Standard Venipuncture Research Articles

Capillary blood self-collection for high-throughput proteomics.

In this study, we sought to compare protein concentrations obtained from a high-throughput proteomics platform (Olink) on samples collected using capillary blood self-collection (with the Tasso+ device) versus standard venipuncture (control). Blood collection was performed on 20 volunteers, including one sample obtained via venipuncture and two via capillary blood using the Tasso+ device. Tasso+ samples were stored at 2°C-8°C for 24-hs (Tasso-24) or 48-h (Tasso-48) prior to processing to simulate shipping times from a study participant's home. Proteomics were analyzed using Olink (384 Inflammatory Panel). Tasso+ blood collection was successful in 37/40 attempts. Of 230 proteins included in our analysis, Pearson correlations (r) and mean coefficient of variation (CV) between Tasso-24 or Tasso-48 versus venipuncture were variable. In the Tasso-24 analysis, 34 proteins (14.8%) had both a correlation r>0.5 and CV<0.20. In the Tasso-48 analysis, 68 proteins (29.6%) had a correlation r>0.5 and CV<0.20. Combining the Tasso-24 and Tasso-48 analyses, 26 (11.3%) proteins met these thresholds. We concluded that protein concentrations from Tasso+ samples processed 24-48h after collection demonstrated wide technical variability and variable correlation with a venipuncture gold-standard. Use of home capillary blood self-collection for large-scale proteomics should be limited to select proteins with good agreement with venipuncture.

Evaluation of the Tasso+ blood self-collection device for quantitation of plasma cytomegalovirus (CMV) DNAemia in adult solid organ transplant recipients (SOTr).

We evaluate an FDA-cleared blood self-collection device (Tasso+) and demonstrate that it is patient-acceptable and yields a liquid blood sample with quantitative CMV DNAemia results comparable to those of standard venipuncture samples. This opens up possibilities for self-blood collection to monitor for CMV and potentially other viruses in transplant and other at-risk populations.

Factors that modulate platelet reactivity as measured by 5 assay platforms in 3429 individuals

BackgroundAssessment of platelet function is key in diagnosing bleeding disorders and evaluating antiplatelet drug efficacy. However, there is a prevailing “one-size-fits-all” approach in the interpretation of measures of platelet reactivity, with arbitrary cutoffs often derived from healthy volunteer responses. ObjectivesOur aim was to compare well-used platelet reactivity assays. MethodsBlood and platelet-rich plasma obtained from the Framingham Heart Study (N = 3429) were assayed using a range of agonists in 5 platelet assays: light transmission aggregometry, Optimul aggregometry, Multiplate impedance aggregometry (Roche Diagnostics), Total Thrombus-Formation Analysis System, and flow cytometry. Using linear mixed-effect models, we determined the contribution of preanalytical and technical factors that modulated platelet reactivity traits. ResultsA strong intra-assay correlation of platelet traits was seen in all assays, particularly Multiplate velocity (r = 0.740; ristocetin vs arachidonic acid). In contrast, only moderate interassay correlations were observed (r = 0.375; adenosine diphosphate Optimul Emax vs light transmission aggregometry large area under the curve). As expected, antiplatelet drugs strongly reduced platelet responses, with aspirin use primarily targeting arachidonic acid–induced aggregation, and explained substantial variance (β = −1.735; P = 4.59 × 10−780; variance proportion = 46.2%) and P2Y12 antagonists blocking adenosine diphosphate responses (β = −1.612; P = 6.75 × 10−27; variance proportion = 2.1%). Notably, female sex and older age were associated with enhanced platelet reactivity. Fasting status and deviations from standard venipuncture practices did not alter platelet reactivity significantly. Finally, the agonist batch, phlebotomist, and assay technician (more so for assays that require additional sample manipulation) had a moderate to large effect on measured platelet reactivity. ConclusionCaution must be exercised when extrapolating findings between assays, and the use of standard ranges must be medication-specific and sex-specific at a minimum. Researchers should also consider preanalytical and technical variables when designing experiments and interpreting platelet reactivity measures.

Vein Visualization With a Near Infrared Imaging Device and Its Impact on Students' and Nurses' Skills in an Academic Teaching University Hospital.

Venipuncture for blood collection is frequently delegated to medical or nursing students, while their individual skills depend on the quality of teaching. The aim of this study was to evaluate the use of a near infrared imaging (NIR) system on the visualization of veins and its potential benefit for the education of medical personnel. Participants answered a questionnaire following standardized venipuncture for blood sampling with the help of an NIR device. Vein visibility with the NIR device and its ability to facilitate venipuncture were examined. Visibility of veins was significantly better with the NIR, and its direction was clearly delineated. Sixty-nine percent of the participants stated that they felt more secure with venipuncture after using the NIR device. Patients' individual factors limited the visibility of veins. The adjuvant use of an NIR system for venipuncture improves participants' subjective skills through visualization of veins and their direction.

Comparison of Blood Biomarkers in Systemic Blood and Varicose Veins: A Cross-sectional Study

Introduction: Varicose Veins (VV) are enlarged, convoluted, and elongated veins that primarily affect the superficial veins in the lower limbs and are one of the most prevalent indications of vascular diseases. The reasons for elevated venous pressure are understood, but the inflammatory cytokines that initiate the ultimate pathways of tissue destruction and are in charge of the clinical characteristics of Chronic Venous Insufficiency (CVI) are yet unknown. Although inflammation plays a crucial role in the process of tissue apoptosis, it also plays a crucial role in tissue repair and regeneration. Aim: To investigate changes in blood markers of varicose vein inflammation and endothelial damage and compare them with systemic markers in VV patients and conclude that they are increased in VV blood. Materials and Methods: The comparative cross-sectional study was conducted in the Department of Biochemistry on 70 patients with primary VV who were scheduled for Outpatient Sclerotherapy at Nootan Medical College and Research Centre, Sankalcahnd Patel Vidyadham in Visnagar, Gujarat, India from April 2021 to June 2023. Chronic lower extremity Venous Disease (CVD) was categorised using the Clinical Aetiology Anatomy Pathophysiology (CEAP) classification method. Blood samples were obtained above the knee from the tortuous and dilated varicose tributaries of the great saphenous vein (local) and from the antecubital (systemic) vein by standard venipuncture. Erythrocytes, leukocytes, platelets, haemoglobin, and haematocrit were determined using an automatic haematology analyser. D-dimer and High sensitivity C-reactive Protein (hsCRP) were determined by an immune turbidimetric assay. IL-6 and von Willebrand factor (vWF) were measured by Enzyme Linked Immunosorbent Assay (ELISA) using commercially available kits according to the manufacturers’ instructions. An Independent samples t-test was used to compare group difference, and p-value ≤0.05 were considered significant in all two-sided statistical tests. Results: Basic haematologic test results {systemic versus (vs) varicose blood samples} were comparable. In VV, the following parameters were significantly increased compared to systemic blood: Haemoglobin (12.85±1.81 g/dL vs. 15.82±1.57 g/ dL, p&lt;0.001), hsCRP (1.34±1.01 mg/L vs. 3.78±1.67 mg/L, p&lt;0.001), IL-6 (2.65±1.07 pg/mL vs. 4.17±1.51 pg/mL, p&lt;0.001), vWF (90.73±16.72% vs. 127.30±19.92, p&lt;0.001). D-dimer was also substantially higher in samples extracted from leg VV than in systemic blood (105.87±17.72 ng/mL vs. 85.61±18.18 ng/mL, p&lt;0.001). Conclusion: Blood from VV has shown a higher level of several inflammatory markers and signs of endothelial dysfunction. This is most likely the result of worsening venous pressure and dilated, convoluted superficial veins that restrict blood flow. The procoagulant qualities of the local blood and damage to the venous wall, leading to a chronic inflammatory response, may accelerate the disease’s progression and thrombotic consequences.

Simultaneous LC–MS/MS method for the quantitation of Azithromycin, Hydroxychloroquine and its metabolites in SARS-CoV-2(−/ +) populations using dried blood spots

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to a global pandemic of coronavirus disease 2019 (COVID-19). Early in the pandemic, efforts were made to test the SARS-CoV-2 antiviral efficacy of repurposed medications that were already approved and available for other indications, including hydroxychloroquine (HCQ) and azithromycin (AZI). To reduce the risk of SARS-CoV-2 exposure for clinical-trial study participants and to conform with lockdowns and social distancing guidelines, biospecimen collection for HCQ and AZI included at-home dried blood spot (DBS) collection rather than standard venipuncture by trained clinicians. In this study, we developed and validated the first sensitive and selective simultaneous LC–MS/MS method to accurately quantitate the concentration of HCQ, HCQ metabolites (Desethylchloroquine [DCQ], Bisdesethylchloroquine [BDCQ], Monodesethylhydroxychloroquine [DHCQ]) and AZI extracted from DBS. The validated method was successfully applied for the quantification of over 2000 DBS specimens to evaluate the pharmacokinetic profile of AZI, HQC, and its metabolites. This new method has a small sample volume requirement (~ 10 µL), results in high sensitivity (1 ng/mL), and would facilitate remotely conducted therapeutic drug monitoring.

Frequency of Rh-e Antigen and reference values of Erythrocyte Sedimentation Rate and Red Cell Indices in an Undergraduate Students’ population in Port Harcourt, Nigeria.

Introduction: Red cell antigens alongside red cell indices provide an essential support to the diagnosis and monitoring of haematological diseases while the erythrocyte sedimentation rate (ESR) indicates and monitor an increase in inflammatory activity within the body. This study aims to determine Rh-e antigen, Erythrocyte Sedimentation Rate and Red cell indices values in apparently healthy undergraduate students of the Rivers State University, Port Harcourt, Nigeria. Material and Methods: One hundred and fifty (150) undergraduate students aged between 17-28years were enrolled in the study and standard venipuncture technique used to collect 5ml of blood. Determination of the Rh-e antigen was carried out using anti-e monoclonal antibodies (Lorne Diagnostics UK), Red cell indices obtained using BC 5000 Mindray Haematology Analyser and ESR by Westergren method. Results: Among the 150 subjects, 130 (86.6%) were positive while 20 (13.3%) were negative for Rh-e antigen. The mean±SD of the mean cell volume (MCV), mean cell haemoglobin (MCH), mean cell haemoglobin concentration (MCHC), red cell distribution width co-efficient of variation (RDW-CV), red cell distribution width-standard deviation (RDW-SD) and erythrocyte sedimentation rate (ESR) were 83.12 ± 10.74, 31.13 ± 3.25, 34.00 ± 3.32, 13.32 ± 1.61, 39.70 ± 2.26 and 30.36 ± 2.15 in the same order, while the reference ranges were 61.64-104.6 for MCV, 24.63-37.63 for MCH, 27.36–40.64 for MCHC, 10.10–16.54 for RDW (CV), 35.18–44.22 for RDW (SD) and 26.06-34.66 for ESR. Gender had no effect on MCV (p=0.3007) and MCHC (p=0.1436) but significant effect on MCH (p=0.030), RDW-CV (p&lt;0.001), RDW-SD (p=0.0005) and ESR (p=0.036) with a perfect positive correlation (r=1) between all the studied parameters. Conclusion: This study revealed a high (86.6%) prevalence for Rh-e antigen, established normal reference ranges for red cell indices and erythrocyte sedimentation rates and showed that gender has significant effects on MCH, RDW-CV, RDW-SD and ESR among healthy undergraduate students of Rivers State University. These findings are of clinical and research relevance.

Maximizing Microsampling: Measurement of Comprehensive Metabolic and Lipid Panels Using a Novel Capillary Blood Collection Device.

Demand continues to grow for patient-centric sampling solutions that enable collection of small volumes of blood outside of healthcare facilities. Various technologies have been developed to facilitate sample collection but gaps in knowledge remain, preventing these technologies from replacing standard venipuncture. A novel blood collection device, Touch Activated Phlebotomy (TAP) II® from YourBio Health, and standard fingerstick collection using a BD Microtainer® were utilized to collect capillary serum samples. Measurements of a comprehensive metabolic and lipid panels were measured on these samples and compared to results from venous serum samples that were collected in parallel. Hemolysis was used to assess sample quality. Sample volumes obtained from self-collected TAP II samples were also determined. Correlation of capillary serum with respect to venous serum was demonstrated (R > 0.9) for professionally collected TAP II samples, self-collected TAP II samples, and professionally collected fingerstick samples for alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, cholesterol, high-density lipoprotein, total bilirubin, and triglycerides. Results for creatinine demonstrated acceptable correlation, however, a consistent negative bias was observed. Biases (with unacceptable correlations) were also observed for measurements of carbon dioxide and potassium. Correlative results for albumin were not consistently acceptable across the collection techniques utilized while the remaining analytes tested did not demonstrate acceptable correlations under any condition. Correlation results, however, would improve with a wider distribution of analyte concentrations. Collections of small volumes of liquid blood continue to show potential as a patient-centric solution.

Levels of some coagulation parameters among apparently healthy Medical Laboratory Science undergraduate students of Rivers State University, Port Harcourt

Introduction: Prothrombin time (PT), International normalized ratio (INR) and activated partial thromboplastin time (APTT) are screening tests used to evaluate the overall integrity of the intrinsic, extrinsic and common coagulation pathway as well as monitoring and management of coagulation disorders. This study was aimed at assessing the PT, INR and APTT among apparently healthy undergraduate Medical Laboratory Science students of Rivers State University, Port Harcourt. Materials and Methods: A total of 100 apparently healthy undergraduate Medical Laboratory Science students of Rivers State University, Port Harcourt comprising of 44 males and 56 females within the age range of 17-40 years were recruited for this study. Five milliliters (5ml) of venous blood was collected from each participant using a standard venipuncture technique into a vacutainer bottle containing 3.2% tri-sodium citrate anticoagulant in a ratio of 1:9 of the anticoagulant and the blood and mixed thoroughly. Prothrombin time and activated partial thromboplastin time were determined by clotting method using the Helena C4 semi-automated, photo-optical coagulation analyzer and the Agappe thromboplastin test kit manufactured by Agappe Diagnostics Switzerland while INR was calculated by using the ratio of the study subjects’ PT to the mean of control PT raised to the power of the reagent international sensitivity index (ISI). The data obtained was analyzed using Graphpad Prism Software version 6.00. Data was presented as means, median, range and standard deviation. Results: The mean ± SD of the PT, INR and APTT were 12.9± 1.624s, 1.01±0.1281 and 37.99±8.898s in the same order. The reference intervals obtained for PT, INR and APTT were 9.7-16.2s, 0.8-1.3 and APTT 20.2-55.8s in the same order. The lower limits were within the ranges established by previous researchers while the upper limits were higher. The age range 21-25 had the highest frequency count (54), which was followed by &lt;20 (26), 26-30 (17) and then &lt;30 (3). The overall mean values for the age groups were within the established normal values and as such no statistically significant difference was observed between the various groups. Conclusion: This study has established the mean values and reference intervals of PT, INR and APTT for apparently healthy Medical Laboratory Science undergraduate students of Rivers State University, Port Harcourt as well as established that age does not have any significant effect on PT, INR and APTT. Due to geography, lifestyle, and genetic diversity, it is recommended that each laboratory establishes geography-specific reference intervals for PT, INR and APTT.

FRI-157 - Comparison of HCVRNA results using plasma separation card with gold standard veni-puncture

FRI-157 - Comparison of HCVRNA results using plasma separation card with gold standard veni-puncture

Platelets from blood diversion pouches (DPs) are a suitable alternative for functional, bioenergetic, and metabolomic analyses.

The collection of the first blood flow into a diversion pouch (DP) has become widely adopted in blood donation systems to reduce whole-blood unit contamination from skin bacteria. The strict control of pre-analytical variables, such as blood collection and proper anticoagulant selection, is critical to diminish experimental variability when studying different aspects of platelet biology. We hypothesize that the functional, mitochondrial, and metabolomic profiles of platelets isolated from the DP are not different from the ones isolated from standard venipuncture (VP), thus representing a suitable collection method of platelets for experimental purposes. Whole blood from the blood DP or VP was collected. Platelets were subsequently isolated and washed following standard protocols. Platelet function was assessed by flow cytometry, light transmission aggregometry, clot retraction, and under flow conditions using the total thrombus formation analyzer (T-TAS). Mitochondrial function and the platelet metabolome profiles were determined by the Seahorse extracellular flux analyzer (Agilent, Santa Clara, CA, USA) and ultra-high-pressure liquid chromatography-mass spectrometry metabolomics, respectively. Platelets isolated from VP and the DP have similar functional, mitochondrial, and metabolic profiles with no significant differences between both groups at baseline and upon activation by any of the assays mentioned above. The findings of our study support the use of platelets from the DP for performing functional and metabolic studies on platelets from a wide range of blood donors. The DP may serve as an alternative blood collection method to standard VP, allowing the study of diverse aspects of platelet biology, such as age, sex, race, and ethnicity, in many eligible individuals for blood donation.

Linking the Levels of Ferritin and Haematological Indices with Variations in Body Mass Index and Waist Circumference of Apparently Healthy Adults in Port Harcourt.

Background: The risk of some diseases associated with excessive adiposity and the impact it has on health care cost, makes it imperative for this study to aim at linking variations in body mass index and waist circumference to the levels of ferritin and some haematological indices in apparently healthy adult residents in Port Harcourt. We hypothesized therefore, that high body mass index and waist circumference might influence the amount of stored iron in the body. Materials and Methods: Two hundred and fifty adults aged 18- 50 years who were resident in Port Harcourt, Nigeria were recruited which includes 67 (53.60%) female and 58 (46.40%) males for test and control. 125 subjects with normal weight according to world health organization standard were used as control group, 56 overweight subjects, and 69 obese subjects were the test groups. Five milliliter blood sample was collected by standard venipuncture from each subject, 3mls was dispensed into plain tubes and spun to obtain the serum meant for ferritin assay using STAT FAX-2100 by awareness technology, 2mls of the blood was used for the analysis of complete blood count using automated haematology analyzer. Body Mass index and Waist Circumference were taken using a stadiometer (for height), weighing scale (for weight) and a measuring tape. A well-structured questionnaire was also used in this study. Results: There was no statistically significant difference in the mean levels of mean corpuscular haemoglobin (p=0.3057) and mean corpuscular volume(p=0.4860) between the normal weight and overweight /obese subjects. Mean level of ferritin was higher in the overweight and obese subjects compared to normal weight but not statistically significant. However, the mean levels of haematocrit (p=0.0002), haemoglobin (p=0.0001) and red blood cell counts (p&lt;0.0001) were significantly higher in the overweight and obese group compared to the normal weight subject. The mean of waist circumference was significantly higher in the overweight and obese subjectscompared to control subjects p&lt;0.0001. Additionally, it was observed in this study that body mass index and waist circumference is associated with age. Conclusion: Based on this study, it may be stated that overweight, and obesity is increasing in Port Harcourt. Neither anaemia nor iron overload was observed in this study. Furthermore, normal ferritin level among overweight and obese people does not necessarily indicate normal iron storage, therefore, serum ferritin should be used in conjunction with haematological indices for the diagnosis and monitoring of iron deficiency anaemia or iron overload in obese people. Further research with larger sample size is recommended to study the correlation between serum ferritin, complete blood count, other Anthropometric indices, with body mass index in apparently healthy adults in Rivers State Nigeria

Standard Venipuncture vs a Capillary Blood Collection Device for the Prospective Determination of Abnormal Liver Chemistry.

Abnormal liver function is a common manifestation of human disease and may also occur in approved and investigational medications as drug-induced liver injury (DILI). Capillary blood collection devices may allow for more frequent and convenient measurement outside of the clinic. Validation of such approaches is lacking. This prospective, biospecimens collection study evaluated the Tasso+ in patients with abnormal liver tests (NCT05259618). The primary objective was to define the concordance of alanine aminotransferase (ALT) obtained via Tasso+ compared to standard venipuncture. Secondary objectives included measurement of 14 other analytes and patient surveys. At the time of venipuncture, 2 Tasso+ samples were collected: one was centrifuged and shipped, and the other was refrigerated and shipped as whole blood. Thirty-six patients with elevated ALT values were enrolled. In total, 100 venipuncture, 50 Tasso+ centrifuged, and 48 Tasso+ whole blood samples were obtained. Tasso+ centrifuged samples demonstrated concordance correlation coefficients (CCC) of >0.99 for ALT, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and total bilirubin and CCC >0.95 for albumin, chloride, enzymatic creatinine, serum glucose, magnesium, and phosphorus. Tasso+ whole blood showed CCC of >0.99 for AST, bilirubin total, and enzymatic creatinine and CCC >0.95 for ALT, ALP, albumin, magnesium, and phosphorus. Hemolysis was comparable across the 3 sample types, but its impact was reflected in the Tasso+ potassium data. Patient feedback indicated a very favorable patient experience. The capillary blood collection device, Tasso+, showed substantial to almost perfect concordance to standard venipuncture for measurement of abnormal liver function. Studies are ongoing to validate longitudinal sampling outside of the clinic. Clinicaltrials.gov Registration Number: NCT05259618.

OP52 Health Technology Assessment Of Pain-Free Blood Draw Devices In Pediatrics

IntroductionBlood collection in a pediatric population is a time-consuming activity and an unpleasant experience. Moreover, many laboratory tests require only small amounts of blood while larger quantity of blood is usually drawn, generating excess waste that must be properly disposed of. To solve patient concerns and workflow inefficiencies biomedical companies developed Pain-Free Blood Draw (PFBD) devices. The aim of this health technology assessment (HTA) study is to compare the performances of PFBD devices with the standard venipuncture to evaluate the potential benefits of introducing PFBD devices into clinical practice.MethodsPFBD devices use microneedles that breach the stratum corneum, significantly reducing the pain perception due to the superficial skin penetration. Decision-oriented HTA method, was applied to conduct the HTA process. It is an analytical instrument that integrates the EunetHTA CoreModel with the analytic hierarchy process, to choose the best technology solution by identifying the main evaluation criteria and defining the weightsof system and performance values. Eight professionals have been involved to define the evaluation criteria and to measure the two technologies’ performance. As the method requires, a literature review was conducted to define the evaluation scheme represented by a multilevel decision tree composed of evaluation areas (domains) and key performance indicators (KPI).ResultsFive evaluation domains were included in the analysis (clinical effectiveness, safety, costs, organizational aspects, and technical characteristics), described by 35 KPIs. Preliminary clinical effectiveness results showed diagnostic concordance between blood samples obtained with PFBD and venipuncture. Even if the additional costs of PFBD, these devices seem to improve the safety by reducing the biological risks for operators. Moreover, considering pediatric patients, organizational aspects would benefit by the use of PFBD in terms of ease of use, compliance of patients, and time reduction for blood collection.ConclusionsResults showed that PFBD not only have great repercussions in terms of clinical benefits, especially for pediatric patients, but also a significant impact in terms of organizational aspects.

Evaluation of at-home serum anti-Müllerian hormone testing: a head-to-head comparison study

BackgroundFor optimal fertility testing, serum anti-Müllerian hormone levels are used in combination with other testing to provide reliable ovarian reserve evaluations. The use of the ADx 100 card is widely commercially available for at-home reproductive hormone testing, but data demonstrating that its results are reproducible outside of a clinical setting are limited, as well as comparisons of its performance with other newer blood collection techniques. This study aimed to evaluate the concordance of serum AMH levels found via standard venipuncture and self-administered blood collection using the TAP II device (TAP) and ADx card in women of reproductive age.MethodsThis was a prospective, head-to-head-to-head within-person crossover comparison trial that included 41 women of reproductive age (20–39 years). It was hypothesized that the TAP device would be superior to the ADx card both in terms of agreement with venipuncture reference standard and patient experience. Each subject had their blood drawn using the three modalities (TAP, ADx, and venipuncture). We evaluated the concordance of AMH assays from samples obtained via the TAP device and ADx card with the gold standard being venipuncture. Two-sided 95% CIs were generated for each method to compare relative performance across all three modes. Patient preference for the TAP device versus the ADx card was based on self-reported pain and Net Promoter Score (NPS).ResultsThe TAP device was superior to the ADx card on all outcome measures. TAP R-squared with venipuncture was 0.99 (95% CI 0.99, > 0.99), significantly higher than the ADx card, which had an R-squared of 0.87 (95% CI 0.80, 0.94) under most favorable treatment. TAP sensitivity and specificity were both 100% (no clinical disagreement with venipuncture), versus 100 and 88%, respectively, for the ADx card. Average pain reported by users of the TAP device was significantly lower than the ADx card (0.75 versus 2.73, p < 0.01) and the NPS was significantly higher than the ADx card (+ 72 versus − 48, p < 0.01).ConclusionsThe TAP was non-inferior to venipuncture and superior to the ADx card with respect to correlation and false positives. Moreover, the TAP was superior to both alternatives on patient experience.Trial registrationNCT04784325 (Mar 5, 2021).

Ubiquitin carboxyl-terminal esterase L1 is not elevated in the serum of concussed rugby players: an observational cross-sectional study

Concussion diagnosis is complicated by a lack of objective measures. Ubiquitin carboxyl-terminal esterase L1 (UCHL1) is a biomarker that has been shown to increase following traumatic brain injury but has not been investigated in concussed athletes on the sideline of athletic events. Therefore, this study was conducted to determine if UCHL1 can be used to aid in sideline concussion diagnosis. Blood was taken via standard venipuncture from a recreationally active control group, a group of rugby players prior to match play (pre-match), rugby players following match-play (match-control), and rugby players after suffering a sport-related concussion (SRC). UCHL1 was not significantly different among groups (p > 0.05) and was unable to distinguish between SRC and controls (AUROC < 0.400, p > 0.05). However, when sex-matched data were used, it was found that the female match-control group had a significantly higher serum UCHL1 concentration than the pre-match group (p = 0.041). Differences were also found in serum UCHL1 concentrations between male and female athletes in the match-control group (p = 0.007). This study does not provide evidence supporting the use of UCHL1 in sideline concussion diagnosis when blood is collected soon after concussion but does show differences in serum UCHL1 accumulation between males and females.

Some Haemostatic Indices and Body Mass Index of Apparently Healthy Deskbound and Non-Deskbound Employees of a Tertiary Institution in Port Harcourt, Nigeria

Background: Prothrombin time (PT) and international normalized ratio (INR) is typically used in conjunction with activated partial thromboplastin time (APTT) to evaluate the overall integrity of the intrinsic, extrinsic and common coagulation pathway and to monitor the treatment of coagulation disorders while BMI screens for weight categories ;an important health index. A high BMI can indicate high body fatness while a low BMI connotes risks of being underweight. These extremes have obvious health challenges. The aim of the study is to determine some haemostatic indices and body mass index in apparently healthy deskbound and non-deskbound employees of the Rivers State University, Port Harcourt. Methods: A total of hundred (100) employees of the Rivers State University were recruited for this study comprising of 37 females and 63 males, out of which 53 were non-deskbound and 47 deskbound. The deskbound employees were those that work for an average of seven hours sitting down at a stretch while the non-deskbound work for an average of less than seven hours sitting down at a stretch. Using a structured questionnaire, demographic information was collected from each participant. The weight and blood pressure (BP) of each participant was taken using a weighing scale and a MOTECH digital BP monitor respectively. A standard venipuncture technique was used to collect 3ml of blood into 3.2% tri-sodium citrate anticoagulant (at the ratio of 9:1 blood-anticoagulant) for analysis. Activated partial thromboplastin time (APTT) and prothrombin time (PT) were analyzed using the Helena C4 semi-automated coagulation analyzer, photo-optical coagulation analyzer and the Agape test kit manufactured by Agape diagnostics Switzerland. International normalized ratio (INR) was calculated from the PT results. The data obtained was analyzed using Graphpad Prism software version 6.00 produced by Graphpad software Inc. USA. Data was presented as means, median, range and standard deviation. Comparison between two means was done using student t-test analysis. Results: The mean ± SD of the PT, INR, APTT and BMI were 13.21 ± 1.97s, 1.03 ± 0.15, 29.7 ± 4.90s and 27.02 ± 2.95s in the same order and the reference ranges established for both deskbound and non-deskbound employees as the following values: PT (s): 9.27-17.15, APTT (s): 19.9-39.5 and INR: 0.73-1.33. Comparison of the prothrombin time (PT), international normalized ratio (INR), activated thromboplastin time (APTT) and BMI between non-deskbound and deskbound staff showed a statistical significant difference for APTT (P=0.0119) and BMI (P=0.0427) while the PT and INR showed no significant statistical difference. However, all the measured haemostatic parameters were within the reference ranges. Conclusion: The increased APTT observed among the deskbound employees is a pointer to an abnormal haemorrhage if their sedentary working lifestyle continues without any ameliorative measures. Also the increased BMI seen among the Deskbound employees connotes overweight and its attendant health consequences. It is therefore recommended that the deskbound employees should make it a point of duty to walk around in-between their working schedules to break the long hours of sitting down.

Haematological and Anthropometric Profile in Gestational Diabetes Mellitus with Non-diabetic Pregnant Women in Port Harcourt, Nigeria

Aim: Haematological and anthropometric profile of pregnant women who had gestational diabetes and non-diabetic pregnant women attending antenatal clinic in a Tertiary Hospital in Rivers State, Nigeria were evaluated,&#x0D; Methods: This was a cross sectional study involving 70 pregnant women comprising of 40 diabetic and 30 non-diabetics for the purpose of comparing haematological and anthropometrical parameters in diabetic and non-diabetic pregnant women. Using standard venipuncture technique,5ml blood sample was aseptically drawn from the subjects and 2.5ml dropped into each of two different anticoagulant sample bottles -Ethylene Diamine Tetra acetic Acid(EDTA) and fluoride-oxalate bottles respectively. The methods of choice for estimation of parameters were Enzymatic Colorimetric method for glucose and Automation using Sysmex KX-21N Haematology Analyzer for full blood count. Results were statistically analyzed using Graph Pad prism version 5.0 and statistical significance set at P&lt;0.05.&#x0D; Results: Mean± SD results for diabetic and non-diabetic pregnant women respectively showed Haemoglobin concentration (10.99±0.69g/dl versus 10.69±1.01g/dl), Packed cell volume (31.7±1.96% versus 32.89±3.89%), Red blood cell(3.99±0.29106/µl versus 3.85±0.39×106/µl), Mean cell haemoglobin (27.51±1.22pg versus 27.54±2.22pg), Platelets count (223.3±52.67103/µl versus 205.5±45.09×103/µl), Mean cell haemoglobin concentrations(34.49±1.19g/dl versus 32.54±3.17g/dl)these results were not statistically significantly different(P&gt;0.05). The mean± SD of white blood cell (9.73±0.49103/µl versus 7.27±1.66×103/µl) and mean cell volume (79.3±4.16 fl and 85.24±0.39fl) were statistically significantly different (P&lt;0.05).Mean± SD of subject’s blood pressure showed, Systolic (116±11.52 mm/Hg and 105±5.72 mm/Hg),Diastolic (77±17.86 and 68±1.11 mm/Hg), results were statistically significantly different (P&lt;0.001).Age did not show statistical significant difference (P&gt;0.05).Body mass index (BMI) 28.33±3.81 kg/m2, 32.86±5 kg/m2, 37.96±.3.44 kg/m2 showed statistically significant difference (P&lt;0.05) at the Gestational ages of(1-3), (4-6) and (7-9) months respectively while that of the non-diabetic were obviously not statistically significantly different (P&gt;0.05).&#x0D; Conclusion: Gestational diabetes is capable of causing changes in haematological parameters; but it could improve or disappear after child birth. Factors such as lifestyle activities and diet can predispose pregnant women to gestational diabetes mellitus and this can lead to complications for both the mother and the baby.

Evaluation of Interleukin 10 Levels among Pulmonary Tuberculosis Patients Attending Aminu Kano Teaching Hospital, Kano

Despite medical advances, tuberculosis is responsible for over one billion deaths in the last 200 years. This study was carried out to determine interleukin 10 levels in serum of tuberculosis patients attending Aminu Kano Specialist Hospital, Kano (AKTH). A total of 330 subjects were enlisted for this study. The subjects were grouped into: Group A (30 control) and Group B (300 subjects). DNA sequences specific for Mycobacterium tuberculosis and rifampicin resistance were detected using Gene Xpert MTB/RIF assay. 5mls of blood were aseptically collected from subjects using standard venipuncture procedure into plain tubes for HIV and Interleukin 10 assay. TB patients co-infected with HIV were excluded from this study. The Interleukin 10 level was measured using commercial Sandwich ELISA kits. The result revealed that there was significant difference (p&lt;0.05) between the interleukin 10 levels of the test (11.30±3.79) and control group (9.38±4.39). Furthermore, the result showed that there was no significant difference (p&gt;0.05) between the interleukin-10 levels of rifampicin resistant (11.80±3.87) and non-rifampicin resistant patients (11.65±3.55). Interleukin 10 was also found to be higher among patients aged 30-39 (12.33±3.31) and female patients (11.95±3.50) than in male patients (11.45±3.65). Furthermore, Interleukin 10 level was found to be higher in TB patients before anti TB treatment (12.54±3.82) than in patients after treatment (9.86±3.59). The findings of the study showed that interleukin 10 is a viable biomarker in the pathogenesis of TB infection and can be used as prognostic marker for management of TB patients.

Validation of Medicinal Leeches (Hirudo medicinalis) as a Non-invasive Blood Sampling Tool for Hematology and Biochemistry Profiling in Mammals.

Blood sampling is a challenging procedure in many captive animals. Although manual restraint or anesthesia are usually possible, they entail intense stress and a high risk of injuries or organ failure. Blood sampling using medicinal leeches (Hirudo medicinalis) represents a promising non-invasive alternative to venipuncture; however, leech blood meal was to date used only for qualitative analyses such as genetic or serological screenings. Hence, the aim of this study was to evaluate the suitability of the leech blood sampling method for quantification of hematological and biochemical parameters. Medicinal leeches were manually applied on 67 zoo animals of eleven species, and control blood samples were obtained by venipuncture of the jugular vein. The leeches drew up to 20 ml of blood in 20 to 55 min. Although most hematological and biochemical parameters were significantly altered in leech-derived samples, their values showed strong (r = 0.62–0.79; 10/24 parameters) to very strong (r > 0.8; 13/24 parameters) correlations with venipuncture in all blood parameters, except for sodium (r = 0.39). As the parameter alterations and correlations were similar among species, simple cross-species regression formulas were sufficient to correct the alterations, thereby ensuring good repeatability between leeches and venipuncture in most parameters. Our data thus suggest that medicinal leeches can be used as a reliable non-invasive and stress-reducing alternative to standard venipuncture, even for quantitative assays. This opens new opportunities for a significant improvement to animal welfare in zoological gardens, conservation programmes, and ecophysiological research, where quantification of blood parameters is often needed.