Pre-analytical quality in clinical chemistry testing is as important as analytical and post-analytical quality. The most prevalent pre-analytical interference and a major source of error producing unreliable laboratory test results is hemolysis of blood samples. In vitro hemolysis may be due to the blood withdrawal technique or sample handling whereas in vivo hemolysis can originate from acquired, hereditary, or iatrogenic conditions and is not technique dependent. Interpreting in vivo or in vitro hemolysis requires clinicians to supply reliable clinical history and findings. Even then, to reject or release the result with interpretation is still under debate. Thus, hemolyzed specimens are a serious pre-analytical problem calling for well-designed and strictly implemented laboratory guidelines. The aim of this non-systematic review (addressed to healthcare professionals) was to highlight the challenges in identifying and rejecting hemolysis specimens.

Hyperprolactinemia (hPRL) often poses a diagnostic dilemma due to the presence of macroprolactin. Understanding the prevalence of macroprolactinemia (mPRL) has an important implication in managing patients with hPRL. The primary aim of this study was to determine the prevalence of mPRL globally and to explore selected factors influencing the prevalence estimate. Studies with original data related to the prevalence of mPRL among patients with hPRL from inception to March 2020 were identified, and a random effects meta-analysis was performed. Of the 3770 records identified, 67 eligible studies from 27 countries were included. The overall global prevalence estimate was 18.9% (95% CI: 15.8%, 22.1%) with a substantial statistical heterogeneity (I² = 95.7%). The highest random effects pooled prevalence was observed in the African region (30.3%), followed by Region of the Americas (29.1%), European (17.5%), Eastern Mediterranean (13.9%), South-East Asian (12.7%), and Western Pacific Region (12.6%). Lower prevalence was observed in studies involving both sexes as compared to studies involving only female participants (17.1% vs. 25.4%) and in more recent studies (16.4%, 20.4%, and 26.5% in studies conducted after 2009, between 2000 and 2009, and before 2000, respectively). The prevalence estimate does not vary according to the age group of study participants, sample size, and types of polyethylene glycol (PEG) used for detection of macroprolactin (PEG 6000 or PEG 8000). With macroprolactin causing nearly one-fifth of hPRL cases, screening for mPRL should be made a routine before an investigation of other causes of hPRL.

Restoration Of Glutamine Synthetase Activity, Nitric Oxide Levels And Amelioration Of Oxidative Stress By Propolis In Kainic Acid Mediated Excitotoxicity

Thyroid hormones have a catabolic effect on bone homeostasis. Hence, this study aimed to evaluate serum vitamin D, calcium, and phosphate and bone marker levels and bone mineral density (BMD) among patients with different thyroid diseases. This cross-sectional study included patients with underlying thyroid diseases (n = 64, hyperthyroid; n = 53 euthyroid; n = 18, hypothyroid) and healthy controls (n = 64). BMD was assessed using z-score and left hip and lumbar bone density (g/cm²). The results showed that the mean serum vitamin D Levels of all groups was low (<50 nmol/L). Thyroid patients had higher serum vitamin D levels than healthy controls. All groups had normal serum calcium and phosphate levels. The carboxy terminal collagen crosslink and procollagen type I N-terminal propeptide levels were high in hyperthyroid patients and low in hypothyroid patients. The z-score for hip and spine did not significantly differ between thyroid patients and control groups. The hip bone density was remarkably low in the hyperthyroid group. In conclusion, this study showed no correlation between serum 25(OH)D levels and thyroid diseases. The bone markers showed a difference between thyroid groups with no significant difference in BMD.

Introduction: Procalcitonin (PCT) has attracted significant attention as a novel biomarker of sepsis. This study aimed to assess the agreement between blood results of PCT, obtained using the Finecare™ FIA Meter Plus (FS113), a point-of-care (POC) procalcitonin testing device, and the automated Elecsys® BRAHMS PCT assay on the Cobas e411, among critically ill septic patients. Methodology: This observational study was conducted in the intensive care unit of Hospital Universiti Sains Malaysia, in 2021. Whole blood samples were collected and tested with the Finecare™ FIA Meter Plus (FS113) (Wondfo, China) for PCT measurement. Additionally, the same whole blood samples were centrifuged to produce plasma samples, which were then analyzed using the automated Elecsys® BRAHMS PCT assay on the Cobas e411 (Roche Diagnostics, Germany). Results: A total of 40 samples were analyzed in this study. Both PCT measurement techniques demonstrated a significant correlation, with a correlation coefficient of 0.96. Regression analysis revealed the following results: an Ordinary Least Square (OLS) slope of 0.91 (95% CI 0.83, 1.00) with an intercept of 1.27 (95% CI -0.75, 3.29); a Deming slope of 0.95 (95% CI 0.80, 1.10) with an intercept of 0.77 (95% CI -0.44, 1.85); and a Passing-Bablok slope of 1.16 (95% CI 0.99, 1.36) with an intercept of 0.22 (95% CI 0.08, 0.58). Conclusion: The point-of-care procalcitonin measurement provided by the Finecare™ FIA Meter Plus presents a viable alternative for assessing procalcitonin levels among septic patients in the intensive care unit (ICU). Abbreviations: CLIA- chemiluminescence immunoassays; PCT- Procalcitonin; POC- Point-of-care Key words: procalcitonin, point of care, sepsis, Intensive care unit Citation: Ismail MA, Mazlan MZ, Hassan SK, Azman WNW, Koon TS, Yaacob NM, Omar M, Mohamad NAN. Evaluation of agreement between point-of-care and laboratory automated immunoassay in procalcitonin measurement among critically ill patients. Anaesth. pain intensive care 2023;27(4):470−477; DOI: 10.35975/apic.v27i4.2277 Received: November 27, 2022; Reviewed: July 11, 2023; Accepted: July 11, 2023

The study compared two plasma procalcitonin (PCT) assays, the point of care (POC) Finecare™ Procalcitonin Rapid Quantitative Test and the Elecsys^® BRAHMS PCT immunoassay, in sepsis ICU patients. Forty-one plasma samples were analyzed, showing a strong correlation (r = 0.98) and no significant difference in PCT values. The mean POC PCT value was 4.46 ng/mL (SD 8.68), and for laboratory BRAHMS PCT, it was 4.67 ng/mL (SD 10.03). The study found a strong linear relationship between plasma POC PCT and laboratory BRAHMS PCT (r = 0.98). Different regression methods showed varying intercepts and slopes: Ordinary Least Squares had an intercept of 0.49 and a slope of 0.85; Deming regression showed an intercept of 0.43 and a slope of 0.86; Passing–Bablok regression showed an intercept of 0.02 and a slope of 1.08. Precision results for cut-offs of 0.5 ng/mL were a coefficient of variation (CV) of 5%, and for 2.5 ng/mL, the CV was 2.5%. The Pearson correlation coefficient (r) for linearity was ≥0.99. The study revealed no significant difference between the POC Finecare™ PCT and Elecsys^® BRAHMS PCT immunoassay in sepsis samples from ICU patients, supported by strong correlation, minimal bias, a consistent CV, and linearity.