Fingerstick Samples Research Articles

Setting Single or Multiple Goals for Diet and Physical Activity Behaviors Improves Cardiovascular Disease Risk Factors in Adults With Type 2 Diabetes: A Pragmatic Pilot Randomized Trial.

The purpose of this study was to evaluate a 4-month telephone-based goal-setting and decision support intervention among adults with type 2 diabetes mellitus (T2DM) and multiple risk factors for cardiovascular disease (CVD). A randomized pretest-posttest control group design was employed. Overweight or obese adults aged 40 to 75 years with T2DM and ≥1 additional CVD risk factor were provided with individualized CVD risk information. At baseline and each biweekly telephone call, the multiple-goal group self-selected both diet- and physical activity-related goals, the single goal group set a single goal, and the control group received information about community health resources. Dietary intake was assessed via a food frequency questionnaire, physical activity via questionnaire, and A1C and blood lipids via fasting fingerstick sample. Between-group differences for clinical (ie, A1C, blood pressure, and blood lipids), physical activity, and dietary variables were evaluated using Kruskal-Wallis, Mann-Whitney U, analysis of variance, and t tests. From pre- to postintervention, the single-goal group demonstrated significant improvement in systolic blood pressure and intake of servings of fruits, vegetables, and refined grains (all P < .05). The multiple-goal group reported significant reduction in percent energy from total, saturated, monounsaturated, and trans fat intake and significant increase in leisure time walking (all P < .05). A multiple-goal approach over 4 months can improve dietary and physical activity outcomes, while a single-goal approach may facilitate improvement in one behavioral domain. Additional research is needed to evaluate maintenance of the achieved changes.

Hemoglobin assessment: precision and practicability evaluated in the Netherlands-the HAPPEN study.

Most donors do not like the invasive hemoglobin (Hb) measurement in fingerstick capillary samples. Alternative noninvasive devices have recently become available. In this study we assessed the precision and practicability of noninvasive devices and compared them with measurements in capillary and venous samples. A total of 2589 blood donors were included in the study. Hb levels were measured with the noninvasive devices NBM 200 or Haemospect and compared with values obtained with the invasive devices HemoCue 201 and HemoCue 301 and with venous values. Precision was evaluated in terms of sensitivity and specificity for detection of Hb levels below the cutoff level for donation, taking venous values as "reference values." Hb levels measured with both invasive and noninvasive devices differed significantly from venous measurements. Measurements with invasive devices correlated stronger with venous values and were more precise. Sensitivity ranged from 30.1% (HemoCue 201) to 3.5% (Haemospect) in men and from 36.6% (HemoCue 201) to 10.8% (Haemospect) in women. Specificity ranged from 99.8% (HemoCue 201) to 95.5% (Haemospect) in men and from 98.9% (HemoCue 201) to 94.6% (NBM 200) in women. Most donors preferred the noninvasive measurement. Measurements with invasive devices showed stronger correlation and better agreement with venous values than noninvasive devices. Sensitivity was low for all measurement devices, particularly the noninvasive ones. In terms of precision invasive measurement would be preferred for donor screening, although a majority of donors preferred the noninvasive measurement.

Postprandial capillary-venous glucose gradient in Type 1 diabetes: magnitude and clinical associations in a real world setting.

AimsTo determine the magnitude of the peripheral glucose gradient in patients with Type 1 diabetes in a real world setting and to explore its relationship with insulin dose and macronutrient intake.MethodsAll patients used mealtime analogue insulin. The glucose gradient was assessed using antecubital fossa venous and finger‐stick capillary samples, collected concurrently at room temperature. Baseline sampling occurred before the administration of an insulin dose and breakfast of the patient's choosing. Breakfast was consumed an average of 15 min after baseline. The macronutrient content of breakfast was documented. Sampling was repeated 1 and 2 h after baseline.ResultsThe mean (95% CI) plasma capillary–venous glucose gradient values for 43 patients were: pre‐breakfast, 0.21 (0.08–0.34) mmol/l; 1 h after baseline, 0.87 (0.66–1.07) mmol/l; and 2 h after baseline, 0.52 (0.33–0.71) mmol/l. Glucose gradient and dietary carbohydrate intake (g/kg body weight) were positively correlated at both 1 h (P < 0.01) and 2 h after baseline (P < 0.01). No relationship was observed between this gradient and mealtime insulin dose, or the glucose concentration at either time point.ConclusionsIn patients with Type 1 diabetes, a clinically significant glucose gradient is present after the ingestion of a carbohydrate‐rich meal. As postprandial capillary and venous plasma glucose concentrations are not equivalent, defining the site of sample collection is important.

An entomological and seroepidemiological study of the vectorial-transmission risk of Chagas disease in the coast of northern Chile.

Four species of triatomines are known from Chile: Triatoma infestans Klug, Mepraia spinolai Porter, M. gajardoi Frías, Henry & González, and M. parapatrica Frías (Hemiptera: Reduviidae), the last three are endemic. The geographical distribution of M. gajardoi includes the coastal areas in the north of Chile between 18° and 21°S, an area with both a resident workforce and summer-season visitors. A study was developed to assess the risk of vectorial transmission of Chagas disease by M. gajardoi in hut settlements on the coast of the Tarapacá Region, in particular in Caleta San Marcos and Caleta Río Seco. The study comprised fingerstick sampling of 95 persons, venous samples from 29 domestic dogs and capture of 52 triatomines, from both fishing coves. The samples were analysed by enzyme-linked immunosorbent assay (ELISA) and polymerase chain reaction (PCR) techniques. The results show that, of the total number of persons studied, 100% were negative for Trypanosoma cruzi Chagas (Trypanosomatida: Trypanosomatidae) antibodies, 10.34% of canids were positive for the antibody and 5.8% of M. gajardoi were infected to the PCR technique. The presence of this species in areas close to human settlements constitutes a risk to human populations established on the coast of northern Chile.

Accuracy Evaluation of CONTOUR(®)PLUS Compared With Four Blood Glucose Monitoring Systems.

IntroductionThe aim of this study was to compare the accuracy of 5 blood glucose monitoring systems (BGMSs; CONTOUR®PLUS [CP], Accu-Chek® Active [ACA], Accu-Chek® Performa [ACP], FreeStyle Freedom™ [FF], OneTouch® SelectSimple™ [OTSS]).MethodsStudy staff tested fingerstick samples from 106 subjects aged ≥18 years using the 5 BGMSs. Some samples were modified to achieve blood glucose concentrations throughout the measuring range. The primary endpoint was comparison of the mean absolute relative difference (MARD) from the reference value (Yellow Springs Instruments [YSI]) across the overall tested glucose range. Other endpoints were MARD in the low (≤80 mg/dL [≤4.4 mmol/L]), middle (81–180 mg/dL [4.5–10.0 mmol/L]), and high (>180 mg/dL [>10.0 mmol/L]) glucose ranges, and MARD for unmodified samples in the overall glucose range.ResultsCONTOUR®PLUS had a statistically significantly lower MARD than all BGMSs across the overall tested range (27–460 mg/dL [1.5–25.5 mmol/L]) and in the high glucose range. In the low glucose range, CP had a lower MARD than all BGMSs, which was statistically significant except for ACP. For unmodified samples across the overall tested range, CP had a lower MARD than all BGMSs and was statistically significantly lower except for ACA.ConclusionsCONTOUR®PLUS had the lowest mean difference from the reference values (by MARD) when compared with other BGMSs across multiple glucose ranges with modified and unmodified samples.FundingBayer HealthCare LLC, Diabetes Care.Trial registration number: ClinicalTrials.gov Identifier NCT01714232.Electronic supplementary materialThe online version of this article (doi:10.1007/s13300-015-0121-3) contains supplementary material, which is available to authorized users.

Rapid diagnostics for Ebola in emergency settings

Rapid diagnostics for Ebola in emergency settings

Inaccuracy of Venous Point-of-Care Glucose Measurements in Critically Ill Patients: A Cross-Sectional Study.

IntroductionCurrent guidelines and consensus recommend arterial and venous samples as equally acceptable for blood glucose assessment in point-of-care devices, but there is limited evidence to support this recommendation. We evaluated the accuracy of two devices for bedside point-of-care blood glucose measurements using arterial, fingerstick and catheter venous blood samples in ICU patients, and assessed which factors could impair their accuracy.Methods145 patients from a 41-bed adult mixed-ICU, in a tertiary care hospital were prospectively enrolled. Fingerstick, central venous (catheter) and arterial blood (indwelling catheter) samples were simultaneously collected, once per patient. Arterial measurements obtained with Precision PCx, and arterial, fingerstick and venous measurements obtained with Accu-chek Advantage II were compared to arterial central lab measurements. Agreement between point-of-care and laboratory measurements were evaluated with Bland-Altman, and multiple linear regression models were used to investigate interference of associated factors.ResultsMean difference between Accu-chek arterial samples versus central lab was 10.7 mg/dL (95% LA -21.3 to 42.7 mg/dL), and between Precision PCx versus central lab was 18.6 mg/dL (95% LA -12.6 to 49.5 mg/dL). Accu-chek fingerstick versus central lab arterial samples presented a similar bias (10.0 mg/dL) but a wider 95% LA (-31.8 to 51.8 mg/dL). Agreement between venous samples with arterial central lab was the poorest (mean bias 15.1 mg/dL; 95% LA -51.7 to 81.9). Hyperglycemia, low hematocrit, and acidosis were associated with larger differences between arterial and venous blood measurements with the two glucometers and central lab. Vasopressor administration was associated with increased error for fingerstick measurements.ConclusionsSampling from central venous catheters should not be used for glycemic control in ICU patients. In addition, reliability of the two evaluated glucometers was insufficient. Error with Accu-chek Advantage II increases mostly with central venous samples. Hyperglycemia, lower hematocrit, acidosis, and vasopressor administration increase measurement error.

Clinical correlation between a point-of-care testing system and laboratory automation for lipid profile

BackgroundWe evaluated the clinical correlation between the CardioChek PA analyzer and a clinical laboratory reference method to use for screening program purposes. MethodsFasting blood samples were collected on 516 patients (age 20–85y). One venous sample was collected using a serum tube for the evaluation on a COBAS reference analyzer. A second venous sample was collected in a lithium heparin tube and was evaluated on the CardioChek PA analyzer (CCPA venous). A fingerstick sample (CCPA fingerstick) was evaluated only on the CardioChek PA analyzer. Linear regression analyses were performed for each measured analyte, total cholesterol, HDL-cholesterol and triglycerides. ResultsThe correlation between the CCPA fingerstick and CCPA venous was extremely high for HDL-C and triglycerides, and good for total cholesterol. Our results demonstrated a good clinical agreement for total cholesterol, HDL-C and triglycerides between 97.7% and 94.6% in the comparison of the CCPA to the reference analyzer. ConclusionsWe identified the pre-analytic phase as an important step to guarantee the quality of results and indicate that the CardioChek PA is a reliable lipid point-of-care testing system that can be used for the application of clinical screening anywhere.

Use of Dried Blood Spots for Estimating Children?s Exposures to Heavy Metals in Epidemiological Research

Background: Children’s exposures to arsenic (As), lead (Pb), mercury (Hg), and cadmium (Cd) are of particular concern in early-life. Exposures to heavy metals are traditionally measured in whole venous blood, which is costly and invasive. As an alternative we describe a method for quantifying As, Pb, Hg, and Cd in dried blood spot (DBS) samples. Objectives: To validate a method for quantifying levels of As, Pb, Hg, and Cd in finger-stick DBS samples. Background metal contamination in blood collection cards poses a challenge for quantifying heavy metals in DBS samples. Here we report a method to remove background contamination from the filter paper prior to blood collection to improve assay precision. Methods: Matched samples of venous blood and finger-stick DBS samples were collected from 82 children ages 1-21. Whole venous blood samples were also applied to pre-cleaned and untreated blood collection cards. All samples were analyzed for As, Pb, Hg, and Cd using inductively coupled plasma mass spectrometry (ICP-MS). Results: Matched venous blood and finger-stick DBS samples from untreated cards were significantly correlated, but with relatively weak R2 values of 0.083, 0.186, 0.498, and 0.022 for As, Cd, Hg, and Pb, respectively. When blood collection cards were decontaminated prior to blood collection the correlations between venous blood and DBS samples were highly significant, with R2 values of 0.66, 0.99, 0.98, and 0.94 for As, Pb, Hg, and Cd, respectively. Conclusions: Standard blood collection cards contain significant and highly variable background levels of heavy metals. Once blood collection cards are treated to remove residual contamination, DBS sampling can be used as a minimally-invasive alternative to venipuncture to estimate exposures to toxic metals.

Comparative Accuracy of 3 Blood Glucose Monitoring Systems that Communicate with An Insulin Pump

This study compared the accuracy of the Contour® Next Link blood glucose monitoring system (BGMS) with 2 other BGMSs (OneTouch® UltraLink® and Nova Max Link™), all 3 of which can communicate wirelessly with an insulin pump. Study staff tested fingerstick samples from 112 subjects aged ≥18 years with each BGMS. All BGMS results were compared to YSI 2300 STAT Plus™ Glucose Analyzer results from the same sample source. To safely obtain a wide range of glucose values, 3 blood samples were obtained from each subject (1 sample was tested fresh from the fingertip [unmodified], and the other 2 samples were modified to raise or lower the glucose concentration). The primary endpoint evaluated was difference in accuracy among the BGMSs across the entire tested glucose range (34 to 561 mg/dL). Additional comparisons were made of accuracy in the low (≤80 mg/dL) and high (>180 mg/dL) glucose ranges. BGMS accuracy was assessed by mean absolute relative difference (MARD). The Contour® Next Link BGMS had a statistically significantly lower MARD from the reference value than the other BGMSs across the entire tested glucose range, calculated using all samples as well as only unmodified (i.e., natural) samples. In the low and high glucose ranges, the Contour® Next Link also had a statistically significantly lower MARD from the reference value than the other BGMSs. As assessed by MARD, the Contour® Next Link BGMS was significantly more accurate than the other BGMSs evaluated, all of which can communicate wirelessly with an insulin pump.

Effect of a single bout of resistance exercise on arterial stiffness following a high-fat meal.

Consumption of a high-fat meal (HFM) causes postprandial lipemia and vascular dysfunction. Acute resistance exercise (RE) alone may also have a negative effect on vascular function. The purpose of this study was to measure arterial stiffness and postprandial lipemia after a HFM with or without acute RE. 9 recreationally active men (age 24±5 years, BMI 25±3 kg/m2) completed both: (1) HFM alone and (2) HFM+RE in a randomized order. Pulse wave velocity (PWV) from carotid to femoral artery and carotid to radial artery were used as measures of central/aortic and peripheral arterial stiffness, respectively. Circulating triglycerides (TRG) were obtained from finger stick samples as a marker of lipemia. There was a significant condition-by-time interaction for TRG (p<0.05). TRG levels increased significantly following both conditions with a significantly attenuated increase following HFM+RE (p<0.05). There was a significant condition-by-time interaction for peripheral PWV as this parameter increased following HFM, but decreased following HFM+RE (p=0.021). Central PWV did not change with HFM or HFM+RE (p>0.05). Following a HFM, acute RE attenuates postprandial lipemia and improves peripheral arterial stiffness without having a negative effect on central arterial stiffness.

Arterial Catheter Setup for Glucose Control in Critically Ill Patients: A Randomized Controlled Trial

Use of an arterial catheter to obtain hourly blood samples for intensive insulin therapy monitoring avoids causing patients the discomfort of repeated fingersticks. Returning the clearing volume may decrease procedure-related blood loss by 50% and minimize the risk of anemia. To compare the feasibility of 2 arterial catheter clearing-volume return setups for hourly blood extractions and to evaluate the related complications and the accuracy of arterial samples in determining glycemia. In an open clinical trial, 90 critical patients undergoing intensive insulin therapy who had a radial arterial catheter were randomized to an intervention group-nonwaste needleless setup or nonwaste syringe setup and compared with the standard setup (control group). Mechanical and infectious complications related to the arterial catheter were evaluated. Blood glucose measurements at point-of-care glucometer (arterial catheter or fingerstick sample) were compared with laboratory results (venous blood). No patient had catheter-related infection in the intervention group (an estimated 12776 manipulations); the control group had 2 infection episodes in 5230 catheter-days (an estimated 13 075 manipulations). The incidence of bacterial colonization was not significantly higher in the needleless group than in the syringe group (22.2% vs 12.2%; relative risk, 0.55; 95% CI, 0.16-1.71), with 1778 (SD, 114) and 1918 (SD, 82) catheter manipulations, respectively. Arterial catheter complications were negligible in all patients. Glycemia was detected from arterial catheter samples as effectively as with laboratory results (venous samples) except when hematocrit was less than 25%. Use of blood obtained via an arterial catheter is safe and effective for glucose monitoring in patients undergoing intensive insulin therapy, with no increase in complications of catheterization.

Diagnosis and monitoring of cytomegalovirus infection by the quantification of viral load in dried blood spots samples

Evaluation of: Limaye AP, Santo Hayes TK, Huang ML, et al. Quantitation of cytomegalovirus DNA load in dried blood spots correlates well with plasma viral load. J. Clin. Microbiol. 51, 2360–2364 (2013).Cytomegalovirus (CMV) represents the major infectious cause of birth defects, as well as an important pathogen for immune-compromised individuals. Several studies described the use of dried blood spots (DBS) for the detection of CMV DNA for late diagnosis of congenital CMV infection in cases of strong clinical suspicion. In the article under evaluation, Limaye et al. perform for the first time the quantification of CMV in pairs of finger-stick DBS and plasma samples collected from transplant patients. The work concluded that finger-stick DBS could be an alternative sample type for quantification of CMV load that correlates well with plasma levels. Prospective trials to evaluate the use of DBS for monitoring CMV load in transplant recipients will be required.

Fast Image Analysis for the Micronucleus Assay in a Fully Automated High-Throughput Biodosimetry System

The development of, and results from an image analysis system are presented for automated detection and scoring of micronuclei in human peripheral blood lymphocytes. The system is part of the Rapid Automated Biodosimetry Tool, which was developed at the Center for High-Throughput Minimally Invasive Radiation Biodosimetry for rapid radiation dose assessment of many individuals based on single fingerstick samples of blood. Blood lymphocytes were subjected to the cytokinesis-block micronucleus assay and the images of cell cytoplasm and nuclei are analyzed to estimate the frequency of micronuclei in binucleated cells. We describe an algorithm that is based on dual fluorescent labeling of lymphocytes with separate analysis of images of cytoplasm and nuclei. To evaluate the performance of the system, blood samples of seven healthy donors were irradiated in vitro with doses from 0-10 Gy and dose-response curves of micronuclei frequencies were generated. To establish the applicability of the system to the detection of high doses, the ratios of mononucleated cells to binucleated cells were determined for three of the donors. All of the dose-response curves generated automatically showed clear dose dependence and good correlation (R(2) from 0.914-0.998) with the results of manual scoring.

Evaluation of Two Different Methods for Hemoglobin Screening of Blood Donors to Use in Mobile Blood Collection Team

AIM: The aim of the study is to compared two point-of care hemoglobin concentration measuring devices with laboratory measurements to determine their accuracy in mobile blood collection conditions. This two devices were the Pronto-7 (Masimo Corp., Irvine,CA) pulse co-oximeter and HemoCue Hb 201+ uses spectrophotometric method. METHODS: Blood samples were collected from 152 individuals. The samples were tested for total hemoglobin measurement by three different methods: noninvaziv pulse co-oximeter device Pronto-7, finger-stick blood sample on an automated spectrophotometric device HemoCue and venous samples on an automated hemotology analyzer (reference device) RESULTS: According to the venous samples (mean Hb value is 14.6 g/dl), the mean hemoglobin levels were detected slightly higher in the fingerstick samples (mean Hb value is 15.1 g/dl) and slightly lower in the pulse co-oximetry (mean Hb value is 14.1 g/dl). The sensivity of HemoCue, Pronto-7 was 97.7%, 81.6% and their specifity was 31.2% and %43.7, respectively. The positive predictive values (PPV) of HemoCue and Pronto-7 were high (92.3% and 92.5%, respectively) but both of their negative predictive values (NPV) were low (62.5% and 21.8%, respectively). Of blood donors, 88.4% (138/152) percent were correctly classified with HemoCue and 78.2% were with Pronto-7. COCLUSION: Taking automated laboratory hemoglobin measurement as a reference, Pronto-7 gave lower readings for Hb value and was less accurate than the Hemo-Cue system

Comparative Performance Evaluation of the CONTOUR® NEXT Blood Glucose Monitoring System

Compare the performance of the CONTOUR® NEXT blood glucose monitoring system (BGMS) with other BGMSs. Study staff tested fingerstick samples from 146 subjects aged ≥18 years with diabetes using the CONTOUR® NEXT BGMS and 5 other BGMSs (Accu-Chek® Aviva Nano, Freestyle Lite®, OneTouch® Ultra® 2, OneTouch® Verio™ Pro and Truetrack®). All were compared to a blood sample from the same source assayed on a YSI. Subjects’ glucose levels were safely lowered or raised to provide a wide range of values; extreme glucose levels were achieved by blood sample glucose modification (i.e. glycolysis or addition of glucose solution). Analysis of variance (ANOVA) was conducted to compare the mean absolute difference (MAD) from the laboratory reference value across BGMSs. Comparisons of system accuracy were evaluated across a number of BG ranges (<3.9 mmol/L [70 mg/dL]; primary endpoint). In the low glucose range (<3.9 mmol/L [70 mg/dL]), CONTOUR® NEXT had a significantly lower MAD than all systems except Freestyle Lite®. Across the entire tested range (1.2 to 27.5 mmol/L [21 to 496 mg/dL]), CONTOUR® NEXT had a significantly lower MAD than all other BGMSs. By Parkes-Consensus Error Grid analysis, 100% of CONTOUR® NEXT, Accu-Chek® Aviva Nano and OneTouch® Verio™ Pro results were within Zone A. As assessed by MAD, the CONTOUR® NEXT was significantly more accurate than 4 of 5 BGMSs in the low glucose range. Across the entire glucose range tested (as assessed by MAD), CONTOUR® NEXT was significantly more accurate compared with the 5 other BGMSs evaluated.

Field Evaluation of a Prototype Paper-Based Point-of-Care Fingerstick Transaminase Test

Monitoring for drug-induced liver injury (DILI) via serial transaminase measurements in patients on potentially hepatotoxic medications (e.g., for HIV and tuberculosis) is routine in resource-rich nations, but often unavailable in resource-limited settings. Towards enabling universal access to affordable point-of-care (POC) screening for DILI, we have performed the first field evaluation of a paper-based, microfluidic fingerstick test for rapid, semi-quantitative, visual measurement of blood alanine aminotransferase (ALT). Our objectives were to assess operational feasibility, inter-operator variability, lot variability, device failure rate, and accuracy, to inform device modification for further field testing. The paper-based ALT test was performed at POC on fingerstick samples from 600 outpatients receiving HIV treatment in Vietnam. Results, read independently by two clinic nurses, were compared with gold-standard automated (Roche Cobas) results from venipuncture samples obtained in parallel. Two device lots were used sequentially. We demonstrated high inter-operator agreement, with 96.3% (95% C.I., 94.3–97.7%) agreement in placing visual results into clinically-defined “bins” (<3x, 3–5x, and >5x upper limit of normal), >90% agreement in validity determination, and intraclass correlation coefficient of 0.89 (95% C.I., 0.87–0.91). Lot variability was observed in % invalids due to hemolysis (21.1% for Lot 1, 1.6% for Lot 2) and correlated with lots of incorporated plasma separation membranes. Invalid rates <1% were observed for all other device controls. Overall bin placement accuracy for the two readers was 84% (84.3%/83.6%). Our findings of extremely high inter-operator agreement for visual reading–obtained in a target clinical environment, as performed by local practitioners–indicate that the device operation and reading process is feasible and reproducible. Bin placement accuracy and lot-to-lot variability data identified specific targets for device optimization and material quality control. This is the first field study performed with a patterned paper-based microfluidic device and opens the door to development of similar assays for other important analytes.

Low Blood Long Chain Omega-3 Fatty Acids in UK Children Are Associated with Poor Cognitive Performance and Behavior: A Cross-Sectional Analysis from the DOLAB Study

BackgroundOmega-3 long-chain polyunsaturated fatty acids (LC-PUFA), especially DHA (docosahexaenonic acid) are essential for brain development and physical health. Low blood Omega-3 LC-PUFA have been reported in children with ADHD and related behavior/learning difficulties, as have benefits from dietary supplementation. Little is known, however, about blood fatty acid status in the general child population. We therefore investigated this in relation to age-standardized measures of behavior and cognition in a representative sample of children from mainstream schools.Participants493 schoolchildren aged 7–9 years from mainstream Oxfordshire schools, selected for below average reading performance in national assessments at age seven.MethodWhole blood fatty acids were obtained via fingerstick samples. Reading and working memory were assessed using the British Ability Scales (II). Behaviour (ADHD-type symptoms) was rated using the revised Conners’ rating scales (long parent and teacher versions). Associations were examined and adjusted for relevant demographic variables.ResultsDHA and eicosapentaenoic acid (EPA), accounted for only 1.9% and 0.55% respectively of total blood fatty acids, with DHA showing more individual variation. Controlling for sex and socio-economic status, lower DHA concentrations were associated with poorer reading ability (std. OLS coeff. = 0.09, p = <.042) and working memory performance (0.14, p = <.001). Lower DHA was also associated with higher levels of parent rated oppositional behavior and emotional lability (−0.175, p = <.0001 and −0.178, p = <.0001).ConclusionsIn these healthy UK children with below average reading ability, concentrations of DHA and other Omega-3 LC-PUFA were low relative to adult cardiovascular health recommendations, and directly related to measures of cognition and behavior. These findings require confirmation, but suggest that the benefits from dietary supplementation with Omega-3 LC-PUFA found for ADHD, Dyspraxia, Dyslexia, and related conditions might extend to the general school population.

Capillary versus venous haemoglobin determination in the assessment of healthy blood donors

To determine the accuracy of fingerstick haemoglobin assessment in blood donors, the performance of a portable haemoglobinometer (HemoCue Hb 201+) was prospectively compared with that of an automated haematology analyzer (Cell-Dyn 4000). Haemoglobin values obtained by the latter were used as the 'true' result. Capillary fingerstick samples were assayed by HemoCue in 150 donors. Fingerstick samples from two sites, one on each hand, were obtained from a subset of 50 subjects. Concurrent venous samples were tested using both HemoCue and Cell-Dyn devices. Capillary haemoglobin values (HemoCue) were significantly greater than venous haemoglobin values (HemoCue), which in turn were significantly greater than venous haemoglobin values by Cell-Dyn (mean ± SD: 14.05 ± 1.51, 13.89 ± 1.31, 13.62 ± 1.23, respectively; P < 0.01 for all comparisons among groups). Nine donors (6%) passed haemoglobin screening criteria (≥ 12.5 g/dl) by capillary HemoCue, but were deferred by Cell-Dyn values (false-pass). Five donors (3%) were deferred by capillary sampling, but passed by Cell-Dyn (false-fail). Substantial variability in repeated fingerstick HemoCue results was seen (mean haemoglobin 13.72 vs. 13.70 g/dl, absolute mean difference between paired samples 0.76 g/dl). Hand dominance was not a factor. Capillary samples assessed via a portable device yielded higher haemoglobin values than venous samples assessed on an automated analyzer. False-pass and false-fail rates were low and acceptable in the donor screening setting, with 'true' values not differing by a clinically significant degree from threshold values used to assess acceptability for blood donation.

The new noninvasive occlusion spectroscopy hemoglobin measurement method: a reliable and easy anemia screening test for blood donors

The tests used for anemia screening in blood donors are based on fingerstick samples, leading to discomfort and complaints. The aim of this study was to analyze the feasibility of occlusion spectroscopy method in blood banks and to compare the method with fingerstick hemoglobinometer and hemoglobin (Hb) determination on an automatic blood analyzer. The study enrolled 205 consecutive volunteer blood donors. Samples were collected by fingerstick and venous punction to determine Hb level by a Hemocue Hb201+ (Hb-F) and automatic blood analyzer (Hb-V) and compare to the noninvasive Hb determination by occlusion spectroscopy using NBM200 system (Hb-NI). The percentage errors of Hb-F and Hb-NI of all donors as well as stratified by sex, weight, and age levels were compared to Hb-V as reference values using Wilcoxon signed rank test. The results obtained with Hb-F showed significant errors (p<0.001) in the general group as well as when stratified by sex, weight, and age groups, above values obtained with Hb-V. Hb-NI showed significant errors only in females (p=0.026) and weight level of 61 to 70kg (p=0.034), below Hb-V values. Hb-NI seems to be a good method in terms of precision and feasibility for anemia screening of blood donors as well as being much more comfortable for donors.