Evaluation of Siemens Atellica AMH assay and comparison with Roche, Beckman and Ansh Labs.

Background: Anti-Müllerian hormone (AMH) is an important marker for ovarian reserve and response to fertility treatments. However, interassay variability exists due to the lack of a standardized method. This study evaluates the performance of the new Siemens Healthineers Atellica IM AMH assay against established assays (Beckman DxI 600 Access, Roche cobas Elecsys® e801, and Ansh Labs AMH ELISA).

Prospective and External Validation of an Ensemble Learning Approach to Sensitively Detect Intravenous Fluid Contamination in Basic Metabolic Panels.

Background: Intravenous (IV) fluid contamination within clinical specimens causes an operational burden on the laboratory when detected, and potential patient harm when undetected. Even mild contamination is often sufficient to meaningfully alter results across multiple analytes. A recently reported unsupervised learning approach was more sensitive than routine workflows, but still lacked sensitivity to mild but significant contamination.

Laboratory Anomalies in the Basic Metabolic Panel: Core Curriculum 2025.

Laboratory testing plays an integral part in medical decision making. However, laboratory results can sometimes vary significantly, leading to anomalous outcomes that are not consistent with the clinical picture. These anomalies can occur even in the best of laboratories simply because the total testing process includes elements that are not totally under the laboratory's control.

Direct analysis in real time mass spectrometry (DART-MS/MS) for rapid urine opioid detection in a clinical setting.

Background And Aims: Current laboratory methods for opioid detection involve an initial screening with immunoassays which offers efficient but non-specific results and a subsequent liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation which offers accurate results but requires extensive sample preparation and turnaround time. Direct Analysis in Real Time (DART) tandem mass spectrometry is evaluated as an alternative approach for accurate opioid detection with efficient sample preparation and turnaround time.

Materials And Methods: DART-MS/MS was optimized by testing the method with varying temperatures, operation modes, extraction methods, hydrolysis times, and vortex times.

Accounting for differences between serum and plasma: An indirect approach to derive reference intervals for total protein, albumin, and globulin.

Background: Observable quantitative variations exist between plasma and serum in routine protein measurements, often not reflected in standard reference intervals. In this study, we describe an indirect approach for estimating a combined reference interval (RI) (i.e.

Puzzling undetectable haptoglobin in a transfused pregnant patient.

Background-aim: Pregnancy induces physiological changes that can affect serologic and immunologic markers, potentially resulting in lower or undetectable haptoglobin values compared to non-pregnant counterparts. Such variations may lead to inaccurate diagnosis of hemolysis.

Methods: We report a case of a patient in second trimester of pregnancy receiving induction chemotherapy due to B-cell acute lymphocytic leukemia with undetectable haptoglobin levels in a routine laboratory sample collected less than 12 h posttransfusion of red cell unit.

Rapid serum tubes reduce transport hemolysis and false positive rates for high-sensitivity troponin T.

Introduction: Hemolysis in the emergency department (ED) can significantly delay results and appropriate action. We evaluated the main sources of hemolysis during sample collection, and to evaluate the use of rapid serum tubes (RST) as a transport hemolysis-mitigating measure for high-sensitivity troponin T (hs-cTnT) testing.

Methods: We examined the effect of tube type, tube fill, types of sample draw and collection methods on hemolysis and hs-cTnT in samples (n = 158) from ED patients.

Nitrous oxide abuse direct measurement for diagnosis and follow-up: update on kinetics and impact on metabolic pathways.

Recreational use of nitrous oxide (NO) has become a major health issue worldwide, with a high number of clinical events, especially in neurology and cardiology. It is essential to be able to detect and monitor NO abuse to provide effective care and follow-up to these patients. Current recommendations for detecting NO in cases of recreational misuse and consumption markers are lacking.

Biomarkers vs Machines: The Race to Predict Acute Kidney Injury.

Background: Acute kidney injury (AKI) is a serious complication affecting up to 15% of hospitalized patients. Early diagnosis is critical to prevent irreversible kidney damage that could otherwise lead to significant morbidity and mortality. However, AKI is a clinically silent syndrome, and current detection primarily relies on measuring a rise in serum creatinine, an imperfect marker that can be slow to react to developing AKI.

Urinary Biomarkers of Tubular Health and Risk for Kidney Function Decline or Mortality in Diabetes.

Introduction: Diabetes is a leading cause of end-stage kidney disease (ESKD). Biomarkers of tubular health may prognosticate chronic kidney disease (CKD) progression beyond estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR).

Methods: We examined associations of five urinary biomarkers of tubular injury and repair (NGAL, KIM-1, IL-18, MCP-1, YKL-40) with kidney function decline (first occurrence of a decrease in eGFR ≥30 mL/min/1.

A preliminary study of hydrocodone and hydromorphone to oxycodone ratios for distinguishing impurities from independent opioid use.

Background: Urine drug testing (UDT) monitors prescription compliance and/or drug abuse. However, interpretation of UDT results obtained by liquid chromatography-tandem mass spectrometry (LC-MS-MS) can be complicated by the presence of drug impurities that are detected by highly sensitive methods. Hydrocodone is a drug impurity that can be found as high as 1% in oxycodone pills.

Contamination of clinical blood samples with crystalloid solutions: An experimental approach to derive multianalyte delta checks.

Background: Laboratorians are left unguided by a paucity of literature on how to configure rules for the detection of intravenous (IV) fluid contamination in blood samples. We designed a study to determine the in vitro effect of increasing blood sample contamination from commonly used crystalloid solutions and how these observations can guide the derivation of multianalyte delta checks to detect such pre-analytical error.

Methods: In this study, we spiked increasing volumes of commonly used IV fluids (normal saline (NS), lactated ringers (LR), and 5% dextrose) into blood samples that were collected from healthy donors.