Automated Chemistry Analyzer Research Articles

Report and abstracts for 20th ACCP conference with training workshops, and technology exhibits

A report is made on the 2-day, 20th annual conference held by the Association for Comparative Clinical Pathology (ACCP). This included two workshops that were given by veterans of the toxicologic clinical pathology community including on haematotoxicity and on the interpretation of clinical pathology data of pre-clinical toxicology studies in support of pharmaceuticals in development. Also, included was a series of scientific and technology presentations on the latest developments in toxicologic and veterinary clinical pathology. Key developments presented on were the invention of a rapid and simple diagnostic test for lymphoma, the Atellica- automated chemistry analyser for laboratory animals, and development of an advanced flow cytometric technique for bone marrow. Distinguished invited speakers gave lectures on treatment of acute myeloid leukaemia and on comparison of surgical and medical treatments for diabetic nephropathy. Technology vendors described in 5-minute presentations their latest products. And poster presenters also gave 5-minute presentations describing their work. The report is illustrated by photographs taken during the conference, capturing the presenters of talks and featuring new student presenters. This is followed by abstracts of most of the scientific presentations that were given. A few abstracts that had been submitted the previous year are also included, as there had been no report on this ACCP meeting of 2018. There were lighter moments, including a wine reception, conversations at the conference centre pub, a great conference dinner featuring the best of English cuisine, and trips to the conference center spa and recreation facilities.

Serum Ceruloplasmin levels in Type 2 Diabetes mellitus – Assessing the cardiovascular risk

Type 2 diabetes mellitus is an endocrinological disease associated with hyperglycemia characterized by both insulin resistance and defective insulin secretion. Cardiovascular diseases are the peak reason for mortality in India, highest rate seen in Tamil Nadu state, from the age of 25 to 69 years. Many studies have revealed the importance of inflammatory pathway playing a pivotal role in the development and progression of diabetic complications. Ceruloplasmin, a copper containing mettalo-enzyme having antioxidant property (e.g ferroxidase activity) is an ideal marker to know the cardiovascular status, glycemic status, dyslipidemia and cancer risk. The purpose of the present study was to evaluate the effects of Body Mass Index (BMI) and Ceruloplasmin levels on the incidence of cardiovascular diseases in Type 2 Diabetes mellitus patients. Fasting Blood glucose, lipid profile which includes serum triglyceride, total cholesterol, LDL, VLDL, HDL and serum ceruloplasmin were investigated using fully automated chemistry analyzer. Diabetic patients were segregated into three groups based on their BMI, which was correlated with inflammatory marker ceruloplasmin to assess the cardiovascular risk. The mean value and standard deviation of ceruloplasminin controls (n=60) and diabetic cases divided into normal weight, over weight and obese (n=20 each) were 38.3±8.45, 36±7.99, 33.2±3.57and34.2±6.24 mg/dl respectively. Ceruloplasmin among the cases and controls were not statistically significant. Serum ceruloplasmin levels and BMI showed no correlation among the group 1 diabetic cases and was not significant (p=0.29), among the group 2diabetic cases it showed weak correlation and was not significant (p=0.85), and it also showed no correlation among the group 3 diabetic cases and was not significant (p=0.65).This study revealed no significant association between serum ceruloplasmin level and BMI in all diabetic group subjects separately.

Assessing Propylene Glycol Interference at Concentrations Relevant to Serum Levels With Electronic Cigarette Use in an Enzymatic Ethylene Glycol Assay

Abstract Introduction Clinical laboratory measurement of ethylene glycol (ETG) by enzymatic methods is known to be subject to interference with high (several hundred milligrams/deciliter) concentrations of propylene glycol (PG). An estimated 10.8 million people in the United States, or almost 1 in 20 Americans, are reported to use electronic cigarettes (e-cigarettes; ie, “vaping”), in which PG is frequently used as a liquid solvent. No published reports exist investigating whether serum concentrations of PG that may be seen with e-cigarette use (generally, concentrations of 10-15 mg/dL in moderate users and up to 30 mg/dL in heavy users) can lead to either interference flags in analytical ETG measurement or falsely positive ethylene glycol concentrations being reported. Methods Studies were conducted to assess PG interference on enzymatic ETG measurement. Commercially acquired human AB serum (catalog # 35-060-CI; Corning Life Sciences) was spiked with various amounts of PG (catalog #158720010; Acros Organics/Thermo Fisher Scientific) to achieve both concentrations of PG expected with e-cigarette use (0-30 mg/dL) and supra-physiological concentrations (>30 mg/dL) for comparative purposes. PG-spiked sera were tested using a quantitative enzymatic ETG assay (Quantitative Ethylene Glycol kit, catalog #C504-0A; Catachem) previously validated as a laboratory-developed test on an AU5810 automated chemistry analyzer (Beckman Coulter). Results None of the tested PG concentrations designed to mimic physiological levels expected with e-cigarette use (0, 5, 10, 15, 20, 25, and 30 mg/dL) caused falsely positive quantitative ETG results, defined as values above the ETG limit of quantitation (LOQ) of 5 mg/dL. At these low concentrations, interference patterns neither were observed in reaction monitors, nor were instrument interference error flags triggered. As concentrations of PG approached 50 mg/dL, abnormal curve appearances were observed in the instrument reaction monitor, although this neither resulted in interference error flags nor false detection of ETG. However, as PG concentrations approached and exceeded ≥100 mg/dL, both interference flags and falsely positive ETG results were observed. Conclusion Results from the present experiments demonstrate that serum concentrations of PG expected with e-cigarette use did not cause interference with enzymatic ethylene glycol detection in this assay.

Evaluation of hypoglycemic, antihyperglycemic and antihyperlipidemic activities of 80% methanolic seed extract of Calpurnia aurea (Ait.) Benth. (Fabaceae) in mice.

BackgroundDiabetes mellitus is one of the most common chronic health problems in the world. As currently available antidiabetic medications have limitations in terms of safety, efficacy, and cost, it is an important research area to investigate medicinal plants for new antidiabetic compounds that can lead to effective, safe and less costly pharmacotherapy. The present study was done to evaluate the antidiabetic and antidyslipidemic activities of 80% methanolic seed extract of Calpurnia aurea (Ait.) Benth. (Fabaceae) in mice.MethodsBlood glucose lowering activity of three doses (2.75 mg/kg, 5.5 mg/kg and 11 mg/kg) of the hydromethanolic seed extract of Calpurnia aurea was studied in three animal models: normoglycemic mice, oral glucose-loaded mice, and streptozotocin-induced diabetic mice. Additionally, the effect of the seed extract on body weight and serum lipid profile was studied in the streptozotocin-induced diabetic mice. Glibenclamide (5 mg/kg) was used as a standard drug in all animal models of the study. Blood glucose level was measured using a glucose meter, whereas serum lipid level was measured using an automated chemistry analyzer. Data were analyzed using one-way analysis of variance followed by Tukey’s post hoc multiple comparison test.ResultsHydromethanolic extract of C. aurea seeds showed blood glucose lowering activity in all animal models, and it improved body weight loss and diabetic dyslipidemia in diabetic mice after 14 days of treatment.ConclusionThis study revealed that hydromethanolic extract of Calpurnia aurea seeds has significant hypoglycemic, antihyperglycemic and antihyperlipidemic activities.

Frequency and Pattern of Dyslipidaemia in Pakistani Females with Coronary Artery Disease

Objective: To determine the frequency and pattern of lipid abnormalities in diagnosed female patients of coronary artery disease in a tertiary care hospital of Karachi.
 Methods: This cross-sectional study was conducted from January 2016 to August 2016. A total of 300 female patients of Coronary Artery Disease (CAD), diagnosed on the basis of angiography were in- cluded in the study. For detection of lipid profile abnormalities five ml of fasting venous sample of 10-
 12 hours was obtained from the left median cubital vein under aseptic conditions. The blood was centrifuged for 5 minutes. Automated chemistry analyzer was used for lipid profile measurement via kits of the CYPRESS Laboratory (Langdorp, Belgium). Statistical analysis was done via SPSS version 17 and results were expressed as percentage and mean ± standard deviation.
 Results: Mean age of recruited females was 51.36 ± 13.71 years. About 81.39% of patients were found with abnormal lipid profile. The frequency of low high-density lipoprotein cholesterol in studied population was 61.66%, high triglycerides 19.33% whereas; high low-density lipoprotein cholesterol was 17.33% respectively. Combined two parameter dyslipidaemia patterns was found in 41.32% fol- lowed by mixed dyslipidaemia in 19.33%, while isolated high-density lipoprotein hypocholesteraemia in 12.00% of study population.
 Conclusion: We conclude that low levels of high-density lipoprotein cholesterol and hypertriglyceridemia, in both combined and isolated pattern, are more prevalent in Pakistani females with CAD.The data from the current study may increase the knowledge of the guidelines for lipid low- ering need in females.

Acacia Senegal (Gum Arabic) Supplementation Modulate Lipid Profile and Ameliorated Dyslipidemia among Sickle Cell Anemia Patients.

Background Sickle cell disease (SCD) is an inherited haemolytic anemia with a variable course and severity. Knowledge of prognostic biomarkers may help in the establishment of therapeutic intervention, management, and follow-up of patients. There have been scattered reports of low high-density lipoprotein cholesterol (HDL-C) and increased triglyceride (TG) in SCD patients. In addition, TG levels have been suggested to be elevated in patients with increased endothelial activation. An increased TG level has been associated with haemolysis, vascular dysfunction, and increased prevalence of pulmonary hypertension. Gum Arabic (GA) is an edible, dried, gummy exudate from the acacia Senegal tree. Several studies on GA ingestion have shown reduced plasma cholesterol and low-density lipoprotein (LDL) concentrations in both animals and humans. We investigated GA's therapeutic potential to modulate serum lipids in patients with sickle cell anemia. Methods This study recruited and documented secondary outcomes in 47 patients (aged 5–42 years) carrying hemoglobin SS. The patients received 30 g/day of GA for 12 weeks. Total cholesterol, TG, LDL, and HDL were measured before and after GA intake. Cobas C311 (Roche, Germany) automated chemistry analyser was used for direct determination of the values of the lipid profile. Results GA significantly decreased total cholesterol (TC), TG, and LDL (p = 0.006, 0.04, and 0.02, resp.). GA showed no effect on HDL level. Baseline serum TG and LDL correlated significantly with the hydrogen peroxide (H2O2) level, which is known as an oxidative stress marker (p = 0.003 and 0.04, resp.). None of the lipid profile elements correlated with age. Conclusion Our results revealed that dyslipidemia in sickle cell patients is associated with oxidative stress but not associated with age. The findings showed that GA significantly decreased TC, LDL, and TG levels, revealing a novel effect of GA, which is considered a natural dietary fibre that can modulate lipid profile in patients with sickle cell anemia. Trial Registration This retrospective trial is registered with ClinicalTrials.gov Identifier: NCT02467257 on 3 June, 2015.

The Spectacular Role of the Human Microbiome in Preventing Post-prandial or Metabolic Endotoxemia (OR23-02-19)

ObjectivesTo determine if 30-d of oral spore-based probiotic supplementation could reduce dietary endotoxemia. MethodsApparently healthy men and women (n = 75) were screened for post-prandial dietary endotoxemia. Subjects whose serum endotoxin concentration increased by at least 5-fold from pre-meal levels at 5-h post-prandial were considered “responders” and were randomized to receive either placebo (rice flour) or a commercial spore-based probiotic supplement [Bacillus indicus (HU36), Bacillus subtilis (HU58), Bacillus coagulans, and Bacillus licheniformis, and Bacillus clausii] for 30-d. The dietary endotoxemia test was repeated at the conclusion of the supplementation period. Dietary endotoxin (LAL) and triglycerides (enzymatic) were measured using an automated chemistry analyzer. Serum disease risk biomarkers were measured using bead-based multiplex assays (Luminex and Milliplex) as secondary, exploratory measures. ResultsData were statistically analyzed using repeated measures ANOVA and a P < 0.05. We found that spore-based probiotic supplementation was associated with a 42% reduction in endotoxin (12.9 ± 3.5 vs 6.1 ± 2.6, P = 0.011) and 24% reduction in triglyceride (212 ± 28 vs 138 ± 12, P = 0.004) in the post-prandial period Placebo subjects presented with a 36% increase in endotoxin (10.3 ± 3.4 vs 15.4 ± 4.1, P = 0.011) and 5% decrease in triglycerides (191 ± 24 vs 186 ± 28, P = 0.004) over the same post-prandial period. We also found that spore-based probiotic supplementation was associated with significant post-prandial reductions in IL-12p70 (24.3 ± 2.2 vs 21.5 ± 1.7, P = 0.017) and IL-1β (1.9 ± 0.2 vs 1.6 ± 0.1, P = 0.020). Compared to placebo post supplementation, probiotic subject had less ghrelin (6.8 ± 0.4 vs 8.3 ± 1.1, P = 0.017) compared to placebo subjects. Conclusions30 days of supplementation with spore-based probiotics showed a 60% reduction in biomarkers of leaky gut when compared to the placebo group. These findings suggest that probiotics may play an integral role in reducing chronic low-grade inflammation that leads to chronic disease and autoimmunity. Funding SourcesThe present study was funded in part by a competitive research grant from Microbiome Labs, LLC (Glenview, IL) to the University of North Texas. Supporting Tables, Images and/or Graphs▪▪▪

Microalbuminuria detection: comparisons of two differently semiquantitative urine strip tests with a quantitative automated chemistry analyzer

A k-path vertex cover (VCPk) is a vertex set C of graph G such that every path of G on k vertices has at least one vertex in C. Because of its background in keeping data integrality of a network, minimum VCPk problem (MinVCPk) has attracted a lot of researches in recent years. This paper studies the minimum weight connected VCPk problem (MinWCVCPk), in which every vertex has a weight and the VCPk found by the algorithm induces a connected subgraph and has the minimum weight. It is known that MinWCVCPk is set-cover-hard. We present two polynomial-time approximation algorithms for MinWCVCP3. The first one is a greedy algorithm achieving approximation ratio 3ln n. The difficulty lies in its analysis dealing with a non-submodular potential function. The second algorithm is a 2-stage one, finding a VCP3 in the first stage and then adding more vertices for connection. We show that its approximation ratio is at most lnδmax+4+ln2, where δmax is the maximum degree of the graph. Considering the inapproximability of this problem, this ratio is asymptotically tight.

Preventive oral rehydration salts III could protect intestinal function in rats with exertional heatstroke

To observe the damage of various organs of rats with exertional heatstroke (EHS), and to investigate the protective effect of oral rehydration salts III (ORS III) on multi-organ function in rats with EHS. Fifty-one male Sprague-Dawley (SD) rats were randomly divided into four groups by random digit table: normal control group (n = 13), EHS group (n = 13), EHS+water group (n = 12), and EHS+ORS III group (n = 13). All rats in the EHS groups received adaptive training for 7 days before the experiment. On the 8th day, the rats of EHS+water and EHS+ORS III groups were orally given 20 mL/kg water or ORS III 30 minutes before the experiment. No pretreatment was performed in the EHS group. EHS model was reproduced by forcing rats to run under hot environment. The rats which refused to exercise and which core temperature > 40.5 centigrade were considered as the onset of EHS. The rats in the normal control group were exposed to room temperature (25±2) centigrade and humidity (50±5)% without any treatment. Six hours later, blood of inferior vena cava was collected, and the levels of serum MB isoenzyme of creatine kinase (CK-MB), lactate dehydrogenase (LDH), alanine transaminase (ALT), aspartate transaminase (AST), serum creatinine (SCr), blood urea nitrogen (BUN), serum potassium, serum sodium and serum chloride were determined by automatic chemical analyzer. Serum intestinal fatty acid-binding protein (I-FABP) was determined by enzyme linked immunosorbent assay (ELISA). The levels of LDH, ALT, AST, BUN, serum sodium and serum chloride in the EHS group were significantly higher than those in the normal control group [LDH (U/L): 1 220±427 vs. 837±485, ALT (U/L): 138 (97, 164) vs. 37 (33, 42), AST (U/L): 409 (380, 566) vs. 86 (78, 104), BUN (mmol/L): 11.7 (9.6, 13.2) vs. 5.9 (5.5, 6.1), serum sodium (mmol/L): 148.0 (143.5, 154.5) vs. 139.0 (138.0, 140.5), serum chloride (mmol/L): 100.9±2.3 vs. 97.3±1.4, all P < 0.05], but no significant difference in CK-MB, SCr or serum potassium could be found [CK-MB (U/L): 1 280±373 vs. 1 379±480, SCr (μmol/L): 38.2±7.5 vs. 35.5±6.3, serum potassium (mmol/L): 5.5 (4.4, 6.2) vs. 4.7 (4.4, 4.9), all P > 0.05]. In the EHS+ORS III group, only serum potassium level was significantly lower than that in the EHS group [mmol/L: 4.0 (3.7, 4.4) vs. 5.5 (4.4, 6.2), P < 0.01], while no significant difference in other parameters was found between the EHS+ORS III group and the EHS group as well as the EHS+water group. Serum I-FABP level in the EHS group was significantly higher than that in the normal control group [μg/L: 36.90 (29.10, 45.00) vs. 11.39 (0.31, 20.80), P < 0.01]. Serum I-FABP level in the EHS+water and EHS+ORS III groups were notably lower than that in the EHS group [μg/L: 24.19 (20.00, 28.36), 0.31 (0.31, 5.58) vs. 36.90 (29.10, 45.00), both P < 0.01], additionally, I-FABP level was much lower in the EHS+ORS III group (P < 0.01). EHS could lead to liver, intestinal barrier dysfunction and electrolyte disturbance. Pre-treatment of ORS III could alleviate the intestinal dysfunction and electrolyte disorder caused by EHS in rats. It can lower the serum potassium to some extent. However, ORS III failed to protect liver from EHS.

Commonly used fluoroquinolones cross-react with urine drug screens for opiates, buprenorphine, and amphetamines

ObjectivesFluoroquinolone antibiotics are commonly used in the treatment of infections and have previously been confirmed to cross-react with previous generations of opiates immunoassays. In this work we evaluated the cross-reactivity of the three fluoroquinolones in use at our institution with a panel of 10 urine drug screens. Design and methodsDrug preparations of levofloxacin, ciprofloxacin, and moxifloxacin that were designed for intravenous delivery were added to drug-free urine at varying concentrations. Spiked urine samples were screened for illicit and therapeutic drugs on an Abbott Architect c16000 automated chemistry analyzer. Percent cross-reactivity was calculated. ResultsLevofloxacin displayed clinically relevant cross-reactivity with the Abbott MULTIGENT opiates and Thermo CEDIA® buprenorphine immunoassays but did not cross-react with the Abbott MULTIGENT oxycodone or methadone immunoassays. Moxifloxacin displayed clinically relevant cross-reactivity only with the Abbott MULTIGENT amphetamine/methamphetamine assay. Ciprofloxacin did not cross-react with any of the 10 immunoassays. ConclusionsThis study demonstrates that levofloxacin cross-reacts with modern immunoassays for two related opioids (buprenorphine and morphine) and moxifloxacin cross-reacts with the amphetamine/methamphetamine assay. Urine concentrations of these fluoroquinolones that are consistent with therapeutic use produced results above commonly used-cutoffs for positivity. This underscores the necessity of confirmatory testing of presumptively positive urine drug screens.

Assessment of lipid per-oxidation and endothelial dysfunction in patients of coronary artery disease

Assessment of lipid per-oxidation and endothelial dysfunction in patients of coronary artery disease - IJCBR- Print ISSN No: - 2394-6369 Online ISSN No:- 2394-6377 Article DOI No:- 10.18231/2394-6377.2019.0003, International Journal of Clinical Biochemistry and Research-Int J Clin Biochem Res

Technical accuracy of ten self-monitoring blood glucose devices commonly used in Dhaka City of Bangladesh

Due to inadequate regulatory mechanisms, the accuracy of the self-monitoring blood glucose (SMBG) devices is not ensured leading to potentially serious clinical consequences in Bangladesh. The present study was undertaken to evaluate the technical accuracy of ten most commonly used SMBG devices marketed in Dhaka City of Bangladesh. Top ten SMBG devices sold in Dhaka City were studied on a group of 100 type 2 diabetes mellitus subjects. Blood glucose values estimated (at fasting and 2 h after breakfast) by SMBG devices, using a blinding technique, were compared with the corresponding laboratory values by enzymatic method using the Dimension RXLMax automated chemistry analyzer. Hematocrit was measured using the Sysmex XT 2000 hematology autoanalyzer. The mean absolute relative error (MARE, %) was used as an indicator of accuracy and precision together. A highly significant correlation was observed between the device and laboratory values. However, none of the devices showed an acceptable accuracy at 5–10% deviation from the corresponding laboratory values either at fasting or postprandial states. On pooling together data from two prandial states, even at 15% deviation limits, 70% of the devices failed to show accurate results. On calculation of MARE, 60% devices were found to be beyond 15% error limit at 95% accuracy level. Corresponding analysis with 90% accuracy level showed 30% beyond the limit. Blood glucose results from around 30% of the top ten SMBG devices sold in Dhaka City do not have even minimum level of technical accuracy, and many others are not optimum in their accuracy levels.

Prevalence of Diabetes Mellitus and Associated Risk Factors Among Adults Attending at Feres Meda Health Centre, Addis Ababa, Ethiopia, 2017

Background: Diabetes is a family of disorders that is characterized by hyperglycemia. The disorders of diabetes differ in their etiology and symptoms and in the consequences of the disease. Diabetes mellitus is a high rising disease all over the world and in our country, because of some lifestyle change of the community. Therefore, this study aims to determine the prevalence of DM and its associated factors among adults in Feres Meda health center at Addis Ababa, Ethiopia. Methods: A cross-sectional study was conducted from November 2016 to March 2017. Patient demographic characteristics were collected using a pre-tested standard questionnaire format. Height, weight and blood pressure were measured physically and 5 ml fasting blood sample was collected to analyze blood glucose by glucose oxidase method using automated chemistry analyzer. Statistical analysis was performed by using Statistical software version 20. Results: Out of the 392 participants, 58.7% of them were females. The age of participants ranged from 19 to 80 years with a mean of 34.34 years. Among the study participants, 2.6% of them had DM and 6.9% of the participants had high fasting blood glucose value (pre-diabetes). Age (P = 0.048), WC (P=0.001), and family history of DM (P= 0.024) were significantly associated with the development of DM. Conclusion: High prevalence of undiagnosed diabetes mellitus was observed among study population. Therefore, regular screening of DM, particularly for those individuals having higher waist circumstance, family history of DM and older age, is mandatory to control blood glucose early.

Study of oxidative stress in ovarian cancer

Background: Ovarian cancer is the fifth most common form of cancer in the world and is often asymptomatic in its early stages. Development of ovarian cancer-specific biomarkers for the early detection of disease could improve the current dismal survival rate. Evaluation of serum carbohydrate antigen 125 (CA125), alkaline phosphatase (ALP) and oxidative stress in ovarian carcinoma patients may improve the prognosis of the disease through earlier detection. Aim of the study: The aim of this study was to find the relative risk of ovarian cancer in patients screened for CA125, ALP, Nitric oxide (NO) and Malondialdehyde (MDA) as a marker for lipid peroxidation. Material and methods: 451 subjects with ovarian cancer were screened for serum CA125 levels using a chemiluminescence analyser, out of which 164 showed values above 21 U/ml. 80 subjects with higher values were further analysed for MDA and NO using spectrophotometry and ALP by fully automated chemistry analyser. Results: The selected 80 subjects with CA125 values above 74 U/ml had increased ALP, NO and MDA, also showing positive correlation amongst these parameters. Conclusions: Benefits of CA125 screening vary with age group according to blood CA125 levels. Enzyme ALP levels are elevated with higher values of CA125. MDA and NO indicate oxidative stress and increase as the ovarian marker values increase. Positive correlation amongst the parameters indicates a significant increase in oxidative stress in ovarian cancer. For women with various CA125 levels in different age groups, screening and treatment depends upon individual decision and clinical examination.

VITAMIN D STATUS;

… Objective: Our primary objective was to estimate the vitamin D status amongboth the rural and urban dwellers of Sargodha. Study Design: A cross sectional population survey.Place and Duration of Study: Individuals were selected from six different medical centersin the Sargodha city, Vitamin D measurement was done in Khan Lab Sargodha from January2013 to June 2013. Methodology: After an awareness campaign, healthy individuals and medicalpatients from six different clinics in Sargodha city were selected after excluding the diseasesthat interfered with the metabolism of calcium and vitamin D. The initial assessment involvedan interview based questionnaire, at the clinic by the treating doctor. It recorded the informationregarding age, sex, weight, residence, and co-morbid conditions like, DM, hypertension,ischemic heart disease and kidney disease and medications especially oral vitamin D supplementation.The physical assessments included height, weight record and blood pressuremeasurements. The test: It was performed in Khan Lab Sargodha. Quantitative determinationof 25-OH vitamin D was done from the serum by using competitive immunoluminometric assayon Maglumi 1000 fully automated chemistry analyzer. Results: Out of total 100 specimens 46were found to be having low levels of vitamin D levels. Insufficient levels (21-29 ng/ml) were presentin 10 individuals. It was less than 10 ng/ml in 11, less than 5 ng/ml in 4, while 21 individualswere having levels between 10-20 ng/ml. Five individuals had levels more than 100 ng/ml.None of the individuals had level in toxic range. Out of 56 females 27(48.22%) had low vitaminD levels, while out of 44 males 19 (43.2%) were found to be having levels less than 30ng/ml.The median age of individuals having levels less than 30ng/ml was 37 years (14-57 years). Therelationship of high BMI and vitamin deficiency was statistically non-significant (p-value = .282).Conclusions: Although the sample size is small, however our study reveals that a large proportion(46%) of studied individuals representing the asymptomatic general population is havinglow level of vitamin D. in order to address this public issue concrete measures need to be takenin order to prevent adverse consequences of low vitamin D levels.

A method of measuring iron content in Chinese fir leaf and root tissues by using an automatic chemical analyzer

This paper discusses a new method for determining the iron content in Chinese fir leaves and roots using a SmartChem200 automatic chemical analyzer. With a pH value of 4-5, Fe3+ was reduced to Fe2+ by hydroxylamine hydrochloride, and Fe2+ and 1,10-phenanthrolinemonohydrate generated an orange complex. The iron content was calculated based on the absorbance measured at a wavelength of 510 nm. The absorbance is directly proportional to the Fe2+ content within a certain concentration range of Fe2+. The absorbance had a good linear relationship with the Fe2+ content in the range of 0.01 mgL−1 to 5 mgL−1; the linear regression equation of the standard curve was Y=0.0632*X-0.00002, and the correlation coefficient was 1.0000. The method is convenient and rapid, and the experimental results were reliable.

Verification of the Heska Element Point‐of‐Care blood gas instrument for use with venous blood from alpacas and llamas, with determination of reference intervals

The Heska Element POC ("EPOC") is a blood gas instrument intended for use with canine, feline, and equine whole blood; no verification for use with camelid specimens has been reported. Using camelid specimens and commercial quality control materials (QCM), we investigatee EPOC analytical performance and establish EPOC camelid reference intervals (RIs). Camelid blood (n=124) was analyzed using the EPOC (pH, pCO2 , pO2 , HCO3 , base excess, SO2 , sodium, potassium, chloride, ionized calcium, TCO2 , anion gap, HCT, HGB, glucose, lactate, and creatinine); plasma was analyzed using a Roche Cobas c501 (sodium, potassium, chloride, TCO2 , anion gap, glucose, and creatinine). Method comparison data were assessed using Pearson's correlation, Passing-Bablok regression, and Bland-Altman plots. EPOC precision was evaluated using QCM and camelid blood. For all measurands except anion gap, the EPOC vs Cobas instrument correlation was r>.85. Except for pO2 and pCO2 , EPOC precision (QCM and blood) ranged from a repeatability CV <1%-6.3%. Mild constant bias for chloride, glucose, TCO2 , anion gap, and creatinine, and mild proportional bias for chloride, glucose, and anion gap were present. The total error (QCM data) for the EPOC instrument was below the ASVCP-recommended allowable total error. Alpacas had higher potassium and lactate, while llamas had higher creatinine, sodium, chloride, ionized calcium, pO2 , and SO2 . Statistical RIs based on alpaca (n=74-96) and llama data (n=12-17) are reported descriptively. The EPOC analyzer shows good performance with camelid blood. A lack of complete agreement with automated chemistry analyzers highlights the importance of interpreting patient data using instrument-specific RIs.

Technical note: Evaluation of the diagnostic accuracy of 2 point-of-care β-hydroxybutyrate devices in stored bovine plasma at room temperature and at 37°C

The use of point-of-care (POC) devices to measure blood metabolites, such as β-hydroxybutyrate (BHB), on farm have become an important diagnostic and screening tool in the modern dairy industry. The POC devices allow for immediate decision making and are often more economical than the use of laboratory-based methods; however, precision and accuracy may be lower when measurements are performed in an uncontrolled environment. Ideally, the advantages of the POC devices and the standardized laboratory environment could be combined when measuring samples that do not require an immediate result-for example, in research applications or when immediate intervention is not the goal. The objective of this study was to compare the capability of 2 POC devices (TaiDoc, Pharmadoc, Lübeck, Germany; Precision Xtra, Abbott Diabetes Care, Abingdon, UK) to measure BHB concentrations either at room temperature (RT; 20-22°C) or at 37°C compared with the gold standard test in stored plasma samples. Whole blood from multiparous Holstein dairy cows (n = 113) was sampled from the coccygeal vessels between 28 d before expected calving and 42 DIM. Whole-blood BHB concentrations were determined cow-side using the TaiDoc POC device. Plasma was separated within 1 h of collection and stored until analysis. A subset of stored plasma samples (n = 100) consisting of 1 sample per animal was chosen retrospectively based on the BHB concentrations in whole blood within the range of 0.2 to 4.0 mmol/L. The samples were analyzed for BHB plasma concentration using an automated chemistry analyzer (Hitachi 917, Hitachi, Tokyo, Japan), which was considered the gold standard. On the same day, the samples were also measured with the 2 POC devices, with samples either at RT or heated up to 37°C. Our study showed high Spearman correlation coefficients (>0.99) using either device and with samples at both temperatures compared with the gold standard. Passing-Bablok regression revealed a very strong correlation (>0.99), indicating good agreement between both POC devices and the gold standard method. For hyperketonemia detection, defined as BHB concentration ≥1.2 mmol/L, the sensitivity for both POC devices at RT and 37°C was equally high at 100%. Specificity was lowest (67.4%) for the TaiDoc used with plasma at RT and was highest (86.5%) when plasma was measured at 37°C with the Precision Xtra meter. Bland-Altman plots revealed a mean bias of 0.25 and 0.4 mmol/L for the Precision Xtra meter and TaiDoc, respectively, when tested on plasma at 37°C. Our data showed that both POC devices are suitable for measuring BHB concentration in stored bovine plasma, and accuracy was highest when samples were heated to 37°C compared with RT.

Erythroferrone and iron status parameters levels in pediatric patients with iron deficiency anemia.

To investigate the link between serum erythroferrone (ERFE) levels and iron status parameters in pediatric patients with iron deficiency anemia. The study consisted of 66 children (36 with iron deficiency anemia and 30 healthy age- and gender-matched controls) who were investigated for serum levels of iron, total iron-binding capacity (TIBC) using automated chemistry analyzer, serum ferritin using electrochemiluminescence immunoassay and ERFE by specific enzyme-linked immunosorbent assay (ELISA) kit. Serum erythroferrone levels in iron deficiency anemia patients (191.55 ± 83.74pg/mL) were significantly higher than those in control group (42.22±16.55pg/mL) (P<.001). In iron deficiency anemia patients, serum erythroferrone concentrations correlated negatively with hemoglobin concentration (r=-.39; P=.01), serum iron (r=-.63; P<.001), transferrin saturation (r=-.66; P<.001), and serum ferritin (r=-.46; P=.004) while positive correlation was observed between serum erythroferrone concentrations and TIBC (r=.62; P<.001) CONCLUSION: The newly identified erythroferrone hormone may act as physiological hepcidin suppressor in cases with iron deficiency anemia, and so it may serve as a specific promising target of therapy in such cases.

Establishing reference intervals for ALT, AST, UR, Cr, and UA in apparently healthy Chinese adolescents

BackgroundThe current child-specific reference intervals (RIs) are inadequate or even unavailable for many analyses in China. Many of the RIs used in Chinese laboratories were derived from Chinese adult standards or from foreign studies. The aim of this study was to establish specific RIs for alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea (UR), creatinine (Cr) and uric acid (UA) for apparently healthy Chinese adolescents. MethodsOverall, 1682 apparently healthy adolescents were enrolled. Serum ALT, AST, UR, Cr and UA were measured by an ARCHITECT C-8000 automated chemistry analyzer. The 2.5th and 97.5th percentile RIs were determined using non-parametric methods. ResultsThe established reference intervals for ALT, AST, UR, CR and UA were 7.5–42.8 U/L, 12.8–40.2 U/L, 3.12–6.38 mmol/L, 42.7–91.2 μmol/L, and 180.2–409.6 μmol/L in boys and 6.5–32.8 U/L, 10.4–32.5 U/L, 3.05–6.47 mmol/L, 40.2–88.8 μmol/L and 176.5–394.0 μmol/L in girls, respectively. The median and upper and lower limits for the RIs of ALT, AST, Cr and UA were higher in boys than they were in girls (P < 0.05). ConclusionRIs based on adult criteria are not applicable to adolescents. It was necessary to establish specific, accurate and suitable RIs for Chinese adolescents. We have established reference intervals of ALT, AST, UR, Cr and UA that are defined specifically for Chinese adolescents and are appropriate for universal use among Chinese laboratories.