A family whose autistic son died after being taken to a mental health unit raise concerns.

Health Secretary Wes Streeting delivers message amid mounting concern about winter pressures.

Annals of Clinical Biochemistry, Ahead of Print.
IntroductionThe aim of our study was to determine reference intervals for serum pentraxin 3 and calprotectin, as well as for urine calprotectin according to the CLSI EP28-A3C guidelines for defining, establishing, and verifying reference intervals in the clinical laboratory.Materials and methodsA total of 120 serum and urine samples from either healthy volunteers or outpatients were used for reference interval establishment. The participants had CRP levels, leucocyte counts, serum urea levels, creatinine levels, and estimated glomerular filtration rates (CKD-EPI eGFRs) within the reference range and no medical history of acute/chronic inflammatory diseases/conditions or cancer. Calprotectin was measured via a commercially available turbidimetric method – the Bühhlmann fCAL® Turbo Reagent Kit – while pentraxin 3 was measured using the Human Pentraxin 3 ELISA Kit from the BioVendor Group.ResultsThe serum calprotectin reference range was ≤3.6 mg/L, the 90% CI for the upper reference range was 3.1–4.1 mg/L, while the serum pentraxin 3 reference concentration was ≤3.0 µg/L, and the 90% CI for the upper reference range being 2.7–3.2 µg/L. Additionally, the urinary calprotectin concentration was ≤1.4 mg/L, with a 90% CI for the upper reference range of 1.0–1.7 mg/L.ConclusionThis study reports sample and method-specific reference intervals for the detection of various inflammatory conditions.

Annals of Clinical Biochemistry, Ahead of Print.

Women in agony are using their savings to pay for urgent treatment to avoid waits of up to two years.

The government has pledged to determine the evidence - and establish whether the benefits outweigh any potential harms of prescribing puberty blockers to children questioning their gender

The government has pledged to determine the evidence - and establish whether the benefits outweigh any potential harms of prescribing puberty blockers to children questioning their gender

Adele was losing so much blood she needed the equivalent of three people's worth.

Patients speak out as a leaked report reveals many were failed over several years.

Annals of Clinical Biochemistry, Ahead of Print.

Annals of Clinical Biochemistry, Ahead of Print.
ObjectiveWe aim to establish the sex-related reference intervals (RIs) of PIVKA-II in southwest China by indirect method with the real-world data.MethodsBetween 29 July 2016 and 5 February 2024, PIVKA-II test data were collected from 120,780 healthy adult participants (aged 18 to 97 years) in the Laboratory Information System (LIS) of West China Hospital to establish reference intervals. Additionally, a validation group comprised of 2068 healthy adults was evaluated using the same detection algorithm and platform. Following the CLSI EP28-A3 guideline, Box-Cox transformation was applied for normal transformation, and outliers were identified using the Tukey method. Furthermore, we employed the standard normal deviate test (z-test) recommended by Harris and Boyd to determine whether to stratify reference intervals by age and sex subclasses.ResultsWe successfully established population-specific RI for PIVKA-II in southwest China using an indirect method. By utilizing a robust dataset and conducting rigorous statistical analyses, we delineated sex-specific RIs, with values of 0–35 mAU/mL for males and 0–29 mAU/mL for females according to the normal distribution method, and 0–32 mAU/mL for males and 0–28 mAU/mL for females using the non-parametric method. These intervals are more suitable for the local population than those derived from manual methods.ConclusionThese RIs provide valuable guidance for the accurate interpretation of PIVKA-II levels in the local population.

Families of children operated on by Yaser Jabbar say independent reports into their care are a "whitewash".

People struggling with their weight welcome the NHS rollout of Mounjaro but worry about delays.

NHS England medical director warns hospitals under strain after sharp rise in flu cases.

Annals of Clinical Biochemistry, Ahead of Print.
BackgroundIdentifying gender and age-related eGFR trends is crucial for precise renal function assessment. This study aims to analyse eGFR distribution with the full age spectrum (FAS) equation and establish reference intervals based on gender and age in a single-centre cohort.MethodsFollowing the inclusion and exclusion criteria outlined in this study, a total of 24,024 reference individuals were ultimately selected. Using the approach recommended by the CLSI C28-A3 guidelines, we assessed the distribution of eGFR across different gender and age groups. The two-sided nonparametric method (P2.5–P97.5) was applied to establish the eGFR reference intervals for a healthy Chinese population.ResultsThe eGFR levels in healthy adults exhibited a non-normally distributed pattern. Notably, there were significant differences in eGFR levels between males and females, with females showing a notably higher eGFR level than males. Additionally, eGFR levels demonstrated significant variations across different age groups within both male and female cohorts. As age increased, eGFR showed a significant decline, except in individuals aged 20–29 and 30–39 years. Therefore, reference intervals for eGFR were created based on both gender and age.ConclusionsWe established the reference interval for eGFR using the FAS equation, drawing from a large sample population at a single centre. This establishes a potential framework for evaluating renal function in healthy individuals and for diagnosing and treating kidney-related diseases.

NHS England medical director warns hospitals under strain after sharp rise in flu cases.

NHS experts report unprecedented demand for the new generation of obesity treatments.

Annals of Clinical Biochemistry, Ahead of Print.
ObjectiveThis study aimed to examine the levels of solute carrier family seven number 11 (SLC7A11) and glutathione peroxidase 4 (GPX4) in the serum of patients with acute ischaemic stroke (AIS) and their relationship with disease severity.MethodsA total of 148 patients with AIS together with 148 healthy controls (HCs) were enrolled. The expression levels of SLC7A11 and GPX4 in serum were detected immediately as early as possible. Radiographic severity was detected by Alberta Stroke Program Early CT Score (ASPECTS). Disease severity was evaluated using modified Rankin Scale (mRS). High-sensitivity C-reactive protein (hs-CRP) and matrix metalloproteinase-9 (MMP-9) expression levels were also measured. A correlation analysis was conducted to determine the relationship between the expression levels of SLC7A11 and GPX4 with the clinical severity of the disease and the levels of hs-CRP and MMP-9. Furthermore, receiver operating characteristic (ROC) curve analysis was utilized to assess the potential of SLC7A11 and GPX4 as diagnostic markers.ResultsCompared to the HC group, the serum expression levels of SLC7A11 and GPX4 were significantly lower in the AIS group. Serum SLC7A11 levels were positively associated with serum GPX4 levels. The AIS group included 50 patients with mild neurological impairment, 52 with moderate neurological impairment, and 46 with severe neurological impairment. AIS patients with mild neurological impairment had drastically higher serum SLC7A11 and GPX4 levels compared with those with moderate neurological impairment. AIS patients with moderate neurological impairment showed significantly higher serum SLC7A11 and GPX4 concentrations compared with those with severe neurological impairment. ROC curve analysis demonstrated that both serum SLC7A11 and GPX4 may both act as potential indicators for evaluating of AIS disease severity. In addition, both serum SLC7A11 and GPX4 levels were positively correlated with ASPECTS. Both serum SLC7A11 and GPX4 levels were negatively associated with hs-CRP as well as MMP-9 levels. Serum SLC7A11 and GPX4 levels were significantly increased following comprehensive therapy.ConclusionsDecreased SLC7A11 and GPX4 levels may reflect disease severity of AIS.

Anastasia Cameron makes wigs for cancer patients after her own poor experiences.

Annals of Clinical Biochemistry, Ahead of Print.
BackgroundThe Sampson-NIH and Martin-Hopkins low-density lipoprotein cholesterol (LDL-C) equations are advocated as being superior to the Friedewald calculation. However, their mathematical complexity means they may have different biological and analytical variation when tracking LDL-C in the same patient. This study has established the biological variation (BV) of calculated and directly measured LDL-C (dLDL-C) in patients taking equivalent doses of a long (atorvastatin) and short (simvastatin) half-life statin. It also modelled how analytical imprecision might add to these BVs.MethodsIn a crossover study of lipid BV involving 26 patients with type 2 diabetes (T2DM) initially taking either simvastatin 40 mg or atorvastatin 10 mg, fasting lipids were measured 10 times over 5 weeks after a 3 month run-in. The same procedure was then followed for the alternate statin. Outlier removal and CV-ANOVA established the BV of dLDL and each formula. Analytical measurement uncertainty was estimated from 6 months of real-world data.ResultsThe intra-individual BV of dLDL-C measurement was considerably lower with atorvastatin than simvastatin (CV 1.3%(95% CI 1.1–1.5%) vs. 11.1%(10.2–12.2%), respectively). No equation could distinguish this difference (Friedewald 11.0%(95% CI 10.0–12.1%) vs. 12.9%(11.8–14.2%), Sampson-NIH 10.4%(9.5–11.5%) vs. 11.7% (10.7–12.8%) and Martin-Hopkins 9.3%(8.5–10.3%) vs. 11.3%(10.3–12.4%)). Real-world analytical CVs were 2.6% (Sampson-NIH), 2.6% (Martin-Hopkins) 2.8% (Friedewald) and 2.0% (dLDL-C).ConclusionsInherent biological LDL-C variability using these formulae is substantially greater than direct measurement in T2DM patients taking atorvastatin. Typical analytical imprecision was also greater. Together, this may fundamentally limit these equations’ ability to track true LDL-C changes in patients taking popular statin treatments.