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Lee R, Yoo IY, Oh EJ, Choi AR, Nho D, Cho SY, Lee J, Ahn HL, Park YJ, Lee DG. Dextrose-containing fluids causing false-positive serum galactomannan: a case-control study and interrupted time series analysis. Clin Microbiol Infect 2024; 30:682.e1-682.e4. [PMID: 38309324 DOI: 10.1016/j.cmi.2024.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/23/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES This study aimed to identify the cause of false-positive serum Aspergillus antigen galactomannan (GM) results in our centre. METHODS We performed a case-control study aiming to elucidate the factors associated with false-positive GM results. Independent risk factors for false-positive GM were evaluated through a multivariable regression analysis. An interrupted time series analysis was used to evaluate the effectiveness of an intervention removing the identified factors. RESULTS Among 568 patients tested, GM was positive in 130 patients of whom 97 had false-positive GM (cases). These were compared with 427 patients with true-negative GM (controls). Administration of dextrose-containing fluids within 6 days before GM testing was an independent predictor for false-positive GM results (adjusted odds ratio [aOR], 18.60; 95% CI, 8.95-38.66. An analysis of GM presence in different dextrose-containing fluids revealed positivity in 34.8% (8 of 23) (manufacturer A) and 33.3% (5 of 15) (manufacturer B) of the samples. Investigation of the manufacturing process revealed that the saccharification process employed enzymes derived from Aspergillus niger. After identifying the root cause of false positivity, GM-containing dextrose fluid use was restricted. Interrupted time series analysis showed an immediate reduction of GM false-positivity (-6.5% per week, p = 0.045) and a declining trend (-0.33% per week, p = 0.005) postintervention. CONCLUSIONS Administering dextrose-containing fluids was the primary factor causing false-positive serum Aspergillus antigen GM assay results. Our investigation led to a modification of the manufacturing process of the dextrose-containing fluids.
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Affiliation(s)
- Raeseok Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Young Yoo
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun-Jee Oh
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ae Ran Choi
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dukhee Nho
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Yeon Cho
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jongin Lee
- Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hye Lim Ahn
- Department of Pharmacy, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yeon-Joon Park
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Gun Lee
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Vaccine Bio Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Hasanpour Z, Choopani S, Ashrafi F, Talebi A, Nematbaksh M. The Effect of Dextrose Hypotonic vs Saline Hydration on Methotrexate-Induced Nephrotoxicity in Male and Female Rats. Adv Biomed Res 2024; 13:14. [PMID: 38525397 PMCID: PMC10958733 DOI: 10.4103/abr.abr_269_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 01/25/2023] [Accepted: 02/01/2023] [Indexed: 03/26/2024] Open
Abstract
Background High-dose methotrexate (HDMTX) as a cytotoxic agent might cause various side effects. Hyperhydration has been implemented as the major strategy to decrease the potential risk of toxicities induced by HDMTX. This study aims to assess the renoprotective effect of hydration with dextrose water (DW) 5% versus normal saline (N/S) 0.9% against methotrexate (MTX) induced nephrotoxicity. Materials and Methods This experimental animal study has been conducted on 36 Wistar rats (200-250 g) categorized into six groups, including male (n = 6) and female (n = 6) rats receiving sodium chloride 0.9% saline plus MTX, DW 5% plus MTX, or MTX alone. By the fifth day after the MTX injection, biochemical indexes were measured. The rats were also sacrificed and renal specimens were evaluated microscopically to determine kidney tissue damage (KTD). Results The groups were not significantly different with regard to blood urea nitrogen (BUN) (P = 0.5), creatinine (Cr) (P = 0.24), kidney weight (P = 0.34), and urine flow (UF) (P = 0.5), while KTD score was remarkably less in the hydrated groups (P < 0.001). Weight loss in DW-treated rats was significantly more than N/S-treated ones, and creatinine clearance (CrCl) and urine load (UL) of Cr were statistically similar between males and females in the control group, but significantly lower among the DW5% treated males. Conclusion Based on the findings of this study, hydration with N/S was superior to DW5% for the prevention from HDMTX-induced nephrotoxicity. Besides, we found insignificant differences between male versus female rats in response to the hydration for HDMTX-induced renoprotection; however, females probably benefit more.
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Affiliation(s)
- Zahra Hasanpour
- Department of Internal Medicine, Oncology-Hematology Section, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Samira Choopani
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Physiology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Farzaneh Ashrafi
- Department of Internal Medicine, Oncology-Hematology Section, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ardeshir Talebi
- Department of Clinical Pathology, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehdi Nematbaksh
- Water and Electrolytes Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
- Isfahan Institute of Basic and Applied Sciences Research, Isfahan, Iran
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Qi Q, Fox MS, Lim H, Sullivan R, Li A, Bellyou M, Desjardins L, McClennan A, Bartha R, Hoffman L, Scholl TJ, Lee TY, Thiessen JD. Glucose Infusion Induced Change in Intracellular pH and Its Relationship with Tumor Glycolysis in a C6 Rat Model of Glioblastoma. Mol Imaging Biol 2023; 25:271-282. [PMID: 36418769 DOI: 10.1007/s11307-022-01726-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 03/12/2022] [Accepted: 03/25/2022] [Indexed: 11/26/2022]
Abstract
INTRODUCTION The reliance on glycolytic metabolism is a hallmark of tumor metabolism. Excess acid and protons are produced, leading to an acidic tumor environment. Therefore, we explored the relationship between the tumor glycolytic metabolism and tissue pH by comparing 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) and hyperpolarized [1-13C]pyruvate MR spectroscopy imaging (MRSI) to chemical exchange saturation transfer (CEST) MRI measurements of tumor pH. METHODS 106 C6 glioma cells were implanted in the brains of male Wistar rats (N = 11) using stereotactic surgery. A 60-min PET acquisition after a bolus of FDG was performed at 11-13 days post implantation, and standardized uptake value (SUV) was calculated. CEST measurements were acquired the following day before and during constant infusion of glucose solution. Tumor intracellular pH (pHi) was evaluated using amine and amide concentration-independent detection (AACID) CEST MRI. The change of pHi (∆pHi) was calculated as the difference between pHi pre- and during glucose infusion. Rats were imaged immediately with hyperpolarized [1-13C]pyruvate MRSI. Regional maps of the ratio of Lac:Pyr were acquired. The correlations between SUV, Lac:Pyr ratio, and ∆pHi were evaluated using Pearson's correlation. RESULTS A decrease of 0.14 in pHi was found after glucose infusion in tumor region. Significant correlations between tumor glycolysis measurements of Lac:Pyr and ∆pHi within the tumor (ρ = 0.83, P = 0.01) and peritumoral region (ρ = 0.76, P = 0.028) were observed. No significant correlations were found between tumor SUV and ∆pHi within the tumor (ρ = - 0.45, P = 0.17) and peritumor regions (ρ = - 0.6, P = 0.051). CONCLUSION AACID detected the changes in pHi induced by glucose infusion. Significant correlations between tumor glycolytic measurement of Lac:Pyr and tumoral and peritumoral pHi and ∆pHi suggest the intrinsic relationship between tumor glycolytic metabolism and the tumor pH environment as well as the peritumor pH environment.
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Affiliation(s)
- Qi Qi
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Department of Physics and Astronomy, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Matthew S Fox
- Department of Physics and Astronomy, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada
| | - Heeseung Lim
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Robarts Research Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Rebecca Sullivan
- Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada.,Department of Pathology, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Alex Li
- Robarts Research Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Miranda Bellyou
- Robarts Research Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Lise Desjardins
- Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada
| | - Andrew McClennan
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada
| | - Robert Bartha
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Robarts Research Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Department of Medical Imaging, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Lisa Hoffman
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada.,Department of Pathology, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Department of Anatomy and Cell Biology, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Timothy J Scholl
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada.,Ontario Institute for Cancer Research, Toronto, ON, M5G 0A3, Canada
| | - Ting-Yim Lee
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada.,Robarts Research Institute, The University of Western Ontario, London, ON, N6A 3K7, Canada.,Department of Medical Imaging, The University of Western Ontario, London, ON, N6A 3K7, Canada
| | - Jonathan D Thiessen
- Department of Medical Biophysics, The University of Western Ontario, London, ON, N6A 3K7, Canada. .,Molecular Imaging Program, The University of Western Ontario, London, ON, N6A 3K7, Canada. .,Imaging Program, Lawson Health Research Institute, London, ON, N6A 4V2, Canada. .,Department of Medical Imaging, The University of Western Ontario, London, ON, N6A 3K7, Canada.
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Nieto García A, Berbel Tornero O, Monleón Sancho J, Alberola-Rubio J, López Rubio ME, Picó Sirvent L. [Evaluation of pain in children of 2, 4 and 6 months after the application of non-pharmacological analgesia methods during vaccination]. An Pediatr (Barc) 2018; 91:73-79. [PMID: 30448108 DOI: 10.1016/j.anpedi.2018.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 10/27/2022] Open
Abstract
INTRODUCTION Young children perceive pain as much, or even more than adults, and the pain may have short- and long-term consequences. The literature describes the use of non-pharmacological interventions to alleviate pain during vaccination. The aim of this study was to assess 3such interventions for analgesia during vaccination: non-nutritive sucking (NNS), breastfeeding (BF), and administration of a 50% dextrose solution (D50W). MATERIALS AND METHODS A prospective, non-randomised cohort study was carried out on infants aged 2, 4 and 6 months that received 1, 2, or 3 vaccines, respectively, according to the routine immunisation schedule. There were 3treatments: NNS, BF, and 2mL of D50W combined with NNS. Pain was assessed using the LLANTO scale, and the duration of crying. RESULTS The study included 387 infants. The mean scores in the LLANTO scale at ages 2 and 6 months were significantly lower in breastfed infants compared to infants managed with NNS (P=.025 and P<.001, respectively), or infants given D50W (P=.025 and P=.001), and the difference was not statistically significant at age 4 months (P=.21 and P=.27). There were no significant differences between infants managed with NNS and D50W at 2, 4, and 6 months (P=.66, P=.93 and P=.45, respectively). The duration of crying was significantly lower at age 6 months in breastfeed infants compared to infants managed with NNS or D50W (P=.013 and P=.017). No breastfed child (n=129) experienced side effects. CONCLUSIONS In infants born to term with adequate weight for gestational age, breastfeeding reduces pain on the administration of 1 or 2 vaccines. When 3 vaccines are given, the reduction is minimal. Administration of D50W does not have any additional analgesic effect in infants compared to being held by a parent combined with NNS during vaccination. BF during vaccination is not associated with any side effects.
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Affiliation(s)
| | - Octavio Berbel Tornero
- Pediatría, Centro de Salud de Paterna, Departamento de Valencia-Arnau de Vilanova-Lliria; Facultad de Medicina. Universidad Católica San Vicente Mártir, Valencia
| | - Javier Monleón Sancho
- Unidad de Patología Uterina, Hospital Universitario Politécnico La Fe, Valencia, España
| | | | | | - Leandro Picó Sirvent
- Servicio de Pediatría, Hospital Universitario Casa Salud, Valencia, España; Facultad de Medicina. Universidad Católica San Vicente Mártir, Valencia
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