| 1. |
- Ahmed, Degmo Said, et al.
(författare)
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Quantitative determination of cerebrospinal fluid bilirubin on a high throughput chemistry analyzer
- 2009
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Ingår i: Clinical laboratory. - 1433-6510. ; 55:7-8, s. 283-288
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Subarachnoid hemorrhage is a condition with high rates of mortality and morbidity. The diagnosis requires an urgent cerebral computed tomography scan and also a lumbar puncture if the scan fails to demonstrate intracranial blood. In Sweden the cerebrospinal fluid (CSF) is analyzed by spectrophotometric scanning for the presence of hemoglobin and bilirubin. The aim of the study was to develop a quantitative diazo reagent based analysis of cerebrospinal fluid bilirubin as a replacement for spectrophotometric scanning. METHODS: The CSF bilirubin assay on an Architect C8000 chemistry analyzer was compared with spectrophotometry using patient samples. RESULTS: The method correlates with spectrophotometry, has a good linearity and precision. CONCLUSIONS: Quantitative bilirubin measurement offers shorter turnaround times, simplifies the interpretation of the results and reduces work load in comparison with spectrophotometry.
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| 2. |
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| 3. |
- Bahrmann, Philipp, et al.
(författare)
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Quantification of Renal Function and Cardiovascular Mortality in Patients Admitted to the Emergency Department with Suspected Acute Coronary Syndromes : Results from the TRAPID-AMI Study
- 2017
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Ingår i: Clinical Laboratory. - 1433-6510. ; 63:9, s. 1457-1466
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Tidskriftsartikel (refereegranskat)abstract
- Background: Increases in the novel serum marker cystatin C are detectable much earlier in the course of chronic kidney disease (CKD) even when levels of serum creatinine are still in the normal range. A major factor causing a decrease in serum creatinine is increasing age. Patients with CKD are more likely to develop cardiovascular disease (CVD) than a healthy population and to suffer premature deaths from CVD related to CKD. The aim of this study was to investigate whether cystatin C, serum creatinine, and estimated glomerular filtration rate (eGFR) predict cardiovascular mortality in patients admitted to the emergency department (ED) with suspected acute coronary syndromes (ACS).Methods: In 1,282 patients (mean age 62 15 years, 477 women, 805 men) with suspected ACS, baseline cystatin C concentrations, serum creatinine, and estimated glomerular filtration rate (eGFR) were measured at the ED. Clinical assessment and serial high sensitivity cardiac troponin T (hs-cTnT) measurements were used for the diagnosis of ACS. Seventeen cardiovascular deaths were registered during a median follow-up of 365 days.Results: HRs from univariate Cox regression models for each of the potential biomarkers were 12.02 (95% CI 5.10 - 28.34) for cystatin C, 4.53 (1.75 - 11.70) for serum creatinine, and 0.97 (0.96 - 0.99) for eGFR. All three biomarkers showed a significant association with cardiovascular mortality in univariate analyses. The HRs from a model with all three potential biomarkers were 59.21 (95% CI 9.69 - 361.76) for cystatin C, 0.08 (0.01 - 0.58) for serum creatinine, and 0.98 (0.96 - 1.01) for eGFR. The risk association was significant for ln (cystatin C) and ln (serum creatinine).Conclusions: Results of this prospective study show that the quantification of renal function using cystatin C is useful for predicting cardiovascular mortality in patients with suspected ACS at the ED.
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| 4. |
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| 5. |
- Carlsson, Lena, et al.
(författare)
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High Concentrations of the Angiogenic Peptide VEGF-A in Seminal Fluid and its Association to Prostasomes
- 2016
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Ingår i: Clinical Laboratory. - 1433-6510. ; 62:8, s. 1515-1520
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Tidskriftsartikel (refereegranskat)abstract
- Background: Angiogenesis is the formation of new blood vessels by capillary sprouting from pre-existing vessels. This process is associated with increased expression of angiogenic factors like vascular endothelial growth factor (VEGF). The VEGF family consists of five members denoted VEGF-A, B, C, D and placenta growth factor (PlGF). Prostasomes are exosome-like extracellular vesicles existing in seminal plasma. The present study aimed at investigating the possible relationship between VEGF-A in seminal fluid and blood plasma and the prostasomal association of VEGF-A.Methods: Measurement of VEGF-A concentrations was carried out in seminal plasma from 40 males and in blood plasma from 40 male blood donors utilizing commercial ELISA kits. The prostasomal association of VEGF-A was investigated by flow cytometry.Results: We found highly elevated concentrations of VEGF-A in seminal fluid (median value 150000 pg/mL) compared with those of blood plasma. Flow cytometric analysis showed that VEGF-A is bound to the surface of prostasomes.Conclusions: Prostasomes and seminal plasma contain the angiogenic factor VEGF-A in high concentrations exceeding that of blood plasma by 1000 times.
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| 6. |
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| 7. |
- Eriksson, Mats B, et al.
(författare)
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Troponin I can be Determined in Intraosseous Aspirates in a Porcine Shock Model
- 2015
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Ingår i: Clinical Laboratory. - 1433-6510. ; 61:7, s. 825-829
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Determination of troponin I may be important in the management of the critically ill patient. In medical emergencies, especially when vascular access is difficult to achieve, the use of intraosseous (10) needles is recommended. We aimed to perform a descriptive study, aiming to elucidate whether IO needles can be used to evaluate troponin I in a porcine model of human shock.METHODS: Eight pigs were anesthetized and challenged with a 6 hours continuous intravenous infusion of E. coli endotoxin. An IO needle (EZ-IO®) was inserted in the proximal tibia of each pig. Circulatory variables were monitored and troponin I was sampled from arterial and venous blood and also from bone marrow aspirates.RESULTS: Circulatory deterioration developed in all endotoxemic animals, which was reflected by a profound deterioration of left ventricular stroke work index. Troponin I levels were nearly identical in both arterial, venous, and IO samples during the first hour of endotoxemia. At 1 hour, all mean troponin I levels had more than doubled as compared to baseline. The troponin I levels continued to increase over time and were markedly elevated versus baseline levels during the 2nd and 6th hours, regardless of sampling site. At 3 hours, IO troponin I reached a plateau, whereas troponin I in both arterial and venous blood continued to increase.CONCLUSIONS: This investigation has shown that troponin I can be analyzed in bone marrow aspirates in a shock model. This may be useful in medical emergencies, where cardiac damage is suspected to be involved. The levels of IO troponin I increased during the first 3 hours of shock, after which it remained at a high level. During this initial period there was, in parallel, a progressive circulatory deterioration.
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| 8. |
- Fall, Tove, 1979-, et al.
(författare)
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Reference Intervals for Fecal Calprotectin in Adults Using Two Different Extraction Methods in the Uppsala-SCAPIS Cohort
- 2017
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Ingår i: Clinical Laboratory. - 1433-6510. ; 63:9, s. 1493-1496
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fecal calprotectin measurement is generally recommended to exclude inflammatory bowel disease (IBD) in patients with suspected IBD. A problem with the fecal calprotectin assays so far has been the rather long test-turnaround times. Recently a particle enhanced turbidimetric immunoassay (PETIA) for fecal calprotectin with assay times of approximately 10 minutes has been introduced on the European market. The aim of this study was to define reference intervals for adults with this new fecal calprotectin PETIA using two different extraction methods. Methods: Samples were collected from 382 healthy individuals from the Swedish CArdioPulmonary bioImage Study (SCAPIS) Uppsala cohort in the age range 50 - 65 years. 202 samples were processed with CALEX® Cap extraction device (BÜHLMANN, Schönenbuch, Switzerland) and 180 samples were extracted using weighed samples. The extracted samples were analyzed on a Mindray BS-380 using the fCal Turbo PETIA reagent (BÜHLMANN). Results: The calculated reference values for the Calex device were < 199 µg/g for the whole cohort, < 184 µg/g for females, and < 215 µg/g for males, while the corresponding values for weighed samples were < 153 µg/g for the whole cohort, < 141 µg/g for females, and < 215 µg/g for males. There were no significant statistical differences for calprotectin levels in males and females. Conclusions: The CALEX device yielded slightly higher calprotectin values. As there were no significant gender differences, the study indicates gender independent reference intervals of < 199 µg/g feces for the CALEX device and < 153 µg/g feces for weighed samples in patients in the 50 - 65 year age range.
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| 9. |
- Fall, Tove, 1979-, et al.
(författare)
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Reference Intervals for Fecal Calprotectin in Pregnant Women Using a Particle Enhanced Turbidimetric Assay
- 2019
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Ingår i: Clinical Laboratory. - 1433-6510. ; 65:7, s. 1293-1297
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fecal calprotectin is widely used as a marker for inflammatory bowel diseases (IBD). IBD often affects women during their reproductive years, but there are no established reference intervals during pregnancy. The aim of the present study was to define reference values during pregnancy and in the postpartum period to allow comparisons between patient results and reference values.METHODS: Fecal samples were collected from 84 healthy females during pregnancy week 26 to 28 and a second sample was collected six months after delivery. The samples were weighed, extracted, and centrifugated to remove debris. The extracted samples were then analyzed on a chemistry analyzer using a particle enhanced turbidimetric immunoassay reagent.RESULTS: The calculated reference interval during pregnancy was < 127 μg/g (90% confidence interval, 90 - 164 μg/g) and the corresponding reference interval during the postpartum period was < 143 μg/g (60 - 226 μg/g). There were no significant statistical differences between F-calprotectin values analyzed at the two sampling times.CONCLUSIONS: The reference values are slightly higher than the cutoff values of 50 - 100 μg/g often used as General cutoff for fecal calprotectin.
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| 10. |
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| 11. |
- Haarburger, David, et al.
(författare)
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Serum proteome changes following human immunodeficiency virus infection.
- 2013
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Ingår i: Clinical laboratory. - 1433-6510. ; 59:5-6, s. 639-46
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Tidskriftsartikel (refereegranskat)abstract
- Quantification of viral RNA levels and CD4 cell count determinations are the most widely used laboratory assays employed in monitoring HIV patients. However, these tests are expensive, complex to perform, and require advanced laboratory infrastructure and highly skilled laboratory technicians. For these reasons, alternative ways to monitor the progression of HIV have been sought. The aim of this study was to compare the serum proteome of asymptomatic HIV-positive subjects to HIV-negative controls in order to identify novel protein changes that are induced in the human serum proteome following HIV infection. It is hoped that monitoring changes in these protein could be used as a cheaper biomarker for the progression of HIV infection.
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| 12. |
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| 13. |
- Jonsson, Hans, et al.
(författare)
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Point of Care Analysis of Hematology in the Operating Theater - a Prospective Observational Study of Accuracy and Feasibility
- 2023
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Ingår i: Clinical Laboratory. - : CLIN LAB PUBL. - 1433-6510. ; 69:2, s. 230-237
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Major surgery entails the risk of severe hemorrhage, and an optimized substitution with red blood cell (RBC) and platelet (PLT) transfusions necessitate rapid test results for RBCs/hemoglobin (HGB)/hematocrit (HCT), and PLTs. The HemoScreen (PixCell Medical, Yokneam Ilit, Israel) is an automated point-of-care hematology analyzer employing image analysis and single-use cuvettes. This study aimed to investigate the correspondence between the HemoScreen and standard laboratory testing (SLT) using the Sysmex XN-9000 in patients undergoing major surgery and to evaluate the feasibility in the operating theater.METHODS: A total of 145 blood samples from 91 adult patients were sampled during abdominal and orthopedic surgery and analyzed on both cell counters. Coefficient of variation (CV) was calculated, Passing-Bablok regression analysis was performed, and Bland-Altman plots were constructed. User experience was assessed through a questionnaire.RESULTS: The HemoScreen showed imprecision with a CV below 5%. Passing-Bablok regression showed positive proportional and negative constant errors for HGB and HCT, a positive proportional error for PLTs, but no dif-ference for RBCs. Bias in the Bland-Altman plots with limits of agreement: RBCs 0.09 x 1012/L (+/- 0.20 x 1012/L), HGB 1.1 g/L (+/- 8.4 g/L), HCT 0.4 % (+/- 2.6%), and PLTs 28.8 x 109/L (+/- 33 x 109/L). The analyzer was scored easy to use with shorter turnaround times compared to SLT.CONCLUSIONS: The HemoScreen is feasible and provides rapid test results with acceptable accuracy for the evaluated application but the two methods cannot be regarded as interchangeable based on the results in this study.
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| 14. |
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| 15. |
- Khezri, Banafsheh, et al.
(författare)
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Estimation of the possible economic effects of a sequential testing strategy with NT-proBNP before echocardiography in primary care
- 2014
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Ingår i: Clinical Laboratory. - 1433-6510. ; 60:7-8, s. 881-886
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:The object of the study was to estimate the possible economic effects of a sequential testing strategy with NT-proBNP from a primary care payer perspective.METHODS:The study data were collected from primary care physicians in the County of Uppland from 2005 through 2012. Two different cut-off levels were used for negative NT-proBNP in the rule-out test: 300 and 400 pg/mL. The cost-effectiveness of the testing strategy was estimated through the short-term cost avoidance and reduction in demand for echocardiographies.RESULTS:The female patients were slightly older than the males. Based on the data from 2012, the estimated costs for NT-proBNP tests and echocardiographies per county were reduced by EUR 300000/100000 inhabitants with the 300 pg/mL cut-off and EUR 350000/100000 inhabitants with the 400 pg/mL.CONCLUSIONS:The use of NT-proBNP as a rule-out test in a sequential testing strategy reduced the cost for diagnostic work-up of primary care patients with suspected heart failure.
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| 16. |
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| 17. |
- Larsson, Anders, et al.
(författare)
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Evaluation of Automated Determination of Bilirubin and Oxyhemoglobin in Cerebrospinal Fluid Using the DrugLog© Instrument
- 2020
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Ingår i: Clinical Laboratory. - : Clinical Laboratory Publications. - 1433-6510. ; 66:11, s. 2357-2364
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In a heterogenous group of patients with acute headache it is important to diagnose subarachnoid hemorrhage (SAH), a potentially lethal but treatable condition, with short turnaround time and high precision. Spectrophotometry of cerebrospinal fluid (CSF) is an essential part in the investigation of patients with suspected SAH but the analysis is slow and operator dependent.METHODS: We have evaluated a new instrument for ultraviolet and visible light (UV-VIS) spectroscopy (DrugLog©, Pharmacolog, Uppsala, Sweden) for automatic determination of oxyhemoglobin and bilirubin in CSF samples. The instrument incorporates software for calculating the absorbance values thus eliminating operator bias. Bilirubin and oxyhemoglobin in CSF was analyzed both with DrugLog© and traditional spectrophotometry at 415 and 476 nanometers (A415 and A476) using patient samples containing varying amounts of bilirubin and oxyhemoglobin.RESULTS: The DrugLog© method showed a strong correlation both for bilirubin (Pearson's r = 0.996) and oxyhemo-globin (Pearson's r = 0.993). The DrugLog© method had good linearity and precision, offering an automated determination of bilirubin and oxyhemoglobin, eliminating operator bias.CONCLUSIONS: The DrugLog© instrument has a short assay time and showed good agreement with traditional spectrophotometry.
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| 18. |
- Larsson, Anders, et al.
(författare)
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Weight reduction is associated with decreased CRP levels
- 2013
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Ingår i: Clinical Laboratory. - 1433-6510. ; 59:9-10, s. 1135-1138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Obesity is very costly for society and weight reduction is important to reduce obesity related dis-eases. We have evaluated the effect of weight reduction on CRP values to see if high sensitivity CRP could be used to provide persons on life style intervention programs with positive feedback.Methods: Study subjects (n = 26) were recruited to a life style intervention program aiming for weight loss among the laboratory staff at Uppsala University Hospital, Sweden. Blood samples for high sensitivity CRP were collect-ed at inclusion and after 4 weeks. Body composition was estimated by measurements performed on an inexpensive bioimpedance analyzer.Results: CRP reduction was significantly associated with weight reduction after four weeks (p = 0.00005) and eight weeks (p = 0.0002). Data from the bioimpedance analyzer were not useful on an individual level.Conclusions: High sensitivity CRP could be used to provide positive feedback in workplace weight reduction pro-grams.
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| 19. |
- Mandic-Havelka, Aleksandra, et al.
(författare)
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Turbidimetric Determination of Fecal Calprotectin Using Two Table Top Chemistry Analyzers : Mindray BS-200E and Cobas® c111
- 2017
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Ingår i: Clinical Laboratory. - 1433-6510. ; 63:5, s. 907-913
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Fecal calprotectin assays are widely used in diagnosis and monitoring of inflammatory bowel disease (IBD) in patients with suspected IBD. The most frequently used technique is ELISA and microtiter plates. Turbidimetric assays for analysis of fecal calprotectin can significantly reduce turnaround time. Many laboratories may be reluctant to run fecal samples on their large chemistry analyzers. The aim of this study was to evaluate fecal calprotectin particle enhanced turbidimetric immunoassay (PETIA) on smaller chemistry analyzers that could be dedicated for fecal samples.METHODS: The BÜHLMANN fCAL® turbo assay was validated on two table top chemistry analyzers, Mindray BS-200E and cobas® c111.RESULTS: The assay was linear in the range between 20 and 1,900 µg/g with a limit of quantification around 20 µg/g on both instruments. The total coefficient of variation was < 7% in the range between 50 and 1,300 µg/g on both instruments. No antigen excess hook effect was observed up to 18,000 µg/g on the Mindray BS-200E and up to 20,000 µg/g on cobas® c111. The BÜHLMANN fCAL® turbo assay showed a high correlation with the BÜHLMANN fCAL® ELISA.CONCLUSIONS: Running the BÜHLMANN fCAL® turbo on Mindray BS-200E or cobas® c111 chemistry analyzers can provide rapid test results without exposing large routine chemistry analyzers to stool samples.
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| 20. |
- Olausson, Johan, et al.
(författare)
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Evaluation of the Meritas® BNP Test for Point-of-Care Testing
- 2015
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Ingår i: Clinical Laboratory. - 1433-6510. ; 61:7, s. 727-730
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: BNP and NT-proBNP are widely used as rule-out tests for heart failure (HF) and they are frequently requested by primary care doctors. A point-of-care (POC) test would reduce the time to diagnosis for patients with suspected HF. The aim of the study was to evaluate a POC BNP test.METHODS: Plasma BNP results obtained with the Meritas® POC instrument (n = 82) were compared with the corresponding plasma BNP results analyzed on an Advia Centaur analyzer (Siemens Healthcare, Erlangen, Germany).RESULTS: The two methods showed concordant results with a Passing-Bablok correlation between the two methods: BNP(Meritas) = 1.00 x BNP(Siemens) + 1.09; r = 0.9773.CONCLUSIONS: The study show that the Meritas® BNP assay could be used in primary care permitting rapid BNP testing to rule out heart failure.
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| 21. |
- Osman, Abdimajid, et al.
(författare)
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Exon resequencing of the gene encoding UCMA/GRP reveals a common carboxy-terminal 138Thr > Ser Polymorphism
- 2013
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Ingår i: Clinical Laboratory. - : Clinical Laboratory Publications. - 1433-6510. ; 59:11-12, s. 1397-1401
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Tidskriftsartikel (refereegranskat)abstract
- Background: The upper zone of growth plate and cartilage matrix-associated protein (UCMA), also called Gla-rich protein (GRP), is a novel protein found at sites af-fected by pathological calcifications.Methods: We performed a full exon resequencing on DNA samples from 17 chronic kid-ney disease (CKD) patients (stage 5) and compared the results with 121 healthy con-trols in a Swedish population.Results: A novel non-synonymous single nucleotide polymorphism (SNP) causing a car-boxy-terminal amino acid exchange was found. This SNP involves an alteration of the last ACC codon for threonine in exon 5 (adjacent to the stop codon) to an AGC ser-ine codon (138Thr > Ser). Six controls and two CKD patients were heterozygous for the 138Thr > Ser polymorphism. Both patients had histories of vascular calcifica-tion; however, it is uncertain whether this SNP has any significance for the func-tional domains of the UCMA protein. In addition, a heterozygous transversion muta-tion was found in a patient at SNP rs4750328 (A/G) in intron 2, involving an ex-change of the ancestral A allele to a T base.Conclusions: The 138Thr > Ser polymorphism seems to be the only non-synonymous SNP found in the UCMA gene in a Swedish population.
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| 22. |
- Osman, Abdimajid
(författare)
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MicroRNAs in Health and Disease - Basic Science and Clinical Applications
- 2012
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Ingår i: CLINICAL LABORATORY. - : CLIN LAB PUBL. - 1433-6510. ; 58:5-6, s. 393-402
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Forskningsöversikt (refereegranskat)abstract
- MicroRNAs (miRs) are small RNAs that fine-tune gene expression at posttranscriptional level. They are involved in virtually all physiological processes, such as development and differentiation, heart function, metabolism, haemostasis, and apoptosis. Anucleated human platelets were revealed to contain comparatively many different miR species relative to nucleated cells, suggesting a functional impact of miRs on these small cells. In recent years, numerous studies have established the significance of miRs in different physiological states. Sufficient evidence exists to suggest that miRs are involved in a range of diseases, including cancer and cardiovascular disorders. Aberrant expression levels of miRs are found in tissues and in sera from patients with different forms of malignant tumours. Utilising these miRs as biomarkers for disease is a valuable diagnostic strategy. In addition, a novel class of synthetic oligonucleotides, called antagomirs, has recently been introduced as efficient silencers of overexpressed miRs in cancer. Overall, miRs represent an important class of small RNAs with a huge impact on health and disease. Future studies will further illuminate the potential value of miRs in diagnostics and therapeutics.
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| 23. |
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| 24. |
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| 25. |
- Rahmati, Kobra, et al.
(författare)
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A comparison of serum and EDTA plasma in the measurement of glutamic acid decarboxylase autoantibodies (GADA) and autoantibodies to islet antigen-2 (IA-2A) using the RSR radioimmunoassay (RIA) and enzyme linked immunosorbent assay (ELISA) kits.
- 2008
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Ingår i: Clinical Laboratory. - 1433-6510. ; 54:7-8, s. 227-235
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Glutamic acid decarboxylase antibodies (GADA) and tyrosine phosphatase antibodies (islet antigen-2 antibodies; IA-2A) are used in clinical practise to identify type 1 diabetes. METHODS: GADA and IA-2A were measured with RSR-ELISA kits in samples from 76 newly diagnosed type 1 diabetic children and 120 healthy controls. The aim was to evaluate performance of RSR-ELISA kits for GADA and IA-2A when serum and Ca2+ treated plasma were used. RESULTS: GADA achieved high area under the curve (AUC) both for serum 0.95 (95% CI 0.90-0.99) and for Ca2+ treated plasma 0.95 (95% CI 0.91-0.99). At specificity 98%, sensitivity was 84% for serum and 87% for Ca2+ treated plasma. IA-2A achieved AUC 0.92 (95% CI 0.87-0.97) for serum and 0.94 (95% CI 0.90-0.98) for Ca2+ treated plasma. Using the lowest standard (15 WHO-Units/ml) as cut-off, specificity for serum was 100% and for Ca2+ treated plasma 99% with sensitivity 74% in both cases. Sensitivity was higher in ELISA compared to RIA (74%; p = 0.0080) for GADA measurement and similar for ELISA and RIA IA-2A measurements (76%; p = 0.50). CONCLUSION: Both RSR-ELISAs, GADA and IA-2A showed excellent performance for serum as well as for Ca2+ treated plasma.
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| 26. |
- Rollborn, Niclas, et al.
(författare)
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Reference Intervals for Plasma Free Kappa and Lambda Chains and Kappa/Lambda Ratio using PENIA
- 2023
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Ingår i: Clinical Laboratory. - : Clinical Laboratory Publications. - 1433-6510. ; 69:8
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Determination of free light chains is used increasingly for patients with multiple myeloma and other plasma cell dyscrasias. The aim of the present study was to define reference intervals for free kappa and lambda chains and kappa/lambda ratio in lithium heparin plasma and compare the test results with cystatin C based estimated glomerular filtration rate.METHODS: Free kappa and lambda chains were measured in Liheparin plasma from 222 healthy blood donors using free light chain reagents and a BNII nephelometer from Siemens Diagnostics.RESULTS: Calculated reference intervals for kappa chain, free was 4.73 mg/L (90% confidence interval 4.00 - 5.45) - 22.66 mg/L (20.33 - 24.98), for lambda chain, free was 4.33 mg/L (3.70 - 4.95) - 29.28 mg/L (26.96 - 31.59), and for Kappa/Lambda Chain ratio 0.59 (0.56 - 0.62) - 1.46 (1.37 - 1.56). There was no need for gender or age specific reference intervals. Cystatin C based estimated glomerular filtration rate had a significant effect on the levels of free light chains.CONCLUSIONS: The study presents reference intervals for plasma free light chains and compared results of estimated glomerular filtration rate with free light chains of kappa and lambda.
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| 27. |
- Strandberg, Gunnar, et al.
(författare)
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Comparison of Intraosseous, Arterial, and Venous Blood Sampling for Laboratory Analysis in Hemorrhagic Shock
- 2019
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Ingår i: Clinical Laboratory. - 1433-6510. ; 65:7, s. 1169-1177
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intraosseous (IO) access is often indicated for administration of drugs and fluids in emergencies when venous access is challenging. There is no consensus regarding whether and which laboratory analyses may be performed on IO aspirates, and research on hemodynamically unstable subjects is limited.Methods: Twelve anesthetized pigs were sampled from IO, venous, and arterial accesses during stable circulation and after hemorrhage corresponding to 20% and 40% of the blood volume. Samples were analyzed for blood gases and acid-base status, electrolytes, hematocrit, creatinine, glucose, alanine aminotransferase (ALT), aspartate aminotransferase (AST), γ-glutamyltransferase (γ-GT), alkaline phosphatase (ALP), and creatine kinase (CK).Results: Average differences of blood gases and acid-base parameters, sodium, creatinine, hematocrit, ALT, and γ-GT and between IO and venous samples were small at baseline and after hemorrhage while differences for lactate and glucose increased with hypovolemia. Both IO-arterial and venoarterial differences in acid-base parameters increased with hypovolemia. Dispersions of differences were often large.Conclusions: Average levels of blood gases, acid base parameters, hematocrit, CK, AST, γ-GT, creatinine, and ALT, but not lactate and glucose, were similar in IO and venous samples in hypovolemia. However, precision was limited, indicating that IO test results should be confirmed when other vascular access is established, and that analysis of IO samples should be limited to acute situations and not used for detailed diagnostics in this setting.
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| 28. |
- Strandberg, Gunnar, et al.
(författare)
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Intraosseous Samples Can Be Used for CreatinineMeasurements - An Experimental Study in the Anaesthetised Pig
- 2014
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Ingår i: Clinical Laboratory. - 1433-6510. ; 60:10, s. 1587-1591
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Tidskriftsartikel (refereegranskat)abstract
- Background: Intraosseous (IO) access is a valuable tool in prehospital locations and in emergency departments when other forms of vascular access are unavailable. Creatinine is often used for dose adjustment of drugs that may be administered through intraosseous cannulae. We aimed to study the possibility of analysing creatinine in intraosseous samples and study the accuracy and precision of such measurements.Methods: Eight pigs with endotoxin induced septic shock were sampled hourly for six hours and analysed for plasma creatinine. Samples were collected from arterial, venous, and IO cannulae.Results: There was an increase in creatinine values during the later part of the experiment. The coefficients of variation between the three sampling sites were less than 10% at all sampling times.Conclusions: Based on our findings intraosseous samples can be used for creatinine determination in emergency settings.
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| 29. |
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