investigate a large number of specimens and determine the cause of discrepancies.Method: This study included 18,994 subjects who underwent coagulation tests at our hospital from May 2020 to December 2020. Measuring reagents included HemosIL SynthASil APTT (APTT-SS, Instrumentation Laboratory) and Coagpia APTT-N (APTT-N, Sekisui Medical).Results: A total of 451 patients demonstrated APTT-N of >39 seconds and an APTT-N/SS ratio of >1.3. A C-reactive protein (CRP) level of ≥1.4 mg/L demonstrated a significant positive correlation, with a higher APTT-N/SS indicating higher CRP levels. All 28 subjects receiving no anticoagulants and who had remaining specimens underwent a cross-mixing test (CMT). Of them, 17 were suspected for lupus anticoagulant (LA) by both the waveform shape and the index of circulating anticoagulant (ICA) value, 6 by the ICA value, and 5 were difficult to determine.Conclusion: This study revealed that the APTT-N prolongation correlated with CRP degree and the transient involvement of LA in CMT results due to CRP. This study indicated various reactivities depending on the assay reagents used. Further testing is warranted if LA is suspected, considering the patient's background.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142116620","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

Correction to: Interference of Hemoglobin Variants with HbA1c Measurements by Six Commonly Used HbA1c Methods. 更正：血红蛋白变异体对六种常用 HbA1c 测量方法的干扰。

Laboratory medicine Pub Date : 2024-08-20 DOI: 10.1093/labmed/lmae073

引用次数: 0

Automated feathered edge blood smear analysis: early diagnosis of carcinocythemia in a case of disseminated intravascular coagulation with multi-organ failure. 自动羽状边缘血涂片分析：在一例伴有多器官功能衰竭的弥散性血管内凝血病例中早期诊断出癌细胞增多症。

Laboratory medicine Pub Date : 2024-08-19 DOI: 10.1093/labmed/lmae068

Marth Briers, Marnix Mylemans, Thomas Tousseyn, Lo Man Lai, Mercedeh Tajdar, Christine Van Laer

{"title":"Automated feathered edge blood smear analysis: early diagnosis of carcinocythemia in a case of disseminated intravascular coagulation with multi-organ failure.","authors":"Marth Briers, Marnix Mylemans, Thomas Tousseyn, Lo Man Lai, Mercedeh Tajdar, Christine Van Laer","doi":"10.1093/labmed/lmae068","DOIUrl":"https://doi.org/10.1093/labmed/lmae068","url":null,"abstract":"Carcinocythemia, known as the presence of circulating tumor cells in the peripheral blood, is difficult to detect when the carcinoma cells are minimally present. We describe a case of a 56-year-old patient presenting with disseminated intravascular coagulation (DIC) and multiple organ failure. Despite initial suspicion of sepsis, a peripheral blood smear showed the presence of atypical cells, mainly located at the feathered edge, leading to a presumptive diagnosis of carcinocythemia of unknown primary origin. The presence of a high-fluorescent cell population detected by our hematology analyzer (Sysmex XN-9100) and immunohistochemical staining with pancytokeratin AE1/AE3 confirmed the carcinoma cell origin. The patient died 4 days after referral to our hospital. Postmortem examination revealed a pleomorphic lobular breast carcinoma (triple-negative, androgen receptor-negative). Given the clinical acuity of patients with carcinocythemia, early diagnosis is essential to guide management. This case underscores the importance of optimizing current workflows relying on complex flagging algorithms and enhanced digital imaging to aid in the early detection of such rare condition. When patients present with DIC of unknown origin and high fluorescent signals are detected on the hematology analyzer, carcinocythemia should actively be ruled out by extensive microscopic peripheral blood examination.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142001624","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

Extra cut-off value of aldosterone-to-renin ratio for screening primary aldosteronism in hypertensive patients with diabetes mellitus. 用于筛查糖尿病高血压患者原发性醛固酮增多症的醛固酮-肾素比值的额外临界值。

Laboratory medicine Pub Date : 2024-08-19 DOI: 10.1093/labmed/lmae065

Dubo Chen, Yuzhe Li, Jiayin Wu, Wenbin Lin, Liangying Zhong, Pinning Feng, Wenjia Gan

{"title":"Extra cut-off value of aldosterone-to-renin ratio for screening primary aldosteronism in hypertensive patients with diabetes mellitus.","authors":"Dubo Chen, Yuzhe Li, Jiayin Wu, Wenbin Lin, Liangying Zhong, Pinning Feng, Wenjia Gan","doi":"10.1093/labmed/lmae065","DOIUrl":"https://doi.org/10.1093/labmed/lmae065","url":null,"abstract":"Primary aldosteronism (PA) and diabetes mellitus (DM) may coexist. We previously found that DM and impaired glucose tolerance (IGT) may decrease the efficiency of the aldosterone-to-renin ratio (ARR) for screening PA. Thus, we wanted to determine appropriate ARR cut-off values for screening PA in patients with hypertension with DM and IGT. Data from 736 patients with hypertension were collected. They were divided into PA (77 cases), PA with DM (27 cases), PA with IGT (44 cases), hypertension without PA (353 cases), hypertension with DM (without PA, 127 cases), and hypertension with IGT (without PA, 108 cases). Receiver operating characteristic (ROC) curves were used to identify the appropriate ARR cut-off values in different conditions. Screening efficiencies of these cut-off values were evaluated across different groups. ARR cut-off values for screening PA in hypertensive patients without DM and IGT, with DM, and with IGT were 29.65, 23.15, and 26.9, respectively. All cut-off values demonstrated high sensitivity and specificity: 92.2% and 88.7%, 92.6% and 79.5%, and 88.6% and 85.2%, respectively, and areas under the ROC curves were 0.941, 0.904, and 0.909, respectively. Our results suggest that extra ARR cut-off values may be necessary for effective screening PA in hypertensive patients with DM and IGT, particularly in those with DM.","PeriodicalId":94124,"journal":{"name":"Laboratory medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142006203","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