A multicenter study of in vitro and in vivo values in human RBCs frozen with 40-percent (wt/vol) glycerol and stored after deglycerolization for 15 days at 4°C in AS-3: assessment of RBC processing in the ACP 215

BACKGROUND: The FDA has approved the storage of frozen RBCs at -80 degrees C for 10 years. After deglycerolization, the RBCs can be stored at 4 degrees C for no more than 24 hours, because open systems are currently being used. Five laboratories have been evaluating an automated, functionally closed system (ACP 215, Haemonetics) for both the glycerolization and deglycerolization processes. STUDY DESIGN AND METHODS: Studies were performed at three military sites and two civilian sites. Each site performed in vitro testing of 20 units of RBCs. In addition, one military site and two civilian sites conducted autologous transfusion studies on ten units of previously frozen, deglycerolized RBCs that had been stored at 4 degrees C in AS-3 for 15 days. At one of the civilian sites, 10 volunteers received autologous transfusions on two occasions in a randomized manner, once with previously frozen RBCs that had been stored at 4 degrees C in AS-3 for 15 days after deglycerolization and once with liquid-preserved RBCs that had been stored at 4 degrees C in AS-1 for 42 days. RESULTS: The mean +/- SD in vitro freeze-thaw-wash recovery value was 87 +/- 5 percent; the mean +/- SD supernatant osmolality on the day of deglycerolization was 297 +/- 5 mOsm per kg of H(2)O, and the mean +/- SD percentage of hemolysis after storage at 4 degrees C in AS-3 for 15 days was 0.60 +/- 0.2 percent. The paired data from the study of 10 persons at the civilian site showed a mean +/- SD 24-hour posttransfusion survival of 76 +/- 6 percent for RBCs that had been stored at 4 degrees C for 15 days after deglycerolization and 72 +/- 5 percent for RBCs stored at 4 degrees C in AS-1 for 42 days. At the three sites at which 24-hour posttransfusion survival values were measured by three double-label procedures, a mean +/- SD 24-hour posttransfusion survival of 77 +/- 9 percent was observed for 36 autologous transfusions to 12 females and 24 males of previously frozen RBCs that had been stored at 4 degrees C in AS-3 for 15 days after deglycerolization. CONCLUSION: The multicenter study showed the acceptable quality of RBCs that were glycerolized and deglycerolized in the automated ACP 215 instrument and stored in AS-3 at 4 degrees C for 15 days.     

Knowledge of HIV/AIDS transmission and screening in United States blood donors

BACKGROUND: Increased knowledge of HIV transmission and behavioral and test screening may encourage high-risk blood donors to self-defer. STUDY DESIGN AND METHODS: Knowledge of HIV transmission and screening and the association with demographics, screening test reactivity, and unreported deferrable risks (UDRs) was assessed by a 1998 anonymous mail survey sent to 92,581 blood donors, of whom 57 percent responded. Groups were compared by using weighted chi-square tests and logistic regression analysis. RESULTS: Four percent of the donors thought that it was very likely or somewhat likely for a person to contract HIV from donating blood, and 20 percent perceived a similar risk from blood transfusion. Only 60 percent of the donors knew that the available screening tests may not detect a recent infection. Thirty-seven percent either did not know or felt it was acceptable to donate blood to obtain HIV testing. Those most likely to answer knowledge questions incorrectly were more likely to have a higher prevalence of test reactivity or UDRs and to be 相似文献   

Interference of anti-streptavidin antibodies: More common than we thought? In relation to six confirmed cases

Automated immunoassays are extensively used in routine laboratory diagnostics of endocrine disorders because of their advantages, such as high sensitivity, precision, and specificity. However, these methods are limited by the susceptibility of the immunochemical reaction to various interferences. They may present interferences related to the assay’s design, for example, the endogenous presence of anti-streptavidin antibodies (ASA) in platforms that use the biotin-streptavidin interaction. To date, there have been few reports in the literature of interference from endogenous ASA. However, such antibodies would potentially lead to falsely decreased or increased results of hormones that can lead to incorrect diagnoses.We report six patients with unusual thyroid function tests, incongruent to their clinical findings. They present elevated concentrations of total T3 and T4 and TSH values within the reference range when measured at Cobas 8000® e801 module (Roche Diagnostics®). Neither patient had been taking biotin; however, all demonstrated the presence of ASA causing falsely high results on competitive assays and also falsely low results on sandwich assays. The hormone panel was also analyzed in the same samples using a different platform available in our laboratory: Cobas 6000® e601 module (Roche Diagnostics®). Nine samples were sent to an external laboratory to be measured with the chemiluminescent method: ADVIA Centaur® (Siemens® Healthcare Diagnostics). The interference seems to affect e801 module and competitive assays the most without affecting results obtained by this chemiluminescent method. This interference could potentially affect other assays performed on the same platform, such as ATPO and estradiol.Finally, laboratories should suspect the presence of interference when there is no correlation between the hormone profile and the patient’s clinic. The biotin neutralization protocol demonstrated its effectiveness to eliminate ASA interference.     

Fulminant type 1 diabetes: Focusing on triggering factors

Fulminant type 1 diabetes (FT1D) is a novel type of type 1 diabetes that is caused by extremely rapid destruction of the pancreatic β cells. Early diagnosis or prediction of FT1D is critical for the prevention or timely treatment of diabetes ketoacidosis, which can be life-threatening. Understanding its triggers or promoting factors plays an important role in the prevention and treatment of FT1D. In this review, we summarised the various triggering factors of FT1D, including susceptibility genes, immunological factors (cellular and humoural immunity), immune checkpoint inhibitor therapies, drug reactions with eosinophilia and systemic symptoms or drug-induced hypersensitivity syndrome, pregnancy, viral infections, and vaccine inoculation. This review provides the basis for future research into the pathogenetic mechanisms that regulate FT1D development and progression to further improve the prognosis and clinical management of patients with FT1D.     

Insuffisance rénale chronique et biotine : un duo propice aux bilans thyroïdiens et parathyroïdiens erronés, à propos de 2 cas

In clinical chemistry, many immunoassays apply biotin and streptavidin in the assay principle. Presence of high levels of biotin in patient samples can produce negative or positive interference depending on the assay format. In this study, we describe 2 clinical cases with chronic kidney failure and with unusual thyroid and parathyroid function test results due to biotin interference. We studied the impact of biotin levels on thyroid stimulating hormone (TSH), free thyroxine (T4L) and parathormone (PTH) results with a pool of sera loaded with several concentrations of biotin. In sandwich assays (TSH and PTH), excess biotin displaces biotinylated antibodies resulting in apparently low concentration of the analyte. With competitive immunoassays (T4L), excess biotin competes with biotinylated analog for the binding sites on streptavidin resulting in low signal and falsely high concentration of the analyte. In conclusion, chronic kidney failure combined to therapeutic biotin is in favour of high levels of biotin which causes seriously misleading results in assays using biotin-streptavidin mechanisms.     

初探血清FT3,FT4测定对肾阳虚的诊断价值

报道了３７例肾虚病人与４９例正常人血清ＦＴ３、ＦＴ４（ＲＩＡ）及ＴＳＨ－ＩＲＭＡ的测定结果。结果表明，肾阳虚病人血清ＦＴ３、ＦＴ４分别为２．９３±１．６６、８．１８±４．４４，与正常对照组比较，有高度统计学意义，提示血清ＦＴ３、ＦＴ４和ＴＳＨ测定相结合，对诊断肾阳虚有重要参考价值。     

原发性甲状腺功能减退症误诊原因探讨

甲状腺功能减退症 (简称甲减 )是由多种原因所致的甲状腺激素的合成分泌或生物效应不足而引起的全身性内分泌疾病 ,许多病因不明者 ,可能属自身免疫性炎症所致 ,表现典型者诊断多不困难 ,但本病起病隐袭 ,发展缓慢 ,早期症状缺乏特异性 ,很容易误诊 ,本文收集甲低 6 2误诊资料     

农药叶枯宁对大鼠血清甲状腺素水平影响的时效关系

[目的 ]研究甲状腺素干扰物叶枯宁对大鼠血清游离T4(FT4)和促甲状腺激素 (TSH)水平的影响及其时效关系 ,为建立甲状腺素干扰物甄别方法体系的体内方法提供实验依据。 [方法 ]叶枯宁二甲亚砜溶液灌胃染毒 ,剂量为 5 0mg/kg ,分别设 5、6、10、2 0d实验组及溶剂对照组 ,在染毒期满后处死动物 ,取血清测FT4和TSH ,同时观察甲状腺组织学改变。 [结果 ]与对照相比 ,5d组出现显著的FT4降低并伴TSH升高 (P <0 0 5 ) ,6d及以后组则未见差异 ;组织学观察到 5d、6d组甲状腺滤泡上皮增生 ,10d组出现实心芽 ,2 0d组出现实心继发滤泡。 [结论 ]叶枯宁对大鼠血清FT4和TSH水平的影响发生在 5d之内 ,并可继发引起甲状腺增生。本实验为建立甲状腺素干扰物的初筛方法奠定了基础     

化学发光法与放射免疫法检测血清FT3、FT4及TSH的比较

目的 :对化学发光法 (CLIA)与放射免疫法 (RIA)两种方法测定血清游离三碘甲状腺原氨酸 (FT3 )、游离甲状腺素 (FT4)及促甲状腺激素 (TSH)浓度进行比较。方法 :分别采用CLIA和RIA平行测定 6 6份临床送检标本并进行线性实验、回收实验、对比实验和精密度实验。结果 :两种方法的相关性良好 (r =0 .995 ) ,无显著差异 (P >0 .0 5 ) ,回收率均接近 10 0 % ,但CLIA的批间CV %及批内CV %均低于RIA。结论 :CLIA的精密度和重复性均优于RIA。