Biological variation and analytical goals of four thyroid function biomarkers in healthy European volunteers.

BACKGROUND: Interpretation of thyroid function tests by means of biological variation (BV) data is essential to identify significant changes between serial measurements at an individual level. Data on thyroid parameters in adults are limited. OBJECTIVES: We aimed at determining the BV of four thyroid function test (thyroid-stimulating hormone (TSH), free thyroxin (FT4), free triiodothyronine (FT3) and thyroglobulin (Tg)) by applying recent recommendations to acquire BV data on a latest generation of immunoassay. METHODS: Nineteen healthy volunteers (8 males and 11 females) were drawn every week during 5 consecutive weeks. Samples were analysed in duplicate on the Cobas 602 analyzer (Roche Diagnostics). After normality assessment, outlier exclusion and homogeneity of variance analysis, analytical variation (CVA ), within-subject biological variation (CVI ) and between-subject biological variation (CVG ) were determined using nested ANOVA. RESULTS: CVA , CVI and CVG were 0.9%, 19.7% and 37.6% for TSH; 3.6%, 4.6% and 10.8% for FT4; 2.2%, 6.0% and 8.6% for FT3; and 0.9%, 15.4% and 84.9% for Tg. Index of individuality (II) for all parameters was between 0.2 and 0.7. The percentage above which the change between two measures is truly significant (reference change value) was 54.7% for TSH, 16.2% for FT4, 17.7% for FT3 and 42.8% for Tg. CONCLUSION: Based on recent international recommendations, our study provides updated BV data for four thyroid function tests in European healthy volunteers. Reliable BV characteristics, and especially RCV, can facilitate the interpretation of consecutive thyroid function tests in an individual and therefore have the potential to efficiently support clinical decisions regarding thyroid diseases.

O-negative blood shortage management in a university hospital: Impact of transfusing RhD-positive red blood cells to RhD-negative patients.

BACKGROUND: Shortages of O-negative red blood cells are becoming increasingly common, forcing hospitals' blood transfusion services to find solutions to conserve this blood group for patients who need it most. The present study aimed to retrospectively evaluate the practice of transfusing selected RhD-negative patients with RhD-positive red blood cells and to assess the impact of this measure on patients and blood transfusion service management. METHODOLOGY: Transfusion data of 1199 RhD-negative patients hospitalised at Cliniques Universitaires Saint-Luc between 2019 and 2022 were analysed. For patients who received RhD-positive red blood cells, age, gender, reason for hospital admission, indication for transfusion, and immunohematology analyses were recorded. These data enabled an assessment of transfusion practices over the years, characterisation of patients who received RhD-mismatched transfusions, determination of the alloimmunisation rate, and calculation of the total number of RhD-negative red blood cells saved. RESULTS: During the study period, 141 RhD-negative patients received 604 RhD-positive red blood cells. A change in transfusion practices was observed over the years, with a greater proportion of RhD-negative patients being transfused with RhD-positive red blood cells in 2022 (28%) compared to 2019 (2%). The overall alloimmunisation rate was at least 20%, and 416 red blood cells were saved without any consequences. Patients undergoing cardiovascular surgery received the highest number of RhD-positive red blood cells. CONCLUSION: The transfusion of selected RhD-negative patients with RhD-positive red blood cells is a low-risk practice that helps conserve RhD-negative red blood cells. However, there is a minimum 20% risk of alloimmunisation, which could have clinical and transfusion-related consequences in the future.

Characterisation of an interference affecting the triiodothyronine measurement on two different immunoassays.

We report a case of falsely elevated triiodothyronine (T3) due to anti-T3 antibody interference in two immunoassays (Cobas 8000 e602® module (Roche Diagnostics) and Architect® i2000 (Abbott)). The interference was investigated using various laboratory methods including the search for heterophilic antibodies, biotin detection and the polyethylene glycol precipitation of potential interfering macromolecules. The presence of anti-T3 autoantibodies was detected and measured by radioimmunoprecipitation. Our investigations confirmed the clinical suspicion of a falsely elevated free T3. No further explorations or unnecessary treatments were conducted for this patient after identification of the interference. This underlines the importance of implementing systematic analytical procedures in laboratories for the search of suspected interferences.

There is an urgent need to adopt a pull-flow logic for the supply of RBCs to meet patients' needs: A single center study.

BACKGROUND: Despite major demographic changes, several decisions and initiatives, among which Patient Blood Management, have led to a significant reduction in the transfusion of packed red blood cells (RBCs) in Belgium, as it has been observed in many countries. Unfortunately, not all blood groups were proportionately impacted and shortage in O D-negative RBCs is regularly or chronically observed. The goal of this study was to examine how to optimize the use and the supply of O D-negative blood in our academic hospital. METHODOLOGY: All blood transfusions performed at Cliniques universitaires Saint-Luc between January 1, 2019 and December 31, 2021 were reviewed. The blood group of the patients was compared with the blood group of the RBCs actually supplied and transfused. RESULTS: 49.823 RBCs transfusions were analyzed. The patients' needs didn't reflect those of a Caucasian population, with an increase of O (47.9%) and B (10.3%) for the ABO blood group, and a quite high proportion of R0r (8.6%) for the Rh blood group. Only two thirds of O D-negative RBCs were transfused to O rr or R0r patients. CONCLUSION: The application of PBM and the ethnic imbalance between blood donor and patient populations are two important risk factors for chronic shortages of O D-negative blood. To adapt blood component resources, it is essential to have a complete picture of the real needs of patients according to their blood group profile. Blood donor centers must adapt to the evolving needs of hospitals in order to plan future supplies in a "pull-flow" approach.

Drug combination using an injectable nanomedicine hydrogel for glioblastoma treatment.

Lauroyl-gemcitabine lipid nanocapsules (GemC12-LNC) hydrogel, administered intratumorally or perisurgically in the tumor resection cavity, increases animal survival in several orthotopic GBM models. We hypothesized that GemC12-LNC can be used as nanodelivery platform for other drugs, to obtain a combined local therapeutic approach for GBM. Paclitaxel (PTX) was selected as a model molecule and PTX-GemC12-LNC formulation was evaluated in terms of physicochemical and mechanical properties. The PTX-GemC12-LNC hydrogel stability and drug release were evaluated over time showing no significant differences compared to GemC12-LNC. The drug combination was evaluated on several GBM cell lines showing increased cytotoxic activity compared to the original formulation and synergy between PTX and GemC12. Our results suggest that GemC12-LNC hydrogel can be used as nanodelivery platform for dual drug delivery to encapsulate active agents with different mechanisms of action to achieve a better antitumor efficacy against GBM or other solid tumors.