LabMed, Volume 3, Issue 2 (June 2026) – 6 articles

Whole blood viscosity (WBV) is a key hemorheological property influenced by cellular and biochemical factors and is associated with cardiovascular, cerebrovascular, and microcirculatory disorders. Despite its clinical relevance, comprehensive reference intervals for WBV and oxygen delivery indices—the ODI (oxygen delivery index) and TODI (tissue oxygen delivery index)—in healthy male and female adults have not been established. The objectives of this study were to (1) determine sex-specific reference intervals of WBV in healthy adults, (2) establish reference intervals for the ODI and TODI, and (3) evaluate the influence of hematologic, biochemical, lipid, and non-lipid determinants—as well as the effects of age—on systolic and diastolic blood viscosity (SBV and DBV). WBV was measured across nine shear rates (1–1000 s⁻¹) in 150 healthy men and 150 healthy women using an automated scanning capillary tube viscometer (SCTV). Hematologic and biochemical profiles were obtained, and correlations with DBV and SBV were assessed. Reference intervals were calculated using CLSI-recommended nonparametric methods. WBV was consistently higher in men than women across all shear rates, with sex-based differences accentuated at low shear. Hemoglobin and hematocrit showed the strongest positive correlations with WBV (r ≈ 0.77–0.80), while RDW and HDL cholesterol showed negative associations. Triglycerides exhibited strong viscosity-enhancing effects in men, whereas total cholesterol, LDL, and triglycerides were all significantly increased viscosity in women. Protein-related determinants (total protein, albumin, and γ-gap) displayed striking sex divergence, with strong positive associations in men but attenuated or negative associations in women. Age showed no meaningful relationship with WBV in either sex. Reference intervals for the ODI and TODI revealed modest sex differences with tighter distributions in women. WBV, ODI, and TODI demonstrate clear sex-specific physiological patterns in healthy adults. Hematocrit remains the dominant determinant of blood viscosity, while lipid and protein-related factors contribute differently in men and women. These newly established reference intervals provide essential benchmarks for clinical interpretation and for understanding viscosity-related risk in cardiovascular and microcirculatory disease. Full article

Helicobacter pylori is the leading cause of chronic gastrointestinal tract diseases, with a worldwide prevalence of around 50%. For identification in medical practice, non-invasive methods such as the immunochromatographic test for antigen in stool (SAT) and the urease breath test (UBT) are widely used. Recently, we developed a highly sensitive and specific nested PCR (NPCR) that involves two amplification reactions and uses primers designed to target the variable regions of the 16S rRNA gene to amplify a short 148 bp amplicon. The aim of this study was to compare two classical methods, SAT and UBT, with the 148 bp amplicon NPCR. We examined samples from 137 volunteers, and found 46 positives with NPCR using stool samples, 34 with UBT, and only 24 with SAT. H. pylori origin of the 148 bp amplicons was confirmed by sequencing. NPCR had the highest detection rate in this cohort, suggesting that a portion of the population may be misdiagnosed, particularly by SAT. Due to the cost and simple performance in practice, SAT is a method of choice for initial screening. However, in cases of negative results and persistent digestive problems, we recommend the more sensitive UBT. NPCR may be a useful complementary method, especially in discordant or clinically suspicious cases. Full article

Hepatitis B virus (HBV) is the smallest partially double-stranded, reverse-transcribing DNA virus, with four open reading frames (ORFs) encoding viral proteins. It is classified into nine geographically distributed genotypes (A–I). In Kenya, the molecular characterization of HBV among patients seeking medical care remains poorly defined. This observational study aimed to characterize HBV among patients seeking medical care in Kenya’s endemic region, focusing on circulating genotypes and ORF mutations. Serum samples were collected from the outpatient departments of selected health facilities, with demographic and clinical information extracted from patients’ medical records. Hepatitis B surface antigen (HBsAg) was tested at the facilities, and 85 HBsAg-positive samples were collected for molecular analysis. The basal core promoter and pre-core (BCP/PC), polymerase, and surface regions of the viral genome were amplified and sequenced to determine genotypes and to profile their mutations. Out of 85 HBsAg-positive samples, 38 samples tested positive for HBV DNA, and 26 samples were successfully sequenced. HBV genotype A was prevalent at 73.1% (19/26), followed by genotype D at 23.1% (6/26), and genotype E at 3.8% (1/26). Genotype A sequences clustered with both A1 Asian and African subgenotypes, whereas genotype D clustered with subgenotypes D6 and D1. All HBV genotype A, D, and E sequences were serotypes adw2, ayw2, and ayw4, respectively. HBV core promoter mutations (A1762T/G1764A) were detected in both genotype D and genotype A isolates. The pre-core G1896A mutation was highly prevalent in genotype D samples (5/6; 83.3%) but was not observed in genotypes A or E. Analysis of mutations within the “a” determinant region revealed genotype-specific patterns: genotype A predominantly harbored V14A, P46H, S58C, and P67Q substitutions; genotype E showed N59S; and genotype D exhibited V14A, C69stop, S104T, and W182stop mutations. Two drug resistance mutations (V191I and A194T) were present in two chronic patients, one with genotype A and the other with genotype D. In conclusion, HBV genotypes A and D are the most prevalent among Kenyan patients with chronic HBV infection. The presence of point mutations in the ORFs among patients seeking medical care highlights the need for molecular surveillance to better understand the viral diversity and its potential clinical and public health implications. Full article

A 34-year-old healthy man was referred for colonoscopy due to tenesmus and rectal bleeding in the absence of systemic or immunosuppressive conditions. Incomplete bowel preparation limited the examination, but rectal inspection revealed a well-demarcated erythematous lesion with a granular, micronodular surface and fibrinous areas. The mucosa appeared friable and bled with minimal contact. The differential diagnosis included infectious and inflammatory etiologies. Histologic analysis showed granulation tissue with moderate lymphoplasmacytic infiltration, and C-reactive protein (CRP) confirmed Herpes Simplex Virus type 2 (HSV-2). This case underscores the importance of considering sexually transmitted infections (STIs) such as HSV in the differential diagnosis of rectal bleeding, even in immunocompetent individuals. Full article

The ADA 2026 Standards of Care in Diabetes introduces pivotal updates that refine diagnostic and therapeutic workflows. Expanding upon the 2025 guidelines, the 2026 edition broadens continuous-glucose-monitoring (CGM) eligibility to include all individuals on insulin or non-insulin therapies where CGM aids management. Significant new guidance addresses hyperglycemia management in oncology, identifying metformin as the preferred first-line intervention for drug-induced glycemic excursions. Additionally, type 1-diabetes (T1D) risk stratification is refined; a confirmed single IA-2 autoantibody now warrants monitoring levels similar to the Stage 2 disease. Furthermore, prerequisites for automated-insulin-delivery (AID) initiation have been removed to streamline technology access. For laboratory professionals, these revisions emphasize the critical role of advanced glycemic metrics and precise autoantibody profiling in complex clinical contexts. Full article

Sepsis is a life-threatening syndrome caused by dysregulated host response to infection and remains a major global health challenge with high healthcare burden. Early recognition is critical for improving outcomes, yet current diagnostic tools and conventional biomarkers such as C-reactive protein and procalcitonin have important limitations related to kinetics, specificity, and cost. This review examines Monocyte Distribution Width (MDW), a novel hematologic parameter derived from routine complete blood count analysis, as an emerging biomarker for early sepsis detection and prognostic assessment. MDW reflects monocyte morphological heterogeneity associated with innate immune activation and rises early in the inflammatory cascade, often at the time of initial clinical presentation. Evidence from emergency department and intensive care unit studies demonstrates that MDW provides high sensitivity and negative predictive value for early sepsis screening and performs comparably to or better than established biomarkers, particularly when integrated with clinical scoring systems and other laboratory indices. Beyond diagnosis, elevated MDW correlates with disease severity, organ dysfunction, and adverse outcomes, suggesting prognostic utility. Although promising, current evidence is limited by heterogeneity and the need for standardized cut-off values and multicenter validation. Overall, MDW represents a rapid, cost-effective adjunct that may enhance multimodal sepsis assessment and clinical decision-making. Full article