Microsoft word - dcm004-6 metodica 17oh progesterone ce
17OH PROGESTERONE for routine analysis Direct immunoenzymatic determination of 17OH Progesterone in human serum or plasma.
REF DKO004 INTENDED USE 2. PRINCIPLE
Competitive immunoenzymatic colorimetric method for
17OH Progesterone (antigen) in the sample competes
quantitative determination of 17OH Progesterone
with horseradish peroxidase 17OH Progesterone
(enzyme-label ed antigen) for binding onto the limited
The 17OH Progesterone kit is intended for
number of anti- 17OH Progesterone coated on the
laboratory use only.
After incubation, the bound/free separation is
1. CLINICAL SIGNIFICANCE
performed by a simple solid-phase washing.
17-Hydroxyprogesterone (17OH Progesterone or 17α-
The enzyme substrate (H2O2) and theTMB-substrate
OHP or 17-OHP) is a C-21 steroid hormone produced
(TMB) are added. After an appropriate time has
in the adrenal gland and gonads, during the synthesis
elapsed for maximum colour development, the
of glucocorticoids and sex steroids. It is derived from
enzyme reaction is stopped and the absorbance are
progesterone via 17-hydroxylase, a P450c17 enzyme,
or from 17-hydroxypregnenolone via 3β-hydroxysteroid
17OH Progesterone concentration in the sample is
calculated based on a series by a set of standard.
17-OHP has no defined physiologic role except as a
The colour intensity is inversely proportional to the
17OH Progesterone concentration in the sample.
Serum 17-OHP levels are age-dependent, with peak
levels observed during fetal life and the immediate
3. REAGENTS, MATERIALS AND INSTRUMENTATION
postnatal period. During the first week of life, serum 17
-OHP levels fal ~50-fold as compared to cord blood
3.1. Reagents and materials suppliedin the kit
values. A smal transient increase occurs in male
1. 17OH Progesterone Standards (6x1 vial = 1 mL)
infants 30-60 days postnatal y. Levels for both sexes
REF DCE002/0406-0
remain at constant low levels during childhood, and
REF DCE002/0407-0
then progressively increase during puberty reaching
adult levels of ~100 ng/dL (~3.03 nmol/L). As with
REF DCE002/0408-0
cortisol, serum 17-OHP levels normal y have an
REF DCE002/0409-0
ACTH-dependent diurnal variation, with peak levels in
REF DCE002/0410-0
the morning and a nadir at night. In addition, ovarian
production of 17-OHP increases during the luteal
REF DCE002/0411-0
17-hydroxyprogesterone is a natural progestin and in
pregnancy increases in the third trimester primarily
REF DCE002/0402-0
3. Coated Microplate (1 microplate breakable coated
Normal levels are 3-90 ng/dl in children, and in
women, 15-70 ng/dl prior to ovulation, and 35-290
REF DCE002/0403-0
Measurements of levels of 17-hydroxyprogesterone
are useful in the evaluation of patients with suspected
H2O2-TMB 0.26 g/L (avoid any skin contact)
congenital adrenal hyperplasia as the typical enzymes
REF DCE004-0
that are defective, namely 21-hydroxylase and 11β-
hydroxilase, lead to a build-up of 17-OHP. In contrast,
Sulphuric acid 0.15 mol/L (avoid any skin contact)
have very low or undetectable levels of 17-OHP.
REF DCE005-0
Elevated serum 17-OHP levels at baseline and/or after
ACTH stimulation have also been reported in other
3.2. Reagents necessary not supplied in the kit Standard 3.3. Auxiliary materials and instrumentation Notes Store all reagents at 2÷8°C in the dark. Open the bag of reagent 3 (COATED MICROPLATE) only when it is at room temperature and close
Remove the contents from each wel ; wash the wel s
Do not remove the adesive sheets on the unutilised
with 300 µL of distil ed water. Repeat the washing
procedure by draining the water completely.
4. PRECAUTIONS
The reagent contain Proclin 300R as preservative.
Avoid the exposure of reagent TMB/H2O2 to
Incubate at room temperature 22÷28°C for 15 minutes in
Maximum precision is required for reconstitution
This method al ows the determination of 17OH
Read the absorbance (E) at 450 nm against Blank.
Progesterone from 0.2 ng/mL to 19.2 ng/mL.
The clinical significance of the determination of
6. QUALITY CONTROL
17OH Progesterone can be invalidated if the
Each laboratory should assay controls at normal, high
patient was treated with cortisone or natural or
and low levels range of 17OH Progesterone for
monitoring assay performance. These controls should
be treated as unknowns and values determined in
5. PROCEDURE
every test procedure performed. Quality control charts
should be maintained to fol ow the performance of the
5.1. Preparation Standard
supplied reagents. Pertinent statistical methods should
be employed to ascertain trends. The individual
0,S1,S2,S3,S4,S5)
The standard has the fol owing concentration of 17OH
laboratory should set acceptable assay performance
limits. Other parameters that should be monitored
include the 80, 50 and 20% intercepts of the standard
curve for run-to-run reproducibility. In addition,
maximum absorbance should be consistent with past
experience. Significant deviation from established
Stability of Standards: until the expiration date of the
performance can indicate unnoticed change in
experimental conditions or degradation of kit reagents.
When are open, the standards are stable six months
Fresh reagents should be used to determine the
5.2. Preparation of the Sample 7. LIMITATIONS OF PROCEDURE
The determination of 17OH Progesterone can be
performed in human plasma as wel as in serum.
7.1. Assay Performance.
Store the sample at -20°C if the determination is not
Sample(s), which are contaminated microbiological y,
performed on the same day of the sample connection.
should not be used in the assay. Highly lipemeic or
haemolysed specimen(s) should similarly not be used.
5.3. Procedure
It is important that the time of reaction in each wel is
As it is necessary to perform the determination in
held constant for reproducible results. Pipetting of
duplicate, prepare two wel s for each of the six points
samples should not extend beyond ten (10) minutes to
of the standard curve (S0-S5), and for each sample,
avoid assay drift. If more than one (1) plate is used, it
is recommended to repeat the dose response curve.
Addition of the substrate solution initiates a kinetic
reaction, which is terminated by the addition of the
stop solution. Therefore, the addition of the substrate
and the stopping solution should be added in the same
sequence to eliminate any time deviation during
reaction. Plate readers measure vertical y. Do not
touch the bottom of the wel s. Failure to remove
adhering solution adequately in the aspiration or
decantation wash step(s) may result in poor replication
10.4. Specificity
The cross reaction of the antibody calculated at 50%
according to Abraham are shown in the table:
7.2. Results interpretation
If computer control ed data reduction is used to
calculate the results of the test, it is imperative that the
predicted values for the calibrators fal within 10% of
8. RESULTS 10.5. Correlation with RIA 8.1. Mean Absorbance
The Dia.metra 17OH Progesterone ELISA was
Calculate the mean of the absorbance (Em) for each
compared to another commercial y available 17OH
point of the standard curve and of each sample
progesterone assay. 38 serum samples were analysed
8.2. Standard Curve
Plot the mean value of absorbance of the standards
(17-OHP Diametra)=0.83*(17-OHP RIA)+0.17
(Em) against concentration. Draw the best-fit curve
through the plotted points. (es: Four Parameter
11. WASTE MANAGEMENT
Reagents must be disposed off in accordance with
8.3. Calculation of Results
Interpolate the values of the samples on the standard
curve to obtain the corresponding values of the
BIBLIOGRAPHY
1. Wisdom, G.B. Clin. Chem. 22/8 1243 - 1255
9. REFERENCE VALUES
The serum or plasma 17OH Progesterone reference
2. De Vil a, G.O. et al. J.Clin. Endoc. Metob.
3. Hubl, W., et al Endokrinologie, 1982, 79 (2),
4. Arakawa, H., et al Chem. Pharm. Bul . Tokyo 30 (8)
5. D. Riad - Fanny, et al Endocr. Reviews, 3 (4) 304
CHILDREN 10. PERFORMANCE AND CHARACTERISTICS 10.1. Precision Ed 06/2010 DCM004-6
Within run variation was determined by replicate
DiaMetra S.r.l. Headquater: Via Garibaldi, 18 – 20090
measurements (16x) of two different control sera in
SEGRATE (MI) Tel. 0039-02-2139184 – 02-26921595
one assay. The within assay variability is ≤ 7.4%.
Manufact: Via Giustozzi (già via Bartolomei), 35 – Z.I
Between run variation was determined by replicate
Paciana – 06034 FOLIGNO (PG) ITALY. Tel. 0039-
measurements of three different control sera in
different lots. The between assay variability is ≤ 13%.
10.2. Accuracy
The recovery of 1 – 2 – 4 ng/mL of 17OH
Progesterone added to a sample gave an average
value (±SD) of 103.94% ± 2.78% with reference to the
10.3. Sensitivity
The lowest detectable concentration of 17OH
Progesterone that can be distinguished from the zero
standard is 0.09 ng/mL at the 95 % confidence limit.
DIA.METRA SRL PACKAGING INFORMATION SHEET Spiegazione dei simboli Explanation of symbols Explication des symboles Significado de los simbolos DE Verwendete Symbole Explicaçao dos simbolos
Producto sanitario para diagnóstico In vitro
Dispositif medical de diagnostic in vitro
Dispositivos medicos de diagnostico in vitro
Establa hasta (usar antes de último día del mes)
Utiliser avant (dernier jour du mois indiqué)
Utilizzare prima del (ultimo giorno del mese)
Contém o suficiente para “n” testes
DIA.METRA SRL PACKAGING INFORMATION SHEET
SUGGERIMENTI PER LA RISOLUZIONE DEI PROBLEMI/TROUBLESHOOTING ERRORE CAUSE POSSIBILI/ SUGGERIMENTI Nessuna reazione colorimetrica del saggio - mancata dispensazione del coniugato - contaminazione del coniugato e/o del Substrato - errori nell’esecuzione del saggio (es. Dispensazione accidentale dei reagenti in sequenza errata o provenienti da flaconi sbagliati, etc.) Reazione troppo blanda (OD troppo basse) - coniugato non idoneo (es. non proveniente dal kit originale) - tempo di incubazione troppo breve, temperatura di incubazione troppa bassa Reazione troppo intensa (OD troppo alte) - coniugato non idoneo (es. non proveniente dal kit originale) - tempo di incubazione troppo lungo, temperatura di incubazione troppa alta - qualità scadente dell’acqua usata per la soluzione di lavaggio (basso grado di deionizzazione) - lavaggi insufficienti (coniugato non completamente rimosso) Valori inspiegabilmente fuori scala - contaminazione di pipette, puntali o contenitori- lavaggi insufficienti (coniugato non completamente rimosso) CV% intrasaggio elevato - reagenti e/o strip non portate a temperature ambiente prima dell’uso - il lavatore per micropiastre non lava correttamente (suggerimento: pulire la testa del lavatore) CV% intersaggio elevato - condizioni di incubazione non costanti (tempo o temperatura) - controlli e campioni non dispensati allo stesso tempo (con gli stessi intervalli) (controllare la sequenza di dispensazione) - variabilità intrinseca degli operatori ERROR POSSIBLE CAUSES / SUGGESTIONS No colorimetric reaction - no conjugate pipetted reaction after addition - contamination of conjugates and/or of substrate - errors in performing the assay procedure (e.g. accidental pipetting of reagents in a wrong sequence or from the wrong vial, etc.) Too low reaction (too low ODs) - incorrect conjugate (e.g. not from original kit) - incubation time too short, incubation temperature too low Too high reaction (too high ODs) - incorrect conjugate (e.g. not from original kit) - incubation time too long, incubation temperature too high - water quality for wash buffer insufficient (low grade of deionization) - insufficient washing (conjugates not properly removed) Unexplainable outliers - contamination of pipettes, tips or containers insufficient washing (conjugates not properly removed) too high within-run - reagents and/or strips not pre-warmed to CV% Room Temperature prior to use - plate washer is not washing correctly (suggestion: clean washer head) too high between-run - incubation conditions not constant (time, CV % temperature) - controls and samples not dispensed at the same time (with the same intervals) (check pipetting order) - person-related variation
CODIGO DE ETICA CAPITULO I DISPOSICIONES GENERALES ARTÍCULO 1.- OBJETIVO. El presente Código tiene por objeto establecer el conjunto de normas y principios que regulan laconducta individual y colectiva de todas las Trabajadoras y Trabajadores de la Caja Petrolera deSalud en el ejercicio de sus funciones. ARTÍCULO 2º.- ÁMBITO DE APLICACIÓN. Su aplicación es de carácter o
EL TRIBUNAL INTERNACIONAL DEL DERECHO DEL MAR: ALGUNAS CONSIDERACIONES SOBRE SU JURISDICCIÓN Y PROCEDIMIENTO Declaración del Juez Hugo Caminos, representante del Tribunal Internacional del Derecho del Mar, en ocasión del Primer Encuentro de Cortes Internacionales y Regionales de Justicia en el Mundo en celebración de los Cien Años de la Corte Centro Americana de Justi