Understanding the key differences between ISO 15189:2022 and ISO 15189:2012 for an improved medical laboratory quality of service

<abstract>
<title style='display:none'>Abstract</title>
Risk is one of the greatest challenges in a medical laboratory. Risk-based thinking is a concept that always preoccupies medical laboratory technicians. The objectives of this work were to bring forward the specialty standards recommendations for the implementation of risk management principles in medical laboratory, the accreditation requirement of ISO 15189:2012; to demonstrate that the understanding of the fundamental notions of the concept of risk, the effectively apply of the means of identifying, assessing and controlling risks, and the risk monitoring and handling through strategies of acceptance, elimination, transfer and mitigation of risks can ensure the continuous improvement processes. A model to approach to risk management in a medical laboratory establishes the inputs, the outputs, the techniques, and the activities carried out in each of the following sub-processes of the risk management process: risk management process planning, risk identification, risk analysis and evaluation, development of the risk response plan and risk monitoring, control and revision. The concepts of risk and risk management are applied accordingly to standards ISO 31000:2018 and ISO 22367:2020 of International Organization for Standardization (ISO). Risk management ensures that the fundamental requirements for healthy, proactive internal control of the medical laboratory are met.
</abstract>

Approaching Risk Management in Medical Laboratories

<abstract><title style='display:none'>Abstract</title><bold>Background</bold>: In Turkey, prior to transfusion and apheresis, it is mandatory to screen blood for HBsAg, anti-HCV, anti-HIV 1/2, and syphilis. In recent years, efforts have been made to create effective diagnostic algorithms for screening, and as a screening strategy, many countries have switched from traditional algorithms to reverse algorithms. This study was carried out to evaluate the results we obtained after changing to chemiluminescence immunoassay (CLIA) based reverse algorithm, which is more sensitive and specific than the traditional algorithm and VDRL test we currently use for syphilis screening.<bold>Methods</bold>: The screening algorithm was initiated with the treponemal CLIA method. The reactive samples were tested using a nontreponemal test VDRL and a second treponemal test TPHA. In the descriptive analyses, the averages, numbers, and percentage distributions were calculated. The group comparisons were undertaken with the chi-square test, accepting p &lt; 0.05 as statistically significant.<bold>Results</bold>: Of the 5,053 samples that were tested with CLIA syphilis TPA assay 5,043 were negative (99.802%) and 10 were positive reactive (0.198%), and the difference between the two was statistically significant (p &lt; 0.001). Ten samples that were recurrently reactive were analyzed by VDRL and TPHA tests simultaneously. VDRL was negative in all 10 samples, whereas TPHA was negative in one sample, but positive in nine samples at a titer of ≥1/160.<bold>Conclusion</bold>: Based on the results of this study, we decided to use the CLIA method and reverse algorithm instead of using the traditional algorithm and VDRL as the initial screening method.</abstract>

The evaluation of the reverse algorithm for syphilis screening in blood donors

<abstract>
<title style='display:none'>Abstract</title>
<bold>Background</bold>: We aimed to investigate the clinical application value of Abbott Alinity analyzer in syphilis-specific antibody testing.
<bold>Methods</bold>: A total of 100 patients admitted from June 2021 to June 2022 for early syphilis diagnosis were selected and subjected to Treponema pallidum (TP) antibody testing by chemiluminescent microparticle immunoassay (CMIA) using Abbott Alinity analyzer. With TP particle agglutination (TPPA) retesting as the gold standard for syphilis diagnosis, the signal-to-cutoff (S/CO) ratio of the TP antibody testing was plotted into the receiver operating characteristic curve to determine the diagnostic value of CMIA and CLIA in detecting positive TP antibody and to identify the optimal cutoff point.
<bold>Results</bold>: In the case of S/CO ratio ≥7.00, the patients with positive CMIA were diagnosed with positive findings after TPPA confirmation. With the S/CO ratio of 1.00-4.99, the coincidence rate of CLIA with positive TPPA was 81.82% (45/55), and all patients with positive CLIA had positive results confirmed by TPPA test when the S/CO ratio was &gt;5.00. When the optimal cutoff value of S/CO ratio for TP was determined as 6.98 by CMIA, the sensitivity, specificity, and maximum area under the curve (AUC) were 94%, 88% and 0.91, respectively. At the optimal cutoff value (S/CO ratio: 4.56) determined by CLIA, the sensitivity was 84%, the specificity was 80%, and the maximum AUC was 0.84.
<bold>Conclusions</bold>: In the case of S/CO ratio ≥7.00, both methods have high sensitivity and specificity, which can directly give positive reports and shorten the sample turnaround time.
</abstract>

Clinical application value of Abbott Alinity analyzer in syphilis-specific antibody testing

<abstract><title style='display:none'>Abstract</title><bold>Introduction</bold>: Freezing of tissues with liquid nitrogen is the most common method in studies performed at the RNA level. However, the use of RNA stabilization solutions has become a popular alternative method. The aim of this study is to investigate the effectiveness of RNAlater on RNA stabilization in different tissues.<bold>Material and Methods:</bold> In this study, RNA were isolated from the lung, heart, liver and skeletal muscle tissues of rats that were frozen with liquid nitrogen (snap frozen, SF group) or stored in RNAlater solution (RL group), and the changes in concentration, purity, reference genes expression, and fold-change levels between groups were analyzed.<bold>Results</bold>: In the RL group, the concentration of RNA isolated from the liver tissues was higher (P&lt;0.05), whereas the A260/280 ratio was lower in the heart and liver tissues (P&lt;0.05). PPIA and SRP72 genes were found to have lower Ct values in the heart tissues of rats in the RL group (P&lt;0.05 and P&lt;0.001, respectively) than the SF group. Expression levels of PPIA, ACTB, and SRP72 genes across the tissues were found to be different between the groups (P&lt;0.05). The gene expression level examined in terms of fold-change was significantly different in the RL group (upregulated up to 4 folds and downregulated about 0.5 fold) (P&lt; 0.05).<bold>Conclusions</bold>: The results showed that RNAlater can maintain the RNA integrity and can also change the results of gene expression because it does not inhibit biological activity. The snap freezing method is more reliable because gene expression is more stable in tissues frozen with liquid nitrogen.</abstract>

Comparative Evaluation of RNAlater Solution and Snap Frozen Methods for Gene Expression Studies in Different Tissues

Editors Revista Română de Medicină de Laborator University of Medicine and Pharmacy, Tîrgu Mureş, Romania, Department of Epidemiology

Editors Revista Română de Medicină de Laborator University of Medicine and Pharmacy, Tîrgu Mureş, Romania, Department of Histology

Editors Revista Română de Medicină de Laborator University of Medicine and Pharmacy, Tîrgu Mureş, Romania, Department of Laboratory Medicine

Suggestions and Recommendations on Statistical Analysis and Research Methodology

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
Proficiency Testing/Interlaboratory Comparisons play an important role that is widely accepted in demonstrating the validity of results of any laboratory and inspection body. To ensure a coherent approach in the field within an economy, accreditation bodies develop specific policies for laboratories and inspection bodies’ participation in proficiency testing/interlaboratory comparisons.
</sec>
<sec><title style='display:none'>Methods</title>
39 Proficiency Testing/Interlaboratory Comparisons policies of accreditation bodies were reviewed for key requirements: initial accreditation, participations of accreditation per accreditation cycle and acceptance criteria of PT/ILC providers.
</sec>
<sec><title style='display:none'>Results</title>
Within the analyzed policies a wide range of approaches was identified especially for the number of participations and acceptance criteria set by different bodies
</sec>
<sec><title style='display:none'>Conclusions:</title>
Even though the analyzed policies belong to accreditation bodies which are signatories of the same regional agreement, there is no harmonized approach with respect to Proficiency Testing/Interlaboratory Comparisons usage in the accreditation process
</sec>
</abstract>

A comprehensive review of Proficiency Testing / Interlaboratory Comparisons Policies of the EA-MLA signatories applicable to medical laboratories

<abstract>
<title style='display:none'>Abstract</title>
<bold>Introduction</bold>: Metabolic syndrome (MS) is linked to oxidative stress and intracellular redox imbalance, both triggered by chronic inflammatory conditions. The aim of our research was to figure out if bariatric surgery changes the production of free radicals in obese people. In addition, the relationship between metabolic syndrome(MS) and associated conditions is represented by oxidative stress (OS) and intracellular redox imbalance, both of which are induced by the chronic inflammatory conditions that define MS.
<bold>Methods</bold>: The literature search was conducted on PubMed, Cochrane Library, and ScienceDirect, using terms related to severe obesity, nitro-oxidative factors, pro-inflammatory status and reactive oxygen species. Six studies were included. We included papers published till 2022, with a concentration on more recent publications (January 2019 to December 2022).
<bold>Results</bold>: Studies that analyzed the status of the patient after bariatric surgery at 1, 2, 3, 6, 12 months were included in the review, regarding inflammation: CRP levels,IL-6, and regarding oxidative stress: MPO serum activity, blood plasma proteins: dityrosine, kynurenine, glycophore, amyloid and Amadori products, had been found strongly statistically significant decreased at each periodic analyze, the same thing applied to regulatory hormones such as leptin, and due to the fact that these patients have the possibility to keep their weight stable for a longer period, all these factors kept their levels low even 4 years after the intervention.
<bold>Conclusion</bold>: Bariatric surgery is an efficient and quick solution in increasing the quality of life.
</abstract>

The role of nitro oxidative factors in metabolic dysfunctions: A link between severe obesity and weight-loss treatment – a narrative review

<abstract>
<title style='display:none'>Abstract</title>
<bold>Introduction</bold>: Stroke is a disease with high mortality and morbidity. Currently, there are no specific laboratory markers that can replace or improve clinical and radiological diagnosis and prognosis. We evaluated the role of C-reactive protein (CRP), fibrinogen and D-dimer in predicting short-term outcomes in acute ischemic stroke.
<bold>Methods</bold>: We included 118 acute ischemic stroke patients, admitted within 24 h of onset, mean age 72.73±10.08 years. The severity of the stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS), and for poor outcome (PO) we accepted a severe functional deficit at the end of the hospital stay with NIHSS ≥15, and for good outcome (GO) – NIHSS ≤ 14. In all patients, we monitored the dynamics of CRP, fibrinogen and D-dimer and evaluated their predictive value regarding to the PO and GO of the stroke.
<bold>Results</bold>: D-dimer had the strongest poor predictive value at admission (p&lt;0.001). Six hours after admission, CRP, D-dimer or both were higher in PO patients (p=0.046, p=0.022 and p=0.006, respectively). At the 24.h, only CRP could be used to predict PO (p&lt;0.001). Elevated CRP, D-dimer or both have been determined as strong indicators of PO with 72 hours of admission (p&lt;0.001, p=0.032 and p=0.001, respectively). Fibrinogen levels were higher 72 hours after admission without a significant relationship with the NIHSS.
<bold>Conclusion</bold>: Changes in routine biomarkers CRP and D-dimer, but not fibrinogen, can predict short-term stroke prognosis and may be associated with the risk of early neurological deterioration or death during hospital stay.
</abstract>

Evaluation of routine laboratory markers as short-term outcome indicators in patients with acute ischemic stroke

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Background</title>
We aimed to analyze the correlations of the expressions of Toll-like receptor 4 (TLR4) and Janus kinase 3 (JAK3) in peripheral blood mononuclear cells (PBMCs) with T helper 17 cell (Th17)/regulatory T cell (Treg) imbalance in patients with ankylosing spondylitis (AS).
</sec>
<sec><title style='display:none'>Methods</title>
A total of 101 AS patients were enrolled into an AS group. Based on the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score, they were subdivided into a stable AS (ASS) group (BASDAI score &lt;4 points, n=42) and an active AS (ASA) group (BASDAI score ≥4 points, n=59). Meanwhile, 50 healthy volunteers who received health examination in the same time period were assigned into a healthy control (HC) group. RT-qPCR was performed to determine the mRNA expressions of TLR4 and JAK3 in PBMCs. Enzyme-linked immunosorbent assay was conducted to measure the levels of Th17/Treg-related cytokines [interleukin (IL)-10, IL-17, IL-23, and transforming growth factor-β (TGF-β)] in the serum.
</sec>
<sec><title style='display:none'>Results</title>
The mRNA expressions of TLR4 and JAK3 had positive correlations with IL-17 (r=0.592, 0.542) and IL-23 levels (r=0.529, 0.590) (P 0.05). The levels of TLR4 mRNA, JAK3 mRNA, IL-17, and IL-23 were all correlated with the occurrence of AS (P&lt;0.05). The areas under the receiver operating characteristic curves of TLR4, JAK3, and their combination in PBMCs for predicting the occurrence of AS were 0.912, 0.835, and 0.919, respectively.
</sec>
<sec><title style='display:none'>Conclusions</title>
TLR4 combined with JAK3 can effectively predict the occurrence of AS.
</sec>
</abstract>

Correlations of expressions of Toll-like receptor 4 and Janus kinase 3 in peripheral blood mononuclear cells with T helper 17 cell/regulatory T cell imbalance in patients with ankylosing spondylitis

<abstract>
<title style='display:none'>Abstract</title>
<bold>Introduction</bold>: influenza is an acute viral disease caused by infection of the upper respiratory tract - difficult to control, which affects a large part of the population. Neuraminidase inhibitors (NAIs), such as oseltamivir and zanamivir, are the antiviral drugs utilized in Romania for the treatment of respiratory infections caused by the influenza viruses. The objective of the study is to monitor and analyze influenza viruses circulating in Romania, in terms of their susceptibility to oseltamivir, with the aim of signalling the emergence of viral strains resistant to antivirals.
<bold>Methods</bold>: The phenotypic method was performed to evaluate the inhibitory effect of oseltamivir on the neuraminidase enzyme activity of influenza viruses. Genotypic methods (SNP-based assays or sequencing of neuraminidase/whole genome) were used for detecting amino acid substitutions associated with influenza antiviral resistance. The study period is from 2016 to 2023.
<bold>Results</bold>: from the total number of influenza viruses isolated during the period (833 isolated), 670 strains were characterized antigenically and genetically, and the phenotypic susceptibility to antivirals was performed for 245 isolated viral strains. According to WHO criteria categories antiviral susceptibility based on IC50 data, none of the test results indicated reduced or highly reduced inhibition by oseltamivir.
<bold>Conclusion</bold>: This monitoring, carried out in the National Influenza Center Romania - Cantacuzino NMMIRD, is extremely important to maintain effective flu control and further development of other antiviral agents.
</abstract>

Monitoring the sensitivity of influenza viruses to oseltamivir, in Romania, from 2016 to 2023

<abstract>
<title style='display:none'>Abstract</title>
<sec><title style='display:none'>Introduction</title>
Heart failure (HF) is a structural and functional disease that affects millions of people worldwide. The role of inflammation has been demonstrated in many diseases. However, the impact of the Systemic Inflammatory Response Index (SIRI) and the Systemic Immuno-Inflammation Index (SII) on mortality in HF patients has not been adequately investigated. Therefore, in this study, we aimed to demonstrate the effect of SIRI and SII on mortality in patients diagnosed with HF.
</sec>
<sec><title style='display:none'>Methods</title>
Our research is a retrospective, single-centre study comprising patients who were diagnosed with HF and presented at the emergency department. We focused on those diagnosed with decompensated HF between January and November 2022. The study recorded the demographic information and hemogram parameters of the patients. The patients’ in-hospital mortality status was recorded and the effect of these parameters on mortality was assessed.
</sec>
<sec><title style='display:none'>Results</title>
We recruited 122 eligible patients for our research study. Patients with mortality exhibited significantly higher median SIRI levels compared to those without mortality (6.07 (1.99-12.23) vs 2.46, p=0.038), and the group with mortality had significantly higher median SII levels compared to the other group (6625.05 (4704.73-7539.51) vs. 982.48 (180.69-1929.45); p&lt;0.001). ROC curves were generated to assess the efficacy of WBC, SIRI, SII, and CRP parameters in discriminating mortality, and it was confirmed that WBC, SIRI, and SII were all statistically significant predictors of mortality. SIRI and SII demonstrated superior diagnostic ability compared with WBC and CRP, as evidenced by their respective AUC values of 0.929 and 0.671, sensitivities of 91.7% and 50%, and specificities of 91% and 94%.
</sec>
<sec><title style='display:none'>Conclusions</title>
SIRI and SII can be used as mortality indicators in heart failure patients.
</sec>
</abstract>

Effect of Systemic Inflammatory Response Index (SIRI) and Systemic Immuno-Inflammation Index (SII) on mortality in heart failure patients

<abstract><title style='display:none'>Abstract</title><bold>Objectives:</bold> The goal of the study was to investigate the correlations between the interleukin-6 IL-6 -174 G/C and IL-6 -572 G/C gene polymorphisms and sepsis risk and severity in adult ICU patients.<bold>Materials and Methods:</bold> We prospectively assessed 107 septic patients and divided them into two subgroups: organ dysfunction-free sepsis subgroup S (n=60) and septic shock subgroup SS (n=47). A control group of 96 healthy individuals was included. Both patients and controls underwent IL-6 -174 G/C and -572 G/C genotyping and circulating IL-6 in the study group which were measured from samples taken in the first day of sepsis diagnosis.<bold>Results:</bold> No differences in the genotype frequencies of the two polymorphisms between study and control groups were identified. The GC genotype and C allele of IL-6 -572 G/C gene polymorphism was statistically significant more frequent in the organ dysfunction-free subgroup (p=0.01, p=0.004 respectively). No statistically significant differences for the IL-6 -174 G/C gene polymorphism were found between the two sepsis subgroups. Circulating IL-6 levels were significantly higher in the septic shock subgroup and among patients with GG genotypes of both studied polymorphisms.<bold>Conclusion:</bold> We underline the possible role of IL-6 -572 G/C as a marker of severe evolution. There is no evidence of a direct role of IL-6 -174 G/C gene polymorphism in sepsis risk and outcome. Il-6 levels are correlated with sepsis severity but not with variant genotype of investigated IL-6 gene polymorphisms.</abstract>

Infectious Diseases Clinic, University of Medicine and Pharmacy Tirgu Mureș,

Department of Genetics, University of Medicine and Pharmacy, Tirgu Mureș,

Anesthesiology and Intensive Care Clinic, University of Medicine and Pharmacy Tîrgu Mureș,

Genetics Laboratory, Center for Advanced Medical and Pharmaceutical Research, University of Medicine and Pharmacy Tîrgu Mureș,

Immunology Laboratory, Center for Advanced Medical and Pharmaceutical Research, University of Medicine and Pharmacy Tîrgu Mureș,

Department of Epidemiology, University of Medicine and Pharmacy Tîrgu Mureș,

IL-6 gene polymorphisms and sepsis in icu adult romanian patients: a prospective study

<abstract><title style='display:none'>Abstract</title><bold>Background/aim</bold>: This prospective study aimed to determine the presence of the most common carbapenemase genes, blaOXA-48, blaKPC, blaIMP, blaVIM and blaNDM on carbapenem resistant clinical K.pneumoniae and E.coli isolates. <bold>Materials and methods</bold>: Isolates were selected according to EUCAST guideline; gradient test and disc diffusion with both meropenem and ertapenem discs. Resistance rates of these isolates to other antimicrobial agents were also examined by disc diffusion method. Carbapenem resistance gene were investigated by using Real-Time PCR. <bold>Results</bold>: A total of 3845 E. coli and 1689 K.pneumoniae isolates from clinical samples between January 2015 and April 2017 were evaluated. The 419 isolates were found as carbapenem resistant but only the first resistant isolate (n=155; 126 K.pneumoniae and 29 E.coli) of each patient were included. Carbapenem resistant isolates were most frequently isolated from intensive care units (48.8%). Colistin was the most effective antibiotic (91.0%). The 121 (78.1%) of the tested isolates were positive for OXA-48 (103 K.pneumoniae and 18 E.coli) and 9 K. pneumoniae carrying blaNDM were also positive for blaOXA-48. VIM, IMP and KPC type carbapenemases were not detected in any isolates. <bold>Conclusion</bold>: Carbapenem-resistant pathogens have been shown to be able to develop resistance mechanisms with more than one carbapenemase encoding gene.</abstract>

Arising Prevalence of OXA-48 producer <italic>Escherichia coli</italic> and OXA-48 with NDM co-producer <italic>Klebsiella pneumoniae</italic> Strains

<abstract><title style='display:none'>Abstract</title> Introduction: Prior studies assessing sex differences correlated with the levels of human immunodeficiency virus (HIV) RNA and absolute CD4 cell count in adults and children, treated or untreated with antiretroviral (ARV) therapy presented conflicting results. Objective: To assess comparative HIV RNA levels and absolute CD4 cell count in men and women from a large cohort of HIV-infected long term survivors patients. Methods: 462 HIV infected patients were analyzed cross-sectionally and longitudinally after being split into three groups: 156 naïve deceased patients, median age at death 10 years, 197 ARV treated patients, median age 17 years and 109 ARV treated patients, median age 23 years followed up until 2011. HIV RNA and absolute CD4 cell count were measured in all patients enrolled in the study. Results: In cross-sectional analysis of 156 naïve patients HIV RNA median levels were lower in females comparing to males, 4.95 vs. 5.73 HIV RNA log10 (copies/ml). Female absolute CD4 cell count was slightly higher, (median 97 vs. 65.5 cells/μL; P = 0.0001). Cross-sectional analysis of 197 ARV treated patients showed a lower log10 HIV RNA level in females compared to males, (P=0.0001), and also lower median CD4 count values in women, 336 cells/μL vs 456 cells/μL in men, P=.0001. Longitudinal analysis revealed statistically significant results: mean log viral loads were lower in females (F=13.90, P= 0.0009) and absolute CD4 cell count was lower in malse (F=16.72, P&lt;0.0001), almost across all tested ages. Conclusion: We report steady sex differences in HIV RNA levels and absolute CD4 cell count in ART-treated HIV-infected patients, a fact that may suggest a reevaluation of our current treatment strategies according to sex.</abstract>

Carol Davila University of Medicine and Pharmacy, 8 Eroilor Sanitari, Bucharest, Romania, Tel: 0040723699253; fax:0040214243247

Public Health Direction, Giurgiu, Romania

Sex differences in HIV-1 viral load and absolute CD4 cell count in long term survivors HIV-1 infected patients from Giurgiu, Romania

<abstract><title style='display:none'>Abstract</title> Background. Validating new sepsis biomarkers can contribute to early diagnosis and initiation of therapy. The aim of this study is to evaluate the sepsis predictive capacity of soluble urokinase plasminogen receptor (suPAR) and its role in evaluating the prognosis of bloodstream infections. Material and method. We conducted a prospective pilot study on 49 systemic inflammatory response syndrome (SIRS) patients admitted to the intensive care unit (ICU), that were divided, on the basis of bacteremia in group A (SIRS with bacteremia, n=14) and group B (SIRS without bacteremia, n=35). Hemoculture and blood samples were drawn on the first day to determine suPAR, C-reactive protein (CRP) and procalcitonin (PCT). We set to identify significant cut-off values in estimating bacteremia and mortality in septic patients. Results. In group A, suPAR values were 14.3 ng/mL (range 10-45.5 ng/mL) and in group B, 9.85 ng/mL (range 3.4-48 ng/mL) p=0.008. Area under the curve (AUC) for suPAR was 0.745 (95% CI: 0.600-0.859), for CRP 0.613 (95% CI: 0.522-0.799) and for PCT 0.718 (95% CI: 0.477-0.769). Cut-off value for suPAR in bacteremia prediction was 9.885 ng/mL, with 100% sensibility and 51.43% specificity. Mortality in group A was 85.7% (12/14) and in group B 74.3% (26/39), p&gt;0.05. Area under the curve (AUC) for suPAR was 0.750 (95% CI: 0.455-0.936), for CRP 0.613 (95% CI: 0.413-0.913) and for PCT 0.618 (95% CI: 0.373-0.888). Cut-off value of suPAR in predicting mortality was 11.5 ng/mL, with 66.67% sensibility and 100% specificity. Conclusions. In our study suPAR had a predictive capacity for bacteremia and seems to be an independent factor for mortality prognosis in septic patients.</abstract>

Infectious Diseases Clinic, University of Medicine and Pharmacy Tirgu Mures, Romania

Anesthesiology and Intensive Care Clinic, University of Medicine and Pharmacy Tirgu Mures,Romania

Department of Epidemiology, University of Medicine and Pharmacy Tirgu Mures, Romania

Department of Laboratory Medicine, University of Medicine and Pharmacy Tirgu Mures, Romania

Soluble urokinase-type plasminogen activator receptor (suPAR) – a possible biomarker for bacteremia in sepsis / Forma solubilă a receptorului pentru activatorul de plasminogen de tip urokinază (suPAR) – un biomarker posibil pentru bacteriemie în sepsis

Clinical County Emergency Hospital Sibiu,

Faculty of Medicine, University Lucian Blaga, Sibiu,

University of Medicine and Pharmacy Tîrgu Mureș,

Complete blood count and differential in diagnosis of early onset neonatal sepsis

Involvement of inflammatory cytokines in obesity and its complications

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Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

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Revista Romana de Medicina de Laborator

Romanian Journal of Laboratory Medicine

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