Summary
Introduction
The Belgian national External Quality Assessment Scheme performed a survey to assess the effect of the direct oral anticoagulant apixaban on the coagulation assays prothrombin ...time (PT), activated partial thromboplastin time (aPTT), fibrinogen and antithrombin as performed with a large number of reagent/instrument combinations.
Methods
Four lyophilized plasma samples spiked with apixaban (0, 41, 94 and 225 ng/mL) were sent to the 195 Belgian and Luxembourg clinical laboratories performing coagulation testing.
Results
PT and aPTT were barely influenced at the concentrations tested. At 225 ng/mL apixaban, PT and aPTT clotting times were only 1.15 times longer than at 0 ng/mL. Among PT reagents, RecombiPlasTin 2G® showed a slightly higher sensitivity with 225 ng/mL apixaban prolonging the PT clotting time 1.3‐fold. Among aPTT reagents, there was no appreciable difference in sensitivity.
Fibrinogen results were unaffected by the presence of apixaban, but antithrombin activity was considerably overestimated when measured with a FXa‐based assay. At 225 ng/mL apixaban, the median percentage increase in antithrombin level was 31% when measured with the Liquid Antithrombin® reagent and 44% with the Innovance Antithrombin® reagent.
Conclusion
Our data provide clinical laboratories with useful information on the impact of apixaban on their routine coagulation assays.
Autoantibodies to nuclear antigens, i.e. antinuclear antibodies (ANA), antibodies to double-stranded DNA (dsDNA) and extractable nuclear antigens (ENA), are useful as diagnostic markers for a variety ...of autoimmune diseases. In March 2010, the Belgian national External Quality Assessment Scheme sent a questionnaire on ANA, anti-dsDNA and anti-ENA antibody testing designed by the Dutch EASI (European Autoimmunity Standardization Initiative) team, to all clinical laboratories performing ANA testing. Virtually all laboratories completed the questionnaire (97·7%, 127/130). This paper discusses the results of this questionnaire and provides valuable information on the state-of-the-art of ANA, anti-dsDNA and anti-ENA antibody testing as practiced in the Belgian laboratories. In addition, this work presents practical recommendations developed by the members of the advisory board of the scheme as a result of the outcome of this study.
One of the main goals of the European Autoimmunity Standardisation Initiative (EASI) is the harmonisation of test-algorithms for autoantibodies related to systemic autoimmune rheumatic diseases ...(SARD).
A questionnaire was used to gather information on methodology, interpretation, and the algorithm for detection of anti-nuclear antibodies (ANA) in relation to their antigen-specificity. The questionnaire was sent to 1200 laboratories in 12 European countries.
The response rate was 47.2%. The results reveal not only apparent differences between countries, but also within countries.
Awareness of these differences may as such already stimulate harmonisation, but the observed differences may also direct recommendations that may further contribute to achieving the EASI goal of harmonisation of autoimmune diagnostics for SARD.
Objective. The Belgian national External Quality Assessment Scheme (EQAS) for haematology organized a survey to assess the reliability of haemoglobin (Hb) measurements with the blood gas analysers ...(BGAs) currently available in Belgian hospitals. Material and methods. All hospital laboratories received two specimens of fresh EDTA anticoagulated whole blood and were asked to determine the Hb concentration using both the conventional haematology analyser (HA) and all BGAs in the hospital. Ninety-seven hospital laboratories participated in the study and a total of 166 results were reported. The BGAs used (grouped according to technology) were Rapidlab 845, 855, 865 (Bayer 1, n = 41), Rapidlab 1245, 1265, Rapidpoint 405 (Bayer 2, n = 19), GEM Premier 3000 (Instrumentation Laboratory, IL, n = 13), ABL 500 and 600 series (Radiometer 1, n = 13), ABL 700 and 800 series (Radiometer 2, n = 35), Omni C, S5 (Roche 1, n = 7), Omni 3, 6, 9, S2, S4, S6 (Roche 2, n = 21). Results. For the BGAs from Bayer, Radiometer and Roche, interlaboratory variation ranged from 0.6 % to 4.1 %, indicating good precision and close agreement between centres. A significant negative bias observed on the GEM Premier 3000 using the EDTA anticoagulated blood samples did not appear to be present in fresh heparinized whole blood samples. There was no significant difference in imprecision and bias between Hb measurements on BGA situated in and outside the central laboratory.
Blood smear analysis is a well known technique in medical laboratories. Clinical relevance of this analysis and its interpretation are very important. Consequently, monitoring of laboratory ...performance by an external quality assessment scheme is strongly recommended. Most starting external quality organizers set up a scheme for clinical chemistry. Due to a lack of guidance documents, many organizers are reluctant to offer a hematology scheme. This article aims to be a very practical guidance document for external quality assessment organizers for the set up of blood smear schemes.
Clinical, scintigraphic and laboratory findings in a group of 23 hyperthyroid patients with inappropriate total intrathyroidal iodine pool (ITI), measured by X-ray fluorescence, were compared to ...those of 25 hyperthyroid patients with low ITI. Differences are discussed which may be useful in the diagnosis of this clinical entity.
The analytical and clinical performance of three radioisotopic methods for the measurement of free thyroxine-Gamma Coat (125I) Free T4, RIA-gnost FT4 and Amerlex-MAB* FT4-were assessed in comparison ...with the Scalvo two-step chromatographic method. The analytical evaluation indicated excellent performance of Amerlex-MAB FT4. For the other methods, precision and sensitivity were comparable and acceptable for routine use. Only Gamma Coat FT4 showed a significant positive intra-assay drift. None of the methods showed a significant correlation with thyroxine-binding globulin. Amerlex-MAB FT4 results were weakly positively correlated with albumin. Sclavo, RIA-gnost and particularly GammaCoat FT4 results were affected by the presence of increased concentrations of free fatty acids. All methods classified hyperthyroid patients correctly. Slight overlaps existed between the hypothyroid and euthyroid populations. Significant decreases in free thyroxine (FT4) during the third trimester of pregnancy were detected by all assays. In patients with chronic renal failure, serum FT4 was within reference limits more often when measured by Sclavo or Amerlex-MAB methods than by RIA-gnost or GammaCoat techniques. In conclusion, all assays performed well from both technical and diagnostic points of view.
The present study reports a biopsy technique on decompacted late mouse morulae. Zygotes were collected from hyperstimulated F1 hybrids (C57BL6j females x CBAca males) and cultured in modified Earle's ...balanced salt solution supplemented with 0.5% bovine serum albumin until the late morula stage (92 h post administration of human chorionic gonadotrophin). Decompaction was obtained by exposure of the embryos to Ca(2+)-Mg(2+)-free phosphate-buffered saline (PBS) or an aqueous solution of ethylene-diaminetetraacetic acid (EDTA) and glycine. Using micromanipulation, a single blastomere was aspirated without removal or softening of the zona. The impact of the different decompaction procedures and the biopsy technique was studied by vital staining, by in-vitro culture up to the early egg-cylinder staged and by the recovery of living mice after transfer to pseudopregnant foster mothers. Our investigations revealed no impact of decompaction and biopsy on immediate viability, as assessed by fluorescein diacetate staining. A significant reduction (P less than 0.05) in the number of mouse morulae that reached the early egg-cylinder stage in vitro was observed after the biopsy procedure. We observed that after this microbiopsy technique, successful pregnancies can be obtained but at a lower percentage compared to controls (P less than 0.01).
In 2000, the Belgian Scientific Institute of Public Health introduced a voluntary external quality assessment scheme for lymphocyte immunophenotyping. This paper provides an analysis of the first six ...surveys. Specimens consisted of fresh EDTA-anticoagulated whole blood and were sent by overnight mail. The 41 participants were surveyed for methodology and were asked to report white blood cell count, percentage of lymphocytes, and percentages and absolute numbers of CD3+, CD4+, CD8+, and CD19+ cells. Median intralaboratory coefficients of variation were 1.0, 1.3, 1.7, and 3.2% for CD3+, CD4+, CD8+, and CD19+ cell percentages, respectively. Interlaboratory variability was consistently lower than 6.5% for CD3+ and CD4+CD3+ cell percentages, and lower than 9.5% for CD8+CD3+ cell percentages. Median coefficients of variation for the absolute values were higher, ranging from 10.1% for CD4+CD3+ cells to 16.5% for CD19+ cells. The percentage of CD4+CD3+ and CD8+ CD3+ cells was in several samples significantly lower than the percentage of total CD4+ and CD8+ cells. The number of laboratories measuring total CD4+ and CD8+ cells decreased by 30% during the programme. Between-laboratory variability remained stable over time. Analysis of individual laboratory performance indicated that some laboratories markedly improved their results.
