No abstract

Regular measurement of prothrombin time as an international normalized ratio PT (INR) is mandatory for optimal and safe use of warfarin. Scandinavian evaluation of laboratory equipment for primary health care (SKUP) evaluated the microINR portable coagulometer (microINR) (iLine Microsystems S.L., Spain) for measurement of PT (INR). Analytical quality and user-friendliness were evaluated under optimal conditions at an accredited hospital laboratory and at two primary health care centres (PHCCs). Patients were recruited at the outpatient clinic of the Laboratory of Medical Biochemistry, St Olav's University Hospital, Trondheim, Norway (n = 98) and from two PHCCs (n = 88). Venous blood samples were analyzed under optimal conditions on the STA-REvolution with STA-SPA + reagent (Stago, France) (Owren method), and the results were compared to capillary measurements on the microINR. The imprecision of the microINR was 6% (90% CI: 5.3-7.0%) and 6.3% (90% CI: 5.1-8.3) in the outpatient clinic and PHCC2, respectively for INR ≥2.5. The microINR did not meet the SKUP quality requirement for imprecision ≤5.0%. For INR <2.5 at PHCC2 and at both levels in PHCC1, CV% was ≤5.0. The accuracy fulfilled the SKUP quality goal in both outpatient clinic and PHCCs. User-friendliness of the operation manual was rated as intermediate, defined by SKUP as neutral ratings assessed as neither good nor bad. Operation facilities was rated unsatisfactory, and time factors satisfactory. In conclusion, quality requirements for imprecision were not met. The SKUP criteria for accuracy was fulfilled both at the hospital and at the PHCCs. The user-friendliness was rated intermediate.

We report a case of pseudohyponatraemia due to severe hypertriglyceridaemia-induced acute pancreatitis, stemming from unknown diabetes. A woman in her late 30s was admitted to the local hospital by her general practitioner due to severe hyponatraemia (116 mmol/L) and upper abdominal pain. At admission to the hospital, there was a discrepancy of 19 mmol/L between arterial and venous sodium, along with severe hypertriglyceridaemia and hypercholesterolaemia. Pancreatitis was diagnosed using a CT scan. The patient received plasmapheresis which significantly reduced triglycerides, and venous plasma sodium was normalised indicating pseudohyponatraemia at admission. Finally, a haemoglobin A1c of 83 mmol/mol was found. Diabetes was diagnosed, and insulin was initiated.

Background Plasma viscosity is an important biomarker both in diagnostics and treatment monitoring of plasma cell dyscrasias and other disorders with hyperviscosity syndrome as a clinical manifestation. Here, we investigate the performance of a new microfluidic-based viscometer for clinical use, establish a new reference range to be used with this instrument and determine the importance of sampling temperature. Methods The microVisc™ viscometer was evaluated for within-run and between-run imprecision and bias using standardized reference material (Paragon controls) and Seronorm™ control material. The reference range was established for the adult population using EDTA-plasma from 120 healthy blood donors. Sampling temperature was investigated by drawing and transporting blood at room temperature and 37°C and comparing the viscosity between the two sampling methods. Results The microfluidic-based viscometer performed well, and imprecision was comparable to ReoRox® G2 free oscillation rheometer. A new reference range for the adult Danish population was established as 1.2–1.5 mPa s at 37°C. Furthermore, sampling temperature at room temperature and 37°C was investigated, and there was no difference in results obtained. Conclusions MicroVisc™ is suitable for measuring plasma viscosity in a clinical setting and results can be evaluated using the established reference range. Blood sampling for viscosity analysis can be performed as a standard procedure at room temperature.

No abstract