The capillary zone electrophoresis (CZE) and high-performance liquid chromatography (HPLC) methods were compared in terms of HbA2 measurement for the assessment of hemoglobinopathies.
CZE was ...compared with HPLC for the evaluation of patients without hemoglobinopathy (n=321), with β-thalassemia trait (n=113), and with common (HbD-Punjab, E, C, S/A, and S/S) and rare (HbS/D, O-Arap, Lepore, G-Coushata, Setif, Hamadan, Q-Iran, and H) variants (n=21). The reference range for HbA2 was determined by CZE.
Among patients without hemoglobinopathy, the median (2.5
-97.5
percentiles) values were 97.4% (97.0-98.0%) and 97.5% (96.6-98.4%) for HbA (p=0.060) and 2.4% (1.6-3.0%) and 2.5% (1.6-3.1%) for HbA2 (p<0.001) by HPLC and CZE, respectively. The reference range for HbA2 was 1.6-3.1% by CZE. In the comparison of methods for HbA2, there was a constant error of 0.255 (confidence interval: 0.062-0.448) and bias of 0.10% (limit of agreement: 0.33-0.53), and higher values were obtained with CZE. A strong correlation was observed between the methods (r=0.782). Interrater agreement was almost perfect for clinical diagnosis (ϰ=0.911). The two methods detected and identified the common variants similarly. All rare variants, except HbH by HPLC and HbS/D by CZE, were detected as separate peaks by both methods.
The two methods were in agreement regarding the preliminary identification of β-thalassemia patients. Different Hb variants were detected by both methods but with possible methodological interference for HbA2 measurements. CZE is a reliable and simple alternative for the evaluation of hemoglobinopathies. The standardization of HbA2 measurements should be prioritized as more techniques become available in routine laboratory practice.
Abstract
Objective: When D-dimer is used to evaluate suspected venous thromboembolism in pregnant patients, the reference interval of common population may cause misinterpretation. The present study ...aims to determine reference intervals of D-dimer in the three trimesters.
Methods: Four-hundred sixteen pregnant women and 32 non-pregnant women were enrolled in this cross-sectional study. Reference group had comprised 123 pregnant in the first trimester (5-11 week), 164 pregnant in the second trimester (13-20 week) and 126 pregnant women in the third trimester (25-35 week). D-dimer levels were analyzed via immunoturbidimetric assay.
Results: If the threshold of 0.50 mg/L for diagnosis of VTE is used, 4.8% of pregnant women in the second trimester and 23.8% of pregnant women in the third trimester would have D-dimer levels exceeding this cut-off value. Reference intervals of D-dimer were determined as 0.11-0.40 mg/L; 0.14-0.75 mg/L and 0.16-1.3 mg/L in first, second and third trimester, respectively.
Conclusion: The established D-dimer reference intervals for each trimester of pregnancy are different from those used in common population. These reference intervals may assist clinicians in making accurate clinical decisions. Further studies are needed to establish new cut-off values for the D-dimer to rule out VTE in each trimester.
Objective
To compare tear fluid levels of matrix metalloproteinase 9 (MMP-9) and IL-1ß cytokines between healthcare workers wearing facial masks and controls with correlations in clinical findings.
...Methods
In a prospective, controlled clinical trial tear fluid was analyzed for MMP-9 and IL-1ß levels using a commercially available test (Invitrogen; Thermo Fisher Scientific Inc. Waltham, Massachusetts, USA). Symptoms and signs of dry eye disease (DED) were evaluated using the ocular surface disease index (OSDI), noninvasive tear break-up time (NIBUT), tear meniscus height (TMH), Oxford corneal staining, meibomiography, and clinical findings of meibomian gland dysfunction (MGD).
Results
In the 38 eyes of healthcare workers and 30 eyes of controls, there was no statistically significant difference between the groups in terms of age and sex (
p
> 0.05). The mean OSDI score, daily mask wear time, meibomiography degree, and rate of positive clinical findings of MGD were higher in group 1 than in group 2, and the mean NIBUT was higher in group 2. (
p
> 0.05). The mean values of IL-1ß and MMP-9 were higher in group 1 (
p
= 0.036 and
p
= 0.001, respectively). The TMH and Oxford score percentages were similar between the two groups (
p
> 0.05).
Conclusions
Elevated levels of IL-1ß and MMP-9 in the basal tear fluid reveal increased ocular inflammation in healthcare professionals. Lower NIBUT values with higher OSDI and meibomian gland loss scores support ocular surface disturbance depending on regular mask use.
Objective
We aimed to evaluate apelin‐13 levels, total oxidant/antioxidant status in Alzheimer’s disease (AD) and to investigate the relationship between these parameters.
Methods
Patients newly ...diagnosed with AD were enrolled in the study. The control group consisted of age‐ and gender‐matched healthy individuals. Serum levels of apelin‐13, total antioxidant status (TAS), and total oxidant status (TOS) were measured. Oxidative stress index was calculated (TOS/TAS) for each participant.
Results
We reported that serum apelin‐13 and TAS values were significantly lower in the AD group compared with controls, and they found a fair but insignificant relationship between Apelin‐13 and TAS values.
Conclusion
According to our results, we suggested that insufficient apelin‐13 and TAS levels may contribute to the pathogenesis of AD.
The purpose of this study was to evaluate apelin‐13 levels, total antioxidant status (TAS), and total oxidant status (TOS) in Alzheimer’s disease (AD) and investigate the relationship among these parameters. Patients newly diagnosed with AD were enrolled in the study. The control group consisted of age‐ and gender‐matched healthy individuals. Serum levels of apelin‐13, TAS, and TOS were measured. Oxidative stress index was calculated (TOS/TAS) for each participant. Apelin‐13 and TAS values were significantly lower in the AD group compared to controls. There was a fair but insignificant correlation between apelin‐13 and TAS values. Insufficient levels of apelin‐13 and TAS may contribute to the pathogenesis of AD.
Background
We evaluated the diagnostic performance of HbA1c in diabetes and prediabetes and compared its efficiency in a model where HbA1c is used as a screening test.
Material and method
Records of ...945 patients who had undergone simultaneous OGTT and HbA1c were evaluated. American Diabetes Association (ADA) criteria were used for diagnosis. Agreement between OGTT and HbA1c was evaluated. Using OGTT as the gold standard, the diagnostic performance of HbA1c was evaluated with ROC analysis and optimum cutoffs were determined. Then, the group was rearranged as if HbA1c was performed first as a screening test with new cutoffs and if OGTT was performed for diagnosis among suspected individuals.
Results
According to OGTT, 53 (5.6%) patients were diabetic and 247 were prediabetic; 18 of diabetics (34%) and 94 of prediabetics (38%) were diagnosed by HbA1c with present ADA cutoffs. The kappa coefficient for agreement between OGTT and HbA1c was 0.756 for diabetes and 0.336 for prediabetes. In ROC analysis, optimal HbA1c cutoff points were 38 mmol/mol (AUC 0.953) for diabetes and 35.5 mmol/mol (AUC 0.673) for prediabetes. In a new model after initial screening with HbA1c, 398 patients with HbA1c > 35.5 mmol/mol were taken for further OGTT. Fifty-three of diabetics (100%) and 199 of prediabetics (81%) were diagnosed. Prediabetic 48 patients (19%) were missed.
Conclusion
HbA1c showed poor performance in diagnosis of diabetes and prediabetes. Instead, using HbA1c as a screening test with well-defined cutoff may offer practical and economical advantages greatly reducing the number of OGTTs required.
To evaluate the effect of ejaculation on serum prostate-specific antigen (PSA) concentrations in patients with lower urinary tract symptom (LUTS).
Our study includes 98 men (62 study and 36 control). ...After three days of sexual abstinence, blood samples were drawn for the measurement of baseline PSA levels. Then the patients were told to ejaculate. One, 5, 24 and 72 hours after ejaculation, serum total (tPSA), free (fPSA) and complexed PSA (cPSA) levels were measured. Serum PSA sampling was performed at the same intervals in the control group without ejaculation.
The mean age in study and control groups patients were 59.03±0.99 years, 61.14±1.30 years, respectively. In the study group, changes in tPSA and fPSA levels after ejaculation were found statistically significant while changes in cPSA levels and f/tPSA ratios were not significant (p=0.016, p=0.0003, p=0.176, and p=0.173, respectively). Baseline values showed significant differences with 1st and 5th hours. No significant changes in tPSA, fPSA, cPSA levels and f/tPSA values were found in control group (p=0.223, p=0.224, p=0.444, and p=0.718, respectively). The changes in the number of patients exceeding the cutoff values after ejaculation were not statistically significant for tPSA, cPSA, and f/tPSA ratio.
In this study, ejaculation increased tPSA and fPSA concentrations but it didn't have a significant effect on serum cPSA levels and f/tPSA ratios. However, recent ejaculation may affect the biopsy indication at least near cut off PSA values. Further studies are needed to explain the mechanisms of alterations in the concentration of PSA.
This report describes the case of a patient with ethylenediaminetetraacetic acid- (EDTA) and citrate-dependent pseudothrombocytopenia (PTCP). An EDTA tube (BD Vacutainer K2 EDTA; Becton, Dickinson ...and Company, Franklin Lakes, NJ, USA) platelet count indicated thrombocytopenia (15x109/L and 8x109/L), which was inconsistent with his clinical condition, and prompted further investigation. A repeat sample was drawn into both EDTA tubes and tubes containing 3.2% sodium citrate 9NC coagulation sodium citrate 3.2%, 3.5 mL, Vacuette®, (Greiner Bio-One International GmbH, Kremsmunster, Austria) and immediately measured in the laboratory. The platelet count was 157x109/L and 171x109/L in the EDTA and citrated samples, respectively. Simultaneous peripheral blood smear examinations were performed with capillary, EDTA, and citrated samples. Platelet clumps were observed only in the EDTA sample. The tubes were kept at 25°C and measurements were repeated at 10, 15, 60, 90, and 120 minutes. The platelet counts had decreased by 63% and 76% at the end of 120 minutes in the EDTA and citrated samples, respectively. After 20 minutes at 37°C, the number of platelets had increased by 76% and 87% in the EDTA and citrated samples, respectively. In cases of this kind of a contradiction between laboratory results and clinical status, laboratory specialists should suspect PTCP and be prepared to manage these findings. Close communication between the clinician and the laboratory helps to avoid unnecessary investigation and inappropriate treatment.
Purpose
Although cancer diagnosed during pregnancy is rare, the coexistence of pregnancy and malignancy becomes more common in view of prolongation of reproductive age. Therefore, it is important ...that the specificity of a tumor marker be evaluated during pregnancy to avoid misinterpretation in the follow-up of a pregnant cancer patient. The present study aims to investigate the serum concentrations of CA-125, CA 15-3, CA 19-9 and CEA in healthy pregnant women through gestation.
Methods
In this prospective study, we followed thirty healthy pregnant women. Blood samples were obtained during each trimester of pregnancy (10–12, 22–24 and 34–36 weeks). The maternal serum levels of CA-125, CA 15-3, CA 19-9 and CEA were measured using electrochemiluminescence immunoassay.
Results
There was no difference between the first and second trimester serum levels of CA 125, CEA and CA 19-9. However, serum CA 125 levels in third trimester were found to be significantly elevated in pregnants compared to the second trimester (median values 19.6 vs. 15.6 IU/mL,
p
= 0,009). Similarly, the serum CEA levels in third trimester were significantly higher than those of second trimester (median values 1.1 vs. 0.7 ng/ml,
p
= 0.001). It is also found that CEA and CA 19-9 assay values were significantly elevated in the third trimester of pregnancy when compared with the first trimester of pregnancy (CEA median values 1.1 vs. 0.7 ng/ml,
p
= 0.02 and CA 19-9 median values 11.6 vs. 7.7 IU/mL,
p
= 0,02). Three trimester had statistically similar levels for serum CA 15-3 (median values 17.5, 19.7 and 18.3 U/mL, respectively). The four tumor markers assay values were found generally within the normal range.
Conclusions
These findings suggest that maternal serum levels of CA 125, CEA and CA 19-9 were increased during third trimester of pregnancy. However, these elevations were within the normal range. CA 15-3 is independent of gestation and reliable tumor markers in monitoring malignancy in pregnant patients.
This study aims to evaluate the analytical properties of the DIAGON CoagXL (Budapest, Hungary) coagulation system.
The study includes a total of 212 normal, 49 pathologic plasma samples sent to our ...laboratory. The par-tial thromboplastin time (PTT) and activated partial thromboplastin time (aPTT) measurements were performed on the Diagon CoagXL and Stago StaR coagulometers. The precision, method comparison, carry-over, activity determination, and reference range verification studies were performed with Diagon CoagXL, the test analyzer.
In the precision study performed with normal and pathologic plasma samples for the PT and aPTT tests, the within-day coefficient of variation (CV%) was 1.9 in the normal and 0.68 in the pathologic plasma for the PT, and for the aPTT it was 0.61 in the normal and 0.9 in the pathologic plasma. The between-day CV% was 1.6 in the normal plasma and 5.5 in the pathologic plasma for the PT and 3.7 in the normal plasma and 2.1 in the pathologic plasma for the aPTT. In the comparison study, the entire group mean ± standard deviation (mean ± SD) value for the INR was found to be 3.13 ± 1.26 in the CoagXL and 2.67 ± 0.82 in the StaR analyzer. The difference between these values was statistically significant (p < 0.006). For aPTT, mean ± SD value was found to be 39.44 ± 25.02 seconds (sec) in the CoagXL analyzer and 43.4 ± 27.63 sec in the StaR analyzer. The difference between these values was not statistically significant (p > 0.5). In the carryover study, the carryover value was -0.16 for the PT and 0 for the aPTT, which was under the allowable limit value (< 3 SD). In the percent activity determination study, regression equation of prothrombin activity (%) versus time (sec) was found as y = 341.6567 ± 37.1920x + 1.0913x2 (R2 = 0.97). The reference range verification analyses reveal that the manufacturer ranges were acceptable.
Verification studies of CoagXL analyzer system was acceptable. But in comparison studies of PT we saw that there are still problems with recommended INR system.
Abstract
Background
We evaluated population characteristics of serum 25-hydroxyvitamin D (25(OH)D) levels and determined the influence of age, gender and season in an extensive dataset.
Materials and ...methods
Laboratory results of 103,509 adults and 19,186 children were retrospectively evaluated. Study group was classified regarding ages as; <40, 40–50, 50–60 and >60 years for adults and 0–1, 1–12 months,1–3, 4–6, 7–9, 10–12, 13–15 and 16–18 years for children. Seasonal values were also determined. Levels were measured by Architect i1000 SR (Abbott Diagnostics, USA).
Results
The median (2.5–97.5 percentiles) of 25(OH)D levels were 38.75 (9.5–158.25) nmol/L for adults and 43.25 (11.25–125.5) nmol/L for children. There were significant gender differences for both adults and children. Values differed significantly among age subgroups (p’s < 0.01). A total of 63% of adults and 59.5% of children had 25(OH)D levels below 50 nmol/L (p < 0.001). 25(OH)D levels were significantly lower in the winter compared with summer (p’s < 0.001). Even levels in summer were moderate deficient for all group.
Conclusion
The rate of 25(OH)D deficiency was remarkable during the whole year. This will provide large-scale data about 25(OH)D status in Turkish people and may contribute to the prevention and treatment of this condition for better healthcare outcomes.
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