BACKGROUND: Assessment of kidney function in emergency settings is essential across all medical subspecialties. Daily assessment of patient creatinine results from emergency medical services showed that some deviated from expected values, implying drug-related interference. METHODS: Real-time clinical evaluation of an enzyme method (Roche CREP2) in comparison with the Jaffé gen. 2 method (Roche CREJ2) was performed. During the period of December 2022 and January 2023, we analyzed 8,498 patient samples, where 5,524 were heavily medicated STAT patient specimens, 500 were pediatric specimens, and 2,474 were from a distant general population in a different region using the same methods. RESULTS: In 109 out of 5,524 hospital specimens (1.97%, p < 0.001), the CREP2 value was apparently (25% or more) lower than CREJ2. Suspect interfering medication was found in a sample of 43 out of 46 reviewed patients where medication data were available. This phenomenon was not observed in the general population. CONCLUSION: In a polymedicated urgent care hospital population, a creatinine enzyme method produces unreliable results, apparently due to multiple drug-related interferences.
- Publikační typ
- časopisecké články MeSH
The inability to predict the evolution of the COVID-19 epidemic hampered abilities to respond to the crisis effectively. The cycle threshold (Ct) from the standard SARS-CoV-2 quantitative reverse transcription-PCR (RT-qPCR) clinical assay is inversely proportional to the amount of SARS-CoV-2 RNA in the sample. We were interested to see if population Ct values could predict future increases in COVID-19 cases as well as subgroups that would be more likely to be affected. This information would have been extremely helpful early in the COVID-19 epidemic. We therefore conducted a retrospective analysis of demographic data and Ct values from 2,076,887 nasopharyngeal swab RT-qPCR tests that were performed at a single diagnostic laboratory in the Czech Republic from April 2020 to April 2022 and from 221,671 tests that were performed as a part of a mandatory school surveillance testing program from March 2021 to March 2022. We found that Ct values could be helpful predictive tools in the real-time management of viral epidemics. First, early measurement of Ct values would have indicated the low viral load in children, equivalent viral load in males and females, and higher viral load in older individuals. Second, rising or falling median Ct values and differences in Ct distribution indicated changes in the transmission in the population. Third, monitoring Ct values and positivity rates would have provided early evidence as to whether prevention measures are effective. Health system authorities should thus consider collecting weekly median Ct values of positively tested samples from major diagnostic laboratories for regional epidemic surveillance.
- MeSH
- COVID-19 * epidemiologie diagnóza MeSH
- dítě MeSH
- lidé MeSH
- retrospektivní studie MeSH
- RNA virová genetika analýza MeSH
- SARS-CoV-2 * genetika MeSH
- senioři MeSH
- virová nálož MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
Cíle studie: Vývoj a implementace metody stanovení volných metanefrinů v plazmě pomocí kapalinové chromatografie s tandemovou hmotnostní detekcí (LC-MS/MS) pro rutinní použití v diagnostické laboratoři, která eliminuje omezení klasické kapalinové (HPLC) nebo plynové chromatografie (GC) a imunoanalytických metod, jako jsou náročná příprava vzorků, derivatizace a interferující substance. Typ studie: Vývoj analytické metody. Posouzení vhodnosti pro rutinní použití v diagnostické laboratoři. Název a sídlo pracoviště: Laboratoř klinické biochemie – Oddělení instrumentálních metod, Spadia lab, a.s., Dr. Slabihoudka 6232/11, 708 52 Ostrava. Materiál a metody: Vývoj a validace metody byly provedeny na LC-MS/MS systému Agilent 6490 Triple Quadrupole. Pro chromatografickou separaci byla použita kolona SeQuant®ZIC®HILIC HPLC 3,5 mm, 100Å, PEEK 100 x 2,1 mm metalfree (Merck KGaA, Německo) a gradientová eluce. Pro stanovení analytických parametrů metody byly použity lyofilizované kalibrační a kontrolní materiály z firmy Recipe Chemicals and Instruments GmbH (Německo) a Chromsystems Instruments α Chemicals GmbH (Německo). Do studie bylo zařazeno 40 pacientů s diagnózou arteriální hypertenze. Výsledky: Analytické parametry nově vyvinuté metody jsou vyhovující. Variační koeficienty (CV) preciznosti v sérii a mezilehlá preciznost se pohybovaly pod 10%. Výtěžnost, určená metodou standardního přídavku se pohybovala v rozmezí 89 až 98%. Limit stanovitelnosti pro MN byl 0,035 nmol/l, pro NMN 0,049 nmol/l. Metoda splňuje požadavky validace pro oba analyty. Bylo provedeno srovnání tří metod stanovení volných metanefrinů v plazmě: 2-MET Plasma ELISAFast Track (Labor Diagnostika Nord GmbH, Něměcko), HPLC metoda s elektrochemickou detekcí (ECD) a komerčně dodávaná diagnostická souprava FEO Kit (VUOS a.s., Česká republika) a nově vyvinutá LC-MS/MS metoda. Statistická analýza byla provedena pomocí programu MedCalc 16.1 (Medcalc Software bvba, Belgie) s využitím Passing Bablokovy regresní analýzy. Závěr: Neuroendokrinní tumory představují heterogenní skupinu onemocnění s různou klinickou symptomatologií a etiopatogenezí. Neuroendokrinní tumory, jako jsou feochromocytom nebo paragangliom, vykazují setrvalou nebo paroxyzmální nadměrnou produkci katecholaminů. Jejich 3-O-methylované metabolity, metanefrin (MN) a normetanefrin (NMN), jsou preferovány pro diferenciální diagnostiku feochromocytomu vzhledem k jejich vysoké diagnostické senzitivitě a specificitě. Prezentovaná LC-MS/MS metoda eliminuje nevýhody klasických chromatografických technik a imunoanalytických metod, přičemž zásadními aspekty jsou: jednoduchá příprava vzorku, krátká doba analýzy a požadované analytické parametry.
Objective: The development and implementation of method for the determination of free metanephrines in plasma by the liquid chromatography tandem mass spectrometry (LC-MS/MS) suitable for routine practice in diagnostic laboratory which overcomes inconveniences related with classical liquid (HPLC) or gas chromatography (GC) and immunoassay approaches, like extensive sample preparation, the step of derivatization or interfering substances. Design: Analytical method development. Assessment of suitability for routine practice in diagnostic laboratory. Settings: Department of Clinical Biochemistry – Instrumental methods section, Spadia lab, a.s., Dr. Slabihoudka 6232/11, 708 52 Ostrava Material and Methods: Method development and validation were performed on Agilent 6490 Triple Quadrupole LC-MS/MS system. Chromatographic separation was achieved on SeQuant®ZIC®HILIC HPLC 3,5 µm, 100Å, PEEK 100 x 2,1 mm metal-free HPLC Column (Merck KGaA, Germany) by gradient elution. For determination of analytical parameters lyophilised plasma calibrators (purchased from RECIPE Chemicals and Instruments GmbH, Germany) and controls (purchased from Recipe Chemicals and Instruments GmbH and Chromsystems Instruments α Chemicals GmbH, Germany) were used. The study included 40 patients with diagnosis arterial hypertension. Results: The analytical performance of the new developed method is satisfactory. The intra-assay and inter-assay coefficients of variation (CV) were below 10%. Recoveries determined by standard addition were from 89 to 98%. The limit of quantification for MN was 0.035 nmol/l, for NMN was 0.049 nmol/l. This method fulfilled requirements for validation parameters for both analytes. Comparison of three methods for quantification of free metanephrines in plasma was performed– 2-MET Plasma ELISAFast Track (Labor Diagnostika Nord GmbH, Germany), FEO Kit (VUOS a.s., Czech Republic) dedicated for HPLC-ECD systems and developed LC-MS/MS method. Statistical analysis was performed using the MedCalc 16.1 (Medcalc Software bvba, Belgium) using the Passing Bablok regression. Conclusions: Neuroendocrine tumors represent a clinically and etiologically diverse group of disorders. Neuroendocrine tumors, such as pheochromocytomas or paragangliomas, exhibit a persistent or pyroxysmal excessive catecholamines production. 3-O-methylated catecholamine metabolites, metanephrine (MN) and normetanephrine (NMN), are prioritized for diagnosis of pheochromocytoma due to their highest diagnostic sensitivity and specificity. Presented LC-MS/MS method overcomes classical HPLC and immunoassay approaches. Method provides simple step of sample preparation, short runtime and required analytical parameters
- MeSH
- časná detekce nádoru MeSH
- chromatografie kapalinová metody přístrojové vybavení MeSH
- ELISA metody MeSH
- feochromocytom diagnóza krev MeSH
- hmotnostní spektrometrie metody přístrojové vybavení MeSH
- metanefrin analýza krev MeSH
- odběr biologického vzorku metody normy MeSH
- reagenční diagnostické soupravy MeSH
- MeSH
- biomedicínský výzkum MeSH
- hemostáza MeSH
- kardiovaskulární nemoci MeSH
- klinické lékařství MeSH
- veterinární lékařství MeSH
- Publikační typ
- biografie MeSH
- O autorovi
- Klement, Petr, 1951-2010 Autorita
- Publikační typ
- abstrakt z konference MeSH
- Publikační typ
- abstrakt z konference MeSH
