rss_2.0Revista Romana de Medicina de Laborator FeedSciendo RSS Feed for Revista Romana de Medicina de Laborator Romana de Medicina de Laborator 's Cover anticoagulant in children – a confounding factor in diagnosis and targeted therapy<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction:</bold> Lupus anticoagulant (LAC) belongs to a heterogeneous group of antibodies directed against negatively charged phospholipid-binding proteins, inhibiting phospholipid-dependent reactions. We assessed the frequency, etiological background, clinical and biological expression as well as the appropriate management and outcome of LAC in a pediatric population.</p> <p><bold>Patients and methods:</bold> We included 19 pediatric patients diagnosed with a positive LAC test during a period of 1 year. LAC detection was carried out according to the ISTH/SCC guidelines 2012. Coagulometric assays were performed in order to check for coagulation factor activities. The presence of specific inhibitors has been tested by the Bethesda assay.</p> <p><bold>Results:</bold> LAC was positive in 0.4% of the patients monitored for increased activated partial thromboplastin time (aPTT) during the study period of 1 year. In contrast to the asymptomatic clinical image presented by the majority of our patients, the biological picture was dominated by an elevated aPTT (79 %), the aPTT ratio correlating significantly with the strength of LAC. In 58 % of the patients LAC became negative within 12 weeks, in another 4 (21%) patients within 20 weeks, whereas in 4 (21%) patients LAC remained positive throughout the follow-up.</p> <p><bold>Conclusion</bold>: Albeit usually innocent in asymptomatic patients, LAC needs to be seriously taken into consideration from the diagnostic point of view in order to avoid dangerous therapeutic attitudes..</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00Insights into Innate Immune Response Against SARS-CoV-2 Infection<abstract> <title style='display:none'>Abstract</title> <p>The innate immune system is mandatory for the activation of antiviral host defense and eradication of the infection. In this regard, dendritic cells, natural killer cells, macrophages, neutrophils representing the cellular component, and cytokines, interferons, complement or Toll-Like Receptors, representing the mediators of unspecific response act together for both activation of the adaptive immune response and viral clearance. Of great importance is the proper functioning of the innate immune response from the very beginning. For instance, in the early stages of viral infection, the defective interferon response leads to uncontrolled viral replication and pathogen evasion, while hypersecretion during the later stages of infection generates hyperinflammation. This cascade activation of systemic inflammation culminates with cytokine storm syndrome and hypercoagulability state, due to a close interconnection between them. Thus an unbalanced reaction, either under- or over- stimulation of the innate immune system will lead to an uncoordinated response and unfavorable disease outcomes. Since both cellular and humoral factors are involved in the time-course of the innate immune response, in this review we aimed to address their gradual involvement in the antiviral response with emphasis on key steps in SARS-CoV-2 infection.</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00The effects of microwave radiation generated by mobile phones on the tear film<abstract> <title style='display:none'>Abstract</title> <p>Electromagnetic radiation (ER) emitted by mobile phones and other modern devices has potentially harmful effects on ocular tissue. Their effects on the eye surface and tear film are little known so far. The aim of this paper was to investigate the effects of ER emitted by the phone mobile on the tear film. For this study, we selected a total of 50 subjects, young, healthy, without chronic treatment, who are not contact lens wearers and who have no history of ophthalmic surgery. Schirmer I test, tear pH and tear ferning test (TFT) were performed on all subjects before (“-pre”) being exposed to ER emitted by the mobile phone and after (“-post”) exposure for 5 minutes, the pH and TFT of the tears were performed. Following the analysis of the obtained results, we found that there are significant changes in tear quality and increased tear pH, which over time can lead to tear film instability, damage to the eye surface and the appearance of dry eye syndrome.</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00Essentials in the diagnosis of postoperative myocardial lesions similar to or unrelated to rejection in heart transplant<abstract> <title style='display:none'>Abstract</title> <p><bold>Background, objectives</bold>: Histological diagnosis of control biopsies in patients with heart transplant represents a significant step of monitoring, with a great influence on adjusting immunosuppressive treatment. Histological lesions are usually related to ischemia and reperfusion, with varying degrees of intensity. This study aimed to highlight the most important aspects of the histological diagnosis and differential diagnosis of postoperative myocardial lesions associated or unrelated to rejection in heart transplant.</p> <p><bold>Materials and Methods</bold>: This retrospective study involved 53 patients who received cardiac transplant between 2000 and 2017. Patients were monitored by lesion quantification of endomyocardial biopsies, with diagnoses established based on biopsy material in the early, medium and late post-transplant periods. Hematoxylin eosin, Masson’s trichrome, and Van Gieson stains were used; immunohistochemical determinations used CD4, CD20, CD45, CD68, HLA-DR, VEGF and CD31.</p> <p><bold>Results</bold>: Ischemia and reperfusion lesions were diagnosed on all biopsies in the first 6 weeks post-transplant. Nine cases of the Quilty effect were identified, and in 12 cases, the biopsies were performed on the same spot as previous biopsies. A significant number of transplanted patients presented cytomegalovirus that was difficult to diagnose on endomyocardial biopsies.</p> <p><bold>Conclusions</bold>: The detailed study of ischemia and reperfusion lesions, as well as of changes un-related to rejection becomes a major objective in the short, medium and late post-transplant period. Overdiagnosis of rejection induces changes of the immunosuppressive therapeutic protocol, with alarming repercussions on cytomegalovirus reactivation, and risks of potentiating inflammation, myocyte destruction and the recurrence of disorders related to both inducing and aggravating heart failure.</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00The Expression of miR-155-5p and Local Matrix Gla Protein in Meningiomas<abstract> <title style='display:none'>Abstract</title> <p>Meningiomas are classified by the World Health Organization (WHO) in three grades, based on morphological features. Independent of this grading, the presence of calcification in meningiomas influences their growth rate. The messenger RNA of matrix Gla protein (MGP), an extra-hepatic protein with different conformations involved in the homeostasis of ectopic calcification has been found in meningiomas and was shown to be regulated in breast cancer by miR-155-5p, a specific micro RNA. Therefore, we investigated the expression of miR-155-5p and its relationship with local MGP conformations in different grade meningiomas. According to the WHO classification, our 41 samples of meningiomas were stratified in groups WHO I and WHO II. Using real time polymerase chain reaction, we observed a higher miR-155-5p expression in group WHO I versus group WHO II [with a fold change (FC) of 3.83, p=0.027)]. Moreover, the expression of miR-155-5p was higher in calcified tumors compared to non-calcified tumors in all samples (FC=3.01, p=0.047) and in group WHO I (FC=3.65, p=0.048). Utilizing immunohistochemistry, we determined the concurrent presence of all MGP conformations in calcified meningiomas. This study was the first to establish higher miR-155-5p expression in grade WHO I and calcified meningiomas, which could improve molecular classification and targeted therapy and also the presence of all MGP conformations in calcified meningiomas, confirming the existence of an anti-calcification mechanism in meningiomas..</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00Deity, love, punishment, rage, and mythonyms from head to toes. A brief history of some medical terms<abstract> <title style='display:none'>Abstract</title> <p>Although it is undoubtful that today’s Medical English is rooted in Greek and Latin, it is particularly interesting that figures from Greek mythology are the roots of words to describe conditions, body parts, feelings, substances, etc. While there are numerous medical terms that are derived from the names of Greek mythological figures, this paper will only investigate words ranging from A to H and will try to justify the relationship between the concepts and the choice of terminology.</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00Correction factor between two calcitonin assays: DiaSorin LiaisonXL and Cobas E601<abstract> <title style='display:none'>Abstract</title> <p><bold>Introduction</bold>: Calcitonin measurement is important for the diagnosis and monitoring of medullary thyroid carcinoma. Unfortunately, in clinical practice, different detection systems assays are used in the follow-up of the patients, which can be misleading.</p> <p><bold>Objective</bold>: To identify the correction factor for calcitonin measurement on two different immunoanalysers: DiaSorin-LiaisonXL (immunochemiluminescence) and CobasE601 (electro-immunochemiluminescence).</p> <p><bold>Methods</bold>: We selected 89 registered CT samples (28-from men; 61-from women), that were analysed on CobasE601 with reported values between 0.5 pg/ml and 2812 pg/ml (128.5±513.98). These CT samples were selected randomly to cover as wide a range of values as possible, and represented either basal CT (n=38) or selected from CT stimulation tests (n=51). Samples were evaluated subsequently on DiaSorin-LiaisonXL. All patients gave their informed consent.</p> <p><bold>Results</bold>: Between the two assays a segmented linear correlation was noted. We identified the following general linear regression equation: 1.108x+19.337 (p&lt;0.05). The bias increased at high calcitonin values. Therefore, for a better accuracy we analysed the regression equation segmentally. A statistic difference (p&lt;0.05) was noted for CT values ranged between 350-2600 pg/ml (n=31) on DiaSorin-LiaisonXL, for which the linear regression equation for CobasE601 becomes 1.009x+169.796.</p> <p><bold>Conclusions</bold>: Calcitonin correction factors are highly important in the dynamic follow up of a patient suffering from medullary thyroid carcinoma when different detection systems assays are used to determine calcitonin. We identified the correction factors for calcitonin determination between two different frequently used chemiluminescence immunoanalysers: DiaSorin-LiaisonXL and CobasE601. However, it is strongly advisable to use the same analyser in order to establish biochemical evolution of calcitonin.</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00Genetic Diagnostic Approaches in Familial Hypercholesterolemia Evaluation<abstract> <title style='display:none'>Abstract</title> <p>Familial hypercholesterolemia (FH) manifested as atherosclerosis is a major cause of coronary heart disease. Different scoring systems based on clinical and paraclinical data are currently used, but the FH diagnosis should be made only in the presence of the causative genetic defect. In the present study, 12 symptomatic (previously diagnosed with atherosclerosis) and asymptomatic family members were investigated. Serum lipids were measured using commercial reagents. A genetic investigation was performed by Sanger sequencing using commercial reagents and custom primers, while copy number variations and a selected set of 40 point mutations were evaluated using in vitro diagnostic medical devices. For the investigated patients, serum lipids were within the reference range, due to the fact that the subjects were following lipid-lowering therapy, and smoking was the only identifiable additional risk factor. Four benign exon variants and three intron variants situated within the low-density lipoprotein cholesterol receptor gene were identified by Sanger sequencing. No copy number variations and none of the 40 investigated point mutations were determined. Although independently considered benign, the combined effect of the identified genetic conditions could be pathogenic under the influence of additional risk factors. Even in the presence of a diagnosis made using clinical scores, the molecular diagnosis is often challenging, attesting to the complexity of FH genetic etiology.</p> </abstract>ARTICLE2021-07-31T00:00:00.000+00:00Evaluation of Plasma AA/DHA+EPA Ratio in Obese Romanian Children<abstract><title style='display:none'>Abstract</title><p>The <bold>aim</bold> of the study was to evaluate the plasma profile of arachidonic acid (AA), docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA), as well to analyze the relationship of Omega 6/Omega 3 ratio with anthropo-metric parameters and insulin resistance markers.</p><p><bold>Material and methods:</bold> Plasma levels of free fatty acids (FFAs) were measured using a high-throughput LC-MS AB Sciex4600 in 202 children (127 obese and 75 non-obese), age and sex-matched. Lipid and glucose profiles were assessed with current laboratory methods, while insulin resistance and beta-cell function were evaluated using HOMA-IR and HOMA-β respectively.</p><p><bold>Results:</bold> In obese children, AA and AA/(DHA+EPA) ratio were significantly higher regardless of age and gender. In the lowest quartile of DHA, there was a clear trend for insulin resistance, with plasma insulin level, HOMA-IR, and HOMA-β significantly higher compared to the highest quartile of DHA. After adjustment for age and gender DHA remains a negative predictive factor for insulin resistance. Waist-to-height ratio (WHtR), a marker of visceral obesity was higher in children with a higher AA/(DHA+EPA) ratio.</p><p><bold>Conclusions:</bold> In obese children, the AA is higher in concordance with insulin resistance. Additionally, children with a higher AA/(DHA+EPA) ratio have greater BMI, fat mass, waist circumference, and WHtR, important indicators of central adiposity, and cardio-metabolic disorders. LC/MS is a versatile tool for Omega ratio assessment, especially in children where the sample size is a limiting factor for metabolic and nutrition evaluation.</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Frequency, Distribution and Genotyping of Species in Patients with<abstract><title style='display:none'>Abstract</title><p><bold>Background</bold>: Malassezia species are reported to play a role in the etiology of Psoriasis vulgaris.</p><p><bold>Objective</bold>: The aim of this study was to determine the presence, frequency, distribution, and genotyping of skin colonization of Malassezia species in Psoriasis vulgaris and to compare with healthy individuals and to investigate its relationship with the severity of the disease.</p><p><bold>Methods</bold>: Skin samples were taken from scalp, arm, body, and leg of 34 psoriasis patients (lesional/non-lesional skin) and 30 healthy volunteers. Overall, 392 skin scraping samples were taken for the isolation of Malassezia species, which were incubated on the modified-Dixon agar. Conventional culture methods were used for Malassezia species identification. In isolates, genotyping was carried out by PCR-RFLP method.</p><p><bold>Results</bold>: In the samples from psoriatic lesions, most frequently isolated Malassezia species were M.globosa and M.furfur. Similarly, the most frequently isolated species in healthy volunteers was M. globosa; followed by M.restricta and M.sympodialis. The M.furfur isolation rate in psoriatic scalp and leg lesions of the patients was significantly higher than in healthy volunteers. There was no relationship between the severity of the disease and the isolated species.</p><p><bold>Conclusion</bold>: It was found that there was a difference between patients with psoriasis and healthy controls regarding presence and frequency of Malassezia species. Therefore, our study results support the view that Malessezia species may be associated with the etiopathogenesis of psoriasis. In addition, we surmise that the treatment applications for the regulation of skin microbiota of psoriasis patients will contribute positively to the treatment of psoriasis.</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Reliability of Friedewald formula in patients with type 2 diabetes mellitus and its relation to lipid profile in diabetes regulation<abstract><title style='display:none'>Abstract</title><p><bold>Introduction</bold>: Many laboratories utilize Friedewald formula (FF) to analyze LDL cholesterol levels of patients including diabetes mellitus (DM). Therefore, it is essential to consider the coherence of results acquired by FF and direct measurement. The number of studies that investigated the effect of lipid parameters, especially TG/HDL cholesterol ratio, on the difference between the two methods is limited. The study was designed to compare LDL cholesterol values obtained by using FF with direct measurement, and to evaluate the relationship between diabetes regulation and lipid profile.</p><p><bold>Material and Methods</bold>: In the cross-sectional study, 529 type 2 DM patients and 1703 non-DM subjects were divided into four groups regarding TG concentrations. Unlike other studies, the study focuses on direct LDL (DLDL) cholesterol levels obtained with the help of different DLDL cholesterol kits (n=20). The correlations were implemented between HbA1c and lipid profiles.</p><p><bold>Results</bold>: It was determined that the bias% was over 10% in 24% of patients with 100-199 mg/dL TG levels. The parameter revealed that the most significant difference and the strongest correlation with HbA1c was TG/HDL cholesterol ratio in patients with type 2 DM.</p><p><bold>Conclusions</bold>: In patients with type 2 DM, even if it was TG &lt;200 mg/dL, LDL calculated with FF should be evaluated together with the TG/HDL cholesterol ratio. Otherwise, direct measurement can be recommended. This ratio is related to diabetes regulation and may be used to monitor patients..</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Investigation of Apoptotic and Inflammatory Activity in Liver Tissue of Rats Fed with Clam (, Linnaeus 1758)<abstract><title style='display:none'>Abstract</title><p>One of the most important threats for living things in aquatic ecosystems is environmental pollution. The changes in water quality caused by environmental pollution also reduce the quality of life for organisms in the environment. Among these, the crustaceans which are most affected by the negative changes of environment, fed by the filtration method, are seen as pollution indicator. The consumption of these creatures reaches all steps of the pyramid, especially humans, through the food chain. People who frequently use seafood in their diets may be affected by these negative changes. Heavy metal contents of the clams obtained from Dardanelles were determined by the ICPOES. Twenty-four female Wistar albino rats were fed for 30 days with the experimental diet using clams (Pecten maximus), which was dried and formed into pellets and added to the food in certain proportions. At the end of the study, the subjects were sacrificed under anesthesia, liver tissues were taken, and histochemical examination was performed. TUNEL method was performed to detect apoptotic activity, and immunohistochemical staining with TNF-α and NF-κB antibodies to determine inflammation. Concluding from the results, it was observed that the degeneration of vital digestive system tissues such as liver was inevitable in living creatures that frequently consume seafood obtained from unhealthy environment in their daily diets. The high analysis values of the heavy metal (P. maximus) in food additive can be considered as a reason for histopathological results.</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Predictors associated with increased troponin in acute decompensated and chronic heart failure patients<abstract><title style='display:none'>Abstract</title><p><bold>Background:</bold> Myocardial injury (INJ) expressed by elevated high-sensitivity troponin (hs-Tn) is common in heart failure (HF), due to cardiovascular and non-cardiac conditions. The mechanisms of INJ in acute decompensated HF (ADHF) versus chronic HF (CHF) are still debated. This study’s purpose was to evaluate the determinants of elevated hs-TnT in ADHF and CHF.</p><p><bold>Methods</bold>: We retrospectively analyzed consecutive HF patients with hs-TnT measured on admission, hospitalized in a tertiary-care hospital. Rehospitalizations, acute coronary syndromes, embolisms, infections, autoimmunity and malignancy were excluded. Cut-off point for hs-TnT was 14 ng/L.</p><p><bold>Results</bold>: Our study included 488 HF patients, 56.55% with ADHF. Mean age was 72.52±10.09 years. 53.89% were females. 67.75% ADHF and 45.75% CHF patients had elevated hs-TnT. Median hs-TnT was higher in ADHF versus CHF (21.05[IQR 12.74-33.81] vs 13.20[IQR 7.93-23.25], p&lt;0.0001). In multivariable analysis in ADHF and CHF, log10NT-proBNP (HR=5.30, 95%CI 2.71–10.38, p&lt;0.001, respectively HR=5.49, 95%CI 1.71–17.57, p=0.004) and eGFR (HR=0.72, 95%CI 0.62–0.85, p&lt;0.001, respectively HR=0.71, 95%CI 0.55–0.93, p=0.014) were independent predictors for increased hs-TnT. Independent factors associated with elevated hs-TnT in ADHF were male sex (HR=2.52, 95%CI 1.31-4.87, p=0.006) and chronic pulmonary obstructive disease (COPD) (HR=10.57, 95%CI 1.26-88.40, p=0.029), while in CHF were age (HR=2.68, 95%CI 1.42-5.07, p=0.002) and previous stroke (HR=5.35, 95%CI 0.98-29.20, p=0.053).</p><p><bold>Conclusion</bold>: HF severity, expressed by NT-proBNP levels, and kidney disease progression, expressed by eGFR, were independent predictors associated with increased hs-TnT in both ADHF and CHF. Specific independent predictors were also indentified in ADHF (male sex, COPD) and CHF (age, history of stroke).</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Prevalence of ∆F508 cystic fibrosis carriers in a Romanian population group candidiasis in Konya area: Etiology, risk factors, virulence patterns, and antifungal susceptibility<abstract><title style='display:none'>Abstract</title><p>Vulvovaginal candidiasis (VVC), a common genital tract infection, is known to affect millions of women worldwide. In this study, it was aimed to determine the prevalence, virulence, possible risk factors and antifungal susceptibility model of Candida species. Vaginal swab samples were taken from patients aged 18 years and older who presented to the gynecology outpatient clinic with signs and symptoms suggestive of vulvovaginitis. Demographic data were recorded using a questionnaire. Standard microbiological methods were used for the identification of the isolates. Broth microdilution method was used to determine the antifungal susceptibility of Candida isolates. Virulence factors of Candida strains were determined by performing proteinase, phospholipase, hemolytic and biofilm activity tests. Sequencing of the isolates identified as Candida were performed using ITS 1-4 primers. Vaginal discharge (OR: 3.365; 95% CI: 1.595-7.101), burning complaint (OR: 9.098; 95% CI: 2.284-36.232) and history of allergy (OR: 3.396; 95% CI: 0.968) were risk factors. The results showed that the most common isolated strain was Candida albicans (57%). It was found that the prevalence of C. glabrata remained at 26%, 44 of the C. albicans isolates presented proteinase, 35 had phospholipase, 47 had biofilm, and 47 had hemolytic activity. In this study, susceptible dose-dependent and resistant rates of all Candida strains were found for fluconazole as 9% and 16%, respectively. Host and organism-related factors should be considered in the clinical treatment of VVC, and continuous monitoring of changes in the prevalence of Candida species and susceptibility rates is required for effective antifungal therapy.</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00The possibility of clinical use for the oxidative stress marker in correlation with blood flow parameters in pregnancy-induced hypertension<abstract><title style='display:none'>Abstract</title><p><bold>Introduction</bold>: In pregnancy-induced hypertension (PIH) there is a disorder in placental blood flow which causes intrauterine fetal hypoxia, and oxidative stress has a significant role in this condition. The aims of this research were to analyze the relation of thiobarbituric acid reactive substance (TBARS), as a marker of oxidative stress and absent end-diastolic flow (AEDF), as well as the relation of TBARS and cerebroplacental ratio (CPR).</p><p><bold>Methods</bold>: The research included 200 pregnant women in the gestation period from 28th to 40th, 100 were in a control group and 100 were with PIH. The CPR and TBARS were analyzed in all examined pregnant women. The CPR was calculated by dividing the Doppler indices of the middle cerebral artery by the umbilical artery.</p><p><bold>Results</bold>: Mean value of TBARS in the group with the PIH who had AEDF was in the interval of high values - 43.22 μmol/l. The result shows that through the application of Spearman’s coefficient, the correlation results in a statistically significant correlation between CPR and TBARS values: ρ = - 0.249, p = 0.0001.</p><p><bold>Conclusion</bold>: PIH has a very high level of oxidative stress, especially in pregnant women with absent end-diastolic flow in the umbilical artery and pathologic CPR. The Spearman’s test results in statistical significance and negative correlation, which means that in higher TBARS values, values of CPR are lower and vice versa, which indicates a possibility of clinical application of TBARS.</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Prognostic value of serum lactate dehydrogenase in hospitalized patients with Covid-19<abstract><title style='display:none'>Abstract</title><p><bold>Background</bold>: Biochemical markers in COVID-19 remain to be defined. We analyzed the usefulness of LDH and ferritin in predicting outcome.</p><p><bold>Methods</bold>: This retrospective study analyzed ferritin and LDH concentrations obtained during the first 11 days of hospitalization in COVID-19 patients. We compared the change in ferritin and LDH concentrations obtained on each day of hospital admission with respect to baseline values between patients with favorable and unfavorable outcomes. We used receiver operating curve analysis to determine cutoffs for predicting outcomes.</p><p><bold>Results</bold>: We analyzed 387 patients. For determinations done on the 9th day, increases in LDH concentrations &gt; 14.6% over the baseline yielded 80% positive predictive value, and a lack of increase yielded 96% negative predictive value for unfavorable outcomes. The change in ferritin concentration yielded lower predictive values.</p><p><bold>Conclusion:</bold> The percentage of change in LDH with respect to the baseline on the 9th day of hospitalization can predict outcome..</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00Pseudohyponatremia and falsely increased serum osmolal gap caused by paraprotein in a patient with severe metabolic acidosis – a case study<abstract><title style='display:none'>Abstract</title><p><bold>Introduction:</bold> The aim of the study is to present a case study of a 63-year-old male with pseudohyponatremia, falsely increased serum osmolal gap and severe metabolic acidosis.</p><p><bold>Material and Methods:</bold> Venous whole blood (direct sodium selective electrode measurement) and serum (indirect sodium selective electrode measurement) were used to measure sodium concentration. Serum cholesterol, triacylglycerides and total protein were measured to confirm pseudohyponatremia. Base excess in extracellular fluid and serum bicarbonate concentrations were employed as markers of metabolic acidosis. Serum protein electrophoresis and free light chain analysis were used for the detection of paraproteins.</p><p><bold>Results:</bold> Venous whole blood acid base analysis showed a pH of 7.171, negative base excess in extracellular fluid of – 18.6 mmol/L and sodium concentration of 140 mmol/L. Serum test measurement revealed serum sodium concentration of 130 mmol/L, osmolal gap of 24 mmol/kg, creatinine concentration of 702 µmol/L, HCO3- concentration of 6.1 mmol/L and total protein concentration of 134.9 g/L. Serum paraprotein IgG kappa with a concentration of 86 g/L and a serum free light chains kappa/lambda ratio of 223.5, along with the final diagnosis of multiple myeloma were detected. Toxic alcohol ingestion was considered, both methanol and ethylene glycol tests were negative.</p><p><bold>Conclusions:</bold> High paraprotein concentrations in serum may lead to pseudohyponatremia when measured by indirect ion selective electrodes. Multiple myeloma frequently leads to renal failure with metabolic acidosis.</p></abstract>ARTICLE2021-04-27T00:00:00.000+00:00-ITD DNA allelic burden, but not mRNA levels, influences the biological characteristics of AML patients<abstract><title style='display:none'>Abstract</title><p>FMS-like tyrosine kinase 3 gene internal tandem (FLT3-ITD) mutations represent one of the most frequent genetic lesions in acute myeloid leukemia (AML) and imparts a negative prognostic. For an optimal patient management, current clinical guidelines recommend the evaluation of the allelic ratio (AR), expressed as the DNA FLT3-ITD/WT mutational burden. We sought to evaluate the differences between the AR and FLT3-ITD/WT mRNA ratio (RR) and their respective impact on the biological characteristics of AML patients. A total of 32 DNA and mRNA samples from AML patients with FLT3-ITD were evaluated. There was a good correlation between the AR and RR (Spearman’s rho= 0.652, P &lt;0.001). None of the biological characteristics were influenced by the RR values, whereas patients with high AR values (≥0.5) had higher WBC counts (Mann-Whitney, P= 0.01), LDH levels (Mann-Whitney, P= 0.037), and circulating blasts levels (Mann-Whitney, P= 0.023) than patients with low AR values (&lt;0.5). Also, there was a good correlation between AR values and WBC count (Spearman’s correlation, P= 0.001), and LDH levels (Spearman’s correlation, P= 0.007). In our study population the AR, but not the RR, influenced the biological characteristic of patients suggesting a dose-independent effect of FLT3-ITD mutations.</p></abstract>ARTICLE2021-01-29T00:00:00.000+00:00Extended panel of biomarkers for long term monitoring of effectiveness of 3 direct antiviral regimen in HCV genotype 1b infection: results from a Romanian infectious disease hospital<abstract><title style='display:none'>Abstract</title><p><bold>Background</bold>: Hepatitis C virus can be eradicated with antiviral therapy, thus reducing the risk of disease progression and death associated with the final stage of liver disease.</p><p><bold>Methods</bold>: 241 patients received PrOD+RBV for 12 weeks. Clinical and laboratory data were assessed at baseline, week 4, 8, 12 (end of treatment, EOT), and 12 weeks after therapy (sustained virological response, SVR). Subsequently, biological and virological measurements were performed at least 48 weeks after obtaining SVR12 in responder patients.</p><p><bold>Results</bold>: Per protocol SVR12 rate was 97,6%. Severe adverse events were reported in 3 patients (1.24%) and led to treatment discontinuation (liver decompensation). One 58-year-old patient who completed the treatment died before SVR evaluation due to acute mesenteric ischemia (not related to antiviral therapy). Baseline total bilirubin above 2 mg/dl can be considered a predictive factor for non-response to PrOD+RBV treatment (p = 0.004). Of the 30 patients evaluated at least 48 weeks after SVR no one presented relapses, with no statistically significant differences in biological parameters changes and no adverse events were noted during the 48-week follow up period.</p><p><bold>Conclusion</bold>: Our study revealed the high effectiveness and good safety profile of PrOD +RBV in patients with genotype-1b HCV compensated cirrhosis (Child Pugh A) which were maintained during a 48-week period after treatment finalization.</p></abstract>ARTICLE2021-01-29T00:00:00.000+00:00en-us-1