Evaluación del analizador Glucocard Memory 2 para medir la concentración de glucosa en sangre capilar

ObjetivoEvaluar la validez y precisión analítica y la practicabilidad del sistema medidor de la concentración de glucosa Glucocard Memory 2 diseñado para el autocontrol del paciente diabético.DiseñoDescriptivo, transversal. Validación de un instrumento de medida siguiendo las recomendaciones de la Sociedad Española de Bioquímica Clínica y Patología Molecular.!EmplazamientoEstudio realizado en un laboratorio de atención primaria.MuestraNoventa y tres muestras de sangre de pacientes diabéticos seleccionadas mediante muestreo consecutivo de los tubos recibidos en el laboratorio para realizar el protocolo analítico de seguimiento de diabetes.Mediciones y resultados principalesLa repetibilidad del sistema se estudió analizando la precisión intradía a 4 concentraciones distintas de glucosa, obteniéndose coeficientes de variación entre el 2,12% (a 410 mg/dl de glucosa) y un 4,17% (a 37,2 mg/dl). La linealidad del analizador se demostró experimentalmente entre 27 y 485 mg/dl. La exactitud se evaluó por comparación con el procedimiento habitual del laboratorio (Hitachi 747, GOD-PAP), calculando la recta de regresión mediante el método de Passing-Bablok (y = 1,01, × –2,34) y mediante la obtención del coeficiente de correlación intraclase, cuyo resultado fue del 99%. La técnica de análisis de «error Grid» para investigar la significación clínica de las posibles desviaciones respecto al método de referencia dio un 100% de resultados dentro de la zona de exactitud clínica. El estudio de la practicabilidad mostró una gran simplicidad de manejo.ConclusionesEl Glucocard Memory 2 es un analizador para la medición de la glucemia capilar y venosa con una extrema simplicidad de manejo y unas excelentes características analíticas.ObjectiveTo evaluate the analytical reliability and accuracy as well as the practicability of the Glucocard Memory 2 glucose meter, intended to the control of the diabetic patient.DesignDescriptive, crossover study. To validate an analytical instrument according to guidelines of the Spanish Society of Clinical Biochemistry and Molecular Pathology.SettingPrimary health care, urban setting.ParticipantsNinety-three blood samples from diabetic patients were used. These samples were selected by a consecutive sampling of the tubes received in the laboratory for the diabetes follow-up protocol.Measurements and main resultsRepeatability of the system was studied analysing the within-run precision at four concentrations of glucose.We obtained coefficients of variation between 2.12% (at 410 mg/dl of glucose) and 4.17% (at 37.2 mg/dl). The linearity study allowed to check experimentally the linear response of the instrument between 27 and 485 mg/dl. The accuracy was evaluated comparing the Glucocard results with the routine procedure of our laboratory (Hitachi 747, GOD-PAP) and calculating the regression parameters with the Passing and Bablok method (y = 1,01 × –2,34) and the intraclass correlation (99%). To evaluate the clinical significance of possible deviations related with the reference laboratory method the «error Grid» analysis was used. This analysis showed that 100% of Glucocard Memory 2 results fell into the clinical accuracy zone. Practicability study showed that the instrument is very simple to use.ConclusionsGlucocard Memory 2 is a glucose meter intended to the measurement of glucose both on capillary and venous blood that, besides its extreme simplicity of use, shows very good analytical features

The impact of the COVID-19 pandemic on Sexually Transmitted Infections surveillance data : incidence drop or artefact?

Altres ajuts: Fundacion Alfonso Martin Escudero and the Medical Research Council (grant numbers MR/K501256/1, MR/N013468/1).Background: Before the COVID-19 pandemic, Sexually transmitted infections (STIs) were increasing in Europe, and Spain and Catalonia were not an exception. Catalonia has been one of the regions with the highest number of COVID-19 confirmed cases in Spain. The objective of this study was to estimate the magnitude of the decline, due to the COVID-19 pandemic, in the number of STI confirmed cases in Catalonia during the lockdown and de-escalation phases. Methods: Interrupted time series analysis was performed to estimate the magnitude of decline in the number of STI reported confirmed cases - chlamydia, gonorrhoea, syphilis, and lymphogranuloma venereum- in Catalonia since lockdown with historical data, from March 13th to August 1st 2020, comparing the observed with the expected values. Results: We found that since the start of COVID-19 pandemic the number of STI reported cases was 51% less than expected, reaching an average of 56% during lockdown (50% and 45% during de-escalation and new normality) with a maximum decrease of 72% for chlamydia and minimum of 22% for syphilis. Our results indicate that fewer STIs were reported in females, people living in more deprived areas, people with no previous STI episodes during the last three years, and in the HIV negative. Conclusions: The STI notification sharp decline was maintained almost five months after lockdown started, well into the new normality. This fact can hardly be explained without significant underdiagnosis and underreporting. There is an urgent need to strengthen STI/HIV diagnostic programs and services, as well as surveillance, as the pandemic could be concealing the real size of the already described re-emergence of STIs in most of the European countries