Knowledge among clinical personnel on the impact of hemolysis using blood gas analyzers.

Objectives: In the light of a rapidly increasing use of POCT blood gas testing, where tests and interpretation are performed by non-laboratory personnel, the objective was to investigate the knowledge among personnel in the Nordic countries using blood gas analyzers with focus on the interference from hemolysis.

Methods: Information was obtained from a self-developed, pre-tested online questionnaire. The questions covered demographic information about the respondents and specific questions on handling of and knowledge about blood gas analyses and the impact of hemolysis.

Validation of point-of-care tests used at in-home assessments among older adults in primary care.

Background: Diagnosing acute disease in older adults is challenged by vague and atypical symptoms. Point-of-care tests (POCTs) at home may improve diagnostics and clinical decision-making. We compared various POCT devices to routine testing in acutely ill older adults to assess their clinical reliability.

No Detectable Differences in microRNA Plasma Levels between Diabetic Hypertensive Patients with and without Incident Subclinical Atrial Fibrillation.

: Long-term rhythm monitoring (LTRM) can detect undiagnosed atrial fibrillation (AF) in patients at risk of AF and stroke. Circulating microRNAs (miRNAs), which have been shown to play a role in atrial electrical and structural remodelling, could help to select patients who would benefit most from LTRM. The aim of this study was to investigate whether patients with diabetes mellitus (DM) and hypertension and screen-detected subclinical AF (SCAF) using an insertable cardiac monitor (ICM) have significantly different plasma baseline levels of five selected miRNAs playing a role in the modulation of atrial electrical and structural remodelling (miR-21-5p, miR-29b-3p, miR-150-5p, miR-328-3p, and miR-432-5p) compared to those without SCAF.

Critical test result management at Danish hospital laboratories: a national survey.

Critical test results in clinical laboratories are crucial for timely patient care, serving as indicators of potentially life-threatening conditions. Despite their importance, a notable heterogeneity in management practices exists globally. This study investigates the current practices of managing critical results at Danish clinical biochemistry laboratories and identifies areas prone for improvement.

DANSPOT: A Multicenter Stepped-Wedge Cluster-Randomized Trial of the Reclassification of Acute Myocardial Infarction: Rationale and Study Design.

Background: Cardiac troponins are the preferred biomarkers for the diagnosis of acute myocardial infarction. Although sex-specific 99th percentile thresholds of troponins are recommended in international guidelines, the clinical effect of their use is poorly investigated. The DANSPOT Study (The Danish Study of Sex- and Population-Specific 99th percentile upper reference limits of Troponin) aims to evaluate the clinical effect of a prospective implementation of population- and sex-specific diagnostic thresholds of troponins into clinical practice.

Considerations for the use of biochemical laboratory registry data in clinical and public health research.

Objectives: To inform researchers of central considerations and limitations when applying biochemical laboratory-generated registry data in clinical and public health research.

Study Design And Setting: After review of literature on registry-based studies and the utilization of clinical laboratory registry data, relevant paragraphs and their applicability toward the creation of considerations for the use of biochemical registry data in research were evaluated. This led to the creation of an initial ten considerations.

Comparison of international guideline recommendations for the diagnosis of pulmonary embolism.

Pulmonary embolism is one of the leading causes of death due to cardiovascular disease. Timely diagnosis is crucial, but challenging, as the clinical presentation of pulmonary embolism is unspecific and easily mistaken for other common medical emergencies. Clinical prediction rules and D-dimer measurement allow stratification of patients into groups of expected prevalence and are key elements in adequate selection of patients for diagnostic imaging; however, the strengths and weaknesses of the multiple proposed prediction rules, when to measure D-dimer, and which cutoff to apply might be elusive to a significant proportion of physicians.

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With the increased sensitivity of the newest cardiac troponin assays, the risk of false positive cardiac troponin measurements has also increased. As summarised in this review, there are multiple possible causes of cardiac troponin release including several non-cardiac illnesses, particularly kidney disease. Further, there is a risk of analytical interference in which case repeated measurements with a different assay is a good tool.

Trends in low-density lipoprotein cholesterol goal achievement and changes in lipid-lowering therapy after incident atherosclerotic cardiovascular disease: Danish cohort study.

Background: We aimed to investigate trends in low-density lipoprotein cholesterol (LDL-C) goal achievement (LDL-C<1.8 mmol/L, equivalent to 70 mg/dL), initiation of lipid-lowering therapy (LLT) and changes in LLT intensity in individuals with atherosclerotic cardiovascular disease (ASCVD) at very high risk of recurrent cardiovascular disease.

Methods: A cohort study design was used including individuals with incident ASCVD and LDL-C≥1.

Recommendation for the design of stability studies on clinical specimens.

Objectives: Knowledge of the stability of analytes in clinical specimens is a prerequisite for proper transport and preservation of samples to avoid laboratory errors. The new version of ISO 15189:2022 and the European directive 2017/746 increase the requirements on this topic for manufacturers and laboratories. Within the project to generate a stability database of European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group Preanalytical Phase (WG-PRE), the need to standardise and improve the quality of published stability studies has been detected, being a manifest deficit the absence of international guidelines for the performance of stability studies on clinical specimens.

The angiotensin AT-receptor agonist compound 21 is an antagonist for the thromboxane TP-receptor - Implications for preclinical studies and future clinical use.

Since the AT-receptor (ATR) agonist C21 has structural similarity to the AT-receptor antagonists Irbesartan and Losartan, which are antagonists not only at the ATR, but also at thromboxane TP-receptors, we tested the hypothesis that C21 has TP-receptor antagonistic properties as well. Isolated mouse mesenteric arteries from C57BL/6 J and ATR-knockout mice (ATR) were mounted in wire myographs, contracted with either phenylephrine or the thromboxane A (TXA) analogue U46619, and the relaxing effect of C21 (0.1 nM - 10 µM) was investigated.

Elevated Hemolysis Index is associated with higher risk of cardiovascular diseases.

Objectives: hemolysis is associated with thromboembolism. Although an increased Hemolysis Index (HI) can be due to as well as hemolysis, both reflects a more fragile erythrocyte population. We therefore hypothesized that HI above upper reference limit would be associated with an increased risk of cardiovascular disease (CVD).

Comparison of plasma total carbon dioxide and standard hydrogen carbonate in a hospital laboratory setting.

Background: Studies comparing venous total carbon dioxide (tCO) and standard hydrogen carbonate (HCO(P,st)) has shown diverse results, and it is debatable whether these two parameters can be used interchangeably for workup of acid-base disorders in a hospital setting.

Method: All patients with an HCO(P,st) requisition from any department at Odense University Hospital between 11th May 2021 and 1st June 2021 had tCO and HCO(P,st) analysed simultaneously. TCO was measured on Cobas® 8000, c702 module, while HCO(P,st) was calculated based on measurements on ABL835 Flex.

Statin use before and after the KDIGO Lipids in chronic kidney disease guideline: A population-based interrupted time series analysis.

In November 2013, the Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease was published, recommending statins for all individuals 50 years or older with an estimated glomerular filtration rate below 60 ml/min/1.73 m to lower the risk of major cardiovascular events. We quantified the prevalence of statin use among the target population before and after the guideline publication in a large Danish cohort of individuals with an estimated glomerular filtration rate below 60 ml/min/1.

Lithium and the risk of chronic kidney disease: A population-based case-control study.

The association between lithium use and chronic kidney disease (CKD) needs further evaluation. We aimed to investigate this association using Danish nationwide healthcare registers and routinely collected plasma creatinine measurements from the Funen Laboratory Cohort. We conducted a case-control study nested within the population of Funen, 2001-2015.

Improved cardiovascular profile in Danish centenarians? A comparative study of two birth cohorts born 20 years apart.

Purpose: Cardiovascular health among middle-aged and older people has improved in high-income countries. It is unknown whether this also applies for the oldest-old and if so, is it driven by better treatment or by a health improvement? Therefore, we compared two Danish centenarian birth cohorts born in 1895 and 1915, respectively, to investigate if the cardiovascular profile had improved in the most recent born cohort.

Methods: All individuals turning 100 years old in 1995 and 2015, respectively, were included with participation rates of 74% (n = 106) and 79% (n = 238), respectively.

Accuracy of a point-of-care blood lactate measurement device in a prehospital setting.

Point-of-care blood lactate is a promising prognostic biomarker of short-term mortality risk. Portable lactate meters need validation in the prehospital setting before widespread implementation and it is unknown whether the mode of sampling (arterial, capillary or venous) matters. This study aims to compare the StatStrip Xpress Lactate Meter's (SSX) accuracy to a validated blood gas analyser, ABL90 FLEX (ABL90), in arterial samples in the prehospital environment and to determine if lactate levels measured in venous and capillary blood samples are sufficiently accurate compared to arterial lactate levels.

Circulating biomarkers, echocardiographic parameters, and incident subclinical atrial fibrillation in patients with diabetes and hypertension.

Background: Long-term rhythm monitoring (LTRM) can detect undiagnosed atrial fibrillation (AF) in patients at high risk of AF and stroke. Biomarkers and echocardiographic parameters could, however, help identify patients benefitting most from LTRM. The aim of this study was to investigate, whether circulating biomarkers of cardiac and vascular function (brain natriuretic peptide (BNP), cardiac troponin I (cTnI), copeptin, and mid-regional proadrenomedullin (MR-proADM)) and echocardiographic parameters were associated with incident subclinical AF (SCAF) in a population at high risk of stroke in the presence of AF.

Venous Thromboembolism in Pediatric Cancer Patients with Central Venous Catheter-A Systematic Review and Meta-analysis.

Pediatric cancer patients hold an increased risk of venous thromboembolism (VTE) due to their cancer. Central venous catheters (CVCs) further increase the VTE risk. This systematic literature review elucidates the VTE incidence in pediatric cancer patients with CVC.

Management of Cancer-Associated Venous Thrombosis: A Nationwide Survey among Danish Oncologists.

 Treatment patterns for cancer-associated venous thrombosis (CAT) has been shown to be nonconsistent with contemporary guideline recommendations, resulting in poor patient outcomes.  The study aimed to describe contemporary CAT management in Danish oncology departments and identify knowledge gaps and inconsistencies between guidelines and clinical practice.  A survey questionnaire in Danish was developed based on contemporary national guidelines.

[Work-up of thrombophilia].

The number of thrombophilia investigations has been steadily increasing over the past decade. However, it is debatable to what extent treatment of thromboembolic events is further qualified by thrombophilia investigations. Based of the most recent literature as well as international and national expert opinions, this review provides a status on the frequency and severity of inherited and acquired thrombophilia, discusses indication for thrombophilia assessment, states the analyses to be included in the test panel, and the clinical implications that presence of thrombophilia may have.

Measurement of vitamin D in dried blood spots stored under different temperature conditions.

Background: As part of the Survey of Health, Ageing and Retirement in Europe (SHARE) study, dried blood spot samples were obtained for measurement of potential biological biomarkers, among those vitamin D. Unfortunately, no studies describe the impact of high temperatures on dried blood spot samples and vitamin D measurements.

Materials And Methods: Capillary samples were collected on dried blood spot cards from 40 outpatients (median age 78 years) along with venous blood samples.