Venous Blood Samples Research Articles

A-329 Accuracy of the pH, PO2, and PCO2 Tests in the i-STAT® G3+ Cartridge Using the i-STAT 1 System for Venous, Arterial and Capillary Whole Blood Specimens in Clinical Settings

Abstract Background Precise and accurate measurements of blood gases are important for the diagnosis, monitoring and treatment of respiratory, metabolic, and acid-base disturbances. This study demonstrates the accuracy of the pH, partial pressure of oxygen (PO2), and partial pressure of carbon dioxide (PCO2) tests in the i-STAT G3+ cartridge with the i-STAT 1 System in arterial, venous, and capillary whole blood specimens in point of care or clinical laboratory settings. Methods The accuracy of the PO2, and PCO2 tests in the i-STAT G3+ cartridge was assessed at external clinical sites in a method comparison study using whole blood specimens across the measurement range for each test: pH 6.5-7.8, PO2 5-700 mmHg, PCO2 5.0-130.0 mmHg. Specimens used in this study were venous, arterial, and capillary specimens prospectively collected under Institutional Review Board-approved informed consent or were leftover de-identified venous or arterial specimens. The study included venous and arterial whole blood samples from ∼140 adult subjects (≥ 18 years) at 3 clinical sites, and capillary whole blood samples from ∼180 adult subject at 3 clinicals sites and ∼25 neonate subjects (birth to 28 days) at 2 clinical sites. The RapidPoint System was used as comparator. For venous and arterial whole blood, samples were collected and tested in duplicate on the i-STAT G3+ cartridge and in singlicate on the RapidPoint System. For capillary whole blood samples, adult fingerstick samples and neonate heel-stick samples were collected in capillary tubes and tested in singlicate on the i-STAT G3+ cartridge and on the RapidPoint System. Passing-Bablok regression was performed for venous and arterial whole blood samples combined, using the first replicate from the i-STAT G3+ cartridge versus the singlicate result from the comparator, and for capillary whole blood samples (adult and neonate combined) using the singlicate result from the i-STAT G3+ cartridge versus the singlicate result from the comparator. Results Passing-Bablok regression of i-STAT G3+ cartridge results versus the comparator was used to calculate slope and correlation coefficient (r). For adult venous and arterial whole blood results, pH had slope = 0.96 and r = 0.99, PO2 had slope = 1.05 and r = 1.00, and PCO2 had slope = 1.04 and r = 0.98. For adult and neonate capillary whole blood results, pH had slope = 1.02 and r = 0.98, PO2 had slope = 1.09 and r = 0.99, and PCO2 had slope = 1.07 and r = 0.96. Conclusions These results demonstrate that the i-STAT 1 System delivers accurate pH, PO2, and PCO2 test results with ∼2 minutes using the i-STAT G3+ cartridge for venous, arterial and capillary whole blood samples for adult and neonate subjects when tested by end-users in a point of care or clinical laboratory setting. This study was funded by Abbott Laboratories.

A-005 Comparison of Performance of High Sensitive Troponin I (cTNIH) by “Point of care” (POC) and Automated cTNIH Immunoassays in Patients at Low Risk of Heart Attack in a Chilean Emergency Unit; Impact on E.R Department Efficiency

Abstract Background Most cases of death from Acute Myocardial Infarction (AMI) occur in the first hours after the manifestation of clinical symptoms, constituting 40 to 65% in the first hour and approximately 80% in the first 24 hours. For the safe, effective, and rapid diagnosis of a patient with suspected AMI, international guidelines recommend that it be done based on clinical symptoms, together with electrocardiogram and analysis of biomarkers in the context of suspected of non-ST-elevation myocardial infarction (NSTEMI). Troponins are the biomarkers of choice with level A level evidence and the ability to perform screening in patients complaining of chest pain and refer it to the correct clinical approach based on the 0h/1h algorithm. To date, the successful clinical implementation of these rapid algorithms is restricted to hospitals working with well-defined workflows and a robust central laboratory structure. The Atellica® vTLi analyzer is based on the chemiluminescence methodology for the quantification of hs-cTnI levels with low sample volume, low complexity, and may enable the rapid management of patients with chest pain and application of 0h/1h algorithm. Objectives The aim of the study is to evaluate clinical performance in effectiveness and efficiency of the hs-cTnI Atellica® vTLi point of care test to rule out acute myocardial infarction in subjects with low-risk chest pain established with a validated predictive rule, in an adult-Chilean emergency unit, compared to clinical evaluation and the commonly used ADVIA Centaur® troponin test. Methods Descriptive, observational, longitudinal study. Patients over 18 years of age, consulting with acute chest pain of at least one hour from symptom onset and a HEART SCORE less than or equal to 3 points were recruited. A venous blood sample was requested for hs-cTnI analysis by Atellica® vTLi Siemens Healthineers and ADVIA Centaur® Siemens Healthineers. The time difference between sample collection and start of sample analysis; the time difference between sample collection and release of sample results was recorded and the concordance between the two results was determined. Results 50 subjects were included in the study. The difference between blood sampling and start of sample analysis was 5 minutes with Atellica® vTLi POC and 68 minutes with ADVIA Centaur®. The concordance of hs-cTnI Atellica® vTLi POC and ADVIA Centaur® was 94% for predicting medical discharge and confirmed acute myocardial infarction. Conclusions The study findings support the safety and efficiency of the hs-cTnI POC test by providing faster results than central laboratory tests with the same analytical quality, with direct impact on reducing care times in patients consulting for low-risk chest pain.

A-349 Evaluation of i-STAT® Point of Care Blood Gas Cartridges and Competitor Blood Gas Devices Against Reference Standard for PCO2 and PO2

Abstract Background The i-STAT System provides laboratory quality results in minutes at the patient’s bedside. Accurate and rapid test results are critical for clinical decision making in the presence of blood gas disorders, including oxygenation and acid-base status, where the partial pressure oxygen (PO2) and partial pressure carbon dioxide (PCO2) are needed. The purpose of this study was to compare the analytical performance of the PO2 and PCO2 tests in the i-STAT G3+ and i-STAT CG8+ cartridges to the theoretical PO2 and PCO2 in prepared reference standards. Two other blood gas instruments, a benchtop device and a laboratory device were also compared to the reference PO2 and PCO2. Methods Venous whole blood samples were contrived using saturation tonometry with U.S. NIST (National Institute of Science and Technology) traceable gas tanks to prepare the reference standards, which were value assigned to theoretical PO2 or PCO2 levels based on the molar composition of the gas mixture used. Eleven levels spanning the reportable range of each PO2 (5 mmHg - 800 mmHg) and PCO2 (5 mmHg - 130 mmHg) were prepared and tested in duplicate on the i-STAT G3+ and i-STAT CG8+ cartridges, benchtop device, and the laboratory device. Passing-Bablok linear regression analysis was performed to evaluate the slope and correlation coefficient, comparing each blood gas device against the reference PO2 and PCO2 values. Study designs followed CLSI (Clinical and Laboratory Standards Institute) EP09C-ED3:2018, Measurement Procedure Comparison and Bias Estimation using Patient Samples, 3rd Edition. Passing-Bablok regression analysis was also performed for the i-STAT cartridges and benchtop device against the laboratory device. Results The regression analysis was performed against the reference standards. For PO2, slopes for the i-STAT cartridges ranged from 0.93 - 0.97, the slope for the benchtop device was 0.99, and the slope for the laboratory device was 0.97. Correlation coefficients for all devices were 1.00. For PCO2, slopes for the i-STAT cartridges ranged from 0.98 - 1.02, the slope for the benchtop device was 0.85, and the slope for the laboratory device was 1.01. Correlation coefficients were 1.00 for the i-STAT cartridges and laboratory device, and 0.99 for the benchtop device. The regression analysis was also performed against the laboratory device. For PO2, slopes for the i-STAT cartridges ranged from 0.96 - 1.00, and the slope for the benchtop device was 1.02. Correlation coefficients for all devices were 1.00. For PCO2, slopes for the i-STAT cartridges ranged from 0.97 - 1.01, and the slope for the benchtop device was 0.85. Correlation coefficients were 1.00 for the i-STAT cartridges and 0.99 for the benchtop device. Conclusions The study demonstrated that the i-STAT G3+ and i-STAT CG8+ cartridges used with the i-STAT System were shown to provide laboratory quality results within 2 minutes, showing good agreement to both reference standards and laboratory quality devices. For PCO2, the i-STAT System was shown to have better agreement to both theoretical reference standards and the laboratory device than the benchtop device. These studies were funded by Abbott Laboratories.

A-342 Precision Evaluation of the pH, PO2 and PCO2 tests in the i-STAT® G3+ Cartridge using the i-STAT 1 System for Venous, Arterial and Capillary Whole Blood Specimens in Clinical Settings

Abstract Background Precise and accurate measurements of blood gases are important for the diagnosis, monitoring and treatment of respiratory, metabolic, and acid-base disturbances. This study demonstrates the precision of the pH, partial pressure of oxygen (PO2), and partial pressure of carbon dioxide (PCO2) tests in the i-STAT G3+ cartridge with the i-STAT 1 System in arterial, venous, and capillary whole blood specimens in point-of-care or clinical laboratory settings. Methods The precision of the i-STAT pH, PO2, and PCO2 tests in the i-STAT G3+ cartridge was assessed at external clinical sites by end-users using whole blood specimens across the measurement range for each test: pH (6.500 - 7.800 pH units), PO2 (5 - 700 mmHg), PCO2 (5.0 - 130.0 mmHg). The study included venous whole blood samples from ∼140 adult subjects (≥ 18 years) and arterial whole blood samples from ∼140 adult subjects at 3 clinical sites. Each whole blood sample was run in duplicate on the i-STAT G3+ cartridge. In addition, ∼140 specimens were collected in capillary tubes using two fingerstick draws from adult subjects and ∼20 capillary heel-stick specimens were collected into two capillary tubes from neonate subjects (birth - 28 days) at two clinical sites. Specimens used in this study were prospectively collected venous, arterial, or capillary specimens under an Institutional Review Board approved informed consent or were de-identified leftover venous or arterial specimens. For each specimen type, duplicates from each subject were grouped into subintervals based on their mean values. The subintervals included the medical decision levels of 7.300, 7.350 and 7.450 pH units for pH, 30, 45 and 60 mmHg for PO2 and 35, 45, 50 and 70 mmHg for PCO2. The estimates of the pooled standard deviation (SD) and pooled coefficient of variation (%CV), as well as their respective 95% confidence intervals were calculated for each subinterval. Results Across all specimen types (excluding outliers), the pooled SD for pH ranged from 0.00591 - 0.01747 pH units for subintervals 6.500 - 7.300, >7.300 - 7.450, >7.450 - 7.800 pH units. For PO2, the pooled SD ranged from 0.71 - 3.76 mmHg for subintervals 10 - 40 mmHg and >40 - 50 mmHg and the pooled %CV ranged from 1.63 - 8.76 %CV for subintervals >50 - 100 mmHg, >100 - 250 mmHg and >250 - 700 mmHg. For PCO2, the pooled SD ranged from 0.000 - 1.709 mmHg for subintervals 5.0 - 35.0 mmHg, >35.0 - 50.0 mmHg and >50.0 - 62.5 mmHg and the pooled %CV ranged from 1.10 - 3.62 %CV for subinterval >62.5 - 130.0 mmHg. Conclusions The precision study demonstrated that the pH, PO2 and PCO2 tests in the i-STAT G3+ cartridge when tested using the i-STAT 1 System deliver precise results within ∼2 minutes for venous, arterial, and capillary whole blood patient specimens when tested by end users in a point-of-care or clinical laboratory setting. These studies were funded by Abbott Laboratories.

A-341 Precision Evaluation of the i-STAT® Glucose Test in the i-STAT G Cartridge using thei-STAT 1 System for Venous, Arterial and Capillary Whole Blood Specimens in Clinical Settings

Abstract Background Precise and accurate measurements of whole blood glucose levels are important for the diagnosis and treatment of patients suffering from diabetes and hypoglycemia. This study demonstrates the precision of the i-STAT G cartridge with the i-STAT 1 System in arterial, venous, or capillary whole blood in point of care or clinical laboratory settings. Methods The precision of the i-STAT G cartridge was assessed at external clinical sites by intended end users with whole blood specimens across the measurement range of 20 - 700 mg/dL. The study included testing venous whole blood samples from 154 adult (≥ 18 years) patients and arterial whole blood samples from 173 adult patients at three clinical sites. Each whole blood sample was run in duplicate on the i-STAT G cartridge. In addition, 139 capillary whole blood specimens from both adult subjects and neonate subjects (birth - 28 days) were collected and tested for capillary whole blood precision. Duplicate fingerstick draws were collected in capillary tubes from 119 adult subjects at two clinical sites and duplicate heel-stick specimens were collected in capillary tubes from 20 neonate subjects at two clinical sites. Specimens used in this study were prospectively collected venous, arterial, or capillary specimens under an Institutional Review Board approved informed consent or were de-identified leftover venous or arterial specimens. For each specimen type, duplicates from each subject were grouped into subintervals based on their mean values. The subintervals included the glucose medical decision levels of 45 mg/dL, 120 mg/dL and 180 mg/dL. The estimates of the pooled standard deviation (SD) and pooled coefficient of variation (%CV), as well as their respective 95% confidence intervals (CI) were calculated for each subinterval (20-90 mg/dL, >90-150 mg/dL, >150-250 mg/dL, >250-700 mg/dL or >250-400 mg/dL and >400-700 mg/dL, as applicable). The precision estimates for each subinterval were compared against an acceptance criteria of the greater of 3 mg/dL or 5% of the mean (mg/dL) of the subinterval. Results The whole blood precision was found to be less than or equal to 5.00 %CV for all subintervals for each specimen type. For venous specimens, the %CV ranged from 0.35% to 0.43%; for arterial specimens the %CV ranged from 0.26% to 0.46% and for capillary specimens (adult and neonate combined), the %CV ranged from 1.38% to 2.71%. Conclusions The study demonstrated that the i-STAT Glucose test in the i-STAT G cartridge when tested using the i-STAT 1 System delivers precise results within ∼2 minutes for venous, arterial, and capillary whole blood patient specimens across a glucose range of 20 - 700 mg/dL when tested by end users in a point of care or clinical laboratory setting. The studies were funded by Abbott Laboratories.

Getting Tacrolimus Dosing Right.

Tacrolimus (TAC) dosing is typically guided by the trough concentration (C0). Yet, significant relationships between TAC C0 and clinical outcomes have seldom been reported or only with adverse events. Large retrospective studies found a moderate correlation between TAC C0 and the area under the curve (AUC), where, for any given C0 value, the AUC varied 3- to 4-fold between patients (and vice versa). However, no randomized controlled trial evaluating the dose adjustment based on TAC AUC has been conducted yet. A few observational studies have shown that the AUC is associated with efficacy and, to a lesser extent, adverse effects. Other studies showed the feasibility of reaching predefined target ranges and reducing underexposure and overexposure. TAC AUC0-12 h is now most often assessed using Bayesian estimation, but machine learning is a promising approach. Microsampling devices are well accepted by patients and represent a valuable alternative to venous blood sample collection during hospital visits, especially when a limited sampling strategy is required. As AUC monitoring cannot be proposed very frequently, C0 monitoring has to be used in the interim, which has led to fluctuating doses in patients with an AUC/C0 ratio far from the population mean, because of different dose recommendations between the 2 biomarkers. We proposed estimating the individual AUC/C0 ratio and derived individual C0 targets to be used in between or as a replacement for AUC monitoring. Existing technology and evidence are now sufficient to propose AUC monitoring interspersed with individualized-C0 monitoring for all patients with kidney transplants while collecting real-world data to strengthen the evidence.

Correlation between blood cell indices and adiponectin and leptin levels in COVID-19.

Adipose tissue (AT) is a major metabolic organ, functioning through autocrine, paracrine, and endocrine mechanisms. This study investigated the relationship between adipokine levels and blood cell indices, particularly platelets, in individuals with COVID-19. Another aim was to enhance the understanding of AT's endocrine function during dynamic pathological changes, such as acute viral infections like COVID-19. The study was conducted as a cross-sectional analysis at the Clinical Center Vojvodina in 2021 and 2022, including 76 consecutive SARS-CoV-2-positive patients of both sexes. Study parameters were determined from peripheral venous blood samples routinely collected upon hospital admission. The results showed that leptin levels were significantly positively correlated with body mass index (BMI) (ρ = 0.421, P < 0.001) and body fat mass (BFM) (ρ = 0.547, P < 0.001). Simultaneously, a significant negative correlation was observed between adiponectin levels and BMI (ρ = -0.430, P < 0.001). Additionally, a significant positive correlation was found between leptin levels and mean platelet volume (MPV) (ρ = 0.307, P < 0.05), platelet distribution width (PDW) (ρ = 0.325, P < 0.05), and platelet-large cell ratio (P-LCR) (ρ = 0.305, P < 0.05). Leptin's impact on platelet indices was confirmed in both simple and multiple linear regression models, where leptin exhibited a slightly higher beta coefficient than BMI. In contrast, adiponectin levels were negatively correlated with hematocrit (HCT) (ρ = -0.329, P < 0.05). These findings may provide further insight into the previously suspected role of AT in the complex cascade of COVID-19 pathogenesis and platelet activation.

The effect of endobronchial coil treatment (EBCT) on hemorheological parameters and oxidative stress: a pilot study

Objective: Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, curable disease characterized by persistent airflow limitation, respiratory symptoms due to airway and/or alveolar abnormalities caused by severe exposure to harmful particles, gases. During the endobronchial coil treatment (EBCT) process, the volume of the lung parenchyma is reduced by shrinking the elastic recoil. Although there are studies showing worsening of hemorheological parameters in COPD exacerbations, no study investigated whether hemorheological parameters are improved after coil. The aim of this study was to assess the effects of coil therapy on erythrocyte deformability, whole blood viscosity (WBV) measured at autologous, standard (40%) hematocrit and plasma viscosity (PV) in COPD patients. Material and methods: Venous blood samples were taken once from the healthy control group (n=17) and before and 1 month after the treatment from the COPD patients who had been indicated for coil according to GOLD guidelines (n=20). To assess erythrocyte deformability, shear-dependent erythrocyte elongation was measured at 0.3-3.0 Pa by an ektacytometer (LORCA), while WBV, PV were measured using a rotational viscometer. Results: Erythrocyte deformability measured at shear stresses between 0.3-5.33 Pa were found to be higher following treatment compared to pre-coil values. EBCT did not have a statistically significant effect on WBV measured at autologous, 40% hematocrit, PV and oxidative stress indices. Conclusion: Increased erythrocyte deformability determined following EBCT at the shear stresses observed at the pulmonary level is a favourable finding, showing that the procedure may positively affect the hemodynamics of COPD patients as well as causing clinical improvement.

The effects of selenium administration on mean platelet volume, neutrophil-to-lymphocyte ratio, and red cell distribution width in critically ill older adults: A double-blinded randomized clinical trial

BackgroundLow serum Selenium (Se) levels in critical patients have been associated with poor clinical outcomes and higher mortality rates. The purpose of this study was to investigate the effect of Se administration on mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (N/L), and red cell distribution width (RDW) in older adults admitted to the intensive care unit (ICU). MethodThis study was a double-blinded randomized clinical trial. Critically ill patients were randomly divided into two groups of Se and placebo. The Se group (N=30) initially received 3000 mg of Se at once within 3 hours, followed by a dose of 1500 mg daily for 10 days as a one-hour infusion. The control group (N=30) received normal saline for 10 days. A venous blood sample was collected on the first and 10th day. Statistical analysis was performed using SPSS.26 statistical software. To analyze quantitative data in two groups, based on the estimated normality, an independent t-test was used. P value less than 0.05 was considered statistically significant. ResultsOn day 10, the MPV value in the Se group was significantly lower compared to the placebo group (9.32 ± 1.78 and 10.43 ± 2.06, respectively, p = 0.03). Within the Se group, contrary to the controls, the MPV value decreased significantly from day 1 to day 10 (p<0.001). Further, the RDW value in the Se group was significantly lower compared to the placebo group (13.77 ± 1.57 and 15.32 ± 2.42, respectively, p = 0.005). The N/L ratio remained similar between the two groups before and after the intervention. ConclusionOur findings suggest that Se can affect the MPV and RDW parameters in older adults hospitalized in the ICU. However, further studies with a larger population are necessary to support these findings. Clinical Relevancy StatementThe effects of selenium administration on hematological parameters in older adults admitted to the ICU are not well-established. There is limited direct evidence linking serum selenium levels to erythrocyte and hemoglobin stability in humans. The current clinical trial promotes the current literature and shows that selenium holds potential in management of the older ICU patients.

Simultaneous Determination of Methotrexate Concentrations in Human Plasma and Cerebrospinal Fluid Using Two-Dimensional Liquid Chromatography: Applications in Primary Central Nervous System Lymphoma.

In this study, we aimed to develop a method for the simultaneous quantification of methotrexate (MTX) samples extracted from human plasma and cerebrospinal fluid (CSF), using two-dimensional liquid chromatography (2D-LC). Furthermore, we intended to verify whether intravenous mannitol could increase MTX concentration in the CSF of patients. The mobile phase of PUMP1 consisted of 10.0 mmol/L ammonium acetate and acetonitrile. PUMP2 solution consisted of an aqueous solution of 10.0 mmol/L ammonium acetate. The mobile phase of PUMP3 comprised 50.0 mmol/L ammonium acetate and acetonitrile, with a flow rate of 1.0 mL/min. The developed method was successfully employed to simultaneously determine drug levels in plasma and CSF from the patients treated with MTX. CSF samples were obtained by lumbar puncture 0.5 - 2 h after starting the high-dose methotrexate (HD-MTX) infusion (over 4 h) and immediately before the intrathecal (IT) administration of MTX. Venous blood samples were drawn 4 h after the start of infusion. The calibration curve was linear, with a range of 0.07 - 2.38 µmol/L for CSF samples and a range of 0.11 - 5.51 µmol/L for plasma samples. Precision (> 95%) and accuracy (> 97%) were within the acceptance criteria for each quality control (QC) level. Inter- and intra-day accuracy and precision values met the acceptance criteria for each QC level. The correlation between MTX concentrations in the plasma and CSF was moderate (r = 0.502). No significant difference was observed in MTX concentration in CSF between patients using intravenous mannitol and those not using intravenous mannitol (P = 0.682). The developed method was useful for therapeutic drug monitoring of MTX and suitable for assessing the risks and benefits of chemotherapy in patients with primary central nervous system lymphoma. Intravenous mannitol did not increase MTX concentration in the CSF of patients.

Evaluation of angiotensin converting enzyme insertion/deletion, alpha adducin (ADD1) G460W, and IL-10 gene polymorphisms, and determination of prognostic effects in idiopathic sudden sensorineural hearing loss

ObjectiveThe aim of this study was to examine angiotensin converting enzyme (ACE) insertion/deletion, alpha adducin, and interleukin-10 (IL-10) gene polymorphisms (GPs) in terms of both idiopathic sudden sensorineural hearing loss (ISSNHL) risk and their potential prognostic effects. MethodsThe study group consisted of 70 patients and the control group consisted of 50 patients. Venous blood samples were analyzed for relevant GPs via kompetitive allele-specific polymerase chain reaction. Age, sex, affected side, tinnitus, and vertiginous symptom status, number of days between symptom onset and hospital admission, pure tone audiometry results at admission and after treatment were included in the study. Data were compared statistically. ResultsThe D allele of ACE insertion/deletion GP was significantly more frequent in patients with ISSNHL than in the control group (p = 0.032). II genotype was associated with a reduced risk of ISSNHL (p = 0.036). The amount of hearing loss was significantly higher in patients with the TT genotype (p = 0.027) and T allele of the IL-10 GP (p = 0.035) than in the patients without this allele. Severe hearing loss was a poor prognostic factor (p = 0.008). ConclusionsThe D allele of ACE insertion/deletion GP may be involved in the ISSNHL etiology. Due to the association of this allele with occlusive vascular pathologies, ischemia is believed to be a common pathway in the etiopathogenesis of ISSNHL.

UPLC-MS/MS analysis of axitinib and pharmacokinetic application in beagle dogs

ObjectiveTo develop a method for determining the concentration of axitinib in beagle dog plasma and utilize this method to investigate the pharmacokinetics of orally administered axitinib in beagle dogs. MethodsPlasma samples were processed using acetonitrile precipitation and analyzed by UPLC-MS/MS with sunitinib as an internal standard (IS). Chromatographic separation was achieved on a Waters Acquisition UPLC BEH C18 column (50 mm × 2.1 mm, 1.7 μm) with a gradient elution of acetonitrile and 0.1 % formic acid. Mass spectrometry uses an electrospray ion source for positive ion detection in a multiple reaction monitoring mode. The monitored ion transitions for axitinib and sunitinib were m/z 387 → 355.96 and m/z 399.3 → 282.96, respectively. Six beagle dogs were administered 0.33 mg/kg of axitinib orally, and venous blood samples were collected at 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, and 24 h post-dose for pharmacokinetic analysis. ResultsThe assay demonstrated a linear range of 0.5–100 ng/mL (r2 = 0.9992), and the lower limit of quantification was up to 0.5 ng/mL. Precision, as assessed by relative standard deviation (RSD), was within 8.64 % for both intraday and interday variability. The relative error (RE) for precision from −2.77 %–1.20 %. The recovery rate of the analytes exceeded 85.28 % and the matrix effect was approximately 100 %. Plasma samples maintained stability under various conditions, including room temperature storage for 12 h, processed on an automatic sampler at 4 °C for 6 h, three freeze-thaw cycles, and long-term storage at −80 °C for 60 days. Pharmacokinetic parameters were determined using DAS 2.0 software, revealing a half-life (T1/2) of 6.05 h and an area under the curve (AUC (0 →∞)) of 97.13 ng h/mL for axitinib. ConclusionsThe UPLC-MS/MS method developed in this study offers high specificity, rapid analysis, high recovery, excellent linearity, and minimal plasma volume requirements, making it well-suited for pharmacokinetic and drug interaction studies in beagles dogs.

Endoscopic ultrasound-guided vascular interventions: A review (with videos).

Endoscopic ultrasound (EUS) has evolved from a diagnostic to an interventional modality, allowing precise vascular access and therapy. EUS-guided vascular access of the portal vein has received increasing attention in recent years as a diagnostic and therapeutic tool. EUS-guided portal pressure gradient directly measures the hepatic vein portal pressure gradient and is crucial for understanding of liver function and prognostication of liver disease. EUS facilitates the sampling of portal venous blood to obtain circulating tumor cells (CTCs) in pancreatobiliary malignancies. This technique aids in the diagnosis and staging of cancers. EUS-guided interventions have a substantial potential for diagnosing portal vein tumor thrombus (PVTT) in patients with hepatocellular carcinoma. EUS-guided coil and glue embolization have higher efficacy for the treatment of gastric varices than direct endoscopic glue. Pseudoaneurysm (PsA), a rare vascular complication of acute and chronic pancreatitis, is typically managed with interventional radiology (IR)-guided embolization and surgery. EUS is increasingly used in specialized centers for non-variceal gastrointestinal bleeding, particularly for pseudoaneurysm-related bleeding. There is limited data on EUS-guided intervention for bleeding ectopic varices, rectal varices and Dieulafoy lesions, but it is becoming more widely accepted. In this extensive review, we evaluated both current and potential future applications of EUS-guided vascular interventions, including EUS-guided gastric variceal bleed therapy, rectal and ectopic varices, pseudoaneurysmal bleeding, splenic artery embolization, portal pressure gradient measurement, portal vein sampling for CTCs, fine needle aspiration of PVTT, intrahepatic portosystemic shunt placement, liver tumor ablation and EUS-guided cardiac intervention.

Montmorency cherry supplementation enhances 15km cycling time trial performance: Optimal timing 90-min pre-exercise.

Montmorency cherry (MC) can improve endurance performance, but optimal pre-exercise timing of supplementation and influence of training status on efficacy are unknown. We investigated the effect of MC concentrate ingestion between 30- and 150-min pre-exercise in trained and recreational cyclists on 15-km time trial (TT) performance and exercise economy. Twenty participants (10 recreationally active, RA; 10 trained, T) completed 10min of steady-state exercise (SSE) at 40%Δ (SSE) and a TT on four separate occasions following an unsupplemented (US), 30-, 90- or 150-min pre-exercise Montmorency cherry concentrate (MCC) supplementation conditions (MCC30/90/150min). Venous and capillary blood samples were taken at regular intervals pre- and post-SSE and TT. MCC significantly improved TT performance, but not exercise economy. The greatest improvement in performance occurred following MCC90min compared to US (US 1603.1±248s vs. MCC90min 1554.8±226.7s, 2.83% performance improvement). Performance was significantly enhanced for trained (US 1496.6±173.1s vs. MCC90min 1466.8±157.6s) but not recreationally active participants. Capillary [lactate] and heart rate were significantly greater during the TT for the 90-min dose timing (p<0.05). In the MCC30min and MCC90min conditions, plasma ferulic (US 8.71±3.22nmol. L-1 vs. MCC30min 15.80±8.69nmol. L-1, MCC90min 12.65±4.84nmol. L-1) and vanillic acid (US 25.14±10.91nmol.L-1 vs. MCC30min 153.07±85.91nmol. L-1, MCC90min 164.58±59.06nmol. L-1) were significantly higher pre-exercise than in US and MCC150min conditions (p<0.05). There was no significant change in muscle oxygenation status or plasma nitrite/nitrate concentration. MCC supplementation enhanced endurance exercise performance optimally when consumed ∼90min pre-exercise producing maximal plasma phenolic metabolites during exercise. The ergogenic effect was greater for trained participants.

Meals Containing Equivalent Total Protein from Foods Providing Complete, Complementary, or Incomplete Essential Amino Acid Profiles do not Differentially Affect 24-h Skeletal Muscle Protein Synthesis in Healthy, Middle-Aged Women

BackgroundDietary protein quality can be assessed by skeletal muscle protein synthesis (MPS) stimulation. Limited knowledge exists on how consuming isonitrogenous meals with varied protein qualities affects postprandial and 24-h MPS. ObjectivesWe assessed the effects of protein quality and complementary proteins on MPS. We hypothesized that meals containing a moderate amount of high-quality, complete protein would stimulate postprandial and 24-h MPS. Meals containing 2 complementary, plant-based incomplete proteins would stimulate MPS less, and meals containing plant-based incomplete proteins at each meal, but complementary over 24 h would not stimulate MPS. Methods: This quasi-experimental study included a randomized, crossover design to assess protein quality and a nonrandomized low-protein control. We measured postprandial and 24-h MPS responses of healthy middle-aged women (n = 9, age 56 ± 4 y), to 3 dietary conditions: isonitrogenous meals containing 23 g protein/meal from 1) complete protein (lean beef), 2) 2 incomplete, but complementary protein sources (navy/black beans and whole wheat bread), and 3) single incomplete protein sources (black beans or whole wheat bread at 1 meal), but providing a complete amino acid profile over 24 h. In the low-protein group women (n = 8, 54 y) consumed a single breakfast meal containing 5 g of protein. Venous blood and vastus lateralis samples were obtained during primed, constant infusions of L-[ring-13C6]phenylalanine to measure mixed muscle fractional synthetic rates (FSR). ResultsMeals containing complete, complementary, or incomplete proteins did not differentially influence FSR responses after breakfast (P = 0.90) or 24 h (P = 0.38). At breakfast, the complete (P = 0.030) and complementary (P = 0.031) protein meals, but not the incomplete protein meal (P = 0.38), had greater FSR responses compared with the low-protein control meal. ConclusionsIsonitrogenous meals containing a moderate serving of total protein from foods providing complete, complementary, or incomplete essential amino acid profiles do not differentially stimulate muscle protein synthesis after a meal and daily. Trial registration numberThis clinical trial was registered at clinicaltrials.gov as NCT03816579. URLhttps://www.clinicaltrials.gov/ct2/show/NCT03816579?term=NCT03816579&draw=2&rank=1.

Prevalence of physiological and perceptual markers of low energy availability in male academy football players: a study protocol for a cross-sectional study

Low energy availability (LEA) is a core feature of the female athlete triad and relative energy deficiency in sport (REDs). LEA underpins multiple adverse health and performance outcomes in various...

Prevalence of Vitamin D Deficiency among Iraqi People

Objectives: Vitamin D deficiency is one of common health problems and it is found in all ethnicities and all age groups, even in countries that have sun exposure all seasons of the year. Materials and Methods: 600 healthy persons aged 3–65 years were participating in this study. All subjects were lived in Baghdad, Iraq. The subjects were divided into four groups according to age and gender. First group adult male 18-65 year contains 200 participate, second group adult female 18-65 year contains 200 participate, third group children male 3-18 year contains 100 participate and fourth group children female 3-18 year contains 100 participate. venous blood samples were used to measured 25-hydroxy (25(OH) D) levels with cobas techniques method. Results: The results showed that the vitamin D deficiency (serum 25OHD level &lt; 20 ng/ml) is prevalence in 77% of the adult male and the mean value is 12.4 ng/ ml, and the ratio of deficiency is higher in female and reach to 87% of adult women and the mean value is 7.4 ng/ ml. Whereas the vitamin D deficiency in children is lower than adult and the results showed that the 23% of male children have deficiency with mean value 20.7 ng/ml also the female children have deficiency in 22% of them with mean value 20.4 mg/ml. The results showed there is significant differences between men and women in mean value of the serum 25OHD (12.4 vs 7.4 P&gt; 0.01), while there are non-significant differences between children male and children female (20.7 vs 20.4 P&gt; 0.01). Also the results showed there are significant difference between children male and adult male (20.7 vs 12.4 P&gt; 0.01) and there are significant differences between children female and adult female (20.4 vs7.4 P&gt;0.01) Conclusion: the deficiency of vitamin D in Baghdad, Iraq is very high in adult male and female and there is a need general education, health policies for investigation and treatment this problem.

Volatile Organic Compounds (VOC) and Serum Leukotriene B4 between COPD Patients and COPD with Lung Cancer Patients

Introduction: Chronic obstructive pulmonary disease (COPD) is estimated to become the third leading cause of death worldwide in 2030. COPD can affect the lungs and cause chronic systemic inflammation. Leukotriene B4 (LTB4) is involved in COPD and lung cancer pathogenesis. There has been the development of non-invasive methods for detecting lung disease in the last few decades, such as the examination of volatile organic compounds (VOC). This study aimed to analyze the serum LTB4 and the difference of VOCs in exhaled breath of stable COPD patients and COPD with lung cancer patients. Methods: This case-control study recruited 20 stable COPD patients and 20 patients with COPD and lung cancer. An exhaled breath sample was collected in Tedlar bags and analyzed using an arrayed sensor breath analyzer to check the concentration of VOCs. Meanwhile, a venous blood sample was collected to examine the level of LTB4 using an ELISA kit. Independent t-test and Mann-Whitney test were used to analyze the data. Results: The carbon dioxide (CO2), nitrogen dioxide (NO2), carbon monoxide (CO), benzene (C6H6), and propane (C3H8) levels were significantly different (p &lt;0.05) in COPD-only patients compared to COPD with lung cancer patients. Serum LTB4 increased in both groups. Conclusion: CO2, CO, and C3H8 levels increased, but the NO2 level decreased in COPD patients with lung cancer compared to COPD-only patients. Serum LTB4 increased in COPD with lung cancer patients.

Association Between Acute Ischemic Stroke and Raised Serum Gamma Glutamyl Transferase

The serum gamma-glutamyl transferase level predicts the development of cardiovascular illnesses. Serum gamma-glutamyl transferase levels have been linked to atherosclerosis in several investigations, indicating that gamma-glutamyl transferase may be utilized as an early indicator of atherosclerosis. Objective: To determine the association between acute ischemic stroke and raised serum gamma-glutamyl transferase. Methods: After obtaining ethical approval, in this case-control study, 310 patients fulfilling the selection criteria were included from the Medical Emergency Department of, KEMU/ Affiliated hospital, Lahore from August 2022 to February 2023. Informed consent was obtained. After matching for age (40-80 years) and gender (both male and female), 155 controls enrolled preferably the accompanying healthy attendants of the patients and 155 cases i.e. ischemic stroke patients. Venous blood samples were obtained from cases at the time of presentation in the Emergency Department for serum gamma-glutamyl transferase (GGT). Data was collected in structured proforma. Data scrutiny was done using SPSS version 26.0. Mean and standard deviation were used for quantitative variables and frequency for qualitative data. Data were stratified for effect modifiers, and p≤0.05 was taken as significant. Results: In the current study, the frequency of raised GGT was found more among cases as compared to controls i.e. 74% vs 20%, p&lt;0.00001 and OR calculated was 11.5. Conclusions: It was concluded that a considerable percentage of patients had raised gamma-glutamyl transferase at the time of presentation with acute ischemic stroke. These results emphasize the need to keep an eye on GGT levels in ischemic stroke patients as a possible stroke marker.

Effects of 90-Minute Football Match on Red Blood Indices in Sedentary Young Males

While exercise-induced haemorheological alterations are well-documented in various sports, the specific impact of a football match on red blood cell (RBC) parameters remains unknown. This study investigates the acute effects of a 90-minute football match on RBC indices in sedentary young males. After inclusion and exclusion criteria, twenty (20) moderately active, non-smoking male volunteers (mean age: 20.00 ± 0.4 years) participated in the study. Venous blood samples were collected pre- and post- football match to assess RBC count, haematocrit (HCT), and plasma volume (PV). Data generated were subjected to paired student's t-tests using SPSS, to compare values between pre- and post-match measurements. A p-value of less than 0.05 was considered indicative of statistical significance. The results showed a statistically significant decrease in haematocrit (HCT) and red blood cell count (RBC) after the match (p &lt; 0.05) when compared to pre-match values. This was accompanied by a significant increase in plasma volume (PV) (p &lt; 0.05), which was higher than pre-match values. These changes suggest that the physiological demands of the football match influenced blood parameters, likely due to fluid shifts and haemodilution during intense physical activity. These findings suggest potential implications for exercise physiology, diagnosis, and therapy in sports medicine.