The likelihood ratio and its graphical representation.
Authors: Habibzadeh F, Habibzadeh P Abstract Diagnostic tests are important clinical tools. Bayes' theorem and Bayesian approach are important methods for interpreting test results. The Bayesian factor, the so-called likelihood ratio, has not always been well-understood. In this article, we try to discuss the likelihood ratio and its value for a specific test result, a positive or negative test result, and a range of test results, along with their graphical representations. PMID: 31015780 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - April 26, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Rewarding the quantity of peer review could harm biomedical research.
This article also argues that peer review should remain a voluntary mission, and should not be prompted by the need to attain tenure or promotion. PMID: 31015781 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - April 26, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

A balanced scorecard for assessing a strategic plan in a clinical laboratory.
Authors: Alvarez L, Soler A, Guiñón L, Mira A Abstract The Balanced Scorecard (BSC) is a tool for strategic management that is used in many companies and organizations worldwide, both in the public and private sector. With this purpose it has also been used in healthcare organizations and institutions but there are not many studies on the implementation of BSC methodology in the day-to-day clinical laboratory. This review shows the strategy for the development of a BSC, which includes theoretical perspective objectives, as well as some indicators and goals with which the monitoring and quantitative me...
Source: Biochemia Medica - April 26, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Evaluation of a commercial liquid-chromatography high-resolution mass-spectrometry method for the determination of hepcidin-25.
Conclusions: The hepcidin-25 LC-MS/MS kit shows a broad analytical range and meets the imprecision and bias acceptance criteria of ≤ 15%. Serum samples can be stored at RT for 3 h and resist up to two freeze and thaw cycles. PMID: 31015783 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - April 26, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Impact of an Andean breakfast on biochemistry and immunochemistry laboratory tests: an evaluation on behalf COLABIOCLI WG-PRE-LATAM.
Conclusions: Andean breakfast can influence the routine biochemistry and immunochemistry laboratory tests and might expose patient safety to some risks. Therefore, the COLABIOCLI WG-PRE-LATAM calls attention and highlights that the fasting time needs to be carefully considered when performing blood testing in order to prevent spurious results and thus, reduce laboratory errors. PMID: 31015784 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - April 26, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Haemolysis and lipemia interfere with resistin and myeloperoxidase BioVendor ELISA assays.
Conclusions: Resistin BioVendor assays are affected by haemolysis and lipemia already at low degree of interferent. Haemolysis was found to interfere at 1 g/L haemoglobin for both assays, while lipemia interferes at 4.66 mmol/L of triglycerides. PMID: 31015785 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - April 26, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Higher serum lectin-like oxidized low-density lipoprotein receptor-1 in patients with stable coronary artery disease is associated with major adverse cardiovascular events: A multicentre pilot study.
Authors: Zhao ZW, Xu YW, Li SM, Guo JJ, Yi T, Chen LL Abstract Introduction: Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1) is involved in the pathophysiology of atherosclerosis and acute coronary syndromes (ACS). Circulating soluble LOX-1 (sLOX-1) has been linked to the risk of coronary artery disease (CAD). Our aim was to test if baseline serum sLOX-1 was associated with major adverse cardiovascular events (MACE) in patients with stable CAD. Materials and methods: This multicentre pilot study enrolled 833 stable CAD patients. All patients were followed for two years. Serum sLOX-1 concentratio...
Source: Biochemia Medica - February 27, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Changes of salivary biomarkers under different storage conditions: effects of temperature and length of storage.
Conclusions: In short-term storage, the analytes were more stable at 4 ºC than at room temperature, whereas in long-term storage they were more stable at - 80 ºC than at - 20 ºC. PMID: 30799975 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - February 27, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Faecal calprotectin determination: impact of preanalytical sample treatment and stool consistency on within- and between-method variability.
Authors: Juricic G, Brencic T, Tesija-Kuna A, Njegovan M, Honovic L Abstract Introduction: We assessed the differences in faecal calprotectin (FC) concentrations measured by two assays depending on the stool consistency and extraction method. Materials and methods: Stool samples were extracted using the EliA Stool Extraction Kit, Calex® Cap extraction device and respective weighing methods, while FC concentrations were measured using the EliATM Calprotectin and Bühlmann fCAL® Turbo method and checked for within- and between-method variability with regard to extraction method and stool consistency c...
Source: Biochemia Medica - February 27, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Analytical verification of 12 most commonly used urine dipsticks in Croatia: comparability, repeatability and accuracy.
Authors: Vuljanić D, Dojder A, Špoljarić V, Saračević A, Dukić L, Leniček-Krleža J, Vlašić-Tanasković J, Maradin I, Grzunov A, Vogrinc Ž, Šimundić AM Abstract Introduction: Variability among manufacturers of urine dipsticks, respective to their accuracy and measurement range, may lead to diagnostic errors and thus create a serious risk for the patient. Our aims were to determine the level of agreement between 12 most commonly used urine dipsticks in Croatia, examine their accuracy for glucose and total protein and to test their repeatability. Materials and methods: A total of 75 ...
Source: Biochemia Medica - February 27, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Improving home haemodialysis: Stability evaluation of routine clinical chemistry analytes in blood samples of haemodialysis patients.
Authors: Nonkes LJP, van Gelder MK, Kemperman H, Abrahams AC, Boereboom FTJ, Ten Berg MJ, Gerritsen KGF Abstract Introduction: A growing number of dialysis patients is treated with home haemodialysis. Our current pre-analytical protocols require patients to centrifuge the blood sample and transfer the plasma into a new tube at home. This procedure is prone to errors and precludes accurate bicarbonate measurement, required for determining dialysate bicarbonate concentration and maintaining acid-base status. We therefore evaluated whether cooled overnight storage of gel separated plasma is an acceptable alternative. ...
Source: Biochemia Medica - February 27, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Plasma free DNA: Evaluation of temperature-associated storage effects observed for Roche Cell-Free DNA collection tubes.
Conclusions: No unwanted release of genomic DNA from white blood cells could be detected in plasma samples after tube storage for 24 and 48 h regardless of storage temperature. PMID: 30799979 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - February 27, 2019 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Confidence interval for quantiles and percentiles.
Authors: Ialongo C Abstract Quantiles and percentiles represent useful statistical tools for describing the distribution of results and deriving reference intervals and performance specification in laboratory medicine. They are commonly intended as the sample estimate of a population parameter and therefore they need to be presented with a confidence interval (CI). In this work we discuss three methods to estimate CI on quantiles and percentiles using parametric, nonparametric and resampling (bootstrap) approaches. The result of our numerical simulations is that parametric methods are always more accurate regardles...
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Correcting duplicate publications: follow up study of MEDLINE tagged duplications.
Conclusions: Despite clear policies on how to handle DPs, just half (54%) of the DPs in MEDLINE were addressed by journals and only 9% retracted. Publishers, editors, and indexers need to develop and implement standards for better correction of duplicate published records. PMID: 30591809 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

A review of urinary angiotensin converting enzyme 2 in diabetes and diabetic nephropathy.
Authors: Gilbert A, Liu J, Cheng G, An C, Deo K, Gorret AM, Qin X Abstract Urinary angiotensin converting enzyme 2 (ACE2) is significantly increased in diabetes and diabetic nephropathy. While studies on its clinical significance are still underway, its urinary expression, association with metabolic and renal parameters has been in the recent past considerably studied. The recent studies have demystified urine ACE2 in many ways and suggested the roles it could play in the management of diabetic nephropathy. In all studies the expression of urinary ACE2 was determined by enzyme activity assay and/with the quantifica...
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Standardization in laboratory medicine: Two years' experience from category 1 EQA programs in Spain.
Conclusions: The two years of category 1 EQA program experience in Spain have manifested a lack of standardization of 17 most frequent biochemistry tests used in our laboratories. The impact of the information obtained on the lack of standardization is to recommend abandoning methods such as ALT, AST without exogenous pyridoxal phosphate, Jaffe method for creatinine, and do not use non-commutable calibrators, such as aqueous solutions for calcium and sodium. PMID: 30591811 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Prognostic value of procalcitonin and lipopolysaccharide binding protein in cancer patients with chemotherapy-associated febrile neutropenia presenting to an emergency department.
Conclusion: A single measurement of PCT performs similarly as MASCC score to predict serious medical complications in cancer patients with febrile neutropenia and can be a useful tool for risk stratification. Besides, low PCT concentrations can be used to rule-out the presence of bacteraemia. PMID: 30591812 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Fast skeletal troponin I, but not the slow isoform, is increased in patients under statin therapy: a pilot study.
Conclusions: Serum fsTnI could be a good marker for monitoring statin-associated muscular damage outperforming traditional markers. PMID: 30591813 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Analysis of laboratory critical values at a referral Spanish tertiary university hospital.
Conclusions: The analysis of critical values in our hospital is in accordance with that reported in the literature. Our findings demonstrate the importance of incorporating improvement actions not only in critical value notification, but especially in the registration of this activity. PMID: 30591814 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Effects of different anticoagulants on glycated albumin quantification.
Conclusions: Our results demonstrate that the GA% assay is not affected by relevant interferences when K3EDTA, Li-heparin or NaF-EDTA are used as anticoagulants, so they can be used interchangeably without a relevant impact on the clinical use of the test. PMID: 30591815 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Sigma metric revisited: True known mistakes.
Authors: Coskun A, Serteser M, Ünsal I Abstract Six Sigma methodology has been used successfully in industry since the mid-1980s. Unfortunately, the same success has not been achieved in laboratory medicine. In this case, although the multidisciplinary structure of laboratory medicine is an important factor, the concept and statistical principles of Six Sigma have not been transferred correctly from industry to laboratory medicine. Furthermore, the performance of instruments and methods used in laboratory medicine is calculated by a modified equation that produces a value lower than the actual level. This caus...
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Mistaken assumptions drive new Six Sigma model off the road.
Authors: Westgard S, Bayat H, Westgard JO Abstract Oosterhuis and Coskun recently proposed a new model for applying the Six Sigma concept to laboratory measurement processes. In criticizing the conventional Six Sigma model, the authors misinterpret the industrial basis for Six Sigma and mixup the Six Sigma "counting methodology" with the "variation methodology", thus many later attributions, conclusions, and recommendations are also mistaken. Although the authors attempt to justify the new model based on industrial principles, they ignore the fundamental relationship between Six Sigma and the pr...
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Falsely prolonged activated partial thromboplastin time - a pre- and post-analytical issue.
Authors: Gils C, Vinholt PJ, Nybo M Abstract This case highlights two common pre-analytical problems identified in routine coagulation testing of activated partial thromboplastin time (aPTT), which were overlooked because of a concurrent flag code indicating no coagulation and the result was replaced by asterisks. It concerns a boy with gastrointestinal bleeding and prolonged aPTT> 300 seconds, which raised the suspicion of haemophilia. When all other coagulation parameters (including specific coagulation factors VIII and IX) turned out to be normal, aPTT was re-measured using another analysis principle, which r...
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Case report: An index of suspicion in hyponatraemia.
Authors: Barkhuizen M, Hoffmann M, Zöllner EW, Erasmus RT, Zemlin AE Abstract Serum indices can give valuable information and should be interpreted as a result. Lipaemia can influence results through different mechanisms, an important one being the electrolyte exclusion effect. A case of pseudohyponatraemia due to this is reported. A 15-year-old female with type 2 diabetes was seen for follow-up. Her biochemistry results revealed severe hyponatraemia of 118 mmol/L. Her capillary glucose concentration was 13.7 mmol/L with a corrected sodium of 122 mmol/L. A lipaemic index of 3+ (absolute value 1320) was noted, ...
Source: Biochemia Medica - December 31, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Informed consent and ethics committee approval in laboratory medicine.
This article aims to clarify what is specific about obtaining informed consent and ethical approval in laboratory medicine, to provide general guidance on informed consent and ethical approval requirements based on the type of study, and what information should be included in applications for ethical approval and informed consent. This could also provide some guidance for future contributors to the Biochemia Medica. PMID: 30429665 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

"Ultra-sensitive" cardiac troponins: Requirements for effective implementation in clinical practice.
"Ultra-sensitive" cardiac troponins: Requirements for effective implementation in clinical practice. Biochem Med (Zagreb). 2018 Oct 15;28(3):030501 Authors: Lippi G, Sanchis-Gomar F Abstract The measurement of cardiac troponins, either cardiac troponin I or T, has become the culprit of clinical decision making in patients with suspected acute coronary syndrome (ACS), especially in those with non-ST elevation myocardial infarction (NSTEMI). The leading analytical mainstays of cardiac troponin immunoassays include the limit of blank (LoB), limit of detection (LoD), functional sensitivity, the 9...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Red blood cell distribution width in pregnancy: a systematic review.
Authors: Paliogiannis P, Zinellu A, Mangoni AA, Capobianco G, Dessole S, Cherchi PL, Carru C Abstract Anisocytosis has been associated with the severity and prognosis of several acute and chronic diseases, as well as physiological conditions such as pregnancy. Anisocytosis is quantified by the red blood cell distribution width (RDW), expressed as the ratio, multiplied by 100, between the standard deviation (SD) of red blood cell volumes and the mean corpuscular volume, or as the SD of erythrocyte volumes (RDW-SD). The aim of the present review was to report the state of the art on the physiological values and the p...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Improvement of neutrophil gelatinase-associated lipocalin sensitivity and specificity by two plasma measurements in predicting acute kidney injury after cardiac surgery.
Conclusions: The assay results showed an improvement of NGAL diagnostic accuracy evaluating two tests. Consequently, NGAL may be useful for a timely treatment or for the AKI rule out in ICU patients. PMID: 30429668 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Association of abdominal aortic aneurysm diameter with insulin resistance index.
Authors: Lareyre F, Moratal C, Zereg E, Carboni J, Panaïa-Ferrari P, Bayer P, Jean-Baptiste E, Hassen-Khodja R, Chinetti G, Raffort J Abstract Introduction: Epidemiological studies have highlighted a negative association between diabetes and abdominal aortic aneurysm (AAA). The aim of this study was to investigate the association between insulin resistance and AAA size. Materials and methods: This prospective cross sectional monocentric study analysed fasting blood samples from 55 patients with AAA eligible for surgical repair. They were divided into 2 groups according to the median AAA diameter: diameter ...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Significance of LDL and HDL subclasses characterization in the assessment of risk for colorectal cancer development.
This study analyses low-density lipoprotein (LDL) and high-density lipoprotein (HDL) diameters, as well as distribution of LDL and HDL subclasses in patients with CRC, with an aim to determine whether advanced lipid testing might be useful in predicting the risk for the onset of this malignancy. Materials and methods: This case-control study included 84 patients with newly diagnosed CRC and 92 controls. Gradient gel electrophoresis was applied for separation of lipoprotein subclasses and for LDL and HDL diameters determination. Lipid parameters were measured using routine enzymatic methods. Results: Total cholester...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Detection of annexin A8 antibodies in serum of patients with antiphospholipid syndrome.
Conclusion: We demonstrated that AnxA8 IgG isotype antibodies are potential biomarkers for the diagnosis of APS. PMID: 30429671 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Haematology specimen acceptability: a national survey in Chinese laboratories.
Conclusions: Overall, rejection rate was a slightly lower than previously published data. In order to achieve a better quality in the preanalytical phase, haematology laboratories in China should pay more attention on training for phlebotomy and sample transportation, identify main reasons for clotted specimen and take effective measures. The platform in the study will be helpful for long-term monitoring, but simplification and modification should be introduced in the following investigation. PMID: 30429672 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Effect of sample processing and time delay on cell count and chemistry tests in cerebrospinal fluid collected from drainage systems.
Authors: Mlinarić A, Vogrinc Ž, Drenšek Z Abstract Introduction: Cerebrospinal fluid (CSF) from extra-ventricular drainage (EVD) systems is routinely analysed to diagnose EVD-related bacterial meningitis. We investigated the effect of time delay and sample processing on cell count and basic biochemistry results in EVD CSF to define optimal turnaround time and whether manual and automated cell counting are comparable in such samples. Materials and methods: In total, 32 EVD CSF samples were analysed. Baseline testing included cell counting (Fuchs-Rosenthal chamber and Sysmex XE5000) and biochemistry anal...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Computer physician order entry (CPOE) as a strategy to estimate laboratory activity and costs associated with cancer clinical trials.
Conclusions: Strategies through CPOE systems based on restricted and specific profiles for CTs ordering are a promising tool that can improve laboratory associated costs estimation and provide robust evidence in reimbursement negotiation processes with CTs sponsors. PMID: 30429674 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Analysis of selected T cell subsets in peripheral blood after exhaustive effort among elite soccer players.
Authors: Kostrzewa-Nowak D, Nowak R Abstract Introduction: Physical exercise induces developing of naïve T lymphocyte subsets into polarised effector ones by immune system. The aim of the study was to examine the influence of exhaustive effort on the selected Th cell subsets and inflammation markers among soccer players. Materials and methods: Fourteen soccer players aged 18 (16-21) years old performed the progressive efficiency test on mechanical treadmill. Th and Tc memory lymphocytes' subsets and selected cytokine concentrations pre-exercise, post-exercise and in recovery were analysed by flow cytometry...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Evaluation of the analytical performances of the Cobas c513 analyser for HbA1c assay.
Conclusions: This evaluation showed that the analytical performance of the Cobas c513 analyser for HbA1c assay makes it suitable for a routine use in clinical chemistry laboratories. PMID: 30429676 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Reducing test request for anti-thyroglobulin and anti-thyroid peroxidase antibodies: trends before and after interventions based on rejection rules and profile management.
The objective of this study was to identify trends in requests for anti-thyroid peroxidase antibodies (TPOab) and anti-thyroglobulin antibodies (TGab) tests before and after applying set of interventions based on rejection rules and profile management. Materials and methods: Trend analysis was made at semester time intervals (from May-October 2010 to May-October 2017), before and after the intervention semester (May-October 2016). Number of tests (N) TPOab and TGab / 1000 total requests based on total N of both tests and total N of biochemical analysis laboratory requests, was calculated. To find out where the interven...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Calcium-stimulated calcitonin - The "new standard" in the diagnosis of thyroid C-cell disease - clinically relevant gender-specific cut-off levels for an "old test".
Calcium-stimulated calcitonin - The "new standard" in the diagnosis of thyroid C-cell disease - clinically relevant gender-specific cut-off levels for an "old test". Biochem Med (Zagreb). 2018 Oct 15;28(3):030710 Authors: Niederle MB, Scheuba C, Gessl A, Li S, Koperek O, Bieglmayer C, Riss P, Selberherr A, Niederle B Abstract Introduction: Pentagastrin (Pg) stimulated calcitonin (sCT) was used to enhance accuracy in medullary thyroid cancer (MTC) diagnosis. As it is now unavailable, calcium (Ca) has been recommended as an alternative. The aim of this study was to define gender-speci...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

A collaborative study by the Working Group on Hemostasis and Thrombosis of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) on the interference of haemolysis on five routine blood coagulation tests by evaluation of 269 paired haemolysed/non-haemolysed samples.
Authors: Novelli C, Vidali M, Brando B, Morelli B, Andreani G, Arini M, Calzoni P, Giacomello R, Montaruli B, Muccini E, Papa A, Pradella P, Ruocco L, Siviero F, Viola FG, Zanchetta M, Zardo L, Lippi G Abstract Introduction: Haemolysis is the leading cause of sample rejection in laboratory haemostasis. Most studies focused on artificially haemolysed samples. The aim of this study was a prospective assessment of spontaneous haemolysis on haemostasis tests, by comparing results of haemolysed (H) versus new, non-haemolysed (NH) specimens, collected within 4hrs. As new coagulometers can identify interfering substances,...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

The diagnostic accuracy of clinical and laboratory parameters in the diagnosis of acute appendicitis in the adult emergency department population - a case control pilot study.
Authors: Soldo I, Radisic Biljak V, Bakula B, Bakula M, Simundic AM Abstract Introduction: The evaluation of patients with suspected appendicitis strives to identify all patients with presenting symptoms while minimizing negative appendectomy rate. The aim of the study was to identify the optimal combination of clinical and laboratory parameters that should facilitate the emergency department surgeon's definite decision. Materials and methods: The study group comprised 120 patients with suspicion of acute appendicitis (AA). In 60 patients the AA diagnosis was confirmed intraoperatively and by histological analy...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Metabolic follow-up of a Croatian patient with gyrate atrophy and a new mutation in the OAT gene: a case report.
Authors: Zekušić M, Škaričić A, Fumić K, Rogić D, Žigman T, Petković Ramadža D, Vukojević N, Rüfenacht V, Uroić V, Barić I Abstract Gyrate atrophy (GA) of the choroid and retina is a rare autosomal recessive disorder that occurs due to deficiency of the mitochondrial enzyme ornithine aminotransferase (OAT). Hyperornithinemia causes degeneration of the retina with symptoms like myopia, reduced night vision and progressive vision loss. Our patient is a 10-year-old girl with impaired vision and strabismus. As part of the metabolic work-up, plasma amino acid analysis revealed significantly...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Biotin and high-sensitivity cardiac troponin T assay.
Conclusions: Biotin interference is not dependent of initial troponin value. Interference could be successfully neutralized within a time frame compatible with emergency but results still should be carefully interpreted due to possible dilution effect. PMID: 30429682 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Effect of cold agglutinins on red blood cell parameters in a trauma patient: a case report.
In this report we describe the case of a 90-year old female patient admitted to the Emergency department following trauma injuries. A blood testing on admission revealed surprisingly low red blood cell count (0.99 x 1012/L), low haematocrit (0.102 L/L) which did not correlate with haemoglobin concentration (100 g/L), and high erythrocytes indices (mean corpuscular haemoglobin, 101 pg; mean corpuscular haemoglobin concentration, 980 g/L). In the second sample, after repeated collection, almost equal results were observed. Blood smear examination under the microscope revealed clusters of erythrocytes. Cold agglutinins presen...
Source: Biochemia Medica - November 16, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Expected long-term defect rate of analytical performance in the medical laboratory: Assured Sigma versus observed Sigma.
Authors: Bayat H Abstract Reliability of laboratory results is determined by the ratio of incorrect results expected in long-term. Sigma is a measure of defect ratio, therefore long-term Sigma is a measure of the reliability of laboratory results. Commonly, long-term Sigma is estimated based on the short-term Sigma. The Six Sigma methodology assumes that in long-term performances will shift up to 1.5 Sigma, and therefore the long-term Sigma is considered 1.5 Sigma less than short-term Sigma. Analytical performance in the medical laboratory is prone to shifts larger than 1.5 Sigma. Thus, the 1.5 Sigma shift assumed ...
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Analytical Sigma metrics: A review of Six Sigma implementation tools for medical laboratories.
Authors: Westgard S, Bayat H, Westgard JO Abstract Sigma metrics have become a useful tool for all parts of the quality control (QC) design process. Through the allowable total error model of laboratory testing, analytical assay performance can be judged on the Six Sigma scale. This not only allows benchmarking the performance of methods and instruments on a universal scale, it allows laboratories to easily visualize performance, optimize the QC rules and numbers of control measurements they implement, and now even schedule the frequency of running those controls. PMID: 30022879 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Sigma metrics in laboratory medicine revisited: We are on the right road with the wrong map.
Authors: Oosterhuis WP, Coskun A Abstract Reliable procedures are needed to quantify the performance of instruments and methods in order to increase the quality in clinical laboratories. The Sigma metrics serves that purpose, and in the present study, the current methods for the calculation of the Sigma metrics are critically evaluated. Although the conventional model based on permissible (or allowable) total error is widely used, it has been shown to be flawed. An alternative method is proposed based on the within-subject biological variation. This model is conceptually similar to the model used in industry to qua...
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Risk analysis and assessment based on Sigma metrics and intended use.
Authors: Xia Y, Xue H, Yan C, Li B, Zhang S, Li M, Ji L Abstract Introduction: In order to ensure the quality in clinical laboratories and meet the low risk requirements of patients and clinicians, a risk analysis and assessment model based on Sigma metrics and intended use was constructed, based on which differential sigma performance (σ) expectations of 42 analytes were developed. Materials and methods: Failure mode and effects analysis was applied to produce an analytic risk rating based on three factors, each test of which was graded as follows: 1) Sigma metrics; 2) the severity of harm; 3) intended u...
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Sigma metrics for assessing the analytical quality of clinical chemistry assays: a comparison of two approaches: Electronic supplementary material available online for this article.
Conclusions: Both methods of calculating σ can be used for Six Sigma quality management. In practice, laboratories should evaluate Sigma multiple times when optimizing a quality control schedule. PMID: 30022883 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Application of Sigma metrics in assessing the clinical performance of verified versus non-verified reagents for routine biochemical analytes.
Conclusion: Sigma metrics analysis system is helpful for clarifying the performance of candidate non-verified reagents in clinical laboratory. Our study suggests that the quality of non-verified reagents should be assessed strictly. PMID: 30022884 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research

Comprehensive evaluation of the internal and external quality control to redefine analytical quality goals.
Conclusion: The graphic tool designed together with the proposed algorithm enabled the laboratory to standardize the selection procedure of the most appropriate TEa for the test analytical performance. PMID: 30022885 [PubMed - in process] (Source: Biochemia Medica)
Source: Biochemia Medica - July 21, 2018 Category: Biochemistry Tags: Biochem Med (Zagreb) Source Type: research