Lipemic Interference in Basic Metabolic Panels: Increasing the Lipemia Index Threshold in Order to Decrease the Frequency of Ultracentrifugation

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S15-S15
Author(s):  
Joseph Krenzer ◽  
Alyson Nelson ◽  
Trisha Robakowski ◽  
Kevin Grant ◽  
Kornelia Galior ◽  
...  
Keyword(s):  
Clinical Chemistry ◽  
Laboratory Information System ◽  
Substantial Portion ◽  
Routine Testing ◽  
Sample Testing ◽  
Allowable Error ◽  
Turn Around Time ◽  
Potential Impact ◽  
The Difference ◽  
Abbott Architect

Abstract Introduction Lipemia in clinical chemistry samples is a problematic form of interference. Clearing these samples for routine testing can be time consuming and increases the turn-around time for these specimens. In our laboratory, samples with a lipemia index >50 (L-index) are manually inspected and visibly lipemic specimens are cleared by ultracentrifugation. Objective The objective of this study was to determine at what L-index ultracentrifugation of lipemic BMP specimens is necessary prior to sample testing to ensure accurate results. Methods Specimens consisted of routinely ordered basic metabolic panels (BMP) that met current criteria for ultracentrifugation, which included an L-index >50 as measured on the Abbott Architect c8000 and visual lipemia. Specimens meeting these criteria were ultracentrifuged and retested. The difference of the pre-ultracentrifuged and post-ultracentrifuged result was evaluated and put into a percent to find the ‘percent difference’ and evaluated against the total allowable error (TEa) for each analyte. If the difference observed following ultracentrifugation was less than or equal to 50% of the TEa, clearance of lipemia by ultracentrifugation was considered unnecessary. Values from all BMP component tests were analyzed in order to find an L-index threshold at which samples need to be ultracentrifuged which could be applied to the entire panel. The report of lipemic indices for BMPs for the month of January 2020 were extracted from the laboratory information system to evaluate the potential impact of altering the L-index threshold for ultracentrifugation. Results Based on the acceptance criteria of ≤50% of TEa, L-index thresholds for Na, K, Cl, calcium, glucose, creatinine, CO2 and BUN were <203, <410, <287, <387, <410, <285, < 153 and <285, respectively. All the calculated differences or percent differences for each analyte did not exceed 50% of the TEa for a given analyte when the L-index was 150 or less. Adjusting the L-index to 150 and applying it to the 195 lipemic BMP samples in January 2020, would have potentially decreased the number of samples requiring ultracentrifugation to 24 lipemic BMPs (88% reduction). Conclusion These data suggest that an L-index greater than 150 can be used for all analytes within a BMP as the threshold for requiring ultracentrifugation. The BMP is one of the most frequently ordered tests in our laboratory and consistently accounts for a substantial portion of the lipemic samples that require ultracentrifugation. Increasing the L-index at which samples will be ultracentrifuged from 50 to 150 would potentially result in an 88% reduction in one month of BMP samples requiring ultracentrifugation.

High dose ascorbic acid treatment in COVID-19 patients raised some problems in clinical chemistry testing

2020 ◽  
Vol 45 (5) ◽  
pp. 491-498
Author(s):  
Fatih Yesildal ◽  
Ferruh Kemal Isman
Keyword(s):  
Ascorbic Acid ◽  
Ldl Cholesterol ◽  
Clinical Chemistry ◽  
Assay Method ◽  
High Dose ◽  
Serum Samples ◽  
Choice Of Treatment ◽  
High Concentrations ◽  
Clinical Chemistry Tests ◽  
Abbott Architect

AbstractObjectiveCOVID-19 pandemia still continues to threaten the whole world. High dose ascorbic acid (AA) infusion is a choice of treatment and its efficiency is still being investigated. AA interferes with many clinical chemistry tests. However, data about the interference of high concentrations of AA is not sufficient. In this study, we aimed to investigate the interference of AA at high concentrations on commonly used chemistry assays.Materials and MethodsSerum samples at AA concentrations of 200, 150, 100, 75, 50, 25, 10, 5, 2 and 0 mg/dL were prepared by using the stock solution of 15000 mg/dL AA. Each sample was analyzed by using the most common 30 chemistry tests (Abbott Architect C8000, Illinois, USA) and a POCT glucometer (STANDARD GlucoNavii, Gyeonggi-do, Republic of Korea).ResultsCreatinine, sodium and glucose (POCT) tests were found to be positively interfered by increasing AA concentrations; while direct bilirubin, lipase, UIBC, triglyceride, total cholesterol, HDL/LDL cholesterol tests were negatively interfered. Absolute interference (%) increased as the AA concentration increased.ConclusionThis is the largest and first study to investigate the interference of high dose AA, which is used in severe COVID-19 patients nowadays. Manufacturers and clinicians should be aware of the possibility of aberrant results due to high dose AA infusion. Clinicians should not forget to consult a laboratory specialist, since he is the only person to monitor the reactions in all assays, and know the technical subjects like interferences, assay method specifications. This issue is very important for correct decision-making and interpretation of the data-mining studies accurately and efficiently.

scholarly journals A Review of the Challenge in Measuring Hemoglobin A1c

2009 ◽  
Vol 3 (3) ◽  
pp. 439-445 ◽  
Author(s):  
Cas Weykamp ◽  
W. Garry John ◽  
Andrea Mosca
Keyword(s):  
High Performance ◽  
Hemoglobin A1c ◽  
Consensus Statement ◽  
Clinical Chemistry ◽  
Metrological Traceability ◽  
International Diabetes Federation ◽  
The United States ◽  
Medical Laboratory ◽  
Patient Groups ◽  
The Difference

The attraction of the simple biochemical concept combined with a clinical requirement for a long-term marker of glycolic control in diabetes has made hemoglobin A1c (HbA1c) one of the most important assays undertaken in the medical laboratory. The diversity in the biochemistry of glycation, clinical requirements, and management demands has resulted in a broad range of methods being developed since HbA1c was described in the late 1960s. A range of analytic principles are used for the measurement of HbA1c. The charge difference between hemoglobin A0 and HbA1c has been widely utilized to separate these two fractions, most notably found these days in ion-exchange high-performance liquid chromatography systems; the difference in molecular structure (affinity chromatography and immunochemical methods) are becoming widely available. Different results found in different laboratories using a variety of HbA1c analyses resulted in the need for standardization, most notably in the United States, Japan, and Sweden. Designated comparison methods are now located in these three countries, but as they are arbitrarily chosen and have differences in specificity, results of these methods and the reference values and action limits of the methods differ and only harmonized HbA1c in specific geographic areas. A reference measurement system within the concept of metrological traceability is now globally accepted as the only valid analytic anchor. However, there is still discussion over the units to be reported. The consensus statement of the International Federation of Clinical Chemistry (IFCC), the American Diabetes Association, the International Diabetes Federation, and the European Association for the Study of Diabetes suggests reporting HbA1c in IFCC units (mmol/mol), National Glycohemoglobin Standardization Program units (%), and estimated average glucose (either in mg/dl or mmol/liter). The implementation of this consensus statement raised new questions, to be answered in a concerted action of clinicians, biochemists, external quality assessment organizers, patient groups, and manufacturers.

Performance Characteristics of Several Rules for Self-interpretation of Proficiency Testing Data

2005 ◽  
Vol 129 (8) ◽  
pp. 997-1003 ◽  
Author(s):  
R. Neill Carey ◽  
George S. Cembrowski ◽  
Carl C. Garber ◽  
Zohreh Zaki
Keyword(s):  
Proficiency Testing ◽  
Error Detection ◽  
Clinical Laboratory ◽  
Peer Group ◽  
Simulation Techniques ◽  
Allowable Error ◽  
Detection Capabilities ◽  
The Mean ◽  
The Difference

Abstract Context.—Proficiency testing (PT) participants can interpret their results to detect errors even when their performance is acceptable according to the limits set by the PT provider. Objective.—To determine which rules for interpreting PT data provide optimal performance for PT with 5 samples per event. Design.—We used Monte Carlo computer simulation techniques to study the performance of several rules, relating their error detection capabilities to (1) the analytic quality of the method, (2) the probability of failing PT, and (3) the ratio of the peer group SD to the mean intralaboratory SD. Analytic quality is indicated by the ratio of the PT allowable error to the intralaboratory SD. Failure of PT was defined (Clinical Laboratory Improvement Amendments of 1988) as an event when 2 or more results out of 5 exceeded acceptable limits. We investigated rules with limits based on the SD index, the mean SD index, and percentages of allowable error. Results.—No single rule performs optimally across the range of method quality. Conclusions.—We recommend further investigation when PT data cause rejection by any of the following 3 rules: any result exceeds 75% of allowable error, the difference between any 2 results exceeds 4 times the peer group SD, or the mean SD index of all 5 results exceeds 1.5. As method quality increases from marginal to high, false rejections range from 16% to nearly zero, and the probability of detecting a shift equal to 2 times the intralaboratory SD ranges from 94% to 69%.

A Driver Gas Contamination Probe for Shock Tunnels

1968 ◽  
Vol 19 (2) ◽  
pp. 183-191 ◽  
Author(s):  
R. J. Stalker
Keyword(s):  
Speed Of Sound ◽  
Test Section ◽  
Sampling Device ◽  
Routine Testing ◽  
Test Gas ◽  
Driver Gas ◽  
Gas Contamination ◽  
Shock Tunnels ◽  
The Difference ◽  
Driver Gas Contamination

SummaryA probe is described which will detect contamination, by driver gas, of the test section flow in a shock tunnel. It is a continuously sampling device, which responds to the difference between the ambient speed of sound in the driver gas and the test gas. The probe is compact, easy to construct, and can be used for detection of driver gas in routine testing. The theory of the probe is explained, and experiments are reported which confirm its effectiveness.

Permeability of the Isolated Atlantic Salmon (Salmo salar) Chorion to Ions as Estimated by Diffusion Potentials

1987 ◽  
Vol 44 (9) ◽  
pp. 1635-1639 ◽  
Author(s):  
R. H. Peterson ◽  
D. J. Martin-Robichaud
Keyword(s):  
Atlantic Salmon ◽  
Salmo Salar ◽  
Ion Pairs ◽  
Atlantic Salmon Salmo Salar ◽  
Environmental Perturbations ◽  
Hen’S Egg ◽  
Anions And Cations ◽  
Potential Impact ◽  
Diffusion Potentials ◽  
The Difference

The properties of the teleost chorion and perivitelline fluid may allow the embryo to develop in an ionic medium which differs from ambient. A knowledge of these properties facilitates assessment of the potential impact of environmental perturbations (e.g. low-pH episodes) on the developing embryo. Diffusion potentials are created when differing concentrations of a salt solution are imposed upon the opposite sides of isolated Atlantic salmon (Salmo salar) chorions. These diffusion potentials are related to the mobilities of the cations and anions. The magnitude of the diffusion potentials were measured with NaCl, CaC2, H2SO4, and HCl solutions. The results indicate that both anions and cations permeate the chorion. Chloride appears to have greater mobility through the chorion than does sodium, although the difference in mobility of such ion pairs moving through the chorion is not as great as the difference in their mobilities in aqueous solution. Diffusion potentials obtained with CaCl2 solutions, on the other hand, indicate reduced calcium mobility through the chorion relative to chloride. The decreased mobility of Ca2+ is probably due to adsorption to fixed negative charges on the chorion. The properties of the perivitelline potential of the intact egg could be simulated qualitatively by placing a solution of negatively charged colloid (hen's egg albumin) inside the isolated chorion.

Population-based pediatric reference intervals for general clinical chemistry analytes on the Abbott Architect ci8200 instrument

2012 ◽  
Vol 50 (5) ◽  
Author(s):  
Peter Ridefelt ◽  
Mattias Aldrimer ◽  
Per-Olof Rödöö ◽  
Frank Niklasson ◽  
Leif Jansson ◽  
...  
Keyword(s):  
Clinical Chemistry ◽  
Population Based ◽  
Reference Intervals ◽  
Healthy Children ◽  
Age And Gender ◽  
Sodium Potassium ◽  
Daycare Centers ◽  
And Gender ◽  
Gender Specific ◽  
Abbott Architect

AbstractReference intervals are crucial decision-making tools aiding clinicians in differentiating between healthy and diseased populations. However, for children such values often are lacking or incomplete.Blood samples were obtained from 692 healthy children, aged 6 months to 18 years, recruited in daycare centers and schools. Twelve common general clinical chemistry analytes were measured on the Abbott Architect ci8200 platform; sodium, potassium, chloride, calcium, albumin-adjusted calcium, phosphate, magnesium, creatinine (Jaffe and enzymatic), cystatin C, urea and uric acid.Age- and gender specific pediatric reference intervals were defined by calculating the 2.5th and 97.5th percentiles.The data generated is primarily applicable to a Caucasian population when using the Abbott Architect platform, but could be used by any laboratory if validated for the local patient population.

scholarly journals The potential impact of routine testing of individuals with HIV indicator diseases in order to prevent late HIV diagnosis

2013 ◽  
Vol 13 (1) ◽  
Author(s):  
Paola Scognamiglio ◽  
◽  
Giacomina Chiaradia ◽  
Gabriella De Carli ◽  
Massimo Giuliani ◽  
...  
Keyword(s):  
Hiv Diagnosis ◽  
Routine Testing ◽  
Late Hiv Diagnosis ◽  
Potential Impact

scholarly journals Applicability of Commercial Clinical Chemistry Test Kits For Horse Serum

2020 ◽  
Author(s):  
Yoseph Cherinet Megerssa ◽  
Fikru Regassa Gari ◽  
Fanos Tadesse Woldemariyam
Keyword(s):  
Total Cholesterol ◽  
Total Protein ◽  
Healthy Adult ◽  
Clinical Chemistry ◽  
Horse Serum ◽  
Test Method ◽  
Analytical Validation ◽  
Precise Data ◽  
Allowable Error ◽  
Apparently Healthy

Abstract Background: Validation of a test method to determine its fitness for a particular use is critical for confirming that the test can generate accurate and precise data. Although several commercial biochemical test kits exist and validated for humans there is no specific and validated commercial clinical chemistry test kits designed for horse Objective: The aim of this study was to validate commercial clinical chemistry test kits designed for human serum for use in horses to accurately measure total cholesterol urea and total protein in serumMethods: This study used 25 apparently healthy adult horses. Blood samples were collected and pooled serum was prepared. Analytical validation comprises replication and recovery experiments. Total observable error (TEo%), Sigma metrics and quality goal index (QGI) was used to support the analytical validation studies.Result: Intra- and inter-assay variability was 2.05% and 2.08%, 2.26% and 1.89%, 2.4% and 1.63%, for total cholesterol urea and total protein for respectively; recovery was 99.46%, 97.32% and 100.1% for total cholesterol urea and total protein for respectively. TEo% for the specified analytes were within the allowable error indicated ASVCP guidelines. All the three anaytes satisfied the recommended requirement (>3 sigma values). The QGI for urea, as it had below 6σ was 0.95 indicating imprecision and inaccuracy.Conclusion: The results of the research endorse the suitability of the studied commercial clinical chemistry test kits and illustrated the acceptance criteria for serum collected from horse.

scholarly journals Association between Fetal Gender and the Labor Curve at Term Pregnancy

2017 ◽  
Vol 10 (1) ◽  
pp. 1-4
Author(s):  
Rubina Tamrakar Gurung ◽  
P Sharma
Keyword(s):  
Labor Process ◽  
Term Pregnancy ◽  
Male Fetus ◽  
Female Fetus ◽  
Medical College ◽  
Fetal Gender ◽  
Potential Impact ◽  
The Difference ◽  
Term Labor ◽  
First Stage Of Labor

Introduction: Animal and pathologic models have provided evidence for a fetal influence on the labor process; however, the potential impact of fetal gender on the labor curve has gone largely unstudied.Objectives: To determine the association between fetal gender and first stage labor curve at term.Methods: This was a retrospective study. There were 330 patients en­rolled in this study, who gave birth from January 2011 to December 2012 by reviewing the charts. A total of 500 charts were reviewed.Results: There were three hundred thirty (330) patients, out of which a total of 179 (54.2%) patients gave birth to males and 151 (45.8%) gave birth to females. Women who had a male fetus had a longer first stage of labor than women who carried a female fetus. The difference in the birth weight of the infants is statistically significant, male newborns were heavier at birth than female newborns.Conclusions: Term labor in the first stage was found to be slower in women who carried a male fetus compared with those with female fe­tus which is not statistically significant.Journal of Gandaki Medical College  Vol. 10, No. 1, 2017, page: 1-4

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