Evaluation of different POCT devices for glucose measurement in a clinical neonatal setting

Hypoglycaemia is a major cause of neonatal morbidity and may induce long-term developmental sequelae. Clinical signs of hypoglycaemia in neonatal infants are unspecific or even absent, and therefore, precise and accurate methods for the assessment of glycaemia are needed. Glycaemia measurement in newborns has some particularities like a very low limit of normal glucose concentration compared to adults and a large range of normal haematocrit values. Many bedside point-of-care testing (POCT) systems are available, but literature about their accuracy in newborn infants is scarce and not very convincing. In this retrospective study, we identified over a 1-year study period 1,324 paired glycaemia results, one obtained at bedside with one of three different POCT systems (Elite™ XL, Ascensia™ Contour™ and ABL 735) and the other in the central laboratory of the hospital with the hexokinase reference method. All three POCT systems tended to overestimate glycaemia values, and none of them fulfilled the ISO 15197 accuracy criteria. The Elite XL appeared to be more appropriate than Contour to detect hypoglycaemia, however with a low specificity. Contour additionally showed an important inaccuracy with increasing haematocrit. The bench analyzer ABL 735 was the most accurate of the three tested POCT systems. Both of the tested handheld glucometers have important drawbacks in their use as screening tools for hypoglycaemia in newborn infants. ABL 735 could be a valuable alternative, but the blood volume needed is more than 15 times higher than for handheld glucometers. Before daily use in the newborn population, careful clinical evaluation of each new POCT system for glucose measurement is of utmost importanc

von der Transaktion zur Beziehung. Crossing Borders

StudieDie Swiss CRM Studie 2014 befasst sich mit dem Schwerpunktthema kooperatives CRM. Auch dieses Jahr umfasst die Studie den Status Quo sowie die Trends des CRM in der Schweiz

Resistive polymer versus forced-air warming: comparable heat transfer and core rewarming rates in volunteers

BACKGROUND: Mild perioperative hypothermia increases the risk of several severe complications. Perioperative patient warming to preserve normothermia has thus become routine, with forced-air warming being used most often. In previous studies, various resistive warming systems have shown mixed results in comparison with forced-air. Recently, a polymer-based resistive patient warming system has been developed. We compared the efficacy of a standard forced-air warming system with the resistive polymer system in volunteers. METHODS: Eight healthy volunteers participated, each on two separate study days. Unanesthetized volunteers were cooled to a core temperature (tympanic membrane) of 34 degrees C by application of forced-air at 10 degrees C and a circulating-water mattress at 4 degrees C. Meperidine and buspirone were administered to prevent shivering. In a randomly designated order, volunteers were then rewarmed (until their core temperatures reached 36 degrees C) with one of the following active warming systems: (1) forced-air warming (Bair Hugger warming cover #300, blower #750, Arizant, Eden Prairie, MN); or (2) polymer fiber resistive warming (HotDog whole body blanket, HotDog standard controller, Augustine Biomedical, Eden Prairie, MN). The alternate system was used on the second study day. Metabolic heat production, cutaneous heat loss, and core temperature were measured. RESULTS: Metabolic heat production and cutaneous heat loss were similar with each system. After a 30-min delay, core temperature increased nearly linearly by 0.98 (95% confidence interval 0.91-1.04) degrees C/h with forced-air and by 0.92 (0.85-1.00) degrees C/h with resistive heating (P = 0.4). CONCLUSIONS: Heating efficacy and core rewarming rates were similar with full-body forced-air and full-body resistive polymer heating in healthy volunteers

Distribution of GFP labeled SC after delivery in the cisterna magna and the spinal cord.

<p>GFP-SC (green) are detected both in the cerebellar parenchyma (A, B) and meninges (C) 7 days (A–C) after cisterna magna delivery as well as 21 days after in the proximal spinal cord (D). GFP-SCs grafted in the spinal cord parenchyma (E, F) are concentrated around blood vessels, some migrate away from the graft toward a lesion (L) identified by MOG immunostaining through white matter (E, arrows). (F) Same field illustrating GFP-SCs, inset is a higher magnification.</p

One route of SC migration: the blood vessels.

<p>SC grafted in the spinal cord parenchyma are often localized in white matter around blood vessels (asterisks), evidenced with anti-laminin antibody (blue). While at 7 days SC are present close to the blood vessel wall (A), at 21 days they are embedded in the perivascular space but remote from the vascular wall (B).</p

EAE score evolution after GFP-SC graft in the spinal cord.

<p>The graph depicts the clinical scores of EAE animals grafted with GFP-SC (white circles, 7 animals) and medium injected animal (black squares, 5 animals). Surgeries were performed 2 days after the first clinical signs (occurring 12 days after the induction of the disease). A difference between the two groups is observed from day 25 and is significant (Mann-Whitney rank test; p<0.05) around 30 days after the first clinical signs.</p

Illustrations of a focal spinal cord lesion of MOG induced EAE in the DA rat.

<p>LFB staining shows a focal demyelinated lesion in the dorsal funiculus with myelin loss (A–B). ED-1 immunostaining highlights the presence of macrophages/microglia cells within the lesion (C). MBP immunohistochemistry illustrates the loss of myelin and the presence of myelin-laden macrophages (close up in insert) is indicative of recent myelin phagocytosis (D).</p

Comparison of the remyelination potential of GFP-SCs grafted in the cisterna magna or the spinal cord.

<p>Twenty one days after SC delivery in the cisterma magna (A) or the spinal cord (B–F), exogenous remyelination was assessed using an anti-P0 antibody (red). P0 positivity colocalized with GFP-SCs (C, confocal microscopy), more frequently after spinal cord graft than cisterna magna delivery. C is a higher magnification of B and corresponds to the lesion detected on an adjacent section and illustrated in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0042667#pone-0042667-g005" target="_blank">Fig 5C</a>. GFP-SCs produce P0+ myelin (red D, E) that surrounds neurofilament (NF) + axons (blue D, F). Inserts are higher magnifications of dashed boxes.</p