Bogdan Solnica

Publications of Bogdan Solnica

• The effect of hematocrit on the results of measurements using glucose meters based on different techniques.

  Authors: Bogdan Solnica, Jan Skupien, Beata Kusnierz-Cabala, Krystyna Slowinska-Solnica, Przemyslaw Witek, Agnieszka Cempa, Maciej T Malecki

  Clinical chemistry and laboratory medicine : CCLM / FESCC. 11/2011;

  Abstract Background: The aim of the study was to evaluate the effect of hematocrit (HCT) on glucose meter assays based on different measurement techniques. Methods: This paper studied glucose metersAbstract Background: The aim of the study was to evaluate the effect of hematocrit (HCT) on glucose meter assays based on different measurement techniques. Methods: This paper studied glucose meters utilizing the glucose dehydrogenase reaction and four measurement techniques: colorimetry (HemoCue), reflectometry (Accu-Chek Active), amperometry (Optium Xido) and coulometry (Optium Omega). The EDTA venous blood samples HCT were modified by adding or removing defined aliquots of plasma. Glucose concentration was measured using each meter in 27 batches of blood samples, with HCT ranging from 20% to 60% in 10% increments. The data were analyzed using repeated measures models and a linear random effects model. Results: A significant relationship between HCT and glucose reading in all meters was found and, for all meters except Optium Xido, there was a significant modification of this relationship by glucose level. The relative decrease in glucose concentration per 1% increase of the HCT value varied from 0.30% for Optium Omega in samples with glucose concentrations <5.55 mmol/L to 1.37% for Optium Xido in the same stratum (p<0.0001). The 5% glucose meter error (the ADA recommendation) was reached in the <5.55 mmol/L stratum after HCT change by 3.9%-16.7%. Conclusions: There is a significant continuous effect of HCT on measurement accuracy of glucose meters across its wide range of values and glucose concentrations. The most sensitive to the HCT interference was the system utilizing amperometric technique (Optium Xido) followed by the one with reflectometric technique (Accu-Chek Active), while the systems with the coulometric technique (Optium Omega) or colorimetric measurements in whole blood haemolysate (HemoCue) were less sensitive.

• Evaluation of the analytical performance of the coulometry-based Optium Omega blood glucose meter.

  Authors: Bogdan Solnica, Beata Kusnierz-Cabala, Krystyna Slowinska-Solnica, Przemyslaw Witek, Agnieszka Cempa, Maciej T Malecki

  Journal of diabetes science and technology. 11/2011; 5(6):1612-7.

  The goal of diabetes treatment is maintaining near normoglycemia based on self-monitoring of blood glucose (SMBG). In this study, an evaluation of the analytical performance of the coulometry-basedThe goal of diabetes treatment is maintaining near normoglycemia based on self-monitoring of blood glucose (SMBG). In this study, an evaluation of the analytical performance of the coulometry-based Optium Omega™ glucose meter designed for SMBG has been carried out. The assessment of precision and between-lot variability was based on glucose measurements in ethylene-diaminetetraacetic acid venous blood samples. Glucose concentrations measured in 289 fresh capillary blood samples using the Omega glucose meter and the Biosen C_line analyzer were compared. Within-run imprecision coefficient of variation for the lower and higher glucose concentrations amounted to 5.09 and 2.1%, respectively. The relative lot-dependent differences found for the lower and higher glucose concentrations were equal to 6.8 and 2.6%, respectively. The glucose meter error calculated for various concentration ranges amounted from 2.22 to 4.48%. The glucose meter error met the accuracy criteria recommended by the International Organization for Standardization and the American Diabetes Association. The Passing-Bablok agreement test and error grid analysis with 96% of results in zone A indicated good concordance of results, including glucose concentrations below 100 mg/dl. The evaluated Optium Omega glucose meter fits the analytical requirements for its use in blood glucose monitoring in diabetes patients.

• Serum matrix Gla protein concentrations in patients with mild and severe acute pancreatitis.

  Authors: Beata Kusnierz-Cabala, Anna Gurda-Duda, Bogdan Solnica, Danuta Fedak, Paulina Dumnicka, Jozefa Panek, Jan Kulig

  Clinical laboratory. 01/2011; 57(11-12):999-1006.

  Acute pancreatitis (AP) causes an increase in proinflammatory cytokine and acute phase protein levels. Our previous studies in AP showed the role of fetuin A as a negative acute phase protein. MatrixAcute pancreatitis (AP) causes an increase in proinflammatory cytokine and acute phase protein levels. Our previous studies in AP showed the role of fetuin A as a negative acute phase protein. Matrix Gla protein (MGP), beside fetuin A, is one of the main inhibitors of extraosseous calcification. In the present preliminary study we evaluated the relationship between MGP, lipase, and inflammation in AP patients. The study included 40 patients with AP of diverse severity (28 mild, 12 severe), assessed during the early phase of AP (day 1 - day 7 of hospitalization). The concentration of MGP, fetuin A, polymorphonuclear elastase (PMN-elastase), interleukin 6 (IL-6), interleukin 18 (IL-18), hepatocyte growth factor (HGF), high sensitivity tumor necrosis factor alpha (hs TNFalpha), soluble receptor of tumor necrosis factor II (sTNFRII), and neopterin were measured by ELISA kits; albumin, lipase and amylase were measured on a Modular P Chemistry Analyser (Roche Diagnostica, Germany); procalcitonin (PCT) was measured using the LUMItest PCT (Brahms, Germany), and serum amyloid A (SAA) and high sensitivity C-reactive protein (hs CRP) were measured using an immunonephelometric method on a Nephelometer BNII (Siemens Healthcare, Germany). MGP positively correlated with lipase activity (R = 0.64; p < 0.05) on day 1 after admission to hospital. Lower MGP levels were consistent with higher intensity of inflammation, as MGP significantly (p < 0.05) inversely correlated with IL-6 (R = -0.48 on day 3; R = -0.46 on day 5 and R = -0.52 on day 7 after admission), IL-18 (R = - 0.55; R = -0.60; R = -0.48 on day 1, day 3, and day 5, respectively), HGF (R = -0.58 on day 3), hs TNFalpha (R = -0.45 on day 1 and R = -0.64 on day 5), its soluble receptor sTNFRII (R = -0.63; R = -0.61; R = -0.59 on day 3, day 5, and day 7, respectively), hs CRP (R = -0.76 on day 1 and R = -0.83 on day 5), PCT (R = -0.62 on day 1 and R = -0.59 on day 7), SAA (R = -0.45 on day 5) as well as with neopterin (R = -0.52 on day 1 after admission). MGP levels dropped simultaneously with fetuin A (R = 0.50 on day 3; R = 0.60 on day 5 and R = 0.63 on day 7) and albumin concentrations (R = 0.51; R = 0.70; R = 0.94 on day 1, day 5, and day 7 day after admission, respectively). There was a relationship between lipase activity and MGP concentration on day 1 of hospitalization (R = 0.64; p < 0.05). Our preliminary results indicate that the MGP level correlated negatively with all of the proinflammatory cytokines and acute phase proteins studied in patients with AP, and positively with lipase, fetuin A, and albumin measurements. These findings may indicate the role of MGP in calcium and phosphate metabolism disturbances in the course of AP.

• Increased nitric oxide availability attenuates high fat diet metabolic alterations and gene expression associated with insulin resistance.

  Authors: Urszula Razny, Beata Kiec-Wilk, Lukasz Wator, Anna Polus, Grzegorz Dyduch, Bogdan Solnica, Maciej Malecki, Romana Tomaszewska, John P Cooke, Aldona Dembinska-Kiec

  Cardiovascular diabetology. 01/2011; 10:68.

  High fat diet impairs nitric oxide (NO) bioavailability, and induces insulin resistance. The link between NO availability and the metabolic adaptation to a high fat diet is not well characterized.High fat diet impairs nitric oxide (NO) bioavailability, and induces insulin resistance. The link between NO availability and the metabolic adaptation to a high fat diet is not well characterized. The purpose of this study was to investigate the effect of high fat diet on metabolism in mice with decreased (eNOS-/-) and increased (DDAH overexpressed) NO bioavailability. eNOS-/- (n = 16), DDAH (n = 24), and WT (n = 19) mice were fed a high fat diet (HFD) for 13 weeks. Body weight, biochemical parameters, adipokines and insulin were monitored. The matrigel in vivo model with CD31 immunostaining was used to assess angiogenesis. Gene expression in adipose tissues was analyzed by microarray and Real Time PCR. Comparisons of the mean values were made using the unpaired Student t test and p < 0.05 were considered statistically significant. eNOS-/- mice gained less weight than control WT and DDAH mice. In DDAH mice, a greater increase in serum adiponectin and a lesser increment in glucose level was observed. Fasting insulin and cholesterol levels remained unchanged. The angiogenic response was increased in DDAH mice. In adipose tissue of DDAH mice, genes characteristic of differentiated adipocytes were down-regulated, whereas in eNOS-/- mice, genes associated with adipogenesis, fatty acid and triglyceride synthesis were upregulated. Our results indicate that increased NO availability attenuates some HFD induced alterations in metabolism and gene expression associated with insulin resistance.

• [Interleukin 8 and interferon gamma in ocular toxoplasmosis].

  Authors: Jacek Czepiel, Grazyna Biesiada, Iwona Sobczyk-Krupiarz, Grazyna Miklasszewska, Danuta Fedak, Bogdan Solnica, Tomasz Mach, Aleksander Garlicki

  Klinika oczna. 01/2011; 113(4-6):149-52.

  Toxoplasmosis is one of the most common parasitic infections in the world, it is caused by Toxoplasma gondii. The infection is typically asymptomatic or the symptoms are very mild. Approximately 10%Toxoplasmosis is one of the most common parasitic infections in the world, it is caused by Toxoplasma gondii. The infection is typically asymptomatic or the symptoms are very mild. Approximately 10% patients have limphadenopathy, involvement of the others organs, like eyes, nervous system, liver, heart, are observed more rarely. The aim of our study was to assess the level of selected cytokines in blood among patients with ocular toxoplasmosis. We have enrolled in the study 30 patients, 19-42 years old, treated for ocular toxoplasmosis, and 20 healthy volunteers, 20-48 years old, to the control group. Tests for blood morphology, C-reactive protein, the level of IL-8 and IFN-gamma were performed in all patients. The blood parameters in toxoplasmosis group were performed before antiparasitic treatment was given. The level of IFN-gamma in blood was lower among patients with ocular toxoplasmosis comparing with control group (1.52 vs. 4.18 pg/ml; p = 0.002). The level of IL-8 in blood was lower among patients with ocular toxoplasmosis comparing with control group (22.96 vs. 94.3 pg/ml; p = 0,007). There were no correlations between analyzed cytokines and blood morphology or CRP. The low level of IFN-gamma and IL-8 in blood is important factor leading to reactivation of the ocular toxoplasmosis.

• [Analysis of osteopontin in patients with acute pancreatitis].

  Authors: Beata Kuśnierz-Cabala, Danuta Galicka-Latała, Józefa Panek, Anna Gurda-Duda, Paulina Dumnicka, Bogdan Solnica, Jan Kulig

  Przegla̧d lekarski. 01/2011; 68(5):248-52.

  The aim of this study was to analyze osteopontin (OPN) concentrations in patients with acute pancreatitis (AP) and its suitability for diagnosis and prediction of severity during the first 3 daysThe aim of this study was to analyze osteopontin (OPN) concentrations in patients with acute pancreatitis (AP) and its suitability for diagnosis and prediction of severity during the first 3 days from admission to hospital. The study group consisted of 40 patients admitted and hospitalized at I-st and II-nd Depatments of Surgery Jagiellonian University Collegium Medicum in Krakow. All laboratory tests necessary for diagnosis and monitoring of patients were performed in the Diagnostic Dept. of University Hospital, other immunochemistry parameters were assesed in the Diagnostic Dept. of Clinical Biochemistry Jagiellonian University using ELISA kits. The concentrations of OPN in severe acute pancreatitis were significantly higher than in patients with mild form of disease in the whole observation period. Simultaneously, we observed that increased in OPN concentrations in consecutive days of AP may be helpful in prediction of severity and compilations during AP.

• [Evaluation of selected laboratory markers of liver fibrosis in patients with chronic hepatitis type C].

  Authors: Beata Kuśnierz-Cabala, Bogdan Solnica, Tomasz Mach, Grazyna Biesiada, Paulina Dumnicka

  Przegla̧d lekarski. 01/2010; 67(7):450-3.

  The aim of the study was to compare 4 non-invasive biochemical scores of liver fibrosis (age/PLT; AST/ALT; APRI and FORNS) with results of hepatic biopsies classified according to Batts-Ludwig scale.The aim of the study was to compare 4 non-invasive biochemical scores of liver fibrosis (age/PLT; AST/ALT; APRI and FORNS) with results of hepatic biopsies classified according to Batts-Ludwig scale. The study included a total of 99 patients: 44 (44.4%) women with mean +/- SD age of 42 +/- 11.9 years and 55 (55.6%) men (43 +/- 12.2) treated for chronic hepatitis C. RESULTS: Levels of several markers changed significantly after 3 months of treatment (with interferon alpha and ribavirin) comparing to values on admission to hospital: we observed statistically significant differences of ALT: 32.6 +/- 15.7 vs. 61.5 +/- 35.6 (U/l), p<0.001; AST: 34.1 +/- 11.1 vs. 48.2 +/- 26.5 (U/l), p<0.05 and total cholesterol concentration: 4.0 +/- 0.4 vs. 4.9 +/- 0.9 (mmol/l), p<0.01 in women; AST/ALT ratio in both men (0,8 +/- 0,3 vs. 0.69 +/- 0.25; p<0.05) and women (1.2 +/- 0.4 vs. 0.84 +/- 0.24; p<0.001) and age/PLT score: 0.4 +/- 0.3 vs. 0.28 +/- 0.12 (p<0.01) in men. CONCLUSIONS: Non-invasive biochemical scores: age/PLT, APRI and FORNS showed acceptable compliance with liver morphological status characterized in Batts-Ludwig scale as we observed significant differences between F0-F1 and F3-F4 groups. Age/PLT, APRI and FORNS seems to be helpful in prediction of early stage of liver fibrosis in patients with chronic hepatitis C. After 3 months of standard antiviral therapy (interferon alpha and ribavirin) we did not observe statistically significant differences in values of FORNS and APRI scores. Simultaneously, we noticed significant decrease in activity of aminotransferases and AST/ALT ratio recognized by clinicians as standard markers of inflammatory and necrosis processes.

• [Application of chosen granulocyte markers in diagnostics of Leśniowski-Crohn's disease and ulcerative colitis--preliminary research].

  Authors: Danuta Fedak, Dorota Pawlica, Irena Ciećko-Michalska, Bogdan Solnica, Tomasz Mach

  Przegla̧d lekarski. 01/2010; 67(2):114-8.

  About 15% of cases of nonspecific inflammatory bowel diseases are difficult to diagnose based on clinical, radiological and histopatological criteria. In this study we tried to find a biochemicalAbout 15% of cases of nonspecific inflammatory bowel diseases are difficult to diagnose based on clinical, radiological and histopatological criteria. In this study we tried to find a biochemical marker helpful in differential diagnostics and assessment of activity of Leśniowski-Crohn's disease and ulcerative colitis. Plasma concentrations of leukocyte elastase and calprotectin (neutrophiles' proteins), eotaxin (eosinophils chemoatractant) and C-reactive protein were measured in 22 patients with Leśniowski-Crohn's disease and 28 patients witch ulcerative colitis. Significantly higher plasma levels of leukocyte elastase and calprotectin in patients witch ulcerative colitis as compared to Leśniowski-Crohn's disease were found. Thus leukocyte elastase and calprotectin can be considered additional markers differentiating these two diseases. Moreover, plasma concentrations of CRP and leukocyte elastase were associated with the clinical activity of Leśniowski-Crohn's disease whereas CRP and calprotectin concentrations were related to the clinical activity of colitis ulcerosa.

• Serum fetuin A concentrations in patients with acute pancreatitis.

  Authors: Beata Kuśnierz-Cabala, Anna Gurda-Duda, Józefa Panek, Danuta Fedak, Paulina Dumnicka, Bogdan Solnica, Jan Kulig

  Clinical laboratory. 01/2010; 56(5-6):191-5.

  Acute pancreatitis (AP) is a mild and self-limiting disease in most patients, but necrotizing pancreatitis develops in up to 20 - 30% of the cases. Early recognition of severe AP has been consideredAcute pancreatitis (AP) is a mild and self-limiting disease in most patients, but necrotizing pancreatitis develops in up to 20 - 30% of the cases. Early recognition of severe AP has been considered as a key determinant of successful therapy. The aim of this study was to evaluate the clinical value of fetuin A as the new predictor of complications and fatal outcome during acute pancreatitis (AP). The study included 40 patients with AP of diverse severity (28 mild, 12 severe), assessed during the early phase of AP (1st - 7th day of hospitalization). Fetuin A level was measured by ELISA kit (BioVendor). Median serum fetuin A concentrations had a tendency to decrease during examination from 0,371 g/L at admission to 0,288 g/L on the 7th day of hospitalization. In each of 7 days of observation, correlation between the increase in fetuin A and the absolute number of RBC was found (R = 0,34: 1st day R = 0,35: 3rd day, p < 0,05; R = 0,57: 5th day, p < 0,001; R = 0,65: 7th day, p < 0,01). Additionally, we observed the reverse relationship between the decrease in fetuin A and the increase in some inflammatory markers (IL-6: R = -0,61, p < 0,0001; SAA: R = -0,58, p < 0,001; HGF: R = -0,60, p < 0,01; PCT: R = -0,475, p < 0,01). The strongest positive correlation was noticed on the 5th day of hospitalization between decreased levels of fetuin A and albumin (R = 0,83; p < 0,0001). Fetuin A level monitoring is potentially a new marker for non-invasive and accurate prediction status for the hospitalization of patients with AP similar to other negative acute phase proteins like albumin.

• Neopterin and other inflammatory markers in the early period following allogeneic bone marrow transplantation: series of 3 cases.

  Authors: Beata Kuśnierz-Cabala, Dorota Hawrylecka, Patrycja Mensah-Glanowska, Beata Piątkowska-Jakubas, Bogdan Solnica, Aleksander Skotnicki, Paulina Dumnicka

  Polskie archiwum medycyny wewnetrznej. 11/2009; 119(11):756-760.

  The 3 case reports presented here constitute a pilot study assessing the profile of changes in concentrations of selected inflammatory markers, including C-reactive protein, serum amyloid A,The 3 case reports presented here constitute a pilot study assessing the profile of changes in concentrations of selected inflammatory markers, including C-reactive protein, serum amyloid A, neopterin, and interleukin 18, in an early period after allogeneic stem cell transplantation.

• Analysis article on the performance analysis of the OneTouch UltraVue blood glucose monitoring system.

  Authors: Bogdan Solnica

  Journal of diabetes science and technology. 01/2009; 3(5):1166-7.

  In this issue of Journal of Diabetes Science and Technology, Chang and colleagues present the analytical performance evaluation of the OneTouch UltraVue blood glucose meter. This device is anIn this issue of Journal of Diabetes Science and Technology, Chang and colleagues present the analytical performance evaluation of the OneTouch UltraVue blood glucose meter. This device is an advanced construction with a color display, used-strip ejector, no-button interface, and short assay time. Accuracy studies were performed using a YSI 2300 analyzer, considered the reference. Altogether, 349 pairs of results covering a wide range of blood glucose concentrations were analyzed. Patients with diabetes performed a significant part of the tests. Obtained results indicate good accuracy of OneTouch UltraVue blood glucose monitoring system, satisfying the International Organization for Standardization recommendations and thereby locating >95% of tests within zone A of the error grid. Results of the precision studies indicate good reproducibility of measurements. In conclusion, the evaluation of the OneTouch UltraVue meter revealed good analytical performance together with convenient handling useful for self-monitoring of blood glucose performed by elderly diabetes patients.

• Alanine variant of the Pro12Ala polymorphism of the PPARgamma gene might be associated with decreased risk of diabetic retinopathy in type 2 diabetes.

  Authors: Maciej T Malecki, Katarzyna Cyganek, Barbara Mirkiewicz-Sieradzka, Pawel P Wolkow, Krzysztof Wanic, Jan Skupien, Bogdan Solnica, Jacek Sieradzki

  Diabetes research and clinical practice. 05/2008; 80(1):139-45.

  OBJECTIVE: Molecular background of diabetic retinopathy (DR) remains unknown. An interesting group of candidate genes encode proteins involved in insulin resistance. AIM: To search for associationOBJECTIVE: Molecular background of diabetic retinopathy (DR) remains unknown. An interesting group of candidate genes encode proteins involved in insulin resistance. AIM: To search for association between the PPARgamma, calpain 10, PTPN1 genes and DR in type 2 diabetes mellitus (T2DM). METHODS: We examined 238 T2DM subjects without DR (NDR) and 121 with DR (mean diabetes duration: 9.1+/-6.8 and 15.1+/-7.7, respectively). The subjects were genotyped for four markers: Pro12Ala of PPARgamma, SNP43 of calpain 10, rs3787345 and rs754118 of PTPN1. The distributions of the genotypes were compared using the chi(2)-test and Fisher exact test. RESULTS: The alleles and genotypes were not associated with DR in non-stratified analysis. To investigate the impact of T2DM duration, we performed analysis that excluded short duration NDR subjects and long-duration DR subjects. It allowed obtaining groups with similar T2DM duration but different DR status (DR: 88 individuals, 11.4+/-5.3 years; NDR: 136 individuals, 13.2 years+/-6.2, respectively). This analysis suggested that the alanine variant of Pro12Ala might be associated with decreased risk of DR (p=0.026 for alleles, p=0.038 and p=0.014 for genotypes in additive and dominant models, respectively). In multivariable logistic regression that included non-genetic parameters, Pro12Ala was not an independent risk factor (p=0.28). Further analysis showed, however, that Pro12Ala remained significant when urea level was excluded from the model. CONCLUSION: The alanine variant of the Pro12Ala polymorphism of PPARgamma might be associated with decreased risk of DR in T2DM. This effect may be indirect, at least in part, due to diabetic kidney disease.

• Analytical evaluation of the Optium Xido blood glucose meter.

  Authors: Bogdan Solnica, Jerzy Naskalski, Wojciech Gernand

  Clinical chemistry and laboratory medicine : CCLM / FESCC. 01/2008; 46(1):143-7.

  BACKGROUND: The main prevention of chronic diabetic complications is maintaining near normoglycemia. In this study, evaluation of analytical performance of the Optium Xido blood glucose meterBACKGROUND: The main prevention of chronic diabetic complications is maintaining near normoglycemia. In this study, evaluation of analytical performance of the Optium Xido blood glucose meter designed for patients' self-monitoring of glycemia was carried out. METHODS: Glucose concentrations were measured in 118 EDTA blood samples using the Xido glucose meter and the GOD/PAP method on a Modular P clinical analyzer. The results obtained were used for the assessment of accuracy, precision and linearity. Performance of the Xido glucose meter was also assessed using four different reagent strip lots, and the between-lot variation was calculated. RESULTS: The within-run imprecision coefficient of variation (CV) amounted to 4.2%. Good response linearity was found in glucose concentrations of 31-444 mg/dL (1.7-24.7 mmol/L). In the concentration range studied, the glucose meter error was 5.14% and the linear regression equation was y=0.91x+6.2, (r=0.984). The Passing-Bablok agreement test indicated good concordance of results. However, for glucose concentrations<100 mg/dL (5.6 mmol/L) (n=69) the error was 6.82% with regression equation y=0.86x+5.9 (r=0.757). Between-lot differences amounted to 0.7%-18.2%. CONCLUSIONS: The Xido glucose meter has good precision and accuracy when compared to the laboratory method and meets the quality recommendations of the National Committee of Clinical Laboratory Standards (NCCLS, currently the Clinical Laboratory Standards Institute), the National Academy of Clinical Biochemistry (NACB) and the International Organization for Standardization (ISO). However, between-lot variability may result in differences between day-to-day results when the device is continuously used. Therefore, the validation of new lots of reagent strips with a laboratory method is recommended.

• Lower confidence limits for critical systematic errors.

  Authors: Wojciech Gernand, Paulina Dumnicka, Beata Kuśnierz-Cabala, Maria Kapusta, Bogdan Solnica

  Clinical biochemistry. 12/2007; 40(16-17):1317-20.

  OBJECTIVES: The critical systematic error (DeltaSE(C)) can be used to select a quality control scheme. It is just an estimate of the true DeltaSE(C), however, and its precision depends on the sampleOBJECTIVES: The critical systematic error (DeltaSE(C)) can be used to select a quality control scheme. It is just an estimate of the true DeltaSE(C), however, and its precision depends on the sample size. Thus, the lower confidence limit (LCL) of DeltaSE(C) should be adopted instead to guard against false optimism. DESIGN AND METHODS: LCLs are calculated as a function of DeltaSE(C) and sample size using a modified version of Bissell's formula. RESULTS: The uncertainty in DeltaSE(C) may be significant. The largest relative difference between DeltaSE(C) and its LCL is 52.2%, for DeltaSE(C)=2 and n=20. This difference decreases with increasing DeltaSE(C) and sample size. CONCLUSIONS: It is shown that taking into account the uncertainty in DeltaSE(C) can greatly influence quality control planning decisions. Caution should thus be exercised when interpreting control data and choosing an appropriate quality control strategy. The derived equation for LCL is simple, and can be immediately applied to practical solutions.

• An example of a bootstrap technique application for judging a variability of method performance estimates and its consequences for quality control planning.

  Authors: Wojciech Gernand, Bogdan Solnica, Jerzy W Naskalski

  Clinica chimica acta; international journal of clinical chemistry. 10/2007; 384(1-2):160-2.

  BACKGROUND: Flexible fitting of quality control procedures to method performance is an inseparable element of a cost-effective quality management strategy. However, opinions on method performance,BACKGROUND: Flexible fitting of quality control procedures to method performance is an inseparable element of a cost-effective quality management strategy. However, opinions on method performance, based on a restricted number of quality control results used to calculate bias and imprecision, can vary due to the random nature of the data-gathering process. METHODS: We present an example of the bootstrap technique application in evaluating method performance estimates. RESULTS: Our analysis reveals substantial variability in method performance assessment results that should not be omitted. We suggest that the best way of using information concerning method performance is to consider the information in a probabilistic manner. Method performance is a feature presented with an element of probability. The effectiveness of a quality control procedure should be assessed with regard to this probability. CONCLUSIONS: Presented example of a bootstrap technique application increases our awareness of the uncertainty that accompanies method performance judgment and quality control planning.

• Quality control of self-monitoring of blood glucose: why and how?

  Authors: Bogdan Solnica, Jerzy W Naskalski

  Journal of diabetes science and technology (Online). 03/2007; 1(2):164-8.

  The control of analytical quality of self-monitoring of blood glucose (SMBG) is recommended as a routine procedure in diabetes management. This control procedure should be easily accessible toThe control of analytical quality of self-monitoring of blood glucose (SMBG) is recommended as a routine procedure in diabetes management. This control procedure should be easily accessible to patients, convenient, not time-consuming, and provide a reliable assessment of glucose meter performance. Optimally it should be located in the diabetes outpatient clinic. Presently there are two approaches to carrying out SMBG quality control. The first is based on the comparison of results obtained by a controlled glucose meter and use of the laboratory method or point-of-care testing device as a surrogate reference analyzer. The second one is a traditionally organized external quality assessment scheme with use of a dedicated control material, which is distributed to all participants. The recommended allowable meter error in SMBG can be realistically set at 10%.

• Effect of moderate hypercholesterolemia on recognition of hypernatremia using indirect measurements of serum sodium and potassium concentrations.

  Authors: Jerzy W Naskalski, Bogdan Solnica, Wojciech Gernand

  Clinical laboratory. 01/2007; 53(7-8):441-7.

  BACKGROUND: Na+ and K+ concentration measurements by ion-selective electrodes and flame photometry are affected by lipids influencing plasma water content. METHODS: In 166 sera with total cholesterolBACKGROUND: Na+ and K+ concentration measurements by ion-selective electrodes and flame photometry are affected by lipids influencing plasma water content. METHODS: In 166 sera with total cholesterol ranging from 1.19 to 23.3 mmol/L, and triglycerides ranging from 0.34 to 56.3 mmol/L, Na+ and K+ concentrations were assayed using flame photometry and direct ion-selective electrodes of the Vitros 950 analyzer. Linear regression analysis was used to examine inter-method difference as lipid content variable. RESULTS: In hypercholesterolemia and hypertriglyceridemia flame photometry yielded Na+ concentrations lower by 1.85% and 2.15% than ion-selective electrode measurements (p < 0.05). Na+ concentration inter-method difference correlated with total cholesterol and triglycerides. In bivariate analysis, inter-method difference significantly depended on total cholesterol (r2 = 0.09), whereas the impact of triglycerides was weak. In trivariate analysis, total cholesterol had the highest impact (r2 = 0.12), followed by Na+ concentration (r2 = 0.04), while the impact of triglycerides was insignificant. Recognition of hypernatremia significantly depended on total cholesterol (chi2 p = 0.0017); 27% of samples with hyperlipidemia (total cholesterol > 5.2 mmol/L, triglycerides > 2.5 mmol/L) classified as normonatremia by flame photometry presented hypernatremia by direct ion-selective electrode. CONCLUSIONS: The lipid status of patients influences recognition of hypernatremia if assays are based on total plasma volume. No effect of lipids was observed on the recognition of hyperkalemia.

• [Diagnostic aspects and analytical problems of glycemia monitoring in intensive care unit patients]

  Authors: Bogdan Solnica

  Przegla̧d lekarski. 02/2006; 63(9):792-6.

  Blood glucose is one of the most frequently ordered laboratory tests used mainly for diagnosis and monitoring of diabetes treatment. However, disturbances of glucose metabolism occur also in patientsBlood glucose is one of the most frequently ordered laboratory tests used mainly for diagnosis and monitoring of diabetes treatment. However, disturbances of glucose metabolism occur also in patients without diabetes in critical illnesses of various etiopathogenesis, including acute coronary syndrome, multi-organ injuries, sepsis, septic shock, burns or post-surgery trauma. The disturbances are caused by increased secretion of stress hormones and inflammatory cytokines resulting in insulin resistance and hyperglycemia. These changes worsen the course of the disease and prognosis. The management of critically ill patients should include the control of glycemia and maintaining it in the target range. The treatment includes intravenous insulin and glucose administration with monitoring of glycemia. Other abnormalities of glucose metabolism observed in various diseases are hypoglycemic states including neonatal hypoglycemia. Assays of blood glucose in critically ill patients treated in intensive care units should be performed using point-of-care testing (POCT) techniques. Measurements of real time glycemia provide the base for rapid achievement and maintaining glucose target values. It is particularly important when glucose concentrations decide on immediate physician's action, e.g. change in insulin dosage or compensation of hypoglycemia. POCT glucose assays are now included in critical care tests panel and glucose assays may be performed using various dedicated analyzers. This kind of test has its specificity associated with the kind of employed material and the measurement techniques adjusted to "fresh" blood as material of testing, distinguishing results of glucose POCT assays and results obtained in the laboratory. Tests are performed in the blood samples immediately after collection sample and take no longer than a few minutes. Real time glycemia control in intensive care unit patients has become an important part of present medical procedures.

• Quality control of SMBG in clinical practice.

  Authors: Bogdan Solnica, Jerzy W Naskalski

  Scandinavian journal of clinical and laboratory investigation. Supplementum. 02/2005; 240:80-5.

  We present results of quality control of self-monitored blood glucose (SMBG) performed in diabetes outpatient clinic. The tests included: inspection of glucose meter, blood glucose self-measurementWe present results of quality control of self-monitored blood glucose (SMBG) performed in diabetes outpatient clinic. The tests included: inspection of glucose meter, blood glucose self-measurement by a patient, glucose measurement by point-of-care analyzer used in a clinic and with the laboratory method. In the study 158 glucose meters were controlled and compared with HemoCue glucose analyzer used in the clinic as the reference. 122 glucose meters readings were also compared with the reference laboratory method. Tested glucose meters included: Accutrend {18}, Glucotrend {59}, Precision QiD {39}, One Touch {26} and Glucocard II {16}. Reference glucose assays were performed using glucose oxidase method on Hitachi 911 analyzer. Glucose concentrations measured by the controlled glucose meters ranged from 36 to 425 mg/dL. The analytical bias of the glucose meters amounted from 2.48% to 8.27%. Correlation coefficient between results obtained by the tested glucose meters and HemoCue analyzer ranged from 0.957 to 0.980 and between glucose meters and laboratory method from 0.955 to 0.985. Passing-Bablok agreement test and Deming regression analysis indicated good concordance of results between all the tested glucose meters and HemoCue analyzer, whereas good agreement with the laboratory method was found for Accutrend, Glucotrend, Precision QiD and One Touch glucose meters. In conclusion, good analytical performance of the employed glucose meters and a bias less than 10% from the reference values were found. Results of this study show the possibility for routine, convenient for the patient quality control of SMBG in an outpatient clinic.

• [Analytical problems of iodine defficiency examination in Polish Nation-wide deficit control program]

  Authors: Jerzy W Naskalski, Ryszard Drozdz, Bogdan Solnica, Witold Rostworowski, Zbigniew Szybiński, Bohdan Huszno, Małgorzata Trofimiuk, Monika Buziak-Bereza

  Przegla̧d lekarski. 02/2004; 61(12):1325-9.

  The environmental iodine deficiency has been a serious problem in the Polish health care system for many years. In many European countries the prevention of iodine deficiency-related health deficitsThe environmental iodine deficiency has been a serious problem in the Polish health care system for many years. In many European countries the prevention of iodine deficiency-related health deficits in population scale is based on edible salt supplementation with KI. In the decade of the 80-ties the iodine supplementation program in Poland was stopped, which has caused a subsequent increase in prevalence of goiter and iodine deficiency-related hypothyreosis. These diseases were observed in many regions of Poland, including the areas beyond regions of formerly known iodine deficiency endemias. In order to control the whole Polish population, iodine consumption deficit in1991 the "Polish Program of Iodine Deficiency Control and Prevention of Iodine Deficiency-related Disorders" has been established in the year 1991. In 1992--1996 a common iodine supplementation of salt used for general consumption was 20 mg KI/kg of NaCl, and in 1997 the mandatory supplementation of salt was 30 (+10) per kg of salt which has been introduced for the whole country. This paper reports the results of iodine excretion assays in school children 6-12 years old, in the years 1993--94, 1996--97 and 1999--2002 respectively. The obtained collections of iodine urine concentrations have shown distributions with a remarkable rightward skewness. Normalization of distributions required logarythmic transformation. The quartile values obtained for data collections from years 1992--94, 1996--97 and 1999--2002 have shown that in 5-7 years of iodine deficiency prevention program yielded increase in iodine excretion in morning urine samples by about 37.8 microg, while the iodine excretion median values increased from 63.5 mg/L in years 1992--1994 to 94.0 mg/L in years 1999--2001, respectively. The lower limits of iodine excretion ranges calculated as the mean value minus 2SD of transformed data for the years 1992--1994 amounted to: 7.74 mg/L and for the years 1999--2001 amounted to 14.1 microg/l, respectively. Assessing percent of children obtaining low iodine suplementation then recommended (below 50 mg/L in urine sample) amounted to 35.8% in years 1992--1994 and 15.4% in years 1999--2001 respectively.