Hemolysis detection for ethanol measurement in whole blood samples before centrifugation: HemCheck device evaluation

Introduction As previously reported, hemolysis interference affects ethanol measurements as well. Ethanol is the most commonly abused substance worldwide. When sample re-collection is ordered to eliminate hemolysis effects for ethanol testing, this can have unfavorable consequences for these patients. Rapid detection of hemolyzed specimens would alleviate some issues associated with forensic samples. HemCheck™ is a novel POCT device that qualitatively detects free-hemoglobin levels on the specimen shortly after drawing the sample. Materials and methods The system consists of two components. One is a cartridge with a needle that is used to transfer a small volume of whole blood from a vacuum tube to vertical and lateral flow filtration. The second component is a reader. Consumable cartridges are inserted into the reader without the syringe or blood collection tube being removed. A red indicator led illuminates, indicating that the sample has been hemolyzed. We calculated C5-C95 interval and C50 to determine imprecision. We used the Roche Cobas clinical chemistry analyzer as a comparator, and we used leftover samples for imprecision studies. Studies on hemoglobin interference were done using plasma pool samples that had been spiked. Results: Our C50 concentration were 45 mg/dL, the C5-C95 30 mg/dL and 60 mg/dL, respectively. Two methods reveal an overall agreement of 89,2%. Conclusions Even low quantities of free hemoglobin caused a bias in ethanol values, according to the interference experiment. When it came to forensic samples, this bias was crucial. We demonstrated that the HemCheck can significantly improve the preanalytical quality, particularly in forensic specimens.

Evaluation of the Succeeder SF-8200 Fully Automated Coagulation Analyzer

BACKGROUND

The SF-8200 is a new coagulation analyzer developed by Beijing Succeeder Technology Inc., China. The SF-8200 is able to perform clotting, chromogenic, and immunoturbidimetric tests. System capability is a throughput of up to 360 tests per hour, 60 sample tubes can be loaded at any time, and its reaction cuvette capacity is 1,000. The analyzer also has an optional cap piercing module to reduce manual sampling time. We aimed to perform an analytical performance comparison study between Succeeder SF-8200 and Stago Compact Max3 because fully automated coagulation analyzers have become one of the most essential components of clinical laboratories.

METHODS

Routine coagulation tests were assessed, which are the most ordered in laboratories such as PT, aPTT, and fibrinogen. Stago Compact Max-3 was accepted as the reference instrument in the comparison study. The assay precisions were assessed using fresh and pooled plasma samples or consumer internal quality controls. Hemolysis, lipemia, and icterus interferences were also verified.

RESULTS

The coefficients of variation assessed in the intra and inter-assay precision analyses were below 5% representatively for assessed parameters. The inter-analyser comparison demonstrated good results. Results obtained by the SF-8200 showed high comparability predominantly to used reference analyzers, with correlation coefficients ranging from 0.953 to 0.976. In our routine laboratory setting, SF-8200 reached a sample throughput rate of 360 tests per hour. No considerable influence on tests was found for elevated levels of free hemoglobin, bilirubin, or triglycerides.

CONCLUSIONS

In conclusion, the SF-8200 was an accurate, precise, and reliable coagulation analyzer in routine testing. According to our study, the results demonstrated excellent technical and analytical performance.

The use of preanalytical quality indicators: a Turkish preliminary survey study

OBJECTIVES

The utilization of reliable quality indicators (QIs) proven to be suitable for monitoring and improvement tools is one of the best choices to minimize of the risk of errors in all laboratory processes called as total testing process (TTP). In 2008, a Working Group "Laboratory Errors and Patient Safety" (WG-LEPS) established by International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) developed the Model of Quality Indicators (MQI) complying with requirements of the ISO 15189:2012 standard for laboratory accreditation. They have also been dealing with harmonizing the QIs in most laboratories worldwide since then. The present study was set out to investigate the frequency of using IFCC WG-LEPS' pre-QIs by Turkish laboratories and to assess the conformity of them, by taking into account Turkey's conditions.

METHODS

A survey consisting nine questions was applied in 81 laboratories using SurveyMonkey.

RESULTS

According to the survey results, most of the laboratories reported they have used pre-QIs in the quality standards of health prepared by Turkish Ministry of Health (MOH). A part of IFCC WG-LEPS' pre-QIs were being utilized by more than 80% of the laboratories, the rest of which only used by 10% of laboratories.

CONCLUSIONS

The majority of the medical laboratories have been using the pre-QIs included in the guidelines of Quality Standards prepared by the MOH. The pre-QIs are partially compatible with IFCC WG-LEPS' pre-QIs. The definitions of IFCC WG-LEPS' pre-QIs may also be revised to make them more clear and understandable by IFCC WG-LEPS. The insufficiency of Health Information Management Systems (HIMS) limits the use of pre-QIs proposed by IFCC WG-LEPS. Finally, the education of relevant personnel about the use of HIMS and pre-QIs is very crucial to harmonize and to extend the use of IFCC WG-LEPS' pre-QIs in Turkish medical biochemistry laboratories.

SERUM VITAMIN D LEVELS IN DIFFERENT MORPHOLOGIC FORMS OF AGE RELATED CATARACT

Purpose

Vitamin D insufficiency and age related cataract (ARC) are public health problems. We evaluated serum vitamin D levels in ARC patients.

Method

A prospective hospital-based cross-sectional study was designed to measure the vitamin D status of patients with ARC. Patients have grouped either presence of any type of posterior subcapsular cataract (PSC) (group 1) or ARC without the PSC component (Group 2). After full ophthalmologic consideration, patients over 40 years of age with no history of ocular trauma, multivitamin supplement ingestion, chronic renal failure, thyroidectomy, parathyroidectomy, skin cancer, and cigarette smoking were included in the study.

Results

Totally, 79 subjects of which 26 (32.9%) subjects in group 1 and 53 (67.1%) subjects in group 2 were included in the study. Group 1 had mean vitamin D levels of 17.31±13.30 ng/mL. Vitamin D levels in Group 2 were 13.34±7.87 ng/mL. Group 1 did not show vitamin D insufficiency (P = 0.31; one-sample t-test). However, Group 2 showed a statistically significantly lower vitamin D level compared to the insufficiency level of 20ng/mL (P= 0.00; one-sample t-test).

Conclusion

Vitamin D may have an important function in lens metabolism. Vitamin D deficiency and cataract development need further extensive researches.

Serum osteoprotegerin levels in school-aged children with asthma

BACKGROUND

Various inflammatory biomarkers have been used in asthma cases for evaluating inflammation, however it has been determined that the majority of these biomarkers are insufficient for putting forth the course and severity of the disease. Osteoprotegerin is a glycoprotein mediator in the lung and macrophages. As far as we know, there are no studies about the role played by osteoprotegerin in child patients with asthma.

OBJECTIVE

It was planned to examine the relationship between osteoprotegerin levels in childhood asthma and respiratory functions and airway inflammation and to assess its use as a biomarker.

METHODS

The study included patients aged 6-16 years who were diagnosed with asthma at the pediatric allergy outpatient clinic of Bagcilar Training and Research Hospital in Turkey. The correlation analyses for the osteoprotegerin levels of asthma patients and their respiratory functions were examined.

RESULTS

The age average of asthma cases was 10.61±3.04 years and 51.2 % were female. No statistically significant difference was observed between the osteoprotegerin levels of the groups (p>0.05). A negative and statistically significant correlation was observed between the FEV1 and FVC values and osteoprotegerin levels (p=0.015, p=0.003).

CONCLUSIONS

This was the first study to examine the relationship between osteoprotegerin levels and airway inflammation in children with asthma. We believe that there is a need for wider scale studies in which clinical symptoms and more parameters are evaluated for defining the role played by osteoprotegerin level in children with asthma and for determining its usability as a biomarker.

Serum omentin-1 levels in obese children

Background Obesity is an important cause of morbidity, and it has an increasing frequency in childhood. Studies have reported that 33% of adults and 20-27% of children and adolescents are obese. Recently, it has been shown that the prevalence of obesity in the childhood group is higher than the past years. Omentin-1 is an adipokine which is synthesized from the visceral fat tissue but not synthesized in the subcutaneous fat tissue. Omentin-1 has been shown to increase insulin-mediated glucose uptake, especially in the adipose tissue. Studies have shown that plasma omentin-1 levels, which play an important role in the pathogenesis of insulin resistance, are significantly lowered in obese, polycystic ovary syndrome (PCOS) and diabetic patients. The aim of this study was to investigate the relationship between obesity and omentin-1 levels in children. Methods The study included obese children with a body mass index (BMI) greater than the 95th percentile and healthy children with a BMI lower than the 85th percentile. Obese and healthy individuals had similar age and sex distributions. Glucose, insulin, lipid profiles, thyroid panels and metabolic markers were evaluated. Results The levels of omentin-1 in obese children were significantly lower than in the control group (p<0.05). Results of Spearman's correlation analysis for all participants showed that omentin-1 levels were negatively related with triglycerides, total cholesterol, serum free thyroxine (FT4), insulin, homeostatic model assessment of insulin resistance (HOMA-IR), body weight, waist circumference (WC) and BMI percentile values. Conclusions Our findings indicate that serum omentin-1 levels are lower in obese children than in non-obese individuals. Omentin-1 can be used as a metabolic biomarker in children and adolescents.

Is Chronic Curcumin Supplementation Neuroprotective Against Ischemia for Antioxidant Activity, Neurological Deficit, or Neuronal Apoptosis in an Experimental Stroke Model?

AIM

To investigate the neuroprotective effect of chronic curcumin supplementation on the rat forebrain prior to ischemia and reperfusion.

MATERIAL AND METHODS

Forebrain ischemia was induced by bilateral common carotid artery occlusion for 1/2 hour, followed by reperfusion for 72 hours. Older rats were divided into five groups: Group I received 300 mg/kg oral curcumin for 21 days before ischemia and 300 mg/kg intraperitoneal curcumin after ischemia; Group II received 300 mg/kg intraperitoneal curcumin after ischemia; Group III received 300 mg/kg oral curcumin for 21 days before ischemia; Group IV had only ischemia; Group V was the sham-operated group. The forebrain was rapidly dissected for biochemical parameter assessment and histopathological examination.

RESULTS

In forebrain tissue, enzyme activities of superoxide dismutase, glutathione peroxidase, and catalase were significantly higher in Group I than Groups II or III (p < 0.05) while xanthine dehydrogenase and malondialdehyde enzyme activities and concentrations of interleukin-6 and TNF-alpha were significantly lower in Group I when compared to Groups II and III (p < 0.05). A significant reduction in neurological score was observed after 24 and 72 hours in the curcumin-treated groups compared with the ischemic group. We also found a marked reduction in apoptotic index after 72 hours in the groups receiving curcumin. Significantly more TUNEL-positive cells were observed in the ischemic group compared to those treated with curcumin.

CONCLUSION

We demonstrated the neuroprotective effect of chronic curcumin supplement on biochemical parameters, neurological scores and apoptosis following ischemia and reperfusion injury in rats.

Effects of statin treatment with atorvastatin on urolithiasis-associated urinary metabolic risk factors: an experimental study

PURPOSE

To investigate whether atorvastatin has favorable effects on urinary metabolic risk factors associated with urolithiasis.

METHODS

Sixteen male Sprague-Dawley rats were randomly divided into two groups, and baseline spot and 24-h urine samples were collected. Distilled water and atorvastatin were administered to rats during 4 weeks in the control and atorvastatin groups, respectively. At the end of the experimental procedure, spot and 24-h urine samples were collected again. Citrate, oxalate, cystine, uric acid, calcium and magnesium levels were determined in 24-h urine samples. Citrate/creatinine, oxalate/creatinine, uric acid/creatinine, calcium/creatinine and magnesium/creatinine ratios were also calculated in spot urine samples. Comparison of the baseline and post-experimental levels of these parameters was made in each group.

RESULTS

The majority of the parameters were similar before and after the experimental procedure in each group. In the atorvastatin group, uric acid and calcium levels were affected. Administration of atorvastatin was significantly decreased the levels of uric acid, whereas increased the levels of calcium (P = 0.025 and P = 0.017, respectively).

CONCLUSIONS

Our study revealed that atorvastatin has decreasing effect on U_Ua levels, whereas increasing effect on U_Ca levels. We think it cannot certainly be deduced that atorvastatin could be beneficial on overall urinary metabolic risk factors. Contrarily, atorvastatin may lead to an increased risk of calcium stones, but when considering its U_Ua decreasing effect, it may help in reducing the uric acid stone recurrence.

Serum antioxidant enzyme levels are decreased in patients with urinary calcium oxalate stones

PURPOSE

To compare the serum antioxidant enzyme levels between patients with urinary stone disease and healthy volunteers to determine the effect of cellular oxidative stress on urinary calcium oxalate stones formation.Materials &amp; Methods: A total of 51 patients with proven urinary calcium oxalate stones (female 35.3%, mean age: 49.3 years) and 37 healthy subjects (female 45.9%, mean age: 44.1 years) were included. The serum levels of antioxidant catalase, glutathione peroxidase, superoxide dismutase and lipid peroxidation were measured in serum samples taken from the peripheral venous circulation.

RESULTS

Mean serum catalase level of patient group was insignificantly higher than healthy subjects (7.54 mmol- H2O2/mg/sec versus 6.16 mmolH2O2/mg/sec, respectively; P = .06) whereas mean superoxide dismutase level (1.56 U/ml versus 3.86 U/ml, P = .047), glutathione peroxidase level (6.70 U/ml versus 8.19 U/ml, P = .022) and lipid peroxidation level (2.35 nmol/ml versus 3.31 nmol/ml, P = .034) of patient group were significantly lower than healthy subjects. Patients with family history of urinary stone disease had significantly lower mean serumlevels of catalase (P = .037), superoxide dismutase (P = .047) and glutathione peroxidase (P = .01), compared with patients without family history.

CONCLUSION

The findings of this study provide evidence regarding the role of oxidative stress in the development of urinary calcium oxalate stones. Future clinical trials are necessary to elucidate the actual mechanisms of the calcium oxalate stone formation in the environment with increased oxidative stress.

Association of Osteoprotegerin with Obesity, Insulin Resistance and Non-Alcoholic Fatty Liver Disease in Children

BACKGROUND

Osteoprotegerin (OPG) is a member of the tumor necrosis factor superfamily. Reduced OPG levels are related to obesity, insulin resistance, and non-alcoholic fatty liver disease (NAFLD).

OBJECTIVES

The aim of this study was to evaluate the relationship between OPG levels, obesity, insulin resistance, and NAFLD in pediatric patients.

METHODS

This was a prospective, cross-sectional, controlled study that was conducted in the department of pediatrics at Bagcilar training and research hospital in Istanbul, Turkey, between April and August 2015. The study was performed on 107 children with obesity and 37 controls aged 5 - 17 years. In the obese subset, 62 patients had NAFLD. Homeostatic model assessment-insulin resistance (HOMA-IR) was used to calculate insulin resistance. Insulin resistance was defined as a HOMA-IR value greater than 2.5. Plasma OPG levels were measured using enzyme-linked immunosorbent assays. NAFLD was diagnosed by hepatic ultrasound.

RESULTS

The mean age was 11.25 ± 3.38 years in the patient group and 10.41 ± 3.15 years in the control group. The OPG level in the obese group with the mean of 55.20 ± 24.55 pg/mL (median = 48.81 pg/mL) was significantly lower than that in the control group with the mean of 70.78 ± 33.41 pg/mL (median = 64.57 pg/mL) (P = 0.0001). The optimal cut-off point (sensitivity, specificity) of the OPG level for the diagnosis of obesity was ≤ 46, 19 pg/mL. According to logistic regression analysis, fasting insulin (P = 0.036) and OPG (P = 0.01) levels were most affected by obesity. In the obese patients, who had HOMA-IR < 2.5, the mean level of OPG was 58.91 ± 6.88729 pg/mL (median = 49.55). In the obese patients, who had HOMA-IR ≥ 2.5, the mean level of OPG was 54.19 ± 22.21 pg/mL (median = 48.47). No significant correlations were found between OPG and HOMA-IR (P = 0.791). No statistically significant difference was observed in the mean OPG between patients with hepatosteatosis (mean = 54.55 ± 25.01 pg/mL) (median = 49.46) and those without the disease (56.30 ± 24.02 pg/mL) (mean = 48.34) (P = 0.089).

CONCLUSIONS

We confirmed that serum OPG concentrations reduce in obese children. However, no correlation was identified between OPG and insulin resistance. OPG levels are not meaningful in the diagnosis of NAFLD in children with obesity.