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van der Molen AJ, Krabbe JG, Dekkers IA, Geenen RWF, Bellin MF, Bertolotto M, Brismar TB, Cadamuro J, Correas JM, Heinz-Peer G, Langlois MR, Mahnken AH, Ozben T, Quattrocchi CC, Radbruch A, Reimer P, Roditi G, Romanini L, Sebastià C, Simundic AM, Stacul F, Clement O. Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee. Clin Chem Lab Med 2024; 62:608-614. [PMID: 38050439 DOI: 10.1515/cclm-2023-1184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 11/22/2023] [Indexed: 12/06/2023]
Abstract
The Contrast Media Safety Committee of the European Society of Urogenital Radiology has, together with the Preanalytical Phase Working Group of the EFLM Science Committee, reviewed the literature and updated its recommendations to increase awareness and provide insight into these interferences.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Marie-France Bellin
- University Paris-Saclay, AP-HP, University Hospital Bicêtre, Service de Radiologie, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel B Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet, Stockholm, Sweden
- Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Jean-Michel Correas
- Université de Paris, AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Paris, France
| | | | - Michel R Langlois
- Department of Laboratory Medicine, AZ St.-Jan Hospital, Bruges, Belgium
| | - Andreas H Mahnken
- Department of Radiology, Marburg University Hospital, Marburg, Germany
| | - Tomris Ozben
- Department of Clinical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Türkiye
| | | | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Carmen Sebastià
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital Sveti Duh, Zagreb University, Zagreb, Croatia
| | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, Paris, France
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van der Molen AJ, Krabbe JG, Dekkers IA, Geenen RWF, Bellin MF, Bertolotto M, Brismar TB, Cadamuro J, Correas JM, Heinz-Peer G, Langlois MR, Mahnken AH, Ozben T, Quattrocchi CC, Radbruch A, Reimer P, Roditi G, Romanini L, Sebastià C, Simundic AM, Stacul F, Clement O. Analytical interference of intravascular contrast agents with clinical laboratory tests: a joint guideline by the ESUR Contrast Media Safety Committee and the Preanalytical Phase Working Group of the EFLM Science Committee. Eur Radiol 2023:10.1007/s00330-023-10411-x. [PMID: 38060004 DOI: 10.1007/s00330-023-10411-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 08/08/2023] [Accepted: 09/07/2023] [Indexed: 12/08/2023]
Abstract
The Contrast Media Safety Committee of the European Society of Urogenital Radiology has, together with the Preanalytical Phase Working Group of the EFLM Science Committee, reviewed the literature and updated its recommendations to increase awareness and provide insight into these interferences. CLINICAL RELEVANCE STATEMENT: Contrast Media may interfere with clinical laboratory tests. Awareness of potential interference may prevent unwanted misdiagnosis. KEY POINTS: • Contrast Media may interfere with clinical laboratory tests; therefore awareness of potential interference may prevent unwanted misdiagnosis. • Clinical Laboratory tests should be performed prior to radiological imaging with contrast media or alternatively, blood or urine collection should be delayed, depending on kidney function.
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Affiliation(s)
- Aart J van der Molen
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands
| | - Ilona A Dekkers
- Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Remy W F Geenen
- Department of Radiology, Northwest Clinics, Alkmaar, The Netherlands
| | - Marie-France Bellin
- University Paris-Saclay, AP-HP, University Hospital Bicêtre, Service de Radiologie, BioMaps, Le Kremlin-Bicêtre, France
| | | | - Torkel B Brismar
- Department of Clinical Science, Intervention and Technology, Unit of Radiology, Karolinska Institutet and Department of Radiology, Karolinska University Hospital in Huddinge, Stockholm, Sweden
| | - Janne Cadamuro
- Department of Laboratory Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Jean-Michel Correas
- Université de Paris, AP-HP, Groupe Hospitalier Necker, DMU Imagina, Service de Radiologie, Paris, France
| | | | - Michel R Langlois
- Department of Laboratory Medicine, AZ St.-Jan Hospital, Brugge, Belgium
| | - Andreas H Mahnken
- Department of Radiology, Marburg University Hospital, Marburg, Germany
| | - Tomris Ozben
- Department of Clinical Biochemistry, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | | | - Alexander Radbruch
- Clinic for Diagnostic and Interventional Neuroradiology, University Clinic Bonn, and German Center for Neurodegenerative Diseases, DZNE, Bonn, Germany
| | - Peter Reimer
- Department of Radiology, Institute for Diagnostic and Interventional Radiology, Klinikum Karlsruhe, Karlsruhe, Germany
| | - Giles Roditi
- Department of Radiology, Glasgow Royal Infirmary, Glasgow, UK
| | | | - Carmen Sebastià
- Department of Radiology, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Ana-Maria Simundic
- Department of Medical Laboratory Diagnostics, Clinical Hospital Sveti Duh, Zagreb University, Zagreb, Croatia
| | - Fulvio Stacul
- Department of Radiology, Ospedale Maggiore, Trieste, Italy
| | - Olivier Clement
- Université de Paris, AP-HP, Hôpital Européen Georges Pompidou, DMU Imagina, Service de Radiologie, 20 Rue LeBlanc, F-75015, Paris, France.
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Abstract
Concern continues about whether the measurement of apolipoprotein B (apoB) is adequately standardized, and therefore, whether apoB should be applied widely in clinical care. This concern is misplaced. Our objective is to explain why and what the term "standardization" means. To produce clinically valid results, a test must accurately, precisely, and selectively measure the marker of interest. That is, it must be standardized. Accuracy refers to how closely the result obtained with 1 method corresponds to the result obtained with the standard method, precision to how reproducible the result is on repeated testing, and selectivity to how susceptible the method is to error by inclusion of other classes of lipoprotein particles. Multiple expert groups have determined that the measurement of apoB is adequately standardized for clinical care, and that apoB can be measured inexpensively, using widely available automated methods, more accurately, precisely, and selectively than low-density lipoprotein cholesterol or non-high-density lipoprotein cholesterol. ApoB is a standard superior to low-density lipoprotein cholesterol and high-density lipoprotein cholesterol because it is a defined molecule, whereas the cholesterol markers are the mass of cholesterol within lipoprotein particles defined by their density, not by their molecular structure. Nevertheless, the standardization of apoB is being further improved by the application of mass spectrophotometric methods, whereas the limitations in the standardization and, therefore, the accurate, precise, and selective measurement of low-density lipoprotein cholesterol and high-density lipoprotein cholesterol are unlikely to be overcome. We submit that greater accuracy, precision, and selectivity in measurement is a decisive advantage for apoB in the modern era of intensive lipid-lowering therapies.
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Affiliation(s)
| | - Michel R. Langlois
- Department of Laboratory Medicine, AZ St.‐Jan Hospital, Bruges, and Faculty of Medicine and Health SciencesUniversity of GhentGhentBelgium
| | - Christa Cobbaert
- Department of Clinical Chemistry and Laboratory MedicineLeiden University Medical CenterLeidenThe Netherlands
| | - Allan D. Sniderman
- Department of MedicineMike and Valeria Rosenbloom Centre for Cardiovascular Prevention, McGill University Health CentreMontrealQuebecCanada
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Langlois MR. A new milestone on the road to global standardization of apolipoprotein measurements. Clin Chem Lab Med 2022; 61:1-3. [DOI: 10.1515/cclm-2022-1117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Michel R. Langlois
- Department of Laboratory Medicine , AZ St.-Jan Hospital , Bruges , Belgium
- Chair of Science Committee, European Federation of Clinical Chemistry and Laboratory Medicine , Brussels , Belgium
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Briers PJ, Langlois MR. Concordance of apolipoprotein B concentration with the Friedewald, Martin-Hopkins, and Sampson formulas for calculating LDL cholesterol. Biochem Med (Zagreb) 2022; 32:010704. [PMID: 34955672 PMCID: PMC8672388 DOI: 10.11613/bm.2022.010704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 11/05/2021] [Indexed: 11/24/2022] Open
Abstract
Introduction Two new formulas, the Martin-Hopkins and the Sampson formula, were recently developed to overcome shortcomings of the Friedewald formula for calculating LDL-cholesterol. We aimed to compare the concordance of the two formulas with apolipoprotein B (apoB), a surrogate marker of the number of LDL particles. Materials and methods In a study of serum lipid data of 1179 patients who consulted the AZ St-Jan Hospital Bruges for cardiovascular risk assessment, the correlation and concordance of the Friedewald, Martin-Hopkins and Sampson formulas with apoB concentration, measured by immunonephelometry, were determined and compared. Results The Martin-Hopkins formula showed significantly higher correlation coefficient than the Friedewald formula with apoB in the entire dataset and in patients with low LDL-cholesterol < 1.8 mmol/L. Both Martin-Hopkins and Sampson formulas yielded > 70% concordance of LDL-cholesterol with regard to treatment group classification based on population-equivalent thresholds of apoB in hypertriglyceridemic patients (2-4.5 mmol/L), with the highest concordance (75.6%) obtained using Martin-Hopkins formula vs. 60.5% with Friedewald formula. Conclusion The Martin-Hopkins (and, to a lesser extent, Sampson) formula is more closely associated with the number of LDL particles than Friedewald formula. This, in combination with literature evidence of lesser accuracy of the Friedewald formula, is an argument to switch from Friedewald to a modified, improved formula.
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Affiliation(s)
- Pieter-Jan Briers
- Department of Laboratory Medicine, AZ St-Jan Hospital, Brugge, Belgium
| | - Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan Hospital, Brugge, Belgium.,Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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Collinson P, Suvisaari J, Aakre KM, Baum H, Duff CJ, Gruson D, Hammerer-Lercher A, Pulkki K, Stankovic S, Langlois MR, Apple FS, Laitinen P. How Well Do Laboratories Adhere to Recommended Guidelines for Cardiac Biomarkers Management in Europe? The CArdiac MARker Guideline Uptake in Europe (CAMARGUE) Study of the European Federation of Laboratory Medicine Task Group on Cardiac Markers. Clin Chem 2021; 67:1144-1152. [PMID: 34061171 DOI: 10.1093/clinchem/hvab066] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/07/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND The CARdiac MARker Guideline Uptake in Europe (CAMARGUE) program is a multi-country audit of the use of cardiac biomarkers in routine clinical practice. METHODS An email link to a web-based questionnaire of 30 multiple-choice questions was distributed via the professional societies in Europe. RESULTS 374 questionnaires were returned from 39 countries, the majority of which were in northern Europe with a response rate of 8.2%-42.0%. The majority of the respondents were from hospitals with proportionately more responses from central hospitals than district hospitals. Cardiac troponin was the preferred cardiac biomarker, evenly split between cardiac troponin T (cTnT) and cardiac troponin I (cTnI). Aspartate transaminase and lactate dehydrogenase are no longer offered as cardiac biomarkers. Creatine kinase, creatine kinase MB isoenzyme, and myoglobin continue to be offered as part of the cardiac biomarker profile in approximately on 50% of respondents. There is widespread utilization of high sensitivity (hs) troponin assays. The majority of cTnT users measure hs-cTnT. 29.5% of laboratories measure cTnI by a non-hs method but there has been substantial conversion to hs-cTnI. The majority of respondents used ng/L and use the 99th percentile as the upper reference limit (71.9% of respondents). A range of diagnostic protocols are in use. CONCLUSIONS There is widespread utilization of hs troponin methods. A significant minority do not use the 99th percentile as recommended and there is, as yet, little uptake of very rapid diagnostic strategies. Education of laboratory professionals and clinicians remains a priority.
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Affiliation(s)
- Paul Collinson
- Departments of Clinical Blood Sciences and Cardiology, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, UK
| | - Janne Suvisaari
- Clinical Chemistry, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kristin M Aakre
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Hannsjörg Baum
- Institute for Laboratory Medicine and Transfusion Medicine, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | - Christopher J Duff
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK.,School of Primary, Community and Social Care, Keele University, Stoke-on-Trent, UK
| | - Damien Gruson
- Department of Clinical Biochemistry, Cliniques Universitaires St-Luc and Université Catholique de Louvain, Brussels, Belgium
| | | | - Kari Pulkki
- Clinical Chemistry, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Sanja Stankovic
- Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia
| | - Michel R Langlois
- Department of Laboratory Medicine, AZ St. Jan Brugge-Oostende AV, Brugge, Belgium.,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Fred S Apple
- Department of Laboratory Medicine and Pathology, Hennepin Healthcare/HCMC, Minneapolis, MN, USA.,Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Päivi Laitinen
- Clinical Chemistry, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Langlois MR, Nordestgaard BG, Langsted A, Chapman MJ, Aakre KM, Baum H, Borén J, Bruckert E, Catapano A, Cobbaert C, Collinson P, Descamps OS, Duff CJ, von Eckardstein A, Hammerer-Lercher A, Kamstrup PR, Kolovou G, Kronenberg F, Mora S, Pulkki K, Remaley AT, Rifai N, Ros E, Stankovic S, Stavljenic-Rukavina A, Sypniewska G, Watts GF, Wiklund O, Laitinen P. Quantifying atherogenic lipoproteins for lipid-lowering strategies: consensus-based recommendations from EAS and EFLM. Clin Chem Lab Med 2021; 58:496-517. [PMID: 31855562 DOI: 10.1515/cclm-2019-1253] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Indexed: 12/15/2022]
Abstract
The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently addressed present and future challenges in the laboratory diagnostics of atherogenic lipoproteins. Total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDLC), LDL cholesterol (LDLC), and calculated non-HDLC (=total - HDLC) constitute the primary lipid panel for estimating risk of atherosclerotic cardiovascular disease (ASCVD) and can be measured in the nonfasting state. LDLC is the primary target of lipid-lowering therapies. For on-treatment follow-up, LDLC shall be measured or calculated by the same method to attenuate errors in treatment decisions due to marked between-method variations. Lipoprotein(a) [Lp(a)]-cholesterol is part of measured or calculated LDLC and should be estimated at least once in all patients at risk of ASCVD, especially in those whose LDLC declines poorly upon statin treatment. Residual risk of ASCVD even under optimal LDL-lowering treatment should be also assessed by non-HDLC or apolipoprotein B (apoB), especially in patients with mild-to-moderate hypertriglyceridemia (2-10 mmol/L). Non-HDLC includes the assessment of remnant lipoprotein cholesterol and shall be reported in all standard lipid panels. Additional apoB measurement can detect elevated LDL particle (LDLP) numbers often unidentified on the basis of LDLC alone. Reference intervals of lipids, lipoproteins, and apolipoproteins are reported for European men and women aged 20-100 years. However, laboratories shall flag abnormal lipid values with reference to therapeutic decision thresholds.
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Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan, Ruddershove 10, 8000 Brugge, Belgium.,University of Ghent, Ghent, Belgium
| | - Børge G Nordestgaard
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Anne Langsted
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - M John Chapman
- National Institute for Health and Medical Research (INSERM), Paris, France.,Endocrinology-Metabolism Service, Pitié-Salpetriere University Hospital, Paris, France
| | - Kristin M Aakre
- Hormone Laboratory, Haukeland University Hospital, Bergen, Norway
| | - Hannsjörg Baum
- Institute for Laboratory Medicine, Mikrobiologie und Blutdepot, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | - Jan Borén
- Institute of Medicine, Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden.,Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Eric Bruckert
- Department of Endocrinology and Prevention of Cardiovascular Disease, Pitié-Salpetriere University Hospital, Paris, France
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy.,IRCCS Multimedica, Milan, Italy
| | - Christa Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, The Netherlands
| | - Paul Collinson
- Department of Clinical Blood Sciences, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, UK.,Department of Cardiology, St George's University Hospitals NHS Foundation Trust and St George's University of London, London, UK
| | - Olivier S Descamps
- Department of Internal Medicine, Centres Hospitaliers Jolimont, Haine-Saint-Paul, Belgium.,Department of Cardiology, UCL Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Christopher J Duff
- Department of Clinical Biochemistry, University Hospitals of North Midlands NHS Trust, Stoke-on-Trent, UK
| | | | | | - Pia R Kamstrup
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Florian Kronenberg
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Samia Mora
- Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kari Pulkki
- Department of Clinical Chemistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Nader Rifai
- Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona, Spain.,Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Sanja Stankovic
- Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia
| | | | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, NC University, Bydgoszcz, Poland
| | - Gerald F Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Olov Wiklund
- Institute of Medicine, Sahlgrenska Academy at Göteborg University, Gothenburg, Sweden.,Wallenberg Laboratory for Cardiovascular and Metabolic Research, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Päivi Laitinen
- Department of Clinical Chemistry, HUSLAB, Helsinki University Hospital, Helsinki, Finland
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Hammerer-Lercher A, Gruson D, Stankovic S, Collinson P, Suvisaari J, Pulkki K, Duff CJ, Baum H, Stavljenic-Rukavina A, Aakre KM, Langlois MR, Laitinen P. Update on current practice in laboratory medicine in respect of natriuretic peptide testing for heart failure diagnosis and management in Europe. The CARdiac MArker guideline Uptake in Europe (CARMAGUE) study. Clin Chim Acta 2020; 511:59-66. [DOI: 10.1016/j.cca.2020.09.030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 09/21/2020] [Indexed: 12/19/2022]
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Langlois MR, Laitinen P. The CCA Special Issue on Cardiovascular Markers. Clin Chim Acta 2020; 512:121. [PMID: 33152320 DOI: 10.1016/j.cca.2020.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St. Jan Hospital Brugge, and Department of Diagnostic Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Päivi Laitinen
- Clinical Chemistry, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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10
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De Wolf HA, Langlois MR, Suvisaari J, Aakre KM, Baum H, Collinson P, Duff CJ, Gruson D, Hammerer-Lercher A, Pulkki K, Stankovic S, Stavljenic-Rukavina A, Laitinen P. How well do laboratories adhere to recommended guidelines for dyslipidaemia management in Europe? The CArdiac MARker Guideline Uptake in Europe (CAMARGUE) study. Clin Chim Acta 2020; 508:267-272. [DOI: 10.1016/j.cca.2020.05.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/19/2020] [Indexed: 01/05/2023]
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Abstract
PURPOSE OF REVIEW Guidelines propose using non-HDL cholesterol or apolipoprotein (apo) B as a secondary treatment target to reduce residual cardiovascular risk of LDL-targeted therapies. This review summarizes the strengths, weaknesses, opportunities, and threats (SWOT) of using apoB compared with non-HDL cholesterol. RECENT FINDINGS Non-HDL cholesterol, calculated as total-HDL cholesterol, includes the assessment of remnant lipoprotein cholesterol, an additional risk factor independent of LDL cholesterol. ApoB is a direct measure of circulating numbers of atherogenic lipoproteins, and its measurement can be standardized across laboratories worldwide. Discordance analysis of non-HDL cholesterol versus apoB demonstrates that apoB is the more accurate marker of cardiovascular risk. Baseline and on-treatment apoB can identify elevated numbers of small cholesterol-depleted LDL particles that are not reflected by LDL and non-HDL cholesterol. ApoB is superior to non-HDL cholesterol as a secondary target in patients with mild-to-moderate hypertriglyceridemia (175-880 mg/dL), diabetes, obesity or metabolic syndrome, or very low LDL cholesterol < 70 mg/dL. When apoB is not available, non-HDL cholesterol should be used to supplement LDLC.
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Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan Hospital, Ruddershove 10, B-8000, Bruges, Belgium. .,Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. .,Working Group on Guidelines, European Federation of Clinical Chemistry and Laboratory Medicine (EFLM), Brussels, Belgium.
| | - Allan D Sniderman
- Mike and Valeria Rosenbloom Centre for Cardiovascular Prevention, Division of Cardiology, Royal Victoria Hospital-McGill University Health Centre, Montreal, Quebec, Canada
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12
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Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St. Jan Hospital, Bruges, Belgium.,University of Ghent, Belgium
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13
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Abstract
PURPOSE OF REVIEW To summarize and discuss the clinical use of lipid and apolipoprotein tests in the settings of diagnosis and therapeutic follow-up of hyperlipidemia. RECENT FINDINGS The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently produced recommendations on the measurement of atherogenic lipoproteins, taking into account the strengths and weaknesses of analytical and clinical performances of the tests. Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (= LDL + remnant cholesterol) constitute the primary lipid panel for hyperlipidemia diagnosis and cardiovascular risk estimation. LDL cholesterol is the primary target of lipid-lowering therapies. Non-HDL cholesterol or apolipoprotein B should be used as secondary therapeutic target in patients with mild-to-moderate hypertriglyceridemia, 2-10 mmol/l (175-880 mg/dl). Lipoprotein (a) is included in LDL cholesterol and should be measured at least once in all patients at cardiovascular risk, including to explain poor response to statin treatment.
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Affiliation(s)
- Michel R Langlois
- AZ St.-Jan Hospital, Department of Laboratory Medicine, Ruddershove 10, 8000, Brugge, Belgium. .,University of Ghent, Ghent, Belgium.
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
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Langlois MR, Chapman MJ, Cobbaert C, Mora S, Remaley AT, Ros E, Watts GF, Borén J, Baum H, Bruckert E, Catapano A, Descamps OS, von Eckardstein A, Kamstrup PR, Kolovou G, Kronenberg F, Langsted A, Pulkki K, Rifai N, Sypniewska G, Wiklund O, Nordestgaard BG. Quantifying Atherogenic Lipoproteins: Current and Future Challenges in the Era of Personalized Medicine and Very Low Concentrations of LDL Cholesterol. A Consensus Statement from EAS and EFLM. Clin Chem 2018; 64:1006-1033. [PMID: 29760220 DOI: 10.1373/clinchem.2018.287037] [Citation(s) in RCA: 149] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/09/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The European Atherosclerosis Society-European Federation of Clinical Chemistry and Laboratory Medicine Consensus Panel aims to provide recommendations to optimize atherogenic lipoprotein quantification for cardiovascular risk management. CONTENT We critically examined LDL cholesterol, non-HDL cholesterol, apolipoprotein B (apoB), and LDL particle number assays based on key criteria for medical application of biomarkers. (a) Analytical performance: Discordant LDL cholesterol quantification occurs when LDL cholesterol is measured or calculated with different assays, especially in patients with hypertriglyceridemia >175 mg/dL (2 mmol/L) and low LDL cholesterol concentrations <70 mg/dL (1.8 mmol/L). Increased lipoprotein(a) should be excluded in patients not achieving LDL cholesterol goals with treatment. Non-HDL cholesterol includes the atherogenic risk component of remnant cholesterol and can be calculated in a standard nonfasting lipid panel without additional expense. ApoB more accurately reflects LDL particle number. (b) Clinical performance: LDL cholesterol, non-HDL cholesterol, and apoB are comparable predictors of cardiovascular events in prospective population studies and clinical trials; however, discordance analysis of the markers improves risk prediction by adding remnant cholesterol (included in non-HDL cholesterol) and LDL particle number (with apoB) risk components to LDL cholesterol testing. (c) Clinical and cost-effectiveness: There is no consistent evidence yet that non-HDL cholesterol-, apoB-, or LDL particle-targeted treatment reduces the number of cardiovascular events and healthcare-related costs than treatment targeted to LDL cholesterol. SUMMARY Follow-up of pre- and on-treatment (measured or calculated) LDL cholesterol concentration in a patient should ideally be performed with the same documented test method. Non-HDL cholesterol (or apoB) should be the secondary treatment target in patients with mild to moderate hypertriglyceridemia, in whom LDL cholesterol measurement or calculation is less accurate and often less predictive of cardiovascular risk. Laboratories should report non-HDL cholesterol in all standard lipid panels.
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Affiliation(s)
- Michel R Langlois
- Department of Laboratory Medicine, AZ St-Jan, Brugge, and University of Ghent, Belgium;
| | - M John Chapman
- National Institute for Health and Medical Research (INSERM), and Endocrinology-Metabolism Service, Pitié-Salpetriere University Hospital, Paris, France
| | - Christa Cobbaert
- Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Samia Mora
- Divisions of Preventive and Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Alan T Remaley
- Lipoprotein Metabolism Section, Cardiovascular-Pulmonary Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Emilio Ros
- Lipid Clinic, Department of Endocrinology and Nutrition, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona and Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Spain
| | - Gerald F Watts
- Lipid Disorders Clinic, Department of Cardiology, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Jan Borén
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Hannsjörg Baum
- Institute for Laboratory Medicine, Blutdepot und Krankenhaushygiene, Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | - Eric Bruckert
- Pitié-Salpetriere University Hospital, Paris, France
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Italy
| | | | | | - Pia R Kamstrup
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
| | - Florian Kronenberg
- Department of Medical Genetics, Molecular and Clinical Pharmacology, Division of Genetic Epidemiology, Medical University of Innsbruck, Innsbruck, Austria
| | - Anne Langsted
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Kari Pulkki
- Department of Clinical Chemistry, University of Turku and Turku University Hospital, Turku, Finland
| | - Nader Rifai
- Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Grazyna Sypniewska
- Department of Laboratory Medicine, Collegium Medicum, NC University, Bydgoszcz, Poland
| | - Olov Wiklund
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Børge G Nordestgaard
- Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
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De Meyer T, Bekaert S, De Buyzere ML, De Bacquer DD, Langlois MR, Shivappa N, Hébert JR, Gillebert TC, Rietzschel ER, Huybrechts I. Leukocyte telomere length and diet in the apparently healthy, middle-aged Asklepios population. Sci Rep 2018; 8:6540. [PMID: 29695838 PMCID: PMC5916889 DOI: 10.1038/s41598-018-24649-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 04/03/2018] [Indexed: 11/20/2022] Open
Abstract
Telomere length is a prognostic biomarker for aging diseases. As it is unknown whether diet plays a role in these associations, we aimed to assess the impact of diet on telomere length. Moreover, given that telomere length is modulated by oxidative stress and inflammation, an additional goal was to evaluate whether the latter may mediate possible telomere - diet associations. Southern blot measured leukocyte telomere length and food frequency questionnaire data were compared for 2509 apparently healthy men and women (~35 to 55 years) from the Asklepios population. No significant associations were found between telomere length and overall dietary characteristics, such as dietary diversity, quality, equilibrium, and the dietary inflammatory index. Exploratory analysis of individual dietary variables revealed that a higher daily intake of deep fried potato products was associated with shorter telomeres (P = 0.002, 151 bp per 100 g/day), also in both sexes separately. Deep fried potato product consumption was also significantly associated with C-reactive protein (P = 0.032) and uric acid (P = 0.042), but not other inflammation and oxidative stress markers. These results suggest an at most limited association between overall dietary patterns and telomere length in the general population. Nevertheless, the association between telomere length and deep fried potato product intake warrants additional research.
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Affiliation(s)
- Tim De Meyer
- Department of Data Analysis and Mathematical Modelling, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, B-9000, Ghent, Belgium.
| | - Sofie Bekaert
- BIMETRA - Clinical Research Center Ghent, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Marc L De Buyzere
- Department of Cardiovascular Diseases, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Dirk D De Bacquer
- Department of Public Health, Ghent University, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Michel R Langlois
- Department of Laboratory Medicine, Asklepios Core-Lab, AZ St-Jan AV Hospital, Ruddershove 10, B-8000, Bruges, Belgium
| | - Nitin Shivappa
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA
| | - James R Hébert
- Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Suite 241, Columbia, SC, 29208, USA
| | - Thierry C Gillebert
- Department of Cardiovascular Diseases, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Ernst R Rietzschel
- Department of Cardiovascular Diseases, Ghent University Hospital, De Pintelaan 185, B-9000, Ghent, Belgium
| | - Inge Huybrechts
- Department of Public Health, Ghent University, De Pintelaan 185, B-9000, Ghent, Belgium
- International Agency for Research on Cancer; 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France
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Barth JH, Misra S, Aakre KM, Langlois MR, Watine J, Twomey PJ, Oosterhuis WP. Why are clinical practice guidelines not followed? Clin Chem Lab Med 2017; 54:1133-9. [PMID: 26650076 DOI: 10.1515/cclm-2015-0871] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Accepted: 10/19/2015] [Indexed: 11/15/2022]
Abstract
Clinical practice guidelines (CPG) are written with the aim of collating the most up to date information into a single document that will aid clinicians in providing the best practice for their patients. There is evidence to suggest that those clinicians who adhere to CPG deliver better outcomes for their patients. Why, therefore, are clinicians so poor at adhering to CPG? The main barriers include awareness, familiarity and agreement with the contents. Secondly, clinicians must feel that they have the skills and are therefore able to deliver on the CPG. Clinicians also need to be able to overcome the inertia of "normal practice" and understand the need for change. Thirdly, the goals of clinicians and patients are not always the same as each other (or the guidelines). Finally, there are a multitude of external barriers including equipment, space, educational materials, time, staff, and financial resource. In view of the considerable energy that has been placed on guidelines, there has been extensive research into their uptake. Laboratory medicine specialists are not immune from these barriers. Most CPG that include laboratory tests do not have sufficient detail for laboratories to provide any added value. However, where appropriate recommendations are made, then it appears that laboratory specialist express the same difficulties in compliance as front-line clinicians.
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Nordestgaard BG, Langlois MR. Precision of nonfasting lipid profiles should focus on clinical relevance rather than necessarily obtaining the least variation. ACTA ACUST UNITED AC 2017; 55:e189-e190. [DOI: 10.1515/cclm-2016-1104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2016] [Accepted: 12/12/2016] [Indexed: 11/15/2022]
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Hammerer-Lercher A, Collinson PO, Suvisaari J, Christenson RH, Pulkki K, van Dieijen-Visser MP, Duff CJ, Baum H, Stavljenic-Rukavina A, Aakre KM, Langlois MR, Stankovic S, Laitinen P. Are Heart Failure Management Recommendations and Guidelines Followed in Laboratory Medicine in Europe and North America? The Cardiac Marker Guideline Uptake in Europe (CARMAGUE) Study. ACTA ACUST UNITED AC 2017; 1:483-493. [DOI: 10.1373/jalm.2016.021345] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 10/04/2016] [Indexed: 11/06/2022]
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Collinson P, Hammerer-Lercher A, Suvisaari J, Apple FS, Christenson RH, Pulkki K, van Dieijen-Visser MP, Duff CJ, Baum H, Stavljenic-Rukavina A, Aakre KM, Langlois MR, Stankovic S, Laitinen P. How Well Do Laboratories Adhere to Recommended Clinical Guidelines for the Management of Myocardial Infarction: The CARdiac MArker Guidelines Uptake in Europe Study (CARMAGUE). Clin Chem 2016; 62:1264-71. [DOI: 10.1373/clinchem.2016.259515] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Accepted: 06/16/2016] [Indexed: 11/06/2022]
Abstract
Abstract
BACKGROUND
We undertook an assessment of current use of evidence-based guidelines for the use of cardiac biomarkers in Europe (EU) and North America (NA).
METHODS
In 2013–2014 a web-based questionnaire was distributed via NA and EU biochemical societies. Questions covered cardiac biomarkers measured, analytical methods used, decision thresholds, and use of decision-making protocols. Results were collated using a central database and analyzed using comparative and descriptive nonparametric statistics.
RESULTS
In EU, returns were obtained from 442 hospitals, 50% central or university hospitals, and 39% from local hospitals from 35 countries with 395/442 (89%) provided an acute service. In NA there were 91 responses (63.7% central or university hospitals, 19.8% community hospitals) with 76/91 (83.5%) providing an acute service. Cardiac troponin was the preferred cardiac biomarker in 99.5% (EU) and 98.7% (NA), and the first line marker in 97.7% (EU) and 97.4% (NA). There were important differences in the choice of decision limits and their derivations. The origin of the information was also significantly different, with EU vs NA as follows: package insert, 61.9% vs 40%; publications, 17.1% vs 15.0%; local clinical or analytical validation choice, 21.0% vs 45.0%; P = 0.0003.
CONCLUSIONS
There are significant differences between EU and NA use of cardiac biomarkers. This probably relates to different availability of assays between EU and NA (such as high-sensitivity troponin assays) and different laboratory practices on assay introduction (greater local evaluation of assay performance occurred in NA).
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Affiliation(s)
- Paul Collinson
- Departments of Chemical Pathology and Cardiology, St George's Hospital, London, UK
| | | | - Janne Suvisaari
- HUSLAB, Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
| | - Fred S Apple
- Departments of Laboratory Medicine and Pathology, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN
| | | | - Kari Pulkki
- University of Eastern Finland and Eastern Finland Laboratory Centre, Kuopio, Finland
| | | | - Christopher J Duff
- Department of Clinical Biochemistry, University Hospitals of North Midlands, Stoke-on-Trent, UK
| | - Hannsjörg Baum
- Regionale Kliniken Holding RKH GmbH, Ludwigsburg, Germany
| | | | | | - Michel R Langlois
- Asklepios Core-lab, Department of Laboratory Medicine, AZ St-Jan Hospital Bruges and Ghent University, Ghent, Belgium
| | - Sanja Stankovic
- Center for Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia
| | - Paivi Laitinen
- HUSLAB, Department of Clinical Chemistry, Helsinki University Central Hospital, Helsinki, Finland
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Delanghe JR, De Buyzere ML, Speeckaert MM, Langlois MR. Haptoglobin phenotype and Parkinson disease risk. Parkinsonism Relat Disord 2016; 22:108-9. [DOI: 10.1016/j.parkreldis.2015.10.020] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 10/30/2015] [Indexed: 11/29/2022]
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Dumoulin EN, Van Biervliet S, Langlois MR, Delanghe JR. Proteolysis is a confounding factor in the interpretation of faecal calprotectin. ACTA ACUST UNITED AC 2015; 53:65-71. [DOI: 10.1515/cclm-2014-0568] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 06/13/2014] [Indexed: 11/15/2022]
Abstract
AbstractCalprotectin is a 36 kDa calcium and zinc binding protein. An increased level of calprotectin points towards inflammatory bowel disease. However, the biomarker calprotectin shows 14 potential cleavages sites for trypsin. Next to trypsin, also the presence of its inhibitor αAn in vitro model was created. As calprotectin source, leukocytes were isolated and subsequently lysed (1% Triton X-100) and diluted in faecal matrix. Trypsin digestion was carried out by adding trypsin. Incubation occurred for 24 h or 48 h (37 °C). To study the influence of αIn vitro experiments enabled monitoring of the faecal calprotectin digestion, leading to loss of immunoreactivity. Trypsin activity was a potential confounder in the interpretation of calprotectin, in particular for proximal lesions, where exposure of calprotectin to trypsin is prolonged. Relative calprotectin loss was proportional to the amount of trypsin. Decrease of calprotectin was more pronounced after 48 h of incubation in comparison to 24 h of incubation. Analogue experiments also showed stable calprotectin values after adding αTransit time, trypsin activity and addition of blood as a source of α
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Aakre KM, Langlois MR, Watine J, Barth JH, Baum H, Collinson P, Laitinen P, Oosterhuis WP. Critical review of laboratory investigations in clinical practice guidelines: proposals for the description of investigation. Clin Chem Lab Med 2014; 51:1217-26. [PMID: 23037517 DOI: 10.1515/cclm-2012-0574] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 09/07/2012] [Indexed: 11/15/2022]
Abstract
BACKGROUND Correct information provided by guidelines may reduce laboratory test related errors during the pre-analytical, analytical and post-analytical phase and increase the quality of laboratory results. METHODS Twelve clinical practice guidelines were reviewed regarding inclusion of important laboratory investigations. Based on the results and the authors' experience, two checklists were developed: one comprehensive list including topics that authors of guidelines may consider and one consisting of minimal standards that should be covered for all laboratory tests recommended in clinical practice guidelines. The number of topics addressed by the guidelines was related to involvement of laboratory medicine specialists in the guideline development process. RESULTS The comprehensive list suggests 33 pre- analytical, 37 analytical and 10 post-analytical items. The mean percentage of topics dealt with by the guidelines was 33% (median 30%, range 17%-55%) and inclusion of a laboratory medicine specialist in the guideline committee significantly increased the number of topics addressed. Information about patient status, biological and analytical interferences and sample handling were scarce in most guidelines even if the inclusion of a laboratory medicine specialist in the development process seemingly led to increased focus on, e.g., sample type, sample handling and analytical variation. Examples underlining the importance of including laboratory items are given. CONCLUSIONS Inclusion of laboratory medicine specialist in the guideline development process may increase the focus on important laboratory related items even if this information is usually limited. Two checklists are suggested to help guideline developers to cover all important topics related to laboratory testing.
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Affiliation(s)
- Kristin M Aakre
- The Norwegian Quality Improvement of Laboratory Services in Primary Care, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway.
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Korita I, Bulo A, Langlois MR, Verhoye E, Blaton V. Serum amyloid A is independently related to apolipoprotein A-I but not to HDL-cholesterol in patients with angina pectoris. Clin Biochem 2013; 46:1660-3. [DOI: 10.1016/j.clinbiochem.2013.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2013] [Accepted: 07/30/2013] [Indexed: 10/26/2022]
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Delanghe JR, De Buyzere ML, Speeckaert MM, Langlois MR. Genetic aspects of scurvy and the European famine of 1845-1848. Nutrients 2013; 5:3582-8. [PMID: 24036531 PMCID: PMC3798922 DOI: 10.3390/nu5093582] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 08/13/2013] [Accepted: 08/22/2013] [Indexed: 01/30/2023] Open
Abstract
The view of scurvy being exclusively a nutritional disorder needs to be updated. Genetic polymorphisms of HFE and haptoglobin (Hp) may explain the geographic variability of mortality caused by the European famine of the mid-19th century. In this period, potatoes had fallen victim to the potato blight and Ireland was more severely hit than continental Europe. Hereditary hemochromatosis is a genetic disorder with mutations in the HFE gene, characterized by iron overload (with a reduced vitamin C stability) and with a predominance of affected men. The Irish have the world’s highest frequency of the C282Y mutation and the particular iron metabolism of the Irish helps to understand the size of the catastrophe and the observed overrepresentation of male skeletons showing scurvy. Hp is a plasma α2-glycoprotein characterized by 3 common phenotypes (Hp 1-1, Hp 2-1 and Hp 2-2). When the antioxidant capacity of Hp is insufficient, its role is taken over by hemopexin and vitamin C. The relative number of scurvy victims corresponds with the Hp 2-2 frequency, which is associated with iron conservation and has an impact on vitamin C stability. As iron is more abundant in males, males are overrepresented in the group of skeletons showing scurvy signs.
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Affiliation(s)
- Joris R. Delanghe
- Department of Laboratory Medicine, Ghent University Hospital, B 9000 Ghent, Belgium
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +32-9-332-29-56; Fax: +32-9-332-36-59
| | - Marc L. De Buyzere
- Department of Cardiology, Ghent University Hospital, B 9000 Ghent, Belgium; E-Mail:
| | - Marijn M. Speeckaert
- Department of Nephrology, Ghent University Hospital, B 9000 Ghent, Belgium; E-Mail:
| | - Michel R. Langlois
- Department of Laboratory Medicine, AZ Sint Jan Hospital, B 8000 Bruges, Belgium; E-Mail: Michel.
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Langlois MR, Delanghe JR. Is it time to apply genographics in medical diagnosis? Acta Clin Belg 2012; 67:387-388. [PMID: 23340141 DOI: 10.2143/acb.67.6.2062700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Langlois MR, Delanghe JR, De Buyzere M, Rietzschel E, De Bacquer D. Unanswered questions in including HDL-cholesterol in the cardiovascular risk estimation. Is time still on our side? Atherosclerosis 2012; 226:296-8. [PMID: 23102787 DOI: 10.1016/j.atherosclerosis.2012.10.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2012] [Revised: 10/08/2012] [Accepted: 10/10/2012] [Indexed: 11/16/2022]
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Langlois MR. Laboratory approaches for predicting and managing the risk of cardiovascular disease: postanalytical opportunities of lipid and lipoprotein testing. Clin Chem Lab Med 2012; 50:1169-81. [DOI: 10.1515/cclm-2011-0636] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2011] [Accepted: 03/19/2012] [Indexed: 11/15/2022]
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Delanghe JR, Langlois MR, De Buyzere ML. Haptoglobin polymorphism: a key factor in the proatherogenic role of B cells? Atherosclerosis 2011; 217:80-2. [PMID: 21507405 DOI: 10.1016/j.atherosclerosis.2011.03.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Revised: 03/02/2011] [Accepted: 03/11/2011] [Indexed: 10/18/2022]
Abstract
B cells play a role in atherosclerosis. B lymphocytes may reduce the progression of vascular disease. Antibody production against modified auto-antigens is an element in the atheroprotective involvement of B lymphocytes. Paradoxical evidence is emerging from animal studies that suggest a proatherogenic B-cell behaviour independently of autoantibody production. One aspect that has received limited consideration is the role of genetic susceptibility modulated by extracellular matrix proteins. Haptoglobin is a polymorphic glycoprotein that binds to CD22 on B lymphocytes. Hp phenotypes show an important molecular heterogeneity. Hp 2-2 has been linked to an increased susceptibility for atherosclerosis. Haptoglobin and its polymorphism play a role in B-cell migration and function. Hp phenotypes may influence B-T cell dialogue and T cell activation. Haptoglobin is involved in the interplay of lymphocytes, neutrophils, and monocytes. Haptoglobin binds to the CD11b/CD18 receptor and to mast cells. HDL particles can become pro-inflammatory through interactions of Hp-Hb complexes with apolipoprotein A1. Haptoglobin is a chemoattractant to pre-B lymphocytes and monocytes. Beyond the conventional view of haptoglobin as a marker of hemolysis, several findings point towards an immunomodulatory effect of haptoglobin in B-cell mediated progression of atherosclerosis. The balance between proatherogenic and protective immunological properties of the different Hp phenotypes determines if lesions progress or regress. Clinical studies indicate a strong association between the Hp 2-2 phenotype and a more frequent onset of diabetic complications and cardiovascular disease. Findings in animal models (where no haptoglobin polymorphism is present) cannot always be extrapolated to humans.
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Affiliation(s)
- Joris R Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, De Pintelaan 185, B 9000 Ghent, Belgium.
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De Meyer T, Sinnaeve D, Van Gasse B, Rietzschel ER, De Buyzere ML, Langlois MR, Bekaert S, Martins JC, Van Criekinge W. Evaluation of standard and advanced preprocessing methods for the univariate analysis of blood serum 1H-NMR spectra. Anal Bioanal Chem 2010; 398:1781-90. [PMID: 20714889 DOI: 10.1007/s00216-010-4085-x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Revised: 07/30/2010] [Accepted: 08/02/2010] [Indexed: 12/12/2022]
Abstract
Proton nuclear magnetic resonance ((1)H-NMR)-based metabolomics enables the high-resolution and high-throughput assessment of a broad spectrum of metabolites in biofluids. Despite the straightforward character of the experimental methodology, the analysis of spectral profiles is rather complex, particularly due to the requirement of numerous data preprocessing steps. Here, we evaluate how several of the most common preprocessing procedures affect the subsequent univariate analyses of blood serum spectra, with a particular focus on how the standard methods perform compared to more advanced examples. Carr-Purcell-Meiboom-Gill 1D (1)H spectra were obtained for 240 serum samples from healthy subjects of the Asklepios study. We studied the impact of different preprocessing steps--integral (standard method) and probabilistic quotient normalization; no, equidistant (standard), and adaptive-intelligent binning; mean (standard) and maximum bin intensity data summation--on the resonance intensities of three different types of metabolites: triglycerides, glucose, and creatinine. The effects were evaluated by correlating the differently preprocessed NMR data with the independently measured metabolite concentrations. The analyses revealed that the standard methods performed inferiorly and that a combination of probabilistic quotient normalization after adaptive-intelligent binning and maximum intensity variable definition yielded the best overall results (triglycerides, R = 0.98; glucose, R = 0.76; creatinine, R = 0.70). Therefore, at least in the case of serum metabolomics, these or equivalent methods should be preferred above the standard preprocessing methods, particularly for univariate analyses. Additional optimization of the normalization procedure might further improve the analyses.
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Affiliation(s)
- Tim De Meyer
- Laboratory for Bioinformatics and Computational Genomics, Department of Molecular Biotechnology, Faculty of Bioscience Engineering, Ghent University, Coupure Links 653, 9000 Ghent, Belgium.
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Speeckaert MM, Segers H, Van Biesen W, Verstraete A, Langlois MR, Delanghe JR. An unusual case of (pseudo)hypertriglyceridaemia. NDT Plus 2010; 3:570-2. [PMID: 25949470 PMCID: PMC4421427 DOI: 10.1093/ndtplus/sfq148] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2010] [Accepted: 07/15/2010] [Indexed: 12/04/2022] Open
Abstract
A high concentration of glycerol in plasma is an interfering factor in the determination of triglycerides, giving rise to (pseudo)hypertriglyceridaemia. Hyperglycerolaemia may be due to the presence of exogenous glycerol or due to endogenous glycerol accumulation. In the present case report, a 57-year-old male patient with end-stage renal disease presented with a pseudohypertriglyceridaemia based on a pronounced hyperglycerolaemia. The hyperglycerolaemia was due to chronic intake of glycerol-containing alcoholic beverages in combination with a reduced glycerol clearance and glycerol kinase activity. In conclusion, an unexplained hypertriglyceridaemia in patients with an impaired renal function should raise the suspicion of hyperglycerolaemia.
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Affiliation(s)
- Marijn M Speeckaert
- Department of Clinical Chemistry , Ghent University Hospital , Gent , Belgium
| | - Hannah Segers
- Department of Clinical Chemistry , Ghent University Hospital , Gent , Belgium
| | - Wim Van Biesen
- Department of Nephrology , Ghent University Hospital , Gent , Belgium
| | - Alain Verstraete
- Department of Toxicology , Ghent University Hospital , Gent , Belgium
| | - Michel R Langlois
- Department of Clinical Chemistry , AZ Sint Jan Brugge , Brugge , Belgium
| | - Joris R Delanghe
- Department of Clinical Chemistry , Ghent University Hospital , Gent , Belgium
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Vandermeersch A, Ameye S, Puype D, Petitjean D, De Buyzere M, Langlois MR. Estimation of the low-density lipoprotein (LDL) subclass phenotype using a direct, automated assay of small dense LDL-cholesterol without sample pretreatment. Clin Chim Acta 2010; 411:1361-6. [PMID: 20561981 DOI: 10.1016/j.cca.2010.05.038] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2010] [Revised: 05/11/2010] [Accepted: 05/26/2010] [Indexed: 10/19/2022]
Abstract
BACKGROUND A new method (sLDL-EX "SEIKEN") is commercially available for the direct quantification of small dense LDL-cholesterol (sd-LDL) on automated chemistry analyzers, without manual sample pretreatment. We evaluated the performance of this direct assay to estimate the small dense LDL subclass phenotype ("non-A"), defined by polyacrylamide gel tube electrophoresis. METHODS Fasting serum samples from 189 healthy subjects (age 18-75y, 96 females) were collected. The direct sd-LDL assay (from Randox Laboratories) was applied on a Roche Modular P analyzer. The Quantimetrix Lipoprint(TM) LDL System was used to define LDL subclass phenotypes (A and non-A). ROC curve analysis was performed for sd-LDL and other lipids and apolipoproteins (apo) with respect to phenotype non-A. RESULTS sd-LDL concentrations (40.4+/-18.6mg/dl) in the total group correlated (P<0.0001) with apoB (r=0.831), apoB/A-I ratio (r=0.757), non-HDL-cholesterol (r=0.821), triglycerides (r=0.439), and LDL-cholesterol (r=0.641). Higher sd-LDL concentrations (P<0.0001) were measured in subjects with LDL phenotype non-A (53.6+/-17.0mg/dl, n=92) than in those with phenotype A (27.9+/-8.9mg/dl, n=97). In logistic regression analysis, sd-LDL and apoA-I were independently associated with LDL subclass phenotype non-A. Highest areas under ROC curves were obtained for sd-LDL (0.943), triglycerides (0.833), triglyceride/HDL-cholesterol (0.838) and apoB/A-I ratio (0.826) to predict phenotype non-A. The sd-LDL cut-off point for optimal sensitivity (87.9%) and specificity (92.8%) was >38.5mg/dl. CONCLUSIONS The direct, homogeneous sd-LDL method is easily applicable on an automated chemistry analyzer and shows acceptable performance to estimate the electrophoretic LDL subclass phenotype.
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Affiliation(s)
- M R Langlois
- Department of Clinical Chemistry, Ghent University, De Pintelaan 185, B-9000 Ghent, Belgium
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Verhoye E, Van den Bruel A, Delanghe JR, Debruyne E, Langlois MR. Spuriously high thyrotropin values due to anti-thyrotropin antibodies in adult patients. Clin Chem Lab Med 2009; 47:604-6. [DOI: 10.1515/cclm.2009.138] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Verhoye E, Langlois MR. Circulating oxidized low-density lipoprotein: a biomarker of atherosclerosis and cardiovascular risk? Clin Chem Lab Med 2009; 47:128-37. [DOI: 10.1515/cclm.2009.037] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AbstractLow-density lipoproteins (LDLs) are susceptible to structural modifications by oxidation, particularly the small dense LDL particles. The formation of lipid peroxidation derivates, such as thiobarbituric reactive substances, conjugated dienes, lipid hydroperoxides, and aldehydes, is associated with changes in apolipoprotein conformation and affects the functional properties of LDLs. Oxidized LDL (oxLDL) formation in the subendothelial space of the arterial wall is a key initiating step in atherosclerosis because it contributes to foam cell generation, endothelial dysfunction, and inflammatory processes. In the last decade, immunoassays were developed using monoclonal antibodies against oxidation-dependent epitopes of LDL which made it possible to directly measure oxLDL in the circulation. Increased circulating oxLDL concentrations have been related to cardiovascular disease in some studies, although not always independently after adjustment of classical lipid markers. The Asklepios Study, investigating 2524 healthy middle-aged subjects, showed that circulating oxLDL is affected by many biological and lifestyle factors, as well as (generalized) subclinical atherosclerosis.Clin Chem Lab Med 2009;47:128–37.
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Langlois MR, Wallemacq P. The future of hospital laboratories. Position statement from the Royal Belgian Society of Clinical Chemistry (RBSCC). Clin Chem Lab Med 2009; 47:1195-201. [DOI: 10.1515/cclm.2009.271] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Langlois MR, Rietzschel ER, De Buyzere ML, De Bacquer D, Bekaert S, Blaton V, De Backer GG, Gillebert TC. Femoral Plaques Confound the Association of Circulating Oxidized Low-Density Lipoprotein With Carotid Atherosclerosis in a General Population Aged 35 to 55 Years. Arterioscler Thromb Vasc Biol 2008; 28:1563-8. [PMID: 18511698 DOI: 10.1161/atvbaha.108.167346] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Michel R. Langlois
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Ernst R. Rietzschel
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Marc L. De Buyzere
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Dirk De Bacquer
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Sofie Bekaert
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Victor Blaton
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Guy G. De Backer
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
| | - Thierry C. Gillebert
- From the Department of Clinical Chemistry (M.L., V.B.), AZ St-Jan Hospital, Bruges; the Department of Cardiovascular Diseases (E.R., M.D.B., T.G.), Ghent University Hospital; the Department of Public Health (D.D.B., G.D.B.), Ghent University; and the Department of Molecular Biotechnology, Faculty of Bioscience Engineering (S.B.), Ghent University, Belgium. The other Asklepios Investigators are a part of the Association of Primary Care Physicians ASKLEPIOS V.O.F., Nieuwerkerken-Aalst, Belgium
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De Vriese AS, Borrey D, Mahieu E, Claeys I, Stevens L, Vanhaeverbeke A, Roelens M, Langlois MR. Oral Vitamin C Administration Increases Lipid Peroxidation in Hemodialysis Patients. ACTA ACUST UNITED AC 2007; 108:c28-34. [DOI: 10.1159/000112526] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Accepted: 09/06/2007] [Indexed: 11/19/2022]
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Delanghe JR, Langlois MR, De Buyzere ML, Torck MA. Vitamin C Deficiency and Scurvy Are Not Only a Dietary Problem but Are Codetermined by the Haptoglobin Polymorphism. Clin Chem 2007; 53:1397-400. [PMID: 17644791 DOI: 10.1373/clinchem.2007.088658] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Ascorbic acid (vitamin C) is prone to oxidation in vivo. The human plasma protein haptoglobin (Hp) shows a genetic polymorphism with 3 major phenotypes (Hp 1-1, Hp 2-1, and Hp 2-2) that show important functional differences. Despite an adequate nutritional supply, in Hp 2-2 individuals (most common among Asian populations) vitamin C is markedly lower in concentration and particularly prone to oxidation in vivo. Therefore, susceptibility to subclinical and clinical vitamin C deficiency (scurvy) is partly genetically determined. The genetic advantage of the Hp1 allele as a vitamin C stabilizing factor helps to elucidate the direction and successes of long-distance sea crossing human migrations in history. Clinical trials demonstrated Hp phenotype–related effects of antioxidant treatment. Because vitamin C is a first line antioxidant, Hp polymorphism and its effects on vitamin C have major clinical consequences; a marked difference in genetic susceptibility toward atherosclerosis between Hp phenotypes is attributable to variation in LDL oxidation. The classical view of vitamin C and scurvy being a pure nutritional condition needs to be updated. These findings should foster research investigating the role of Hp polymorphism in human disease, and in vitamin C deficiency and atherosclerosis in particular.
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Affiliation(s)
- Joris R Delanghe
- Department of Clinical Chemistry, University Hospital Ghent, Ghent, Belgium.
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Borrey D, Moerman E, Cockx A, Engelrelst V, Langlois MR. Column-switching LC-MS/MS analysis for quantitative determination of testosterone in human serum. Clin Chim Acta 2007; 382:134-7. [PMID: 17462614 DOI: 10.1016/j.cca.2007.03.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2007] [Revised: 03/16/2007] [Accepted: 03/16/2007] [Indexed: 11/24/2022]
Abstract
BACKGROUND An accurate measurement of testosterone is needed in many clinical applications for correct diagnosis and appropriate treatment. Our aim was to develop a fast and robust high-throughput LC-MSMS method for quantification of serum testosterone in women. METHODS Testosterone was derivatized by oximation and extracted with methyl tert-butyl ether from 200 microL of serum. Further matrix elimination was achieved on-line using a column-switching LC-method. The instrumental analysis was performed on an API4000 tandem mass spectrometer equipped with an Agilent series 1312A binary pump and an Agilent series 1311A quaternary pump. The MRM transitions were 304-->124 and 304-->112 for testosterone and 307-->124 and 307-->112 for d(3)-testosterone. RESULTS The total analysis time of the column-switching method was 3 min. Linear calibration curves were obtained in the concentration range from 0.035 nmol/L (0.01 microg/L) to 6.92 nmol/L (2 microg/L). Within-day and between-day precision, expressed as the relative standard deviation at four different concentrations ranged from 4.70% to 9.35%. Correlation with the in-house method (solvent-extraction RIA) showed r(2)=0.920. CONCLUSIONS The presented column-switching method offers a simple, fast and economical analysis of testosterone in human serum. The procedure requires only small sample volumes and is well suited for quantification of testosterone in serum from women and children.
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Affiliation(s)
- Daniëlle Borrey
- Department of Clinical Chemistry, AZ Sint-Jan AV Hospital, Ruddershove 10, Bruges, Belgium.
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Langlois MR, Blaton VH. Historical milestones in measurement of HDL-cholesterol: Impact on clinical and laboratory practice. Clin Chim Acta 2006; 369:168-78. [PMID: 16579980 DOI: 10.1016/j.cca.2006.01.031] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2005] [Accepted: 01/31/2006] [Indexed: 11/16/2022]
Abstract
High-density lipoprotein cholesterol (HDL-C) comprises a family of particles with differing physicochemical characteristics. Continuing progress in improving HDL-C analysis has originated from two separate fields-one clinical, reflecting increased attention to HDL-C in estimating risk for coronary heart disease (CHD), and the other analytical, reflecting increased emphasis on finding more reliable and cost-effective HDL-C assays. Epidemiologic and prospective studies established the inverse association of HDL-C with CHD risk, a relationship that is consistent with protective mechanisms demonstrated in basic research and animal studies. Atheroprotective and less atheroprotective HDL subpopulations have been described. Guidelines on primary and secondary CHD prevention, which increased the workload in clinical laboratories, have led to a revolution in HDL-C assay technology. Many analytical techniques including ultracentrifugation, electrophoresis, chromatography, and polyanion precipitation methods have been developed to separate and quantify HDL-C and HDL subclasses. More recently developed homogeneous assays enable direct measurement of HDL-C on an automated analyzer, without the need for manual pretreatment to separate non-HDL. Although homogeneous assays show improved accuracy and precision in normal serum, discrepant results exist in samples with atypical lipoprotein characteristics. Hypertriglyceridemia and monoclonal paraproteins are important interfering factors. A novel approach is nuclear magnetic resonance spectroscopy that allows rapid and reliable analysis of lipoprotein subclasses, which may improve the identification of individuals at increased CHD risk. Apolipoprotein A-I, the major protein of HDL, has been proposed as an alternative cardioprotective marker avoiding the analytical limitations of HDL-C.
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Affiliation(s)
- Michel R Langlois
- Department of Clinical Chemistry, AZ St. Jan Hospital, Ruddershove 10, B-8000 Brugge, Belgium.
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Abstract
AbstractClin Chem Lab Med 2006;44:924–8.
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Borrey DCR, Godderis KO, Engelrelst VIL, Bernard DR, Langlois MR. Quantitative determination of vigabatrin and gabapentin in human serum by gas chromatography-mass spectrometry. Clin Chim Acta 2005; 354:147-51. [PMID: 15748611 DOI: 10.1016/j.cccn.2004.11.023] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2004] [Revised: 11/18/2004] [Accepted: 11/22/2004] [Indexed: 11/25/2022]
Abstract
BACKGROUND Published methods for routine clinical monitoring of vigabatrin and gabapentin are often very laborious. A simple GC-MS method was developed for the simultaneous quantitative determination of vigabatrin and gabapentin in human serum. METHODS After protein precipitation, the compounds are derivatized by methylation and analysed on a polydimethylsiloxane column using splitless injection. Cyclobarbital is used as the internal standard. To attain maximal sensitivity, detection is performed in selected ion monitoring mode. RESULTS The method was fully validated and linear calibration curves were obtained in the concentration ranges from 5 to 80 microg/mL for vigabatrin and from 5 to 30 microg/mL for gabapentin. The within-day and day-to-day relative standard deviations at three different concentration levels were <10% and <15%, respectively. The limit of quantitation was 2 mug/mL for both compounds. CONCLUSIONS The presented method provides high chromatographic resolution, good sensitivity and unequivocal identification potential and can be used for simultaneous analysis of both antiepileptics.
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Affiliation(s)
- Daniëlle C R Borrey
- Toxicology Unit, Department of Clinical Chemistry, AZ Sint-Jan AV, Ruddershove 10, B-8000 Brugge, Belgium.
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Langlois MR, Oorlynck L, Vandekerckhove F, Criel A, Bernard D, Blaton V. Discrepancy between sperm acrosin activity and sperm morphology: significance for fertilization in vitro. Clin Chim Acta 2004; 351:121-9. [PMID: 15563880 DOI: 10.1016/j.cccn.2004.08.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2004] [Revised: 08/17/2004] [Accepted: 08/17/2004] [Indexed: 10/26/2022]
Abstract
BACKGROUND In routine semen analysis, discrepancies may occur between sperm acrosin activity test results and sperm acrosomal morphology. METHODS Discrepant test results of sperm acrosin activity (spectrophotometric assay) vs. sperm morphology (strict criteria) in the initial diagnostic investigation of 107 infertile couples were evaluated with respect to fertilization rate (% oocytes with 2 pronuclei) further obtained in IVF treatment. RESULTS Acrosin activity positively correlated with sperm morphology (% normal forms) (r=0.537) and fertilization rate (r=0.526). ROC curves for the prediction of > or =50% fertilization rate were comparable for acrosin activity and sperm morphology, with optimal cutoff values at 25 microIU/10(6) sperm and 10%, respectively. In multiple regression analysis, sperm acrosin activity (P=0.002) predicted fertilization rate independently of sperm morphology (P<0.001) and sperm vitality (eosin-nigrosin stain) (P=0.03). Acrosin activities > or =25 microIU/10(6) sperm were observed in 36% of severe teratozoospermic samples (< or =4% normal spermatozoa) associated with low fertilization rate. Twenty percent of the morphologically normal ejaculates showed a low acrosin activity (<25 microIU/10(6) sperm) and low hypoosmotic swelling test (HOST) scores (31.4+/-7.6%) and were associated with low fertilization rate. CONCLUSION The sperm acrosin assay can help to predict sperm fertilizing capacity in IVF independently of sperm morphology.
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Affiliation(s)
- Michel R Langlois
- Andrology Unit, Department of Clinical Chemistry, AZ St-Jan Hospital, Ruddershove 10, B-8000 Bruges, Belgium.
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Langlois MR, De Buyzere ML, Vlierberghe HV, Delanghe JR. Haptoglobin polymorphism and serum ferritin concentration in ageing subjects. Br J Haematol 2004; 124:555-6; author reply 556-7. [PMID: 14984507 DOI: 10.1046/j.1365-2141.2003.04797.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Delanghe JR, Langlois MR, Wuyts B, De Buyzere ML. Performance of urinary flow cytometry in predicting outcome of urine cultures. J Clin Microbiol 2002; 40:2314-5; author reply 2315. [PMID: 12037122 PMCID: PMC130834 DOI: 10.1128/jcm.40.6.2314-2315.2002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Abstract
In humans the iron status is influenced by environmental and genetic factors. Among them, the genetic polymorphism of the hemoglobin (Hb)-binding plasma protein haptoglobin (Hp) has been shown to affect iron turnover. The best known biological function of Hp is capture of free Hb in plasma to allow hepatic recycling of heme iron and to prevent kidney damage during hemolysis. In healthy males, but not in females, the Hp 2-2 phenotype is associated with higher serum iron, higher transferrin saturation, and higher ferritin than Hp 1-1 and 2-1. Moreover, serum ferritin correlates with monocyte L-ferritin content, which is also highest in Hp 2-2 subjects due to endocytosis of multimeric Hb-Hp 2-2 complexes by the recently identified Hb scavenger receptor CD163 in macrophages. This iron delocalization pathway, occurring selectively in Hp 2-2 subjects, has important biological and clinical consequences. The Hp polymorphism is related to the prevalence and the outcome of various pathological conditions with altered iron metabolism such as hemochromatosis, infections, and atherosclerotic vascular disease.
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Affiliation(s)
- Joris R Delanghe
- Department of Clinical Chemistry, Ghent University Hospital, Belgium.
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Delanghe JR, Langlois MR, De Bacquer D, Mak R, Capel P, Van Renterghem L, De Backer G. Discriminative value of serum amyloid A and other acute-phase proteins for coronary heart disease. Atherosclerosis 2002; 160:471-6. [PMID: 11849673 DOI: 10.1016/s0021-9150(01)00607-4] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
We studied the value of serum amyloid A (SAA), a first-class acute-phase protein, as a marker for coronary heart disease (CHD) in a middle-aged male population. In a working population of 16307 men (age, 35-59 years), 446 cases had a history of CHD or prominent Q:QS waves on electrocardiogram. For each case, two matched controls were investigated. SAA, measured by immunonephelometry, was correlated with other acute-phase proteins, cardiovascular risk factors, and infectious serology markers. SAA concentrations were significantly higher in the cases than in controls (P<0.05) and correlated with serum C-reactive protein (CRP) (r=0.61), plasma fibrinogen (r=0.39), serum haptoglobin (r=0.26), and body mass index (r=0.13) (P<0.001). Serum CRP is a better marker for CHD than SAA, which showed discriminative power only in a univariate model comparing highest versus lowest tertile (odds ratio, 1.39; 95% confidence interval, 1.03-1.87). Neither SAA nor other acute-phase proteins correlated with Chlamydia pneumoniae immunoglobulin (Ig)G, Helicobacter pylori IgG and IgA, and cytomegalovirus IgG. In conclusion, although SAA has a discriminative value for CHD, serum CRP is to be preferred as a first-class acute-phase reactant for detection of the disease.
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Affiliation(s)
- Joris R Delanghe
- Department of Clinical Chemistry, Microbiology and Immunology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
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Kasvosve I, Delanghe JR, Gomo ZAR, Gangaidzo IT, Khumalo H, Langlois MR, Moyo VM, Saungweme T, Mvundura E, Boelaert JR, Gordeuk VR. Effect of transferrin polymorphism on the metabolism of vitamin C in Zimbabwean adults. Am J Clin Nutr 2002; 75:321-5. [PMID: 11815325 DOI: 10.1093/ajcn/75.2.321] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Transferrin is the major iron binding protein in human plasma. In black persons, the transferrin CD phenotype has been associated with alterations in certain markers of iron status. OBJECTIVE We studied vitamin C status in a Zimbabwean population according to transferrin phenotype because vitamin C metabolism is influenced by iron-driven oxidative stress. DESIGN The study population consisted of 150 black African adults, 90 of whom were at risk of iron overload on the basis of high dietary iron content in the form of traditional beer. Transferrin phenotypes, indirect measures of iron status, and leukocyte ascorbic acid concentrations were determined. The in vitro rate of L-ascorbic acid depletion in sera from different transferrin phenotypes was investigated. RESULTS The transferrin phenotype frequencies of transferrin CC and CD were 0.893 and 0.107, respectively. The iron status of transferrin CC and CD subjects was similar. After adjustment for traditional beer consumption, baseline leukocyte vitamin C concentrations were significantly higher in 16 transferrin CD subjects ( +/- SE: 2.10 +/- 0.34 and 2.61 +/- 0.28 fmol/leukocyte in men and women, respectively) than in 134 transferrin CC subjects ( +/- SE: 1.65 +/- 0.11 and 1.99 +/- 0.11 fmol/leukocyte in men and women, respectively; P = 0.024). Oral administration of ascorbic acid (2.0 g every 24 h for 48 h) led to slower rises in leukocyte vitamin C concentrations in subjects with the transferrin CD phenotype than in subjects with the transferrin CC phenotype (P = 0.028). After in vitro supplementation of serum with 570 micromol vitamin C/L, the rate of L-ascorbic acid depletion was significantly lower in subjects of a transferrin CD phenotype than in subjects with the transferrin CC phenotype. CONCLUSION Transferrin polymorphism may affect vitamin C status in blacks.
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Affiliation(s)
- Ishmael Kasvosve
- Department of Chemical Pathology, Medical School, University of Zimbabwe, Harare, Zimbabwe
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