Clinical Chemistry Department Research Articles

Magnesium matters: unveiling hidden risks in kidney transplant patients through total and ionized magnesium profiling

BackgroundIn kidney transplant (KT) patients, magnesium (Mg2+) deficiency is widespread. It is often encountered early after KT, may persist longer, and is frequently promoted by calcineurin inhibitors (CNIs) and tubular leakage. Studies demonstrated an association between post-KT hypomagnesemia and allograft dysfunction. The concentration of the active form, the ionized Mg2+ (iMg2+), is not measured clinically, and total Mg2+ (tMg2+) and iMg2+ correlations are conflicting. We assess the cross-sectional prevalence of hypomagnesemia in KT patients. The correlation of demographic and anthropometric parameters was also studied.MethodsA prospective, single-center analysis of KT patients was conducted at the University Hospital of Bern, Switzerland (March 2023–August 2023). Blood samples were collected at least twice for the majority of patients. tMg2+ has been quantified from a plasma sample at the Clinical Chemistry Department of the University Hospital of Bern. The PRIME® ES analyzer (Nova Biomedical, USA) provided results for iMg2+. The following co-variables were considered: age, comorbidities, kidney disease, KT history, estimated glomerular filtration rate (eGFR), and treatment (including Mg2+ supplementation and immunosuppression).ResultsA total of 208 measurements in 104 patients were performed [once in 9/104 patients (8.7%), twice in 86/104 (82.7%), and three times in 9/104 (8.7%)]. Compared to that in healthy volunteers (51 measurements in 51 participants), mean iMg2+ was significantly lower in KT patients {KT: 0.46 mmol/L [interquartile range (IQR): 0.40–0.50], volunteers: 0.57 mmol/L (IQR 0.54–0.61), p < 0.01}. Overall, iMg2+ and tMg2+ showed strong category agreement (r2 = 0.93, p < 0.01). In linear regression, low iMg2+ correlated with CNI exposure. For 110/208 measurements (52.9%), a reduced iMg2+ (cutoff: 0.42 mmol/L) was shown. In 58/208 (27.9%), both values were reduced, and 52/208 (25%) had isolated reduced iMg2+. In principal component analysis, patients with isolated low iMg2+ clustered with patients with low iMg2+ and tMg2+.ConclusioniMg2+ and tMg2+ were strongly correlated. A substantial proportion of patients show isolated low iMg2+. Currently, it is unclear if these patients suffer from Mg2+ deficiency.

First trimester maternal tryptophan metabolism and embryonic and fetal growth: the Rotterdam Periconceptional Cohort (Predict Study).

What is the association between first trimester maternal tryptophan (TRP) metabolites and embryonic and fetal growth? Higher 5-hydroxytryptophan (5-HTP) concentrations are associated with reduced embryonic growth and fetal growth and with an increased risk of small-for-gestational age (SGA), while higher kynurenine (KYN) concentrations are associated with a reduced risk of SGA. The maternal TRP metabolism is involved in many critical processes for embryonic and fetal growth, including immune modulation and regulation of vascular tone. Disturbances in TRP metabolism are associated with adverse maternal and fetal outcomes. This study was embedded within the Rotterdam Periconceptional Cohort (Predict Study), an ongoing prospective observational cohort conducted at a tertiary hospital from November 2010 onwards. A total of 1115 women were included before 11 weeks of gestation between November 2010 and December 2020. Maternal serum samples were collected between 7 and 11 weeks of gestation, and TRP metabolites (TRP, KYN, 5-HTP, 5-hydroxytryptamine, and 5-hydroxyindoleacetic acid) were determined using a validated liquid chromatography (tandem) mass spectrometry method. Serial 3D ultrasound scans were performed at 7, 9, and 11 weeks of gestation to accurately assess features of embryonic growth, including crown-rump length (CRL) and embryonic volume (EV) offline using virtual reality systems. Fetal growth parameters were retrieved from medical records and standardized according to Dutch reference curves. Mixed models were used to assess associations between maternal TRP metabolites and CRL and EV trajectories. Linear and logistic regression models were utilized to investigate associations with estimated fetal weight (EFW) and birthweight, and with SGA, respectively. All analyses were adjusted for potential confounders. Maternal 5-HTP concentrations and the maternal 5-HTP/TRP ratio were inversely associated with embryonic growth (5-HTP, √CRL: β = -0.015, 95% CI = -0.028 to -0.001; 5-HTP 3√EV: β = -0.009, 95% CI = -0.016 to -0.003). An increased maternal 5-HTP/TRP ratio was also associated with lower EFW and birthweight, and with an increased risk of SGA (odds ratio (OR) = 1.006, 95% CI = 1.00-1.013). In contrast, higher maternal KYN concentrations were associated with a reduced risk of SGA in the unadjusted models (OR = 0.548, 95% CI = 0.320-0.921). Residual confounding cannot be ruled out because of the observational design of this study. Moreover, this study was conducted in a single tertiary hospital, which assures high internal validity but may limit external validity. The novel finding that maternal 5-HTP concentrations are associated with a smaller embryo and fetus implies that disturbances of the maternal serotonin pathway in the first trimester of pregnancy are potentially involved in the pathophysiology of fetal growth restriction. The association between higher maternal KYN concentrations and a reduced risk of SGA substantiate the evidence that the KYN pathway has an important role in fetal growth. More research is needed to delve deeper into the potential role of the maternal TRP metabolism during the periconception period and pregnancy outcome for mother and offspring. This study was funded by the Department of Obstetrics and Gynecology and the Department of Clinical Chemistry of the Erasmus MC, University Medical Center, Rotterdam, the Netherlands. The authors have no competing interests to disclose. N/A.

Prognostic impact of the controlling nutritional status score in Chinese patients undergoing cardiac surgery

Prognostic impact of the controlling nutritional status score in Chinese patients undergoing cardiac surgery

Severe Hypercalcemia in Pregnancy Presenting a Diagnostic Conundrum.

Journal Article Severe Hypercalcemia in Pregnancy Presenting a Diagnostic Conundrum Get access Emma E Croker, Emma E Croker Department of Clinical Chemistry; NSW Health Pathology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaDepartment of Diabetes and Endocrinology, John Hunter Hospital, New Lambton Heights, NSW, Australia Address correspondence to this author at: John Hunter Hospital, Locked Bag 1, Hunter Region, NSW, Australia, 2310. Tel +61-(2)-49214380; e-mail emma.croker@health.nsw.gov.au. https://orcid.org/0000-0003-4104-3923 Search for other works by this author on: Oxford Academic Google Scholar Carl Jenkinson, Carl Jenkinson Andrology, ANZAC Research Institute, Sydney NSW 2139, Australia Search for other works by this author on: Oxford Academic Google Scholar Richard Ruddell, Richard Ruddell Department of Clinical Chemistry; NSW Health Pathology, John Hunter Hospital, New Lambton Heights, NSW, Australia Search for other works by this author on: Oxford Academic Google Scholar Katie Wynne Katie Wynne Department of Diabetes and Endocrinology, John Hunter Hospital, New Lambton Heights, NSW, AustraliaSchool of Medicine and Public Health, College of Health, Medicine and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia Search for other works by this author on: Oxford Academic Google Scholar The Journal of Applied Laboratory Medicine, jfad030, https://doi.org/10.1093/jalm/jfad030 Published: 21 June 2023 Article history Received: 08 February 2023 Accepted: 31 March 2023 Published: 21 June 2023

CLSI Guided Reference Interval Limits for Cancer Biomarkers for Adults and Geriatrics

Reference interval limits for cancer biomarkers in geriatrics are rare because priority is given to the development of reference interval limits for those in the age range of 18–60 years, which are normally used for clinical trials study. The aim of this study was therefore to develop gender and age-specific reference interval limits for cancer markers CA19-9, CEA, CA 15-3, CA 125, and PSA for adults and geriatrics in Taita-Taveta County, Kenya, using the CLSI CA28-A3 guideline. This prospective cross-sectional study involved 244 healthy referents, including 124 females and 120 males of ages 50–95, between May 2015 and December 2017 at the Department of Clinical Chemistry of Moi Subcounty Hospital, Voi, Kenya. Serum CA 19-9, CEA, CA 15-3, CA 125, and PSA of the 244 referents were measured using a well-calibrated, quality controlled Clinical Chemistry AutoAnalyzer. Gender differences in the measured values of the biomarkers were assessed using the Mann-Whitney U test, while age differences were assessed using the Kruskal-Wallis H test followed by the Mann-Whitney U test with an adjusted significant ρ-value of less than 0.0167. Reference interval limits for the measured cancer biomarkers were expressed in terms of medians and ranged between 2.5 and 97.5 percentiles. The established 95% reference interval limits were: 0-58 U/mL males and 0-42.8 U/mL females for CA 19–9, 0–7 ng/mL for CEA, 0-56.9 U/mL for CA 15–3, 0–25 ng/mL for CA 125, and 0–6.8 ng/mL for PSA. Gender-related biomarker values were developed for CA 19-9 adults and geriatrics (60–70 years), CEA for geriatrics (60–70 years), and CA 15-3 for adults. Age-related biomarker values were developed for CA 19–9 males and not for females. In conclusion, gender-related 95% reference interval limits were developed for CA 19-9, CEA, CA 15-3, CA 125, and PSA, and age-related 95% reference interval limits were established for CA 19-9. CA 19-9 decreased from adulthood to the early elderly and increased in the more elderly population. These developed reference interval limits for these biomarkers, which differed from those reported in previous literature, could be adopted for use in Taita-Taveta County, Kenya, for better medical care. Doi: 10.28991/SciMedJ-2022-04-02-04 Full Text: PDF

German Camejo (1936–2021)

German Camejo (1936–2021)

The relationship between the laboratory diagnosis of Lyme neuroborreliosis and climate factors in Kalmar County Sweden — an overview between 2008 and 2019

The purpose of this study was to describe the epidemiology of Lyme neuroborreliosis (LNB) in Kalmar County, in southern Sweden, between 2008 and 2019, and to analyse the relationship between the LNB incidence and climate factors. Data containing cerebrospinal fluid (CSF) cell counts and borrelia CSF/serum antibody index results was received from the departments of clinical chemistry and microbiology at Kalmar County hospital. For this study, we defined LNB as a case with a positive borrelia antibody CSF/serum index and CSF leukocytes > 5 × 106/L. Climate data including mean temperature, humidity and precipitation covering Kalmar County was collected from the Swedish Meteorological and Hydrological Institute. A total of 5051 paired serum-CSF samples from 4835 patients were investigated of which 251 laboratory LNB cases were found. The average annual LNB incidence in Kalmar County 2008–2019 was 8.8 cases per 100,000 inhabitants. Positive relationships were observed between mean temperature and LNB incidence (p < 0.001) as well as precipitation and LNB incidence (p = 0.003), both with a one calendar month delay. The results suggest an association between climate factors such as mean temperature and precipitation and LNB incidence, presumably through increased/decreased human-tick interactions. This calls for increased awareness of LNB in both the short perspective after periods of warmth and heavy precipitation as well as in a longer perspective in relation to possible climate change. Further studies with larger study groups, covering other geographical areas and over longer periods of time are needed to confirm these findings.

Use of Quantitative Dried Blood Spots to Evaluate the Post-Vaccination Level of Neutralizing Antibodies against SARS-CoV-2.

To combat the COVID-19 pandemic, vaccines against SARS-CoV-2 are now given to protect populations worldwide. The level of neutralizing antibodies following the vaccination will evolve with time and vary between individuals. Immunoassays quantifying immunoglobulins against the viral spike (S) protein in serum/plasma have been developed, but the need for venous blood samples could limit the frequency and scale of control in populations. The use of a quantitative dried blood spot (DBS) that can be self-collected would simplify this monitoring. The objective of this study was to determine whether a quantitative DBS device (Capitainer qDBS 10 µL) could be used in combination with an Elecsys anti-SARS-CoV-2 S immunoassay from Roche to follow the development and persistence of anti-S antibodies. This objective was carried out through two clinical studies. The first study investigated 14 volunteers who received two doses of the Comirnaty (Pfizer) vaccine. The levels of anti-S antibodies and the progression over time post-vaccination were studied for three months. The level of produced antibodies varied between subjects, but a similar trend was observed. The anti-S antibodies were highly stimulated by the second dose (×100) and peaked two weeks later. The antibody levels subsequently decreased and three months later were down to 65%. DBS proved to be sufficiently sensitive for use in evaluating the immune status against SARS-CoV-2 over a prolonged time. The second cohort was composed of 200 random patients from a clinical chemistry department in Stockholm. In this cohort, we had no information on previous COVID-19 infections or vaccination. Nevertheless, 87% of the subjects had anti-S immunoglobulins over 0.8 U/mL, and the bias between plasma and DBS proved to be variable, as was also seen in the first vaccination study.

Female Voice-Related Sexual Attractiveness to Males: Does it Vary With Different Degrees of Conception Likelihood?

Previous investigations have found that female voice-related attractiveness to males increases when both conception likelihood (CL) and voice fundamental frequency (fo) are elevated. To test this hypothesis, we conducted a perceptual experiment where 78 heterosexual males rated sexual attractiveness of 9 female voice samples, recorded at menstrual, follicular and luteal phases of the menstrual cycle under two double-blinded randomly allocated conditions: a natural menstrual cycle (placebo condition) and when using an oral contraceptive pill (OCP condition). The voice samples yielded a total of 54 stimuli that were visually sorted and rated using Visor software. Concentrations of estrogens, progesterone and testosterone were analyzed, and measurements of speaking fundamental frequency (sfo) and its standard deviation (sfoSD), fo derivative (dfo) and fo slope were made. A multilevel ordinal logistic regression model nested in listeners and in females, and adjusted by phase and condition, was carried out to assess the association between ratings and: (1) phases and conditions; (2) sex steroid hormonal concentrations; and (3) voice parameters. A high probability of obtaining high ratings of voice sexual attractiveness was found for: (1) menstrual phase of placebo use and follicular phase of OCP use; (2) for low estradiol to progesterone ratio and testosterone concentrations; and (3) for low dfo. The latter showed a moderate statistical association with ratings of high attractiveness, as compared with the small association found for the remaining variables. It seems that the voice is a weak cue for female CL. Female sexual attraction to males may be a consequence of what females do in order to regulate their extended sexuality across the menstrual cycle rather than of estrus cues, the use of paralinguistic speech patterns being an example.

MODULATION OF THENRF2 BINDING REGIONS THROUGH SYNTHETIC INHIBITORS

21Jul 2020 MODULATION OF THENRF2 BINDING REGIONS THROUGH SYNTHETIC INHIBITORS Nagiasuliman M.S.c and Omer Balla Ph.D Department of Clinical Chemistry, College Of Medical Laboratory Science, Al Gezeria University, Madani, box 20, Sudan.

In memory of Professor Rolf Neth October 6, 1926 – March 17, 2020

With great sadness, we learned of the passing of Professor Dr. med. Rolf-Dietmar Neth, the founder of the Wilsede meeting, on March 17, 2020, aged 93 in his home town Buchholz near Wilsede/Lüneburger Heide. Rolf Neth was born 6.10.1926. After the 2nd World War, Rolf Neth studied Medicine from 1949 to 1955 at the University of Göttingen. Then he was at the Max-Planck-Institut für Experimentelle Medizin (University Göttingen, 1956-1957), and promoted his skills in clinical and experimental hematology in St. George Hospital (1958-1959) in Hamburg. From 1960, his activity was connected with the pediatric clinics of Hamburg University where he became a Professor at the Children Hospital in 1972. From 1970 to 1980, Rolf Neth was occupied implementing new laboratory diagnostic approaches in the booming field of clinical hematology. Blood cancer treatment was developed, due to novel drugs invented to combat leukemic cells and rescue the small patients which 10-20 years ago had only zero chance to survive. Histo- and immunochemical diagnostics became routine tests for evaluation of clinical forms of leukemias and efficiency of their therapy. Since 1982, he coordinated laboratory hematology at the Department of Clinical Chemistry, University Hamburg, until retirement in 1992. Along with contribution to clinical laboratory science, Professor Neth, over 1973 to 2002, arranged a series of famous Wilsede Meetings "Modern Trends in Human Leukemia" dedicated to leukemia research and treatment. Rolf Neth and Robert Gallo decided time and topic of the meeting, and Rolf Neth proposed a place, i.e., a lonely village in the Luneburg heath, not far from his home. Hence, Leukemia and Viruses was selected as a specific topic for a meeting in Germany, because it was timely for convergence between clinical medicine and cancer biology. Rolf Neth organized the first Wilsede meetings himself for more than 20 years, until he passed these efforts to Wolfram Ostertag and Axel Zander. In the late 1990s, Carol Stocking and Boris Fehse took on this responsibility. Over last years, Wilsede meetings were arranged by Nicolaus Kröger and Boris Fehse. And as long as his health permitted, Rolf Neth came along to see how his baby was doing. He participated and assisted at any stage of the next meeting. We are thankful to have had the privilege of knowing and cooperating with Rolf Neth and to cherish his legacy by keeping the Wilsede tradition alive. He was married with Hanne-Lore Cohrs, 8.11. 1958, survived by his wife of 62 years Hanne-Lore, and four sons and several grandchildren.

Diagnostic Significance of Serum Total Bile Acid Levels in Suspected Cases of Obstetric Cholestasis

Introduction: Intrahepatic Cholestasis of Pregnancy (ICP) is significantly associated with adverse maternal and fetal outcome and therefore accurate diagnosis and timely initiation of therapy is of utmost importance. Aims &amp; Objectives: To find out the diagnostic significance of serum total bile acid measurement in suspected cases of obstetric cholestasis. Place and duration of study: It was a cross sectional study conducted in the Department of Clinical Chemistry and Immunology, Chughtai Institute of Pathology from July 2018 to February 2019. Material &amp; Methods: Two hundred pregnant females whose serum total bile acid (TBA) was determined were included in the study. Pregnant females with cholestasis due to medical reasons other than ICP were excluded from the study. The patients were contacted for relevant clinical details which were recorded on a pre-designed proforma. Data was analyzed using SPSS 23.0. Univariate analysis was done to find out percentages and frequencies. Results: Mean age of 200 pregnant females was 27 years having Mean TBA value of 32.8 ?mol/L. 63% females were primiparous. 197 (98.5%) patients gave the history of pruritus while 193 (96.5%) patients presented with dark urine. Only 30 patients (15%) gave history of using progesterone during pregnancy. Total Bile acid value was &gt;10 ?mol/L for 84 primiparous and 48 multiparous cases (n=132). There was no significant difference in the mean TBA value on the basis of parity, medication, mode of delivery or presence and absence of itch. Conclusion: ICP is a multi factorial reversible condition and bile acid estimation plays a major role in correct clinical assessment of patients with obstetric cholestasis.

Urinary Concentrations of Phthalate Metabolite Mixtures in Relation to Serum Biomarkers of Thyroid Function and Autoimmunity among Women from a Fertility Center.

Background:Although previous epidemiological studies have explored associations of phthalate metabolites with thyroid function, no studies to date have assessed associations of mixtures with thyroid function and autoimmunity among potentially susceptible subgroups such as subfertile women.Objective:We aimed to explore associations of mixtures of urinary phthalate metabolites with serum markers of thyroid function and autoimmunity.Methods:This cross-sectional study included 558 women attending a fertility center who provided one spot urine and one blood sample at enrollment (2005–2015). We quantified urinary concentrations of eight phthalate metabolites using mass spectrometry, and biomarkers of thyroid function [thyroid-stimulating hormone (TSH), free and total thyroxine (, ) and triiodothyronine (, ), and autoimmunity [thyroid peroxidase and thyroglobulin antibodies (TPOAb and TgAb, respectively)] in serum using electrochemiluminescence assays. We applied principal component analysis (PCA) and Bayesian kernel machine regression (BKMR) to identify the main patterns of urinary phthalate metabolites. We used linear mixed models to assess the association between PCA-derived factor scores in quintiles and serum thyroid function and autoimmunity, adjusting for age, body mass index (BMI), specific gravity (SG), and, for the PCA, other factor scores.Results:We observed two factors using PCA, one representing the di(2-ethylhexyl) (DEHP) and another non-DEHP metabolites. Compared to women in the lowest quintile of the DEHP factor scores, women in the highest quintile had significantly lower serum concentrations of , , , and [absolute difference: ; 95% confidence interval (CI): , ; ; absolute difference: ; 95% CI: , ; ; absolute difference: ; 95% CI: 0.54, ; ; and absolute difference: ; 95% CI: , ; , respectively]. Using BKMR, we observed that mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) was the primary contributor to these negative associations. DEHP and non-DEHP factor scores were not associated with serum TSH, TgAb, or TPOAb.Conclusions:Mixtures of urinary DEHP metabolites were inversely associated with serum biomarkers of thyroid function but not with autoimmunity, which were within normal ranges for healthy adult women. https://doi.org/10.1289/EHP6740

Hyperreninemia and low total body water may contribute to acute kidney injury in COVID-19 patients in intensive care.

Corona virus disease 2019 (COVID-19) is primarily associated with respiratory failure but both renal and circulatory failure is a common occurrence in patients with more severe disease that require intensive care [1], or die of the disease [2]. The developing guidelines for treating COVID-19 patients in intensive care suggest a frugal fluid strategy to avoid acute respiratory distress syndrome [3]. However, this may leave fluid resuscitation insufficient for renal and circulatory function increasing the risk of acute kidney injury (AKI). This case series is part of a study approved by the National Ethical Review Agency (EPM; No. 2020-01623). Informed consent was obtained from the patient, or next of kin if the patient was unable give consent. The Declaration of Helsinki and its subsequent revisions were followed. Plasma renin as well as biochemistry was collected with routine clinical sampling in the morning and analysed by the clinical chemistry department at Uppsala University Hospital according to standard procedures. We present a case series where we found pronounced hyperreninemia in association with hypernatremia, hyperchloremia and low glomerular filtration rate primarily in patients late in their intensive care stay (Table 1).TABLE 1: Biochemistry of patients ordered by days after intensive care admissionThere are several possible explanations for these findings. One is that the ACE2 affinity of SARS-COV-2 [4] directly affects the renin–angiotensin system and drives renin secretion despite high circulating sodium chloride. However, the association with high sodium and chloride suggests extra cellular fluid contraction and for the kidneys excessively restrictive fluid therapy with hypovolemia and water deficit. An alternative is a virus-induced or cytokine-induced renin release acting as a pseudohypovolemia. In this setting, the combination of high renin and high chloride may interact through the tubuloglomerular feedback system to supress glomerular filtration rate, thereby contributing to the development of AKI in COVID-19 patients. The data may also suggest that this is an iatrogenic cause during intensive care as we do not see it in recently admitted patients. The restrictive use of fluid resuscitation in COVID-19 may be beneficial for the lungs but may also promote AKI. However, if coagulopathy and microthrombi contribute importantly to the progression as has been suggested, low circulating volume may impair pulmonary flow regulation and thereby oxygenation as well. Significantly, the use of renin–angiotensin blockers have been found to be associated with improved outcome [5], and the present data may suggest that ameliorating the overactivation of the renin–angiotensin system may be a mechanism. In conclusion, patients with COVID-19 tend to develop hyperreninemia combined with hypernatremia and hyperchloremia in intensive care, which is associated with AKI in a way that suggests hypovolemia or pseudohypovolemia. ACKNOWLEDGEMENTS Conflicts of interest There are no conflicts of interest.

Development of preanalytical criteria assessment of quality of vacuum blood collection systems affecting clinical examination of patients

This paper presents comparative studies of preanalytical quality indices of vacuum gel systems (VGS) from four manufacturers, i.e., GL 795 (China), Vacuette (Austria), BD Vacutainer SST (USA) and Zdravmedtech (Russia). The analysis of the number of qualitative defects of the preanalytic phase of blood collection in vacuum gel tubes at the inpatient departments and in Department of Clinical Chemistry (preanalytic laboratory), in accordance with adopted criteria based on Russian industry standards, which are implemented with European indices of pre-analytic stage. The obtained results allowed us to identify a number of qualitative defects at pre-analytic stage for the vacuum gel systems from each manufacturer, including to summarize the data on number of these defects. Based on these results, the most common defects in each of the VGS presented by manufacturers are formulated. The results obtained can be used by manufacturers to improve the quality (structures) of the mentioned vacuum gel tubes.The results of the comparative characteristics of VGS of different manufacturers were evaluated by their influence on the indexes of hemolysis (IH), ictericity, lipemia. The resulting indices of ictericity and lipemia do not allow to use them as criteria for assessing quality of the gel systems. The frequency of IH occurrence in serum at &gt; 50 conventional units in VGS of different manufacturers was studied. It was revealed, that IH in the range from 10 to 50 conventional units and more, can be used as a criterion of VGS quality.Comparison of routine biochemical parameters in VGS of different manufacturers, i.e., alanine aminotransferase, aspartate aminotransferase, direct bilirubin, lactate dehydrogenase (LDH), serum K+, was also carried out. It was found that the largest deviations from the average value were obtained for aspartate aminotransferase indices of more than 12.47% in Russian test tubes, and for direct bilirubin of more than 12.25% in Chinese test tubes and more than 9.15% in Russian test tubes. The study showed influence of IH upon quantitative values of lactate dehydrogenase for VGS from different manufacturers. It is proposed to use lactate dehydrogenase as an analyte. On this basis, it is possible to recommend a comparative quality assessment of vacuum gel systems, with IH cutoff level of more than 19 conventional units. It remains relevant to search for other analytes that can be used to assess the quality of VGS from different manufacturers. Some areas of research in biochemical testing are outlined. Preliminary data are obtained on usage of vacuum systems from different manufacturers for quality assessment, as well as conditions for performing these tests, along with the level of the hemolysis index of more than 10 conventional units.

DETECTION OF HUMAN CYTOMEGALO VIRUS AMONG MALE WITH INFERTILITY DISORDERS IN KHARTOUM STATE, SUDAN.

16Jan 2019 DETECTION OF HUMAN CYTOMEGALO VIRUS AMONG MALE WITH INFERTILITY DISORDERS IN KHARTOUM STATE, SUDAN. Mohamad Yusuf Abdi , Mohammed Ahmed Ibrahim Holie , Ahmed Mohamed Ahmed Fadlalla and Elsadig Mohamed Ahmed. Department of microbiology, faculty of medical laboratory, University of Alzaem Alazhari, Khartoum Bahri, Sudan. Department of obstetrics and gynecology, faculty of medicine and health sciences, University of Alzaem Alazhari, Khartoum Bahri, Sudan. Department of medical laboratory sciences, college of applied medical sciences, University of Bisha. Bisha, 61922. p.o Box 551. Saudi Arabia. Department of clinical chemistry, faculty of medical laboratory, University of Elimam Elmahdi, Kosti, Sudam.

A systematic survey of low S-cortisol levels at the department of clinical chemistry: indications for testing and frequency of undiagnosed adrenal insufficiency

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

ASSESSMENT OF INSULIN RESISTANCE INDEX (HOMA-IR) AND LIPID PROFILE AMONG SUDANESE WOMEN WITH GALLSTONES.

30Dec 2017 ASSESSMENT OF INSULIN RESISTANCE INDEX (HOMA-IR) AND LIPID PROFILE AMONG SUDANESE WOMEN WITH GALLSTONES. Nisreen Abdalmuty Abdalrahman and Amar Mohamed Ismail. Department of Clinical Chemistry, Faculty of Medical Laboratory Science, University of AL-Neelain-Sudan. Department of Biochemistry and Molecular Biology, Faculty of Science and Technology, University of AL-Neelain -Sudan.

Hyperactivity in childhood as a predictor of school performance in elementary school: modifying effect of a serotonin receptor gene (5-HTR2A)

Introducción. La carga genética se ha sugerido como un elemento que interactúa con los predictores de la ejecución académica aunque la evidencia a este respecto es escasa. El propósito del estudio fue examinar si el temperamento hiperactivo influye en la ejecución escolar en función de la variabilidad del gen receptor de serotonina (5-HTR2A).Método. Los participantes en el estudio fueron 909 niñas y niños de Finlandia con edades comprendidas entre los 3 y los 12 años que fueron evaluados por las madres en relación a una dimensión del temperamento (baja actividad, actividad media o inquieto/hiperactivo). El ADN fue extraído de muestras sanguíneas. Existían tres grupos alélicos del 5-HTR2A: T/T, T/C y C/C. El rendimiento académico se evaluó mediante las puntuaciones medias de curso (PMC) en educación primaria a la edad de 12 años.Resultados. El modelo lineal general revela una interacción significativa entre la actividad el polimorfirmos del 5-HTR2A (p=.019). La actividad alta predecía bajo rendimiento académico en el genotipo T/T (b=-.25, p=.003), y alguna relación con el genotipo C/C (b=-.14, p=.002), y no se encontró ninguna asociación entre el temperamento y el rendimiento académico en relación al genotipo T/C (b=.03, p=.600). El grupo T/T con alta actividad tenía pero rendimiento académico en comparación con el resto de grupos alélicos.Discusión y conclusiones. Las características temperamentales han sido tradicionalmente consideradas como un factor de riesgo que puede tener diferentes efectos educativos en función de la vulnerabilidad genética. No obstante, la influencia de los mecanismos sociales y biológicos en lugar de los genes sobre los resultados educativos debe estudiarse más.

Endocrinopathies and renal outcomes in lithium therapy: impact of lithium toxicity.

Lithium is the mainstay of treatment for bipolar disorder, mania and an augmentation therapy in patients with treatment resistant depression. It has a narrow therapeutic index, with recognized adverse multi-system and endocrine side effects. To assess the impact of lithium therapy, in particular lithium toxicity, on the development of endocrine and renal disorders in a cohort of patients in a single tertiary referral centre in Ireland. A retrospective analysis was performed of the prevalence of lithium toxicity and renal, thyroid and parathyroid dysfunction in our study population. We collected laboratory data from the Clinical Chemistry department of the Adelaide and Meath Hospital incorporating the National Children's Hospital (AMNCH), Dublin, Ireland. Our study population included all patients who had at least one serum lithium measurement from January 1st 2000 to December 31st 2014 inclusive. A total of 580 patients were included in the study. Among our study group, 70 patients (12.1%) had 1 toxic lithium measurement (lithium level >1.2 mmol/l). 27.8% (n > 161) of patients developed stage 3 Chronic kidney Disease (CKD) or higher, which was commoner in those patients who developed toxic lithium levels (P < 0.0001) and in those who developed hypernatraemia (P > 0.0001). 16.2% of patients (n > 94) had one serum sodium >145 mmol/l during follow up. 60 patients(10.3%) had a TSH >10 mU/l, while complete suppression of TSH (<0.05 mU/l) was observed in 22 patients (3.8%) during follow-up. 4% (n > 37) of the study population had ≥1 serum corrected calcium level > 2.55 mmol/l, and 4 patients had biochemical confirmation of primary hyperparathyroidism but PTH levels were only performed in 2.8% (n > 16) of the studypopulation. Stage 3 CKD is common in patients receiving lithium therapy. Lithium toxicity is associated with CKD and hypernatraemia. Thyroid dysfunction and hypercalcaemia are common in patients receiving lithium therapy. Patients receiving lithium therapy require surveillance of renal, thyroid and bone biochemistry.