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Coucke B, Dilissen E, Cremer J, Schrijvers R, Theys T, Van Gerven L. Leukocyte-and Platelet-Rich Fibrin for enhanced tissue repair: an in vitro study characterizing cellular composition, growth factor kinetics and transcriptomic insights. Mol Biol Rep 2024; 51:954. [PMID: 39230578 PMCID: PMC11374859 DOI: 10.1007/s11033-024-09890-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/26/2024] [Indexed: 09/05/2024]
Abstract
BACKGROUND Leukocyte- and platelet-rich fibrin (L-PRF) is an autologous platelet concentrate, prepared by centrifugation of blood and consisting of a dense fibrin network with incorporated leukocytes and platelets. This study aims to perform an in-depth analysis of the cells, growth factors, and transcriptome of L-PRF. METHODS AND RESULTS Fresh, 1 week and 2 weeks cultured human L-PRF membranes and liquid L-PRF glue were characterized on cellular and transcriptional level using flow cytometry (n = 4), single-cell RNA sequencing (n = 5) and RT-qPCR. Growth factor kinetics were investigated using ELISA (EGF, VEGF, PDGF-AB, TGF-β1, bFGF). L-PRF contained a large number of viable cells (fresh 97.14 ± 1.09%, 1 week cultured 93.57 ± 1.68%), mainly granulocytes in fresh samples (53.9 ± 19.86%) and T cells in cultured samples (84.7 ± 6.1%), confirmed with scRNA-seq. Monocytes differentiate to macrophages during 1 week incubation. Specifically arterial L-PRF membranes were found to release significant amounts of VEGF, EGF, PDGF-AB and TGF-β1. CONCLUSION We characterized L-PRF using in vitro experiments, to obtain an insight in the composition of the material including a possible mechanistic role for tissue healing. This was the first study characterizing L-PRF at a combined cellular, proteomic, and transcriptional level.
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Affiliation(s)
- Birgit Coucke
- Research Group Experimental Neurosurgery and Neuroanatomy and Leuven Brain Institute, Department of Neurosciences, KU Leuven, Herestraat 49 box 811, Leuven, B-3000, Belgium.
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium.
| | - Ellen Dilissen
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium
| | - Jonathan Cremer
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium
| | - Rik Schrijvers
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium
| | - Tom Theys
- Research Group Experimental Neurosurgery and Neuroanatomy and Leuven Brain Institute, Department of Neurosciences, KU Leuven, Herestraat 49 box 811, Leuven, B-3000, Belgium
- Neurosurgery, University Hospitals Leuven, Leuven, Belgium
| | - Laura Van Gerven
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology & Transplantation, KU Leuven, Leuven, Belgium
- Laboratory of Experimental Otorhinolaryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
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2
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Heeger LE, Koster MIJ, Caram-Deelder C, Bekker V, van der Bom JG, Lopriore E. Umbilical Cord Blood as an Alternative to Neonatal Blood for Complete Blood Count: A Comparison Study. J Pediatr 2024; 271:114059. [PMID: 38636783 DOI: 10.1016/j.jpeds.2024.114059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/08/2024] [Accepted: 04/14/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE To assess concordance between umbilical cord blood (UCB) and neonatal blood (NB) laboratory test results at birth. STUDY DESIGN This retrospective study considered very preterm neonates (<32 weeks' gestational age) admitted to a tertiary neonatal intensive care unit from 2012 to 2023. Inclusion criteria required neonates with a complete blood count measured in both UCB and NB drawn within 2 hours after birth. Median hemoglobin (Hb) and hematocrit (Hct) concentrations were compared between UCB (venous samples) and NB (venous, arterial, or capillary samples). RESULTS A total of 432 neonates with paired UCB and NB values were included in the study. Hb concentration in UCB was 14.7 g/dL (IQR 13.5-16.1 g/dL) compared with 14.8 g/dL (IQR 12.6-19.3 g/dL) in venous NB samples, 13.9 g/dL (IQR 12.9-15.3 g/dL) in arterial NB and 18.7 g/dL (IQR 16.6-20.8 g/dL) in capillary NB. The regression equation showed a correction factor of 1.08 for converting Hb values from UCB to venous NB. Median Hct concentration in UCB was 0.45 L/L (IQR: 0.41-0.49 L/L) compared with 0.48 L/L (IQR 0.43-0.54 L/L) in venous NB, 0.42 L/L (IQR 0.38-0.45 L/L) in arterial NB and 0.57 L/L, (IQR 0.51-0.63 L/L) in capillary NB. CONCLUSIONS Hb and Hct concentrations measured in UCB are similar to those measured in venous blood in very preterm infants and are valid alternatives for NB tests at birth. Hb and Hct concentrations in arterial and capillary NB are respectively lower and higher compared with UCB measurements.
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Affiliation(s)
- Lisanne E Heeger
- Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands; Sanquin Blood Supply Foundation, Clinical Center for Transfusion Research, Amsterdam, The Netherlands
| | - Myrthe I J Koster
- Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Camila Caram-Deelder
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Vincent Bekker
- Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands
| | - Johanna G van der Bom
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Enrico Lopriore
- Division of Neonatology, Department of Pediatrics, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.
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3
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Hess AS. Oxygen Extraction Ratios to Guide Red Blood Cell Transfusion. Transfus Med Rev 2024; 38:150834. [PMID: 38839487 DOI: 10.1016/j.tmrv.2024.150834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 04/09/2024] [Accepted: 04/24/2024] [Indexed: 06/07/2024]
Abstract
Hemoglobin-based red blood cell transfusion (RBC) triggers do not clearly identify which patients with moderate anemia (hemoglobin 7-10 g/dL) will benefit from RBC transfusion. The National Heart, Lung, and Blood Institute has recognized the need for bedside oxygenation measures to enhance transfusion decision-making. This narrative review uses four studies to explore the potential of the oxygen extraction ratio (O2ER)-the ratio of consumed oxygen to delivered oxygen in a critical tissue bed as a more physiologically relevant indicator for guiding RBC transfusions in patients with moderate anemia. The aim of this review is to present existing data on the relationship between O2ER and responsiveness to RBC transfusion, as well as the feasibility of O2ER as bedside measure of tissue oxygenation. This review presents a narrative appraisal of three critical papers that investigate the relationship between O2ER and transfusion outcomes, and one paper that demonstrates proof-of-concept for a noninvasive device to measure O2ER at the bedside. Despite limitations in the existing studies, including small sample sizes and observational designs, the evidence collectively suggests that O2ER has the potential to enhance transfusion decision accuracy. The development of noninvasive measurement devices could facilitate widespread implementation in many kinds of care settings.
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Affiliation(s)
- Aaron S Hess
- Departments of Anesthesiology and Pathology & Laboratory Medicine, University of Wisconsin, Madison, WI, USA.
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4
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Tymko MM, Drapeau A, Vieira-Coelho MA, Labrecque L, Imhoff S, Coombs GB, Langevin S, Fortin M, Châteauvert N, Ainslie PN, Brassard P. Acute isometric and dynamic exercise do not alter cerebral sympathetic nerve activity in healthy humans. J Cereb Blood Flow Metab 2024:271678X241248228. [PMID: 38613232 DOI: 10.1177/0271678x241248228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
The impact of physiological stressors on cerebral sympathetic nervous activity (SNA) remains controversial. We hypothesized that cerebral noradrenaline (NA) spillover, an index of cerebral SNA, would not change during both submaximal isometric handgrip (HG) exercise followed by a post-exercise circulatory occlusion (PECO), and supine dynamic cycling exercise. Twelve healthy participants (5 females) underwent simultaneous blood sampling from the right radial artery and right internal jugular vein. Right internal jugular vein blood flow was measured using Duplex ultrasound, and tritiated NA was infused through the participants' right superficial forearm vein. Heart rate was recorded via electrocardiogram and blood pressure was monitored using the right radial artery. Total NA spillover increased during HG (P = 0.049), PECO (P = 0.006), and moderate cycling exercise (P = 0.03) compared to rest. Cerebral NA spillover remained unchanged during isometric HG exercise (P = 0.36), PECO after the isometric HG exercise (P = 0.45), and during moderate cycling exercise (P = 0.94) compared to rest. These results indicate that transient increases in blood pressure during acute exercise involving both small and large muscle mass do not engage cerebral SNA in healthy humans. Our findings suggest that cerebral SNA may be non-obligatory for exercise-related cerebrovascular adjustments.
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Affiliation(s)
- Michael M Tymko
- Integrative Cerebrovascular and Environmental Physiology SB Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Science, University of Guelph, Guelph, Canada
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Audrey Drapeau
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - Maria Augusta Vieira-Coelho
- Department of Biomedicine, Pharmacology and Therapeutics Unit, Faculty of Medicine, University of Porto, Portugal
- Department of Psychiatry and Mental Health, University Hospital Center of São João, Porto, Portugal
| | - Lawrence Labrecque
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - Sarah Imhoff
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - Geoff B Coombs
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Canada
| | - Stephan Langevin
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - Marc Fortin
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - Nathalie Châteauvert
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
| | - Philip N Ainslie
- Centre for Heart, Lung and Vascular Health, School of Health and Exercise Sciences, University of British Columbia - Okanagan, Kelowna, Canada
| | - Patrice Brassard
- Department of Kinesiology, Faculty of Medicine, Université Laval, Québec, Canada
- Institut universitaire de cardiologie et de pneumologie de Québec-Université Laval, Québec, Canada
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5
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McMahon R, Hill C, Rudge J, Herbert B, Karsten E. Stability of inflammation markers in human blood collected using volumetric absorptive microsampling (VAMS) under typical laboratory storage temperatures. Cytokine 2023; 171:156355. [PMID: 37690424 DOI: 10.1016/j.cyto.2023.156355] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/28/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023]
Abstract
Dried blood spots (DBS) collected on filter paper such as Guthrie cards are stored for years at room temperature. The assumption is that once dried, the samples remain stable and quantifiable indefinitely since the metabolites these were initially designed to measure, are known for their extended stability. The concentration of other blood proteins such as cytokines, however, are known to vary with storage even in liquid samples stored at -80 °C for extended periods of time. We sought to determine if cytokines are stable for up to 5 months when stored as a dried blood sample using volumetric absorptive microsampling (VAMS) devices. To test this, blood was collected from 4 healthy participants, spiked with recombinant cytokines, and collected into 30 µL VAMS devices. These prepared VAMS devices were stored at room temperature, 4 °C, or -20 °C for up to 5 months and matching VAMS liquid extracts were stored at -80 °C for the same period of time. At each timepoint, the samples were extracted from the VAMS devices and the extracts were analysed by Luminex® for quantification of up to 31 cytokines. These methods were also tested in a remote clinical study over a period of up to 8 months. Cytokine analysis revealed that room temperature, the current standard for DBS and VAMS storage, performed the poorest out of all storage temperatures with significant losses in 13/21 analytes compared to 4 °C at 5 months. Storage at 4 °C or colder performed well for the majority of analytes tested, however out of those, the optimal storage temperature differed for each analyte. There were a small number of analytes that performed poorly regardless of storage conditions and for fractalkine, this was found to be caused by inefficient recovery during extraction. Cytokine concentrations from finger-prick samples were also found to be much more variable that those in venous blood samples. Our results highlight the need to understand the stability of analytes of interest before committing to longitudinal collection and storage of samples in VAMS devices. These data give confidence that storage at 4 °C or colder was beneficial for cytokine stability. Wherein 25/31 cytokines were quantifiably stable at -20 °C when stored for 3 months and 17/21 were quantifiably stable after 5 months when stored at 4 °C.
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Affiliation(s)
- R McMahon
- Sangui Bio Pty Ltd, Sydney, Australia; The Kolling Institute, Sydney, Australia.
| | - C Hill
- Sangui Bio Pty Ltd, Sydney, Australia; The Kolling Institute, Sydney, Australia
| | - J Rudge
- Trajan Scientific and Medical (Neoteryx), Australia
| | - B Herbert
- Sangui Bio Pty Ltd, Sydney, Australia; The Kolling Institute, Sydney, Australia
| | - E Karsten
- Sangui Bio Pty Ltd, Sydney, Australia; The Kolling Institute, Sydney, Australia; University of Sydney, Australia
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6
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Meikopoulos T, Begou O, Theodoridis G, Gika H. Ceramides biomarkers determination in quantitative dried blood spots by UHPLC-MS/MS. Anal Chim Acta 2023; 1255:341131. [PMID: 37032061 DOI: 10.1016/j.aca.2023.341131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/10/2023] [Accepted: 03/22/2023] [Indexed: 03/30/2023]
Abstract
A method was developed for the analysis of four ceramide species; namely C16:0, C18:0, C24:0 and C24:1 in quantitative Dried Blood Samples (qDBS) by LC-MS/MS and validated with the aim to give prominence to an interesting application of at-home blood microsampling for health monitoring. Ceramides, being key-role metabolites implicated in regulation of diverse cellular processes have been considered as emerging biomarkers for different disease states, such as cardiovascular diseases, type 2 diabetes and others. Here, Capitainer device was utilized to provide accurate and consistent volumes of samples, ideal for accurate determinations. The method requires a 10 μL sample offering duplicate analysis by device, is quick and enables the sample collection by distance as it was proved that ceramides under study were stable at various conditions, including RT. Intra and inter-day accuracy of the determination were estimated between 87.6% - 113% and 90.6% -113%, respectively, while intra- and inter-day precision were calculated from 0.2% to 9.9% %RSD and 0.1% - 8.0% %RSD, respectively. The data acquired by ten healthy individuals indicated that circulating ceramides are at higher levels in whole blood taken from the fingertip in comparison to the reported values in plasma or serum.
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7
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Frater JL, Hirsch-Ginsberg C, d'Onofrio G, George TI. Arterial blood as an alternative specimen source for complete blood cell count: More human studies are needed. Int J Lab Hematol 2023; 45:e90-e92. [PMID: 36627166 DOI: 10.1111/ijlh.14019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Accepted: 12/30/2022] [Indexed: 01/12/2023]
Affiliation(s)
- John L Frater
- Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri, USA
| | - Cheryl Hirsch-Ginsberg
- Division of Pathology and Laboratory Medicine, University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Giuseppe d'Onofrio
- Department of Hematology, Catholic University of the Sacred Heart, Rome, Italy
| | - Tracy I George
- Department of Pathology, University of Utah School of Medicine, Salt Lake City, Utah, USA
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8
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Madimenos FC, Gildner TE, Eick GN, Sugiyama LS, Snodgrass JJ. Bringing the lab bench to the field: Point-of-care testing for enhancing health research and stakeholder engagement in rural/remote, indigenous, and resource-limited contexts. Am J Hum Biol 2022; 34:e23808. [PMID: 36166487 DOI: 10.1002/ajhb.23808] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 08/03/2022] [Accepted: 09/12/2022] [Indexed: 01/25/2023] Open
Abstract
Point-of-care testing (POCT) allows researchers and health-care providers to bring the lab bench to the field, providing essential health information that can be leveraged to improve health care, accessibility, and understanding across clinical and research settings. Gaps in health service access are most pronounced in what we term RIR settings-rural/remote regions, involving Indigenous peoples, and/or within resource-limited settings. In these contexts, morbidity and mortality from infectious and non-communicable diseases are disproportionately higher due to numerous geographic, economic, political, and sociohistorical factors. Human biologists and global health scholars are well-positioned to contribute on-the-ground-level insights that can serve to minimize global health inequities and POCT has the potential to augment such approaches. While the clinical benefits of POCT include increasing health service access by bringing testing, rapid diagnosis, and treatment to underserved communities with limited pathways to centralized laboratory testing, POCT also provides added benefits to both health-focused researchers and their participants. Through portable, minimally invasive devices, researchers can provide actionable health data to participants by coupling POCT with population-specific health education, discussing results and their implications, creating space for participants to voice concerns, and facilitating linkages to treatment. POCT can also strengthen human biology research by shedding light on questions of evolutionary and biocultural importance. Here, we expand on the epidemiological and research value, as well as practical and ethical challenges of POCT across stakeholders (i.e., participant, community, health researcher, and trainee). Finally, we emphasize the immense opportunities of POCT for fostering collaborative research and enhancing access to health delivery and information and, by extension, helping to mitigate persistent global health inequities.
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Affiliation(s)
- Felicia C Madimenos
- Department of Anthropology, Queens College (CUNY), New York, USA.,New York Consortium of Evolutionary Primatology (NYCEP), CUNY Graduate Center, New York, USA
| | - Theresa E Gildner
- Department of Anthropology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Geeta N Eick
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA
| | | | - James J Snodgrass
- Department of Anthropology, University of Oregon, Eugene, Oregon, USA.,Center for Global Health, University of Oregon, Eugene, Oregon, USA.,Global Station for Indigenous Studies and Cultural Diversity, Hokkaido University, Sapporo, Japan
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9
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Tahiroglu V, Kara F. Effects of acute inflammation on platelet indices: An experimental study. BAGHDAD JOURNAL OF BIOCHEMISTRY AND APPLIED BIOLOGICAL SCIENCES 2022. [DOI: 10.47419/bjbabs.v3i03.150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and objective: It is well known that inflammation may affect the platelets. However, there are inconsistencies between the results of observational studies investigating changes in platelet indices in inflammatory conditions. This study aimed to investigate the possible effects of acute inflammation on platelet indices in plantar inflammation model in rats.
Methods: A total of 10 rats, 5 in each group, were used in the study. Lambda-carrageenan and saline were applied subcutaneously to the right hind paw of the rats in the inflammation group and in the control group, respectively. Six hours after the administration, blood samples were taken from femoral arteries and femoral veins, and platelet indices were measured by a hematology analyzer. In addition, plantar tissue samples belonging to the control and inflammation groups were evaluated histopathologically.
Results: On histopathological examination, no pathological condition was observed in the control group, while there were changes consistent with acute inflammation in the lambda-carrageenan-injected group. There was no significant difference in terms of platelet indices between both the arterial and vein samples and between the control and inflammation groups.
Conclusions: Our results suggest that platelet indices cannot be used in the diagnosis of acute inflammatory conditions. However, in our opinion, these findings must not be interpreted as that acute inflammation does not affect platelet number and volume. Instead, we believe that it may be more appropriate to say that acute inflammation does not produce a quantitatively significant change in platelet indices due to the combination of the opposite effects.
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10
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Zarbl J, Eimer E, Gigg C, Bendzuck G, Korinth M, Elling-Audersch C, Kleyer A, Simon D, Boeltz S, Krusche M, Mucke J, Muehlensiepen F, Vuillerme N, Krönke G, Schett G, Knitza J. Remote self-collection of capillary blood using upper arm devices for autoantibody analysis in patients with immune-mediated inflammatory rheumatic diseases. RMD Open 2022; 8:rmdopen-2022-002641. [PMID: 36104118 PMCID: PMC9476144 DOI: 10.1136/rmdopen-2022-002641] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 08/31/2022] [Indexed: 12/14/2022] Open
Abstract
Objectives To evaluate the feasibility, accuracy, usability and acceptability of two upper arm self-sampling devices for measurement of autoantibodies and C reactive protein (CRP) levels in patients with immune-mediated rheumatic diseases (IMRDs). Methods 70 consecutive patients with IMRD with previously documented autoantibodies were assigned to supervised and unsupervised self-collection of capillary blood with the Tasso+ or TAP II device. Interchangeability of 17 biomarkers with standard venesection was assessed by: concordance, correlation, paired sample hypothesis testing and Bland-Altman plots. Patients completed an evaluation questionnaire, including the System Usability Scale (SUS) and Net Promoter Score (NPS). Results While 80.0% and 77.0% were able to safely and successfully collect capillary blood using the Tasso+ and TAP II within the first attempt, 69 of 70 (98.6%) patients were successful in collecting capillary blood within two attempts. Concordance between venous and capillary samples was high; 94.7% and 99.5% for positive and negative samples, respectively. For connective tissue disease screen, anti-Ro52 and anti-proteinase 3 autoantibody levels, no significant differences were observed. Self-sampling was less painful than standard venesection for the majority of patients (Tasso+: 71%; TAP II: 63%). Both devices were well accepted (NPS; both: +28%), usability was perceived as excellent (SUS; Tasso+: 88.6 of 100; TAP II: 86.0 of 100) and 48.6 %/62.9% of patients would prefer to use the Tasso+/TAP II, respectively, instead of a traditional venous blood collection. Conclusions Remote self-collection of capillary blood using upper arm-based devices for autoantibody and CRP analysis in patients with autoimmune rheumatic diseases is feasible, accurate and well accepted among patients. Trial registration number WHO International Clinical Trials Registry (DRKS00024925).
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Affiliation(s)
- Joshua Zarbl
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | | | | | | | | | - Arnd Kleyer
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - David Simon
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Sebastian Boeltz
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | | | - Johanna Mucke
- Policlinic and Hiller Research Unit for Rheumatology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Felix Muehlensiepen
- Centre for Health Services Research Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany.,Université Grenoble Alpes, Grenoble, France
| | | | - Gerhard Krönke
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Georg Schett
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Johannes Knitza
- Department of Internal Medicine 3, Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany .,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Université Grenoble Alpes, Grenoble, France
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11
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Feasibility of Cell-Free DNA Measurement from the Earlobe during Physiological Exercise Testing. Diagnostics (Basel) 2022; 12:diagnostics12061379. [PMID: 35741187 PMCID: PMC9222055 DOI: 10.3390/diagnostics12061379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/27/2022] [Accepted: 05/30/2022] [Indexed: 11/30/2022] Open
Abstract
Circulating, cell-free DNA (cfDNA) has been discussed as an upcoming blood-based biomarker in exercise physiology, reflecting important aspects of exercise load. cfDNA blood sampling has evolved from elaborate venous to efficient capillary sampling from the fingertips. In this study, we aimed to evaluate the principal feasibility of cfDNA blood sampling from the earlobe. Therefore, we obtained cfDNA concentrations from the fingertips, earlobe, and the antecubital vein during physiological exercise testing. Significantly higher concentrations were obtained from the earlobe compared to fingertip samples. All of the measurement methods showed good to excellent repeatability (ICCs of 0.85 to 0.93). In addition, the control experiments revealed that repeated sampling from the earlobe but not from the fingertips increased cfDNA at rest. In summary, cfDNA sampling is feasible for all sampling sources. However, at rest, cfDNA collected from the earlobe tend to increase over time in the absence of physical load, potentially limiting this sampling method.
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12
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Becker M, Gscheidmeier T, Groß HJ, Cario H, Woelfle J, Rauh M, Metzler M, Zierk J. Differences between capillary and venous blood counts in children-A data mining approach. Int J Lab Hematol 2022; 44:729-737. [PMID: 35485526 DOI: 10.1111/ijlh.13846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 03/01/2022] [Accepted: 03/21/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Capillary sampling of blood counts is a well-established alternative to venipuncture in paediatrics. However, the sampling method has to be considered when interpreting test results, as measurements differ. Ethical and practical considerations prevent simultaneous venous and capillary sample acquisition in comprehensive paediatric cohorts that span all ages for the purpose of a direct method comparison, resulting in uncertainty regarding the interpretation of capillary test results. METHODS We applied a data mining method to calculate the differences between capillary and venous blood count analytes using laboratory data collected during patient care. We examined 486 401 blood counts performed between 2010 and 2017 in two German paediatric tertiary care centers in children from birth to 18 years analysed on SYSMEX XE-2100 and SYSMEX XE-5000 devices, and analysed the differences between capillary and venous test results in 15 218 paired samples performed within 24 h. RESULTS We identified the mean systematic differences between capillary and venous (capillary-venous) test results for haemoglobin (+6.5 g/L), haematocrit (+2.38%), platelet count (-7.01 × 109 /l), red cell count (+0.18 × 1012 /L), white cell count (-0.64 × 109 /L), mean corpuscular cell volume (+2.07 fl), mean corpuscular haemoglobin (+0.33 pg), mean corpuscular haemoglobin concentration (-4.4 g/L) and red cell distribution width (+0.40%). The effect of age on these mean deltas is negligible, while the levels of test results influence the difference between capillary and venous test results in most analytes. CONCLUSIONS Our results improve guidance regarding the interpretation of capillary test results for children of all ages and in both physiological and pathological ranges.
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Affiliation(s)
- Mathias Becker
- Department of Pediatrics and Adolescent Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Thomas Gscheidmeier
- Core Facility of Clinical Chemistry, University Medical Centre Ulm, Ulm, Germany
| | - Hans-Jürgen Groß
- Core Facility of Clinical Chemistry, University Medical Centre Ulm, Ulm, Germany
| | - Holger Cario
- Department of Pediatrics and Adolescent Medicine, University Medical Centre, Ulm, Germany
| | - Joachim Woelfle
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Manfred Rauh
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Markus Metzler
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
| | - Jakob Zierk
- Department of Pediatrics and Adolescent Medicine, University Hospital Erlangen, Erlangen, Germany
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13
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Horsager J, Okkels N, Van Den Berge N, Jacobsen J, Schact A, Munk OL, Vang K, Bender D, Brooks DJ, Borghammer P. In vivo vesicular acetylcholine transporter density in human peripheral organs: an [ 18F]FEOBV PET/CT study. EJNMMI Res 2022; 12:17. [PMID: 35362761 PMCID: PMC8975951 DOI: 10.1186/s13550-022-00889-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 03/17/2022] [Indexed: 11/20/2022] Open
Abstract
Background The autonomic nervous system is frequently affected in some neurodegenerative diseases, including Parkinson’s disease and Dementia with Lewy bodies. In vivo imaging methods to visualize and quantify the peripheral cholinergic nervous system are lacking. By using [18F]FEOBV PET, we here describe the peripheral distribution of the specific cholinergic marker, vesicular acetylcholine transporters (VAChT), in human subjects. We included 15 healthy subjects aged 53–86 years for 70 min dynamic PET protocol of peripheral organs. We performed kinetic modelling of the adrenal gland, pancreas, myocardium, renal cortex, spleen, colon, and muscle using an image-derived input function from the aorta. A metabolite correction model was generated from venous blood samples. Three non-linear compartment models were tested. Additional time-activity curves from 6 to 70 min post injection were generated for prostate, thyroid, submandibular-, parotid-, and lacrimal glands. Results A one-tissue compartment model generated the most robust fits to the data. Total volume-of-distribution rank order was: adrenal gland > pancreas > myocardium > spleen > renal cortex > muscle > colon. We found significant linear correlations between total volumes-of-distribution and standard uptake values in most organs. Conclusion High [18F]FEOBV PET signal was found in structures with known cholinergic activity. We conclude that [18F]FEOBV PET is a valid tool for estimating VAChT density in human peripheral organs. Simple static images may replace kinetic modeling in some organs and significantly shorten scan duration. Clinical Trial Registration Trial registration: NCT, NCT03554551. Registered 31 May 2018. https://clinicaltrials.gov/ct2/show/NCT03554551?term=NCT03554551&draw=2&rank=1. Supplementary Information The online version contains supplementary material available at 10.1186/s13550-022-00889-9.
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Affiliation(s)
- Jacob Horsager
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark. .,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
| | - Niels Okkels
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Neurology, Aarhus University Hospital, Aarhus, Denmark
| | - Nathalie Van Den Berge
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Jan Jacobsen
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark
| | - Anna Schact
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark
| | - Ole Lajord Munk
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark
| | - Kim Vang
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark
| | - Dirk Bender
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark
| | - David J Brooks
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark.,Institute of Translational and Clinical Research, University of Newcastle Upon Tyne, Newcastle upon Tyne, UK
| | - Per Borghammer
- Department of Nuclear Medicine and PET, Aarhus University Hospital, Palle Juul-Jensens Boulevard 165, J220, 8200, Aarhus N, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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14
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Lamaj G, Pablo-Trinidad A, Butterworth I, Bell N, Benasutti R, Bourquard A, Sanchez-Ferro A, Castro-Gonzalez C, Jiménez-Ubieto A, Baumann T, Rodriguez-Izquierdo A, Pottier E, Shelton A, Martinez-Lopez J, Sloan JM. Usability evaluation of a non-invasive neutropenia screening device (PointCheck™) for cancer chemotherapy patients: Observational Study (Preprint). J Med Internet Res 2022; 24:e37368. [PMID: 35943786 PMCID: PMC9621111 DOI: 10.2196/37368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 06/03/2022] [Accepted: 07/18/2022] [Indexed: 11/22/2022] Open
Abstract
Background Patients with cancer undergoing cytotoxic chemotherapy face an elevated risk of developing serious infection as a consequence of their treatment, which lowers their white blood cell count and, more specifically, their absolute neutrophil count. This condition is known as neutropenia. Neutropenia accompanied by a fever is referred to as febrile neutropenia, a common side effect of chemotherapy with a high mortality rate. The timely detection of severe neutropenia (<500 absolute neutrophil count/μL) is critical in detecting and managing febrile neutropenia. Current methods rely on blood draws, which limit them to clinical settings and do not allow frequent or portable monitoring. In this study, we demonstrated the usability of PointCheck, a noninvasive device for neutropenia screening, in a simulated home environment without clinical supervision. PointCheck automatically performs microscopy through the skin of the finger to image the blood flowing through superficial microcapillaries and enables the remote monitoring of neutropenia status, without requiring venipuncture. Objective This study aimed to evaluate the usability of PointCheck, a noninvasive optical technology for screening severe neutropenia, with the goal of identifying potential user interface, functionality, and design issues from the perspective of untrained users. Methods We conducted a multicenter study using quantitative and qualitative approaches to evaluate the usability of PointCheck across 154 untrained participants.
We used a mixed method approach to gather usability data through user testing observations, a short-answer qualitative questionnaire, and a standardized quantitative System Usability Scale (SUS) survey to assess perceived usability and satisfaction. Results Of the 154 participants, we found that 108 (70.1%) scored above 80.8 on the SUS across all sites, with a mean SUS score of 86.1 across all sites. Furthermore, the SUS results indicated that, out of the 151 users who completed the SUS survey, 145 (96%) found that they learned how to use PointCheck very quickly, and 141 (93.4%) felt very confident when using the device. Conclusions We have shown that PointCheck, a novel technology for noninvasive, home-based neutropenia detection, can be safely and effectively operated by first-time users. In a simulated home environment, these users found it easy to use, with a mean SUS score of 86.1, indicating an excellent perception of usability and placing this device within the top tenth percentile of systems evaluated for usability by the SUS. Trial Registration ClinicalTrials.gov NCT04448314; https://clinicaltrials.gov/ct2/show/NCT04448314 (Hospital Universitario 12 de Octubre registration) and NCT04448301; https://clinicaltrials.gov/ct2/show/NCT04448301 (Boston Medical Center registration)
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Affiliation(s)
| | | | | | - Nolan Bell
- Leuko Labs, Inc, Boston, MA, United States
| | | | | | | | | | - Ana Jiménez-Ubieto
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Tycho Baumann
- Hematology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Elizabeth Pottier
- Section of Hematology & Medical Oncology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States
| | - Anthony Shelton
- Section of Hematology & Medical Oncology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States
| | | | - John Mark Sloan
- Section of Hematology & Medical Oncology, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, United States
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15
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Altered erythropoiesis in newborns with congenital heart disease. Pediatr Res 2022; 91:606-611. [PMID: 33531673 DOI: 10.1038/s41390-021-01370-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 12/31/2020] [Accepted: 01/05/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Fetal hypoxia has been implicated in fetal growth restriction in congenital heart disease (CHD) and leads to stress erythropoiesis in utero. The objective is to assess erythropoiesis and its association with growth in newborns with CHD. METHODS Fetuses with prenatally diagnosed CHD from 2013 to 2018 were retrospectively reviewed. Pregnancies with multiple gestation, genetic abnormalities, major extra-cardiac anomalies, and placental abruption were excluded. Complete blood count tests at birth were compared to published normative values. Spearman correlation assessed associations of red blood cell (RBC) indices with birth anthropometrics and prenatal Doppler measures. RESULTS A total of 160 newborns were included. Median gestational age was 38.3 (37.3, 39.0) weeks. Infants ≥37 weeks gestation had lower hemoglobin (Hgb), hematocrit, and elevated nucleated RBC (nRBC), mean corpuscular volume, and mean corpuscular hemoglobin compared to reference. No differences in RBC indices were observed in infants <34 and 34-37 weeks gestation. There was no difference in Hgb and nRBC between CHD subgroups. Neither Hgb nor nRBC were associated with birth anthropometrics or Doppler patterns. CONCLUSIONS Term infants with CHD demonstrated multiple alterations in erythrocyte indices suggesting ineffective stress erythropoiesis in late gestation resulting in lower Hgb at birth. Altered erythropoiesis was not correlated to growth or Doppler patterns. IMPACT Newborns with congenital heart disease (CHD) born at term gestation demonstrated altered erythropoiesis. Term newborns with CHD have decreased hemoglobin levels despite having red blood cell indices consistent with stress erythropoiesis, suggesting an incomplete compensatory response to in utero physiologic disturbances associated with CHD. The etiology is unknown; however, it may be influenced by multiple risk factors during pregnancy in the maternal-fetal dyad. Alterations in red blood cell indices were not associated with outcomes of fetal growth.
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17
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Dimitrakakis N, Waterhouse A, Lightbown S, Leslie DC, Jiang A, Bolgen DE, Lightbown K, Cascio K, Aviles G, Pollack E, Jurek S, Donovan K, Hicks-Berthet JB, Imaizumi K, Super M, Ingber DE, Nedder A. Biochemical and Hematologic Reference Intervals for Anesthetized, Female, Juvenile Yorkshire Swine. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE : JAALAS 2022; 61:21-30. [PMID: 34903312 PMCID: PMC8786382 DOI: 10.30802/aalas-jaalas-21-000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/19/2021] [Accepted: 08/05/2021] [Indexed: 06/14/2023]
Abstract
Swine are widely used in biomedical research, translational research, xenotransplantation, and agriculture. For these uses, physiologic reference intervals are extremely important for assessing the health status of the swine and diagnosing disease. However, few biochemical and hematologic reference intervals that comply with guidelines from the Clinical and Laboratory Standards Institute and the American Society for Veterinary Clinical Pathology are available for swine. These guidelines state that reference intervals should be determined by using 120 subjects or more. The aim of this study was to generate hematologic and biochemical reference intervals for female, juvenile Yorkshire swine (Sus scrofa domesticus) and to compare these values with those for humans and baboons (Papio hamadryas). Blood samples were collected from the femoral artery or vein of female, juvenile Yorkshire swine, and standard hematologic and biochemical parameters were analyzed in multiple studies. Hematologic and biochemical reference intervals were calculated for arterial blood samples from Yorkshire swine (n = 121 to 124); human and baboon reference intervals were obtained from the literature. Arterial reference intervals for Yorkshire swine differed significantly from those for humans and baboons in all commonly measured parameters except platelet count, which did not differ significantly from the human value, and glucose, which was not significantly different from the baboon value. These data provide valuable information for investigators using female, juvenile Yorkshire swine for biomedical re- search, as disease models, and in xenotransplantation studies as well as useful physiologic information for veterinarians and livestock producers. Our findings highlight the need for caution when comparing data and study outcomes between species.
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Affiliation(s)
- Nikolaos Dimitrakakis
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Anna Waterhouse
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Shanda Lightbown
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Daniel C Leslie
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Amanda Jiang
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Dana E Bolgen
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Kayla Lightbown
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Kelly Cascio
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Gabriela Aviles
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Elizabeth Pollack
- Animal Research, Boston Children’s Hospital, Boston, Massachusetts; and
| | - Sam Jurek
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Kathryn Donovan
- Animal Research, Boston Children’s Hospital, Boston, Massachusetts; and
| | - Julia B Hicks-Berthet
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Kazuo Imaizumi
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Michael Super
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
| | - Donald E Ingber
- Wyss Institute for Biologically Inspired Engineering at Harvard University, Boston, Massachusetts
- Vascular Biology Program and Department of Surgery, Boston Children’s Hospital and Harvard Medical School, Boston, Massachusetts
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, Massachusetts
| | - Arthur Nedder
- Animal Research, Boston Children’s Hospital, Boston, Massachusetts; and
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18
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Nwankwo L, McLaren K, Donovan J, Ni Z, Vidal-Diaz A, Loebinger M, Morrisey A, Igra A, Shah A. Utilisation of remote capillary blood testing in an outpatient clinic setting to improve shared decision making and patient and clinician experience: a validation and pilot study. BMJ Open Qual 2021; 10:bmjoq-2020-001192. [PMID: 34413067 PMCID: PMC8378365 DOI: 10.1136/bmjoq-2020-001192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 08/05/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND In a tertiary respiratory centre, large cohorts of patients are managed in an outpatient setting and require blood tests to monitor disease activity and organ toxicity. This requires either visits to tertiary centres for phlebotomy and physician review or utilisation of primary care services. OBJECTIVES This study aims to validate remote capillary blood testing in an outpatient setting and analyse impact on clinical pathways. METHODS A single-centre prospective cross-sectional validation and parallel observational study was performed. Remote finger prick capillary blood testing was validated compared with local standard venesection using comparative statistical analysis: paired t-test, correlation and Bland-Altman. Capillary was considered interchangeable with venous samples if all three criteria were met: non-significant paired t-test (ie, p>0.05), Pearson's correlation coefficient (r)>0.8% and 95% of tests within 10% difference through Bland-Altman (limits of agreement). In parallel, current clinical pathways including phlebotomy practice were analysed over 4 weeks to review test predictability. A subsequent pilot cohort study analysed potential impact of remote capillary blood sampling on shared decision making. A final implementation phase ensued to embed the service into clinical pathways within the institution. RESULTS 117 paired capillary and venous blood samples were prospectively analysed. Interchangeability with venous blood was seen with glycated haemoglobin (%), total protein and C reactive protein. Further tests, although not interchangeable, are likely useful to enable longitudinal remote monitoring (eg, liver function and total IgE). 65% of outpatient clinic blood tests were predictable with 16% of patients requiring further follow-up. Patient and clinician-reported improvement in shared decision making given contemporaneous blood test results was observed. CONCLUSIONS Remote capillary blood sampling can be used accurately for specific tests to monitor chronic disease, and when incorporated into an outpatient clinical pathway can improve shared decision making and patient experience. Further research is required to determine health economic impact and applicability within telemedicine-based outpatient care.
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Affiliation(s)
- Lisa Nwankwo
- Pharmacy, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Kate McLaren
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Jackie Donovan
- Department of Pathology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Zhifang Ni
- Faculty of Medicine, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alberto Vidal-Diaz
- Faculty of Medicine, Department of Surgery and Cancer, Imperial College London, London, UK
| | - Michael Loebinger
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK,National Heart and Lung Institute, London, UK
| | - Alice Morrisey
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Adam Igra
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Anand Shah
- Department of Respiratory Medicine, Royal Brompton and Harefield NHS Foundation Trust, London, UK,MRC Centre of Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London, UK
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19
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Meng QH. Are Arterial Blood Samples Acceptable for Chemistry Testing in Laboratory Practice? J Appl Lab Med 2021; 6:1380-1383. [PMID: 34313299 DOI: 10.1093/jalm/jfab060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 05/14/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Qing H Meng
- Department of Laboratory Medicine, Division of Pathology and Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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20
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Zeljkovic A, Csuzdi Balog Z, Dukai E, Vekic J, Jelic-Ivanovic Z, Spasojevic-Kalimanovska V. Indirect reference intervals for haematological parameters in capillary blood of pre-school children. Biochem Med (Zagreb) 2021; 31:010709. [PMID: 33594298 PMCID: PMC7852301 DOI: 10.11613/bm.2021.010709] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/09/2020] [Indexed: 11/30/2022] Open
Abstract
Introduction Indirect estimation of reference intervals (RIs) is straightforward and inexpensive procedure for determination of intra-laboratory RIs. We applied the indirect approach to assess RIs for haematological parameters in capillary blood of pre-school children, using results stored in our laboratory database. Materials and methods We extracted data from laboratory information system, for the results obtained by automatic haematology analyser in capillary blood of 154 boys and 146 girls during pre-school medical examination. Data distribution was tested, and logarithmic transformation was applied if needed. Reference intervals were calculated by the nonparametric percentile method. Results Reference intervals were calculated for: RBC count (4.2-5.4 x1012/L), haemoglobin (114-146 g/L), MCH (25.0-29.4 pg), MCHC (321-368 g/L), RDW-SD (36.1-43.5 fL), WBC count (4.5-12.3 x109/L), neutrophils count (1.7-6.9 x109/L) and percentage (29.0-69.0%), lymphocytes count (1.6-4.4 x109/L) and percentage (21.9-60.7%), PLT (165-459 x109/L), MPV (8.1-11.4 fL) and PDW (9.2-14.4%). Gender specific RIs were calculated for monocytes count (male (M): 0.2-1.6 x109/L; female (F): 0.1-1.4 x109/L) and percentage (M: 2.5-18.3%; F: 1.8-16.7%), haematocrit (M: 0.34-0.42 L/L; F: 0.34-0.43 L/L), MCV (M: 73.4-84.6 fL; F: 75.5-84.2 fL) and RDW (M: 12.1-14.3%; F: 11.7-13.9%), due to observed gender differences in these parameters (P = 0.031, 0.028, 0.020, 0.012 and 0.001; respectively). Estimated RIs markedly varied from the literature based RIs that are used in the laboratory. Conclusions Indirect method employed in this study enables straightforward assessment of RIs in pre-school children. Herein derived RIs differed from the literature-based ones, indicating the need for intra-laboratory determination of RIs for specific populations and sample types.
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Affiliation(s)
- Aleksandra Zeljkovic
- Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | | | - Eva Dukai
- Department of Laboratory Diagnostics, Healthcare Centre Kanjiža, Kanjiža, Serbia
| | - Jelena Vekic
- Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
| | - Zorana Jelic-Ivanovic
- Department for Medical Biochemistry, Faculty of Pharmacy, University of Belgrade, Belgrade, Serbia
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21
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Agrawal P, Katragadda S, Hariharan AK, Raghavendrachar VG, Agarwal A, Dayalu R, Awasthy D, Sharma SC, Sivasamy YK, Lakshmana P, Shanmugam A, Veeramachaneni V, Gupta V, Vani BP, Subaiya L, Syamala TS, Hariharan R, Chandru V, Bloom DE. Validation of whole genome sequencing from dried blood spots. BMC Med Genomics 2021; 14:110. [PMID: 33879142 PMCID: PMC8056537 DOI: 10.1186/s12920-021-00951-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 03/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Dried blood spots (DBS) are a relatively inexpensive source of nucleic acids and are easy to collect, transport, and store in large-scale field surveys, especially in resource-limited settings. However, their performance in whole-genome sequencing (WGS) relative to that of venous blood DNA has not been analyzed for various downstream applications. METHODS This study compares the WGS performance of DBS paired with venous blood samples collected from 12 subjects. RESULTS Results of standard quality checks of coverage, base quality, and mapping quality were found to be near identical between DBS and venous blood. Concordance for single-nucleotide variants, insertions and deletions, and copy number variants was high between these two sample types. Additionally, downstream analyses typical of population-based studies were performed, such as mitochondrial heteroplasmy detection, haplotype analysis, mitochondrial copy number changes, and determination of telomere lengths. The absolute mitochondrial copy number values were higher for DBS than for venous blood, though the trend in sample-to-sample variation was similar between DBS and blood. Telomere length estimates in most DBS samples were on par with those from venous blood. CONCLUSION DBS samples can serve as a robust and feasible alternative to venous blood for studies requiring WGS analysis.
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Affiliation(s)
- Pooja Agrawal
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Shanmukh Katragadda
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Arun K Hariharan
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | | | - Arunika Agarwal
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Rashmi Dayalu
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, 02115, USA
| | - Disha Awasthy
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Sanjay C Sharma
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Yasodha Kannan Sivasamy
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - P Lakshmana
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Ashwini Shanmugam
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Vamsi Veeramachaneni
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Vaijayanti Gupta
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - B P Vani
- The Institute for Social and Economic Change, Dr. VKRV Rao Road, Teachers Colony, Nagarabhavi, Bangalore, Karnataka, 560072, India
| | - Lekha Subaiya
- The Institute for Social and Economic Change, Dr. VKRV Rao Road, Teachers Colony, Nagarabhavi, Bangalore, Karnataka, 560072, India
| | - T S Syamala
- The Institute for Social and Economic Change, Dr. VKRV Rao Road, Teachers Colony, Nagarabhavi, Bangalore, Karnataka, 560072, India
| | - Ramesh Hariharan
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India
| | - Vijay Chandru
- Strand Life Sciences Pvt. Ltd., Ground Floor, UAS Alumni Association Building, Veterinary College Campus, Bellary Road, Bangalore, Karnataka, 560024, India.
- Centre for BioSystems Science and Engineering, 3rd Floor, C Wing, Biological Sciences Building, Indian Institute of Science, Bangalore, 560012, India.
| | - David E Bloom
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, 02115, USA.
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Leski TA, Taitt CR, Bangura U, Lahai J, Lamin JM, Baio V, Koroma MS, Swaray AG, Jacobsen KH, Jackson O, Jones BW, Phillips CL, Ansumana R, Stenger DA. Comparison of capillary and venous blood for malaria detection using two PCR-based assays in febrile patients in Sierra Leone. Malar J 2021; 20:133. [PMID: 33676502 PMCID: PMC7936501 DOI: 10.1186/s12936-021-03644-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background Rapid and sensitive diagnostics are critical tools for clinical case management and public health control efforts. Both capillary and venous blood are currently used for malaria detection and while diagnostic technologies may not be equally sensitive with both materials, the published data on this subject are scarce and not conclusive. Methods Paired clinical samples of venous and capillary blood from 141 febrile individuals in Bo, Sierra Leone, were obtained between January and May 2019 and tested for the presence of Plasmodium parasites using two multiplexed PCR assays: the FilmArray-based Global Fever Panel (GFP) and the TaqMan-based Malaria Multiplex Sample Ready (MMSR) assay. Results No significant differences in Plasmodium parasite detection between capillary and venous blood for both assays were observed. The GFP assay was more sensitive than MMSR for all markers that could be compared (Plasmodium spp. and Plasmodium falciparum) in both venous and capillary blood. Conclusions No difference was found in malaria detection between venous and capillary blood using two different PCR-based detection assays. This data gives support for use of capillary blood, a material which can be obtained easier by less invasive methods, for PCR-based malaria diagnostics, independent of the platform.
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Affiliation(s)
- Tomasz A Leski
- Center for Bio/Molecular Science & Engineering, U.S. Naval Research Laboratory, Washington, DC, USA.
| | - Chris Rowe Taitt
- Center for Bio/Molecular Science & Engineering, U.S. Naval Research Laboratory, Washington, DC, USA
| | - Umaru Bangura
- Mercy Hospital Research Laboratory, Bo, Sierra Leone
| | - Joseph Lahai
- Mercy Hospital Research Laboratory, Bo, Sierra Leone
| | | | - Victoria Baio
- Mercy Hospital Research Laboratory, Bo, Sierra Leone
| | | | - Abdulai G Swaray
- College of Science, George Mason University, Fairfax, Virginia, USA
| | - Kathryn H Jacobsen
- Department of Global & Community Health, George Mason University, Fairfax, Virginia, USA
| | | | | | | | - Rashid Ansumana
- Mercy Hospital Research Laboratory, Bo, Sierra Leone.,Njala University, Bo, Sierra Leone
| | - David A Stenger
- Center for Bio/Molecular Science & Engineering, U.S. Naval Research Laboratory, Washington, DC, USA
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Tayari H, Flaherty D, Yamaoka TT, Auckburally A. Assessment of pulse co-oximetry technology after in vivo adjustment in anaesthetized dogs. Vet Anaesth Analg 2021; 48:297-304. [PMID: 33610477 DOI: 10.1016/j.vaa.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/16/2020] [Accepted: 08/21/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To compare values of haemoglobin concentration (SpHb), arterial haemoglobin saturation (SpO2) and calculated arterial oxygen content (SpOC), measured noninvasively with a pulse co-oximeter before and after in vivo adjustment (via calibration of the device using a measured haemoglobin concentration) with those measured invasively using a spectrophotometric-based blood gas analyser in anaesthetized dogs. STUDY DESIGN Prospective observational clinical study. ANIMALS A group of 39 adult dogs. METHODS In all dogs after standard instrumentation, the dorsal metatarsal artery was catheterised for blood sampling, and a pulse co-oximeter probe was applied to the tongue for noninvasive measurements. Paired data for SpHb, SpO2 and SpOC from the pulse co-oximeter and haemoglobin arterial oxygen saturation (SaO2) and arterial oxygen content (CaO2) from the blood gas analyser were obtained before and after in vivo adjustment. Bland-Altman analysis for repeated measurements was used to evaluate the bias, precision and agreement between the pulse co-oximeter and the blood gas analyser. Data are presented as mean differences and 95% limits of agreement (LoA). RESULTS A total of 39 data pairs were obtained before in vivo adjustment. The mean invasively measured haemoglobin-SpHb difference was -2.7 g dL-1 with LoA of -4.9 to -0.5 g dL-1. After in vivo adjustment, 104 data pairs were obtained. The mean invasively measured haemoglobin-SpHb difference was -0.2 g dL-1 with LoA of -1.1 to 0.6 g dL-1. The mean SaO2-SpO2 difference was 0.86% with LoA of -0.8% to 2.5% and that between CaO2-SpOC was 0.66 mL dL-1 with LoA of -2.59 to 3.91 mL dL-1. CONCLUSIONS Before in vivo adjustment, pulse co-oximeter derived values overestimated the spectrophotometric-based blood gas analyser haemoglobin and CaO2 values. After in vivo adjustment, the accuracy, precision and LoA markedly improved. Therefore, in vivo adjustment is recommended when using this device to monitor SpHb in anaesthetised dogs.
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Affiliation(s)
- Hamaseh Tayari
- ChesterGates Veterinary Specialists CVS (UK) Ltd, Chester, UK.
| | - Derek Flaherty
- Southern Counties Veterinary Specialist (SCVS) (UK) Independent Vetcare Ltd, Ringwood, UK
| | | | - Adam Auckburally
- Southern Counties Veterinary Specialist (SCVS) (UK) Independent Vetcare Ltd, Ringwood, UK
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24
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Wielińska-Wiśniewska H, Nowak JK, Da Browski M, Szydłowska P, Szczepanik M, Cichocka K, Krzyżanowska-Jankowska P, Walkowiak J. Reliability of Capillary Complete Blood Count in Children With Acute Gastroenteritis. Front Pediatr 2021; 9:715576. [PMID: 34447730 PMCID: PMC8384108 DOI: 10.3389/fped.2021.715576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 07/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background: To assess the reliability of complete blood count (CBC) in the capillary blood of children with acute gastroenteritis (AGE), with a focus on leukocytes. Methods: This was a retrospective cross-sectional study. Complete blood count was compared between the capillary and venous blood in children admitted to a pediatric gastroenterology department with primary diagnosis of AGE (ICD-10 A09, A08.0, A08.2). Capillary blood was obtained in the emergency room and venous blood was sampled in the ward shortly thereafter during peripheral intravenous line placement. Results: One hundred and forty children were included. The mean (±SD) age and weight of patients were 3.0 ± 2.9 years and 16 ± 9 kg; 26% had leukocytosis. The mean difference between obtaining results of capillary and venous blood tests was 2 ± 1 h. Area under the receiver operating characteristic curve (AUC) for the identification of leukocytosis using the capillary blood was 0.98 (95% CI 0.96-1.0). The sensitivity and specificity were 86 and 98%, respectively (accuracy 95%). The positive and negative predictive values were 94 and 95%, respectively. The intraclass correlation coefficient revealed high concordance between capillary and venous CBC measurements (leukocyte count 0.94, hemoglobin 0.88, erythrocyte count 0.77, hematocrit 0.79, platelet count 0.90). Matched pairs comparisons revealed marginally higher erythrocytes (difference of medians: 0.2 T/L), hemoglobin (0.3 g/dL), hematocrit (1.0%), and platelets (9 G/L) in the capillary blood. Conclusion: Capillary CBC is useful in detecting leukocytosis in children with AGE.
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Affiliation(s)
- Hanna Wielińska-Wiśniewska
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Jan K Nowak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Michał Da Browski
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Paula Szydłowska
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariusz Szczepanik
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Cichocka
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | | | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
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25
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Comparison of Hematological and Biochemical Results Derived from Arterial and Venous Blood Samples in Post-Anesthetic Dogs. Animals (Basel) 2020; 10:ani10112069. [PMID: 33182229 PMCID: PMC7695303 DOI: 10.3390/ani10112069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022] Open
Abstract
Simple Summary In contrast to humans, general anesthesia is required for both surgical procedures and diagnostic imaging like magnetic resonance imaging (MRI) and computed tomography (CT) in small animals. Because the post-anesthetic period is a particularly high risk time for death, serial monitoring of biochemical and hematological parameters could be required. Blood samples could be collected from an indwelling arterial catheter to avoid stress caused by venipuncture, but studies using arterial blood for hematological and biochemical testing have been limited. The aim of this study is to compare hematological and biochemical results derived from venous and arterial blood samples, and to evaluate their clinical interchangeability in post-anesthetic dogs. We found statistically significant but clinically irrelevant differences in hemoglobin, glucose, creatinine, and calcium levels, and results from venous and arterial blood samples are not clinically interchangeable for gamma-glutamyl transpeptidase and potassium levels. Abstract Collecting blood from an indwelling arterial catheter may reduce stress from repeated venipuncture in patients requiring serial monitoring, but the use of arterial blood for hematological and biochemical testing remains understudied. Here, we compared hematological and biochemical results of arterial and venous blood and evaluated their clinical interchangeability. Blood samples from dogs who had recovered from anesthesia, collected by both arterial catheterization and venipuncture, were analyzed. To assess clinical acceptance between paired samples, the limit of agreement between the values derived from the arterial and venous blood samples was compared with the allowable total error (TEa) recommended for each parameter. We found no significant differences between the arterial and venous sample results for red/white blood cell and platelet counts and hematocrit, blood urea nitrogen, phosphate, total protein, albumin, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, total bilirubin, sodium, potassium, and chloride levels, whereas hemoglobin, glucose, creatinine, and calcium levels differed significantly (p < 0.05). Moreover, only gamma-glutamyl transpeptidase and potassium exceeded the recommended TEa. Hematological and biochemical results derived from venous and arterial blood samples are clinically interchangeable in post-anesthetic dogs, with the exception of gamma-glutamyl transpeptidase and potassium; thus, these values should be used with caution.
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26
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Golding CN, Schaltz-Buchholzer F, Sanca L, Clipet-Jensen C, Benn CS, Au N, Chipperfield K, Kollmann TR, Amenyogbe NA. Feasibility of manual white blood cell counts as a predictor of neonatal sepsis in a low-resource setting. Trans R Soc Trop Med Hyg 2020; 114:566-574. [PMID: 32333010 DOI: 10.1093/trstmh/traa023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/17/2020] [Accepted: 03/13/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Manual white blood cell (WBC) differential counts as a predictor for neonatal sepsis development in a low-resource setting have not been thoroughly evaluated. We hypothesized that manual differentiation (specifically immature:total [I:T] neutrophil ratios) would be feasible and useful as an adjunct to predict early-onset neonatal sepsis (EONS). Secondarily, we hypothesized that vaccination with bacillus Calmette-Guérin (BCG) and oral polio vaccine (OPV) could alter WBC differential counts and thus might reduce its predictive performance. METHODS We performed a prospective cohort study within a randomized trial, randomizing healthy, high-risk newborns admitted to the nursery at the national hospital in Guinea-Bissau 1:1 to BCG+OPV at admission or at discharge (usual practice). Thin capillary blood films were prepared at 2 d of age in a subset of 268 neonates. WBC counts were assessed by microscopy and neonates were followed up for sepsis development within 2 weeks. RESULTS Ninety-eight percent (264/268) of smears provided interpretable reads. Of the 264 children, 136 had been randomized to receive BCG+OPV prior to sampling; the remaining 128 were vaccinated at discharge. The I:T ratio (average 0.017) was lower among children who did not develop clinical sepsis but did not predict sepsis (p=0.70). Only three children had an I:T ratio >0.2 (associated with a higher probability of clinical sepsis in previous studies) but did not develop sepsis. Immunization did not alter WBC composition. CONCLUSIONS Manual WBC differentials are feasible in low-resource settings. WBC differentials are not affected by standard newborn immunization. However, the I:T ratio had no value in predicting subsequent development of sepsis.
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Affiliation(s)
- Christian N Golding
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
- Institute of Health, Aarhus University, Nordre Ringgade 1, Aarhus C 8000, Denmark
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
| | - Frederik Schaltz-Buchholzer
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
- OPEN, Department of Clinical Research, University of Southern Denmark, and Odense University Hospital, J.B. Winsløws Vej 9A, Odense C 5000, Denmark
| | - Lilica Sanca
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
| | - Clara Clipet-Jensen
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
| | - Christine S Benn
- Bandim Health Project, Indepth Network, Apartado 861, Bissau 1004, Guinea-Bissau
- Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, Copenhagen S 2300, Denmark
- OPEN, Department of Clinical Research, University of Southern Denmark, and Odense University Hospital, J.B. Winsløws Vej 9A, Odense C 5000, Denmark
| | - Nicholas Au
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227-2211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5
| | - Kate Chipperfield
- Department of Pathology and Laboratory Medicine, University of British Columbia, Rm. G227-2211 Wesbrook Mall, Vancouver, BC Canada V6T 2B5
| | - Tobias R Kollmann
- Department of Pediatrics, University of British Columbia, Rm 2D19, 4480 Oak Street, Vancouver, BC Canada V6H 3V4
| | - Nelly A Amenyogbe
- Department of Experimental Medicine, University of British Columbia, 2775 Laurel Street, Vancouver, BC Canada V5Z 1M9
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27
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Eick GN, Cepon-Robins TJ, Devlin MJ, Kowal P, Sugiyama LS, Snodgrass JJ. Development and validation of an ELISA for a biomarker of thyroid dysfunction, thyroid peroxidase autoantibodies (TPO-Ab), in dried blood spots. J Physiol Anthropol 2020; 39:16. [PMID: 32678000 PMCID: PMC7364519 DOI: 10.1186/s40101-020-00228-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 07/07/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The prevalence of allergic and autoimmune conditions has been steadily increasing in wealthy nations over the past century. One hypothesis put forward to explain this is the Old Friends Hypothesis, which posits that increased hygiene, urbanization, and lifestyle changes have reduced our exposure to parasites and microbes that we co-evolved with, resulting in immune dysregulation. However, research in traditionally living populations, who are exposed to greater parasite and pathogen loads such as those encountered during our evolution, is limited, in part due to a lack of minimally invasive, field-friendly biomarkers of autoimmune disorders. We therefore developed an ELISA to assess positivity for thyroid peroxidase autoantibody (TPO-Ab), an indicator of autoimmune thyroid disease, based on dried blood spot (DBS) samples. RESULTS We used the Accubind anti-thyroid peroxidase test system to screen our validation samples comprising matched fingerprick DBS, venous DBS, and plasma samples from 182 adults. After confirming that we had TPO-Ab-positive individuals in our validation sample (n = 12), we developed an indirect ELISA to measure TPO-Ab levels from one 3-mm DBS punch. The sensitivity and specificity of our assay for DBS samples ranged from 91.7-100% and 98.2-98.8%, respectively, using a cut-off value of ≥ 26 IU/mL. Intra-assay reliability for duplicate quality control DBS punches was 5.2%, while inter-assay reliability ranged from 11.5-24.4% for high, medium, and low DBS controls. Dilutional linearity ranged from 80 to 120%, and spike and recovery experiments indicated that the DBS matrix does not interfere with the detection of TPO-Ab. TPO-Ab levels remained stable in DBS samples stored at - 28 °C or - 80 °C, but decreased over time in DBS samples kept at 22 °C or at 37 °C. CONCLUSIONS We developed an in-house, kit-independent indirect ELISA assay to determine individuals' TPO-Ab positivity based on dried blood spots, representing a cost-effective method with potential applications in a range of research settings.
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Affiliation(s)
- Geeta N Eick
- Department of Anthropology, University of Oregon, Eugene, OR, 97403, USA.
| | - Tara J Cepon-Robins
- Department of Anthropology, University of Colorado Springs, Colorado Springs, CO, 80918, USA
| | - Maureen J Devlin
- Department of Anthropology, University of Michigan, Ann Arbor, MI, USA
| | - Paul Kowal
- University of Newcastle Research Centre for Generational Health and Ageing, Newcastle, New South Wales, Australia.,Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
| | - Larry S Sugiyama
- Department of Anthropology, University of Oregon, Eugene, OR, 97403, USA
| | - J Josh Snodgrass
- Department of Anthropology, University of Oregon, Eugene, OR, 97403, USA
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28
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Shaban L, Al-Taiar A, Rahman A, Al-Sabah R, Mojiminiyi O. Anemia and its associated factors among Adolescents in Kuwait. Sci Rep 2020; 10:5857. [PMID: 32246050 PMCID: PMC7125127 DOI: 10.1038/s41598-020-60816-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 02/11/2020] [Indexed: 11/09/2022] Open
Abstract
We estimated the prevalence of anemia among school children and investigated factors associated with this problem in Kuwait. A cross-sectional study was conducted on 1415 adolescents randomly selected from middle schools in Kuwait. Hemoglobin, iron, ferritin, folate and vitamin B12, in addition to many other laboratory indicators, were measured in a venous blood sample. Data on risk factors for anemia were collected from parents and adolescents. Multiple logistic regression was used to investigate factors associated with anemia. The prevalence of anemia was 8.06% (95% CI: 6.69-9.60%), which was significantly higher among females compared to males (10.96% vs. 5.04%; p < 0.001). Mean (SD) Hb level was 133.7 (9.89) g/L and 130.00 (10.48) g/L among males and females, respectively (p < 0.001). The prevalence of mild, moderate and severe anemia was 5.94%, 1.91% and 0.21%, respectively. Gender, age, iron concentration and ferritin were associated with anemia in multivariable analysis. These data indicate that anemia among school children in Kuwait is of mild public health significance. Further reduction in anemia in school girls should focus on correcting iron deficiency. Surveillance systems for anemia may consider using a cut-off point that is specific for the method of blood sampling and the method of Hb measurement.
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Affiliation(s)
- Lemia Shaban
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Kuwait, Kuwait
| | - Abdullah Al-Taiar
- School of Community & Environmental Health, College of Health Sciences, Old Dominion University, Norfolk, VA, 23529, USA
| | - Abdur Rahman
- Department of Food Science and Nutrition, College of Life Sciences, Kuwait University, Kuwait, Kuwait.
| | - Reem Al-Sabah
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
| | - Olusegun Mojiminiyi
- Department of Pathology, Faculty of Medicine, Kuwait University, Kuwait, Kuwait
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29
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Rej PH, Bondy MH, Lin J, Prather AA, Kohrt BA, Worthman CM, Eisenberg DTA. Telomere length analysis from minimally-invasively collected samples: Methods development and meta-analysis of the validity of different sampling techniques: American Journal of Human Biology. Am J Hum Biol 2020; 33:e23410. [PMID: 32189404 DOI: 10.1002/ajhb.23410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/07/2020] [Accepted: 02/29/2020] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Telomeres are the protective caps of chromosomes. They shorten with cell replication, age, and possibly environmental stimuli (eg, infection and stress). Short telomere length (TL) predicts subsequent worse health. Although venous whole blood (VWB) is most commonly used for TL measurement, other, more minimally invasive, sampling techniques are becoming increasingly common due to their field-friendliness, allowing for feasible measurement in low-resource contexts. We conducted statistical validation work for measuring TL in dried blood spots (DBS) and incorporated our results into a meta-analysis evaluating minimally invasive sampling techniques to measure TL. METHODS We isolated DNA extracts from DBS using a modified extraction protocol and tested how they endured different shipping conditions and long-term cryostorage. We then included our in-house DBS TL validation statistics (correlation values with VWB TL and age) in a series of meta-analyses of results from 24 other studies that published similar associations for values between TL measured in DBS, saliva, and buccal cells. RESULTS Our modified DBS extraction technique produced DNA yields that were roughly twice as large as previously recorded. Partially extracted DBS DNA was stable for 7 days at room temperature, and still provided reliable TL measurements, as determined by external validation statistics. In our meta-analysis, DBS TL had the highest external validity, followed by saliva, and then buccal cells-possibly reflecting similarities/differences in cellular composition vs VWB. CONCLUSIONS DBS DNA is the best proxy for VWB from the three minimally-invasively specimen types evaluated and can be used to expand TL research to diverse settings and populations.
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Affiliation(s)
- Peter H Rej
- Department of Anthropology, University of Washington, Seattle, Washington, USA
| | - Madison H Bondy
- Department of Anthropology, Emory University, Atlanta, Georgia, USA
| | - Jue Lin
- Department of Biochemistry and Biophysics, University of California, San Francisco, California, USA
| | - Aric A Prather
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Brandon A Kohrt
- Department of Psychiatry and Behavioral Services, George Washington University, Washington, District of Columbia, USA
| | - Carol M Worthman
- Department of Anthropology, Emory University, Atlanta, Georgia, USA
| | - Dan T A Eisenberg
- Department of Anthropology, University of Washington, Seattle, Washington, USA.,Center for Studies in Demography and Ecology, Seattle, Washington, USA
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Multicenter comparison of three intraoperative hemoglobin trend monitoring methods. J Clin Monit Comput 2019; 34:883-892. [PMID: 31797199 PMCID: PMC7447626 DOI: 10.1007/s10877-019-00428-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 11/20/2019] [Indexed: 01/28/2023]
Abstract
Transfusion decisions are guided by clinical factors and measured hemoglobin (Hb). Time required for blood sampling and analysis may cause Hb measurement to lag clinical conditions, thus continuous intraoperative Hb trend monitoring may provide useful information. This multicenter study was designed to compare three methods of determining intraoperative Hb changes (trend accuracy) to laboratory determined Hb changes. Adult surgical patients with planned arterial catheterization were studied. With each blood gas analysis performed, pulse cooximetry hemoglobin (SpHb) was recorded, and arterial blood Hb was measured by hematology (tHb), arterial blood gas cooximetry (ABGHb), and point of care (aHQHb) analyzers. Hb change was calculated and trend accuracy assessed by modified Bland–Altman analysis. Secondary measures included Hb measurement change direction agreement. Trend accuracy mean bias (95% limits of agreement; g/dl) for SpHb was 0.10 (− 1.14 to 1.35); for ABGHb was − 0.02 (− 1.06 to 1.02); and for aHQHb was 0.003 (− 0.95 to 0.95). Changes more than ± 0.5 g/dl agreed with tHb changes more than ± 0.25 g/dl in 94.2% (88.9–97.0%) SpHb changes, 98.9% (96.1–99.7%) ABGHb changes and 99.0% (96.4–99.7%) aHQHb changes. Sequential changes in SpHb, ABGHb and aHQHb exceeding ± 0.5 g/dl have similar agreement to the direction but not necessarily the magnitude of sequential tHb change. While Hb blood tests should continue to be used to inform transfusion decisions, intraoperative continuous noninvasive SpHb decreases more than − 0.5 g/dl could be a good indicator of the need to measure tHb.
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31
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Dubach IL, Christ ER, Diem P. HbA 1c-testing: Evaluation of two point-of-care analysers. Prim Care Diabetes 2019; 13:583-587. [PMID: 31175054 DOI: 10.1016/j.pcd.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 05/02/2019] [Accepted: 05/12/2019] [Indexed: 01/15/2023]
Abstract
BACKGROUND HbA1c is a critical parameter for the medical management of patients with diabetes mellitus. Interventions that reduce HbA1c levels lead to a diminution of microvascular complications. For two decades, point of care testing (POCT) methods have been regularly used to measure HbA1c. The results significantly impact on the management of patients with diabetes mellitus and the accuracy of the results is critical. It is important to know the performance of common methods of HbA1c measurements in daily life. We, therefore, aimed at evaluating the accuracy of two different analysers especially developed for POCT and compared them to a reference method. METHODS We prospectively tested two widely used POCT methods to measure HbA1c, namely Afinion™ AS100 Analyzer (Axis-Shield, Oslo Norway) and DCA Vantage™ Analyzer (Siemens Healthcare Diagnostics, Tarrytown NY, US) in venous samples of 100 patients. As a reference method, we used the high-performance liquid chromatography method G8 HPLC used in the Biochemistry Laboratory of the Inselspital Bern. The National Glycohaemoglobin Standardization Program (NGSP) has certificated all methods used in this study. The comparability and degree of agreement was assessed using Bland-Altman plot. RESULTS The HbA1c levels ranged from 33 to 116 mmol/mol (5.2-12.8%), 31-122 mmol/mol (5.0-13.3%) and 30-119 mmol/mol (4.9-13%) for Afinion™, DCA Vantage™ and G8 HPLC Analyzer, respectively. The 95% limits of agreement were between -0.84 and +0.30 for the Afinion™ and -0.71 and +0.29 for DCA Vantage™. The results of both POCT were significantly lower with a bias of -0.27% and -0.21% (p < 0.0001) for Afinion™ and DCA Vantage™ Analyzer, respectively. CONCLUSIONS The POCT methods tested in this study showed a good correlation with the laboratory reference method, however, with an overall negative bias.
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Affiliation(s)
- Irina L Dubach
- Division of Internal Medicine, University of Zurich, Zurich, Switzerland; Diabetes Technology Research Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Emanuel R Christ
- Division of Endocrinology, Diabetes and Metabolism, University of Basel, Basel, Switzerland
| | - Peter Diem
- Diabetes Technology Research Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland.
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Otto Mattsson T, Lindhart CL, Schöley J, Friis‐Hansen L, Herrstedt J. Patient self‐testing of white blood cell count and differentiation: A study of feasibility and measurement performance in a population of Danish cancer patients. Eur J Cancer Care (Engl) 2019; 29:e13189. [DOI: 10.1111/ecc.13189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 05/26/2019] [Accepted: 10/24/2019] [Indexed: 12/26/2022]
Affiliation(s)
| | | | - Jonas Schöley
- Department of Public Health University of Southern Denmark Odense Denmark
| | | | - Jørn Herrstedt
- Department of Clinical Oncology Zealand University Hospital Roskilde Denmark
- University of Copenhagen Copenhagen Denmark
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Kim H, Do SH, Hwang JW, Na HS. Intraoperative continuous noninvasive hemoglobin monitoring in patients with placenta previa undergoing cesarean section: a prospective observational study. Anesth Pain Med (Seoul) 2019; 14:423-428. [PMID: 33329772 PMCID: PMC7713795 DOI: 10.17085/apm.2019.14.4.423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 04/09/2019] [Accepted: 04/25/2019] [Indexed: 11/17/2022] Open
Abstract
Background Obstetric patients with placenta previa are at risk for sever peripartum hemorrhage. Early detection of anemia and proper transfusion strategy are important for the management of obstetric hemorrhage. In this study, we assessed the utility and accuracy of noninvasive hemoglobin (SpHb) monitoring in patients with placenta previa during cesarean section. Methods Parturients diagnosed with placenta previa and scheduled for cesarean section under spinal anesthesia were enrolled. SpHb and laboratory Hb (Lab-Hb) were measured during surgery as primary outcomes. Results Seventy-four pairs of SpHb and Lab-Hb were collected from 39 patients. The correlation coefficient was 0.877 between SpHb and Lab-Hb (P < 0.001). The Bland–Altman plot showed a mean difference ± SD of 0.3 ± 0.8 g/dl between noninvasive Hb and Lab-Hb, and the limits of agreement were −1.2 to 1.8 g/dl. The magnitude of the difference between SpHb and Lab-Hb was < 0.5 g/dl in 64.9%; however, it was > 1.5 g/dl in 10.8%. Conclusions SpHb monitoring had a good correlation with Lab-Hb. A small mean difference between SpHb and lab-Hb might not be clinically significant; however, the limits of agreements were not narrow. In particular, SpHb could be overestimated in the anemic population. Based on our results, further studies investigating the accuracy and precision of SpHb monitoring should be performed in parturients presenting Hb below 10 g/dl.
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Affiliation(s)
- Hyunsung Kim
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sang-Hwan Do
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jung-Won Hwang
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hyo-Seok Na
- Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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Driver ID, Stobbe RW, Wise RG, Beaulieu C. Venous contribution to sodium MRI in the human brain. Magn Reson Med 2019; 83:1331-1338. [PMID: 31556169 PMCID: PMC6972645 DOI: 10.1002/mrm.27996] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 07/05/2019] [Accepted: 08/26/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE Sodium MRI shows great promise as a marker for cerebral metabolic dysfunction in stroke, brain tumor, and neurodegenerative pathologies. However, cerebral blood vessels, whose volume and function are perturbed in these pathologies, have elevated sodium concentrations relative to surrounding tissue. This study aims to assess whether this fluid compartment could bias measurements of tissue sodium using MRI. METHODS Density-weighted and B1 corrected sodium MRI of the brain was acquired in 9 healthy participants at 4.7T. Veins were identified using co-registered 1 H T 2 ∗ -weighted images and venous partial volume estimates were calculated by down-sampling the finer spatial resolution venous maps from the T 2 ∗ -weighted images to the coarser spatial resolution of the sodium data. Linear regressions of venous partial volume estimates and sodium signal were performed for regions of interest including just gray matter, just white matter, and all brain tissue. RESULTS Linear regression demonstrated a significant venous sodium contribution above the underlying tissue signal. The apparent venous sodium concentrations derived from regression were 65.8 ± 4.5 mM (all brain tissue), 71.0 ± 7.4 mM (gray matter), and 55.0 ± 4.7 mM (white matter). CONCLUSION Although the partial vein linear regression did not yield the expected sodium concentration in blood (~87 mM), likely the result of point spread function smearing, this regression highlights that blood compartments may bias brain tissue sodium signals across neurological conditions where blood volumes may differ.
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Affiliation(s)
- Ian D Driver
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Robert W Stobbe
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
| | - Richard G Wise
- Cardiff University Brain Research Imaging Centre, School of Psychology, Cardiff University, Cardiff, United Kingdom
| | - Christian Beaulieu
- Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada
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Srisala S, Pongsakul N, Sahakijpicharn T, Hongeng S, Chutipongtanate S, Apiwattanakul N. Capillary blood as an alternative specimen for enumeration of percentages of lymphocyte subsets. BMC Res Notes 2019; 12:633. [PMID: 31554512 PMCID: PMC6761722 DOI: 10.1186/s13104-019-4659-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 09/18/2019] [Indexed: 02/02/2023] Open
Abstract
Objective Capillary blood has been increasingly used in point-of-care setting for clinical monitoring in immunology and infectious diseases. We explored whether percentages of lymphocyte subsets (T-cells; CD3+, helper T-cells; CD4+, cytotoxic T-cells; CD8+, B-cells; CD19+, NK cells; CD56+, gamma delta T-cells, and regulatory T-cells) with regard to total lymphocyte count from capillary and venous blood of healthy volunteers were in good agreement. Results All percentages of lymphocyte subsets with regard to total lymphocyte count from capillary blood were significantly correlated with those from venous blood (r ≥ 0.9 for every cell type). However, Bland–Altman plots showed high agreement between capillary and venous samples only in those of CD3+, CD4+, and CD8+ cells (limit of agreement percentages from mean venous blood < 20%). However, the agreement of percentages of other lymphocyte subsets from venous and capillary blood was mediocre. We concluded that capillary blood could be used as an alternative for venous blood to determine percentages of CD3+, CD4+, and CD8+ cells with regard to total lymphocyte count.
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Affiliation(s)
- Supanart Srisala
- Section for Research Center, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand
| | - Nutkridta Pongsakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand
| | - Thiantip Sahakijpicharn
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand
| | - Suradej Hongeng
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand
| | - Somchai Chutipongtanate
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand.
| | - Nopporn Apiwattanakul
- Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, 270 Rama VI Road, Bangkok, 10400, Thailand.
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Saito K, Ueno S, Nakayama A, Nitta SI, Arai K, Hasunuma T, Saito Y. Overall Similarities and a Possible Factor Affecting Plasma Metabolome Profiles Between Venous and Capillary Blood Samples From 20 Healthy Human Males. J Pharm Sci 2019; 108:3737-3744. [PMID: 31493412 DOI: 10.1016/j.xphs.2019.08.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/08/2019] [Accepted: 08/21/2019] [Indexed: 12/23/2022]
Abstract
Amino acids and lipids are biomarkers used to assess the presence and severity of disease, as well as the toxicological response to drugs. Although upper-extremity venipuncture is a well-used standard technique, fingertip capillary sampling is a more convenient procedure. Delineating the global differences in amino acid and lipid levels in capillary and venous blood samples is paramount for expanding the application of capillary blood tests in biomarker assays. We recruited 20 healthy male subjects and collected plasma obtained from both fingertip capillary and antecubital venous blood. The samples were analyzed to determine the overall profiles of amino acids and lipids and to test for differences in their levels between both vessel types. The results demonstrated that the differences between capillary and venous blood had a lower impact than interindividual variations; however, trends of separation between them were observed for amino acids. The levels of 5 out of 28 amino acids scored fold changes over 30%, while 9 out of 498 lipids had a fold change over 30%. The time required for fingertip blood collection could be a factor for the differences in 3 metabolites. These findings provide useful information for the application of fingertip capillary blood sampling in biomarker assays.
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Affiliation(s)
- Kosuke Saito
- Division of Medical Safety Science, National Institute of Health Sciences, 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-9501, Japan
| | - Satoko Ueno
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-8681, Japan
| | - Akira Nakayama
- Research Institute for Bioscience Products & Fine Chemicals, Ajinomoto Co., Inc., 1-1 Suzuki-cho, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-8681, Japan
| | - Shin-Ichiro Nitta
- Bioanalysis Department, LSI Medience Corporation, 3-30-1 Shimura, Itabashi-ku, Tokyo 174-8555, Japan
| | - Koji Arai
- Bioanalysis Department, LSI Medience Corporation, 3-30-1 Shimura, Itabashi-ku, Tokyo 174-8555, Japan
| | - Tomoko Hasunuma
- Department of Research, Clinical Trial Center, Kitasato University Kitasato Institute Hospital, 5-9-1 Shirokane, Minato-ku, Tokyo 108-8642, Japan
| | - Yoshiro Saito
- Division of Medical Safety Science, National Institute of Health Sciences, 3-25-26 Tonomachi, Kawasaki-ku, Kawasaki-shi, Kanagawa 210-9501, Japan.
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Lehane A, Were M, Wade M, Hamadu M, Cahill M, Kiconco S, Kajubi R, Aweeka F, Mwebaza N, Li F, Parikh S. Comparison on simultaneous caillary and venous parasite density and genotyping results from children and adults with uncomplicated malaria: a prospective observational study in Uganda. BMC Infect Dis 2019; 19:559. [PMID: 31242863 PMCID: PMC6595677 DOI: 10.1186/s12879-019-4174-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 06/09/2019] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Blood smear microscopy remains the gold-standard method to diagnose and quantify malaria parasite density. In addition, parasite genotyping of select loci is the most utilized method for distinguishing recrudescent and new infections and to determine the number of strains per sample. In research settings, blood may be obtained from capillary or venous compartments, and results from these matrices have been used interchangeably. Our aim was to compare quantitative results for parasite density and strain complexity from both compartments. METHODS In a prospective observational study, children and adults presenting with uncomplicated Plasmodium falciparum malaria, simultaneous capillary and venous blood smears and dried blood spots were collected over 42-days following treatment with artemether-lumefantrine. Blood smears were read by two microscopists, any discrepancies resolved by a third reader. Parasite DNA fingerprinting was conducted using six microsatellites. Bland Altman analysis and paired t-test/McNemar's test were used to assess the difference in density readings and measurements. RESULTS Two hundred twenty-three participants were included in the analysis (177 children (35 HIV-infected/142 HIV-uninfected), 21 HIV-uninfected pregnant women, and 25 HIV-uninfected non-pregnant adults). Parasite density measurements did not statistically differ between capillary and venous blood smears at the time of presentation, nor over the course of 42-day follow-up. Characterization of merozoite surface protein-2 (MSP-2) genetic polymorphism demonstrated a higher level of strain diversity at the time of presentation in venous samples, as compared with capillary specimens (p = 0.02). There was a high degree of variability in genotype-corrected outcomes when pairs of samples from each compartment were compared using MSP-2 alone, although the variability was reduced with the use of multiple markers. CONCLUSIONS Parasite density measurements do not statistically differ between capillary and venous compartments in all studied demographic groups at the time of presentation with malaria, or over the course of follow-up. More strains were detected by MSP-2 genotyping in venous samples than in capillary samples at the time of malaria diagnosis. The use of multiple polymorphic markers reduces the impact of variability in strain detection on genotype-corrected outcomes. This study confirms that both capillary and venous compartments can be used for sampling with confidence in the clinical research setting. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov under registration no. NCT01717885 .
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Affiliation(s)
- Aine Lehane
- Yale School of Public Health, New Haven, CT USA
| | - Moses Were
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | | | | | - Sylvia Kiconco
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Richard Kajubi
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | | | - Norah Mwebaza
- Infectious Diseases Research Collaboration, Kampala, Uganda
| | - Fangyong Li
- Yale School of Public Health, New Haven, CT USA
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Neufeld LM, Larson LM, Kurpad A, Mburu S, Martorell R, Brown KH. Hemoglobin concentration and anemia diagnosis in venous and capillary blood: biological basis and policy implications. Ann N Y Acad Sci 2019; 1450:172-189. [PMID: 31231815 PMCID: PMC7496102 DOI: 10.1111/nyas.14139] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 05/14/2019] [Accepted: 05/20/2019] [Indexed: 11/28/2022]
Abstract
Anemia is an important public health challenge and accurate prevalence estimates are needed for program planning and tracking progress. While venous blood assessed by automated hematology analyzers is considered gold standard, most population‐based surveys use point‐of‐care diagnostics and capillary blood to estimate population prevalence of anemia. Several factors influence hemoglobin (Hb) concentration, including human and analytic error, analysis method, and type of instrument, but it is unclear whether biological variability exists between venous and capillary blood. The objective of this paper was to systematically review sources of Hb variability and the potential biological basis for venous and capillary differences. We use data from a recent survey in the state of Uttar Pradesh, India, to illustrate the implications on anemia prevalence estimates. Significant differences in Hb concentration between capillary and venous blood samples are common. Most but not all find capillary Hb concentration to be higher than venous. Instrument/method variability and human error play an important role, but cannot fully explain these differences. A normative guide to data collection, analysis, and anemia diagnosis is needed to ensure consistent and appropriate interpretation. Further research is needed to fully understand the biological implications of venous and capillary Hb variability.
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Affiliation(s)
| | - Leila M Larson
- Global Alliance for Improved Nutrition (GAIN), Geneva, Switzerland.,Department of Medicine, the University of Melbourne, Melbourne, Victoria, Australia
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Accuracy and trending ability of hemoglobin measurement by the Pulse CO-Oximeter during vascular surgery. J Clin Monit Comput 2019; 34:501-508. [DOI: 10.1007/s10877-019-00337-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 06/06/2019] [Indexed: 12/19/2022]
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Whitehead RD, Mei Z, Mapango C, Jefferds MED. Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings. Ann N Y Acad Sci 2019; 1450:147-171. [PMID: 31162693 DOI: 10.1111/nyas.14124] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 04/22/2019] [Accepted: 05/02/2019] [Indexed: 01/17/2023]
Abstract
This paper describes and compares methods and analyzers used to measure hemoglobin (Hb) in clinical laboratories and field settings. We conducted a literature review for methods used to measure Hb in clinical laboratories and field settings. We described methods to measure Hb and factors influencing results. Automated hematology analyzer (AHA) was reference for all Hb comparisons using evaluation criteria of ±7% set by College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA). Capillary fingerprick blood usually produces higher Hb concentrations compared with venous blood. Individual drops produced lower concentrations than pooled capillary blood. Compared with the AHA: (1) overall cyanmethemoglobin (1.0-8.0 g/L), WHO Colour Scale (0.5-10.0 g/L), paper-based devices (5.0-7.0 g/L), HemoCue® Hb-201 (1.0-16.0 g/L) and Hb-301 (0.5-6.0 g/L), and Masimo Pronto® (0.3-14.0 g/L) overestimated concentrations; (2) Masimo Radical®-7 both under- and overestimated concentrations (0.3-104.0 g/L); and (3) other methods underestimated concentrations (2.0-16.0 g/L). Most mean concentration comparisons varied less than ±7% of the reference. Hb measurements are influenced by several analytical factors. With few exceptions, mean concentration bias was within ±7%, suggesting acceptable performance. Appropriate, high-quality methods in all settings are necessary to ensure the accuracy of Hb measurements.This paper describes and compares methods and analyzers used to measure hemoglobin (Hb) in clinical laboratories and field settings. With few exceptions, mean concentration bias was within ±7%, suggesting acceptable performance. Appropriate, high-quality methods in all settings are necessary to ensure the accuracy of Hb measurements.
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Affiliation(s)
- Ralph D Whitehead
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Zuguo Mei
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carine Mapango
- Division of Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Maria Elena D Jefferds
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Scholkmann F, Ostojic D, Isler H, Bassler D, Wolf M, Karen T. Reference Ranges for Hemoglobin and Hematocrit Levels in Neonates as a Function of Gestational Age (22⁻42 Weeks) and Postnatal Age (0⁻29 Days): Mathematical Modeling. CHILDREN (BASEL, SWITZERLAND) 2019; 6:E38. [PMID: 30832270 PMCID: PMC6463180 DOI: 10.3390/children6030038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 02/26/2019] [Accepted: 02/27/2019] [Indexed: 11/16/2022]
Abstract
Hematological values of neonates need to be interpreted taking into account the fact that the reference ranges depend on the age of the neonate. We aimed to derive two general mathematical models for reference ranges for hemoglobin concentration (cHb) and hematocrit (Hct) levels in neonates as a function of gestational age (GA) and postnatal age (PNA), since it is known that GA and PNA are independent factors determining cHb and Hct. For this purpose, cHb and Hct values from the data set of Henry and Christensen (2015, Clin. Perinatol., 42, 483⁻497) from about 100,000 neonates (GA: 22⁻42 weeks, PNA: 0⁻28 days) were used and general models with two quadratic functions were derived. To the best of our knowledge, the models we have developed are the first published ones to provide reference ranges for cHb and Hct for neonates incorporating the parallel dependence on GA and PNA.
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Affiliation(s)
- Felix Scholkmann
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Daniel Ostojic
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Helene Isler
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Dirk Bassler
- Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Martin Wolf
- Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
| | - Tanja Karen
- Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland.
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Kohatsu L, Bolu O, Schmitz ME, Chang K, Lemwayi R, Arnett N, Mwasekaga M, Nkengasong J, Mosha F, Westerman LE. Evaluation of Specimen Types for Pima CD4 Point-of-Care Testing: Advantages of Fingerstick Blood Collection into an EDTA Microtube. PLoS One 2018; 13:e0202018. [PMID: 30138398 PMCID: PMC6107158 DOI: 10.1371/journal.pone.0202018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/26/2018] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Effective point-of-care testing (POCT) is reliant on optimal specimen collection, quality assured testing, and expedited return of results. Many of the POCT are designed to be used with fingerstick capillary blood to simplify the blood collection burden. However, fingerstick blood collection has inherent errors in sampling. An evaluation of the use of capillary and venous blood with CD4 POCT was conducted. METHODS Three different specimen collection methods were evaluated for compatibility using the Alere Pima CD4 assay at 5 HIV/AIDS healthcare sites in Dar es Salaam, Tanzania. At each site, whole blood specimens were collected from enrolled patients by venipuncture and fingerstick. Pima CD4 testing was performed at site of collection on venipuncture specimens (Venous) and fingerstick blood directly applied to a Pima CD4 cartridge (Capillary-Direct) and collected into an EDTA microtube (Capillary-Microtube). Venous blood was also tested at the laboratory by the reference CD4 method and Pima for comparison analysis. RESULTS All three specimen collection methods were successfully collected by healthcare workers for use with the Pima CD4 assay. When compared to the reference CD4 method, Pima CD4 testing with the Capillary-Microtube method performed similarly to Venous, while Pima CD4 counts with the Capillary-Direct method were slightly more biased (-20 cells/μL) and variable (-229 to +189 cells/μL limit of agreement). Even though all three collection methods had similar invalid Pima testing rates (10.5%, 9.8%, and 8.3% for Capillary-Direct, Capillary-Microtube, and Venous respectively), the ability to perform repeat testing with Capillary-Microtube and Venous specimens increased the likelihood of acquiring a valid CD4 result with the Pima assay. CONCLUSIONS Capillary blood, either directly applied to Pima CD4 cartridges or collected in an EDTA microtube, and venous blood are suitable specimens for Pima CD4 testing. The advantages of capillary blood collection in an EDTA microtube are that it uses fingerstick collection which mimics venous blood and allows extra testing without additional blood collection.
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Affiliation(s)
- Luciana Kohatsu
- United States Centers for Disease Control & Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, Georgia, United States of America
| | - Omotayo Bolu
- United States Centers for Disease Control & Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, Georgia, United States of America
| | - Mary E. Schmitz
- United States Centers for Disease Control & Prevention, Dar es Salaam, Tanzania
- Allan Rosenfield Global Health Fellowship, Association of Schools and Programs of Public Health, Washington DC, United States of America
| | - Karen Chang
- United States Centers for Disease Control & Prevention, Dar es Salaam, Tanzania
- Allan Rosenfield Global Health Fellowship, Association of Schools and Programs of Public Health, Washington DC, United States of America
| | - Ruth Lemwayi
- African Field Epidemiology Network, Dar es Salaam, Tanzania
| | - Nichole Arnett
- United States Centers for Disease Control & Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, Georgia, United States of America
| | - Michael Mwasekaga
- United States Centers for Disease Control & Prevention, Dar es Salaam, Tanzania
| | - John Nkengasong
- United States Centers for Disease Control & Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, Georgia, United States of America
| | - Fausta Mosha
- African Field Epidemiology Network, Dar es Salaam, Tanzania
- Ministry of Health Community Development Gender Elderly and Children, Government of Tanzania, Dar es Salaam, Tanzania
| | - Larry E. Westerman
- United States Centers for Disease Control & Prevention, Center for Global Health, Division of Global HIV/AIDS, Atlanta, Georgia, United States of America
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Bæk O, Jensen KJ, Andersen A, Balé C, Martins C, Biering-Sørensen S, Poulsen A, Benn CS. Seasonal and sex-specific variations in haematological parameters in 4 to 5.5-month-old infants in Guinea-Bissau, West Africa. Trans R Soc Trop Med Hyg 2018; 111:30-37. [PMID: 28371872 PMCID: PMC5914425 DOI: 10.1093/trstmh/trx014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Accepted: 03/22/2017] [Indexed: 12/02/2022] Open
Abstract
Objective This study investigated seasonal and sex-specific variations in the haematological parameters and established reference ranges for these parameters in healthy 4 to 5.5-month-old infants in Guinea-Bissau. Methods Within a randomised trial of early measles vaccination, over a period of 13 months blood samples were collected from infants aged 4 to 5.5 months. Haematological parameters were determined by an automated cell counter and compared in linear regression models providing geometric mean ratios (GMR). Results Blood samples from 501 infants (n=248 boys, 49.5%) were obtained, and 285 (56.9%) were collected in the rainy season. Median age was 4.7 months (range 3.7 to 7.2 months). Eosinophil and platelet counts were lower in the dry season (December to May) than in the rainy season (GMR 0.79 [95% CI 0.68–0.92]) and 0.93 [0.87–1.00], respectively). The calculated reference ranges were wider and generally higher than those from a US population of comparable age, but neutrophil levels were notably lower in Guinea-Bissau. Conclusions The study indicated that eosinophil and platelet counts of infants were subject to seasonal variations. The reference ranges for haematological values were comparable to other African populations and corroborated that neutropenia regularly occurs in African infants.
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Affiliation(s)
- Ole Bæk
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
- Department of Infectious Diseases, Hvidovre Hospital, DK-2650 Copenhagen, Denmark
| | - Kristoffer Jarlov Jensen
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Andreas Andersen
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Carlito Balé
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
| | - Cesario Martins
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
| | - Sofie Biering-Sørensen
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, DK-2300 Copenhagen, Denmark
| | - Anja Poulsen
- Department of Paediatrics and Adolescent Medicine, Rigshospitalet, DK-2100 Copenhagen, Denmark
| | - Christine Stabell Benn
- Bandim Health Project, Indepth Network, codex 1004, Bissau, Guinea-Bissau
- Research Center for Vitamins and Vaccines (CVIVA), Statens Serum Institut, DK-2300 Copenhagen, Denmark
- OPEN, University of Southern Denmark/Odense University Hospital, DK-4000 Odense, Denmark
- Corresponding author: Present address: Research Center for Vitamins and Vaccines, Statens Serum Institut, Artillerivej 5, DK-2300 Copenhagen S, Denmark; Tel: +45 3268 8354; E-mail:
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Stout SA, Lin J, Hernandez N, Davis EP, Blackburn E, Carroll JE, Glynn LM. Validation of Minimally-Invasive Sample Collection Methods for Measurement of Telomere Length. Front Aging Neurosci 2017; 9:397. [PMID: 29270121 PMCID: PMC5723637 DOI: 10.3389/fnagi.2017.00397] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Accepted: 11/17/2017] [Indexed: 12/17/2022] Open
Abstract
Objective: The discovery of telomere length (TL) as a biomarker of cellular aging and correlate of age-related disease has generated a new field of research in the biology of healthy aging. Although the most common method of sample collection for TL is venous blood draw, less-invasive DNA collection methods are becoming more widely used. However, how TL relates across tissues derived from these sample collection methods is poorly understood. The current study is the first to characterize the associations in TL across three sample collection methods: venous whole blood, finger prick dried blood spot and saliva. Methods: TL was measured in 24 healthy young adults using three modes of sample collection for each participant: venous whole blood, finger prick dried blood spot and saliva. Relative TL was measured using quantitative polymerase chain reaction. Results: TL in finger prick dried blood spots (DBS) washighly correlated with TL in whole blood (r = 0.84, p < 0.001). Salivary TL was also correlated with whole blood TL (r = 0.56, p = 0.005), but this association was not as strong as that of dried blood spot TL (Steiger’s Z = 2.12, p = 0.034). TL was longer in saliva than in whole blood or DBS (p’s < 0.001). Conclusions: These findings have important implications for future study design by supporting the validity of less-invasive methods that can be implemented with vulnerable populations or in the field. Further, these findings aid in interpreting the burgeoning area of biological aging research and may shed light on our understanding of inconsistencies in the empirical literature.
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Affiliation(s)
- Stephanie A Stout
- Department of Psychology, University of Denver, Denver, CO, United States
| | - Jue Lin
- Department of Biochemistry and Biophysics, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Natalie Hernandez
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Elysia P Davis
- Department of Psychology, University of Denver, Denver, CO, United States.,Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, United States
| | - Elizabeth Blackburn
- Department of Biochemistry and Biophysics, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Judith E Carroll
- Cousins Center for Psychoneuroimmunology, University of California, Los Angeles, Los Angeles, CA, United States
| | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA, United States
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Siebenmann C, Keiser S, Robach P, Lundby C. CORP: The assessment of total hemoglobin mass by carbon monoxide rebreathing. J Appl Physiol (1985) 2017; 123:645-654. [DOI: 10.1152/japplphysiol.00185.2017] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/14/2017] [Accepted: 06/26/2017] [Indexed: 11/22/2022] Open
Abstract
In this Cores of Reproducibility in Physiology (CORP) article, we present the theory and practical aspects of the carbon monoxide (CO) rebreathing method for the determination of total hemoglobin mass in humans. With CO rebreathing, a small quantity of CO is diluted in O2and rebreathed for a specified time period, during which most of the CO is absorbed and bound to circulating hemoglobin. The dilution principle then allows calculation of the total number of circulating hemoglobin molecules based on the number of absorbed CO molecules and the resulting changes in the fraction of carboxyhemoglobin in blood. Total hemoglobin mass is derived by multiplication with the molar weight of hemoglobin. CO rebreathing has been used for >100 yr and has undergone steady improvement so that today excellent values in terms of accuracy and precision can be achieved if the methodological precautions are carefully followed.
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Affiliation(s)
- Christoph Siebenmann
- The Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stefanie Keiser
- Center for Integrative Human Physiology, Institute of Physiology, University of Zürich, Zürich, Switzerland; and
| | - Paul Robach
- National School for Mountain Sports, Site of the National School for Skiing and Mountaineering (ENSA), Chamonix, France
| | - Carsten Lundby
- The Centre for Physical Activity Research, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Tang R, Yang H, Choi JR, Gong Y, You M, Wen T, Li A, Li X, Xu B, Zhang S, Mei Q, Xu F. Capillary blood for point-of-care testing. Crit Rev Clin Lab Sci 2017; 54:294-308. [PMID: 28763247 DOI: 10.1080/10408363.2017.1343796] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Clinically, blood sample analysis has been widely used for health monitoring. In hospitals, arterial and venous blood are utilized to detect various disease biomarkers. However, collection methods are invasive, painful, may result in injury and contamination, and skilled workers are required, making these methods unsuitable for use in a resource-limited setting. In contrast, capillary blood is easily collected by a minimally invasive procedure and has excellent potential for use in point-of-care (POC) health monitoring. In this review, we first discuss the differences among arterial blood, venous blood, and capillary blood in terms of the puncture sites, components, sample volume, collection methods, and application areas. Additionally, we review the most recent advances in capillary blood-based commercial products and microfluidic instruments for various applications. We also compare the accuracy of microfluidic-based testing with that of laboratory-based testing for capillary blood-based disease diagnosis at the POC. Finally, we discuss the challenges and future perspectives for developing capillary blood-based POC instruments.
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Affiliation(s)
- Ruihua Tang
- a School of Life Sciences , Northwestern Polytechnical University , Xi'an , P.R. China.,b Key Laboratory for Space Bioscience and Biotechnology , Northwestern Polytechnical University , Xi'an , P.R. China.,c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,d College of Bioresources Chemical and Materials Engineering , Shaanxi University of Science and Technology , Xi'an , China
| | - Hui Yang
- a School of Life Sciences , Northwestern Polytechnical University , Xi'an , P.R. China.,b Key Laboratory for Space Bioscience and Biotechnology , Northwestern Polytechnical University , Xi'an , P.R. China
| | - Jane Ru Choi
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China
| | - Yan Gong
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,e The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology , Xi'an Jiaotong University , Xi'an , P.R. China.,f Xi'an Diandi Biotech Company , Xi'an , P.R. China
| | - MinLi You
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,e The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology , Xi'an Jiaotong University , Xi'an , P.R. China
| | - Ting Wen
- f Xi'an Diandi Biotech Company , Xi'an , P.R. China
| | - Ang Li
- g Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology , Xi'an Jiaotong University , Xi'an , P.R. China
| | - XiuJun Li
- h Department of Chemistry , University of Texas at El Paso , El Paso , TX , USA
| | - Bo Xu
- i School of Finance and Economics , Xi'an Jiaotong University , Xi'an , P.R. China
| | - Sufeng Zhang
- d College of Bioresources Chemical and Materials Engineering , Shaanxi University of Science and Technology , Xi'an , China
| | - Qibing Mei
- a School of Life Sciences , Northwestern Polytechnical University , Xi'an , P.R. China.,b Key Laboratory for Space Bioscience and Biotechnology , Northwestern Polytechnical University , Xi'an , P.R. China
| | - Feng Xu
- c Bioinspired Engineering and Biomechanics Center (BEBC) , Xi'an Jiaotong University , Xi'an , P.R. China.,e The Key Laboratory of Biomedical Information Engineering of Ministry of Education, School of Life Science and Technology , Xi'an Jiaotong University , Xi'an , P.R. China
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Posttransfusion Increase of Hematocrit per se Does Not Improve Circulatory Oxygen Delivery due to Increased Blood Viscosity. Anesth Analg 2017; 124:1547-1554. [PMID: 28328758 DOI: 10.1213/ane.0000000000002008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Blood transfusion is used to treat acute anemia with the goal of increasing blood oxygen-carrying capacity as determined by hematocrit (Hct) and oxygen delivery (DO2). However, increasing Hct also increases blood viscosity, which may thus lower DO2 if the arterial circulation is a rigid hydraulic system as the resistance to blood flow will increase. The net effect of transfusion on DO2 in this system can be analyzed by using the relationship between Hct and systemic blood viscosity of circulating blood at the posttransfusion Hct to calculate DO2 and comparing this value with pretransfusion DO2. We hypothesized that increasing Hct would increase DO2 and tested our hypothesis by mathematically modeling DO2 in the circulation. METHODS Calculations were made assuming a normal cardiac output (5 L/min) with degrees of anemia ranging from 5% to 80% Hct deficit. We analyzed the effects of transfusing 0.5 or more units of 300 cc of packed red blood cells (PRBCs) at an Hct of 65% and calculated microcirculatory DO2 after accounting for increased blood viscosity and assuming no change in blood pressure. Our model accounts for O2 diffusion out of the circulation before blood arriving to the nutritional circulation and for changes in blood flow velocity. The immediate posttransfusion DO2 was also compared with DO2 after the transient increase in volume due to transfusion has subsided. RESULTS Blood transfusion of up to 3 units of PRBCs increased DO2 when Hct (or hemoglobin) was 60% lower than normal, but did not increase DO2 when administered before this threshold. CONCLUSIONS After accounting for the effect of increasing blood viscosity on blood flow owing to increasing Hct, we found in a mathematical simulation of DO2 that transfusion of up to 3 units of PRBCs does not increase DO2, unless anemia is the result of an Hct deficit greater than 60%. Observations that transfusions occasionally result in clinical improvement suggest that other mechanisms possibly related to increased blood viscosity may compensate for the absence of increase in DO2.
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Abstract
PurposeDry eye syndrome (DES) causes significant morbidity. Trials of blood-derived products in treatment of the condition show promising results. However, their production is expensive and time-consuming. We investigate fingerprick autologous blood (FAB) as an alternative low-cost, readily accessible treatment for DES.Patients and methodsProspective, non-comparative, interventional case series. In total, 29 eyes of 16 DES patients (2 males and 14 females) from two NHS sites in the United Kingdom. Patients instructed to clean a finger, prick with a blood lancet, and apply a drop of blood to the lower fornix of the affected eye(s), 4 times daily for 8 weeks then stop and review 4 weeks later. Follow-up visits occurred ~3 days, 2, 4, 8 weeks into therapy, and 4 weeks post-cessation. At each visit, visual acuity, corneal staining, Schirmer's test, tear break-up time (TBUT), and ocular comfort index (OCI) were measured, and photographs taken. Results were analysed using Student's paired t-test.ResultsAt 8 weeks, there was improvement in mean Oxford corneal staining grade (3.31 to 2.07 (P<0.0001)), TBUT (5.00 to 7.80 s (P<0.05)), visual acuity (0.08 to 0.01 LogMAR equivalent (P<0.05)), and OCI score (56.03 to 39.72 (P<0.0001)). There was no statistically significant change in Schirmer's test results. Four weeks post-cessation versus immediately after completion of FAB therapy, mean staining grade worsened from 2.07 to 2.86 (P<0.0001). OCI score worsened from 39.72 to 44.67 (P<0.05).ConclusionsIn our limited case series FAB appears to be a safe and effective treatment for DES.
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Accuracy of Capillary Hemoglobin Measurements for the Detection of Anemia among U.S. Low-Income Toddlers and Pregnant Women. Nutrients 2017; 9:nu9030253. [PMID: 28282926 PMCID: PMC5372916 DOI: 10.3390/nu9030253] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 03/01/2017] [Accepted: 03/06/2017] [Indexed: 12/01/2022] Open
Abstract
The aim of this study is to evaluate the accuracy of capillary hemoglobin (Hb) measurements in detecting anemia among low-income toddlers (aged 12–35 months) and pregnant women. In analyses of data among toddlers from Kansas City (n = 402) and St. Louis, Missouri (n = 236), and pregnant women at <20 weeks gestation from Cleveland, Ohio (n = 397), we compared subjects’ anemia status based on capillary Hb concentrations in finger puncture samples as measured by the HemoCue system with their anemia status based on venous Hb concentrations as measured by the HemoCue and Coulter Counter. The sensitivity of capillary blood analyses in identifying cases of anemia was 32.8% (95% Confidence Intervals (CI): 21.0%–46.3%), among Kansas City toddlers, 59.7% (95% CI: 45.8%–72.4%) among St. Louis toddlers, and 66.7% (95% CI: 46.0%–83.5%) among pregnant women in Cleveland; the corresponding specificities were 97.7%, 86.6%, and 96.7%, respectively. The correlation between HemoCue and Coulter Counter measurements of venous Hb (0.9) was higher than that between HemoCue measurements of capillary and venous blood (0.8). The results show that Hb measurements of capillary blood with HemoCue were not optimal for determining the anemia status of toddlers and pregnant women.
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