Randox Health takes life-extending diagnostic service on the road

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Randox Health takes life-extending diagnostic service on the road

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03 September 2019

Randox Health Mobile Clinic

Do you know about our Mobile Health Service?

Clients of Randox Health are benefiting from “full-body MoTs” by providing blood samples in state-of-the-art Mobile Service clinics based on Mercedes-Benz Sprinters. The company’s phlebotomists use their strikingly styled vehicles to visit workplaces, gyms, private homes, and other locations, and provide an ultra-convenient service which can extend lives.

Randox Health is committed to identifying and preventing illness by detecting small changes in blood. Its patented diagnostic testing technology is capable of identifying up to 350 individual ‘biomarkers’ in a single sample. Randox Health operates clinics in Belfast, Liverpool and London, and introduced its first mobile unit in 2017. Such has been the demand from health-conscious clients throughout Ireland, that it has now added a second.

Based in Liverpool, the newer vehicle is from the latest-generation Sprinter range launched last year, which combines unprecedented levels of cab quality and comfort, with 4G wi-fi connectivity, and an industry-leading armoury of active and passive safety features. Like its predecessor, the 3.5-tonne 314 CDI L2 chassis cab was supplied by Intercounty Truck & Van, one of two members of the Mercedes-Benz Vans retail network whose parent company is Ballyvesey Holdings, of Newtownabbey, Northern Ireland.

Both vehicles’ purpose-designed bodies are the work of specialist coachbuilder Annard, of Loughall, County Armagh. Features include ‘pop out’ sections that address Randox Health’s requirement for additional floor space. With their aerodynamic enhancements, colour-coded door mirrors and bumpers, and alloy wheels, the Sprinters are real head-turners, and have attracted enthusiastic feedback from clients.

Explaining the rationale behind Randox Health’s decision to launch its mobile clinic service, Operations Manager Lauren Donaghy said: 

“Increasing demand from corporate clients and private individuals for our pioneering health checks meant we needed to come up with a solution which ensured they were accessible to all.

“Our mobile service was the answer, and by providing men and women, young and old, with what effectively amount to full-body MoTs, we’re now transforming the delivery of healthcare in the UK and Ireland.”

Lauren continued: “We provide a world-leading service, so naturally we were keen to partner with a world-leading automotive brand able to provide vehicles that offer the highest standards of reliability, comfort and safety.

“The name Mercedes-Benz is synonymous with quality, ingenuity and performance, so we knew it would be the perfect fit for our equally innovative and ambitious company. Ballyvesey Holdings, meanwhile, has worked with Mercedes-Benz for years, and came highly recommended. “With their bespoke design, the vehicles provide a perfect combination of phlebotomy functionality and patient comfort, while maintaining the look and feel of a high-end clinic room,” added Lauren Donaghy.

“People are able to book an appointment at a place of their choosing, and being able to undergo their health check in a luxurious Mercedes-Benz means the experience is first-class from start to finish.”

A world-leading health service

Mercedes-Benz Vans UK has been doing its bit to highlight issues of health and wellbeing affecting the UK’s community of van drivers, operators and owners, through its Business Barometer programme. In its latest bulletin, the manufacturer focused on poor quality diets and the apparent reluctance of many to visit a doctor, while previous instalments have covered everything from hydration in hot weather, to the affects of air pollution, and the high stress levels induced by a shortage of parking provision.

The Sprinter 314 CDI is powered by a fuel-efficient 2.1-litre common rail turbodiesel engine – although this model is now also available with front-wheel drive, as with its stablemate Randox Health’s new van transmits its 143 hp output via the rear wheels. Like all Mercedes-Benz vans, Randox Health’s Mobile Service vehicles are backed by three-year, unlimited mileage warranties and came with free MobiloVan cover, which includes round-the-clock emergency roadside assistance.

Randox Health: What We Do

Randox Health packages go beyond a health check. We have the world’s most comprehensive full-body health programmes available on the market today, thanks to Randox Biochips which enable hundreds of individual tests to be carried out from one sample and giving you truly unrivalled knowledge about your health and wellbeing both now and in the future. Our goal is to help you extend your life. Your health matters to us and, above all, we are committed to improving healthcare worldwide by identifying and preventing illness at the earliest possible stage.

How we can help you

Identifying the very first signs and risks of disease can help prevent health problems that may be on the horizon. Randox Health aim to do this before the appearance of unpleasant symptoms or illness. Prevention is always better than cure. Long-term mild dehydration may have caused damage to your health and our packages tests for up to 350 different biomarkers. Read about our packages here, or contact a member of our team for more information!

 

 

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Contact us or visit our Randox Health page to view more.

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Randox Food Diagnostics are attending AOAC Denver 2019

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30 August 2019

Randox Food Diagnostics are attending AOAC Denver 2019

Randox Food Diagnostics are exhibiting at AOAC in Denver. Various contaminants are administered to animals during the farming process to treat infection and maintain herd health. Regulations are often adhered to, as quality control procedures are put in place to ensure the safe supply of agricultural produce and this is where Biochip technology can streamline the quality control process. By offering a system that can analyse up to 48 sample simultaneously, our technology delivers higher throughput which in turn saves time and money on laboratory costs and labour.

Randox Food and Biochip Array Technology

Biochip Array technology (BAT) is designed with the aim of revolutionising the screening practices of your laboratory. Designed to work across a wide variety of matrices, BAT uses a micro-spotting technique to create an assay that can detect and provide quantitative results for up to 44 residues from a single sample.

The market leading 9mm x 9mm ceramic chip brings the capacity to detect the range of antibiotics, anti-parasitic, anti-inflammatory, growth promoting and mycotoxin residues simultaneously in a range of food and feed samples.

AOAC’s annual meeting is taking place this September in Denver. The meeting organises scientific sessions, roundtable discussions, workshops and poster presentations discussing a variety of analytical methods and requirements. Attended by scientists from across the world the conference discusses science at a different level.

At AOAC Denver you will get the opportunity to speak to our experts on the Biochip Array Technology. By visiting booth #416 you will get an introduction to BAT and find out how the technology can perfectly fit any of your screening needs.

To learn more about Biochip Array Technology contact info@randoxfooddiagnostics.com or stop by Booth #416 at AOAC Denver 2019 and chat the Randox Food team!

Find out more about AOAC.

Want to know more?

Contact us or visit our Randox Food Diagnostics website.

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Flexible Drug and Alcohol Testing Methods

06 August 2019

Flexible Drug and Alcohol Testing Methods

At Randox Testing Services our complete testing solutions include flexible drug and alcohol testing methods that can be tailored to meet our customer needs. In all aspects of testing we ensure the accuracy and reliability of results and utilise strict chain of custody procedures across all our testing methods.

To guarantee the most effective form of testing our dedicated Account Managers make informed recommendations to our customers on what type of testing best suits their business needs. The different methods are outlined below along with the sample types that can be tested:

Drug and Alcohol Testing Methods

  • Abstinence Monitoring

Conducted as a follow up on a confirmed positive drug or alcohol test. If an employer provides support to an employee who has had a confirmed positive drug or alcohol test, this type of testing may be used to help with rehabilitation.

  • Post-Incident

Used to determine if drugs or alcohol may have contributed to an accident/incident in the workplace. This type of testing can be an effective tool in accident investigations and it is our recommendation that should an incident occur, all employees involved should be tested.

  • Pre-Employment

This is the most popular type of workplace testing especially in industries which have safety critical roles. This type of testing is an essential part of a company’s recruitment process and clearly states the company’s position on drug and alcohol misuse for any potential employee.

  • Random

A popular type of testing within workplaces as it acts as a deterrent to drug and alcohol abuse. A company’s drug and alcohol testing policy should clearly outline that they carry out random workplace testing ensuring employees do not know when the event is planned.

  • With-Cause

Performed when a company is suspicious that an employee may be currently under the influence of alcohol or misusing drugs. This suspicion is normally raised if an employee is acting out of character and there has been observed different behaviours.

Sample Types

  • Urine (Alcohol and Drugs)

The most common sample type for drug testing and offers a longer detection window than oral fluid for drugs.

  • Oral Fluid (Drugs only)

Oral fluid testing analyses a saliva sample for parent drugs and their metabolites, providing analysis of short-term drug abuse.

  • Hair (Alcohol and Drugs)

A hair drugs test offers a longer window of detection than alternative testing and can provide a detailed view or overall picture of drug use. Detection window is based on hair length with 1cm of head equating to approximately 1 month of detection.

  • Breath (Alcohol only)

Breath can be tested for alcohol using hand-held devices which provide immediate results. These devices can gauge blood alcohol content (BAC) by measuring deep lung air.

About Randox Testing Services

Randox Testing Services is a market leader in the drug and alcohol testing industry. Our expertise is relied upon by a range of leading safety-critical companies across the world.

We pride ourselves on helping our customers improve the health and safety of their working environment through helping them implement a comprehensive substance misuse policy. Our expertise within this industry allows us to craft customised packages to meet the testing needs of any workplace. Our drug and alcohol testing methods are flexible to adapt to any changes and our testing processes are accurate, to guarantee reliable results.

Contact us today be at testingservices@randox.com or call 028 9445 1011 to speak to one of our experts.

Want to know more?

Contact us or visit our website to read more.


Drugs of Abuse – A Global Pandemic

4th September 2019

Drugs of Abuse – A Global Pandemic

The prevalence of drug addiction and abuse across the globe has become a growing concern. It is currently estimated that 71 million people use drugs of abuse with around 166,000 direct deaths occurring from drug use in 2017.

The WHO (World Health Organisation) estimate that 11 million people inject drugs across the globe, of which 1.3 million are living with HIV, 5.5 million with hepatitis C, and 1 million with both HIV and hepatitis C. In addition to infectious disease, long term drug abuse increases the risk of several cancers, cardiovascular effects, respiratory effects, gastrointestinal effects, kidney & liver damage and mental health issues.

The abuse of drugs is one of the most pressing issues in the USA and other countries globally. Drug abuse not only affects the individual, but can also have far-reaching consequences that affect family, employment, personal health, health care systems, local communities, and society as a whole.

Global Drug Abuse – The buzz that keeps on going!

> Misuse of illicit drugs affects society through secondary costs incurred such as crime, reduced productivity at work, and health care expenses.

> Substance abuse costs the US health care system about $11 billion, with overall costs reaching $193 billion.

> Substance abuse and addiction also affects other areas of life leading to broken families, destroyed careers, death due to negligence or accident, domestic violence, physical abuse and child abuse.

> Drug abuse and addiction changes the chemistry of your brain. The longer an individual abuses drugs, the more damage is caused, making it more difficult to return to ‘normal’ during drug rehabilitation.

> Treating and tackling drug addiction is a challenge. As drug treatment and health services continue to fall short, there is an increased need to continuously adapt drug detection and analysis.

Randox laboratories are at the forefront, aiding the fight against drugs of abuse with a comprehensive range of 10 drugs of abuse assays including several stimulants, sedatives and opioids available to run on Randox’s very own clinical chemistry analysers, the RX series. To find out now how Randox is helping to tackle the ongoing prevalence of drugs of abuse click here or buy directly from the Randox Online Store.

About Randox Laboratories

    As a world leader in the in-vitro diagnostic industry with over 35 years’ experience, Randox is leading the charge in moving from a one-size-fits-all approach towards decisions, practices and products tailored to the needs of the individual.  This innovative approach to diagnostics has facilitated the development of revolutionary products designed specifically to enhance a patients’ quality of life.

    Want to know more?

    Contact us or visit our Drugs of Abuse pages to learn more.

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    • References


    What Do You Know about Dehydration?

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    News       Getting Fit        Eating Healthy

    02 August 2019

    What do you know about Dehydration?

    Dehydration: Do you know the signs?

    Dry mouth with thick saliva, headaches, feeling sleepy or irritable, weakness, dizziness made worse when you are standing… sounds like a hangover, right? These are actually all symptoms of early to mild dehydration.

    While not a hangover, this can happen from drinking alcohol as it suppresses your production of a hormone called vasopressin. This hormone would normally tell your kidneys to reabsorb water rather than passing it along to your bladder – which explains the ten trips to the bathroom on a night out –  and also makes your hangover worse the next day. Below are a list of dehydration signs to look out for:

     

     

    Early or mild dehydration include:

    • Flushed face
    • Extreme thirst or unable to drink
    • Dry, warm skin
    • Can’t pass urine or reduced amounts, dark yellow colour
    • Dizziness, made worse when you are standing
    • Feeling Weak
    • Cramping in the arms and legs
    • Sleepy or irritable
    • Headaches
    • Dry mouth with thick saliva

    Moderate to severe dehydration include:

    • Heart failure
    • Low blood pressure
    • Fainting
    • Convulsions
    • Sunken dry eyes
    • Fast but weak pulse
    • Severe muscle contractions in the arms, legs or back
    • Bloated stomach
    • Skin loses its firmness and looks wrinkled
    • Rapid and deep breathing – faster than normal
    • Lack of elasticity of the skin

    Are you at risk?

    While anyone can become dehydrated, there are certain groups that are particularly at risk such as infants, older people, diabetics and athletes. But what can you do to prevent dehydration? Drink plenty of fluids. Water is the best fluid to drink when dehydrated but also having a non-fizzy, low sugar sports drink will help to replace electrolytes that have been lost. These are minerals the body needs such as chloride, calcium, magnesium, sodium and potassium. Long term dehydration can have serious effects on your health.

     

    Randox Health: What We Do

    Randox Health packages go beyond a health check. We have the world’s most comprehensive full-body health programmes available on the market today, thanks to Randox Biochips which enable hundreds of individual tests to be carried out from one sample and giving you truly unrivalled knowledge about your health and wellbeing both now and in the future. Our goal is to help you extend your life. Your health matters to us and, above all, we are committed to improving healthcare worldwide by identifying and preventing illness at the earliest possible stage.

     

    How we can help you? 

    Identifying the very first signs and risks of disease can help prevent health problems that may be on the horizon. Randox Health aim to do this before the appearance of unpleasant symptoms or illness. Prevention is always better than cure. Long-term mild dehydration may have caused damage to your health and our packages tests for up to 350 different biomarkers. Read about our packages here, or contact a member of our team for more information!

    Want to know more?

    Contact us or visit our Randox Health page to view more.

    Our Randox Health programmes

    Everyman

    Everywoman

    Signature

    Specialised testing


    Total Bile Acids: The Value of Fifth Generation Tests

    22 July 2019

    Total Bile Acids: The Value of Fifth Generation Tests

    Bile acids are water-soluble, amphipathic end products of cholesterol metabolism and are involved in liver, biliary and intestinal diseases. They are formed in the liver and are absorbed in the small intestine before being excreted. The fundamental role of bile acids is to aid in the digestion and absorption of fats and fat-soluble vitamins in the small intestine.1

    Intrahepatic Cholestasis of Pregnancy

    Intrahepatic cholestasis of pregnancy (ICP) is a pregnancy-specific liver disorder. It can be indicated by pruritus, jaundice, elevated total bile acids and/or serum transaminases and usually affects women during the second and third trimester of pregnancy.2,3

    Intrahepatic Cholestasis of pregnancy or Obstetric Cholestasis is a condition that restricts the flow of bile through the gallbladder resulting in a build-up of bile acids in the liver.3 Due to the build-up, bile acids leak into the bloodstream where they are detected at concerning levels. It is an extremely serious complication of pregnancy that can lead to the increased risk of premature birth or even stillbirth, as such it is vital that women with the disease are monitored carefully.

    In healthy pregnancies, there is very little increase in total bile acid levels although a slight increase is likely to be seen in the third trimester. Measurement of total bile acids in serum is thought to be the most suitable method of diagnosing and monitoring ICP.6

    According to several reports total bile acid levels in ICP can reach as high as 100 times the upper limit of a normal pregnancy. It has been reported that a doubling in maternal serum bile acids, results in a 200% increased risk of stillbirth with total bile acids thought to trigger the onset of preterm labour. Additionally, bile acids can affect the foetal cardiovascular system as it has been found that there are often cardiac rhythm disturbances in the foetus due to the elevated bile acids in circulation.5

    Although it is a rare condition, with only 0.3-0.5% of women likely to develop ICP, it can have extreme risks and so it is important to properly diagnose and monitor the condition.6 ICP increases the risk of meconium staining of the amniotic fluid and is reported to be a sign of foetal distress. This complication is found in 16-58% of all ICP cases, worryingly 100% of cases have resulted in foetal death. The frequency of this condition is found to be greater in pregnancies with higher levels of serum total bile acids.

    Did you know?

    Liver disease is the only major cause of death still increasing every year with 2 million deaths per year being caused by it.4

    Risk factors

    There are several risk factors associated with ICP such as a family history of ICP, use of oral contraceptives, assisted reproduction techniques and multiple gestation. Genetic influence accounts for approximately 15% of ICP cases. Dietary selenium is a contributing environmental factor as serum selenium levels often decrease throughout pregnancy. Further to this, incidences of ICP rise in the winter months, most likely due to the fact selenium levels are naturally less during these months.7,8

    Total Bile Acids

    In addition to ICP, bile acid levels are also measured in the diagnosis of other liver disorders. The bile acids test in an extremely sensitive indicator of liver function, capable of detecting changes in hepatic function before clinical symptoms arise, thus providing valuable information that standard liver function tests cannot. As a result of its high sensitivity, bile acids can be used to assess liver function in transplant patients, allowing monitoring of the transplant success and of antirejection therapy. The bile acids test is most beneficial when used in conjunction with standard liver function tests such as ALT and AST which are markers of liver damage rather than liver function.

    Measurement of Total Bile Acids

    The enzyme cycling method, also known as the Fifth Generation Bile Acids test, is a method that allows for signal amplification through cycled regeneration reactions as can be seen in Figure 1. In the presence of Thio-NAD, the enzyme 3-α hydroxysteroid dehydrogenase (3-α  HSD) converts bile acids to 3-keto steroids and Thio-NADH.  The reaction is reversible and 3-α  HSD can convert 3-keto steroids and Thio-NADH to bile acids and Thio-NAD.  In the presence of excess NADH, the enzyme cycling occurs efficiently and the rate of formation of Thio-NADH is determined by measuring specific change of absorbance at 405 nm and is proportional to the amount of total bile acids in the sample. The analysing capability of the fifth generation total bile acids assay is far beyond the performance of conventional bile acid tests.10,11

    Figure 1: The assay principle

    Inadequacies of Traditional Bile Acids Assays

    Determining the cause and extent of liver damage is important in guiding treatment decisions and preventing disease progression. Standard liver function tests include; ALT, AST, ALP, GGT and Bilirubin. The measurement of TBA is most beneficial in conjunction with these standard liver tests and offers unrivalled sensitivity allowing identification of early stage liver dysfunction. There are several commercial methods available for the detection and measurement of TBA in serum. Traditional TBA tests based on the enzymatic method use nitrotetrazolium blue (NBT) to form a formazan dye. The reaction is measured at 546nm and the intensity of the colour is proportional to the concentration of bile acids.

    Newer methods such as the enzyme cycling method or fifth generation methods offer many advantages including greater sensitivity, liquid reagents, small sample volumes and reduced instrument contamination from formazan dye. Additionally, the fifth generation assay does not suffer from interference from lipaemic or haemolytic samples. Both lipemia and haemolysis are common in new-borns and pregnant women, so this further supports that the fifth generation test is more sensitive for these sample types.12

    Want to know more?

    Contact us or download our total bile acids whitepaper

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    • References

      [1] The continuing importance of bile acids in liver and intestinal disease. A.f., Hofmann. 1999, Arch Intern Med, pp. 2647-2658.

      [2] Diagnostic and Therapeutic Profiles of Serum Bile Acids in Women with Intrahepatic Cholestasis of Pregnancy – A Pseudo-Targeted Metabolomics Study. Cui, Yue. Xu, Biao. Zhang, Xiaoqing. He, Yifan. Shao, Yong. Ding, Min. s.l. : Clinica Chimica, 2018, Vol. 483.

      [3] Randox Laboratories. Bile Acids Test for Obstetric Cholestasis – A serious complication of pregnancy. 2012.

      [4] British Liver Trust (2019) Facts about Liver Disease, Available at: https://www.britishlivertrust.org.uk/about-us/media-centre/facts-about-liver-disease/ (Accessed: 18th June 2019).

      [5] .Geenes, Victoria. Williamson, Catherine. 17, s.l. : World J Gastroenterol, 2009, Vol. 15.

      [6] Howland, Genevieve. Cholestasis of Pregnancy: Why You Can’t Ditch the Itch. Mama Natural. [Online] December 22, 2018. [Cited: February 19, 2019.] https://www.mamanatural.com/cholestasis-of-pregnancy/.

      [7] Bile Acid Levels and Risk of Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Meta-Analysis. Cui, Donghua, et al.

      [8] Intrahepatic Cholestasis of Pregnancy. Chivers, Sian. Williamson, Catherine. 7, 2018, Vol. 28.

      [9] Masoud, N; Neill, S.H. Serum bile acids as a sensitive biological marker for evaluating hepatic effects of organic solvents. Available from URL: https://www.ncbi.nlm.nih.gov/pubmed/23885947 [Accessed 1 November 2018]

      [10] Microassay of Serum Bile Acids by an Enzymatic Cycling Method. Komiyama, Y, et al. 10, s.l. : Chemical and Pharmaceutical Bulletin, 1982, Vol. 30.

      [11] Evaluation of a Colorimetric Enzymatic Procedure for Determining the Total Bile Acids in the Blood. Agape, V, et al. 3, s.l. : Minerva Gastroenterologica e Dietologica, 1989, Vol. 35.

      [12] Total Bile Acids Test & Clinical Diagnosis. Diazyme. 2019.


    Diabetes: The Role of Fructosamine

    13 June 2019

    Diabetes: The Role of Fructosamine

    Diabetes Week is an annual week to raise awareness of diabetes. This year, the aim is to increase the public’s understanding of diabetes 1. Diabetes mellitus (DM) is a global epidemic, increasing at an alarming rate and burdening healthcare systems 2.  DM is a life-long condition characterised by the body’s inability to produce / respond to insulin resulting in the abnormal metabolism of carbohydrates and elevated blood glucose levels.

    Whilst it is important to increase the public’s understanding of DM, it is imperative that clinicians and physicians are aware of the different in vitro diagnostic tests to diagnose and monitor DM. Not only is this vital, but is also important that clinicians and physicians also understand the different methodologies available when choosing the diagnostic test.

    It has been highlighted in numerous clinical studies that diabetic complications may be reduced through the long-term monitoring and tight control of blood glucose levels. Both fasting plasma glucose (FPG) and glycated haemoglobin A1c (HbA1c) tests are universally accepted as reliable measurements of diabetic control. However, studies have emerged highlighting the role of fructosamine in diabetes monitoring. Whilst HbA1c provides an index of glycaemia over 2 to 3 months, fructosamine provides this index over the course of 2 to 3 weeks, enabling closer monitoring of diabetic control 1.

    Did you know?

    Diabetes is estimated to be the seventh leading cause of death with 1.6 million deaths attributed to diabetes in 2016 3

    Drawbacks of Traditional Diabetes Tests

    The FPG test measures the level of blood sugars which is used to diagnose and monitor diabetes based on insulin function. The main drawback of this test is that a hormone called glucagon, produced in the pancreas, is triggered during prolonged fasting, signalling the liver to release glucose into the bloodstream. In diabetic conditions, either the body is unable to generate enough insulin or cannot appropriately respond to insulin. Consequently, FPG levels remain high 4.

    In the 1980’s, HbA1c was incorporated into clinical practice as HbA1c levels correlated well with glycaemic control over a 2 to 3-month period. The main drawback of this test is that any condition that reduces the survival rate of erythrocytes such as haemolytic anaemia will falsely lower the HbA1c test results, regardless of the assay method utilised 5.

    Fructosamine Testing

    In a diabetic patient where blood glucose levels are abnormally elevated, the concentration levels of fructosamine also increase as fructosamine is formed by a non-enzymatic Maillard reaction between glucose and amino acid residues of proteins. During this glycation process, an intermediate labile Schiff base is produced which is converted to a more stable ketoamine (fructosamine) via an Amadori rearrangement 2.

    Fructosamine has been identified as an early indicator of diabetic control compared to other markers such as HbA1c. Red blood cells live for approximately 120 days, HbA1c represents the average blood glucose levels for the previous 2 to 3 months. Conversely fructosamine has a shorter lifespan, about 14 to 21 days, reflecting average blood glucose levels from the previous 2 to 3 weeks. Due to the shorter time span of fructosamine, it is also used to evaluate the effectiveness of medication changes and to monitor the treatment of gestational diabetes. The test is also particularly useful in situations where HbA1c cannot be reliably measured e.g. haemolytic anaemia, thalassemia or with genetic haemoglobin variants 5.

    Fructosamine Assay Methodology

    The most commonly utilised method for fructosamine testing is the colorimetric method. Whilst widely available, automated and inexpensive, the main drawback is the lack of standardisation across the different fructosamine assays 4.

    Randox, on the other hand, utilise an enzymatic method, offering improved specificity and reliability compared to conventional NBT-based methods. The Randox enzymatic method does not suffer from non-specific interferences unlike existing methods which can also be time consuming and difficult to automate.

    The Randox fructosamine assay is also standardised to the highest level as the Randox fructosamine calibrator and control is assigned relative to human serum glycated with 14C-glucose, which directly reflects the nature of the patient sample.

    With an excellent stability of 28 days on-board the analyser, the Randox fructosamine assay is developed in a liquid ready-to-use format for convenience and ease-of-use.

    Randox offer fully automated applications detailing instrument-specific settings for the convenient use of the Randox fructosamine assay on a wide range of clinical chemistry analysers.

    Want to know more?

    Contact us or download our diabetes brochure

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    Aldolase: A Myositis Biomarker

    29 May 2019

    Aldolase: A Myositis Biomarker

    The month of May is devoted to myositis awareness, a muscle-wasting disease resulting in reduced muscle strength and fatigue. The term ‘myositis’ is an umbrella term referring to the “general inflammation or swelling of the muscle”.  However, myositis is more often referred to as a disease involving chronic inflammation of the muscles which does not improve with rest. This condition is also known as idiopathic inflammatory myopathy (IIM) 1.

    Myositis is an autoimmune disease characterised by pain, muscle weaknesses, swelling and extreme fatigue which often gradually appear. Myositis can be potentially life-threatening, especially dermatomyositis which affects the heart muscle and lungs. Whilst a rare disease, it is estimated that 75,000 Americans suffer from myositis, however, many are undiagnosed or misdiagnosed with more common autoimmune diseases. Most physicians are unfamiliar with the disease and symptoms and so the consequences of this can be catastrophic in terms of long-term physical muscle damage, disability and even death 1, 2, 3.

    Did you know?

    5,000 to 6,000 people in the UK have a form of myositis 3.

    Table 1 reviews the different forms of myositis

    A table comparing the different types of Myositis

    Table 2 reviews complications with or due to myositis

    Complications with or due to Myositis

    It is vital that physicians are educated to include myositis despite it being a rare disease as it is essential that myositis patients are diagnosed quickly to ensure appropriate treatment plans are implemented.

    Aldolase Testing

    Aldolase testing has been recognised as a marker in the differential diagnosis of muscle weakness as aldolase levels remain consistent where weakness is caused by neurological problems such as multiple sclerosis (MS). Aldolase is an enzyme specifically found in skeletal muscle and the liver. When either the muscle or liver are damaged, aldolase is released into the bloodstream 13 . A few studies support aldolase testing in the diagnosis of myositis:

     1.  Arthritis Research & Therapy (2012): Aldolase predicts subsequent myopathy occurrence in systemic sclerosis 14

    Objective:

    A French monocentric 4-year study prospectively evaluated n=137 systemic sclerosis (SSc) patients without proximal muscle weakness to assess the risk of myopathy related systemic sclerosis (Myo-SSc) according to the European Neuro Muscular Centre criteria. Aldolase, creatine kinase (CK), C-reactive protein (CRP), alanine transaminase (ALT) and aspartate transaminase (AST) were evaluated.

    Conclusion:

    Aldolase is a valuable diagnostic tool in the identification of SSc patients at a high risk of developing subsequent Myo-SSc. This enables clinicians to monitor at-risk patients as well as identifying Myo-SSc in its earliest stages, enabling the effective and swift implementation of an appropriate treatment plan when the muscle damage is still in a reversible stage.

    Findings:

    2.  Clinical and Experimental Rheumatology (2013): Isolated elevation of aldolase in the serum of myositis patients: a potential biomarker of damaged early regenerating muscle cells 15

    Objective:

    The in vitro analysis of the gene and protein expression levels of aldolase and CK during muscle cell differentiation.

    Conclusion:

    Aldolase A is expressed in the absence of CK in undifferentiated muscle cells and in the early differentiation process. Isolated elevated serum aldolase A in myositis patients reflects preferential immune-mediated damage of early regenerative cells. Aldolase is a biomarker of damaged early regenerating muscle cells.

    Findings:

    Myositis can be a potentially life-threatening disease when undiagnosed or misdiagnosed. Aldolase is recognised as a biomarker in the diagnosis and monitoring of myositis. Randox are one of the only in-vitro diagnostic manufacturers to offer the aldolase assay in an automated and manual biochemistry format. Not only does the Randox methodology have an excellent correlation coefficient to r=0.9917 when compared against standard methods, the Randox assay is lyophilised for enhanced stability with an excellent measuring range of 1.73 – 106U/l. Moreover, applications are available detailing instrument-specific settings for the convenient use of the Randox aldolase assay on a wide range of clinical chemistry analysers.

    Want to know more?

    Contact us or download our high performance & unique tests brochure

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    Trade Release – Randox RX daytona+ (FDA) 510 (K) Clearance

    24th May 2019

    (FDA) 510 (K) Clearance

    Randox RX daytona+ (FDA) 510 (K) Clearance

    Randox Laboratories a world leader in the in-vitro diagnostic industry with over 35 years’ experience is pleased to announce 510K clearance from the U.S. Food and Drug Administration for the RX daytona+ clinical chemistry analyzer. Renowned for quality and reliability, the RX series leads the way with the world’s most extensive dedicated clinical chemistry test menu comprising routine chemistries, specific proteins, lipids, therapeutic drugs, drugs of abuse, antioxidants, diabetes and veterinary testing. Guaranteeing real cost savings through consolidation of routine and specialized tests onto a single platform, the RX series of analyzers offers excellence in patient care, delivering unrivalled precision, accuracy and reliability.

    The RX daytona+ fully automated, benchtop, clinical chemistry analyzer is capable of performing high quality testing including emergency STAT sampling and boasts a combined throughput of 450 tests per hour including ISE. The most versatile chemistry analyzer in its class, the RX daytona+ presents laboratories with a range of benefits offering optimum performance, unrivalled uptime, flexibility, efficiency and functionality.

    Randox have a long history of being at the forefront of diagnostic testing and have brought to market a range of innovative and versatile clinical chemistry analyzers developed to revolutionize patient testing in a variety of laboratory types including; Clinical Laboratories, University & Research Institutes, Veterinary Laboratories and Food & Wine Laboratories. The capabilities of the RX daytona+ exceed in any laboratory setting regardless of size, boasting an array of innovative features, including a significant reduction in sample volume of just 1.5-35 µl with a sample dead volume of 150 µl for standard and 100 µl for pediatric samples.

    The RX daytona+ presents excellent functionality with easy to use Windows 10 based software, minimal maintenance and advanced QC capabilities generating Levey-Jennings charts, calibration curves and QC statistics all contributing to the increased precision, accuracy and reliability the RX series is famed for. As a performance advantage, the RX daytona+ provides laboratories with the ability to consolidate a wide variety of routine and specialized tests onto a single platform with excellent correlation to gold standard methodologies. Providing laboratories globally with efficiencies in time, money, ease of use, unrivalled uptime and superior technical support, the RX daytona+ is the most advanced and versatile clinical chemistry analyzer available.

    Timothy Lenz – Regional Sales Manager USA

    “The RX Daytona+ receiving FDA 510K clearance will provide a much-needed addition to the US clinical laboratory market. The RX Daytona+ serves the needs of lower throughput, moderate complexity labs, while still offering many of the features found on larger floor-standing analyzers – full automation, ability to process bar-coded samples in primary tubes, variable speed paddle mixers, and dedicated sample and reagent probes, all on a versatile platform with low operating costs and maintenance requirements. The high-quality construction of the RX Daytona+ ensures an incredibly reliable platform with the lowest downtime figures in its class. The wide testing menu of the RX Daytona+ allows labs to bring additional profitable testing in-house, so that results can be returned more quickly, and diagnoses/treatment plans formulated without delay. Randox is the only company that can truly provide a single-vendor solution for clinical chemistry testing – reliable analyzers, dedicated reagents, and third-party QC materials, all from the same provider.”

    About Randox Laboratories

    As a world leader in the in-vitro diagnostic industry with over 35 years’ experience, Randox is leading the charge in moving from a one-size-fits-all approach towards decisions, practices and products tailored to the needs of the individual.  This innovative approach to diagnostics has facilitated the development of revolutionary products designed specifically to enhance a patients’ quality of life.

    Want to know more?

    Contact us or visit our RX page to learn more.

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    • References


    Could H-FABP Have Potential Benefits in Diagnostics Beyond Cardiac Health Problems?

    14th March 2019

    Could H-FABP Have Potential Benefits in Diagnostics Beyond Cardiac Health Problems?

    To date, the most traditional diagnostic test for renal impairment is creatinine. However, although most commonly used, problems can arise when implementing this test as a number of factors are not considered. On this World Kidney Day, Randox will explore the potential utility of H-FABP as a clinical diagnostic marker for cardiac surgery-associated acute kidney injury.

    Acute Kidney Injury (AKI) is defined as an acute decline in renal function that can lead to structural changes. It involves a sudden drop in kidney function that usually arises due to a complication of another serious illness such as impaired renal perfusion, exposure to nephrotoxins, outflow obstruction or intrinsic renal disease. As a result, a patient can experience effects such as impaired clearance and regulation of homeostasis, altered acid/base and electrolyte regulation and impaired volume regulation.1

    The mortality rate associated with AKI varies depending on severity, patient related factors and setting including whether the patient is in intensive care (ICU) or not.2 In the UK, AKI has been found to affect 1 in 5 people admitted to hospital as an emergency and has been found to be deadlier than a heart attack, contributing to around 100,000 deaths each year. Conversely, in the US, age-standardized rates of acute kidney injury hospitalisations increased by 139% among adults with diagnosed diabetes and by 230% among those without diabetes.3, 4

    The rising incidence of AKI comes at price. Patients tend to survive ICU but will be discharged with various degrees of chronic kidney disease (CKD), placing an increasing strain on the health care system. At present, the cost to the NHS is estimated to be between £434 and £620 million, which is more than the costs associated with breast cancer, or lung and skin cancer combined. However, this increased cost and strain could be unnecessary, as research has shown that 30% of the reported 100,000 deaths in the UK could have been prevented with the right care and treatment.3,4

    These unfavourable statistics are the result of late detection of AKI, as to date, a superior method of detection has not been found.

    Cardiac surgery-associated acute kidney injury (CSA-AKI)

    CSA-AKI is a well-recognised postoperative complication of cardiac surgery and is the second most common cause of AKI in the intensive care unit, occurring in up to 30% of patients.5,6 Of these patients, an estimated 1% will require dialysis and the majority will remain dependent on dialysis leading to an increase in mortality. Certain patient groups are more susceptible to CSA-AKI and vulnerability can depend on age, sex, pre-existing cardiac dysfunction, pre-existing CKD, previous cardiac surgery or comorbidity.7

    The pathogenesis of AKI involves multiple pathways including hemodynamic, inflammatory and nephrotoxic factors that overlap  leading to kidney injury.6 Figure 1 illustrates the pathophysiology of AKI following cardiac surgery. It shows that there are multiple physiological processes that are associated with the development of AKI as a result of cardiac surgery.8

    Figure 1 Illustrates the pathophysiology of AKI following cardiac surgery and the various mechanisms that contribute.8

    What is H-FABP?

    Fatty acid-binding proteins (FABPs) are small cytoplasmic proteins that are abundantly expressed in tissues with an active fatty acid metabolism, with their primary function being the facilitation of intracellular long-chain fatty acid transport.9 Elevated FABP serum concentrations are related to a number of common comorbidities including heart failure, CKD, diabetes mellitus and metabolic syndrome, which represent important risk factors for postoperative AKI.10

    H-FABP is most commonly associated with being a marker for acute coronary syndrome (ACS) as its concentrations peak at approximately 6-8 hours after symptom onset, making it easier to detect. Recently studies have highlighted H-FABP as a potential biomarker for the detection of AKI after cardiac surgery. This potential would mean earlier diagnosis of patients, reducing the mortality rate and costs to the health service.

    Potential Mechanism for the release of H-FABP in AKI

    There are a number of hypotheses regarding the release of H-FABP, with myocardial injury being considered the major reason for an increased level. The mechanisms involved in this increase have been found to differ depending on the severity of a patients ACS situation including whether they are in ICU.11

    One possible explanation for the release of H-FABP is the effects of ischemic stress. Ischemic stress induced by non-cardiogenic shock is a type of mechanical stretching which can lead to the leakage of small amounts of macromolecules. This process would lead to the release of H-FABP into the blood. In non-cardiac patients, minor myocardial injury alone may not adequately explain this observed increase. Other factors such as a reduction in the amount of skeletal muscle tissue, lipid disorders, release of free radicals and an increase in free acids produced by the catabolism of glycogen could also contribute to a rise in H-FABP levels.11

    One final process that could lead to increased H-FABP is the damage of vital organ functions which occurs in almost all non-surgical intensive care patients. The degree of leakage of H-FABP may vary depending on the severity of a patient’s condition and whether they have suffered from multiple organ failure or vital organ damage. AKI is a component of multiple organ failure suggesting that serum H-FABP levels may increase in AKI patients as a result. Also, serum H-FABP is excreted by renal tubular cells and patients with an acutely diminished renal function are unable to clear large amounts of H-FABP resulting in increasing levels. These potential mechanisms of H-FABP and its release during AKI provide further confirmation that the measurement of serum H-FABP is an effective biomarker in patients with AKI.11

    Comparison of H-FABP Measurement Against Traditional Acute Kidney Disease Measurement Tools

    For years, no standard method for definition or diagnosis  was in place for AKI. The RIFLE classification was introduced in 2004, which defined and staged renal failure over seven days into five classes of increasing severity including; risk, injury, failure, loss and end-stage kidney disease.

    The RIFLE criteria were then revised by the Acute Kidney Injury Network (AKIN) and introduced four main changes including replacing the period of seven days for serum creatinine (SCr) with forty eight  hours and implementing SCr changes as low as 0.3 mg/dL as the lowest measure considered as AKI. However, despite these changes the Kidney Disease Improving Global Outcome (KDIGO) proposed that AKI is defined when any of the three criteria are met including increase in SCr by 50% in seven days, increase in SCr > 0.3 mg/dL or oliguria.7

    However, despite these advances, identification and management of AKI is still difficult for two main reasons. The change of SCr does not occur until two to three days after the initial insult. Also, serum creatinine can rise for a variety of reasons such as tubular injury, hemodynamic alterations or cardio-renal interactions.

    The utility of SCr as biomarker for CSA- AKI is questionable as changes occur 48 hours to seven days after the original insult.5 The delays in diagnosis of CSA-AKI may have detrimental effects as prolonging the diagnosis period may result in the disease already being well established.12

    Also, a main issue concerning the AKI criteria established is its relevance to the perioperative period. Many surgical patients arrive in hospital without preoperative SCr concentrations being measured, potentially leading to over-diagnosis of AKI. However, when patients do arrive with a preoperative SCr concentration, the opposite can occur and immediate postoperative period SCr concentrations can be lower than baseline as a result of haemodilution.  A comparison of the postoperative and preoperative values can lead to under-diagnosis of AKI and consequently delayed treatment.12

    The research conducted has illustrated that SCr is not the most appropriate biomarker for diagnosis of AKI. Studies have demonstrated that H-FABP has more clinical utility and is released less than thirty minutes after myocardial injury and renally excreted within 24 hours, showing that as a biomarker it responds faster than creatinine.12

    How Randox can Help

    The Randox H-FABP test tests utilises an immunoturbidimetric method, offers a wide measuring range and is available liquid ready-to-use for convenience and ease of use.

    Want to know more?

    Contact us or visit the Randox H-FABP Site

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    Resource Hub

    • References

      1. National Kidney Foundation. Acute Kidney Injury (AKI). National Kidney Foundation. [Online] National Kidney Foundation. [Cited: February 3, 2019.] https://www.kidney.org/atoz/content/AcuteKidneyInjury.
      2. Biomarkers for the prediction of acute kidney injury: a narrative review on current status and future challenges. Geus, de, MG, Betjes and J , Bakker. 2, s.l. : NCBI, 2012, Vol. 5.
      3. Kidney Care UK. A range of useful facts and stats about kidneys. Kidney Care UK. [Online] Kidney Care UK. [Cited: February 15, 2019.] https://www.kidneycareuk.org/news-and-campaigns/facts-and-stats/.
      4. Centers for Disease Control and Prevention. Trends in Hospitalizations for Acute Kidney Injury — United States, 2000–2014. Centers for Disease Control and Prevention. [Online] Centers for Disease Control and Prevention, March 16, 2018. [Cited: February 22, 2019.] https://www.cdc.gov/mmwr/volumes/67/wr/mm6710a2.htm.
      5. Cardiac Surgery-Associated Acute Kidney Injury. Mao, h, et al. s.l. : Karger, 2013, Vol. 3.
      6. Acute Kidney Injury Associated with Cardiac Surgery. Rosner, Mitchell and Okusa, Mark. 1, s.l. : Clinical Journal of American Society of Nephrology, 2016, Vol. 1.
      7. Cardiac surgery-associated acute kidney injury. Loubon, Christian, et al. 4, s.l. : NCBI, 2016, Vol. 19.
      8. Acute kidney injury following cardiac surgery: current understanding and future directions. O’Neal, Jason, Shaw, Andrew and Billings, Frederic. s.l. : NCBI, 2016, Vol. 20.
      9. Heart-type fatty acid-binding protein predicts long-term mortality after acute coronary syndrome and identifieshigh-risk patients across the range of troponin values. Kilcullen, N, et al. 20, s.l. : Epub, 2012, Vol. 50.
      10. Preoperative serum h-FABP concentration is associated with postoperative incidence of acute kidney injury in patients undergoing cardiac surgery. Oezkur, Mehmet, et al. 117, s.l. : BMC Cardiovascular Disorders, 2014, Vol. 14.
      11. The serum heart-type fatty acid-binding protein (HFABP) levels can be used to detect the presence of acute kidney injury on admission in patients admitted to the non-surgical intensive care unit. Shirakabe, A, et al. 1, s.l. : NCBI, 2016, Vol. 16.
      12. Perioperative acute kidney injury. Goren, O and Matot, I. 2, s.l. : British Journal of Anaesthesia, 2015, Vol. 115.

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