Assessment of the optimal cutoff value of fasting plasma glucose to establish diagnosis of gestational diabetes mellitus in Chinese women.

Our aim is to assess the optimal cutoff value of fasting plasma glucose (FPG) in Chinese women at 24-28 weeks' gestation by performing oral glucose tolerance test (OGTT) to improve diagnostic rate of gestational diabetes mellitus (GDM). Data were derived from the Medical Birth Registry of Xiamen. A FPG cutoff value of 5.1 mmol/L confirmed the diagnosis of GDM in 4,794 (6.10%) pregnant women. However, a FPG cutoff value of 4.5 mmol/L should rule out the diagnosis of GDM in 35,932 (45.73%) pregnant women. If we use this cutoff value, the diagnosis of GDM to about 27.3% of pregnant women will be missed. Additionally, a 75-g OGTT was performed in pregnant women with FPG values between 4.5 and 5.1 mmol/L, avoiding the performance of formal 75-g OGTT in about 50.37% pregnant women. Meanwhile, according to maternal age and pre-pregnancy BMI categories, with FPG values between 4.5 mmol/L and 5.1 mmol/L, which had high sensitivity, to improve the diagnostic rate of GDM in all groups. Further researches are needed to present stronger evidences for the screening value of FPG in establishing the diagnosis of GDM in pregnant women.

A direct comparison of four high-risk human papillomavirus tests versus the cobas test: Detecting CIN2+ in low-resource settings.

Low-cost, accurate high-risk human papillomavirus (HR-HPV) tests are needed for cervical cancer screening in limited-resource settings. More than 200 cervical cytological specimens from hospital patients were collected and analyzed for a real-world study. We evaluated the analytical and clinical performance of four widely used HR-HPV test (Tellgen, Hybribio, Liferiver, and Sansure) based on real-time polymerase chain reaction technology platforms, compared with the cobas test. Cervical intraepithelial neoplasia grade 2 or worse lesions (CIN2+) were set as the disease endpoint, and all the five HPV tests were performed with equal sensitivity (McNemar's test; P = 0.971) and specificity (McNemar's test; P = 0.953). All genotyping using the INNO-LiPA HPV test showed that HPV-16, -52, and -54 were the most common types among CIN2+ cases. Overall, the four HR-HPV tests analyzed appear to be as effective as the cobas HPV test in both agreement and clinical performance. Therefore, each of these low-cost HPV test kits could be implemented in limited-resource settings to accelerate the control of cervical cancer. However, we suggest that there is a need to further standardize and optimize testing around clinical sensitivity and specificity.

Assessment of ischemia-modified albumin levels for emergency room diagnosis of acute coronary syndrome.

BACKGROUND: The aim of this study was to retrospectively evaluate the utility of assessing ischemia-modified albumin (IMA) levels for diagnosing acute coronary syndrome (ACS) in patients presenting to the emergency room (ER) with chest pain. METHODS: The records of patients admitted to the ER with chest pain between August 2006 and December 2008 were examined. Those subsequently diagnosed with ACS were included in the study. Serum IMA and cardiac troponin I (cTnI) concentrations were determined in blood samples obtained from patients within 3h of ER admission and on days 1, 3, 7 and 14. IMA and cTnI cut-off values for diagnosis of ACS were employed and the successful diagnosis rates were compared. RESULTS: Of the patients diagnosed with ACS following ER presentation with acute chest pain, the correct diagnosis rate was significantly higher as determined by assessment of IMA vs. cTnI concentrations within 3h of ER presentation (81.02% vs. 42.34%, P<0.01). Thereafter there were no between marker differences in rates of successful diagnosis. CONCLUSIONS: These findings support the notion that IMA may be a useful biochemical marker for the early diagnosis of ACS, particularly in patients presenting to the ER with acute chest pain.