Biochemistry
High Performance Liquid Chromatography-Mass Spectrometry
Recently, and in collaboration with the Hospital Pharmacy Service of the Hospital
Mutua Terrassa University, a high-efficiency chromatography analytical system in tandem with a mass spectrometry detector (HPLC-MS) has been incorporated into Catlab.
This combination of analytical techniques will allow our laboratory to have,the considered, gold-standard method in clinical laboratory, and thus have the ability to measure analytes with great sensitivity and specificity. The study of immunosuppressants will be the first to make use of this technique and new ones will be added later.
Results obtained in Catlab using the new "Prenatal screening protocol for congenital anomalies in Catalonia"
In year 2018 and later in 2021, the screening protocol for congenital anomalies was updated. The latest updates to the protocol include the determination of Cell-free fetal DNA in patients at intermediate and high risk. These new protocols have made it possible to extend the non-invasive study to intermediate-risk patients and to avoid invasive tests in high-risk patients in which Cell-free fetal DNA tested negative.
In Catlab between March and December 2021, 3038 first trimester screenings were performed. Applying the aforementioned protocols, the improvement in the detection of anomalies was shown as 2 alterations were detected in patients with intermediate risk using fetal DNA, as well as the decrease in the need for invasive tests by avoiding this intervention in 66 high-risk patients.
Anti-Müllerian hormone(AMH)- Aplications and quantification.
AMH is a glycoprotein belonging to the transforming growth beta factor superfamily. It has recently emerged as an early and accurate biomarker for ovarian reserve and ovarian aging assesssment. Thus, the determination of this hormone has various applications such as the diagnosis and follow-up of patients with polycystic ovary syndrome or ovarian granulosa cell tumors, among others. In men, its determination is also used for the study of hypogonadism or early puberty.
At Catlab during the year 2020, AMH test has been internalized, using Lumipulse Analyzer,by Fujirebio INC.
The determination is performed using a two-step chemiluminescent immunoassay method that will eventually generate a luminic signal proportional to the amount of AMH present in the sample.
BIOCHEMISTRY - Possible interference by Biotin in some Laboratory tests
Biotin is a water-soluble vitamin that participates in cell proliferation, embryonic development, and in immunological and metabolic functions. It is commonly found in many foods, but also in some vitamin supplements. In 2017, the FDA warned about possible interference in some laboratory tests, due to the high presence of biotin. Catlab, following international recommendations, has been substituting some reagents to avoid possible interference with biotin.
BIOCHEMISTRY - Fecal occult blood updates
Colorectal cancer ranks second in cancer incidence and mortality in developed countries. Recently in Catlab a series of changes have been made to update the technique and improve clinical interpretation. The analyzer and the collection container have been changed. The unit of the expressed results, and the cut-off point has been changed too.
BIOCHEMISTRY - Vitamin D: Update
Recently, the reference values that appear in our report laboratory of Vitamin D have been modified. Currently, there are different methods for measuring them, and the reference values depend on the population studied. They vary with sex, age, seasonal period, geographical latitude, diet, body mass index, ethnic group ... With this great variability, we have decided to update the reference values following the recommendations of the "Protocol d'indicacions per la mesura de vitamina D" approved by the ICS.
TUMOR MARKERS - New markers in prostate cancer.
Prostate cancer continues to be the most common in men, and PSA is the most commonly used marker. The low specificity of PSA in detecting cancer causes a large number of negative biopsies, and also does not help that it can not differentiate between lethal and non-lethal cancer. That is why, in recent multicenter studies, ProPSA (free PSA isoform) and phi index are being positioned as more specific markers.
BIOCHEMISTRY - Biomarkers for infection / sepsis.
The overall mortality in patients with sepsis is between 10-20%, between 20-50% in those with severe sepsis and between 40-80% in patients with septic shock. The immediate adoption of diagnostic-therapeutic decisions will directly affect the evolution, prognosis and survival, therefore, the availability of early and accurate biomarkers is key to effective clinical management of infections.
HORMONES - Progesterone. New reference values.
Currently, in Catlab, measurement of serum progesterone is performed on the Cobas 602 8000_e Roche Diagnostic (Elecsys), by a chemoluminescence immunoassay method (ECLIA). In order to improve the quality of the results obtained in our laboratory, we will proceed to replace the current reagent by a new reagent which have been changed its rat monoclonal antibodies into sheep monoclonal antibodies with greater specificity.
Biochemistry - CKD-EPI
Chronic kidney disease (CKD) is generally defined as a set of heterogeneous diseases that affect renal structure and function. Since 2002, it published a set of guidelines on the evaluation, classification, and stratification of the ERC. Staging classification for risk, they have used different calculations and equations. The currently recommended by the new guidelines is the equation CKD-EPI creatinine.
HORMONES - Cortisol in serum. New reference ranges.
The determination of cortisol in blood is used for diagnosis and treatment of functional disorders of the adrenal gland, like Cushing's syndrome and Addison's disease. In order to improve the quality of the results obtained in our laboratory, we will proceed to replace the current reagent by a new reagent in which have been changed polyclonal antibodies by monoclonal antibodies. The new reference ranges and the date from which they are applicable shall be indicated in the reports.
HORMONES - Human Chorionic gonadotropin realities(hCG)
Human chorionic gonadotropin (hCG) is a heterodimeric glycoprotein with an alpha subunit and a beta subunit. Structural different varieties are found in blood, amniotic fluid and urine in different proportions. The large number of forms hampers its analysis by immunoassay.
HORMONES - Serum Estradiol; New reference intervals
The estradiol (17β-estradiol) is a female sex hormone from estrogen group but is also present in men. In order to improve the quality of the results obtained in our laboratory, soon we will proceed to replace the current reagent (Elecsys Estradiol II) with a new reagent (Elecsys Estradiol III) that were changed polyclonal antibodies by monoclonal antibodies. It has been restandardize against CRM 6400th by DI-GC / MS and have calculated new reference values. The new method is more specific and has less interference.
BIOCHEMISTRY - Bone remodeling biochemical markers
Biochemical markers of bone remodeling measured the activity of osteoblasts and osteoclasts, from the determination of substances produced by bone cells and the determination of the bone components that is shed into the blood circulation during its destruction or formation.
HORMONES - TSH reference values during pregnancy
Pregnancy involves a series of physiological and hormonal changes that alter the function of the thyroid gland. In order to facilitate the monitoring of thyroid function, and contribute to improving the detection of subclinical hypothyroidism in pregnant women, we have incorporated the TSH reference values recommended by scientific societies in the analytical reports of Catlab.
BIOCHEMISTRY - RBC Morphology
The presence of red blood cells in urine can be a primary sign of kidney disease, so that the determination by the laboratory of a simple and rapid test, may be useful in reducing the response time and save others unnecessary tests for patients (cystoscopy, image tests ..)
BIOCHEMISTRY-- Determination of occult blood in stool.
The principal indication for the determination of occult blood in stool is fort heearly detection of colorectal cancer. At CATLAB, a quantitative immunoturbidimetric method is used.
HORMONES – Review and followup of the initial study of the Thyroid Function in the protocols of Primary Care. The initial protocol was: TSH* (T4L*, T3* and thyroid antibody levels). Until now, if TSH was below 0.29 μU/mL or above 6 μU/mL, T4L was generated. If T4L was normal (8.8 pmol/L -20.1 pmol/L) and TSH was above 6 μU/mL ,T3 and thyroid antibody levels were generated
BIOCHEMISTRY - Vitamin D
It is a generic set of substances of similar chemical structure name. Among other functions, plays an important role in the intestinal absorption of calcium and bone metabolism
BIOCHEMISTRY-Free Testosterone and bioavailable testosterone
Many working groups proposed as clinically more useful, the utilitzación of free testosterone and bioavailable testosterone, based on calculations Vermeulen