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  1. Article: Complete laboratory diagnosis of Insulin Autoimmune Syndrome.

    Galván, Raquel / Fernández-Riejos, Patricia / Sánchez Martínez, Pilar María / Rodríguez-Chacón, Carmen / Sánchez Mora, Catalina / León-Justel, Antonio

    Practical laboratory medicine

    2023  Volume 36, Page(s) e00320

    Abstract: The definition of Insulin autoimmune syndrome includes the presence of high levels of blood insulin and insulin autoantibodies. We encountered a 45-years-old white man with a high insulin serum value that do not fit with the C-peptide result. To discard ... ...

    Abstract The definition of Insulin autoimmune syndrome includes the presence of high levels of blood insulin and insulin autoantibodies. We encountered a 45-years-old white man with a high insulin serum value that do not fit with the C-peptide result. To discard or to confirm an analytical interference and diagnose a possible Insulin Autoimmune Syndrome we performed the following investigations: dilution linearity test, heterophilic antibody blocking, polyethylene glycol precipitation, measurements with alternative assays, and gel filtration chromatography by size exclusion. The latter technique confirmed that most of the insulin was complexed with a 150-kDa protein, corresponding to immunoglobulin G, identified as insulin autoantibodies. These antibodies were responsible for hypoglycemia attacks in the patient, who had a previous autoimmune disease. This case highlights the importance of carefully analyzing the results and ruling out possible interferences, as well as considering all kinds of pathologies, even if they are infrequent.
    Language English
    Publishing date 2023-06-19
    Publishing country Netherlands
    Document type Case Reports
    ZDB-ID 2834973-8
    ISSN 2352-5517
    ISSN 2352-5517
    DOI 10.1016/j.plabm.2023.e00320
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Evaluation of health outcomes after the implementation of rotational thromboelastometry in patients undergoing cardiac surgery.

    Rodríguez-Martín, Isabel / Sánchez-Mora, Catalina / Fernández-López, Antonio R / González-Fernández, Francisco J / Téllez-Cantero, Juan Carlos / Blanco-Marquez, Verónica / García de la Borbolla, Mariano / Santos-Jiménez, Juan C / González-Rodríguez, Concepción / Garnacho-Montero, José / Sánchez-Margalet, Víctor

    Scandinavian journal of clinical and laboratory investigation

    2022  Volume 82, Issue 2, Page(s) 143–149

    Abstract: Background: Viscoelastic tests (rotational thromboelastometry, ROTEM: Methods: Retrospective cohort study including 675 patients who underwent cardiac surgery with cardiopulmonary bypass. The incidence of allogeneic blood transfusions and clinical ... ...

    Abstract Background: Viscoelastic tests (rotational thromboelastometry, ROTEM
    Methods: Retrospective cohort study including 675 patients who underwent cardiac surgery with cardiopulmonary bypass. The incidence of allogeneic blood transfusions and clinical postoperative complications were analyzed before and after ROTEM
    Results: Following viscoelastic testing and the implementation of a specific algorithm for coagulation management, the incidence of any allogeneic blood transfusion decreased (41.4% vs 31.9%,
    Conclusions: The monitoring of hemostasis by ROTEM
    MeSH term(s) Cardiac Surgical Procedures/adverse effects ; Humans ; Outcome Assessment, Health Care ; Postoperative Hemorrhage/prevention & control ; Retrospective Studies ; Thrombelastography/methods
    Language English
    Publishing date 2022-02-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 3150-1
    ISSN 1502-7686 ; 0036-5513
    ISSN (online) 1502-7686
    ISSN 0036-5513
    DOI 10.1080/00365513.2022.2034038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Circulating myeloid-derived suppressor cells may be a useful biomarker in the follow-up of unvaccinated COVID-19 patients after hospitalization.

    Jiménez-Cortegana, Carlos / Salamanca, Elena / Palazón-Carrión, Natalia / Sánchez-Jiménez, Flora / Pérez-Pérez, Antonio / Vilariño-García, Teresa / Fuentes, Sandra / Martín, Salomón / Jiménez, Marta / Galván, Raquel / Rodríguez-Chacón, Carmen / Sánchez-Mora, Catalina / Moreno-Mellado, Elisa / Gutiérrez-Gutiérrez, Belén / Álvarez, Nerissa / Sosa, Alberto / Garnacho-Montero, José / de la Cruz-Merino, Luis / Rodríguez-Baño, Jesús /
    Sánchez-Margalet, Víctor

    Frontiers in immunology

    2023  Volume 14, Page(s) 1266659

    Abstract: SARS-CoV-2 infection is the cause of the disease named COVID-19, a major public health challenge worldwide. Differences in the severity, complications and outcomes of the COVID-19 are intriguing and, patients with similar baseline clinical conditions may ...

    Abstract SARS-CoV-2 infection is the cause of the disease named COVID-19, a major public health challenge worldwide. Differences in the severity, complications and outcomes of the COVID-19 are intriguing and, patients with similar baseline clinical conditions may have very different evolution. Myeloid-derived suppressor cells (MDSCs) have been previously found to be recruited by the SARS-CoV-2 infection and may be a marker of clinical evolution in these patients. We have studied 90 consecutive patients admitted in the hospital before the vaccination program started in the general population, to measure MDSCs and lymphocyte subpopulations at admission and one week after to assess the possible association with unfavorable outcomes (dead or Intensive Care Unit admission). We analyzed MDSCs and lymphocyte subpopulations by flow cytometry. In the 72 patients discharged from the hospital, there were significant decreases in the monocytic and total MDSC populations measured in peripheral blood after one week but, most importantly, the number of MDSCs (total and both monocytic and granulocytic subsets) were much higher in the 18 patients with unfavorable outcome. In conclusion, the number of circulating MDSCs may be a good marker of evolution in the follow-up of unvaccinated patients admitted in the hospital with the diagnosis of COVID-19.
    MeSH term(s) Humans ; Myeloid-Derived Suppressor Cells ; Follow-Up Studies ; COVID-19 ; SARS-CoV-2 ; Biomarkers ; Hospitalization
    Chemical Substances Biomarkers
    Language English
    Publishing date 2023-11-14
    Publishing country Switzerland
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2606827-8
    ISSN 1664-3224 ; 1664-3224
    ISSN (online) 1664-3224
    ISSN 1664-3224
    DOI 10.3389/fimmu.2023.1266659
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Emergency severity level-3 patient flow based on point-of-care testing improves patient outcomes.

    Jimenez-Barragan, Marta / Rodriguez-Oliva, Manuel / Sanchez-Mora, Catalina / Navarro-Bustos, Carmen / Fuentes-Cantero, Sandra / Martin-Perez, Salomon / Garrido-Castilla, Jose M / Undabeytia-Lopez, Luisa / Luque-Cid, Antonio / de Miguel-Melendez, Juan / Leon-Justel, Antonio

    Clinica chimica acta; international journal of clinical chemistry

    2021  Volume 523, Page(s) 144–151

    Abstract: Background: Overcrowding of the Emergency Department is rapidly becoming a global challenge and a major source of concern for emergency physicians. The desire to improve Emergency Department throughput requires novel approaches to patient flow.: ... ...

    Abstract Background: Overcrowding of the Emergency Department is rapidly becoming a global challenge and a major source of concern for emergency physicians. The desire to improve Emergency Department throughput requires novel approaches to patient flow.
    Materials and methods: We conducted a prospective and cluster-randomized study, to evaluate the impact in patient outcomes of a new patient flow based on Point-of-Care Testing (POCT). A total of 380 Emergency Severity Level-3 patients were enrolled and studied in two different groups, interventional arm (laboratory analyses performed on POCT analyzers implemented in the Emergency Department) or control arm (central laboratory). The primary outcome was the Emergency Department length of stay. Secondary outcome included the time to first medical intervention, the laboratory turnaround time and the time to disposition decision. Readmission within the 7 days after discharge was also calculated.
    Results: Length of stay significantly decreased by 88.50 min (from 247.00 to 158.50), time to disposition decision by 89.00 min (from 192.00 to 103.00) and laboratory turnaround time by 67.11 min (from 89.84 to 22.73) in the POCT group. No increase in readmission was found.
    Conclusion: Our strategy based on POCT represents a good approach to optimize patient flow in the Emergency Department and it should be seen as a starting point for further studies focusing on improving throughput.
    MeSH term(s) Emergency Service, Hospital ; Humans ; Length of Stay ; Point-of-Care Systems ; Point-of-Care Testing ; Prospective Studies
    Language English
    Publishing date 2021-09-16
    Publishing country Netherlands
    Document type Journal Article ; Randomized Controlled Trial
    ZDB-ID 80228-1
    ISSN 1873-3492 ; 0009-8981
    ISSN (online) 1873-3492
    ISSN 0009-8981
    DOI 10.1016/j.cca.2021.09.011
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  5. Article: Evaluation of 3 Hemoglobin A1c Point of Care Instruments. Point of Care Testing for HbA1c: Evaluation of Cobas b101, B-Analyst and Afinion™.

    Toro-Crespo, María De / Sánchez-Mora, Catalina / Fernández-Riejos, Patricia / Maesa-Márquez, José M / González-Rodríguez, Concepción

    Clinical laboratory

    2017  Volume 63, Issue 7, Page(s) 1107–1112

    MeSH term(s) Blood Cell Count ; Diabetes Mellitus/diagnosis ; Glycated Hemoglobin A ; Humans ; Point-of-Care Systems ; Point-of-Care Testing
    Chemical Substances Glycated Hemoglobin A
    Language English
    Publishing date 2017-07-01
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1307629-2
    ISSN 1433-6510 ; 0941-2131
    ISSN 1433-6510 ; 0941-2131
    DOI 10.7754/Clin.Lab.2017.161212
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Comparison of automated devices UX-2000 and SediMAX/AutionMax for urine samples screening: A multicenter Spanish study.

    Sánchez-Mora, Catalina / Acevedo, Delia / Porres, Maria Amelia / Chaqués, Ana María / Zapardiel, Javier / Gallego-Cabrera, Aurelia / López, Jose María / Maesa, Jose María

    Clinical biochemistry

    2017  Volume 50, Issue 12, Page(s) 714–718

    Abstract: Objectives: In this study we aim to compare UX2000 (Sysmex Corp, Japan) and SediMAX/AutionMax (Arkray Factory Inc., Japan), totally automatized analyzers, against Fuchs-Rosenthal counting chamber, the gold standard technique for sediment analysis.: ... ...

    Abstract Objectives: In this study we aim to compare UX2000 (Sysmex Corp, Japan) and SediMAX/AutionMax (Arkray Factory Inc., Japan), totally automatized analyzers, against Fuchs-Rosenthal counting chamber, the gold standard technique for sediment analysis.
    Design and methods: Urine samples of 1454 patients from three Spanish hospitals were assessed for red and white blood cells (RBC; WBC) using three different techniques: flow cytometry, image-based method and Fuchs-Rosenthal counting chamber. Test strip results were subjected to concordance evaluation. Agreement was assessed by Cohen's weighted kappa for multinomial results. Sensitivity (SE) and specificity (SP) were calculated.
    Results: The categorization of the results showed that UX-2000 had higher concordance over SediMAX for WBC (0.819 vs. 0.546) and similar for RBC (0.573 vs. 0.630). For RBC, UX-2000 had higher SE (92.7% vs. 80.3%) but lower SP (77.1% vs. 87.4%), and showed higher both SE (94.3% vs. 76.7%) and SP (94.7% vs. 88.2%) for WBC. Inter-devices test strip agreement was substantial (kappa>0.600) for all variables except for bilirubin (kappa: 0.598). Intra-device test strip agreement was similar for UX2000 and SediMAX with regard to RBC (kappa: 0.553 vs. 0.482) but better for UX2000 with regard to WBC (0.688 vs. 0.465).
    Conclusions: Both analyzers studied are acceptable for daily routine lab work, even though SediMAX is easier to use in laboratories thanks to its lower maintenance procedure. UX-2000 has shown to have better concordance with the gold standard method. However, it needs some improvements such as an image module in order to decrease manual microscopy review for urine samples.
    MeSH term(s) Adult ; Aged ; Automation, Laboratory/standards ; Emergency Service, Hospital ; Erythrocyte Count/instrumentation ; Erythrocyte Count/standards ; Erythrocytes/pathology ; Female ; Humans ; Inpatients ; Leukocyte Count/instrumentation ; Leukocyte Count/standards ; Leukocytes/pathology ; Male ; Middle Aged ; Outpatients ; Prospective Studies ; Spain ; Urinalysis/instrumentation ; Urinalysis/methods
    Language English
    Publishing date 2017-08
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Multicenter Study ; Observational Study
    ZDB-ID 390372-2
    ISSN 1873-2933 ; 0009-9120
    ISSN (online) 1873-2933
    ISSN 0009-9120
    DOI 10.1016/j.clinbiochem.2017.02.005
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  7. Article ; Online: Midregional proadrenomedullin safely reduces hospitalization in a low severity cohort with infections in the ED: a randomized controlled multi-centre interventional pilot study.

    Gonzalez Del Castillo, Juan / Clemente-Callejo, Carlota / Llopis, Ferran / Irimia, Andreea / Oltra-Hostalet, Fernando / Rechner, Cindy / Schwabe, Andrej / Fernandez-Rodriguez, Verónica / Sánchez-Mora, Catalina / Giol-Amich, Jordi / Prieto-García, Belén / Bardés-Robles, Ignasi / Ortega-de Heredia, Maria Dolores / García-Lamberechts, Eric Jorge / Navarro-Bustos, Carmen

    European journal of internal medicine

    2021  Volume 88, Page(s) 104–113

    Abstract: Introduction: The midregional fragment of proadrenomedullin (MR-proADM) is known to provide accurate short-, mid- and long term prognostic information in the triage and multi-dimensional risk assessment of patients in the emergency department (ED). In ... ...

    Abstract Introduction: The midregional fragment of proadrenomedullin (MR-proADM) is known to provide accurate short-, mid- and long term prognostic information in the triage and multi-dimensional risk assessment of patients in the emergency department (ED). In two independent observational cohorts MR-proADM values identified low disease severity patients without risk of disease progression in the ED with no 28 days mortality that wouldn´t require hospitalization. In this interventional study we want to show that the combination of an MR-proADM algorithm with clinical assessment is able to identify low risk patients not requiring hospitalization to safely reduce the number of hospital admissions.
    Methods: A randomized-controlled interventional multicenter study in 4 EDs in Spain. The study protocol was approved by Ethics Committees. Control arm patients received Standard Care. MR-proADM guided arm patients with low MR-proADM value (≤0.87 nmol/L) were treated as out-patients, with high MR-proADM value (>0.87 nmol/L) were hospitalized. The hospitalization rate was compared between the study arms.
    Results: Two hundred patients with suspicion of infection were enrolled. In the MR-proADM guided arm the hospital admission rate in the intention-to-treat (ITT) population was 17% lower than in the control arm (40.6% vs. 57.6%, p=0.024) and 20% lower in the per protocol (PP) population (37.2% vs. 57.6%, p=0.009). No deaths of out-patients and no significant difference for the safety endpoints readmission and representation rates were observed. The readmission rate was only slightly higher in the MR-proADM guided arm compared to the control arm (PP population: at 14 days 9.3% vs. 7.1%, difference 2.1% (95% CI: -11.0% to 15.2%); and at 28 days 11.1% vs. 9.5%, difference 1.6% (95% CI: -12.2% to 15.4%)). The rate of 28 days representation was slightly lower in the MR-proADM guided arm compared to the control arm (20.4% vs. 26.2%, difference -5.8% (95% CI: -25.0% to 13.4%); PP population).
    Conclusions: Implementing a MR-proADM algorithm optimizes ED workflows efficiently and sustainably. Hospitals can highly benefit from a reduced rate of hospitalizations by 20% using MR-proADM. The safety in the MR-proADM guided study arm was similar to the Standard Care arm.
    Trial registration: ClinicalTrials.gov Identifier NCT03770533.
    MeSH term(s) Adrenomedullin ; Biomarkers ; Emergency Service, Hospital ; Hospitalization ; Humans ; Pilot Projects ; Prognosis ; Protein Precursors ; Spain
    Chemical Substances Biomarkers ; Protein Precursors ; proadrenomedullin ; Adrenomedullin (148498-78-6)
    Language English
    Publishing date 2021-04-24
    Publishing country Netherlands
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 1038679-8
    ISSN 1879-0828 ; 0953-6205
    ISSN (online) 1879-0828
    ISSN 0953-6205
    DOI 10.1016/j.ejim.2021.03.041
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  8. Article ; Online: Evaluation of a HbA1c point-of-care analyzer.

    Menéndez-Valladares, Paloma / Fernández-Riejos, Patricia / Sánchez-Mora, Catalina / Pérez-Pérez, Antonio / Sánchez-Margalet, Victor / González-Rodríguez, Concepción

    Clinical biochemistry

    2015  Volume 48, Issue 10-11, Page(s) 686–689

    Abstract: Objectives: A better glycemic monitoring of diabetic patients and avoiding complications of poorly controlled diabetes could be possible with point-of-care testing technology (POCT) for HbA1c determination. B-Analyst® was studied to check whether it ... ...

    Abstract Objectives: A better glycemic monitoring of diabetic patients and avoiding complications of poorly controlled diabetes could be possible with point-of-care testing technology (POCT) for HbA1c determination. B-Analyst® was studied to check whether it complied with the quality requirements for this purpose.
    Design and methods: We evaluated the B-Analyst® (Menarini Diagnostics), which is based in the principle of latex agglutination immunoturbidimetry, to assess the validity of the technique of HbA1c. We carried out the method comparison with the HA-8180® (Menarini Diagnostics) as a reference method [High Performance Liquid Chromatography (HPLC)]. We assessed the analytical quality of the B-Analyst® studying the accuracy: inter-assay variability and intra-assay study. Furthermore, possible interferences by hemoglobinopathies were studied.
    Results: Regression analysis of the data for the method comparison between HA-8180® and B-Analyst® showed a slope of 1.0085 and an intercept of 0.1208. The Pearson's correlation coefficient was 0.9958 (p<0.0001). Bias study showed a mean difference from B-Analyst® with respect to HA-8180® of 0.1872 with a 95% confidence interval. The standard error of the estimate (Syx) was 0.2091. The concordance correlation coefficient to assess accuracy was 0.9922 (0.9891-0.9945). The CV for the inter-assay study was 1.4%. For the intra-assay study we analyzed 3 samples with different HbA1c % whose CV were 1.03% [4.7% HbA1c (28 mmol/mol)], 0.46% [6.4% HbA1c (46 mmol/mol)] and 0.78% [8.1% HbA1c (65 mmol/mol)].
    Conclusion: The B-Analyst® evaluated not only showed good correlation with HA-8180®, but also it presented a great accuracy both in the inter-assay and in the intra-assay studies. The B-Analyst® complies with quality specifications required for monitoring of diabetic patients.
    MeSH term(s) Chromatography, High Pressure Liquid/standards ; Diabetes Mellitus/blood ; Glycated Hemoglobin A/analysis ; Humans ; Point-of-Care Systems/standards
    Chemical Substances Glycated Hemoglobin A ; hemoglobin A1c protein, human
    Language English
    Publishing date 2015-07
    Publishing country United States
    Document type Evaluation Studies ; Journal Article
    ZDB-ID 390372-2
    ISSN 1873-2933 ; 0009-9120
    ISSN (online) 1873-2933
    ISSN 0009-9120
    DOI 10.1016/j.clinbiochem.2015.03.016
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  9. Article ; Online: Evaluation of two HbA1c point-of-care analyzers.

    Sánchez-Mora, Catalina / S Rodríguez-Oliva, Manuel / Fernández-Riejos, Patricia / Mateo, Joaquín / Polo-Padillo, Juan / Goberna, Raimundo / Sánchez-Margalet, Víctor

    Clinical chemistry and laboratory medicine

    2011  Volume 49, Issue 4, Page(s) 653–657

    Abstract: Background: Measurement of HbA1c is the most important parameter to assess glycemic control in diabetic patients. Different point-of-care devices for HbA1c are available. The aim of this study was to evaluate two point-of-care testing (POCT) analyzers ( ... ...

    Abstract Background: Measurement of HbA1c is the most important parameter to assess glycemic control in diabetic patients. Different point-of-care devices for HbA1c are available. The aim of this study was to evaluate two point-of-care testing (POCT) analyzers (DCA Vantage from Siemens and Afinion from Axis-Shield). We studied the bias and precision as well as interference from carbamylated hemoglobin.
    Methods: Bias of the POCT analyzers was obtained by measuring 53 blood samples from diabetic patients with a wide range of HbA1c, 4%-14% (20-130 mmol/mol), and comparing the results with those obtained by the laboratory method: HPLC HA 8160 Menarini. Precision was performed by 20 successive determinations of two samples with low 4.2% (22 mmol/mol) and high 9.5% (80 mmol/mol) HbA1c values. The possible interference from carbamylated hemoglobin was studied using 25 samples from patients with chronic renal failure.
    Results: The means of the differences between measurements performed by each POCT analyzer and the laboratory method (95% confidence interval) were: 0.28% (p<0.005) (0.10-0.44) for DCA and 0.27% (p<0.001) (0.19-0.35) for Afinion. Correlation coefficients were: r=0.973 for DCA, and r=0.991 for Afinion. The mean bias observed by using samples from chronic renal failure patients were 0.2 (range -0.4, 0.4) for DCA and 0.2 (-0.2, 0.5) for Afinion. Imprecision results were: CV=3.1% (high HbA1c) and 2.97% (low HbA1c) for DCA, CV=1.95% (high HbA1c) and 2.66% (low HbA1c) for Afinion.
    Conclusions: Both POCT analyzers for HbA1c show good correlation with the laboratory method and acceptable precision.
    MeSH term(s) Bias ; Blood Chemical Analysis/instrumentation ; Blood Chemical Analysis/methods ; Blood Chemical Analysis/standards ; Chromatography, High Pressure Liquid ; Chromatography, Ion Exchange ; Glycated Hemoglobin A/analysis ; Humans ; Laboratories/standards ; Point-of-Care Systems/standards ; Reference Values ; Reproducibility of Results
    Chemical Substances Glycated Hemoglobin A ; hemoglobin A1c protein, human
    Language English
    Publishing date 2011-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1418007-8
    ISSN 1437-4331 ; 1434-6621 ; 1437-8523
    ISSN (online) 1437-4331
    ISSN 1434-6621 ; 1437-8523
    DOI 10.1515/CCLM.2011.101
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