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Clinical Chemistry
Journal Prestige (SJR): 2.281
Citation Impact (citeScore): 3
Number of Followers: 61  
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ISSN (Print) 0009-9147 - ISSN (Online) 1530-8561
Published by AACC Homepage  [1 journal]
  • Diagnosis of Gestational Diabetes Mellitus Will Be Flawed until We Can
           Measure Glucose
    • Authors: Bruns D; Metzger B, Sacks D.
      Pages: 265 - 267
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz027
      Issue No: Vol. 66, No. 2 (2020)
  • Macrophage Sensors for Early Cancer Detection
    • Authors: Kwong G.
      Pages: 268 - 270
      Abstract: Along the patient continuum of care, the ability to detect cancer at an early stage has an enormous impact on successful drug treatment and patient outcomes. For example, in ovarian cancer, 5-year survival rates rise sharply from ∼20% to greater than 90% when lesions are detected at stage I rather than IV, yet only ∼15% of patients are detected at the earliest stage due to the poor diagnostic sensitivity of screening. The challenges that limit tumor-shed, or endogenous, biomarkers for early detection are multifaceted. Biomarkers shed from nascent disease sites—which are on the order of a few cubic millimeters in volume but already contain millions of tumor cells—can be diluted by up to 100 000-fold in circulation, making them extremely challenging to detect even with ultrasensitive analytical platforms. Moreover, endogenous biomarkers are secreted by tumor cells at low rates (or not at all) and once in the blood stream biomarkers are rapidly cleared from circulation or are degraded. For biomarkers such as cell-free RNA, their circulation half-lives in blood can be as low as several minutes. Estimates using multicompartment mass transport models have shown that tumor-shed blood biomarkers are at such low concentrations that early tumors may remain undetectable for an entire decade following tumorigenesis (1, 2) based on the detection limits of current biomedical diagnostics. Thus, there remains a stark mismatch between the smallest tumors that can be indicated by blood biomarkers (>2–5 cm) and the size of early stage tumors that would best respond to treatment (<1–5 mm).
      PubDate: Thu, 30 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz017
      Issue No: Vol. 66, No. 2 (2020)
  • Use of Biomarkers to Detect and Manage Acute Kidney Injury: Has Progress
    • Authors: Lieske J; Kashani K, Kellum J, et al.
      Pages: 271 - 276
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz026
      Issue No: Vol. 66, No. 2 (2020)
  • Unusual Iron and Copper Studies in a Patient with Liver Injury and
           Normocytic Anemia
    • Authors: Ruddell R; Lee A, Powell E, et al.
      Pages: 277 - 281
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz001
      Issue No: Vol. 66, No. 2 (2020)
  • Commentary
    • Authors: Badrick T.
      Pages: 280 - 281
      Abstract: Hyperferritinemia is a common finding, and yet 90% of patients with increased ferritin concentrations do not have iron overload (1). The cause is usually increased ferritin synthesis or increased release from damaged cells. Hyporegenerative anemia caused by renal disease, malignancy, chronic inflammation, or marrow failure can also present with mildly increased ferritin (<1000 µg/L) with normal transferrin saturation. If there are increased liver enzymes, then this complicates the investigation, but most patients presenting with increased ferritin concentrations and normal transferrin saturation have either inflammatory disease, chronic alcohol consumption, cell damage, or metabolic abnormalities (obesity).
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz007
      Issue No: Vol. 66, No. 2 (2020)
  • Commentary
    • Authors: Piperno A.
      Pages: 281 - 281
      Abstract: The patient described here has some typical manifestations of aceruloplasminemia, including mild anemia with borderline mean corpuscular volume (MCV) and low mean corpuscular hemoglobin (MCH), low transferrin saturation, and increased serum ferritin with liver and brain iron overload. He also showed glucose abnormalities requiring further investigation. The iron pattern strongly points to functional iron deficiency caused by inadequate iron supply to the bone marrow, due to the defective ferroxidase activity favoring cellular iron retention. Although not included in the classical triad of aceruloplasminemia, anemia with low MCV and/or MCH, is common. In a recent series (1), hematological and iron indices abnormalities were recorded as early manifestations of disease in 86% of patients, preceding diagnosis even by decades, suggesting that ceruloplasmin measurement should be part of the diagnostic work-up of patients with these manifestations.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz009
      Issue No: Vol. 66, No. 2 (2020)
  • Protein Biomarker Quantification by Immunoaffinity Liquid
           Chromatography–Tandem Mass Spectrometry: Current State and Future Vision
    • Authors: Neubert H; Shuford C, Olah T, et al.
      Pages: 282 - 301
      Abstract: AbstractImmunoaffinity–mass spectrometry (IA-MS) is an emerging analytical genre with several advantages for profiling and determination of protein biomarkers. Because IA-MS combines affinity capture, analogous to ligand binding assays (LBAs), with mass spectrometry (MS) detection, this platform is often described using the term hybrid methods. The purpose of this report is to provide an overview of the principles of IA-MS and to demonstrate, through application, the unique power and potential of this technology. By combining target immunoaffinity enrichment with the use of stable isotope-labeled internal standards and MS detection, IA-MS achieves high sensitivity while providing unparalleled specificity for the quantification of protein biomarkers in fluids and tissues. In recent years, significant uptake of IA-MS has occurred in the pharmaceutical industry, particularly in the early stages of clinical development, enabling biomarker measurement previously considered unattainable. By comparison, IA-MS adoption by CLIA laboratories has occurred more slowly. Current barriers to IA-MS use and opportunities for expanded adoption are discussed. The path forward involves identifying applications for which IA-MS is the best option compared with LBA or MS technologies alone. IA-MS will continue to benefit from advances in reagent generation, more sensitive and higher throughput MS technologies, and continued growth in use by the broader analytical community. Collectively, the pursuit of these opportunities will secure expanded long-term use of IA-MS for clinical applications.
      PubDate: Thu, 30 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz022
      Issue No: Vol. 66, No. 2 (2020)
  • Diagnostic Test Accuracy of Commercial Tests for Detection of Shiga
    • Authors: Tarr G; , Lin C, et al.
      Pages: 302 - 315
      Abstract: AbstractBackgroundRapid detection of Shiga toxin–producing Escherichia coli (STEC) enables appropriate monitoring and treatment. We synthesized available evidence to compare the performance of enzyme immunoassay (EIA) and PCR tests for the detection of STEC.MethodsWe searched published and gray literature for studies of STEC EIA and/or PCR diagnostic test accuracy relative to reference standards including at least one nucleic acid amplification test. Two reviewers independently screened studies, extracted data, and assessed quality with the second version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Bivariate random effects models were used to meta-analyze the clinical sensitivity and specificity of commercial EIA and PCR STEC diagnostic tests, and summary receiver operator characteristic curves were constructed. We evaluated the certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.ResultsWe identified 43 articles reflecting 25 260 specimens. Meta-analysis of EIA and PCR accuracy included 25 and 22 articles, respectively. STEC EIA pooled sensitivity and specificity were 0.681 (95% CI, 0.571–0.773; very low certainty of evidence) and 1.00 (95% CI, 0.998–1.00; moderate certainty of evidence), respectively. STEC PCR pooled sensitivity and specificity were 1.00 (95% CI, 0.904–1.00; low certainty of evidence) and 0.999 (95% CI, 0.997–0.999; low certainty of evidence), respectively. Certainty of evidence was downgraded because of high risk of bias.ConclusionsPCR tests to identify the presence of STEC are more sensitive than EIA tests, with no meaningful loss of specificity. However, given the low certainty of evidence, our results may overestimate the difference in performance.
      PubDate: Wed, 29 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz006
      Issue No: Vol. 66, No. 2 (2020)
  • A Prospective Evaluation of Point-of-Care Measurements of Maternal Glucose
           for the Diagnosis of Gestational Diabetes Mellitus
    • Authors: O’Malley E; Reynolds C, O’Kelly R, et al.
      Pages: 316 - 323
      Abstract: AbstractBackgroundPoint-of-care (POC) measurement of glucose is currently recommended only for the monitoring of gestational diabetes mellitus (GDM). This prospective observational study evaluated the use of POC measurements of maternal glucose to diagnose GDM in women being screened selectively with a 1-step 75 g oral glucose tolerance test (OGTT).MethodsThe strictest preanalytic and analytic international laboratory standards were applied to measure maternal plasma glucose at fasting and at 1 and 2 h post glucose load. The recent International Association of Diabetes and Pregnancy Study Groups diagnostic criteria were used. At the same time, maternal capillary glucose was measured. Because of differences in plasma and capillary glucose measurements, regression analysis of POC capillary glucose results vs laboratory plasma glucose results was conducted. The regression equations for plasma glucose were derived in a derivation cohort (n = 102). These equations were applied in the validation cohort (n = 100). Predicted and actual plasma glucose values were compared.ResultsOf the 202 women screened, 36.6% were nulliparous, 56.4% were obese, and 81.2% were Irish-born. Two thirds had a single risk factor for GDM, and a third had multiple risk factors. Based on the plasma measurements, 53.5% had GDM. As a predictor of GDM, the diagnostic accuracy of POC measurement was 83.0% (95% confidence interval, 74.2–89.8).ConclusionsIn high-resource settings where measures to inhibit glycolysis are implemented, the use of POC measurements for the diagnosis of GDM is not justified based on this study. In low- and medium-resource settings, where measures to inhibit glycolysis are not achievable, regression analysis using POC measurements may be acceptable compared with plasma samples subject to glycolysis.
      PubDate: Thu, 30 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz005
      Issue No: Vol. 66, No. 2 (2020)
  • Development and Clinical Validation of a Sensitive Lateral Flow Assay for
           Rapid Urine Fentanyl Screening in the Emergency Department
    • Authors: Li Z; Chen H, Feng S, et al.
      Pages: 324 - 332
      Abstract: AbstractBackgroundRapid identification of fentanyl at the point-of-care is critical. Urine fentanyl concentrations in overdose cases start at single-digit nanograms per milliliter. No fentanyl point-of-care assay with a cutoff at single-digit nanograms per milliliter is available.MethodsA competitive lateral flow assay (LFA) was developed using gold nanoparticles and optimized for rapid screening of fentanyl in 5 minutes. Urine samples from 2 cohorts of emergency department (ED) patients were tested using the LFA and LC-MS/MS. The 2 cohorts consisted of 218 consecutive ED patients with urine drug-of-abuse screen orders and 7 ED patients with clinically suspected fentanyl overdose, respectively.ResultsThe LFA detected fentanyl (≥1 ng/mL) and the major metabolite norfentanyl (≥10 ng/mL) with high precision. There was no cross-reactivity with amphetamine, cocaine, morphine, tetrahydrocannabinol, methadone, buprenorphine, naloxone, and acetaminophen at 1000 ng/mL and 0.03%, 0.4%, and 0.05% cross-reactivity with carfentanil, risperidone, and 9-hydroxyrisperidone, respectively. In 218 consecutive ED patients, the prevalence of cases with fentanyl ≥1 ng/mL or norfentanyl ≥10 ng/mL was 5.5%. The clinical sensitivity and specificity of the LFA were 100% (95% CI, 75.8–100%) and 99.5% (95% CI, 97.3–99.9%), respectively. The positive and negative predictive values were 92.3% (95% CI, 66.7–98.6%) and 100% (95% CI, 98.2–100%), respectively. The concordance between the LFA and LC-MS/MS was 100% in the 7 suspected fentanyl overdose cases (5 positive, 2 negative).ConclusionsThe LFA can detect fentanyl and norfentanyl with high clinical sensitivity and specificity in the ED population with rapid fentanyl screening needs.
      PubDate: Thu, 30 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz023
      Issue No: Vol. 66, No. 2 (2020)
  • A Possible Mechanism behind Faster Clearance and Higher Peak
           Concentrations of Cardiac Troponin I Compared with Troponin T in Acute
           Myocardial Infarction
    • Authors: Starnberg K; Fridén V, Muslimovic A, et al.
      Pages: 333 - 341
      Abstract: AbstractBackgroundAlthough cardiac troponin I (cTnI) and troponin T (cTnT) form a complex in the human myocardium and bind to thin filaments in the sarcomere, cTnI often reaches higher concentrations and returns to normal concentrations faster than cTnT in patients with acute myocardial infarction (MI).MethodsWe compared the overall clearance of cTnT and cTnI in rats and in patients with heart failure and examined the release of cTnT and cTnI from damaged human cardiac tissue in vitro.ResultsGround rat heart tissue was injected into the quadriceps muscle in rats to simulate myocardial damage with a defined onset. cTnT and cTnI peaked at the same time after injection. cTnI returned to baseline concentrations after 54 h, compared with 168 h for cTnT. There was no difference in the rate of clearance of solubilized cTnT or cTnI after intravenous or intramuscular injection. Renal clearance of cTnT and cTnI was similar in 7 heart failure patients. cTnI was degraded and released faster and reached higher concentrations than cTnT when human cardiac tissue was incubated in 37°C plasma.ConclusionOnce cTnI and cTnT are released to the circulation, there seems to be no difference in clearance. However, cTnI is degraded and released faster than cTnT from necrotic cardiac tissue. Faster degradation and release may be the main reason why cTnI reaches higher peak concentrations and returns to normal concentrations faster in patients with MI.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz003
      Issue No: Vol. 66, No. 2 (2020)
  • Level of N6-Methyladenosine in Peripheral Blood RNA: A Novel Predictive
           Biomarker for Gastric Cancer
    • Authors: Ge L; Zhang N, Chen Z, et al.
      Pages: 342 - 351
      Abstract: AbstractBackgroundDysregulation of N6‐methyladenosine (m6A) is associated with various human diseases including cancer. This study aimed to evaluate the level of m6A as a biomarker for gastric cancer (GC) diagnosis.MethodsPeripheral blood samples were collected from 100 GC patients, 30 benign gastric disease (BGD) patients, and 75 healthy controls (HCs). Levels of m6A in total RNA and expression of m6A-related proteins were analyzed.ResultsThe m6A levels in peripheral blood RNA were significantly increased in the GC group compared with those in the BGD or HC groups; moreover, levels increased with the progression and metastasis of GC and decreased in GC patients after surgery. The area under the curve (AUC) for m6A in the GC group was 0.929 (95% CI, 0.88–0.96), which is markedly greater than the AUCs for carcinoembryonic antigen (CEA; 0.694) and carbohydrate antigen 199 (CA199; 0.603). The combination of CEA and CA199 with m6A improved the AUC to 0.955 (95% CI, 0.91–0.98). The expressions of m6A demethylases ALKBH5 and FTO were significantly downregulated in the GC group compared with the HC group. Coculture with GC cells increased the m6A of RNA in promyelocytic (HL-60) and monocytic (THP-1) leukemia cells and nontumorigenic human peripheral blood B lymphocyte cells (PENG-EBV). Furthermore, a xenograft model enhanced the m6A in peripheral blood RNA of mice. Accordingly, expressions of ALKBH5 and FTO were decreased both in vitro and in vivo.ConclusionsLevel of m6A in peripheral blood RNA is a promising noninvasive diagnostic biomarker for GC patients.
      PubDate: Mon, 03 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz004
      Issue No: Vol. 66, No. 2 (2020)
  • Predictive Relevance of Circulating miR-622 in Patients with Newly
           Diagnosed and Recurrent High-Grade Serous Ovarian Carcinoma
    • Authors: Vigneron N; Vernon M, Meryet-Figuière M, et al.
      Pages: 352 - 362
      Abstract: AbstractBackgroundIdentifying patients with high-grade serous ovarian cancer (HGSOC) who will respond to treatment remains a clinical challenge. We focused on miR-622, a miRNA involved in the homologous recombination repair (HRR) pathway, and we assessed its predictive value in serum prior to first-line chemotherapy and at relapse.MethodsSerum miR-622 expression was assessed in serum prior to first-line platinum-based chemotherapy in a prospective multicenter study (miRNA Serum Analysis, miRSA, NCT01391351) and a retrospective cohort (Biological Resource Center, BRC), and was also studied at relapse. Progression-free survival (PFS) and overall survival (OS) were used as primary and secondary endpoints prior to first-line chemotherapy and OS as a primary endpoint at relapse.ResultsThe group with high serum miR-622 expression was associated with a significantly lower PFS (15.4 versus 24.4 months; adjusted HR 2.11, 95% CI 1.2 3.8, P = 0.015) and OS (29.7 versus 40.6 months; adjusted HR 7.68, 95% CI 2.2–26.2, P = 0.0011) in the miRSA cohort. In the BRC cohort, a high expression of miR-622 was also associated with a significantly lower OS (22.8 versus 35.9 months; adjusted HR 1.98, 95% CI 1.1–3.6, P = 0.026). At relapse, high serum miR-622 was associated with a significantly lower OS (7.9 versus 20.6 months; adjusted HR 3.15, 95% CI 1.4–7.2, P = 0.0062). Serum miR-622 expression is a predictive independent biomarker of response to platinum-based chemotherapy for newly diagnosed and recurrent HGSOC.ConclusionsThese results may open new perspectives for HGSOC patient stratification and monitoring of resistance to platinum-based and poly(ADP-ribose)-polymerase-inhibitor-maintenance therapies, facilitating better and personalized treatment decisions.
      PubDate: Thu, 30 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz013
      Issue No: Vol. 66, No. 2 (2020)
  • Non-Parametric Combined Reference Regions and Prediction of Clinical Risk
    • Authors: Malka R; Brugnara C, Cialic R, et al.
      Pages: 363 - 372
      Abstract: AbstractBackgroundMany clinical decisions depend on estimating patient risk of clinical outcomes by interpreting test results relative to reference intervals, but standard application of reference intervals suffers from two major limitations that reduce the accuracy of clinical decisions: (1) each test result is assessed separately relative to a univariate reference interval, ignoring the rich pathophysiologic information in multivariate relationships, and (2) reference intervals are intended to reflect a population’s biological characteristics and are not calibrated for outcome prediction.MethodsWe developed a combined reference region (CRR), derived CRRs for some pairs of complete blood count (CBC) indices (RBC, MCH, RDW, WBC, PLT), and assessed whether the CRR could enhance the univariate reference interval’s prediction of a general clinical outcome, 5-year mortality risk (MR).ResultsThe CRR significantly improved MR estimation for 21/21 patient subsets defined by current univariate reference intervals. The CRR identified individuals with >2-fold increase in MR in many cases and uniformly improved the accuracy for all five pairs of tests considered. Overall, the 95% CRR identified individuals with a >7× increase in 5-year MR.ConclusionsThe CRR enhances the accuracy of the prediction of 5-year MR relative to current univariate reference intervals. The CRR generalizes to higher numbers of tests or biomarkers, as well as to clinical outcomes more specific than MR, and may provide a general way to use existing data to enhance the accuracy and precision of clinical decisions.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz020
      Issue No: Vol. 66, No. 2 (2020)
  • A Closed-Tube Nested Quantitative PCR Assay for Rapid Detection of Intron
           22 Inversions in the Factor VIII Gene
    • Authors: Jin S; Shang Q, Jin W, et al.
      Pages: 373 - 378
      Abstract: AbstractBackgroundAn inversion of intron 22 in the Factor VIII gene (Inv22) is the causative mutation for 45% of severe hemophilia A cases. Available methods for molecular diagnosis of Inv22 are generally tedious and not ideal for routine clinical use.MethodsWe report here a new method using a single closed-tube nested quantitative PCR (CN–qPCR) for rapid detection of Inv22. This method combines a 12-cycle long-distance PCR (LD–PCR) amplifying the int22h regions, followed by a duplex qPCR targeting two specific regions close to the int22h regions. All reagents were added to a single PCR mixture for the closed-tube assay. Sequential LD–PCR and qPCR was achieved by designing primers at substantially different melting temperatures and optimizing PCR conditions.ResultsSeventy-nine male hemophilia A patients of different disease severity were tested by both the CN–qPCR assay and the standard LD–PCR assay. CN–qPCR successfully made calls for all samples, whereas LD–PCR failed in eight samples. For the 71 samples where both methods made calls, the concordance was 100%. Inv22 was detected in 17 out of the 79 samples. Additionally, CN–qPCR achieved clear separation for 10 female carriers and 10 non-Inv22 females, suggesting the assay may also be useful for molecular diagnosis of female carriers.ConclusionsThis new CN–qPCR method may provide a convenient and accurate F8 Inv22 test suitable for clinical use.
      PubDate: Thu, 30 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz021
      Issue No: Vol. 66, No. 2 (2020)
  • The Silence Speaks, but We Do Not Listen: Synonymous c.1824C>T Gene
           Variant in the Last Exon of the Prothrombin Gene as a New Prothrombotic
           Risk Factor
    • Authors: Pruner I; Farm M, Tomic B, et al.
      Pages: 379 - 389
      Abstract: AbstractBackgroundThrombosis is a major global disease burden with almost 60% of cases related to underlying heredity and most cases still idiopathic. Synonymous single nucleotide polymorphisms (sSNPs) are considered silent and phenotypically neutral. Our previous study revealed a novel synonymous FII c.1824C>T variant as a potential risk factor for pregnancy loss, but it has not yet been associated with thrombotic diseases.MethodsTo determine the frequency of the FII c.1824C>T variant we have sequenced patients’ DNA. Prothrombin RNA expression was measured by quantitative PCR. Functional analyses included routine hemostasis tests, western blotting and ELISA to determine prothrombin levels in plasma, and global hemostasis assays for thrombin and fibrin generation in carriers of the FII c.1824C>T variant. Scanning electron microscopy was used to examine the structure of fibrin clots.ResultsFrequency of the FII c.1824C>T variant was significantly increased in patients with venous thromboembolism and cerebrovascular insult. Examination in vitro demonstrated increased expression of prothrombin mRNA in FII c.1824T transfected cells. Our ex vivo study of FII c.1824C>T carriers showed that the presence of this variant was associated with hyperprothrombinemia, hypofibrinolysis, and formation of densely packed fibrin clots resistant to fibrinolysis.ConclusionOur data indicate that FII c.1824C>T, although a synonymous variant, leads to the development of a prothrombotic phenotype and could represent a new prothrombotic risk factor. As a silent variant, FII c.1824C>T would probably be overlooked during genetic screening, and our results show that it could not be detected in routine laboratory tests.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz015
      Issue No: Vol. 66, No. 2 (2020)
  • The Prevalence of Detectable Biotin in a Cohort Presenting for Routine
           Pregnancy Testing: Implications for Risk
    • Authors: Trambas C; Liu K, Luu H, et al.
      Pages: 392 - 393
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz028
      Issue No: Vol. 66, No. 2 (2020)
  • Is This Diabetes' A Case of Very High Hemoglobin A1c
    • Authors: Dennis G; Pyle-Eilola A.
      Pages: 394 - 395
      Abstract: hemoglobinopathyhemoglobin A1c
      PubDate: Mon, 20 Jan 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz011
      Issue No: Vol. 66, No. 2 (2020)
  • Isolated Orotic Aciduria in an 11-Year-Old Boy
    • Authors: Vakili H; Umaña L, Patel K.
      Pages: 396 - 397
      Abstract: Inborn Errors of MetabolismOrotic AciduriaUrea Cycle Disorders
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz012
      Issue No: Vol. 66, No. 2 (2020)
  • Electrolytes Gone Wild in a 56-Year-Old Man
    • Authors: Tang M; McCoy D, Eby C, et al.
      Pages: 398 - 399
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz016
      Issue No: Vol. 66, No. 2 (2020)
  • Nuclear Magnetic Resonance Metabolomics-Enabled Biomarker Discovery for
           All-Cause Mortality
    • Authors: Ayala-Lopez N.
      Pages: 400 - 400
      Abstract: Biomarker discovery has focused on predicting the presence of disease or pathology, prognosis, or cause-specific mortality risk. Predicting mortality risk from all causes would be useful in clinical trials and for medical decision making. Current mortality risk factors include sex, body mass index, HDL cholesterol, triglycerides, creatinine, systolic blood pressure, and total cholesterol; lifestyle indicators such as smoking status and alcohol consumption; and the presence of cancer, diabetes, and cardiovascular disease. Often these mortality risk factors do not have equal mortality associations across age ranges and are indicative of a specific disease or pathology.
      PubDate: Mon, 10 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz014
      Issue No: Vol. 66, No. 2 (2020)
  • Prelude and Fugue
    • Authors: Bouilloux J.
      Pages: 401 - 401
      Abstract: Gloomy and dead waters, silver grey ripples, leaving dark areas.
      PubDate: Sat, 08 Feb 2020 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz008
      Issue No: Vol. 66, No. 2 (2020)
  • Beware of Noncommutability of External Quality Assessment Materials for
           Hemoglobin A1c
    • Authors: Delatour V; Clouet-Foraison N, Jaisson S, et al.
      Pages: 390 - 391
      Abstract: To the Editor:
      PubDate: Sun, 10 Feb 2019 00:00:00 GMT
      DOI: 10.1093/clinchem/hvz024
      Issue No: Vol. 66, No. 2 (2019)
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