An Interference That Makes You Blue?
Notice bibliographique
Résumé
A 66-year-old female with a history of smoking, lung adenocarcinoma, and chronic obstructive pulmonary disease presented with dyspnea and light-headedness for 4 months. She was cyanotic on examination and self-reported increased carboxyhemoglobin in the past. Co-oximetry using 2 separate blood gas instruments at 2 separate time points revealed methemoglobin results that were suppressed due to an interfering substance (in one case) or flagged (in the second case) due to increased sulfhemoglobin (Table 1). Carboxyhemoglobin was elevated at the second time point (Table 1). She was treated with methylene blue after admission. Laboratory results from co-oximetry measurements. aCredited: interfering substance present. bSulfhemoglobin interference detected. Laboratory results from co-oximetry measurements. aCredited: interfering substance present. bSulfhemoglobin interference detected. What was the cause of methemoglobinemia in this patient? Are sulfhemoglobin and carboxyhemoglobin elevated in this patient, and why? How do you obtain an accurate measurement of methemoglobin in the presence of interference? The answers are below. Inherited methemoglobinemia is caused by cytochrome B5 reductase deficiency or hemoglobin M disease (1). This patient had hemoglobin M Saskatoon, which can lead to falsely elevated sulfhemoglobin and carboxyhemoglobin results due to spectral interference using co-oximetry (2). Accurate methemoglobin measurements can be achieved using direct methods such as Evelyn-Malloy (3, 4). Direct measurement of methemoglobin and sulfhemoglobin collected later on day 2 resulted at 10.4% and 0%, respectively. Baseline methemoglobin for hemoglobin M Saskatoon patients can range from 0.5% to 14.9% (4). The corresponding author takes full responsibility that all authors on this publication have met the following required criteria of eligibility for authorship: (a) significant contributions to the conception and design, acquisition of data, or analysis and interpretation of data; (b) drafting or revising the article for intellectual content; (c) final approval of the published article; and (d) agreement to be accountable for all aspects of the article thus ensuring that questions related to the accuracy or integrity of any part of the article are appropriately investigated and resolved. Nobody who qualifies for authorship has been omitted from the list. Ruth Melka (Conceptualization-Equal, Data curation-Equal, Formal analysis-Equal, Investigation-Equal, Methodology-Equal, Visualization-Equal, Writing—original draft-Equal, Writing—review & editing-Equal), Christopher Farnsworth (Conceptualization-Equal, Data curation-Equal, Formal analysis-Equal, Investigation-Equal, Methodology-Equal, Resources-Equal, Writing—review & editing-Equal), and Yanchun Lin (Conceptualization-Equal, Data curation-Equal, Formal analysis-Equal, Investigation-Equal, Methodology-Equal, Project administration-Equal, Resources-Equal, Supervision-Equal, Writing—original draft-Equal, Writing—review & editing-Equal). Upon manuscript submission, all authors completed the author disclosure form. None declared. C.W. Farnsworth declares receipt of research funding from Roche, Abbott, Siemens, Beckman Coulter, Cepheid, and Biomerieux and consulting fees from Abbott, Werfen, and Cytovale. C.W. Farnsworth is SYCL Liaison for 2024–2025 for Clinical Chemistry, ADLM.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».