Hesselbergbowden2984

Pseudothrombocytopenia by ethylenediaminetetraacetic acid (EDTA) is an infrequent phenomenon of in vitro platelet agglutination due to the presence of antiplatelet autoantibodies. It has no clinical significance, but misdiagnosis may lead to clinical or therapeutic decision-making. In this study we report a case of an 8-year-old boy with no history of platelet disorder presenting a low platelet count and a peripheral blood smear showing clumping of platelets by EDTA. The initial diagnosis hypothesis was of an idiopathic thrombocytopenic purpura, and an unnecessary bone marrow aspirate was made even though he did not have personal or family history of bleeding. A second sample collected in sodium citrate confirmed the pseudothrombocytopenia by EDTA. In conclusion, the laboratory should enhance a strong relationship with clinicians trying to avoid misunderstandings as that reflected in this case report. It should be reminded that, in those cases where a pseudothrombocytopenia by EDTA is suspected, a blood smear is mandatory to confirm platelet clumps and blood must be tested anticoagulated with another anticoagulant (i.e., sodium citrate or heparin). Urinalysis is one of the most important tests in the clinical laboratory. In this study we assessed the use of chemical preservative in urinalysis during preanalytical phase. Fifty first morning urine samples from medical laboratory patients were collected and stored with and without chemical preservative. Difference between medians were analyzed using Wilcoxon signed rank test for glucose, bilirubin, ketones, specific gravity, erythrocytes, pH, proteins, nitrites, leukocytes using urine strips; and on leukocytes, erythrocytes, epithelial cells, and bacteria in the urinary sediment, at 90 minutes after sampling. Our results showed that the specific gravity and the pH values increased in samples with chemical preservative in urine strip tests. Concerning urinary sediment analysis no differences were observed in the studied parameters between samples with and without chemical preservative. We suggest that the effect on urine pH is due to the chemical nature of the substances in the preservative. Thus, we caution about the use of chemical preservatives in samples to be analyzed within short time (i.e. less than 1.5 - 2 hours) after sample collection. Avoid chemical preservatives, in this situation, could help avoid changes in the pH and specific gravity, which could eventually help in maintaining quality in the preanalytical phase of urinalysis. Background and objective The analytes stability on serum and plasma are critical for clinical laboratory, especially if there is a delay in their processing or if they need to be stored for future research. The objective of this research was to determine the stability of K3EDTA-plasma and serum on different storage conditions. Materials and methods A total of thirty healthy adults were studied. The serum/plasma samples were centrifuged at 2000g for 10 minutes. Immediately after centrifugation, the serum/plasma analytes were assayed in primary tubes using a Cobas c501 analyzer (T0); the residual serum/plasma was stored at either 2-8°C or -20°C for 15 (T15) and 30 days (T30).Mean concentrations changes in respect of initial concentrations (T0) and the reference change values were calculated. For assessing statistical difference between samples, the Wilcoxon ranked-pairs test was applied. Results We evidenced instability for total bilirubin, uric acid, creatinine and glucose at T15 and T30 and stored at -20°C (p less then 0.05). However, potential clinical impact significance were observed only for total bilirrubin T30 at -20°C, and creatinine T30 at 2-8°C. Conclusions Our results had shown that storage samples at -20°C is a better way to preserve glucose, creatinine, and uric acid. Therefore, laboratories should freeze their samples as soon as possible to guarantee proper stability when there is need to repeat analysis, verify a result, or add a laboratory testing. Introduction In the daily laboratory practice, there are patients coming to blood collection sites chewing sugar-free gum, considering it irrelevant to laboratory tests. The aim of this study was to evaluate whether a sugar-free chewing gum can interfere with laboratory tests. Methods We studied 22 healthy volunteers. After a 12-hour overnight fasting, the first blood sample was collected between 800 and 830 a.m. Then, immediately after the first venous blood collection, the subjects started chewing the gum (declared sugar-free) for 20 min. Subsequent venous blood samples were collected at 1, 2, and 4 hours after chewing the gum. Significant differences between samples were assessed by the Wilcoxon ranked-pairs test. Results Among all the results, statistically significant differences (p less then 0.05) between basal and × hours after chewing sugar-free gum were observed for the following parameters cortisol, insulin, C-peptide, triglycerides, uric acid, urea, amylase, alanine aminotransferase, lipase, creatine kinase, total bilirubin, direct bilirubin, phosphate, iron, potassium, thyroid stimulating hormone, red blood cell count, hematocrit, hemoglobin, mean cell volume, red cell distribution width, white blood cell count, lymphocytes, neutrophils, and eosinophils; whereas, coagulation tests were not impacted by chewing sugar-free gum. Conclusions We recommend instructing the patients to avoid the use of chewing gum before blood collection for laboratory tests. Objective To evaluate the major causes of preanalytical errors in medical laboratory of a tertiary care hospital. Methods It was a retrospective study in which we analyzed the sample rejection data of hematology and chemical pathology sections from January to December 2018. Number of rejected samples, reason for rejection and type of test ordered on monthly basis were recorded on a platform. Results A total of 113,817 samples were received during the study period. SGLT inhibitor Preanalytical errors were found in 1,688 samples, which constitute approximately 1.48% of the total number of samples received. Conclusion Our study highlights the magnitude of preanalytical errors in our setup. Preanalytical errors can lead to loss of patient trust in diagnostic services, can dent the laboratory's reputation, and lead to an increase in the overall operating expenses, both for laboratories as well as the hospitals. Compliance with good laboratory practices can significantly reduce the frequency of pre analytical errors.