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Adrian Man, Cosmin Moldovan and Minodora Dobreanu

Abstract

Starting with the first issue of 2013, the Romanian Review of Laboratory Medicine has implemented a new editorial and publishing system. By this editorial, we try to clarify to all the readers and authors the major changes and their outcome in the journal’s evolution. Thus, we present details related to the current internal organization of the editorial board and the editorial workflow of the submitted manuscripts.

Open access

Septimiu Voidăzan, Cosmin Moldovan and Minodora Dobreanu

Open access

Orsolya Benedek, Mihaly Veres and Minodora Dobreanu

Abstract

Background: Trauma in its early stages leads to an acute inflammatory condition affecting all cellular lines. Neutrophil granulocytes make up the largest population of human white blood cells and are fundamental to the innate immune system. The objective of our pilot study was to evaluate neutrophil death and viability alterations in critically ill trauma patients in correlation with their clinical outcome.

Material and method: Critical ill trauma patients were enrolled in the study. In order to assess alterations in cellular death, blood samples were drawn using EDTA containing tubes and analyzed in the first twenty four hours after admission, then after forty eight and seventy two hours. Annexin V was used as a marker for apoptotic cells and propidium iodide for necrotic cells.

Results: The first two cases exhibited an increase in cellular viability by the second day as shown by a small increase in neutrophil apoptosis and a decrease in neutrophil necrosis. These patients progressed to a positive clinical outcome. The second two cases showed slight modifications in either physiological or pathological cellular death, and increasing levels of cellular necrosis. These patients progressed to a negative clinical outcome.

Conclusions: These cases suggest that neutrophil cell viability and death were associated with the patient’s clinical outcome.

Open access

David Remona Eliza and Dobreanu Minodora

Abstract

Clinical laboratory tests ensure approximately 70% of the medical decisions, so that the time until the release of the results and its accuracy are critical for the diagnosis and the efficiency of the treatment [1]. Risk management involves both the anticipation of what could happen erroneous and the assessment of errors’ frequency as well as the consequences or the severity of the effects caused by it, and finally to decide what can be done in order to reduce the risk to an acceptable clinical level. For this reason, organizations should not see the risk management as a compliance issue, but as an integral part of the decision-making process. EP23-A is a guideline of CLSI that introduces the risk management principles in the clinical laboratory and encourages the laboratories to develop plans of risk management which are addressed to the risks of each laboratory. EP18-A2 proposes 2 techniques for identifying and controlling the errors in the laboratory: FMEA (Failure Mode and Effects Analysis) and FRACAS (Failure Reporting, Analysis and Corrective Action System). The European Committee of Experts and Management of Safety and Quality in Health Care proposed to use the quality indicators to identify the critical stages of each process, thus being possible to assess continuously the medical processes with the aim of identifying the errors when they occur. This review summarizes the principles of the risk management in the clinical laboratory, thus it can achieve its aims to report valid, accurate and reliable test results

Open access

Floredana-Laura Șular and Minodora Dobreanu

Abstract

Objective: The aim of this study was to verify in our laboratory conditions the performance criteria of a commercial kit (PhagoburstTM, Glycotope Biotechnology) as described by the producers. We have also partially altered the use of the available kit by introducing a non-opsonized Candida albicans stimulus, in addition to the opsonized Escherichia coli stimulus provided by the manufacturer. Material and methods: The peripheral blood samples of 6 clinically healthy adults were tested in triplicate according to the manufacturer recommendations. The intraassay imprecision as well as the ranges of neutrophil and monocyte burst activation triggered by various stimuli were assessed. Results: The activation range of granulocytes and monocytes was similar to the one described by the producer in the presence of E. coli (granulocytes: 78.45-99.43% versus 99.6-99.95%, average %CV of 1.53% versus 0.1%, monocytes: 54.63-92.33% versus 81.80-96.67, average %CV 6.92% versus 1.1%). The leukocyte range of activation in the presence of non-opsonized C. albicans was comparable to the one triggered by the fMLP (N-formyl-methionyl-leucyl-phenylalanine) stimulus. Conclusion: The intra-assay precision obtained in our laboratory conditions, as well as the ranges of activated leukocytes, are comparable to the ones described by the producer when using E. coli as a stimulus. The present study shows that introducing an extra fungal stimulus for burst oxidation assessment could provide additional information regarding the non-specific cellular immune response, particularly in patients at risk for candidemia.

Open access

Voidăzan Septimiu, Morariu Silviu-Horia, Căpâlnă Mihai, Mărginean Claudiu and Dobreanu Minodora

Abstract

Background. Cervical cancer (CC) is a major public health problem worldwide. Knowledge of human papillomavirus (HPV) genotype prevalence and distribution is important for the introduction of an effective vaccination program and the corresponding epidemiological monitoring. The aim of this study was to identify and analyze the distribution of high-risk HPV genotypes.

Methods. Data were collected from 136 patients for the detection of circulating HPV genotypes, where Pap test results revealed the presence of koilocytes or high risk (HR) dysplastic lesions, elements that raise the suspicion of HPV infection.

Results. HPV infection was identified in 72 (55.4%) of the patients tested, 34 (47.3%) with single infection, and 38 (52.7%) with multiple infections. Twenty-two different types of HPV were identified: 14 high risk HPV types, 7 low risk HPV types, 1 probable high risk HPV type. HPV 16 was the most frequently detected (55.6%) one, it was involved in single (15 cases) and multiple (25 cases) infections, primarily associated with type 18 (12 cases), and type 52 (11 cases). The presence of HPV 18 (29.2%) and HPV 52 (23.6%) was identified after HPV type 16.

Conclusions. Oncogenic HPV genotypes 16, 18, and 52 were most frequently associated in women with dysplastic lesions, which require the use of polyvalent HPV vaccines when assessing cross-protective effects of specific immunoprophylaxis programs.

Open access

Simona Cernea, Adina Huţanu, Ligia Coroş and Minodora Dobreanu

Abstract

Objectives: The primary aim of this study was to assess residual beta cell function at diagnosis of type 2 diabetes and identify accessible laboratory markers that best estimate it. The secondary objective was to evaluate the change in beta cell function 6 months after starting different therapeutical regimens. Materials and methods: Forty seven subjects were included in the study and each performed a 75-g oral glucose tolerance test (OGTT) at baseline and after 6 months. Metabolic and immunologic parameters were determined from fasting samples. According to the degree of metabolic decompensation, specific therapy was started: metformin, metformin plus gliclazide or insulin therapy (with/out metformin). Early and total beta cell function was evaluated by the disposition index (DI) calculated for 30 minutes and 120 minutes, respectively. Results: At diagnosis, fasting blood glucose (BG) and HbA1c varied largely (129-521 mg/dl and 5.5-14%, respectively). The DI30 and DI120 decreased with more severe glycemic decompensation. For both DI30 and DI120 significant negative correlations were found for glycemic markers (HbA1c, 2-hour BG and maximal BG amplitude) and positive correlation for 2- hour C peptide (p<0.0001 for all). HbA1c value of 7% discriminated an important decrease of DI30 and DI120. Insulin and combined therapy significantly improved DI120 at 6 months (p: 0.0062 and 0.01, respectively), while DI30 was improved only with insulin therapy (p: 0.0326). Conclusions: Beta cell function at onset correlated with HbA1c, 2-hour BG and C peptide during OGTT. Thus OGTT and HbA1c are pivotal for evaluation of beta cell function. Insulin therapy improved early and total insulin secretion at 6 months.

Open access

Elena-Cristina Selicean, Mariana Patiu, Andrei Cucuianu, Delia Dima and Minodora Dobreanu

Abstract

Morphological and immuno- flow cytometry assisted analysis of peripheral blood and bone marrow are mandatory investigations in the diagnosis of acute leukemia. Cytology and immunophenotyping complement each other primarily because they have as common object malignant cell phenotype as a whole. The aim of our study was to analyze correlations between cytology and immunophenotyping on a group of patients investigated for acute myeloid leukemia. In our study the degree of correlation between blast percentage determined by cytology and immunophenotyping was low (r=0.049). The degree of correlation between myeloperoxidase positivity in cytochemistry and immunophenotyping was also low, with better results for cytochemistry. Expression of immunophenotypic markers was consistent with the composition of our group regarding French-American-British classes, except for HLA-DR (49.0%), TdT (3.77%), CD14 (5.66%), CD15 (5.66%). We also discuss the importance of interpreting with caution positivity for erythroid and megakaryocytic markers and differential diagnosis of cases simultaneously expressing CD7 and CD56. In conclusion, interpretation of immunophenotyping by flow citometry, done in close conjunction with morphology, is mandatory to facilitate the use of optimized sample processing methods and of standardized panels, for both appropriate diagnosis and follow-up.

Open access

Adrian Man, Claudia Bănescu, Minodora Dobreanu and Cornel Fraefel

Abstract

Successful experiments in molecular biology require good knowledge about various methods and protocols. In molecular biology, nucleic acid manipulation is the essence, starting with the quality of extraction and ending with several analysis assays (PCR, RT-PCR, qPCR, PCR arrays, molecular cloning, etc). Though many of these are so called “standardized”, in practice there are many variables that can influence the outcome of the experiment. Due to the importance of optimal primer design in PCR assays, we will focus on primer designing and checking software, but we also present other useful free tools that can help researchers in the molecular biology field

Open access

Alina Mărginean, Claudia Bănescu, Alina Scridon and Minodora Dobreanu

Abstract

It is well known that critically ill patients require special attention and additional consideration during their treatment and management. The multiple systems and organ dysfunctions, typical of the critical patient, often results in different patterns of enteral absorption in these patients. Anti-platelet drugs are the cornerstone in treating patients with coronary and cerebrovascular disease. Dual anti-platelet therapy with aspirin and clopidogrel is the treatment of choice in patients undergoing elective percutaneous coronary interventions and is still widely used in patients with acute coronary syndromes. However, despite the use of dual anti-platelet therapy, some patients continue to experience cardiovascular ischemic events. Recurrence of ischemic events is partly attributed to the fact that some patients have poor inhibition of platelet reactivity despite treatment. These patients are considered low- or nonresponders to therapy. The underlying mechanisms leading to resistance are not yet fully elucidated and are probably multifactorial, cellular, genetic and clinical factors being implicated. Several methods have been developed to asses platelet function and can be used to identify patients with persistent platelet reactivity, which have an increased risk of thrombosis. In this paper, the concept of anti-platelet therapy resistance, the underlying mechanisms and the methods used to identify patients with low responsiveness to anti-platelet therapy will be highlighted with a focus on aspirin and clopidogrel therapy and addressing especially critically ill patients.