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The practice of medicine is not always clear-cut. Healthcare providersare often faced with difficult decisions such as what test to perform on patients, what treatment should be given, and what type of follow-up is needed. Providers have a duty to enhance the wellbeing and minimize harm to their patients.

The basic problem shared by many of the biostatistical methods used in marker research is that they relate numbers to other numbers, rather than to anything that we might care about in the real world.

The role of branched-chain amino acids (BCAAs) in cardiovascular disease (CVD) remains poorly understood. We hypothesized that baseline BCAA concentrations predict future risk of CVD and that a Mediterranean diet (MedDiet) intervention may counteract this effect.

Pneumatic tube systems have become a primary way of automating the transport of clinical specimens in medical centers. These may travel within the floors of a building and also between buildings. Although this provides convenience and speed of transport, the excessive acceleration forces and the prolonged time and distance travelled have been linked to pre-analytical variation including hemolysis of blood specimens. As a result, it has been suggested that users regularly assess the forces encountered in a pneumatic tube system.

Postmarket surveillance is an important monitor of the safety of pharmaceuticals and medical devices after regulatory approval and entry to the market. Although premarket studies are substantial, costs prohibit examination of heterogeneous populations or rare events over long durations.

There are nearly 60,000 community pharmacies in the United States today. In addition to being sources of prescriptions and medications, they're also often a site for wellness visits, vaccinations, acute illness diagnosis and treatment, as well as monitoring of chronic disease. Pharmacies often offer a convenient alternative to physician offices because of their accessible locations and extended service hours. Approximately 18% of pharmacies in the U.S. have CLIA-waived status, which means they can perform any of the approximately 120 CLIA-waived tests. Many pharmacists help patients make drug dosage decisions in specialized centers such as coumadin in diabetes clinics. With pharmacists performing and interpreting more laboratory tests, what does this mean for the clinical laboratory community? Do pharmacists receive the proper training to perform and interpret laboratory tests? And how do we ensure the quality of testing?

Protease neprilysin is known to be responsible for the degradation of natriuretic peptides. A recent heart failure (HF) drug, LCZ696 (EntrestoTM), that combines a neprilysin inhibitor and an angiotensin II receptor inhibitor was suggested to augment circulating B-type natriuretic peptide (BNP) concentrations, making the results of BNP measurements diagnostically ambiguous. Because the main form of measured BNP in HF patients is represented by its uncleaved precursor, proBNP, it is important to know the susceptibility of proBNP to cleavage by neprilysin.

CREB-regulated transcription coactivator 3 (CRTC3) is found in adipocytes, where it may promote obesity through disruption of catecholamine signaling. We wished to assess whether CRTC3 is a soluble protein secreted by adipose tissue, explore whether CRTC3 is detectable and quantifiable in the circulation, and ascertain whether CRTC3 serum concentrations are related to metabolic markers in children.

The analysis of dried blood spots has been used routinely for newborn screening since the early 1970s, and the number of disorders screened has expanded substantially in recent years. However, there is a lack of evidence regarding minimum blood spot quality acceptance criteria for sample analysis.

This is the May 2016 issue of Clinical Chemistry, Volume 62, Issue 5.

For many years the determination of a routine lipid profile (total, LDL, and HDL cholesterol and triglycerides) has been done routinely in the clinical laboratory using a blood specimen that is collected in the fasting state.

Primary aldosteronism,also known as Conn's syndrome,is a form of endocrine hypertension that results from excess product of aldosterone by the adrenal glands.

PMore than 70 million couples worldwide are affected by infertility, with male-factor infertility accounting for about half of the cases. Semen analysis is critical for determining male fertility potential, but conventional testing is costly and complex. Here, we demonstrate a paper-based microfluidic approach to quantify male fertility potential, simultaneously measuring 3 critical semen parameters in 10 min: live and motile sperm concentrations and sperm motility.

This is the July 2016 issue of Clinical Chemistry, Volume 62, Issue 7.

This is the June 2016 issue of Clinical Chemistry, Volume 62, Issue 6.