Biochemia medica最新文献

{"title":"What do laboratories know about the pneumatic tube delivery systems they depend on?","authors":"Anushka Jayanetti, Tony Badrick","doi":"10.11613/BM.2026.030801","DOIUrl":"https://doi.org/10.11613/BM.2026.030801","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumatic tube systems (PTS) are a key component of many laboratory sample delivery systems. However, they can be a source of preanalytical error, particularly when samples are lost or damaged. The Key Incident Monitoring and Management (KIMMS) program of the Royal College of Pathologists Australasia Quality Assurance Programs (RCPAQAP) conducted a survey to gather information on the maintenance of these systems.</p><p><strong>Materials and methods: </strong>The categories of questions included general information, service, maintenance and validation of systems, and incident reporting. The responses were compiled and reviewed using Microsoft Forms.</p><p><strong>Results: </strong>The survey found a lack of awareness of servicing and validation records, as well as of the PTS's functionality. Most sites reported incidents with their pneumatic tube systems (37/45, 80%), mainly system failures rather than samples being lost, delayed, or damaged.</p><p><strong>Conclusions: </strong>Greater oversight of laboratories is needed, and relationships with system vendors must be strengthened to ensure quality service.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030801"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148804331","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":"Interference of iron deficiency in glycated hemoglobin testing and its clinical implications: a systematic review and meta-analysis.","authors":"Emanuele Maria Coimbra Souza, Caroline Pereira Domingueti","doi":"10.11613/BM.2026.030503","DOIUrl":"10.11613/BM.2026.030503","url":null,"abstract":"<p><strong>Introduction: </strong>Concentration of glycated hemoglobin (HbA1c) may be influenced by different types of anemia. This systematic review and meta-analysis aimed to evaluate the effect of iron deficiency anemia (IDA) and latent iron deficiency (LID) on HbA1c concentrations.</p><p><strong>Materials and methods: </strong>A search was conducted in Medline/PubMed, Web of Science, Embase, and LILACS up to May 2026. Eligible studies included cross-sectional, cohort, case-control, non-randomized intervention studies and clinical trials assessing the impact of IDA or LID on HbA1c concentrations. Methodological quality was evaluated using the ROBINS-I V2 tool for intervention studies and the Newcastle-Ottawa Scale for cross-sectional studies. Meta-analyses were performed using Review Manager 5 (The Cochrane Collaboration, Copenhagen, Denmark).</p><p><strong>Results: </strong>Among 43 studies evaluating IDA, 33 reported falsely elevated HbA1c concentrations. Of six studies assessing LID, two observed increased HbA1c concentrations. All four studies evaluating iron deficiency regardless of anemia status found elevated HbA1c. Among 19 intervention studies, 14 showed a reduction in HbA1c following iron supplementation. Meta-analyses including 30 studies confirmed increased HbA1c concentrations in patients with IDA (0.66% (0.31 to 1.00) or 7.21 mmol/mol (3.39 to 10.93), P < 0.001). Meta-analysis of four studies verified increased HbA1c in individuals with LID (0.66% (0.01 to 1.32) or 7.21 mmol/mol (0.11 to 14.43), P = 0.05). Meta-analysis of 14 intervention studies demonstrated a reduction in HbA1c following iron therapy (- 0.50% (- 0.92 to - 0.09) or 5.46 mmol/mol (- 10.05 to - 0.98), P = 0.02). Heterogeneity was mainly related to HbA1c assay methods and diagnostic criteria for anemia and iron deficiency.</p><p><strong>Conclusions: </strong>Iron deficiency anemia interferes with HbA1c measurement, leading to falsely elevated values, while LID may also increase HbA1c concentrations.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 3","pages":"030503"},"PeriodicalIF":1.8,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631967/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149121695","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":"Cross-interference of hemolysis, icterus and lipemia: A study with real patient samples.","authors":"Hatice Bozkurt Yavuz, Soycan Tüner","doi":"10.11613/BM.2026.020708","DOIUrl":"10.11613/BM.2026.020708","url":null,"abstract":"<p><strong>Introduction: </strong>Hemolysis, icterus, and lipemia (HIL) are frequent preanalytical interferences, leading to erroneous results or sample rejection. While individual effects of these indices have been studied, their interferences on each other remain largely unexplored. This study aimed to evaluate the cross-interference of HIL parameters using endogenous patient-derived samples, thereby ensuring clinically relevant conditions, and to propose a decision algorithm for improved sample quality assessment.</p><p><strong>Materials and methods: </strong>Following the CLSI-EP07 guideline, high-concentration icterus and lipemia pools from leftover clinical samples and hemolizate pool have been prepared. These pools were serially diluted with low-index serum (HIL0) to obtain defined combinations. Indices were measured using the Abbott Alinity c system. Cross interferences were calculated as percentage bias compared to baseline values.</p><p><strong>Results: </strong>High level hemolysis remained largely unaffected by other indices. Hemolysis in the range of 2.5-10.0 g/L caused a 20-150% false increase in lipemia and a 10-60% false decrease in icterus. Conversely, lipemia in the range of 25-100 index led to a 20-150% false increase in icterus and reduced low level of hemolysis by 10-30%. Similarly, icterus at 42.75-171 µmol/L resulted in a 15-45% false reduction in low levels of hemolysis. No concentration-dependent systematic bias was observed for lipemia and icterus, whereas hemolysis showed level-dependent effects.</p><p><strong>Conclusions: </strong>Cross-interference among HIL indices can lead to misinterpretation if indices are assessed independently. A rule-based, threshold-dependent algorithm incorporating these interactions is proposed to enhance accuracy in sample rejection decisions. Implementation of such integrated approaches, along with manufacturer transparency may significantly improve laboratory reliability.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020708"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262756/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261164","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":"Procollagen I carboxy-terminal propeptide: a multi-faceted biomarker.","authors":"Sharon Philip Jain, Niharika Ikkurthy, Swetha Sundara, Shervinchris Philip Jain","doi":"10.11613/BM.2026.020502","DOIUrl":"10.11613/BM.2026.020502","url":null,"abstract":"<p><p>Procollagen I carboxy-terminal propeptide (PICP) is a cleavage product of procollagen I, the precursor of type I collagen. Type I collagen is the most abundant type of collagen in the human body and plays a central role in maintaining structural integrity across tissues such as skin, bone, vasculature, and connective organs. Procollagen I carboxy-terminal propeptide, released during collagen synthesis, has been associated with fibrotic activity and tissue remodeling in different conditions across organ systems, including the heart, lungs, liver, kidneys, skin, and musculoskeletal system. Although many studies have investigated PICP in individual diseases, ranging from cardiomyopathies to liver cirrhosis and chronic lung disorders, its overall diagnostic and prognostic value remain incompletely defined. Serum PICP is a biomarker of fibrotic activity, with potential to be a valuable screening tool or component of diagnostic risk scores before moving to invasive methods such as biopsy. The ability to monitor fibrotic progression or therapeutic response through a simple blood test presents an opportunity for earlier diagnosis, improved disease stratification, and more efficient treatment monitoring. This literature review aims to provide a comprehensive synthesis of current knowledge on PICP, focusing on its biological role in collagen metabolism and clinical applications. By critically evaluating recent advances in assay methodologies, reference ranges, and interpretation in diverse patient populations, this review highlights both the strengths and limitations of PICP as a diagnostic and prognostic tool to identify future directions for research and clinical practice.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020502"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679935","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 challenging laboratory case due to inappropriate sampling through an antiseptic barrier cap.","authors":"Giovanni Introcaso, Giorgia Piras, Giorgia Mandelli, Sabrina Frisoli, Fabio Bottari","doi":"10.11613/BM.2026.021001","DOIUrl":"10.11613/BM.2026.021001","url":null,"abstract":"<p><p>Antiseptic barrier caps are currently used as novel tools in critically ill patients to achieve sterility of the blood sampling site and to prevent central line-associated bloodstream infections in the intensive care unit. A clinical and laboratory case of analytical interferences on erythrocytes, platelets and leukocytes due to the isopropyl alcohol contained in the antiseptic barrier cap is described. An aged man with history of heart valve disease was monitored for hematological parameters after surgery of mitral and tricuspid valve replacement. Leukocyte scattergrams changes on the Sysmex XN 2000 analyzer with the suspicion of platelet clumps were observed. After investigation on sampling procedure, antiseptic barrier cap of an arterial access (BD PureHub disinfecting cap) was used. Another sample has been requested, and the analysis of complete blood count and peripheral blood smear confirmed the presence of clumped microerythrocytes and erythrocytes with damaged membranes. In addition, differential leukocyte count revealed an overestimation of eosinophils by 10%. A new sample taken from venous access provided accurate results without alterations. The preanalytical error generated during blood sampling highlights the importance of correct use of biomedical devices. Furthermore, hematology analyzer technology represents a promising tool for assessing sample quality.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"021001"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261185","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":"Homovanillic acid and vanillylmandelic acid as neuroblastoma biomarkers in children.","authors":"Sina Kavalakatt, Josko Ivica","doi":"10.11613/BM.2026.020505","DOIUrl":"10.11613/BM.2026.020505","url":null,"abstract":"<p><p>Neuroblastoma (NBL) is the most common pediatric tumor with the highest fatality rate. The survival rate is improved when NBL is diagnosed in children under 1 year of age, but the diagnosis is complex due to the heterogeneity of the disease. This tumor type is characterized by elevated catecholamines and their metabolites, particularly homovanillic acid (HVA) and vanillylmandelic acid (VMA). Numerous analytical methods measuring urinary HVA and VMA have been developed to support the early NBL diagnosis. However, it is difficult to establish age-related reference ranges for these tests in children. To support the diagnostic process, the aim of this review is to provide up-to-date published age-related HVA and VMA reference intervals with focus on neuroblastoma development, catecholamine metabolism and possible interferences in the analytical methods used.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020505"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261192","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":"Extrapyramidal and anticholinergic reactions in an adolescent patient: a case for pharmacogenetic consideration.","authors":"Iris Žunić Išasegi, Ivana Stefanović, Marta Okružnik Želalić, Livija Šimičević, Lana Ganoci, Maja Živković, Ivan Begovac, Nada Božina","doi":"10.11613/BM.2026.020902","DOIUrl":"10.11613/BM.2026.020902","url":null,"abstract":"<p><p>Adolescent patients with borderline personality traits present a significant clinical challenge due to their polymorphic symptomatology occurring together with ongoing psychological and physiological development. While psychotherapy remains the first-line treatment, it is often combined with different psychopharmacological medications. This case report presents a 17.5-year-old female adolescent who developed extrapyramidal symptoms (EPS) following the addition of fluphenazine to her therapy, which had been modified due to deteriorating psychiatric symptoms. After the resolution of the EPS, the patient developed anticholinergic syndrome within a few days. Pharmacogenetic testing showed genetic variations associated with modified drug and dopamine metabolism, which may have contributed to her increased predisposition to drug adverse effects. This case highlights the complexity of psychopharmacological management in adolescents with multidimensional symptomatology and emphasizes the potential value of integrating pharmacogenetic data to guide optimal treatment strategies.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020902"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680058","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":"Myocardial fibrosis and viability: the role of imaging and biomarkers in patients with chronic total occlusion on coronary angiography.","authors":"Željka Dragila Tomašić, Lea Maršić, Anamaria Mikolčić, Lana Maričić, Kristina Selthofer Relatić, Darija Šnajder Mujkić","doi":"10.11613/BM.2026.020503","DOIUrl":"10.11613/BM.2026.020503","url":null,"abstract":"<p><p>In patients with chronic total occlusion on coronary angiography, myocardial viability assessment is an essential tool in guiding treatment decisions, especially revascularization. Current non-invasive tests are often limited by the presence of myocardial fibrosis. This narrative review incorporates evidence from 76 studies and aims to provide an updated overview of non-invasive methods for myocardial viability assessment, with emphasis on the role of myocardial fibrosis. Every imaging modality provides valuable information, even though they differ in sensitivity, specificity, availability, radiation exposure, contraindications and limitations in the presence of fibrosis. Biomarkers that provide insight into different aspects of myocardial fibrosis - including collagen synthesis (procollagen type I carboxy-terminal propeptide and procollagen type III amino-terminal propeptide), as well as inflammation and fibrotic signalling (galectin-3) - may complement imaging by reflecting myocardial remodelling. However, main limitations to this approach are no standardized reference ranges and cut-off values, analytical variability and insufficient validation for clinical outcomes prediction. Despite their potential to guide personalized revascularization decisions, circulating fibrosis biomarkers currently remain experimental tools. Further large-scale prospective clinical studies that incorporate biomarkers with imaging are needed before their implementation into clinical practice.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020503"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148261177","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":"Dendritic cells in hematologic malignancies: a brief review of immunoregulation to new perspectives.","authors":"Gabriel Barroso de Almeida, Mariane Melo Dos Santos, Dyjaene de Oliveira Barbosa, Rogério Reis Conceição, Bruno de Almeida Lopes, Herbert Henrique de Melo Santos, Silvana Beutinger Marchioro","doi":"10.11613/BM.2026.020501","DOIUrl":"10.11613/BM.2026.020501","url":null,"abstract":"<p><p>Dendritic cells (DCs) are essential immune system sentinels, playing a key role in activating naïve T cells against leukemic cells. They have an immunomodulatory function, promoting an immune response and, at the same time, regulating immune tolerance to avoid excessive reactions. Plasmacytoid dendritic cell (pDC) neoplasms are a complex group of disorders, and among the subtypes, acute myeloid leukemia (AML) with pDC dermatosis (AML-pDC) stands out. In this context, pDCs can play an immunomodulatory role by inhibiting or promoting immune responses and acting as tumor progenitors since, in some cases, they can collaborate with the tumor microenvironment, favoring immune evasion and proliferation. However, the clinical significance of pDC in AML is not fully understood. Studies suggest that the interaction of pDCs with the leukemic microenvironment may contribute to disease progression by impairing the immune system's ability to control tumor cells. Understanding the role of DCs in neoplasia is crucial, as it provides important insights for new studies seeking advances in innovative therapeutic strategies, such as dendritic cell vaccines. These vaccines are promising, with low toxicity and the potential to improve the prognosis of individuals affected by AML, stimulating an effective immune response.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020501"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147680071","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":"Tumour lysis syndrome in the setting of a high-grade B-cell lymphoma with primary bone marrow localization - a case report.","authors":"Iva Ivanko, Josipa Josipović, Ivana Ćelap, Sabina Novaković Coha, Hana Matijaca, Tomislav Brblić, Sandra Kojić Katović, Petar Gaćina","doi":"10.11613/BM.2026.020901","DOIUrl":"10.11613/BM.2026.020901","url":null,"abstract":"<p><p>Tumour lysis syndrome (TLS) is an oncologic emergency usually arising after chemotherapy administration, caused by a massive tumour breakdown and characterized by a specific laboratory and clinical findings. We present a case of TLS, both spontaneous and treatment related, in a 59-year-old woman with high grade B-cell lymphoma without apparent bulky disease on radiologic scans. The patient presented with acute kidney failure with marked hyperuricemia (2764 µmol/L) and extremely high lactate dehydrogenase (LD) activity (13,770 U/L). She was treated with rasburicase, corticosteroid pre-phase therapy, sequential chemotherapy and renal replacement therapy tailored to electrolytic disturbances. After initial resolution of spontaneous TLS, at the start of chemotherapy administration, she experienced systemic inflammatory response (SIRS) and therapy related TLS which included, amongst else, vast hyperphosphatemia (6.12 mmol/L). Despite all intensive care treatment, patient went into multiorgan failure preceding lethal outcome. This case report confirms the value of laboratory parameters in establishing the diagnosis of TLS with LD as an indicator of massive tumour turnover. Due to a high risk of deleterious complications, management of extreme TLS cases challenges the current guidelines of TLS therapy. Modern treatment options such as targeted anticytokine therapy could potentially bring benefit in these specific circumstances.</p>","PeriodicalId":94370,"journal":{"name":"Biochemia medica","volume":"36 2","pages":"020901"},"PeriodicalIF":1.8,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067891/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679946","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}