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  • 1.
    Aardal-Eriksson, Elisabeth
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Karlberg, Bengt E.
    Linköping University, Department of Medicine and Care, Internal Medicine. Linköping University, Faculty of Health Sciences.
    Holm, Ann-Charlotte
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Salivary cortisol: an alternative to serum cortisol determinations in dynamic function tests1998In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 36, no 4, p. 215-222Article in journal (Refereed)
    Abstract [en]

    Salivary cortisol was measured as an alternative to serum cortisol as a marker for adrenocortical function following insulin tolerance test, corticotropin-releasing-hormone stimulation and adreno-corticotrophic hormone stimulation. During insulin tolerance test and corticotropin-releasing-hormone stimulation adreno-corticotrophic hormone was also measured. The tests were performed on healthy control subjects as well as on patients under investigation for various disturbances in the hypothalamic-pituitary-adrenocortical axis (insulin tolerance test: 3 controls on two occasions and 14 patients; corticotropin-releasing-hormone stimulation: 4 controls and 18 patients; adreno-corticotrophic hormone stimulation: 6 controls and 10 patients). Five patients underwent both insulin tolerance test and corticotropin-releasing-hormone stimulation. Using criteria for adequate cortisol response in serum, the patients were classified as good or poor responders. In 42 of the 45 tests performed the same conclusion as to cortisol status was drawn when based on serum and salivary cortisol responses. In healthy subjects and good responders the mean cortisol relative increase was greater in saliva than in serum in all three tests (p < 0.05). Characteristic of the results for the insulin tolerance test was a significant initial mean decrease (p < 0.05), not found in serum, and the highest observed salivary cortisol value was delayed for at least 30 minutes compared to that in serum. Plasma adreno-corticotrophic hormone correlated significantly with the cortisol concentrations determined 15 minutes later in serum (r = 0.54–0.64) and in saliva (r = 0.76–0.85). The more pronounced cortisol response in saliva than in serum and its closer correlation with adreno-corticotrophic hormone offer advantages over serum cortisol, suggesting salivary cortisol measurement may be used as an alternative parameter in dynamic endocrine tets.

  • 2.
    Ben, Rayana M.C.
    et al.
    Ben Rayana, M.C., Laboratory of Clinical Chemistry, National Institute of Nutrition, Bab Saadoun, Tunis, Tunisia.
    Burnett, R.W.
    Department of Pathology, Hartford Hospital, Hartford, CT, United States.
    Covington, A.K.
    Department of Chemistry, University of Newcastle upon Tyne, Newcastle upon Tyne, United Kingdom.
    D'Orazio, P.
    Instrumentation Laboratory, Lexington, MA, United States.
    Fogh-Andersen, N.
    Laboratory of Clinical Chemistry, Herlev Hospital, Herlev, Denmark.
    Jacobs, E.
    Clinical Laboratory Program, Wadsworth Center, NY State Deparmtent of Health, Albany, NY, United States.
    Kulpmann, W.R.
    Külpmann, W.R., Klinische Chemie, Medizinische Hochschule, Carl-Neuberg-Str. 1, 30625 Hannover, Germany.
    Kuwa, K.
    Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Japan.
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry.
    Lewenstam, A.
    Center ProSens, Åbo Akademi University, Åbo-Turku, Finland.
    Maas, A.H.J.
    Eurotrol bv, Wageningen, Netherlands.
    Mager, G.
    Fresenius Medical Care Deutschland GmbH, Bad Homburg, Germany.
    Naskalski, J.H.J.
    Department of Clinical Biochemistry, Colleguim Medicum, Jagiellonian University, Krakow, Poland.
    Okorodudu, A.O.
    Department of Pathology, John Sealy Hospital, Galveston, TX, United States.
    Ritter, C.
    Roche Diagnostics GmbH, Graz, Austria.
    St, John A.
    St John, A., ARC Consulting, MT Lawley, WA, Australia.
    Guidelines for sampling, measuring and reporting ionized magnesium in undiluted serum, plasma or blood: International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)2005In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 43, no 5, p. 564-569Article in journal (Refereed)
    Abstract [en]

    All analyzers with ion-selective electrodes for ionized magnesium (iMg) should yield comparable and unbiased results. The prerequisite to achieve this goal is to reach consensus on sampling, measurement and reporting. The recommended guidelines for sampling, measurement and reporting iMg in plasma ("plasma" refers to circulating plasma and the forms in which it is sampled: the plasma phase of anticoagulated whole blood, plasma separated from blood cells, or serum) or blood, referring to the substance concentration of iMg in the calibrants, will provide results for iMg that are approximately 3% greater than its true concentration, and 4% less than its true molality. Binding of magnesium to proteins and ligands in plasma and blood is pH-dependent. Therefore, pH should be simultaneously measured to allow adjustment of iMg concentration to pH 7.4. The substance concentration of iMg may be physiologically and consequently clinically more relevant than the substance concentration of total magnesium. © 2005 by Walter de Gruyter.

  • 3. Ben Rayana, Mohammed C
    et al.
    Burnett, Robert W
    Covington, Arthur K
    DOrazio, Paul
    Fogh-Andersen, Niels
    Jacobs, Ellis
    Kataky, Rity
    Külpmann, Wolf R
    Kuwa, Katsuhiko
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Chemistry.
    Lewenstam, Andrzej
    Maas, Anton H J
    Mager, Gerhard
    Naskalski, Jerzy W
    Okorodudu, Anthony O
    Ritter, Christoph
    St John, Andrew
    Recommendation for measuring and reporting chloride by ISEs in undiluted serum, plasma or blood2006In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 44, no 3, p. 346-352Article in journal (Refereed)
    Abstract [en]

    The proposed recommendation for measuring and reporting chloride in undiluted plasma† or blood by ion-selective electrodes (ISEs) will provide results that are identical to chloride concentrations measured by coulometry for standardized normal plasma or blood samples. It is applicable to all current ISEs dedicated to chloride measurement in undiluted samples that meet the requirements. However, in samples with reduced water concentration, results by coulometry are lower than by ion-selective electrode due to volume displacement. The quantity measured by this standardized ISE procedure is called the ionized chloride concentration. It may be clinically more relevant than the chloride concentration as determined by coulometry, photometry or by ISE after dilution of the sample. © 2006 by Walter de Gruyter.

  • 4.
    Ben Rayana, Mohammed C.
    et al.
    Natl Inst Nutr, Clin Chem Lab, Tunis, Tunisia.
    Burnett, Robert W.
    Hartford Hosp, Dept Pathol, Hartford, CT 06115 USA.
    Covington, Arthur K.
    Univ Newcastle Upon Tyne, Dept Chem, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England.
    D'Orazio, Paul
    Instrumentat Lab, Lexington, MA USA.
    Fogh-Andersen, Niels
    Herlev Hosp, Dept Clin Biochem, Clin Chem Lab, DK-2730 Herlev, Denmark.
    Jacobs, Ellis
    NY State Dept Hlth, Wadsworth Ctr, Clin Lab Program, Albany, NY USA.
    Kulpmann, Wolf R.
    Med Hochschule, Klin Chem, Hannover, Germany.
    Kuwa, Katsuhiko
    Univ Tsukuba, Inst Clin Med, Tsukuba, Ibaraki 305, Japan.
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry.
    Lewenstam, Andrzej
    Abo Akad Univ, Ctr ProSens, Turku, Finland.
    Maas, Anton H. J.
    Eurotrol Bv, Ede, Netherlands.
    Mager, Gerhard
    Fresenius Med Care, Bad Homburg, Germany.
    Naskalski, Jerzy W.
    Jagiellonian Univ, Coll Med, Clin Biochem, Krakow, Poland.
    IFCC guideline for sampling, measuring and reporting ionized magnesium in plasma2008In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 46, no 1, p. 21-26Article in journal (Refereed)
    Abstract [en]

    Analyzers with ion-selective electrodes (ISEs) for ionized magnesium (iMg) should yield comparable and unbiased results for iMg. This IFCC guideline on sampling, measuring and reporting iMg in plasma provides a prerequisite to achieve this goal [in this document, "plasma" refers to circulating plasma and the forms in which it is sampled, namely the plasma phase of anticoagulated whole blood (or "blood"), plasma separated from blood cells, or serum]. The guideline recommends measuring and reporting ionized magnesium as a substance concentration relative to the substance concentration of magnesium in primary aqueous calibrants with magnesium, sodium, and calcium chloride of physiological ionic strength. The recommended name is "the concentration of ionized magnesium in plasma". Based on this guideline, results will be approximately 3% higher than the true substance concentration and 4% lower than the true molality in plasma. Calcium ions interfere with all current magnesium ion-selective electrodes (Mg-ISEs), and thus it is necessary to determine both ions simultaneously in each sample and correct the result for Ca2+ interference. Binding of Mg in plasma is pH-dependent. Therefore, pH should be measured simultaneously with iMg to allow adjustment of the result to pH 7.4. The concentration of iMg in plasma may be physiologically and clinically more relevant than the concentration of total magnesium. Furthermore, blood-gas analyzers or instruments for point-of-care testing are able to measure plasma iMg using whole blood (with intact blood cells) as the sample, minimizing turnaround time compared to serum and plasma, which require removal of blood cells.

  • 5.
    D'Orazio, P.
    et al.
    Instrumentation Laboratory, Lexington, MA, United States.
    Burnett, R.W.
    Hartford Hospital, Hartford, CT, United States.
    Fogh-Andersen, N.
    Herlev Hospital, Herlev, Denmark, Department of Clinical Biochemistry, Herlev Hospital, 2730 Herlev, Denmark.
    Jacobs, E.
    Wadsworth Center, Albany, NY, United States.
    Kuwa, K.
    University of Tsukuba, Tsukuba, Japan.
    Kulpmann, W.R.
    Külpmann, W.R., Medizinizche Hochschule Hannover, Hannover, Germany.
    Larsson, Lasse
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry.
    Lewenstam, A.
    Åbo Akademi University, Åbo-Turku, Finland.
    Maas, A.H.J.
    Eurotrol bv, Ede, Netherlands.
    Mager, G.
    Fresenius, Bad Homburg, Germany.
    Naskalski, J.W.
    Jagiellonian University, Krakow, Poland.
    Okorodudu, A.O.
    Department of Pathology, University of Texas Medical Branch, Galveston, TX, United States.
    Approved IFCC recommendation on reporting results for blood glucose2006In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 44, no 12, p. 1486-1490Article in journal (Refereed)
    Abstract [en]

    In current clinical practice, plasma and blood glucose are used interchangeably with a consequent risk of clinical misinterpretation. In human blood, glucose is distributed, like water, between erythrocytes and plasma. The molality of glucose (amount of glucose per unit water mass) is the same throughout the sample, but the concentration is higher in plasma, because the concentration of water and therefore glucose is higher in plasma than in erythrocytes. Different devices for the measurement of glucose may detect and report fundamentally different quantities. Different water concentrations in the calibrator, plasma, and erythrocyte fluid can explain some of the differences. Results for glucose measurements depend on the sample type and on whether the method requires sample dilution or uses biosensors in undiluted samples. If the results are mixed up or used indiscriminately, the differences may exceed the maximum allowable error for glucose determinations for diagnosing and monitoring diabetes mellitus, thus complicating patient treatment. The goal of the International Federation of Clinical Chemistry and Laboratory Medicine, Scientific Division, Working Group on Selective Electrodes and Point of Care Testing (IFCC-SD-WG-SEPOCT) is to reach a global consensus on reporting results. The document recommends reporting the concentration of glucose in plasma (in the unit mmol/L), irrespective of sample type or measurement technique. A constant factor of 1.11 is used to convert concentration in whole blood to the equivalent concentration in plasma. The conversion will provide harmonized results, facilitating the classification and care of patients and leading to fewer therapeutic misjudgments. © 2006 by Walter de Gruyter.

  • 6.
    Edvardsson, Maria
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Finspång, Health care Center Finspång.
    Sund-Levander, Märtha
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Marcusson, Jan
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Grodzinsky, Ewa
    Linköping University, Department of Medical and Health Sciences, Division of Drug Research. Linköping University, Faculty of Medicine and Health Sciences. Division of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Sweden.
    Differences in levels of albumin, ALT, AST, gamma-GT and creatinine in frail, moderately healthy and healthy elderly individuals2018In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 56, no 3, p. 471-478Article in journal (Refereed)
    Abstract [en]

    Background: Reference intervals are widely used as decision tools, providing the physician with information about whether the analyte values indicate ongoing disease process. Reference intervals are generally based on individuals without diagnosed diseases or use of medication, which often excludes elderly. The aim of the study was to assess levels of albumin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine and gamma-glutamyl transferase (gamma-GT) in frail, moderately healthy and healthy elderly indivuduals. Methods: Blood samples were collected from individuals amp;gt; 80 years old, nursing home residents, in the Elderly in Linkoping Screening Assessment and Nordic Reference Interval Project, a total of 569 individuals. They were divided into three cohorts: frail, moderately healthy and healthy, depending on cognitive and physical function. Albumin, ALT, AST, creatinine and gamma-GT were analyzed using routine methods. Results: Linear regression predicted factors for 34% of the variance in albumin were activities of daily living (ADL), gender, stroke and cancer. ADLs, gender and weight explained 15% of changes in ALT. For AST levels, ADLs, cancer and analgesics explained 5% of changes. Kidney disease, gender, Mini Mental State Examination (MMSE) and chronic obstructive pulmonary disease explained 25% of the variation in creatinine levels and MMSE explained three per cent of gamma-GT variation. Conclusions: Because a group of people are at the same age, they should not be assessed the same way. To interpret results of laboratory tests in elderly is a complex task, where reference intervals are one part, but far from the only one, to take into consideration.

  • 7.
    Forsum, Urban
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine, Clinical Microbiology. Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Microbiology.
    Karlsson, Daniel
    Linköping University, The Institute of Technology. Linköping University, Department of Biomedical Engineering, Medical Informatics.
    Terminology, categories and representation of examinations in laboratory medicine [2]2005In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 43, no 3, p. 344-345Article in journal (Refereed)
    Abstract [en]

    [No abstract available]

  • 8.
    Jones, A Wayne
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery, Division of clinical chemistry.
    Are changes in blood-ethanol concentration during storage analytically significant? Importance of method imprecision2007In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 45, no 10, p. 1299-1304Article in journal (Refereed)
    Abstract [en]

    Background: Knowledge about the stability of drugs and metabolites in biological fluids is important information when the analytical results are evaluated and interpreted. This study examines changes in blood-ethanol concentration (BEC) during the storage of specimens for up to 12 months at 4°C. Methods: Venous blood samples were taken from drunk drivers in evacuated glass tubes containing sodium fluoride and potassium oxalate as chemical preservatives. The concentrations of ethanol in blood were determined in duplicate by headspace gas chromatography on arrival at the laboratory and again after storage in a refrigerator at 4°C for up to 12 months. Results: The relationship between the standard deviation (SD) of analysis of ethanol at concentration intervals of 0.2 mg/g (BEC) was defined by the linear regression equation SD=0.00243+0.0104 BEC (r=0.99). At a mean BEC of 1.64 mg/g, the SD was 0.019 mg/g which corresponds to a coefficient of variation of 1.1%. The mean decrease in BEC (±SD) between first and second analysis was 0.105± 0.0686 mg/g (t=19.3, d.f.=158, p

  • 9.
    Kågedal, Bertil
    et al.
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Farnebäck, Malin
    Linköping University, Department of Biomedicine and Surgery, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Håkansson, Annika
    Department of Oncology, University Hospital MAS and Lund University, Malmö, Sweden.
    Gustafsson, Bertil
    Östergötlands Läns Landsting, Centre for Laboratory Medicine, Department of Clinical Pathology and Cytology. Linköping University, Faculty of Health Sciences.
    Håkansson, Leif
    Linköping University, Department of Biomedicine and Surgery, Oncology. Linköping University, Faculty of Health Sciences.
    How useful are housekeeping genes?: variable expression in melanoma metastases2007In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 45, no 11, p. 1481-1487Article in journal (Refereed)
    Abstract [en]

    Background: There is a certain difference in opinion regarding the optimal choice of housekeeping genes used as normalization factors in gene expression analysis. We have therefore examined the suitability of three housekeeping genes, hypoxanthine phosphoribosyl transferase, β-glucuronidase and β2-micro-globulin, for normalization of expression data from melanoma metastases.

    Methods: The expression of the three housekeeping genes was quantified by quantitative reverse transcription PCR in snap-frozen sections from 44 melanoma metastases, of which 19 were from patients treated with cisplatinum, dacarbazine and interferon-α2b.

    Results: The expression of each housekeeping gene varied considerably between the different metastases. Histopathological examination of the tissue sections revealed variation in the amount of tumor cells in the tissue, necrosis, varying degrees of lymphocyte infiltration, and lymph node remnants. Based on this examination, 16 biopsies were omitted from further analysis because they had cracked, contained empty or necrotic areas, or were dominated by lymph node tissue. Even in sections with more than 90% tumor cells, a wide variation in the expression of the three housekeeping genes was found. The amount of lymphatic infiltrate in the tumors can have an effect on the expression of housekeeping genes in the meta-stases, whereas treatment did not seem to influence the expression.

    Conclusions: We conclude that the choice of housekeeping genes can have great impact on the normalization of specific genes in melanoma metastases. Furthermore, in the analysis of mRNA expression in tumor tissue, microscopic examination is of great importance to evaluate the integrity and cellular composition of the biopsy.

  • 10.
    Kågedal, Bertil
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry.
    Lindqvist, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Molecular and Clinical Medicine.
    Farnebäck, Malin
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry.
    Lenner, Liselotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Experimental Hematology .
    Peterson, Curt
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Medicine and Health Sciences, Clinical Pharmacology . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Oncology UHL.
    Failure of the PAXgene™ Blood RNA System to maintain mRNA stability in whole blood2005In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 43, no 11, p. 1190-1192Article in journal (Refereed)
    Abstract [en]

    In multicentre studies of malignant and inflammatory diseases, whole blood, cell or tissue samples are often collected for analyses of gene expression to predict or monitor treatment effects. For correct analysis, sample stability during handling and transport is crucial. In developing the logistics for multicentre studies in malignant melanoma and inflammatory bowel disease, we found poor stability of a number of transcripts using the PAXgene™ Blood RNA System, which was advertised to maintain RNA stability for several days at room temperature. The results indicate that general statements on sample stability are not reliable and have to be verified for the specific transcripts of interest. © 2005 by Walter de Gruyter. Berlin.

  • 11.
    Lee, Woochang
    et al.
    University of Ulsan.
    Chung, Hee-Jung
    Kwandong University.
    Hannestad, Ulf
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Kim, Sollip
    University of Ulsan.
    Chun, Sail
    University of Ulsan.
    Park, Joong-Yeol
    Asan Medical Centre.
    Song, Junghan
    Seoul National University.
    Kim, Jin Q.
    Konkuk University.
    Min, Won-Ki
    University of Ulsan.
    Letter: Trueness assessment of Korean nation-wide glucose proficiency testing2011In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 49, no 6, p. 1061-1064Article in journal (Other academic)
    Abstract [en]

    n/a

  • 12.
    Lilja, I
    et al.
    Norwegian Univ Sci & Technol, Dept Bot, UNIGEN Ctr Mol Biol, N-7491 Trondheim, Norway Linkoping Univ, Fac Hlth Sci, Clin Res Ctr, Linkoping, Sweden Linkoping Univ, Dept Biomed & Surg, Div Surg, Linkoping, Sweden Kalmar Univ, Dept Nat Sci, Kalmar, Sweden Univ Lund, MAS, Dept Pathol, Malmo, Sweden.
    Gustafson-Svärd, Christina
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Biomedicine and Surgery.
    Franze'n, L
    Norwegian Univ Sci & Technol, Dept Bot, UNIGEN Ctr Mol Biol, N-7491 Trondheim, Norway Linkoping Univ, Fac Hlth Sci, Clin Res Ctr, Linkoping, Sweden Linkoping Univ, Dept Biomed & Surg, Div Surg, Linkoping, Sweden Kalmar Univ, Dept Nat Sci, Kalmar, Sweden Univ Lund, MAS, Dept Pathol, Malmo, Sweden.
    Sjödahl, Rune
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Clinical and Experimental Medicine, Surgery . Östergötlands Läns Landsting, Centre of Surgery and Oncology, Department of Surgery in Östergötland.
    Andersen, S
    Norwegian Univ Sci & Technol, Dept Bot, UNIGEN Ctr Mol Biol, N-7491 Trondheim, Norway Linkoping Univ, Fac Hlth Sci, Clin Res Ctr, Linkoping, Sweden Linkoping Univ, Dept Biomed & Surg, Div Surg, Linkoping, Sweden Kalmar Univ, Dept Nat Sci, Kalmar, Sweden Univ Lund, MAS, Dept Pathol, Malmo, Sweden.
    Johansen, B
    Norwegian Univ Sci & Technol, Dept Bot, UNIGEN Ctr Mol Biol, N-7491 Trondheim, Norway Linkoping Univ, Fac Hlth Sci, Clin Res Ctr, Linkoping, Sweden Linkoping Univ, Dept Biomed & Surg, Div Surg, Linkoping, Sweden Kalmar Univ, Dept Nat Sci, Kalmar, Sweden Univ Lund, MAS, Dept Pathol, Malmo, Sweden.
    Presence of group IIa secretory phospholipase A(2) in mast cells and macrophages in normal human ileal submucosa and in Crohn's disease2000In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 38, no 12, p. 1231-1236Article in journal (Refereed)
    Abstract [en]

    Secretory group IIa phospholipase A(2) (PLA(2)-II) is an important regulator of proinflammatory lipid mediator production and may play a role in ileal inflammation in Crohn's disease. The enzyme has previously only been detected in epithelial Paneth cells. However, one characteristic feature of Crohn's disease is the transmural inflammation. Full thickness ileal sections from nine patients with Crohn's disease, and histologically normal sections from patients with colonic cancer (n=7) and chronic severe constipation (n=1) as controls, were used in this study. PLA(2)-II-positive cells were detected by immunofluorescence and in situ hybridization. Metachromatic staining and esterase staining were used to identify mast cells and macrophages, respectively. It was shown that mast cells and macrophages in the ileal submucosa in both patients and controls showed positive PLA(2)-II staining. The number of PLA(2)-II-labeled cells that did not react with metachromasia, e.g. macrophages, was significantly greater in inflamed Crohn's disease compared to controls. This is, to our knowledge, the first study that has described the presence in healthy, while presence and upregulation of PLA(2)-II-positive cells in inflamed human ileal submucosa. Our findings suggest a proinflammatory potential for secretory PLA(2)-II in submucosa, while proinflammatory stimulation of mast cells and macrophages in vitro has shown that the enzyme is responsible for delayed prostaglandin formation.

  • 13.
    Malentacchi, Francesca
    et al.
    University of Florence, Italy.
    Mancini, Irene
    University of Florence, Italy.
    Brandslund, Ivan
    University of Southern Denmark, Denmark.
    Vermeersch, Pieter
    University Hospital Leuven, Belgium.
    Schwab, Matthias
    University Hospital Tuebingen, Germany; Dr Margarete Fischer Bosch Institute Clin Pharmacol, Germany.
    Marc, Janja
    University of Ljubljana, Slovenia.
    van Schaik, Ron H. N.
    Erasmus University, Netherlands.
    Siest, Gerard
    University of Lorraine, France.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Pazzagli, Mario
    University of Florence, Italy.
    Di Resta, Chiara
    University of Vita Salute San Raffaele, Italy.
    Is laboratory medicine ready for the era of personalized medicine? A survey addressed to laboratory directors of hospitals/academic schools of medicine in Europe2015In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 53, no 7, p. 981-988Article in journal (Refereed)
    Abstract [en]

    Developments in "-omics" are creating a paradigm shift in laboratory medicine leading to personalized medicine. This allows the increase in diagnostics and therapeutics focused on individuals rather than populations. In order to investigate whether laboratory medicine is ready to play a key role in the integration of personalized medicine in routine health care and set the state-of-the-art -knowledge about personalized medicine and laboratory medicine in Europe, a questionnaire was constructed under the auspices of the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) and the European Society of Pharmacogenomics and Personalised Therapy (ESPT). The answers of the participating laboratory medicine professionals indicate that they are aware that personalized medicine can represent a new and promising health model, and that laboratory medicine should play a key role in supporting the implementation of personalized medicine in the clinical setting. Participants think that the current organization of laboratory medicine needs additional/relevant implementations such as (i) new technological facilities in -omics; (ii) additional training for the current personnel focused on the new methodologies; (iii) incorporation in the laboratory of new competencies in data interpretation and counseling; and (iv) cooperation and collaboration among professionals of different disciplines to integrate information according to a personalized medicine approach.

  • 14.
    Oosterhuis, Wytze P.
    et al.
    Zuyderland Medical Centre, Netherlands.
    Bayat, Hassan
    Sina Medical Lab, Iran.
    Armbruster, David
    Abbott Labs, IL 60064 USA.
    Coskun, Abdurrahman
    Acibadem University, Turkey.
    Freeman, Kathleen P.
    IDEXX Labs Ltd, England.
    Kallner, Anders
    Karolinska University Hospital Stockholm, Sweden.
    Koch, David
    Emory University, GA 30322 USA.
    Mackenzie, Finlay
    University Hospital Birmingham NHS Fdn Trust, England.
    Migliarino, Gabriel
    Gmigliarino Consultants, Argentina.
    Orth, Matthias
    Vinzenz von Paul Kliniken gGmbH, Germany.
    Sandberg, Sverre
    University of Bergen, Norway; Haukeland Hospital, Norway.
    Sylte, Marit S.
    Haukeland Hospital, Norway; University of Bergen, Norway.
    Westgard, Sten
    Westgard QC, WI USA.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    The use of error and uncertainty methods in the medical laboratory2018In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 56, no 2, p. 209-219Article in journal (Refereed)
    Abstract [en]

    Error methods - compared with uncertainty methods - offer simpler, more intuitive and practical procedures for calculating measurement uncertainty and conducting quality assurance in laboratory medicine. However, uncertainty methods are preferred in other fields of science as reflected by the guide to the expression of uncertainty in measurement. When laboratory results are used for supporting medical diagnoses, the total uncertainty consists only partially of analytical variation. Biological variation, pre- and postanalytical variation all need to be included. Furthermore, all components of the measuring procedure need to be taken into account. Performance specifications for diagnostic tests should include the diagnostic uncertainty of the entire testing process. Uncertainty methods may be particularly useful for this purpose but have yet to show their strength in laboratory medicine. The purpose of this paper is to elucidate the pros and cons of error and uncertainty methods as groundwork for future consensus on their use in practical performance specifications. Error and uncertainty methods are complementary when evaluating measurement data.

  • 15.
    Oosterhuis, Wytze P.
    et al.
    Zuyderland Medical Centre, Netherlands.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Total error vs. measurement uncertainty: revolution or evolution?2016In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 54, no 2, p. 235-239Article in journal (Refereed)
    Abstract [en]

    The first strategic EFLM conference "Defining analytical performance goals, 15 years after the Stockholm Conference" was held in the autumn of 2014 in Milan. It maintained the Stockholm 1999 hierarchy of performance goals but rearranged them and established five task and finish groups to work on topics related to analytical performance goals including one on the "total error" theory. Jim Westgard recently wrote a comprehensive overview of performance goals and of the total error theory critical of the results and intentions of the Milan 2014 conference. The "total error" theory originated by Jim Westgard and co-workers has a dominating influence on the theory and practice of clinical chemistry but is not accepted in other fields of metrology. The generally accepted uncertainty theory, however, suffers from complex mathematics and conceived impracticability in clinical chemistry. The pros and cons of the total error theory need to be debated, making way for methods that can incorporate all relevant causes of uncertainty when making medical diagnoses and monitoring treatment effects. This development should preferably proceed not as a revolution but as an evolution.

  • 16.
    Parenmark, Anna
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences.
    Landberg, Eva
    Linköping University, Department of Clinical and Experimental Medicine, Clinical Chemistry. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    To mix or not to mix venous blood samples collected in vacuum tubes?2011In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 49, no 12, p. 2061-2063Article in journal (Refereed)
    Abstract [en]

    Background: There are recommendations to mix venous blood samples by inverting the tubes immediately after venipuncture. Though mixing allows efficient anticoagulation in plasma tubes and fast initiation of coagulation in serum tubes, the effect on laboratory analyses and risk of haemolysis has not been thoroughly evaluated. less thanbrgreater than less thanbrgreater thanMethods: Venous blood samples were collected by venipuncture in vacuum tubes from 50 patients (10 or 20 patients in each group). Four types of tubes and 18 parameters used in routine clinical chemistry were evaluated. For each patient and tube, three types of mixing strategies were used: instant mixing, no mixing and 5 min of rest followed by mixing. less thanbrgreater than less thanbrgreater thanResults: Most analyses did not differ significantly in samples admitted to different mixing strategies. Plasma lactate dehydrogenase and haemolysis index showed a small but significant increase in samples omitted to instant mixing compared to samples without mixing. However, in one out of twenty non-mixed samples, activated partial thromboplastin time was seriously affected. less thanbrgreater than less thanbrgreater thanConclusions: These results indicate that mixing blood samples after venipuncture is not mandatory for all types of tubes. Instant mixing may introduce interference for those analyses susceptible to haemolysis. However, tubes with liquid-based citrate buffer for coagulation testing should be mixed to avoid clotting.

  • 17.
    Pavlou, AK
    et al.
    Cranfield University, Postgrad Med Sch, Bedford MK43 0AL, England; Cranfield University, Institute Biosci and Technology, Silsoe, Beds, England; .
    Turner, APF
    Cranfield University, UK.
    Sniffing out the truth: Clinical diagnosis using the electronic nose2000In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 38, no 2, p. 99-112Article in journal (Refereed)
    Abstract [en]

    Recently the use of smell in clinical diagnosis has been rediscovered due to major advances in odour sensing technology and artificial intelligence (AI). It was well known in the past that a number of infectious or metabolic diseases could liberate specific odours characteristic of the disease stage. Later chromatographic techniques identified an enormous number of volatiles in human clinical specimens that might serve as potential disease markers. "Artificial nose" technology has been employed in several areas of medical diagnosis, including rapid detection of tuberculosis (TB), Helicobacter pylori (HP) and urinary tract infections (UTI). Preliminary results have demonstrated the possibility of identifying and characterising microbial pathogens in clinical specimens. A hybrid intelligent model of four interdependent "tools", odour generation "kits", rapid volatile delivery and recovery systems, consistent low drift sensor performance and a hybrid intelligent system of parallel neural networks (NN) and expert systems, have been applied in gastric, pulmonary and urine diagnosis. Initial clinical tests have shown that it may be possible in the near future to use electronic nose technology not only for the rapid detection of diseases such as peptic ulceration, UTI, and TB but also for the continuous dynamic monitoring of disease stages. Major advances in information and gas sensor technology could enhance the diagnostic power of future bio-electronic noses and facilitate global surveillance models of disease control and management.

  • 18.
    Simundic, Ana-Maria
    et al.
    Sestre Milosrdnice University Hospital, Croatia.
    Cornes, Michael P.
    Royal Wolverhampton, England.
    Grankvist, Kjell
    Umeå University, Sweden.
    Lippi, Giuseppe
    Academic Hospital Parma, Italy.
    Nybo, Mads
    Odense University Hospital, Denmark.
    Ceriotti, Ferruccio
    Ist Science San Raffaele, Italy.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Diagnostics, Department of Clinical Chemistry.
    Panteghini, Mauro
    University of Milan, Italy.
    Colour coding for blood collection tube closures - a call for harmonisation2015In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 53, no 3, p. 371-376Article in journal (Refereed)
    Abstract [en]

    At least one in 10 patients experience adverse events while receiving hospital care. Many of the errors are related to laboratory diagnostics. Efforts to reduce laboratory errors over recent decades have primarily focused on the measurement process while pre-and postanalytical errors including errors in sampling, reporting and decision-making have received much less attention. Proper sampling and additives to the samples are essential. Tubes and additives are identified not only in writing on the tubes but also by the colour of the tube closures. Unfortunately these colours have not been standardised, running the risk of error when tubes from one manufacturer are replaced by the tubes from another manufacturer that use different colour coding. EFLM therefore supports the worldwide harmonisation of the colour coding for blood collection tube closures and labels in order to reduce the risk of pre-analytical errors and improve the patient safety.

  • 19.
    Topic, Elizabeta
    et al.
    Chair Comm Educ and Training, Croatia.
    Nikolac, Nora
    University Hospital Sestre Milosrdnice, Croatia.
    Panteghini, Mauro
    University of Milan, Italy.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    Luca Salvagno, Gian
    University of Verona, Italy.
    Miler, Marijana
    Sestre Milosrdnice University Hospital Centre, Croatia.
    Simundic, Ana-Maria
    University Hospital Sestre Milosrdnice, Croatia.
    Infusino, Ilenia
    University of Milan, Italy.
    Nordin, Gunnar
    Equalis, Sweden.
    Westgard, Sten
    Westgard QC, CT USA.
    How to assess the quality of your analytical method?2015In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 53, no 11, p. 1707-1718Article in journal (Refereed)
    Abstract [en]

    Laboratory medicine is amongst the fastest growing fields in medicine, crucial in diagnosis, support of prevention and in the monitoring of disease for individual patients and for the evaluation of treatment for populations of patients. Therefore, high quality and safety in laboratory testing has a prominent role in high-quality healthcare. Applied knowledge and competencies of professionals in laboratory medicine increases the clinical value of laboratory results by decreasing laboratory errors, increasing appropriate utilization of tests, and increasing cost effectiveness. This collective paper provides insights into how to validate the laboratory assays and assess the quality of methods. It is a synopsis of the lectures at the 15th European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Continuing Postgraduate Course in Clinical Chemistry and Laboratory Medicine entitled "How to assess the quality of your method?" (Zagreb, Croatia, 24-25 October 2015). The leading topics to be discussed include who, what and when to do in validation/verification of methods, verification of imprecision and bias, verification of reference intervals, verification of qualitative test procedures, verification of blood collection systems, comparability of results among methods and analytical systems, limit of detection, limit of quantification and limit of decision, how to assess the measurement uncertainty, the optimal use of Internal Quality Control and External Quality Assessment data, Six Sigma metrics, performance specifications, as well as biological variation. This article, which continues the annual tradition of collective papers from the EFLM continuing postgraduate courses in clinical chemistry and laboratory medicine, aims to provide further contributions by discussing the quality of laboratory methods and measurements and, at the same time, to offer continuing professional development to the attendees.

  • 20.
    Watson, Ian D.
    et al.
    European Federat Clin Chemistry and Lab Med, Italy.
    Siodmiak, Joanna
    Nicolaus Copernicus University of Torun, Poland.
    Oosterhuis, Wytze P.
    Atrium Orbis, Netherlands.
    Corberand, Joel
    University Hospital Toulouse, France.
    Jorgensen, Per E.
    Glostrup County Hospital, Denmark.
    Gunnur Dikmen, Zeliha
    Hacettepe University, Turkey.
    Jovicic, Snezana
    University of Belgrade, Serbia; University of Belgrade, Serbia.
    Theodorsson, Elvar
    Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
    European views on patients directly obtaining their laboratory test results2015In: Clinical Chemistry and Laboratory Medicine, ISSN 1434-6621, E-ISSN 1437-4331, Vol. 53, no 12, p. 1961-1966Article in journal (Refereed)
    Abstract [en]

    Background: Medicine is a highly professionalized endeavour, by tradition centred on the authority of physicians. Better education and the advent of the information age cater for increased demands on society in general and on health care in particular to enable people to make informed decisions regarding themselves. Participation in medical decisions requires informed knowledge which is hard to obtain without substantial and time consuming professional help. Methods: We performed a survey amongst the member organizations of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) in order to investigate the recognition and preparedness of providing help to patients in interpreting their laboratory results. Results: Out of 40 EFLM Member Societies, 27 sent their responses to the survey. In most cases the first line delivery of laboratory results to physicians is by computer link (63%). Patients receive their laboratory results on demand from their physician in 60% of cases. However, 34% of laboratory specialists showed a negative attitude for delivering laboratory results to patients. Yet, in 48% of countries 1-5 patients per day ask a laboratory specialist about the significance of laboratory results outside the reference range. When patients are informed about the purpose of laboratory testing, they seek information primarily from their physician, followed by the internet and the Specialist in Laboratory Medicine. Conclusions: Changing practices increasingly enabling patient access to their records are on the increase facilitated by recent innovations in information technologies. Successful transfer of some of the responsibilities of physicians, demands a mutual triangular dialogue between the patient, their physician and laboratory medicine.

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