Comparative Analysis of Whole Blood Ionised Calcium, Lactate and Chloride Concentrations by Gem Premier 3000 and Edan I15 Vet and the Effect of Parity and Postpartum Blood Collection Time on Blood Calcium Status in Holstein With and Without Subclinical Hypocalcemia - Part 1

Lactating Holstein (n=125) were enrolled randomly for the coccygeal whole blood analysis by blood gas devices GEM Premier 3000 (GEM) and Edan i15 Vet (EDAN) between calving to postpartum day 3 (G1) and postpartum day 4 to 27 (G2). Blood pH, ionised calcium (ICA7.4) and lactate analysis were significantly correlated between GEM and EDAN (r=0.86, 0.94, 0.87 respectively). The bias for ICA7.4, lactate and pH analysis was -0.054, -0.344 mmol/L and +0.009 respectively. ICA7.4 was correlated negatively with parity and chloride, but positively with lactate. The averages of ICA7.4 and serum total calcium (TC) was significantly lower in G1 than G2. Chloride and lactate were significantly higher in G1 than G2. Subclinical hypocalcemia prevalence (SCH) (serum TC<2.15 mmol/L, as reference) was 52.9% in G1 and 21.1% in G2. Cows with SCH had frequently over 50% ICA7.4/TC ratio. Sensitivity analysis provided a sensitivity of 57.4% for ICA7.4 cut-points of 1.02 (GEM) and 1.05 (EDAN) mmol/L to detect SCH based on reference serum TC. Primiparous (PRP) with and without SCH in G1 had significantly higher ICA7.4 than multiparous (MUL). Cows with SCH had significantly higher chloride in G1 than G2. MUL had significantly higher lactate and chloride in G1 than G2. Conclusively, ICA7.4 and pH analysis between GEM and EDAN were correlated well with acceptable biases, but high differences occurred in lactate analysis. MUL was at risk in G1 due to lower ICA7.4 and TC over PRP. Higher ICA7.4 of PRP can reduce the risk and frequency of clinical hypocalcemia. SCH correlated negatively with Cl concentration in G1, but not lactate.

Volumetric Absorptive Microsampling as an Alternative Tool for Biomonitoring of Multi-Mycotoxin Exposure in Resource-Limited Areas

Biomonitoring of biological samples arises as an effective tool to evaluate the exposure to mycotoxins in the population. Owing to the wide range of advantages, there is a growing interest in the use of non- and minimally invasive alternative sampling strategies, such as dried blood spot sampling or volumetric absorptive microsampling (VAMS). A VAMS-based multi-mycotoxin method was developed and validated for 24 different mycotoxins. Method validation was based on the Bioanalytical Method Validation Guideline of the Food and Drug Administration from the United States and for most of the studied mycotoxins, the results of the performance characteristics were in agreement with the criteria of the European Commission Decision 2002/657/EC. The recovery for the different mycotoxins was not haematocrit dependent and remained acceptable after storing the VAMS for 7 and 21 days at refrigeration temperature (4 °C) and room temperature, demonstrating that VAMS could be applied to assess mycotoxin exposure in blood in resource-limited areas, where there may be a delay between sampling and analysis. Finally, a comparison between VAMS and a procedure for liquid whole blood analysis, performed on 20 different blood samples, did not result in missed exposed cases for VAMS. Moreover, both methods detected similar levels of ochratoxin A, ochratoxin alpha, zearalenone and aflatoxin B1. Given all the benefits associated with VAMS and the developed method, VAMS sampling may serve as an alternative to conventional venous sampling to evaluate multiple mycotoxin exposure.

Initial In Vivo Evaluation of a Novel Amikacin-Deoxycholate Hydrophobic Salt Delivers New Insights on Amikacin Partition in Blood and Tissues

In this study, an initial in vivo evaluation of a new amikacin-deoxycholate hydrophobic salt aimed at potentiating amikacin action against hard-to-treat lung infections was undertaken by quantifying, for the first time, amikacin in whole blood. Pharmacokinetic evaluation after intranasal administration in a murine model showed higher drug retention in the lungs compared to blood, with no significant differences between the salt and the free drug. Upon repeated administrations, the two treatments resulted in nonsignificant tissue damage and mild higher inflammation for the hydrophobic salt. Whole-blood analysis highlighted an unreported high partition of amikacin in blood components up to 48 h, while significant lung levels were measured up to 72 h. Such a new observation was considered responsible for the nearly overlapping pharmacokinetic profiles of the two treatments. To overcome such an issue, a dry powder in an inhalable form may be best suited. Moreover, if confirmed in humans, and considering the current once-a-day regimen for amikacin aerosols, important yet-to-be-explored clinical implications may be postulated for such amikacin persistence in the organism.

Inaccuracy of Sodium Measurement in Patients with Severe Hypernatremia

Introduction We observed discordant sodium results from a patient with severe hypernatremia such that whole-blood analysis produced results up to 9.6 mmol/L higher than plasma sodium obtained on the same collection. We investigated this bias by comparing other patients’ sodium results and performing comparisons of 3 blood gas and 2 chemistry analyzers. Methods First, the laboratory information system was queried for whole-blood sodium results &gt;160 mmol/L, which were used for comparison against plasma results from the same collection. Second, whole blood was collected from a healthy donor, a portion of which was spiked with sodium chloride to generate 8 samples with target concentrations of 140 to 185 mmol/L. Whole-blood sodium was measured in duplicate on the ABL90, RAPIDPoint 500, and GEM 4000. Plasma sodium was then measured in duplicate on the Architect c8000 and Cobas c702. Finally, plasma was injected on the blood gas analyzers to measure sodium in singleton. Results Overall, 53 paired results from patients showed a significant positive bias on the ABL90 relative to Vitros when sodium was &gt;160 mmol/L. The magnitude of difference was insignificant within the reference range but increased proportionately with concentration. The magnitude and pattern of positive bias in ABL90 sodium results were consistent with the observation in patient results. Conclusion In severe hypernatremia, sodium results produced by blood gas and plasma analyzers can differ significantly.

Effect of changes in laboratory light intensity on biochemistry and haemogram analysis

BackgroundTo investigate the effect of changes in laboratory light intensity on chemistry and whole blood analysis.Materials and MethodsThe light intensity of the laboratory environment was measured and chemical and whole blood analysis was performed on 20 patient blood samples. The light intensity was then increased using projectors and re-measured, and the chemical and whole blood analyses were repeated. The values of the tests pre- and post-light increase were compared by statistical analysis using the Wilcoxon test.ResultsIncreasing light from 195 to 1,168 lux significantly altered the results of the lipase, alkaline phosphatase, creatinine, and iron chemistry tests, (p<0.001 [11.3%], p=0.003 [2.2%], p=0.001 [2%] and p=<0.001 [1.2%], respectively). There was also a significant difference in platelet count (p=<0.001 [188%]).ConclusionsWe show that the platelet count is sensitive to changes in laboratory light intensity at clinically unacceptable levels. The lipase, alkaline phosphatase, creatinine and iron tests are also sensitive to changes in laboratory light intensity, but at clinically acceptable levels.

Recent advancements in microfluidics that integrate electrical sensors for whole blood analysis

In this paper, we review recent advancements in microfluidics that integrate electrical sensors for whole blood analysis. Besides summarizing the features of related work, we also discuss potential challenges that need to be addressed.

Volvulus of the Gallbladder: Case Reports

The volvulus of the gallbladder can be considered a clinical curiosity. However, we herein report three recent demonstrative consecutive cases. Female gender, advanced age and a thin constitution seem to represent common predisposing factors. A brutal and excrutiatingly painful presentation in the right hypochondrium contrast initially with seemingly normal vital parameters. Fever can be observed as well as signs of peritoneal irritation. An X-Ray of the abdomen can show a complete emptiness of the right flank and whole blood analysis can reveal an elevated leucocyte count predominantly neutrophilic. The torsion of the gallbladder thus presents itself as an acute cholecystitis with particularities catching the clinician's attention. The only anatomical predisposing factor resides in an anomaly of the mesocyst. The prognosis is driven by the delay to cholecystectomy as a fatal toxinic syndrome can be dreaded in this fragile population. Population's aging and possibilities to enlarge surgical indications in the elderly, enforces us to abandon the pejorative qualifier of « rare curiosity » attached to the gallbladder volvulus and define it as a clear entity in the gallbladder pathology.

Validation of methods for determining pediatric midazolam using wet whole blood and volumetric absorptive microsampling

Aim: Collection and quantitative analysis in dry blood using volumetric absorptive microsampling (VAMS™) potentially offers significant advantages over conventional wet whole blood analysis. This manuscript explores their use for pediatric sampling and explores additional considerations for the validation of the bioanalytical method. Results: HPLC–MS/MS methods for the determination of midazolam and its major metabolite 1-OH midazolam in both whole wet blood, and dry blood collected on VAMS were developed, validated, and used to support an observational clinical study to compare pharmacokinetic parameters in pediatric patients. Conclusion: Validation data met internationally accepted guideline criteria. A strong correlation was observed in calculated concentrations between wet and dry test samples, indicating that VAMS is a suitable technique for use in pediatric clinical studies.