Collection Of Venous Blood Samples Research Articles

Association of Polymorphism with Periodontitis and Salivary Levels of Hypoxia-Inducible Factor-1α.

This investigation aims to investigate the association between HIF-1α genetic polymorphism and periodontitis and examine and contrast the levels of HIF-1α present in the saliva of subjects afflicted with periodontitis and in the control group. Additionally, this study aims to establish diagnostic proficiency of this biomarker in distinguishing between periodontal health and disease. This study entailed the collection of venous blood samples and unstimulated saliva samples from a total of 160 participants, encompassing 80 individuals diagnosed with periodontitis and 80 periodontitis-free individuals. The periodontal parameters were evaluated, involving the measurement of clinical attachment loss, the probing pocket depth, and the bleeding on probing percentage. Subsequently, genetic analysis of HIF-1α using polymerase chain reaction (PCR) technique, DNA sequencing, and enzyme-linked immunosorbent assays was conducted. The genetic analysis of 352 bp of the HIF-1α gene revealed the presence of 66 single-nucleotide polymorphisms (SNPs) in control samples, whereas 78 SNPs were found in periodontitis sample. The nucleotide A was replaced with a C nucleotide at position 207 of the amplified PCR fragments. The homozygous AA pattern was predominant in the control group, with significant differences between the two groups. In contrast, the homozygous CC pattern was more dominant in the periodontitis group, with significant differences between the two groups. The analysis of Hardy-Weinberg equilibrium for the comparison between the observed and the expected genotypes showed significant differences between the observed and the expected values in the control and periodontitis groups, as well as the total sample. The highest mean values of the measured periodontal parameters were found in the periodontitis group (clinical attachment loss = 4.759, probing pocket depth = 4.050, and bleeding on probing = 30.950) with statistically significant differences between the groups. The periodontitis group showed significantly higher salivary HIF-1α levels compared to control group (p < 0.001). Besides, HIF-1α is a good biomarker in distinguishing between periodontal health and periodontitis. rs1951795 SNP of HIF-1α has no significant impact on the progression of periodontitis and the salivary level HIF-1α. Periodontitis results in a notable elevation in HIF-1α salivary levels, with an outstanding diagnostic ability to distinguish between periodontitis and periodontal health.

Effect of Resveratrol as an adjunct to Scaling and Root Planing in Chronic Periodontitis Patients with Type 2 Diabetes

Resveratrol is a polyphenol stilbene found in red wine, red grape skins and other plants such as mulberries and peanuts. Resveratrol exhibits a wide range of beneficial properties such as anticarcinogenic agent, platelet antiaggregation agent, antiallergenic, antioxidant, and anti- inflammatory agent. Material and Methods A total of 30 patients diagnosed as chronic periodontitis with diabetes were included in this study. and divided into 2 groups, Group-I(SRP+ resveratrol, n=15) &amp; Group-II (SRP alone, n=15). Resveratrol capsules once daily were prescribed for 3 weeks. Plaque index(PI), Gingival index (MSBI), probing pocket depth (PPD), clinical attachment level (CAL) and serum venous blood sample collection for HbA1c levels. All the parameters were recorded at baseline and at 3 months post-operative. Results All the parameters in both Group I and Group II showed statistically significant (P≤0.001) reduction from baseline to 3 months. improvement from baseline to 3 months. When compared between the two groups, a significant difference was observed in Group I in relation with PI and HbA1c levels at 3 months post-operatively. Conclusion Resveratrol as adjunctive to SRP has shown reduction in periodontal parameters in chronic periodontitis along with improved glycemic control in diabetes patients. Key Words: Diabetes, Glycated hemoglobin levels, Resveratrol, Scaling and root planing

Unveiling the Spectrum of Megaloblastic Anemia: Insights from a Multifaceted Study at Abbas Institute of Medical Sciences, Muzaffarabad

Background: This study aimed to determine the frequency of Megaloblastic Anemia cases presenting in the outpatient department (OPD) and wards of AIMS Hospital in Muzaffarabad, AJ&amp;K. Methods: Conducted at the Pathology department of Abbas Institute of Medical Sciences from May 2022 to October 2022, this case-control study analyzed 125 cases from OPD and wards. Patient interviews, venous blood sample collection, and complete blood picture (CP) analysis, including peripheral film (PF) tests and Vitamin B12 and folates levels reports, were conducted using a Hematology analyzer. Statistical analysis using SPSS version 25.0 was employed. Results: Statistical analysis revealed a mean age of 3.656, with females having a higher frequency of Megaloblastic Anemia, especially during childbearing age. Males had a higher frequency in children and the elderly. The residential distribution showed a balance of village and city dwellers, whereas the patient category breakdown showed a higher frequency in the young age group. Conclusion: The study highlighted Megaloblastic Anemia's serious public health significance, its causes, and the observed trends in the study population. Surgical interventions, particularly abdominal surgeries, were identified as potential contributors. Analyses of peripheral smears revealed varying degrees of anemia severity, with most cases being moderate. The study concluded that Megaloblastic Anemia is more common in females, especially during childbearing age, and in males, especially in children and the elderly. These findings highlight the importance of targeted interventions and nutritional education programs in addressing the specific demographic trends observed in this study population.

Clinical validation of novel dried blood spot based collecting device using serum separation for measuring SARS-CoV-2 antibodies.

Accurate surveillance of coronavirus disease 2019 (COVID-19) incidence includes large-scale antibody testing of the population. Current testing methods require collection of venous blood samples by a healthcare worker, or dried blood spot (DBS) collection using finger prick, however this might have some logistic and processing limitations. We investigated the performance of the Ser-Col device for detecting severe acute respiratory syndrome coronavirus-2(SARS-CoV-2) antibodies using a finger prick: DBS-likecollection system that includes a lateral flow paper for serum separation and allows for automated large scale analysis.For this prospective study, adult patients with moderate to severe COVID-19 were included 6 weeks post-symptom onset. Healthy, adult volunteers were included as a negative control group. Venous blood and capillary blood using the Ser-Col device were collected and the Wantai SARS-CoV-2 total antibody ELISA was performed on all samples.We included 50 subjects in the study population and 49 in the control group. Results obtained with venous blood versus Ser-Col capillary blood showed 100% sensitivity (95% CI: 0.93-1.00) and 100% specificity (95% CI: 0.93-1.00).Our study shows the feasibility of SARS-CoV-2 total antibody screening using a standardized DBStechnique with semiautomated processing for large scale analysis.

A Comparison of Sodium Citrate and Sodium BicarbonateIngestion: Blood Alkalosis and Gastrointestinal Symptoms.

This study compared the recommended dose of sodium citrate (SC, 500mg/kg body mass) and sodium bicarbonate (SB, 300mg/kg body mass) for blood alkalosis (blood [HCO3-]) and gastrointestinal symptoms (GIS; number and severity). Sixteen healthy individuals ingested the supplements in a randomized, crossover design. Gelatin capsules were ingested over 15min alongside a carbohydrate-rich meal, after which participants remained seated for forearm venous blood sample collection and completion of GIS questionnaires every 30min for 300min. Time-course and session value (i.e.,peak and time to peak) comparisons of SC and SB supplementation were performed using linear mixed models. Peak blood [HCO3-] was similar for SC (mean 34.2, 95% confidence intervals [33.4, 35.0]mmol/L) and SB (mean 33.6, 95% confidence intervals [32.8, 34.5]mmol/L, p = .308), as was delta blood [HCO3-] (SC = 7.9mmol/L; SB = 7.3mmol/L, p = .478). Blood [HCO3-] was ≥6mmol/L above baseline from 180 to 240min postingestion for SC, significantly later than for SB (120-180min; p < .001). GIS were mostly minor, and peaked 80-90min postingestion for SC, and 35-50min postingestion for SB. There were no significant differences for the number or severity of GIS reported (p > .05 for all parameters). In summary, the recommended doses of SC and SB induce similar blood alkalosis and GIS, but with a different time course.

Ten year survival after an acute heart failure episode

Abstract Background Heart failure (HF) hospitalizations foreshadow a very gloomy outcome. In the first 3 months, the vulnerable period, mortality is around 10% and 28% of patients die in the first-year post hospitalization. Reports on 10-year survival are scarce. Purpose We assessed the 10-year survival rate in a 21st century cohort of acute HF patients and studied survival predictors. Methods We studied a cohort of HF patients that were included in an acute HF registry between March 2009 and December 2010. All patients hospitalized in the Internal Medicine Ward with the primary diagnosis of acute HF were eligible. Both patients with left ventricular systolic dysfunction and those with HF with preserved ejection fraction were included. As part of the registries protocol all patients had a complete examination and a venous blood sample collection both at admission and discharge. Patients were followed up to 10 years and all-cause mortality was the endpoint under analysis. A multivariate Cox-regression model was used to assess variables independently associated with 10-year death. A Receiver operator characteristic (ROC) curve was used to choose the best brain natriuretic peptide (BNP) cut-off for mortality prediction. Results A total of 591 patients surviving an HF decompensation episode were included in the analysis. Mean age was 76 (±12) years, 44.8% were male and 37.9% had preserved ejection fraction. Comorbidity burden was high: 76.6% had arterial hypertension and 50.6% had diabetes. Only 69 (11.7%) patients were alive 10-years post discharge. Survivors were younger (63 vs 78 years), less often presented diabetes, they had higher haemoglobin and albumin levels, better renal function and lower BNP and uric acid levels. Independent predictors of 10-year mortality were higher BNP, increasing age, lower albumin and atrial fibrillation. The area under the ROC curve for the association of BNP with 10-year death was of 0.71 (0.65–0.77), p&amp;lt;0.001. The best BNP cut-off for 10-year mortality prediction was 800pg/mL with a sensitivity of 50.4%, specificity=85.3%, positive predictive value (PPV) =96.3% and negative predictive value (NPV) of 18.6%. Patients with BNP≥800pg/mL have 96.6% probability of dying in the upcoming 10-years, and a HR of 1.95 (1.60–2.38), p&amp;lt;0.001 than those with lower values. Using a discharge BNP cut-off of 50pg/mL the negative predictive value is 66.0% and a PPV is 89.9% of being dead at 10-years. The PPV of dying in the upcoming 10-years was of 100% for patients with discharge BNP≥1864pg/mL. Conclusions The ten year survival rate of a real-world acute HF population was of 11.7%. The variables more strongly associated with 10-year mortality were higher BNP and age. Patients discharged with BNP ≥800pg/mL have 2-fold higher risk of dying in the upcoming 10 years than the remaining. All patients discharged with BNP ≥1864pg/mL were dead 10-years later. Funding Acknowledgement Type of funding sources: None.

Concordance of three point of care testing devices with clinical chemistry laboratory standard assays and patient-reported outcomes of blood sampling methods

BackgroundPoint of care testing (POCT) devices have been developed to facilitate immediate results with the potential to aid screening for new disease and enable patients to self-monitor their disease. Non-communicable diseases (NCDs) are the major cause of mortality globally and are increasing in prevalence as the population ages. Allied health care professionals (AHPs) are skilled in undertaking risk assessment and delivering preventative advice, providing opportunities to access large proportions of the population who may not visit their doctor, within non-traditional community settings. There is evidence of high levels of support from public, patients and health professionals for engaging AHPs in risk-targeted early case detection of certain NCDs. Thus, POCT devices offer a potential alternative to traditional venous blood collection, as novel care pathways for increasing early case detection and access to preventative care. The objectives of this study were to: (i) determine the concordance of the specific POCT devices with laboratory-based standard assays employed within clinical biochemistry laboratories. (ii) compare the sampling experience of both methods via patient-reported experiences.MethodsA prospective, two-centre study was undertaken involving 158 participants who provided informed consent. Venous blood was collected for traditional assays of HbA1c, creatinine/ estimated Glomerular-Filtration-Rate (eGFR) and vitamin-D. Capillary blood was collected by finger prick test and also assayed for the same biochemical indices (Nova StatSensor (creatinine/eGFR); Siemens DCA-Vantage (HbA1C); CityAssays (vitamin-D)). All users were provided with device training. Participants reported any discomfort experienced by each simultaneously applied method (randomised in order) via a 100 mm Visual-Analogue-Scale.ResultsResults for each POCT device and the laboratory standard were analysed by Bland-Altman plots to determine assay concordance. POCT devices demonstrated good concordance with laboratory testing, with at least 95% of all samples being within two standard deviations, for each of the devices tested. The majority of participants reported less discomfort with POCT than venepuncture, with the average reported discomfort being 17/100 mm less for POCT compared to venous blood sample collection on the visual analogue scale.ConclusionsThe POCT devices demonstrated acceptable concordance with laboratory-based assays, and patients reported lower levels of discomfort compared to traditional means of blood collection. This study demonstrates the potential of using these devices as acceptable methods for opportunistic testing of “at-risk” individuals within non-traditional community care settings.

Temporally specific adrenocorticotropic hormone reference intervals for horses in South Africa

An endogenous adrenocorticotropic hormone (ACTH) concentration above the reference interval (RI) is commonly used as means for diagnosing equine pituitary pars intermedia dysfunction (PPID). Basal ACTH concentrations are highly dependent on photoperiod and RIs should be month- and location-specific. To date, no ACTH RIs have been specifically established for South Africa. This study aimed to determine geographically and seasonally relevant RIs for equine ACTH in the Gauteng province of South Africa. A longitudinal prospective study was conducted over twelve months to determine ACTH RIs for a representative population of healthy South African horses in the Gauteng province. Eighty clinically healthy horses under 12 years of age were recruited for monthly venous blood sample collection, from July 2019 to June 2020. ACTH was measured using a chemiluminescent assay. RIs were constructed for each month of the year. This South African population showed similar temporal changes in ACTH concentrations to those previously observed in other locations. Upper reference limits were at their lowest in early summer (21.4 pg/ml, 90% CI 20.8-21.7) with a pronounced increase in autumn (60.6 pg/ml, 90% CI 53.1-62.7), and tapered off in winter (22.3 pg/ml, 90% CI 19.9-23.2). The month-specific ACTH RIs generated in this study will improve the accuracy of diagnosis and monitoring of PPID in the local equine population. These results highlighted the previously recommended need for seasonal and location-specific RIs.

Comparative Analysis of the Most Important Cardiovascular Risk Factors Based on Cross-Sectional Studies in the Population of Latvia.

Background and Objectives: The aim of the study was to analyze the prevalence of cardiovascular risk factors (RFs) in Latvia from the population-based cross-sectional study performed in 2019–2020 and to compare the results with a similar study done in 2009–2010. Materials and Methods: The target sample of 6000 individuals representing a cross-section of Latvia’s inhabitants (aged 25–74) was formed using stratified two-stage cluster sampling. The survey had two components: (1) an interview using a pre-specified questionnaire and (2) physical examination (height, weight, arterial pressure) and collection of venous blood samples to measure levels of fasting glucose (Glu), total cholesterol (TC), high and low-density lipoprotein cholesterol (HDL-C/LDL-C), and triglycerides (Tg). In total, 4070 individuals were interviewed (32% non-response), from which 2218 (55%) individuals underwent physical examination and collection of blood samples. Results: The most frequently observed RFs were high LDL-C (62.0%), smoking (45.3%), and arterial hypertension (36.8%), while the prevalence of self-reported high cholesterol and hypertension was 19.3 and 18.6%, respectively. A decrease in the prevalence of hypertension, high LDL-C, and Glu was noted. Smoking decreased in younger men. The mean number of five most important cardiovascular RFs was 2.0 (95% confidence interval (CI) 2.0, 2.1); 2.3 (95% CI 2.2, 2.4) for men and 1.8 (95% CI 1.7, 19) for women. The average number of RFs has decreased by 0.3 in 10 years, t(5883) = −7.2, p < 0.001. Conclusions: Although the prevalence of cardiovascular RFs remains noteworthy, an improvement in the risk profile of the Latvian population has been observed over the past decade. The study shows subjective self-underestimation of cardiovascular risk.

Senior nursing students' reflections on deviations from guideline adherence regarding venous blood specimen collection practice: A qualitative study

BackgroundVenous blood specimen collection is a common procedure within healthcare and both diagnoses as well as treatment evaluation, are often based on results from these analyses. However, studies among both students and staff have demonstrated suboptimal adherence to venous blood specimen collection practice guidelines which in turn might jeopardize patient safety. ObjectivesThis study aimed to describe final semester nursing students' experiences of deviations from venous blood specimen collection practice guidelines during clinical training. MethodsThis study adopted a qualitative design. Twentysix final (6th) semester nursing students were recruited through purposive sampling at a Swedish university. Data were collected through semi-structured, face-to-face, focus group interviews in September 2015. The transcribed interviews were analyzed using qualitative content analysis. ResultsThe students' experiences generated two categories; 1) Striving to blend in (subcategories Feeling uncomfortable and Adapting to the prevailing practice culture) and 2) Diminished confidence (subcategories Being confused due to inconsistency and Being uncertain about guideline usefulness) forming the overall theme Being a copycat. ConclusionThe research concludes that nursing students adapt to the prevailing practice culture encountered during clinical training, often at the expense of guidelines adherence. Since the students are being assessed during clinical training, the eagerness to belong to the team and be well-liked might be stronger than the ambition to follow guidelines. As a consequence, nursing students in clinical training might become copycats by aligning themselves with the prevailing practice culture which in turn might jeopardize adherence with VBSC guideline practice and thereby patient safety. With the ambition to support nursing students' learning in clinical training, facilitators of learning to comprise both students and supervisors need to be further addressed. Tweetable abstractNursing students adapt to the prevailing venous blood sample collection practice culture and become copycats.

Use of biochemical markers for diabetes prevention in the new decade

Abstract Use of biochemical markers for diabetes prevention in the new decade. There is established evidence that type 2 diabetes mellitus is preceded by a phase, during which there is a cluster of conditions including raised triglycerides and lowered high-density lipoprotein cholesterol, raised fasting glucose, high blood pressure and central obesity. This cluster of risk factors for type 2 diabetes mellitus, constitutes the metabolic syndrome (MetS). Therefore, there is need to screen for this syndrome among the population for the primary prevention of type 2 diabetes mellitus which is a global public health problem. Despite the high prevalence of type 2 diabetes in Mauritius, research work on MetS is scarce. This study was thus undertaken with the primary objective to determine the prevalence of MetS among the employees of a public educational institution in Mauritius. A cross-sectional study which involved randomly identified employees was conducted. The participants were requested to fill in a survey questionnaire, undergo biometric measurements (waist circumference and blood pressure) and venous blood sample collection in a fasting condition. The blood tests included the determination of glucose, triglyceride and cholesterol levels. The 2009 International Diabetes Federation criteria were used for the diagnosis of MetS. The presence of any 3 of 5 risk factors, raised triglycerides, raised glucose, lowered high-density lipoprotein cholesterol, high blood pressure and central obesity constitutes a diagnosis of metabolic syndrome. Ethical clearance was obtained from the Department of Medicine Research Ethics Committee of the University of Mauritius. The prevalence of MetS was found to be 20.1% (40 participants), in the overall population, 31.4% in men (22 out of 70) and 13.95% in women (18 out of 129). The determination of any association by means of the Chi square tests showed there was a significant association between gender and MetS (p &lt; 0.01). Educational level was also associated with the MetS (p &lt; 0.05). Logistic regression analysis confirmed t\he significant association between MetS with gender (p &lt; 0.01) where male gender was more associated with MetS than female. This study with the determination of the prevalence of the MetS among employees constituted the first step in the implementation of a structured workplace health intervention programme in Mauritius. We highlight the importance of workplace interventions with the involvement of a multi-disciplinary team of health professionals for the primary prevention of diabetes, through the screening for the MetS among employees.

Preservation and Extraction of Malaria Parasite DNA from Dried Blood Spots.

Molecular studies related to diagnosis and research rely on collection of blood samples and extraction of high-quality DNA. In Africa, where the populations carried 94% of the total burden of cases and deaths due to malaria in 2019, collection of samples is often challenged by remote study areas and lack of a cold chain to transport and store samples. Collection of blood on filter paper is a technique that is less invasive and has simpler requirements regarding training of staff, storage, and transport of samples than collection of venous blood samples. Dried blood spots (DBS) are therefore commonly used in many research projects. However, DNA quality can be affected by duration and conditions of storage. The quality of the DNA for molecular analyses also depends on a DNA extraction methodology that provides high-quality DNA with high purity and yield. Several protocols for DNA extraction have been described, and many comparative studies have analyzed and optimized the different methodologies to find an alternative to the more costly commercial extraction kits. This chapter describes recommendations for storage and preservation of DBS, and a Chelex-based protocol for extraction of DNA from DBS.

Role of biobanking in managing large-scale epidemiological studies

The success and quality of large-scale epidemiological studies depends entirely on biomaterial quality. Therefore, when arranging the third Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation (ESSE-RF-3) study, increased attention was paid to specifics of collection, processing and further transportation of biological samples and related clinical and anthropometric data of participants from regional collection centers to Biobank.Aim. To develop a methodology for collection of high-quality biomaterials within the large-scale epidemiological study, involving the sampling, processing, freezing of blood and its derivatives (serum, plasma) in the regions, followed by transportation and storage of obtained biomaterial in the Biobank of National Medical Research Center for Therapy and Preventive Medicine (Moscow).Material and methods. To conduct the ESSE-RF-3 study, a design was developed, according to which the collection of venous blood samples in a total volume of 29,5 ml from each participant is planned in all participating regions in order to obtain and store samples of whole blood, serum and two types of plasma.Results. On the basis of international biobanking standards, ethical norms, experience from ESSE-RF and ESSE-RF-2, and literature data, a protocol for biobanking of blood and its derivatives was developed. The type and number of serum and plasma aliquots obtained, the required standard technical means and consumables, as well as logistic biomaterial requirements were determined. Training programs for regional participants were developed. By the beginning of August 2021, 180 thousand samples of whole blood, serum and plasma from more than 23 thousand participants from 28 Russian regions were collected, processed and stored.Conclusion. The presented work made it possible to assess and confirm the compliance of developed biobanking protocol with quality requirements. However, due to the coronavirus disease 2019 pandemic, by August 2021, the Biobank did not reach the maximum effectiveness predicted for the ESSE-RF-3 project.

A nationwide cross-sectional epidemiological study of cardiovascular risk factors as a tool for management of primary and secondary prevention in Latvia

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): EUROPEAN SOCIAL FUND MINISTRY OF HEALTH, LATVIA Background. An increasing prevalence (PREV.) of noncomunicable diseases is a major public health concern in Latvia. Regular nationwide epidemiological studies present an opportunity to estimate the dinamics of PREV of health risk factors (RF) and thus assist in planning resources and improving prevention strategies at national level. Objective. The aim was to analyze the PREV of cardiovascular RF identified in a epidemiological study in 2019-2020. To assess changes in RF prevalence, the results were compared to data from a similar study in 2009-2010. Methods. 4070 inhabitants (age 25-74) of Latvia enrolled. The statistical sample (6000 pers.) was random selected from the Housing Register, Central Statistical Bureau (1’209’756 INDV). The survey included an interview, physical examination (body mass index (BMI), arterial pressure etc.) and venous blood sample collection for fasting glucose (Glu), total cholesterol (TC), high and low-density lipoprotein cholesterol (LDL-C), triglycerides (Tg) measurement. The data were processed using Microsoft Excel and SPSS. Results. The mean number of RF ((AH, TC, LDL-C, Tg, BMI, smoking, arterial hypertension) was 2,93 ±0.1 (mean ± SE) per person for the overall study population. The men group had a significantly greater number of RF than the female group (3.15 ± 0.15 vs.2.55 ± 0.12). A positive correlation between age and the number of RF was found. In the age group 65 and more, the mean number of RF decreased in men and stabilized in women. Although the mean number of RFs has decreased statistically insignificantly over 10 years, changes in the PREV of individual RFs are significant (see table). Decrease of PREV of elevated TC, LDL-C, Glu ≥3.0 mmol/L, as well as a decrease in the PREV of young smokers, men, should be noted. Conclusion. The nationwide data can be used as the baseline characteristics against which other measurements can be compared down the road including of health prevention activities Prevalence of most important RF (%) 2019-2020 2009-2010 RF All Men Women All Men Women TC≥5.0 mmol/L 63.2× 60.7× 65.4× 75,2 72.0 78.0 LDL-C≥3.0 mmol/L 62.0× 63.1× 61.1× 73.7 73.1 73.9 Glucose 5.6-6.99 mmol/L 22.1× 27.1× 17.8× 28.7 35.3 24.9 Arterial Hypertension 38.0× 41.1× 35.3× 44.8 52.9 40.2 BMI≥30.0 kg/m&amp;sup2; 29.1 28.1 29.8 30.7 25.6 32.6 Daily smokers 25-34 y 30.3× 21.8 46.3 22.3 (x) p below 0.05 comparing years 2019-20 and 2009-10

Methodological considerations in designing and implementing the harmonized diagnostic assessment of dementia for longitudinal aging study in India (LASI–DAD)

ABSTRACT The Harmonized Diagnostic Assessment of Dementia for Longitudinal Aging Study in India (LASI–DAD) is a population-representative, prospective cohort study of late-life cognition and dementia. It is part of an ongoing international research collaboration that aims to measure and understand cognitive impairment and dementia risk by collecting a set of cognitive and neuropsychological assessments and informant reports, referred to as the Harmonized Cognitive Assessment Protocol (HCAP). LASI–DAD provides nationally representative data drawn from a subsample of the ongoing Longitudinal Aging Study in India (LASI). One of LASI–DAD’s distinctive features is its rich geriatric assessment, including the collection of venous blood samples and brain imaging data for a subsample of respondents. In this paper, we discuss the methodological considerations of developing and implementing the HCAP protocol in India. The lessons we learned from translating and applying the HCAP protocol in an environment where illiteracy and innumeracy are high will provide important insights to researchers interested in measuring and collecting data on late-life cognition and dementia in developing countries. We further developed an innovative blood management system that enables us to follow the collection, transportation, assay, and storage of samples. Such innovation can benefit other population surveys collecting biomarker data.

Akwa Ibom AIDS indicator survey: Key findings and lessons learnt.

BackgroundThe burden of HIV/AIDS epidemic is huge, but this varies widely by population in Nigeria. Data that could be used to guide the scale up of HIV prevention and control strategies has significant gaps. The study sought to estimate the prevalence of HIV and its associated determinants in Akwa Ibom state.MethodsAkwa Ibom AIDS Indicator Survey (AKAIS) is a population based cross-sectional survey, with a two-stage probability sampling. The survey had both behavioural and biological components. Tablet-based questionnaire was used to collect data on participant’s household information, demographics, socio-economic, and behavioral risk factors associated with HIV; while the biological component involved collection of venous blood samples for participants who were over 19months. For children aged 18months on less, capillary blood from finger prick sample was used. Participants were tested for HIV. Other biomarker tests for HIV positive participants included CD4, HIV-1 RNA viral load and incidence assays.ResultsIn all 15,609 people (8,963 adults aged 15 years and older (55% females), 6,646 individuals less than 15 years (51% males), from 4,313 households, participated in AKAIS. Overall, 2.8% (423 persons; 422 HIV-1 and 1 HIV-2) were found to be HIV positive. HIV prevalence was 4.8% in adults (15 years and above) and 0.4% in pediatric (< = 14 years) participants. HIV prevalence was significantly higher in females (5.6%) than males (3.7%) aged 15 years and older (p <0.001). Overall HIV incidence was 0.41%ConclusionsHIV prevalence among adults was 4.8% with an overall incidence of 0.41%. These estimates are essential to inform strategic control and prevention of HIV epidemic in Akwa Ibom state targeting the affected populations.

Exact time of venous blood sample collection - an unresolved issue, on behalf of the European Federation for Clinical Chemistry and Laboratory Medicine (EFLM) Working Group for Preanalytical Phase (WG-PRE).

Objectives An accurate knowledge of blood collection times is crucial for verifying the stability of laboratory analytes. We therefore aimed to (i) assess if and how this information is collected throughout Europe and (ii) provide a list of potentially available solutions. Methods A survey was issued by the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) Working Group on Preanalytical Phase (WG-PRE) in 2017, aiming to collect data on preanalytical process management, including sampling time documentation, in European laboratories. A preceding pilot survey was disseminated in Austria in 2016. Additionally, preanalytical experts were surveyed on their local setting on this topic. Finally, the current scientific literature was reviewed on established possibilities of sampling time collection. Results A total number of 85 responses was collected from the pilot survey, whilst 1347 responses from 37 European countries were obtained from the final survey. A minority (i.e. ~13%) of responders to the latter declared they are unaware of the exact sampling time. The corresponding rate in Austria was ~70% in the pilot and ~30% in the final survey, respectively. Answers from 17 preanalytical experts from 16 countries revealed that sampling time collection seems to be better documented for out- than for in-patients. Eight different solutions for sample time documentation are presented. Conclusions The sample collection time seems to be documented very heterogeneously across Europe, or not at all. Here we provide some solutions to this issue and believe that laboratories should urgently aim to implement one of these.

A comparison of neutrophil-lymphocyte ratio and body fat percentage in hashimoto's disease induced hypothyroid patients

Aim: Inflammatory mechanisms are activated when the body mass index is increased and in cases of Hashimoto’s Thyroiditis (HT). The neutrophil-lymphocyte ratio (NLR), which is used as a new and easily accessible inflammatory marker, may be related to the body mass index. The objective of this study is to compare the NLR and body fat percentage in patients with Hashimoto’s disease induced hypothyroidism.Material and Methods: The study consisted of 29 patients diagnosed with HT induced hypothyroidism based on the clinical and laboratory findings. The control group consists of 29 healthy individuals who do not suffer from any disease known to increase TSH level. Body analysis is performed for all cases that are included in the study, and the height, weight, body fat percentage, lean body mass, visceral adiposity, basal metabolic rate, and body fluid percentages are calculated, and complete blood count, TSH, FT3, FT4, Anti-TPO tests were performed following 3-4 cc venous blood sample collection from all cases.Results: There were not any significant difference between the patient and control group in terms of gender, BMI, body fat percentage, lead body mass, visceral adiposity, fluid percentage, and basal metabolic rate data (p>0.05). NLR rate was 1.95±1.37 in patient group and 2.52±1.40 in control group. Significant difference was identified in NLR (p=0.025), fat percentage (p=0.002), lean mass (p=0.002) and visceral adiposity data (p=0.006) between the HT patients and control group when the male patients were removed from the groups. NLR was identified statistically significantly low in the patient group when compared to the control group (p0.012). There was no significant correlation between NLR and lean mass, TSH, BMI, visceral adiposity, fluid percentage, and age parameters in both groups.Conclusion: NLR, like other common inflammatory markers, is an inexpensive and easily accessible marker that can be used in hospitalized patients. However, it would be more appropriate to evaluate the conditions that may have effects on the results such as patients drug use and bone marrow suppression. It can be said that more evidence is needed to use NRL as a marker for HT management.

Perception of medical interns towards the skills they acquired.

. The undergraduate medical course in India is for five-and-a-half years. Every medical student has to undergo compulsory rotating residential internship for 12 months. During this period, interns acquire skills under supervision. The literature shows they have limited experience and confidence in performing basic and emergency procedures. We assessed interns' perception of their experience and competence. . We did a questionnaire-based cross-sectional study among medical students after they had completed their internship to reflect on their experience and competence in various procedural skills. A questionnaire (25 questions) based on knowledge and skills was piloted by 15 interns and was reliable (Cronbach alpha 0.9). The Likert scale ranged from never observed to performed independently under supervision. . Seventy-eight of 80 interns responded; 51 were females (65.3%). Three-quarters of interns felt they could independently carry out venous blood sample collection, arterial blood gas interpretation, Pap smear specimen collection and digital rectal examination, but only half felt that they could do a lumbar puncture, cervical dilatation and collection of throat swab. Parenteral drug administration, catheterization, nasogastric tube insertion and cardiopulmonary resuscitation were done confidently by over 90%, but vaginal delivery and application of a plaster slab required assistance. The majority said that they had observed drainage of abscess, excision of sebaceous cyst and endotracheal tube intubation. . Most interns felt that they were competent in performing simple surgical tasks independently. However, conducting a vaginal delivery and endotracheal tube intubation were tasks that needed more support.

P2624Association between renal dysfunction and cardiac sympathetic innervation in patients with heart failure

Abstract Introduction In heart failure (HF) a strict interaction exists between heart and kidney. Previous studies reported a significant impact of sympathetic overdrive, that causes beta-adrenoceptor desensitization, in both renal and heart failure progression. It can be hypothesized that renal failure might be associated with impaired sympathetic activity assessed directly at the myocardial level in patients affected by HF. Purpose Aim of the present observational study was to assess the relationship between renal dysfunction and cardiac sympathetic innervation in HF patients with mildly and severely reduced ejection fraction (HFrEF and HFmEF). Methods Two-hundred and sixty-three patients (84% males; 66±10.8 years) with mild-to-severe HF (EF 31±6.8%) underwent iodine-123 meta-iodobenzylguanidine (123I-MIBG) myocardial scintigraphy to assess sympathetic innervation, evaluating early and late heart to mediastinum (H/M) ratios and washout rate. All patients also underwent clinical evaluation and venous blood sample collection for the assessment of serum creatinine and consequently the estimation of glomerular filtration rate (eGFR) by EPI formula. Results A direct correlation was found between EPI-eGFR and late H/M (r=0,215; p&lt;0.001) (figure 1), with an inverse correlation between NYHA class and late H/M (r=0,152; p=0.013), and a direct correlation between left ventricular EF and late H/M (r=0,348; p&lt;0.001). These results were not confirmed for early H/M, nor washout rate. Dividing the population in reduced eGFR and normal eGFR (cut-off ≤60 ml/min/1,73m2), a statistical significant reduction of late H/M value was found in patients with reduced eGFR (late H/M = 1,49±0,21) compared with patients with preserved eGFR (late H/M = 1,56±0,26) (p=0.020). In a multivariate model, adjusting eGFR for NYHA class and left ventricular EF, reduced eGFR and left ventricular EF remained significant predictors of reduced late H/M (p=0.006 and p&lt;0.001, respectively). Figure 1. linear regression curve Conclusions Patients with impaired renal function and HF show impaired cardiac sympathetic activity compared to HF patients with preserved renal function, and reduced eGFR estimated by EPI formula is a significant predictor of reduced late H/M evaluated by 123I-MIBG. Thus, in future studies, the combination of these two parameters might provide addictive prognostic information in HF patients.