ABSTRACT
BACKGROUND: Current practice for urinalysis mainly entails different manual or semi-automated procedures that generate substantial financial costs, as well as a high and time-consuming workload for laboratory personnel. OBJECTIVE: The aim of this study was to assess whether the availability of integrated and fully automated urinalysis systems such as the UN-Series™ from Sysmex could resolve such concerns. METHODS: The target population was established based on 92,459 urine samples, which is the total average number of urine samples collected in the clinical and microbiology laboratory department of La Mancha Centro Hospital over a 10-year period (2008-2018). Financial data were retrieved from the eSalud database. Reference and test scenarios were defined based on clinical features found in reports from public websites. The cost and savings analyses were based on total costs over a 1-year time frame for the reference and test scenarios. The total average annual time savings for laboratory personnel were also calculated. RESULTS: The comparison of annual costs for current practice versus the automated examination of urine samples found average cost savings of 340,003 per year. Assessment of body fluids using the automated analysis system would provide average annual savings of 1063. The use of the UN-Series™ would save 1615 h annually for laboratory personnel. CONCLUSION: Implementing the UN-Series™ for the automated analysis of urine samples within routine practice in clinical laboratories could minimise costs, provide substantial savings for investment and improve laboratory procedures. Furthermore, the UN-Series™ could contribute to synergy between clinical analysis and microbiology laboratories in Spain.
ABSTRACT
La electroforesis capilar de proteínas séricas es la técnica más utilizada actualmente por los laboratorios clínicos para la detección de componentes monoclonales en suero por su elevada sensibilidad, rapidez y alto nivel de automatización, mejorando notablemente los resultados frente a los métodos basados en la utilización de geles. Sin embargo, se han descrito interferencias por sustancias exógenas no proteicas que absorben a la misma longitud de onda y provocan la aparición de falsos positivos. Se describen dos pacientes a los que se les realiza una extracción de sangre para una analítica programada que incluye la determinación del proteinograma. En ambos casos, justo antes de la extracción, se realizó una tomografía axial computarizada (TAC) de tórax con contraste yodado. En el proteinograma se observa un pico monoclonal en la fracción beta. La inmunofijación e inmunosustracción de ambos sueros no confirma la presencia del pico, por lo que se sospecha la existencia de una interferencia por el contraste yodado. Posteriormente, se solicita una nueva extracción a ambos pacientes para repetir el proteinograma y en ambos casos se observa la desaparición del pico obteniéndose un perfil electroforético totalmente normal (AU)
Capillary electrophoresis of serum proteins is the method most currently used by clinical laboratories for the detection of monoclonal components in serum due to it being highly automated and rapid, with a high sensitivity, significantly improving the results compared to methods based on the use of gel techniques. However, there have been reports of interference by exogenous, non-protein substances that absorb at the same wavelength and cause false positives. Blood samples for laboratory analysis, including protein electrophoresis, were taken from two patients just after they had been subjected to a computed tomography (CT) scan with iodinated contrast. A monoclonal peak was observed in the beta fraction of the electrophoresis pattern, which was unable to be confirmed by immunofixation or immunosubtraction, leading to the suspicion of interference by iodinated contrast. A second sample was requested in bothcases to repeat the analysis, which showed the disappearance of the peak, with a totally normal electrophoretic profile being obtained (AU)
