RESUMO
Albumin is a main biomarker of denutrition severity. Since 2019, the French National Authority of Health (HAS) recommends an immunologic technique as a reference for measuring albuminemia. In a context of partial recovery by the laboratory of GHBS (using colorimetric method with bromcresol purple) of the biological activity of the dialysis center, until then carried out by the Ouest biology - Biolor laboratory (using colorimetric method with bromcresol green) and in order to standardize practices in the healthcare sector, we compared 3 albumin assay techniques: immunoturbidimetric (Diagam®), BCG (Siemens®), BCP (Siemens®) on Siemens Atellica PLCs. The albumin level of 183 patient samples was measured. We show an overestimation of the dosage by the BCG (+ 5.46 g/L compared to IT) and an interference related to the inflammatory state of the patient during the dosage with this technique, as well as an underestimation of the dosage by the BCP (- 0.91 g/L relative to the IT), increased in patients with renal injury. This biological difference is added to a discrepancy in clinical conclusions. A change in dosing technique from BCG to BCP may impact the biological follow-up of patients and the PMSI score (mean difference of - 6.67 g/L between BCG and BCP while the classification of the severity of denutrition uses thresholds set in steps of 5 g/L). This variability of results should be taken into account by the clinicians and constitutes an argument in favor of the standardization of laboratories around a reference technique.
Assuntos
Púrpura de Bromocresol , Albumina Sérica , Verde de Bromocresol , Atenção à Saúde , Humanos , Padrões de ReferênciaRESUMO
PURPOSE: The reduction of the number of embryos transferred while maintaining a satisfactory rate of pregnancy (PR) with in vitro fertilization calls for a refined technique of embryonic selection. This prospective study investigates the significance of early embryonic compaction at day 3 as a marker of the chances of implantation. METHODS: We examined 317 transfers and their outcome involving 509 embryos including 91 compacted embryos. RESULTS: Early compaction seems linked with the ovarian response to stimulation and embryonic quality. The PR is significantly increased when the embryonic cohort contains at least one compacted embryo (44% versus 29.5%, p = 0.01), and when at least one compacted embryo is transferred (44% versus 31%, p < 0.05). The analysis of our single embryo transfers shows that the implantation rates are significantly better for compacted embryos (50% versus 30%, p < 0.05) (OR 2.98; CI 1.02-5.28). CONCLUSION: Thus, early compaction, sometimes observed at day 3, may serve as a useful additional criterion for selecting the embryos transferred.