Open Access Published by De Gruyter

Volume 44 Issue 6

Issue of Journal of Laboratory Medicine

Submit manuscript

Contents
Journal Overview

Publicly Available December 2, 2020

Frontmatter

Page range: i-iii

Download PDF

Laboratory Management

Open Access November 9, 2020

Improved molecular laboratory productivity by consolidation of testing on the new random-access analyzer Alinity m

Martin Obermeier, Monia Pacenti, Robert Ehret, Francesco Onelia, Rory Gunson, Emily Goldstein, Stéphane Chevaliez, Alba Vilas, Allison Glass, Leana Maree, Maria Krügel, Heribert Knechten, Patrick Braun, Gudrun Naeth, Francesca Azzato, Danijela Lucic, Natalia Marlowe, Michael John Palm, Karin Pfeifer, Birgit Reinhardt, Jens Dhein, Ajith Mathew Joseph, Laura Martínez-García, Juan-Carlos Galán

Page range: 319-328

More Download PDF

Abstract

Objectives Automated molecular analyzers have accelerated diagnosis, allowing earlier intervention and better patient follow-up. A recently developed completely automated molecular analyzer, Alinity™ m (Abbott), offers consolidated, continuous, and random-access testing that may improve molecular laboratory workflow. Methods An international, multicenter study compared laboratory workflow metrics across various routine analyzers and Alinity m utilizing assays for human immunodeficiency virus type 1 (HIV-1), hepatitis C virus (HCV), hepatitis B virus (HBV), high-risk human papillomavirus (HR HPV), and sexually transmitted infection (STI) ( Chlamydia trachomatis [CT]/ Neisseria gonorrhoeae [NG]/ Trichomonas vaginalis [TV]/ Mycoplasma genitalium [MG]). Three turnaround times (TATs) were assessed: total TAT (sample arrival to result), sample onboard TAT (sample loading and test starting to result), and processing TAT (sample aspiration to result). Results Total TAT was reduced from days with routine analyzers to hours with Alinity m, independent of requested assays. Sample onboard TATs for standard workflow using routine analyzers ranged from 7 to 32.5 h compared to 2.75–6 h for Alinity m. The mean sample onboard TAT for STAT samples on Alinity m was 2.36 h (±0.19 h). Processing TATs for Alinity m were independent of the combination of assays, with 100% of results reported within 117 min. Conclusions The consolidated, continuous, random-access workflow of Alinity m reduces TATs across various assays and is expected to improve both laboratory operational efficiency and patient care.

Open Access September 7, 2020

Optimization on reagent-loading manner for modular clinical chemistry analyzer series: simulations and verifications

Mingyang Wang, Liang Ming

Page range: 329-333

More Download PDF

Abstract

Objectives The pre- and post-analytical processes have been discussed both in total laboratory system (TLA) and modular automation (MA). The analytical process, especially reagent-related factors influences on the integrated clinical chemistry analyzer, demonstrates a significant effect on clinical chemistry analyzer. Modular analyzer reagent-loading mode influences two mainly factors, testing turnaround time (tTAT) and the cost. Furthermore, how to definite the different reagent loading manners and verify the best reagent loading manner is big challenge. Methods We focus on tTAT, and study how the reagent-related factors effect TAT by simulations and verifications. Parameters were simulated by cobas 8000 workflow simulator for reagent-loading manner with at least three positions (Pattern 1), the module-parallel reagent-loading manner (Pattern 2) and the single-position loading mode (Pattern 3). Results tTAT, reagent on-line time, quality control (QC) cost and performance verification times all declined by 43%. Tuesday effect solved the repetitive problem for verification. Pattern 2 shows optimal performance in Tuesday effect-based verification. Conclusions The optimization of reagent-loading manner saved much workforce, and reduced the QC cost.

Drug Monitoring und Toxicology

Open Access November 26, 2020

Personalized antibiotic therapy – a rapid high performance liquid chromatography–tandem mass spectrometry method for the quantitation of eight antibiotics and voriconazole for patients in the intensive care unit

Tony Böhle, Ulrike Georgi, Dewi Fôn Hughes, Oliver Hauser, Gudrun Stamminger, Dirk Pohlers

Page range: 335-342

More Download PDF

Abstract

Objectives For a long time, the therapeutic drug monitoring of anti-infectives (ATDM) was recommended only to avoid the toxic side effects of overdosing. During the last decade, however, this attitude has undergone a significant change. Insufficient antibiotic therapy may promote the occurrence of drug resistance; therefore, the “one-dose-fits-all” principle can no longer be classified as up to date. Patients in intensive care units (ICU), in particular, can benefit from individualized antibiotic therapies. Methods Presented here is a rapid and sufficient LC-MS/MS based assay for the analysis of eight antibiotics (ampicillin, cefepime, cefotaxime, ceftazidime, cefuroxime, linezolid, meropenem, and piperacillin) applicated by continuous infusion and voriconazole. In addition a dose adjustment procedure for individualized antibiotic therapy has been established. Results The suggested dose adjustments following the initial dosing of 121 patient samples from ICUs, were evaluated over a period of three months. Only a minor percentage of the serum levels were found to be within the target range while overdosing was often observed for β-lactam antibiotics, and linezolid tended to be often underused. The results demonstrate an appreciable potential for β-lactam savings while enabling optimal therapy. Conclusions The presented monitoring method provides high specificity and is very robust against various interferences. A fast and straightforward method, the developed routine ensures rapid turnaround time. Its application has been well received by participating ICUs and has led to an expanding number of hospital wards participating in ATDM.

Allergy and Autoimmunity

Open Access September 17, 2020

Association of endothelin-1 and cell surface adhesion molecules levels in patients with systemic sclerosis

Monika Mauliūtė, Rita Rugienė, Vytautas Žėkas, Loreta Bagdonaitė

Page range: 343-347

More Download PDF

Abstract

Objectives Endothelin-1 (ET-1) has been implicated in the pathogenesis of inflammatory and fibrotic diseases, including systemic sclerosis. In addition to modulating vascular tone and extracellular matrix turnover, ET-1 up-regulates cell surface adhesion molecules–intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1).The aim of the study was to evaluate the diagnostic value of the detection of ET-1, VCAM-1 and ICAM-1 in the diagnosis of systemic sclerosis. Methods A total of 30 patients with systemic sclerosis from Vilnius University Hospital Santaros Clinics were included in the study. Serum levels of ICAM-1, VCAM-1 and ET-1 were assessed by enzyme immunoassay. Results ET-1 concentration was associated with VCAM-1 concentration (r=0.687; p<0.001). No associations between ET-1 and ICAM-1 concentrations were detected. Depending on the duration of the disease no significant differences in the concentrations of ET-1, ICAM-1 and VCAM-1 were detected. Conclusions The results of this study indicated that ET-1 and VCAM-1 may be assessed together as markers of inflammation and the identification of patients at high risk for disease progression.

Original Article

Open Access October 23, 2020

Optimization of a molecular diagnostic strategy to verify SARS-CoV-2 infections by RT-qPCR

Marcel Noßmann

Page range: 349-356

More Download PDF

Abstract

Objectives Fast and precise detection of SARS-CoV-2 RNA in infected patients is essential for treatment decisions. Methods A diagnostic strategy by analyzing nasopharyngeal swabs to detect SARS-CoV-2 RNA in individuals was established. The negative impacts of the individual buffer components on RT-qPCR analysis was reviewed and overcome by RNA purification. To investigate the functionality of the improved protocol we compared the novel diagnostic strategy to a Bead-based RNA extraction method using previously positive tested samples. Results A method to extract purify RNA molecules from SARS-CoV-2 was established. We examined the significance of nucleic acid purification and the need for an RNase inhibitor. Evaluation of 3,664 samples from March 23rd until May 18th in 2020 showed the incidence of COVID-19 infections in Thuringia, Germany. Additionally, benefits and limits of three RT-qPCR kits were assessed. Conclusions Our study suggests that virus capsid lysis combined with nucleic acid purification enables a viable alternative for the molecular diagnostics of SARS-CoV-2 infections. Due to the current delivery delays from different companies, this method offers the possibility to continue diagnosis and to handle the large number of samples.

Letters to the Editor

Open Access October 19, 2020

Laboratory parameters as predictors of mortality in COVID-19 patients on hospital admission

Noemí García-Tardón, André P. Abbes, Alice Gerrits, Robbert J. Slingerland, Gijs den Besten

Page range: 357-359

Download PDF

Open Access November 23, 2020

Inconsistent virus DNA quantification results in clinical hepatitis B and the verification by genotyping and sequencing: a case report

Hanxiang Chen, Mengyuan Yu, Xiaoning Zhang, Bingyang Zhang, Liying Cheng, Wanshan Ma

Page range: 361-364

Download PDF

Acknowledgment

Open Access November 24, 2020

Acknowledgment

Page range: 365-365

Download PDF

About this journal

Objective
The Journal of Laboratory Medicine (JLM), the official journal of the German Society of Clinical Chemistry and Laboratory Medicine (DGKL), and affiliated with the Austrian Society of Laboratory Medicine and Clinical Chemistry (ÖGLMKC), is an open access journal, which is issued bi-monthly. It reports on the latest developments in laboratory medicine. JLM focusses on the diagnostic aspects of the clinical laboratory, although technical, regulatory, and educational topics are equally covered. The journal specializes in publishing high quality, competent and timely review articles on clinical, methodological and pathogenic aspects of modern laboratory diagnostics. Furthermore, JLM publishes original research articles, case reports, point/counterpoint articles and letters to the editor. All contributions submitted for publication in JLM are single-blind peer reviewed by at least two experts in the field. JLM publishes only English-language articles.
Open access publication is partially funded by an unrestricted education grant provided by DGKL and ÖGLMKC. This grant plays no role in the selection and publication of the articles, nor does it influence peer review. For Article Processing Charges, please refer to the link under Supplementary Materials.

Please submit your manuscript here

Topics

Allergy and Autoimmunity
Applied Statistical Methods in Laboratory Medicine
Biobanking
Clinical Chemistry and Metabolism
Drug Monitoring and Toxicology
Endocrinology
Extra-Analytics
Geriatric Laboratory
Hematology
Hemostasiology
Infectiology and Microbiology
Inflammation and Sepsis
Informatics in Laboratory Medicine
Laboratory Management
Molecular-Genetic and Cytogenetic Diagnostics
Oncological Diagnostics/Liquid Profiling
Pediatric Laboratory
Point-of-Care-Testing

Article formats
Review, Mini Review, Original Article, Opinion Paper, Guidelines and Recommendations, Point/Counterpoint, Editorial, Case Study-Mini Review, Laboratory Case Report, Short Communication, Letter to the Editor & Reply