4 FEATURED ARTICLE

A brief review of heparin-induced thrombocytopenia and diagnostic considerations

by Dr Christina C. Pierre and Dr Lindsay Bazydlo Heparin-induced thrombocytopenia (HIT) is a hypercoagulable disorder that is mediated by antibodies against heparin complexed to platelet factor 4. HIT antibodies activate platelets, which generate a self-propagating, pro-coagulant state. A subset of patients with HIT develop thrombosis that can be limb- and/or life-threatening. This review provides […]

5 FEATURED ARTICLE

Monitoring therapeutic drug dosage in rheumatic diseases, chronic inflammatory bowel diseases and psoriasis

by Dr Jacqueline Gosink Tumour necrosis factor (TNF) inhibitors are increasingly used to treat chronic inflammatory bowel diseases, rheumatic diseases and psoriasis. Continuous drug level monitoring and administration interval adjustment accompanying the treatment with TNF inhibitors is the key to successful, individualized and targeted patient care. Concentrations of the TNF inhibitors adalimumab or infliximab can […]

6 FEATURED ARTICLE

Insight into high-sensitivity troponin tests for the early rule-out of NSTEMI

In August 2020 new guidance was issued by the National Institut e for Health and Care Excellence on the use of high-sensitivity troponin tests for the early rule-out of non-ST-elevation myocardial infarction (NSTEMI). CLI caught up with Heather Read-Harper from Beckman Coulter to find out more about the use of cardiac troponin biomarkers in the […]

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ZTA photoZTA Biotech, a Budapest-based biotech startup has announced the breakthrough development of a COVID-19 antibody (IgG) test using the ELISA protocol. This new detection method represents a great step forward in determining if patients have had COVID-19 and if they might still have immunity to the disease. Early results have proven 100% in specificity after testing 280 samples, and 100% sensitivity by testing 260 samples of recovered and symptomatic patients.

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Role of neutrophil extracellular traps in COVID-19 and other disease processes

One of the conundrums presented by COVID-19 is that it is not uncommon for patients to present with remarkably low oxygen saturation levels but with very little breathlessness. Additionally, it has been noted that there is an additional risk of stroke in COVID-19 patients (and COVID-19-recovered patients) and that they seem to have what is being referred to as ‘sticky blood’. A recent paper by Professor Yost (Department of Pediatrics, University of Utah School of Medicine, UT, USA) and colleagues ‘Neutrophil extracellular traps contribute to immunothrombosis in COVID-19 acute respiratory distress syndrome’ discusses the role that neutrophil extracellular traps (NETs) can play in the development of these symptoms and prothrombotic disease outcomes. CLI was very fortunate to catch up with Professor Yost to learn more about NETs and their effects in COVID-19 and other conditions.

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Progress and challenges in the monitoring of hemolysis and clot formation in patients with extracorporeal life support

by Dr Madeleen Bosma
Despite intensive anticoagulation therapy and improved mechanical characteristics of the current systems, hemolysis and clot formation are frequent complications in extracorporeal life support (ECLS/ECMO), which is the standard rescue treatment in patients with severely impaired cardiac and/or pulmonary function. The laboratory aspects of monitoring of hemolysis and hypercoagulation in this patient group are discussed in this short review.

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Status of COVID-19 rapid point-of-care immunoassay testing

by Dr Andrew Lane
The emergence of SARS-CoV-2 and its global proliferation has spurred unprecedented efforts by academia and the in vitro diagnostics industry to develop rapid tests that can be used for point-of-care (POC) testing. At the time of writing, over 200 rapid test kits are under development or have already been commercialized for use. Yet, owing to relaxation of regulatory standards and the unprecedented pace at which tests have been developed, many have not been adequately assessed. In this article, Dr Andy Lane explains the role of POC diagnostics for COVID-19 and the improvements needed for their widespread use, including the importance of high-quality reagents.

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Autoantibodies in myositis: An upgrade for comprehensive serological testing

by Dr Jacqueline Gosink
The autoimmunogenic myositides (idiopathic inflammatory myopathies, IIM) constitute a group of systemic autoimmune rheumatic diseases that are characterized by chronic inflammation of muscles. Unfortunately, the general misdiagnosis rate is high resulting in a delay to diagnosis of several years. Moreover, a significant proportion of patients with IIM suffer from a generalized feeling of severe illness due to the damage caused by both the disease and its treatment. Autoantibodies are useful biomarkers to differentiate clinically indistinguishable subforms of IIM. Despite the low prevalences and isolated occurrence of many autoantibodies in IIM, they constitute the basis for serological diagnostics. The diagnostic information is maximized by employing comprehensive multiparametric assays covering both myositis-specific and myositis-associated autoantibodies.

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1 PRODUCT CHROMSYSTEMS

Chromsystems expands therapeutic drug monitoring by LC-MS/MS to 200 drugs

MassTox TDM Series A, Chromsystems’ unique modular system for therapeutic drug monitoring (TDM), has been extended to cover 200 drugs. The most recent extensions are additional neuroleptics and antimycotis, including bromperidol, caspofungin, isavuconazole, flupentixol and many others.
All 200 drugs can be determined with the same chromatographic setup and identical sample preparation. This eliminates the need for column switching or changes at the setup of the mass spectrometer, thereby helping to minimise workload in the laboratory for efficient drug monitoring by LC-MS/MS.
The system consists of the analytical column, the Basic Kit for sample preparation and chromatography as well as 13 individual parameter sets, which contain all relevant multilevel calibrators, quality plasma controls and internal standards.
For more information, visit: https://chromsystems.com
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Insight into mass spectrometry in clinical science and diagnostics

by Pauline Griffeuille and Dr Sylvain Dulaurent
Mass spectrometry (MS) can be combined with a number of chromatographic separation and ionization methods, which results in powerful technologies for both qualitative and quantitative molecular analysis. CLI caught up with Dr Bhattacharyya (Thermo Fisher’s Senior Manager for Clinical Research and Toxicology) to find out more about the past, present and potential future uses of MS in clinical science and diagnostics.

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