scholarly journals Haematological and biochemical reference intervals in healthy racing and retired Italian Greyhounds

2020 ◽  
Vol 68 (1) ◽  
pp. 71-78
Author(s):  
Paola Scarpa ◽  
Beatrice Ruggerone ◽  
Sara Gironi ◽  
Tiziana Vitiello ◽  
Saverio Paltrinieri
Keyword(s):  
Clinical Decision Making ◽  
Haemoglobin Concentration ◽  
Clinical Pathology ◽  
Clinical Decision ◽  
Reference Intervals ◽  
Specific Reference ◽  
Canine Population ◽  
Mean Corpuscular Haemoglobin ◽  
American Society ◽  
Advia 120

AbstractIn view of the enormous variability of dog breeds, breed-specific reference intervals (RIs) are recommended for use in veterinary clinical decision-making. The aim of this study was to determine whether RIs of the general canine population may be applied to the Italian Greyhound (Piccoli Levrieri Italiani or PLI), and to generate breed-specific RIs, where appropriate. Sixty-three privately owned clinically healthy fasted dogs were examined. Routine haematology and biochemistry were performed on 58 enrolled patients using the ADVIA 120 haematology analyzer and the Cobas Mira system, respectively. Changes in haematological and biochemical parameters depending on sex, age and attitude (resting vs. running dogs) were investigated. The results of PLI were compared with the RIs of the general canine population. In those cases in which these RIs were not validated, new RIs were generated according to the guidelines of the American Society of Veterinary Clinical Pathology. Pre-existing RIs were considered valid based on the recommendations by the Clinical & Laboratory Standards Institute (CLSI). RIs were higher for mean corpuscular haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), cell haemoglobin concentration mean (CHCM) and lower for large unstained cells (LUC). A wider discrepancy between pre-existing and newly established RIs was found for some ADVIA parameters regarding red blood cell (RBC) or reticulocyte morphology. For total protein and cholesterol the new RIs were wider than the pre-existing ones, while albumin, calcium and iron were higher. This study suggests that most of the RIs published in veterinary textbooks cannot be validated for PLIs.

scholarly journals HER2 Testing and Clinical Decision Making in Gastroesophageal Adenocarcinoma: Guideline From the College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology

2016 ◽  
Vol 140 (12) ◽  
pp. 1345-1363 ◽  
Author(s):  
Angela N. Bartley ◽  
Mary Kay Washington ◽  
Christina B. Ventura ◽  
Nofisat Ismaila ◽  
Carol Colasacco ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Pathology ◽  
Clinical Decision ◽  
Evidence Based ◽  
Her2 Testing ◽  
Gastroesophageal Adenocarcinoma ◽  
American Society ◽  
Evidence Based Guideline ◽  
Selection Of

Context.— ERBB2 (erb-b2 receptor tyrosine kinase 2 or HER2) is currently the only biomarker established for selection of a specific therapy for patients with advanced gastroesophageal adenocarcinoma (GEA). However, there are no comprehensive guidelines for the assessment of HER2 in patients with GEA. Objectives.— To establish an evidence-based guideline for HER2 testing in patients with GEA, to formalize the algorithms for methods to improve the accuracy of HER2 testing while addressing which patients and tumor specimens are appropriate, and to provide guidance on clinical decision making. Design.— The College of American Pathologists, American Society for Clinical Pathology, and American Society of Clinical Oncology convened an expert panel to conduct a systematic review of the literature to develop an evidence-based guideline with recommendations for optimal HER2 testing in patients with GEA. Results.— The panel is proposing 11 recommendations with strong agreement from the open-comment participants. Recommendations.— The panel recommends that tumor specimen(s) from all patients with advanced GEA, who are candidates for HER2-targeted therapy, should be assessed for HER2 status before the initiation of HER2-targeted therapy. Clinicians should offer combination chemotherapy and a HER2-targeted agent as initial therapy for all patients with HER2-positive advanced GEA. For pathologists, guidance is provided for morphologic selection of neoplastic tissue, testing algorithms, scoring methods, interpretation and reporting of results, and laboratory quality assurance. Conclusions.— This guideline provides specific recommendations for assessment of HER2 in patients with advanced GEA while addressing pertinent technical issues and clinical implications of the results.

scholarly journals HER2 Testing and Clinical Decision Making in Gastroesophageal Adenocarcinoma: Guideline From the College of American Pathologists, American Society for Clinical Pathology, and the American Society of Clinical Oncology

2017 ◽  
Vol 35 (4) ◽  
pp. 446-464 ◽  
Author(s):  
Angela N. Bartley ◽  
Mary Kay Washington ◽  
Carol Colasacco ◽  
Christina B. Ventura ◽  
Nofisat Ismaila ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Clinical Pathology ◽  
Clinical Decision ◽  
Evidence Based ◽  
Her2 Testing ◽  
Gastroesophageal Adenocarcinoma ◽  
American Society ◽  
Evidence Based Guideline ◽  
Selection Of

Context ERBB2 (erb-b2 receptor tyrosine kinase 2 or HER2) is currently the only biomarker established for selection of a specific therapy for patients with advanced gastroesophageal adenocarcinoma (GEA). However, there are no comprehensive guidelines for the assessment of HER2 in patients with GEA. Objectives To establish an evidence-based guideline for HER2 testing in patients with GEA, formalize the algorithms for methods to improve the accuracy of HER2 testing while addressing which patients and tumor specimens are appropriate, and to provide guidance on clinical decision making. Design The College of American Pathologists (CAP), American Society for Clinical Pathology (ASCP), and the American Society of Clinical Oncology (ASCO) convened an Expert Panel to conduct a systematic review of the literature to develop an evidence-based guideline with recommendations for optimal HER2 testing in patients with GEA. Results The Panel is proposing 11 recommendations with strong agreement from the open comment participants. Recommendations The Panel recommends that tumor specimen(s) from all patients with advanced GEA, who are candidates for HER2-targeted therapy, should be assessed for HER2 status before the initiation of HER2-targeted therapy. Clinicians should offer combination chemotherapy and an HER2-targeted agent as initial therapy for all patients with HER2-positive advanced GEA. For pathologists, guidance is provided for morphologic selection of neoplastic tissue, testing algorithms, scoring methods, interpretation and reporting of results, and laboratory quality assurance. Conclusion This guideline provides specific recommendations for assessment of HER2 in patients with advanced GEA while addressing pertinent technical issues and clinical implications of the results.

scholarly journals HER2 testing of gastro-oesophageal adenocarcinoma: a commentary and guidance document from the Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee

2018 ◽  
Vol 71 (5) ◽  
pp. 388-394 ◽  
Author(s):  
Newton A C S Wong ◽  
Fernanda Amary ◽  
Rachel Butler ◽  
Richard Byers ◽  
David Gonzalez ◽  
...  
Keyword(s):  
Molecular Pathology ◽  
Clinical Decision Making ◽  
Growth Factor Receptor ◽  
Clinical Pathology ◽  
Clinical Decision ◽  
Oesophageal Adenocarcinoma ◽  
Guidance Document ◽  
Her2 Testing ◽  
American Society ◽  
The Uk

The use of biologics targeted to the human epidermal growth factor receptor 2 (HER2) protein is the latest addition to the armamentarium used to fight advanced gastric or gastro-oesophageal junction adenocarcinoma. The decision to treat with the biologic trastuzumab is completely dependent on HER2 testing of tumour tissue. In 2017, the College of American Pathologists, American Society for Clinical Pathology and the American Society of Clinical Oncology jointly published guidelines for HER2 testing and clinical decision making in gastro-oesophageal adenocarcinoma. The Association of Clinical Pathologists Molecular Pathology and Diagnostics Committee has issued the following document as a commentary of these guidelines and, in parallel, to provide guidance on HER2 testing in National Health Service pathology departments within the UK. This guidance covers issues related to case selection, preanalytical aspects, analysis and interpretation of such HER2 testing.

Pediatric reference interval verification for endocrine and fertility hormone assays on the Abbott Alinity system

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Mary Kathryn Bohn ◽  
Siobhan Wilson ◽  
Alexandra Hall ◽  
Khosrow Adeli
Keyword(s):  
Clinical Decision Making ◽  
De Novo ◽  
Reference Interval ◽  
Clinical Decision ◽  
Reference Intervals ◽  
Healthy Children ◽  
Confidence Limits ◽  
Test Results ◽  
Serum Samples ◽  
Abbott Architect

Abstract Objectives The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) has developed an extensive database of reference intervals (RIs) for several biomarkers on various analytical systems. In this study, pediatric RIs were verified for key immunoassays on the Abbott Alinity system based on the analysis of healthy children samples and comparison to comprehensive RIs previously established for Abbott ARCHITECT assays. Methods Analytical performance of Alinity immunoassays was first assessed. Subsequently, 100 serum samples from healthy children recruited with informed consent were analyzed for 16 Alinity immunoassays. The percentage of test results falling within published CALIPER ARCHITECT reference and confidence limits was determined. If ≥ 90% of test results fell within the confidence limits, they were considered verified based on CLSI guidelines. If <90% of test results fell within the confidence limits, additional samples were analyzed and new Alinity RIs were established. Results Of the 16 immunoassays assessed, 13 met the criteria for verification with test results from ≥ 90% of healthy serum samples falling within the published ARCHITECT confidence limits. New CALIPER RIs were established for free thyroxine and prolactin on the Alinity system. Estradiol required special considerations in early life. Conclusions Our data demonstrate excellent concordance between ARCHITECT and Alinity immunoassays, as well as the robustness of previously established CALIPER RIs for most immunoassays, eliminating the need for de novo RI studies for most parameters. Availability of pediatric RIs for immunoassays on the Alinity system will assist clinical laboratories using this new platform and contribute to improved clinical decision-making.

ESTABLISHING IN-HOUSE REFERENCE INTERVALS FOR DOGS IN VETERINARY CLINICS

2016 ◽  
Vol 42 (02) ◽  
pp. 53-67
Author(s):  
Shang-Hsiu Chung ◽  
Li-Wen Chang ◽  
Tsun-Li Cheng ◽  
Chen-Jou Lin ◽  
Wen-Ying Chen ◽  
...  
Keyword(s):  
Uric Acid ◽  
Bile Acid ◽  
Biochemical Parameters ◽  
Clinical Pathology ◽  
Reference Interval ◽  
Reference Intervals ◽  
Gamma Glutamyl Transferase ◽  
Coagulation Parameters ◽  
American Society ◽  
Glutamyl Transferase

Reference interval (RIs) were critical to the identification of illness. However, RIs set in one laboratory may not be appropriate for another because of biological, geographical and instrumental factors. Interpretation of clinical data using inappropriate RIs may cause misclassification of results and misdiagnosis that lead to improper treatment. RIs in Taiwan have been mostly referencing from foreign resources, it is desirable to establish one that is closer to the overall conditions in Taiwan (such as breed, climate, diseases, etc.) and to investigate its differences to foreign RIs. The present study used the American Society for Veterinary Clinical Pathology (ASVCP) guidelines to establish in-house RIs for hematological, biochemical and coagulation parameters using dogs in middle Taiwan. The results were also compared to two foreign and one local RIs. The results suggested that the hematological RIs are more comparable to foreign RIs than the biochemical and hemostatic parameters. Differences were found for biochemical parameters including gamma-glutamyl transferase (GGT), lactate dehydrogenase (LDH), lipase, uric acid, bile acid, bilirubin and magnesium; and coagulation parameters including prothrombin time (PT) and activated partial thromboplastin. In all, 18% (7/40) of the all tested parameters were different from the local RI while 38% (18/48) and 41% (19/46) of the parameters were different from the two foreign RIs. The differences in more than 30% RIs and better similarities to local RIs underscore the importance of having own RIs if possible.

Haematological and coagulation disorders and anaesthesia

2017 ◽  
Author(s):  
Herman G. D. Hendriks ◽  
Joost T. M. de Wolf
Keyword(s):  
Clinical Decision Making ◽  
Haemoglobin Concentration ◽  
Perioperative Period ◽  
Clinical Decision ◽  
Red Blood Cell Transfusion ◽  
Coagulation Management ◽  
Coagulation Activity ◽  
Relative Risks ◽  
Coagulation Tests ◽  
Surgical Bleeding

This chapter covers the principal haematological disorders and their implications for anaesthesia. Haemoglobin concentration is the main determinant of oxygen delivery to the tissues making anaemia a potential concern for the anaesthetist. In deciding whether to correct anaemia with a red blood cell transfusion, the anaesthetist must consider the nature of the surgery and the underling cause of the anaemia as well as the haemoglobin concentration. Techniques to limit the need for blood transfusion and the complications of transfusion are discussed. Perfect haemostasis means control of bleeding without the occurrence of thrombotic events. Coagulation management requires an understanding of this balance and the knowledge that altered coagulation activity may result in clinically relevant bleeding or, in contrast, thrombosis. Therefore, the key in haemostasis is an understanding that every anticoagulant action enhances the risk of bleeding and every procoagulant action enhances the risk of thrombosis. If a specific defect in the haemostatic system is known, treatment is tailored to restore this defect. However, tests to predict surgical bleeding do not exist, as it is for test to predict thrombotic events. The strengths and limitations of coagulation tests should be appreciated before they are used to assist clinical decision-making in the perioperative period. An excellent coagulation test is the clinical field (i.e. the surgical wound). If there are abnormalities in the coagulation tests without clinical bleeding, a correction is hardly necessary. In patients taking anticoagulant medication, consideration must be given on an individual patient basis, to the relative risks of continuing (bleeding) or stopping (thrombotic events) the medication.

scholarly journals A user guide to the American Society of Hematology clinical practice guidelines

2020 ◽  
Vol 4 (9) ◽  
pp. 2095-2110
Author(s):  
Ariel Izcovich ◽  
Adam Cuker ◽  
Robert Kunkle ◽  
Ignacio Neumann ◽  
Julie Panepinto ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Immune Thrombocytopenia ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Cell Disease ◽  
Presentation Formats ◽  
American Society ◽  
The Many

Abstract Since November 2018, Blood Advances has published American Society of Hematology (ASH) clinical practice guidelines on venous thromboembolism, immune thrombocytopenia, and sickle cell disease. More ASH guidelines on these and other topics are forthcoming. These guidelines have been developed using consistent processes, methods, terminology, and presentation formats. In this article, we describe how patients, clinicians, policymakers, researchers, and others may use ASH guidelines and the many related derivates by describing how to interpret information and how to apply it to clinical decision-making. Also, by exploring how these documents are developed, we aim to clarify their limitations and possible inappropriate usage.

Total Amylase and Pancreatic Isoamylase in Serum and Urine: Considerations from Data on Biological Variation

1989 ◽  
Vol 26 (4) ◽  
pp. 335-340 ◽  
Author(s):  
Steven T Cummings ◽  
Callum G Fraser
Keyword(s):  
Clinical Decision Making ◽  
Amylase Activity ◽  
Clinical Decision ◽  
Population Based ◽  
Reference Intervals ◽  
Similar Data ◽  
Creatinine Ratio ◽  
Additional Information ◽  
Pancreatic Isoamylase ◽  
Urine Amylase

The analytical, within-subject and between-subject components of variation were estimated for amylase activity and pancreatic isoamylase activity in serum measured using newer analytical methods. Desirable analytical imprecisions based on within-subject variation were CV ≤ 4·4% and CV ≤ 7·0%, respectively. Conventional population-based reference intervals were not useful because of marked individuality; clinical decision-making points should be derived from the desired sensitivity and specificity. Serial results must change more than about 30% and 40% respectively before significance (P ≤ 0·05) can be claimed. Similar data on total amylase and pancreatic isoamylase activities in random and first morning urines showed that the use of conventional reference intervals was appropriate. Very large changes (> 100%) were required before a difference in serial results was significant. Calculation of the urine amylase/creatinine ratio appeared to confer no advantage. Derivation of the ratio of pancreatic isoamylase to total amylase activity in serum or urine was unlikely to provide additional information of value in either diagnosis or monitoring.

scholarly journals Analytical validation of cardiac troponin I assays in horses

2017 ◽  
Vol 30 (2) ◽  
pp. 226-232 ◽  
Author(s):  
Tanya M. Rossi ◽  
Peter A. Kavsak ◽  
M. Grant Maxie ◽  
David L. Pearl ◽  
W. Glen Pyle ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Clinical Pathology ◽  
Reference Intervals ◽  
Cardiac Troponin I ◽  
Analytical Validation ◽  
Limit Of Quantification ◽  
Equine Medicine ◽  
American Society ◽  
Diagnostic Decision Making

Human cardiac troponin I (cTnI) assays have been used in equine medicine, often without prior analytical validation for equine use. In the absence of appropriate validation, the clinical significance of assay results is uncertain and can lead to misdiagnosis. We followed the American Society for Veterinary Clinical Pathology guidelines and investigated linearity, precision, limit of quantification (LoQ), and comparative recovery for 6 commercial cTnI assays developed for use in human medicine. Clinically acceptable linearity was observed in assays A–D, whereas assay E did not detect equine cTnI in any sample. Comparative recovery revealed 1–3-fold differences between assay results, and low analyte recoveries (2.2–3.4%) were observed in assay F. Precision was investigated in assays A and B, and found to be within acceptable limits. The LoQ was 1.53 ng/L for assay A, and 0.031 µg/L for assay B. Assays A and B performed within clinically acceptable limits and were deemed suitable for use in equine medicine. Assays C and D did not undergo full validation but had acceptable linearity, which demonstrates their potential for use in equine medicine. Assays E and F are unsuitable for use in horses given issues with detection of equine cTnI. The variability in results between assays indicates that reference intervals and cutoffs for diagnostic decision-making are assay specific and should be established prior to adoption by diagnostic laboratories.

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