RADON IN DRINKING WATER FROM ALTERNATIVE SOURCES OF WATER SUPPLY IN THE NORTH OF KOSOVO.

In this study, the results of research on radon activity concentrations in natural mineral waters, traditionally used for drinking but also for other needs, in rural and urban households in northern Kosovo are presented. Radon activity concentration in water was measured by the alpha spectrometric method with a RAD7 device. Radon activity concentrations in the 24 waters studied ranged from 1.6 ± 0.5 to 46.3 ± 6.3 Bq l-1, with an average activity concentration of 12.4 ± 2.0 Bq l-1, which was somewhat higher than the EPA recommended maximum activity concentration, but below the WHO recommended maximum. The contribution of radon activity concentrations in water was determined in relation to the total radon activity in air and enclosed space. The estimated annual effective doses of inhalation and ingestion radon from water were 109.4 ± 16.7 and 2.6 ± 0.4 µSv y-1, respectively.

Interpretative comments - need for harmonization? Results of the Croatian survey by the Working Group for Post-analytics.

INTRODUCTION: Interpretation of laboratory test results is a complex post-analytical activity that requires not only understanding of the clinical significance of laboratory results but also the analytical phase of laboratory work. The aims of this study were to determine: 1) the general opinion of Croatian medical biochemistry laboratories (MBLs) about the importance of interpretative comments on laboratory test reports, and 2) to find out whether harmonization of interpretative comments is needed. MATERIALS AND METHODS: This retrospective study was designed as a survey by the Working Group for Post-analytics as part of national External Quality Assessment (EQA) program. All 195 MBLs participating in the national EQA scheme, were invited to participate in the survey. Results are reported as percentages of the total number of survey participants. RESULTS: Out of 195 MBLs, 162 participated in the survey (83%). Among them 59% MBLs implemented test result comments in routine according to national recommendations. The majority of laboratories (92%) state that interpretative comments added value to the laboratory reports, and a substantial part (72%) does not have feedback from physicians on their significance. Although physicians and patients ask for expert opinion, participants stated that the lack of interest of physicians (64%) as well as the inability to access patient's medical record (62%) affects the quality of expert opinion. CONCLUSION: Although most participants state that they use interpretative comments and provide expert opinions regarding test results, results of the present study indicate that harmonization for interpretative comments is needed.

The concurrence of the current postanalytical phase management with the national recommendations: a survey of the Working Group for Postanalytics of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

INTRODUCTION: The detection and prevention of errors in the postanalytical phase can be done through the harmonization and standardization of constituent parts of this phase of laboratory work. The aim was to investigate how well the ongoing management of the postanalytical phase corresponds to the document "Post-analytical laboratory work: national recommendations" in Croatian medical biochemistry laboratories (MBLs). MATERIALS AND METHODS: All 195 MBLs participating in the national external quality assessment scheme, were invited to undertake a part in a survey. Through 23 questions the participants were asked about management of the reference intervals (RI), delta check, reflex/reflective testing, postanalytical quality indicators and other parts of the postanalytical phase recommended in the national recommendations. The results are presented in numbers and percentages. RESULTS: Out of 195 MBLs, 119 participated in the survey, giving a response rate of 61%. Not all of the respondents provided answers to all the questions. Delta check has not been used in 59% (70/118) of the laboratories. Only 22/113 (20%) laboratories use reflex and/or reflective testing. In 53% of the laboratories, critical results were reported within 30 minutes of the confirmation of the results. In 34% (40/118) of the laboratories, turnaround time and reporting of critical results are two most often monitored postanalytical quality indicators. CONCLUSION: The results showed the critical results reporting and monitoring of postanalytical quality indicators are in the line with the recommendations. However, the management of RI verification, the use of delta check and reflex/reflective testing still must be harmonized among Croatian MBLs.

Laboratory testing of extravascular body fluids: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Part II - Synovial fluid.

Joint diseases are conditions with an often progressive and generally painful nature affecting the patient's quality of life and, in some cases, requiring a prompt diagnosis in order to start the treatment urgently. Synovial fluid (SF) laboratory testing is an important part of a diagnostic evaluation of patients with joint diseases. Laboratory testing of SF can provide valuable information in establishing the diagnosis, be a part of a patient's follow-up and treatment with the purpose of improving the patient's health and quality of life. Synovial fluid laboratory testing is rarely performed in Croatian medical biochemistry laboratories. Consequently, procedures for SF laboratory testing are poorly harmonized. This document is the second in the series of recommendations prepared by the members of the Working group for extravascular body fluid samples of the Croatian Society of Medical Biochemistry and Laboratory Medicine. It addresses preanalytical, analytical, and postanalytical issues and the clinical significance of tests used in SF laboratory testing with the aim of improving the value of SF laboratory testing in the diagnosis of joint diseases and assisting in the achievement of national harmonization. It is intended for laboratory professionals and all medical personnel involved in synovial fluid collection and testing.

Heavy metals and radon content in spring water of Kosovo.

Paper presents results of researches carried out on various locations and immediate vicinity of mining and industrial activities of the northern and south-eastern part of Kosovo. Concentrations of As, Cd, Cr, Cu, Fe, Mn, Ni, Pb, Zn, Rn-222, as well as temperature and pH values of natural spring water were measured at 15 measuring sites (that belong to Zvecan, Leposavic and Novo Brdo municipalities), in April-May and September-October 2019. The quantification of heavy metals' content was performed by applying ICP-OES method. In analysed samples a high content of As, Pb, Fe and Ni was found. Carcinogenic and non-carcinogenic risks due to the content of heavy metals in water were evaluated. Concentration of radon in water was measured by the alpha spectrometric method, and measured values range in the interval from 0.34 ± 0.12 to 341 ± 35 Bq/L. The yearly doses of inhalation and ingestion were determined for the measured concentrations of radon. Mutual correlation by the Pearson correlation coefficient, principal component analysis, cluster analysis and spatial distribution analysis of the researched parameters of sampled water were done. The most expressed mutual dependence of some heavy metals leads to the conclusion that they have the same anthropogenic origin.

General position of Croatian medical biochemistry laboratories on autovalidation: survey of the Working Group for Post-analytics of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

INTRODUCTION: Autovalidation (AV) is an algorithm based on predefined rules designed, among others, to automate and standardize the postanalytical phase of laboratory work. The aim of this study was to examine the overall opinion of Croatian medical biochemistry laboratories regarding various aspects of AV. MATERIAL AND METHODS: This retrospective study is an analysis of the responses of a survey about AV comprised of 18 questions, as part of Module 10 ("Postanalytical phase of laboratory testing") of national External Quality Assessment program, administered by the Croatian Centre for Quality Assessment in Laboratory Medicine. Results were reported as percentages of total number of participants in survey or as proportions of observed data if the overall number of data was <100. RESULTS: 121 laboratories responded to the survey, of which 76% do not use AV, while 11% of laboratories use AV in routine laboratory work. 16/29 laboratories implemented semi-automated AV for general biochemistry (7/29), haematology (5/29), and coagulation (4/29) tests. Analytical measurement ranges, critical values, flags from analysers, interference indices and delta check were the most commonly used rules in the algorithm. 12/29 laboratories performed validation of AV with less than 500 samples (8/29). 7/13 laboratories report the percentage of AV being 20-50%, while 10/13 answered that introduction of AV significantly reduced turnaround time (TAT) (for 20 - 25%), especially for biochemistry tests. CONCLUSIONS: Despite of its numerous benefits (i.e. shorter TAT, less manual validation, standardization of the postanalytical phase), only a small number of Croatian laboratories use AV.

Title does matter: a cross-sectional study of 30 journals in the Medical Laboratory Technology category.

INTRODUCTION: First impression on potential readers is created by the title; therefore, authors should give importance to the title structure. The aim of this study was to establish whether articles created by a smaller number of authors and with shorter, descriptive or declarative titles gain more citations and whether article title length and number of authors correlate to the number of citations. MATERIAL AND METHODS: A cross-sectional study on article citation data for 30 scientific journals published in 2016 in Medical Laboratory Technology field according to Web of Science database was conducted. The type of article, type of title, as well as number of words in the title and number of authors was recorded. RESULTS: In the group of original articles (N = 2623), articles with declarative titles (N = 336, 13%) showed statistically higher number of citations in multiple comparison analysis when compared to descriptive titles (P < 0.001). No correlation was found between number of citations and title word count (r = 0.07, P < 0.001) nor between number of citations and number of authors in group of original articles (r = 0.09, P < 0.001). Original articles with descriptive titles longer than 15 words or with more than six authors are cited more (P = 0.005 and P < 0.001, respectively). CONCLUSION: Based on results of our study, titles do matter. Therefore, authors of original articles might want to consider including their findings in the title and having longer titles.

Laboratory testing of extravascular body fluids: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine. Part I - Serous fluids.

Extravascular body fluids (EBF) analysis can provide useful information in the differential diagnosis of conditions that caused their accumulation. Their unique nature and particular requirements accompanying EBF analysis need to be recognized in order to minimize possible negative implications on patient safety. This recommendation was prepared by the members of the Working group for extravascular body fluid samples (WG EBFS). It is designed to address the total testing process and clinical significance of tests used in EBF analysis. The recommendation begins with a chapter addressing validation of methods used in EBF analysis, and continues with specific recommendations for serous fluids analysis. It is organized in sections referring to the preanalytical, analytical and postanalytical phase with specific recommendations presented in boxes. Its main goal is to assist in the attainment of national harmonization of serous fluid analysis and ultimately improve patient safety and healthcare outcomes. This recommendation is intended to all laboratory professionals performing EBF analysis and healthcare professionals involved in EBF collection and processing. Cytological and microbiological evaluations of EBF are beyond the scope of this document.

Post-analytical laboratory work: national recommendations from the Working Group for Post-analytics on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

The post-analytical phase is the final phase of the total testing process and involves evaluation of laboratory test results; release of test results in a timely manner to appropriate individuals, particularly critical results; and modification, annotation or revocation of results as necessary to support clinical decision-making. Here we present a series of recommendations for post-analytical best practices, tailored to medical biochemistry laboratories in Croatia, which are intended to ensure alignment with national and international norms and guidelines. Implementation of the national recommendations is illustrated through several examples.

Laboratory testing of extravascular body fluids in Croatia: a survey of the Working group for extravascular body fluids of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

INTRODUCTION: We hypothesized that extravascular body fluid (EBF) analysis in Croatia is not harmonized and aimed to investigate preanalytical, analytical and postanalytical procedures used in EBF analysis in order to identify key aspects that should be addressed in future harmonization attempts. MATERIALS AND METHODS: An anonymous online survey created to explore laboratory testing of EBF was sent to secondary, tertiary and private health care Medical Biochemistry Laboratories (MBLs) in Croatia. Statements were designed to address preanalytical, analytical and postanalytical procedures of cerebrospinal, pleural, peritoneal (ascites), pericardial, seminal, synovial, amniotic fluid and sweat. Participants were asked to declare the strength of agreement with proposed statements using a Likert scale. Mean scores for corresponding separate statements divided according to health care setting were calculated and compared. RESULTS: The survey response rate was 0.64 (58 / 90). None of the participating private MBLs declared to analyse EBF. We report a mean score of 3.45 obtained for all statements evaluated. Deviations from desirable procedures were demonstrated in all EBF testing phases. Minor differences in procedures used for EBF analysis comparing secondary and tertiary health care MBLs were found. The lowest scores were obtained for statements regarding quality control procedures in EBF analysis, participation in proficiency testing programmes and provision of interpretative comments on EBF's test reports. CONCLUSIONS: Although good laboratory EBF practice is present in Croatia, procedures for EBF analysis should be further harmonized to improve the quality of EBF testing and patient safety.

The knowledge and understanding of preanalytical phase among biomedicine students at the University of Zagreb.

INTRODUCTION: The educational program for health care personnel is important for reducing preanalytical errors and improving quality of laboratory test results. The aim of our study was to assess the level of knowledge on preanalytical phase in population of biomedicine students through a cross-sectional survey. MATERIALS AND METHODS: A survey was sent to students on penultimate and final year of Faculty of Pharmacy and Biochemistry--study of medical biochemistry (FPB), Faculty of Veterinary Medicine (FVM) and School of Medicine (SM), University of Zagreb, Croatia, using the web tool SurveyMonkey. Survey was composed of demographics and 14 statements regarding the preanalytical phase of laboratory testing. Comparison of frequencies and proportions of correct answers was done with Fisher's exact test and test of comparison of proportions, respectively. RESULTS: Study included 135 participants, median age 24 (23-40) years. Students from FPB had higher proportion of correct answers (86%) compared to students from other biomedical faculties 62%, P < 0.001. Students from FPB were more conscious of the importance of specimen mixing (P = 0.027), prevalence of preanalytical errors (P = 0.001), impact of hemolysis (P = 0.032) and lipemia interferences (P = 0.010), proper choice of anticoagulants (P = 0.001), transport conditions for ammonia sample (P < 0.001) and order of draw during blood specimen collection (P < 0.001), in comparison with students from SM and FVM. CONCLUSIONS: Students from FPB are more conscious of the importance of preanalytical phase of testing in comparison with their colleagues from other biomedical faculties. No difference in knowledge between penultimate and final year of the same faculty was found.

Statistical characteristics of selected elements in vegetables from Kosovo.

Zinc, copper, iron, chromium and cobalt are essential elements for human health, showing toxicity only in high concentrations, while lead and cadmium are extremely toxic even as traces. Therefore, it is important to monitor the contents of toxic metals in vegetables. Large number of vegetables is grown and used in nutrition, in Kosovo. The concentrations of selected elements in vegetables (radish, onion, garlic and spinach) from Kosovo were determined using ICP-OES method. Oral intake of metals and health risk index were calculated. Statistical analysis indicated numerous positive correlations between concentrations of selected elements in vegetables. As a result of principal component analysis, 15 new variables were obtained which were characterized by eigenvalues. The sequence of health quotients for the heavy metals followed the decreasing order Zn = Mn > Pb > Cu > Ni > Fe > Cd > Co > Cr. The health quotients for all investigated heavy metals were below 1 (one), which is considered safe. The vegetables from Kosovo are mainly safe for use in everyday diet.