Biochemistry Laboratory Research Articles

Evaluation of Physicochemical, Functional and Morphological Characteristics of Starch Extracted from Defatted Conophor Seed (Tetracarpidium conophorum)

Aim: Starch is the main carbohydrate store for numerous crops and each crop has distinct and unique characteristics. This study was aimed at investigating the physicochemical composition, functional properties and morphological characteristics of starch extracted from defatted Conophor seed flour.
 Place and Duration: Food Chemistry Laboratory, Department of Food Science and Technology, and Biochemistry Laboratory of the Federal University of Technology, Akure, from March 2023 to September 2023.
 Methodology: Conophor seeds were washed, shelled manually, oven dried, milled into coarse flour and then defatted using solvent extraction method with the use of a soxhlet extractor. The defatted flour was air dried and grounded into fine powder. Starch was extracted by sedimentation at pH 11.0 and then oven dried and grounded into powder. The physicochemical composition, functional properties and morphological characteristics of Conophor starch were studied.
 Results: The physicochemical study shows that Conophor starch was abundant in carbohydrate (77.26%) but had a low protein (4.46%), fat (1.99%) and fibre (1.20%) content. Mineral content of the starch were high with calcium (194.17mg/g), copper (0.05mg/g), manganese (0.42mg/g), magnesium (4.26mg/g), iron (0.34mg/g), zinc (1.59mg/g), phosphorus (26.1mg/g), sodium (23.20mg/g) and potassium (37.13mg/g). The functional property of Conophor starch showed a high water absorption capacity (513.33%), oil absorption capacity (347.57%), emulsion capacity (45.48%), emulsion stability (50.00%), swelling index (246.67%), gelation capacity (12.00m/v) and low foaming capacity (12.69%) and foaming stability (3.26%). Conophor starch had a low pasting property with peak viscosity (14.00 RVU), final viscosity (16.00 RVU) and set-back viscosity (4.00 RVU).
 Conclusion: The study showed Conophor starch to be a rich source of mineral which makes it suitable for use as a supplement and its functional property makes it capable to be used in some industrial processes. However, the low paste quality of the starch renders it unsuitable for use in food processes that requires high paste formation but may be considered suitable for use in non- food related industries.

Two New Arthoniales Species (Lichenized Ascomycota) From Brazil

Objective: The present work aimed to describe, comment, and illustrate two new lichenized species of Ascomycota. Method: Morphological analyses of the samples were performed at the Laboratory in the State University of Bahia (UNEB), Campus VIII. The lichen thalli were observed using a stereomicroscope (Zeiss); chemical treatments were performed to observe the microscopic structures of the lichens after exposure to 10% KOH (potassium hydroxide), lactophenol (cotton blue), Melzer’s reagent, chlorine, and viewed under UV light. The chemical compositions of the lichen were examined using thin layer chromatography (TLC) at the Biochemical Laboratory of the Federal University of Pernambuco. Results and conclusion: Stirtonia juaensis and Cryptothecia paramacrocephala are two new lichenized species of Ascomycota found colonizing the plants Spondias tuberosa Arruda (Umbuzeiro) and Piptadenia moniliformis Benth. (Quipembe) in the Caatinga phytogeographical domain near the village of Juá in the municipality of Paulo Afonso, within the Raso da Catarina Ecoregion in northern Bahia State, Brazil. Originality/value: Research related to lichen taxonomy in Brazil is still scarce, especially in the Caatinga. The new species of Stirtonia and Cryptothecia described and illustrated in this work expand the knowledge about fungi in Brazil.

Spectrum of Organic Aciduria Diseases in Tunisia: A 35-year Retrospective Study.

Organic aciduria diseases (OADs) occur worldwide, with differences in prevalence and patterns between populations. To describe the spectrum of OADs identified in Tunisia over a 35-years period. This retrospective study included patients who were diagnosed with OADs between 1987 and 2022 in the Laboratory of Biochemistry, Rabta Hospital, Tunisia. Organic acids were analyzed using gas chromatography-mass spectrometry. A total of 30,670 urine samples were analyzed for OADs, of which 471 were positive for OADs. The estimated incidence of OADs in Tunisia was 6.78 per 100,000 live births. Methylmalonic (n = 146) and propionic (n = 90) acidurias were the most common OADs (estimated incidence: 2.10 and 1.30 per 100,000 live births, respectively). There were 54 cases of L-2-hydroxyglutatric acidurias and 30 cases of pyroglutamic acidurias, which makes it one of the highest in the world. The main clinical features were hypotonia (65%) and feeding difficulties (41%). Age at diagnosis was highly variable, ranging from 1 day to 49 years. Only 27% of the patients were diagnosed within the first month of life. The prevalence of OADs was highest in the Center-East and Southeast regions. In Tunisia, OADs are relatively frequent, but there are shortcomings regarding the diagnosis of these disorders. The frequency and health/social impact of these disorders warrant the need for implementing newborn screening programs and suitable patient management.

An Atherosclerosis Indicator Hyaluronic Acid: Can Plasma Hyaluronic Acid Be Useful in Diagnosing Alzheimer's Disease?

The aim is to compare the plasma levels of hyaluronic acid (HA) which is closely related to inflam-mation and vascular changes and arterial stiffness (AS) related values in patients with Alzheimer's disease (AD), amnestic type mild cognitive impairment (aMCI), and normal cognitive functions (NCF). Ninety participants were categorized into three groups, patients with AD, MCI, and NCF. Arterial stiffness measurement in the nephrology outpatient clinic, and storage and analysis of plasma samples in the biochemistry laboratory. Of the 90 patients, 32 had NCF, 32 had aMCI, and 26 had AD. Between groups, there was no difference in HA, pulse wave velocity, and augmentation index. The HA level had no statistically significant correlation with any of the other variables. Plasma HA levels will not be useful in the diagnosis of AD. More comprehensive studies with larger number of patients are needed.

LEGOand#174; brick activities for the biochemistry and molecular biology lab

LEGOand#174; brick activities for the biochemistry and molecular biology lab

Analysis of SARS-CoV-2 antibody seroprevalence in Northern Ireland during 2020–2021

BackgroundWith the spread of SARS-CoV-2 impacting upon public health directly and socioeconomically, further information was required to inform policy decisions designed to limit virus spread during the pandemic. This study sought to contribute to serosurveillance work within Northern Ireland to track SARS-CoV-2 progression and guide health strategy. MethodsSera/plasma samples from clinical biochemistry laboratories were analysed for anti-SARS-CoV-2 antibodies. Samples were assessed using an Elecsys anti-SARS-CoV-2 or anti-SARS-CoV-2 S ECLIA (Roche) on an automated cobas e 801 analyser. Samples were also assessed via an anti-SARS-CoV-2 ELISA (Euroimmun). A subset of samples assessed via the Elecsys anti-SARS-CoV-2 ECLIA were subsequently analysed in an ACE2 pseudoneutralisation assay using a V-PLEX SARS-CoV-2 Panel 7 for IgG and ACE2 (Meso Scale Diagnostics). ResultsAcross three testing rounds (June–July 2020, November–December 2020 and June–July 2021 (rounds 1–3 respectively)), 4844 residual sera/plasma specimens were assayed for anti-SARS-CoV-2 antibodies. Seropositivity rates increased across the study, peaking at 11.6 % (95 % CI 10.4 %–13.0 %) during round 3. Varying trends in SARS-CoV-2 seropositivity were noted based on demographic factors. For instance, highest rates of seropositivity shifted from older to younger demographics across the study period. In round 3, Alpha (B.1.1.7) variant neutralising antibodies were most frequently detected across age groups, with median concentration of anti-spike protein antibodies elevated in 50–69 year olds and anti-S1 RBD antibodies elevated in 70+ year olds, relative to other age groups. ConclusionsWith seropositivity rates of <15 % across the assessment period, it can be concluded that the significant proportion of the Northern Ireland population had not yet naturally contracted the virus by mid-2021.

Evaluation of the analytical performance of 80 parameters analyzed in routine biochemistry laboratory by process sigma methodology

Evaluation of the analytical performance of 80 parameters analyzed in routine biochemistry laboratory by process sigma methodology

Does Fredrickson Friedewald’s formula and direct assay of LDL concentration in serum give varying results? - A pilot retrospective study in a tertiary care hospital

Background and Aims: The LDL-C levels guide the cardiovascular risk assessment under the National Cholesterol Education Program Adult Treatment Panel (NCEP) as well as used for the management of dyslipidemia. Traditionally, LDL-C level is calculated using the Friedewald formula i.e., cLDL, however, recently many of the laboratories have shifted to newer methods of direct LDL-C estimation, i.e., dLDL. With this transition, there is increased demand to compare and establish updated LDL-C level cutoffs for the risk assessments of cardiovascular events. Methods: A retrospective observational study, comprising 216 study participants, was conducted in the Department of Biochemistry, Lady Hardinge Medical College, and associated hospitals, in New Delhi for 12 months. Data was collected from 216 adult patients (&gt; 18 years) whose routine fasting lipid profile was done and documented in our clinical biochemistry lab. LDL-C levels done by direct method and calculated methods were compared using the Intraclass correlation coefficient (ICC). Appropriate statistical tests were used with a p-value &lt;0.05 taken as statistically significant. Results: When compared between dLDL-C and cLDL-C significant difference was seen with mean values as 104 ±38.8 and 85.5 ±35.6 mg/dl respectively. However, a strong positive correlation was seen between dLDL-C and cLDL-C, r=0.9, p&lt;0.01. The ICC showed good reliability for overall comparison between dLDL-C and cLDL-C, however, reliability was found to be poor for group 2. Conclusions: Friedewald and modified Friedewald equations can be used as a substitute for direct homogenous LDL estimation when resources are scarce.

Long-term effects of levetiracetam and valproic acid on laboratory parameters in childhood epilepsy

Epilepsy is the most common neurological disorder in childhood which often requires long-term or sometimes lifelong treatment. In this study, we aimed to evaluate the change in hematological and biochemical laboratory parameters at the 24th month compared to the treatment baseline values in pediatric epilepsy patients receiving levetiracetam (LEV) and valproic acid (VPA) monotherapy. Complete blood count panel, biochemical and hormonal parameters were investigated retrospectively at baseline and at 24 months in patients diagnosed with epilepsy at the Balikesir University Medical Faculty pediatric neurology clinic, Türkiye, and started on LEV and VPA monotherapy between 01.08.2019 and 01.08.2022. Forty-nine patients were using LEV and 14 VPA. A statistically significant difference in terms of the complete blood count parameters mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) was observed in the cases using LEV between baseline and the 24th month of treatment (p=0.006, p=0.004). Among the cases using VPA, significant differences between baseline and the 24th month of treatment were determined in the complete blood count parameters red blood cell (RBC), MCV, and monocyte (MON)% values (p=0.004, p=0.022, and p=0.01). In conclusion, epilepsy treatment is a lengthy process in pediatric patients, and patients need to be monitored using hematological and biochemical parameters at specific intervals in terms of potential seizure drug side effects.

Comparison of triglyceride/glucose index and related parameters with Indian Diabetes Risk Score assessment in non-diabetic individuals visiting primary healthcare centre-A community-based cross-sectional study.

Diabetes mellitus is a chronic metabolic disorder and has reached epidemic proportions in developing countries like India. Our study aimed to identify relationship between triglyceride glucose (TyG) index and related parameters with Indian diabetes risk score in non-diabetic individuals. An analytical cross-sectional study was conducted in community at a primary healthcare centre attached to a medical college for six months from April 2022 to October 2022 after getting approval from institute ethical committee. We conducted a cross-sectional study at a primary healthcare centre attached to the medical college for six months duration with a sample size of 107, aged ≥18 years, which included apparently healthy individuals not diagnosed with any type of diabetes. Indian diabetes risk score (IDRS) scale was calculated along with anthropometric measurements and biochemical laboratory investigations like fasting triglyceride and fasting blood glucose. Our study population included 53.3% male and 46.7% female; the mean age of male was 29.70 ± 12.26 and female was 34.28 ± 11.91. The mean TyG index for male and female was 8.48 ± 0.45 and 8.39 ± 0.52, respectively. 52.3% of our study population belonged to high-risk category, and 47.7% belonged to moderate-risk category. We also found positive correlation between TyG index and its related parameters and IDRS score. In linear regression between IDRS and TyG index, we found positive correlation, and in logistic regression showed for every 1 unit rise in age, there was 1.28 times increase in IDRS score (P < 0.001). TyG-WHtR was superior to other TyG-related parameters in identifying high IDRS score (P < 0.001). TyG index and its related parameters can be used as a predictor in identifying diabetes mellitus along with IDRS score assessment in low-cost clinical settings like primary healthcare centre.

Effect of Common Cold on Serum Clozapine Concentrations in Hospitalized Patients with Schizophrenia.

The present study aims to investigate the effect of common cold on the serum clozapine concentrations in hospitalized patients with schizophrenia. A total of 65 schizophrenic patients with common cold receiving clozapine treatment were retrospectively enrolled. The demographic data, medication situation, clozapine concentration, and parameters of routine haematological and biochemical laboratory tests were obtained from the medical record system. The serum clozapine concentration and clozapine concentration/dose (C/D)ratios between the baseline period and cold period were compared by paired-sample t tests. Association between the changes in serum concentration and C/Dratios of clozapine and changes in white blood cell (WBC) and neutrophil (NE) counts was evaluated using Pearson correlation analysis. The serum clozapine concentration (t = -9.856, P < 0.001) and clozapine C/Dratios (t = -10.071, P < 0.001) were found to be significantly elevated in the cold period compared to the baseline period. Moreover, the changes in the serum clozapine concentration were found to be significantly elevated in female patients compared to male patients (t = -2.483, P = 0.017). Furthermore, changes in the serum clozapine concentration were positively correlated to the changes in WBC (r = 0.303, P = 0.014) and NE (r = 0.315, P = 0.011) counts. Similarly, changes in clozapine C/Dratios were positively correlated to the changes in WBC (r = 0.275, P = 0.027) and NE (r = 0.328, P = 0.008) counts. The serum clozapine concentrations in patients with schizophrenia during the common cold period were increased, which might by related to the elevated WBC and NE counts.

The Evaluation of the Quality Performance of Biochemical Analytes in Clinical Biochemistry Laboratory Using Six Sigma Matrices.

Introduction This study was conducted to assess the analytical performance of biochemical tests using Six Sigma methodology and to assess the underlying causes of unsatisfied performance ofanalytes with a sigma value of less than 4 using quality goal index (QGI) and root cause analysis (RCA). Methodology Daily data for internal quality control (IQC) for both level 1 (L1) and level 2 (L2) and monthly data for external quality assessment for a period of six months were recorded. The coefficient of variation (CV), bias, and total allowable error (TEa) were calculated to analyze the sigma (σ) values for 19 biochemical analytes. Quality goal index (QGI) analysis was done to analyze impressions and inaccuracies in analyte performance having a sigma value of less than 4. Root cause analysis (RCA) was done to evaluate the possible causes that can improve quality performance. Results Creatinine and high-density lipoprotein (HDL) had sigma metrics of ≤2.0, and chloride, aspartate aminotransferase (AST), and alkaline phosphatase (ALP) had sigma values between 2 and 3. Glucose, total protein (TP), phosphate (Phos), and potassium had sigma values between 4 and 5 in level 1 QC. Sigma grading for level 2 quality control (QC) also gave similar results. For analytes with σ < 4, QGI analysis exposed inaccuracy or imprecision issues and identified errors such as the reconstitution of IQC, storage temperature, and air bubbles while processing the QC, being common causes of poor performance. Conclusion Six Sigma approach is helpful for quality assurance and identifying areas for improvement.Assessing Six Sigma metrics should be a routine practice to decide the frequency of QC run and to detect errors in analysis.

Safety Management in Chinese University Biochemical Laboratories: A Strategic Approach

This article examines safety management in Chinese university biochemical laboratories, emphasizing the need for improved safety awareness and standardized practices. The study analyzes challenges such as inadequate safety consciousness among researchers, risks associated with chemical reagents, and equipment-related hazards. Comparative insights are drawn from international safety management systems, particularly those in Australian universities. The research proposes solutions including the establishment of a laboratory admission system, strict management of chemical reagents, and the standardization of experimental instrument usage. The findings underscore the importance of rigorous safety protocols and preventive measures to mitigate accidents in university biochemical laboratories.

Point of care testing in Croatia: a survey of the Working group for point of care testing of the Croatian society of medical biochemistry and laboratory medicine.

The aim of this study was to investigate attitudes and routine procedures in point of care testing (POCT) among non-laboratory and laboratory healthcare professionals in Croatia. The Working Group (WG) for POCT of the Croatian society of medical biochemistry and laboratory medicine has designed two anonymous surveys for laboratory staff and non-laboratory staff with a total of 44 questions/statements on POCT (27 questions for non-laboratory staff and 17 for laboratory staff). Surveys were sent to 184 medical biochemistry laboratory (MBL) managers, the Croatian medical chamber and the Croatian chamber of nurses. The survey was disseminated using the online survey platform SurveyMonkey. A total of 112 non-laboratory healthcare professionals and 50 laboratories participated in the survey, which represents a response rate of 0.25% for non-laboratory professionals and 27% for MBLs. The majority of non-laboratory staff stated that POCT enables better medical care for the patient (90/112) and that the implementation of new POCT devices should be the responsibility of a POCT team comprising laboratory and clinical healthcare professionals. The great majority of responding MBLs (42/50) acknowledge that POCT is necessary for better patient care, and also realize that validation of POCT devices and comparison to the central laboratory is necessary before implementation (49/50). The majority of participants consider POCT as a medical tool that enables better patient care but there is still a lack of communication between laboratory and clinical staff. The study identified some critical spots that will help to create national guidelines to ensure high patient safety when using POCT devices.

A study of pre-analytical errors in a public hospital biochemistry laboratory according to their causes and units

The clinical laboratory is an important stakeholder in the patient management process with a direct impact on patient care by providing evidence and data for diagnosis and treatment. Identifying reliable quality indicators in clinical laboratories is an important step in enabling users to measure the quality of laboratory service. Any error in the pre-analytical process affects other processes and jeopardizes patient safety. This study aimed to examine the number of specimen rejections in clinical laboratories, their reasons, and their range according to the departments. The study was a descriptive retrospective study. The population of the study consisted of samples rejected from the Biochemistry Laboratory of a teaching and research hospital in 2021. Data were analyzed using percentage and frequency analysis. The study recommends that practices to minimize errors in the pre-analytical process should be carried out urgently by the management and a training plan for sample collection should established. Keywords: Clot; hemolysis; patient safety; pre-analytical process; sample rejection.

Acute and Sub-chronic Toxicity Evaluation of the Ethanolic Extract of Coula edulis B., (Olacaceae) Stem Bark

Aims: Coula edulis Baill., (Olacaceae) is a non-lignified forest product not well known and widely used in sub-Saharan Africa as a phytomedicine or food additive. However, the toxicity of this plant remains unknown. This study aimed to assess the safety of the ethanolic extract of C. edulis stem bark (CEE).&#x0D; Study Design: Pharmacological study.&#x0D; Place and Duration of Study: Laboratory of Nutrition and Nutritional Biochemistry, Department of Biochemistry, University of Yaounde 1 (Cameroon), between June 2018 and July 2022.&#x0D; Methodology: Studies on the assessment of acute and subchronic toxicity were carried out by guidelines 423 of the Organization for Economic Co-operation and Development (OECD). Subacute toxicity of the sample was assessed over 28 days using repeated doses by OECD Guideline 407.&#x0D; Results: No cases of death and clinical signs of toxicity were observed in the treated rats, suggesting that the LD50 of C. edulis ethanolic extract is greater than 2000 mg/kg bw. Regarding the subacute toxicity study, the administration of CEE also did not result in any changes in the course of body weight. Only a significant decrease in the relative weight of the ovaries in females at the highest dose of 600 mg/kg was observed. In males and females, CEE did not affect lipid profile markers or transaminase levels (AST, ALT). In addition, a small but non-significant (p&gt; 0.05) increase in creatinine was observed without kidney dysfunction. In males, CEE induced an increase in mean corpuscular volume number at 600 mg/kg, while at the same time, mean corpuscular hemoglobin concentration decreased at the 300 mg/kg dose. In females, a significant increase in the number of monocytes, red blood cells, and hemoglobin level were observed. No difference in the levels of urea, glucose, and lipid markers was observed nor histological changes in the organs studied.&#x0D; Conclusion: As would be expected, exposure to CEE did not cause significant toxic effects in treated rats. Therefore, this plant extract can be safely recommended for therapeutic use.

ETUDE COMPARATIVE DE LA PERFORMANCE DIAGNOSTIQUE DES MARQUEURS INDIRECTS D’ALCOOLISATION CHRONIQUE : CDT, GGT ET VGM

ntroduction: gamma glutamyl transferase (GGT) andmean corpuscular volume (MCV) are the traditionalmarkers of chronic alcoholism. For over 30 years,carbohydrate-deficient transferrin (CDT) has been oneof the biological diagnostic tools used in themanagement of alcohol-dependent patients. The aimof this study was to set up a capillary electrophoresisassay for CDT in the Biochemistry Laboratory of theFann Hospital and University Centre, in order to providepractitioners with much more effective diagnostic toolsfor identifying and monitoring alcohol dependence.Materials and methods: The methodology consistedof recruiting patients diagnosed as alcohol-dependentat the Centre de Prise en Charge Intégrée desAddictions de Dakar (CEPIAD) and determining GMV,GGT activity and CDT content. The CDT content wasobtained by capillary electrophoresis and the resultsexpressed as a percentage of total transferrin. Toensure the absence of liver damage, transaminaseactivity was assessed.Results: The results showed that CDT was much moresensitive because it was disturbed in more than halfthe patients, compared with 40% for GGT and 10%for VGM. CDT was elevated in 100% of patientsconsuming more than 1 litre of alcohol. It also appearedthat in the presence of alcoholic hepatitis as evidencedby an ASAT/ALAT ratio &gt; 1, GGT appeared to be moresensitive. The combination of GGT and CDT was moresensitive than either GGT-VGM or CDT-VGM.Conclusion: CDT was a highly relevant parameter inthe diagnosis and monitoring of alcohol-dependentpatients. It is more relevant to combine CDT and GGTthan GGT and VGM, which are traditionally measuredroutinely.Key words: CDT, alcohol dependence, biologicaldiagnosisCorrespondance : Fatoumata Bah,Laboratoire de Toxicologie et Hydrologie de la FMPO de l’UCAD, Dakar.Tel : +221 33 824 65 39.Email : fabah2001@yahoo.fr10

Relationship between biochemical parameters of mineral bone disease and static bone histomorphometry in chronic kidney disease patients on hemodialysis: An Indian cross-section study

AimWe estimated the relationship between routine biochemical laboratory parameters with static bone histomorphometric parameters and their high and low bone turnover capacity predictability in hemodialysis patients. MethodIt was a single-center cross-sectional study, included 28 hemodialysis patients. The routine biochemical parameters measured including calcium, phosphorous, alkaline phosphatase, intact PTH, and 25-hydroxycholecalciferol. The histomorphometric parameters assessed were osteoblasts perimeter, osteoclast perimeter, eroded perimeter, osteoid perimeter, bone fibrosis and bone volume. ResultTotal 28 hemodialysis patients underwent bone biopsy. Seventy percent were male, with a mean age was 33.07±10.42 yrs; serum alkaline phosphatase was 219.10±311.3IU/ml; vitamin D was 18.18±9.56ng/ml, and intact PTH was 650.7±466.0pg/ml. Intact PTH had a significant positive association with osteoblast, osteoclast, eroded surface, and osteoid perimeter. Serum alkaline phosphatase had a significant relationship with bone fibrosis (r=0.525, p-value=0.004). Intact PTH was significantly higher in females than males (1078.75±533.04 vs. 479.6±309.83; p-value=0.004). The osteoid surface was significantly high in females compared to males (p=0.038). Age had a significant impact on osteoblast and eroded surface (p=0.008 and p=0.031, respectively). Intact PTH is a reliable biomarkers for bone turnover compare to ALP (p<0.001 and p=0.554, respectively). ConclusionIntact PTH strongly associated with bone formation, bone resorption parameters. Gender and age had significant impact on static histomorphometric parameters in our study.

Prediction of acute lung injury assessed by chest computed tomography, oxygen saturation/fraction of inspired oxygen ratio, and serum lactate dehydrogenase in patients with COVID-19

IntroductionIn treating acute hypoxemic respiratory failure (AHRF) caused by coronavirus disease 2019 (COVID-19), clinicians choose respiratory therapies such as low-flow nasal cannula oxygenation, high-flow nasal cannula oxygenation, or mechanical ventilation after assessment of the patient's condition. Chest computed tomography (CT) imaging contributes significantly to diagnosing COVID-19 pneumonia. However, the costs and potential harm to patients from radiation exposure need to be considered. This study was performed to predict the quantitative extent of COVID-19 acute lung injury using clinical indicators such as an oxygenation index and blood test results. MethodsWe analyzed data from 192 patients with COVID-19 AHRF. Multiple logistic regression was used to determine correlations between the lung infiltration volume (LIV) and other pathophysiological or biochemical laboratory parameters. ResultsAmong 13 clinical parameters, we identified the oxygen saturation/fraction of inspired oxygen ratio (SF ratio) and serum lactate dehydrogenase (LD) concentration as factors associated with the LIV. In the binary classification of an LIV of ≥20 % or not and with the borderline LD = 2.2 × [SF ratio]−182.4, the accuracy, precision, diagnostic odds ratio, and area under the summary receiver operating characteristic curve were 0.828, 0.818, 23.400, and 0.870, respectively. ConclusionsThese data suggest that acute lung injury due to COVID-19 pneumonia can be estimated using the SF ratio and LD concentration without a CT scan. These findings may provide significant clinical benefit by allowing clinicians to predict acute lung injury levels using simple, minimally invasive assessment of oxygenation capacity and biochemical blood tests.

Improvement of the post-analytical phase by means of an algorithm based autoverification

Abstract Objectives Autoverification (AV) is releasing laboratory results using predefined rules. AV standardizes the verification of laboratory results, improves turnaround time (TAT), detects errors in the total test process, and enables effective use of laboratory staff. In this study, we aimed to evaluate the outcomes of implementing the AV in a tertiary hospital. Methods The study was performed in Gazi University Health Research and Application Hospital, Core Biochemistry Laboratory, between August 2017 and October 2019. Step by step, AV algorithms were designed and implemented via middleware for 29 clinical biochemistry tests. A comprehensive validation was performed before the AV system was run. Initially, AV system was tested with datasets and simulated patients (dry testing). Next, samples that may violate AV rules were tested anonymously with no-named trial barcodes (wet testing). Finally, validation of the system was performed with real patients, while the AV was running in the background but not active (i.e., while the manual verification was still going on). After all these steps were successful, the system was started. Results In the daytime, AV rates were ≥75 % for 23 of 29 tests. In night-shift, AV rates were ≥70 % for 16 of 25 tests. Report-based performance was found 26 % for daytime. TAT in the daytime decreased after AV implementation. Conclusions Although this is the first time we have implemented the AV, a significant percentage of the tests have been verified. However, approaches that will increase the percentage of report-based verification will enhance the efficiency of autoverification.