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Introduction: Hyperprolactinemia may be due to physiological or pathological causes, and may be asymptomatic or induce hypogonadism, infertility, and/or galactorrhea. It is important to take prolactin samples while avoiding stress, as this may increase prolactin levels. Therefore, our aim was to assess the value of prolactin serial sampling after brachial vein cannulation., Patients and Methods: Sixty-six patients (34.9±11.8 years of age, 92.4% female) with an initial elevated random prolactin level were included. A prolactin sample was drawn at baseline and after a 30min rest., Results: The median referral prolactin level was 37.4ng/ml (interquartile range [IQR* 23.3), the baseline prolactin level at serial sampling was 19.5ng/ml (IQR 8), and the value after a 30min rest was 17.1ng/ml (IQR 7.9). Hyperprolactinemia was not confirmed by serial sampling in 45 patients (68.2%). There were no statistically significant differences in referral prolactin levels between patients with and without confirmed hyperprolactinemia (41.2ng/ml and 36.7ng/ml respectively, p=0.3). Galactorrhea was found in 13.6% of patients, amenorrhea or oligomenorrhea in 28.8%, infertility in 7.6%, erectile dysfunction in 4.6%, and gynecomastia in 3%, while 45.5% were asymptomatic. There were no statistical differences regarding the presence or absence of any of these symptoms and subsequent confirmed hyperprolactinemia. Fifty-seven patients (86.4%) were discharged after the results of the prolactin serial sampling were obtained., Conclusions: Prolactin serial sampling may be a useful test to detect artefactual hyperprolactinemias, thus avoiding unnecessary additional tests and treatments., (Copyright © 2020 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.)

Faecal immunochemical tests for haemoglobin (FIT), as an adjunct to clinical information, assist in the triage of patients presenting in primary care with lower abdominal symptoms. Controversy remains regarding whether and which qualitative and quantitative FIT can be used, which groups of patients would benefit most from FIT, whether FIT should be done in primary and/or secondary care, and how FIT should be incorporated into diagnostic pathways. Controversy also exists as to the optimum cut-off used for referral for colonoscopy. A single sample of faeces may be sufficient. Reporting of results requires consideration. FIT provide a good rule in test for colorectal cancer and a good rule out test for significant bowel disease, but robust safety-netting is required for patients with negative results and ongoing symptoms. Risk scoring models have been developed, but their value is unclear as yet. Further evaluation of these topics is required to inform good practice., (Copyright © 2018 Elsevier España, S.L.U. All rights reserved.)

Unlabelled: Plasma testosterone concentrations are essential for the diagnosis of several causes of hypogonadism, including late-onset hypogonadism. Defining the normal range for testosterone concentrations poses certain difficulties due to the changes that occur with age and the variability of the different analytical methods used., Objectives: To study normal ranges of testosterone in healthy young men and to compare the results of distinct analytical methods., Material and Methods: We recruited 20 healthy men with a mean age of 24.5 years (standard deviation (SD): 5.04) and a mean body mass index (BMI) of 23.8% (SD: 3.3). Total testosterone (TT) was measured by immunochemiluminescence (ICLA) and free testosterone (FT) by radioimmunoassay (RIA). Calculated free testosterone (FTc) and bioavailable testosterone (BT) were calculated using Vermeulen's formula. Serum lutropin (LH), follitropin (FSH) and sex hormone binding globulin (SHBG) were measured by immunoradiometric assays (IRMA)., Results: The mean concentrations were 20 nmol/l (SD: 4.96) for TT, 0.054 nmol/L (SD: 0.01) for FT, 0.3834 nmol/L (SD: 0.09) for FTc and 9.9 nmol/L (SD: 2.8) for BT. There was no correlation between testosterone measured by different methods other than an association between FT and FTc (r=0.662, p<0.003) and between FTc and BT (r=0.979, p<0.0001). An inverse correlation was found between BMI and TT concentrations (r: -0.52, p<0.017)., Conclusions: The normal range for testosterone in healthy young men should be established in each laboratory based on the analytical method used., (Copyright 2009 SEEN. Published by Elsevier Espana. All rights reserved.)

Background: Transcutaneous bilirubinometers provide non-invasive data on newborn jaundice. The aim of this study is to evaluate whether the measurement of transcutaneous bilirubin can be correlated with serum bilirubin, and to find out whether gestational age, weight birth, race or hours of life affect those measurements., Method: Descriptive observational cross-sectional study on a sample of 65 simultaneous measurement of transcutaneous (TcB) and serum bilirubin (TSB)., Results: The correlation coefficient between both methods was 0.923. Race, gestational age and birth weight tends to not have any effects on the levels of transcutaneous bilirubin., Conclusion: Although bilirubinometer measurements tend to underestimate serum bilirubin, especially in patients with high levels, it is a useful technique as a screening tool in the evaluation of hyperbilirubinaemia.

Background: The measurement of i-PTH circulating is not easy due to its analytical variablity. Variability that appears in the process that goes from the sample collection to the final result determination. There are several important aspects that can influence within the pre-test variability: type of sample (serum o plasma), temperature, time elapses from blood extraction to freezing and from freezing to i-PTH quantification. Blood coming from centres far from our laboratory do not always meet the required processing conditions. Our aim was to study the stability of i-PTH with varying conditions of temperature and time until freezing in patients with chronic kidney disease (CKD)., Methods: We have analyzed 294 blood samples of 49 patients with chronic kidney disease (18 transplantated patients (36.7%) and 31 patients in haemodyalisis (63.3%)). The blood samples were collected using tubes treated with ethylenediaminotetraacetic acid (EDTA); these samples were subjected to different conditions of temperature and time before they were frozen, constituting 6 groups: blood centrifuged and plasma immediately frozen (group A or reference group); blood maintained 1 hour at room temperature and plasma stored at 2-8 masculineC during 0, 8 and 24 hours (groups B,C,D); blood maintained 3 hours at room temperature and plasma stored at 2-8 masculineC during 0 and 8 hours (groups E,F). The intact PTH (i-PTH) was measured using the immunoradiometric assay (IRMA Total Intact Scantibodies assay). We have analyzed the differences between the PTH-i mean values in the referenced groud and the others. We have applied the tests of homogeneity variance and normality and we have perform a comparation by pairs with the t-test including the Bonferroni correction., Results: The mean value of intact-PTH in the referente Group was 202.5+/-199.72 pg/ml. The means values of intact-PTH in the other groups were 196 +/- 203.23 pg/ml, 202.8 +/- 200.2 pg/ml, 200.06 +/- 194.87 pg/ml, 204.08 +/- 204.073 pg/ml, 197.94 +/- 182.31 pg/ml. The results were practically identical for each group. We did not find important differences with respect to the reference group (p = 0.87, p = 0,99, p = 0,95, p = 0,96, p = 0,90 when comparing with groups 2a, 2b, 2c, 3a y 3b)., Conclusions: The use of EDTA maintain the PTH stability during a longer period without the necessity of freezing the samples immediately. These results can help to state strategies to management the samples in patients with ERC.

Laboratories play a crucial role in the diagnosis of congenital and perinatal cytomegalovirus infection, considering that other viral infections in newborn infants have similar clinical characteristics. The objectives of this work are to compare the results of the polymerase reaction in blood spots and urine as well as point out the relevance of the result in the Guthrie cards to differentiate congenital from perinatal infection. A total of 148 patients suspicious of CMVH infections were studied in the Congenital Perinatal Infections and Sexual Transmission Laboratory, at the National Institute "Carlos G. Malbrán". The dry blood samples (Guthrie cards) and urine of all patients were studied through the polymerase chain reaction. From the 148 patients, 3 presented other infections, 95 tested negative and 50 positive for cytomegalovirus: 35 had congenital infection and 15 perinatal. In the congenital cases, the polymerase reaction in dry blood was positive (sensitivity 100%, specificity 98.9%, VPP 98% and VPN 100%). Four of them with tardive symptoms were studied retrospectively. The urine specimens from the remaining 15 patients that were taken 15 days after birth were analyzed through the same methods, showing a sensitivity of 100%, the retrospective analysis of this dry blood group yielded negative results, so the infection was considered perinatal. Thus, the dry blood polymerase reaction of the newborn infants makes it a reliable assay for diagnosing congenital cytomegalovirus infection and could be used as an alternative method to urine polymerase reaction. In addition, this test is able to reveal whether the infection is congenital or perinatal in those cases of late symptom or other cases of controversial origin.

Objective: Transcutaneous bilirubinometers are useful in screening and monitoring neonatal hyperbilirubinemia. These instruments reduce the number of blood samples needed, but their validity has been questioned. The aim of this study was to evaluate the accuracy and reliability of a classic transcutaneous bilirubinometer., Method: Descriptive observational cross-sectional study of a sam-ple of 117 simultaneous measurements of transcutaneous and serum bilirubin in 82 jaundiced newborn infants. We analyzed the agreement between repeat measurements and measurements in different sites. We developed predictive models of serum bilirubin and analyzed their validity., Results: All points of measurement displayed excellent agreement between repeat measures (intraclass correlation co-efficient higher than 0.92). Forehead measurements had a linear correlation coefficient of 0.75; in the sternum II-near correlation coefficient varied according to the absence or presence of phototherapy (0.86 and 0.54 respectively). The error intervals in which predictions of se-rum bilirubin were found were #+ 2 mg/dl for low values and #+ 4 mg/dl for high values (#> 15 mg/dl)., Conclusions: Reliability of the transcutaneous bilirubinometer evaluated was high, but the substantial degree of error in se-rum bilirubin make its accuracy questionable, especially in patients with high levels.

Background: The diagnosis of paludism is important because of the severity of the clinical picture caused by Plasmodium falciparum, the increasing number of travellers to endemic zones and the emigration from these zones. A comparative study of the QBC techniques (staining with acridin orange and observation with ultraviolet light) and the thick film with Giemsa staining was carried out., Methods: The QBC and thick film were performed parallelly for 17 months in a total of 623 samples pertaining to subjects from endemic zones of paludism (emigrants, immigrants and travellers)., Results: Of the 623 samples studied 49 were positive for paludism by both techniques. Ten were positive with only the thick film and six were positive only with QBC. The sensitivity of QBC versus thick film was 83% and specificity 98.9%. The time used to determine diagnosis with the QBC technique ranged from 6 to 12 minutes from withdrawal of the sample, while with the thick film the time spent was more than 2 hours. The cases positive by thick film and negative with QBC corresponded to patients with very low parasitation. The intensity of parasitation was difficult to determine quantitatively by QBC., Conclusions: Although the QBC technique has the advantage of speed it is inexact with respect to the quantification of parasitemia. Moreover, it is less sensitive than the thick film in patient with very low parasitations and cannot thus substitute the thick film.

The External Quality Control Programme in Haematology (EQCP-H) comprises a monthly remittance of two whole-blood control samples for evaluating red cell count (RBC), white cell count (WBC), platelet count (PC), haematocrit (HT), haemoglobin rate (HB) and red cell indices (MCV, MHC, MCHC), as well as lyophilized plasma for prothrombin time (PT), partial thromboplastin time (PTT) and fibrinogen (F) determination. The participant laboratories were classified for each determination in accordance with the methods used. The evaluation was made on the basis of 1986 data, the number of participants being 230, from Public Health (54%) and private 46%) laboratories. A mean (means) or target value, along with the standard deviation (SD), was obtained for the results received in the Organising Centre for each parameter. In order to find deviation of individual results with respect to means, a deviation index (DI) was calculated with regard to the whole group and to those laboratories using the same methods. The graphic evaluation of the results was plotted on a Youden diagram. The active participation was 58.3 +/- 5.7%, ranging from 33% (PC) to 74% (RBC, HB, HT and MCV). Upon evaluating the whole programme, stress was laid on the global variation coefficient (VC%) attained for each parameter and those pertaining to the analytical systems employed, grouped in accordance with the methodological principles. Global VC% ranged between 3.6% (HB) and 31.9% (PTT), and the values corresponding to the analytical procedure used were below 4% for RBC, HB, MCV and MCHC in automatic systems and also for HB and MCV in semiautomatic systems. Although the working period of EQPC-H is too short to draw definitive conclusions on the improvement it may induce in the methodological quality, the high VC% values found for WBC, PC and manual determination of HB, along with the unacceptable values for PT, PTT and F, should be stressed.