Evaluating the diagnostic performance of Liaison® chemiluminescence assay as screening tool for detection of acute Epstein-Barr infection: A comparative study.

The present investigation assessed the Liaison® diagnostic performance in detecting Epstein-Barr (EBV) IgM-VCA in a large patient cohort, considering age and symptomatology. VIDAS® were employed as a benchmark for acute EBV infection. The study also probed other coexisting conditions and potential cross-reactivity for error sources. A total of 1311 samples were analyzed, with notable associations found only among paediatric (kappa=0.75) and young adult (kappa=0.58) populations with compatible symptoms. ROC analysis revealed varying optimal cutoff values based on age and symptom categorizations. Logistic regression models identified age and patients from Oncology or Infectious Disease as significant factors for false positives. Potential interferences emerged with RF, ANCA, cytomegalovirus-IgM and VHS-IgM. Notably, Liaison® couldn´t distinguish EBV patients from Oncology, Haemathology or Internal Medicine. This study provides valuable insights, such as implementing ageand symptom-specific thresholds or reviewing test requests, for optimizing EBV serology in microbiology laboratories, leading to faster and more reliable responses.

Comparability of two different polyacrylamide gel electrophoresis methods for the classification of LDL pattern type.

BACKGROUND: The measurement of small dense low-density lipoprotein (sdLDL) particles is relevant when assessing cardiovascular risk. However, there is as yet no referenced method for the determination of LDL subfractions or a standardized comparison of the methods currently available. Therefore, the aim of this study was to compare the pattern of LDL particles measured by polyacrylamide tube gel electrophoresis (PTGE) and polyacrylamide gradient gel electrophoresis (PGGE) and to correlate the results with triglyceride concentration. MATERIALS AND METHODS: Serum samples were collected from 177 patients. Lipid profile and LDL particle size were assessed using PTGE and PGGE. RESULTS: Pearson correlation and kappa index revealed a very good agreement between the methods. There was 81.3% concordance for classification of sdLDL particles and 97.2% concordance for classification of large LDL when PTGE and PGGE were compared. LDL size correlated with triglyceride in subjects with triglyceride levels >116 mg/dl, pointing to a high CAD risk, as reflected by their higher prevalence of pattern B. CONCLUSIONS: PTGE correlates favourably and is in very good agreement with PGGE. The determination of LDL particle size may be an appropriate analytical procedure to estimate CAD risk in patients with high triglyceride levels.

Association between AT C573T polymorphism and cardiovascular risk factors in myocardial infarction.

BACKGROUND: Polymorphisms in the AT1 gene have been associated with various parameters related to the pathogenesis of cardiovascular diseases and to myocardial infarction. This study analyzed the relationship between two polymorphisms of the angiotensin II AT-1 receptor gene (AT1_1166 and AT1_573) and the risk of ischemic heart disease by studying their association with several cardiovascular risk factors. METHODS: The sample population comprised 356 subjects: 174 patients who had survived myocardial infarction (61.01 ± 8.15 years), and 182 age- and gender-matched controls (mean age of 60.25 ± 9.43). The polymorphisms of the angiotensin II AT1-receptor gene (C573T and A1166C) were studied by polymerase chain reaction and DNA restriction analysis. We compared the patients' genetic polymorphism with their risk of ischemic heart disease. RESULTS: The A1166C polymorphism did not show any significant differences between the groups. However, with respect to C573T, genotypes tended to differ significantly between cases and controls in the CC and TT types, remaining significant when the CC and CT+TT were grouped. Through analysis of the fit of various multivariate models, we found that the CC genotype is a risk factor for myocardial infarction. This risk remains significant after being adjusted for gender, age, homeostasis model assessment, and anthropometric variables. CONCLUSIONS: There is a relationship between the C573T polymorphism and the pathogenesis of myocardial infarction that seems to be due to its relationship with some risk factors. However, given the multifactorial nature of this pathology, further studies are needed to confirm the evidence that we report herein.

[Prevalence of metabolic syndrome in patients with coronary heart disease]. / Prevalencia del síndrome metabólico entre pacientes con cardiopatía isquémica.

BACKGROUND AND OBJECTIVE: We aimed to know the prevalence of classical cardiovascular risk factors, hyperinsulinism, insulin resistance and metabolic syndrome (MS) in a population with coronary heart disease (CHD) as compared with a population without personal or familial history of cardiovascular risk factors. SUBJECTS AND METHOD: This was an observational and transversal study of cardiovascular risk factors making up the MS in an adult population. 367 subjects aged 35-79 years (268 men and 99 women) were studied; 185 had CHD (141 men and 44 women) and 182 (127 men and 55 women) were included as a control population. 82 individuals of the control group who had no MS components were selected for the calculation of parameters of hyperinsulinism and the HOMA (Homeostasis Model Assessment) index in order to evaluate the insulin resistance. RESULTS: As compared with the control group, patients with CHD showed higher blood pressure (systolic and dyastolic), body mass index (BMI), triglicerydes and apo B100 concentrations, and lower HDL-c and apo A1 values. They also exhibited higher values of glycemia and insulinemia and consequently a higher HOMA index. The values of insulin and HOMA (percentil 75), obtained from the selected group for this purpose, were 12 U/ml and 3.03, respectively. In the CHD population, 38.28% (95% CI, 31.13-45.95) had hyperinsulinism, 47.02% (95% CI, 39.70-54.47) had insulin resistance (HOMA) and 41.08% (95% CI, 33.98-48.55) had MS. CONCLUSIONS: There was a high prevalence of cardiovascular risk factors in the CHD population. Patients with CHD have higher hyperinsulinism and insulin resistance as well as a greater prevalence of MS. Despite treatment, a clear association exists between MS and CHD in both men and women.

Prevalencia del síndrome metabólico entre pacientes con cardiopatía isquémica / Prevalence of metabolic syndrome in patients with coronary heart disease

FUNDAMENTO Y OBJETIVO: Conocer la prevalencia de los factores de riesgo cardiovascular clásicos -hiperinsulinismo, resistencia a la insulina y síndrome metabólico (SM)- en una población con cardiopatía isquémica (CI), comparándola con una población de control seleccionada sin antecedentes personales ni familiares de CI y con escasos factores de riesgo cardiovascular. SUJETOS Y MÉTODO: Se trata de un estudio observacional y transversal de los factores de riesgo cardiovascular integrantes del SM en población adulta. Estudiamos a 367 sujetos de entre 35 y 79 años de edad (268 varones y 99 mujeres); 185 presentaban CI (141 varones y 44 mujeres) y 182 (127 varones y 55 mujeres) fueron utilizados de población control. Del grupo control se seleccionó a 82 individuos sin ninguno de los componentes del SM para el cálculo de los parámetros de hiperinsulinismo y se empleó el índice HOMA (Homeostasis Model Assessment) para la evaluación de la resistencia a la insulina. RESULTADOS: Los pacientes con CI, comparados con el grupo control, presentaron de forma significativa mayor presión arterial (sistólica y diastólica), mayor índice de masa corporal (IMC), mayor valor de triglicéridos y Apo B100, con descensos de HDL y Apo A1. Los pacientes con CI presentaron mayores cifras de glucemia e insulinemia basales y, por consiguiente, fue superior el cálculo del HOMA. Los valores de insulina y HOMA (percentil 75) obtenidos del grupo seleccionado para este fin fueron de 12 µU/ml y 3,03, respectivamente. En la población con CI encontramos un 38,28 por ciento (intervalo de confianza [IC] del 95 por ciento, 31,13-45,95) de hiperinsulinismo, un 47,02 por ciento (IC del 95 por ciento, 39,70-54,47) de resistencia a la insulina (HOMA) y 41,08 por ciento (IC del 95 por ciento, 33,98-48,55) del SM calculado según criterios del Grupo Europeo de Resistencia a la Insulina (EGIR). CONCLUSIONES: En la población con cardiopatía isquémica existe una elevada prevalencia de factores de riesgo cardiovascular. Los pacientes con cardiopatía isquémica presentan mayor frecuencia de hiperinsulinismo, resistencia a la insulina y de síndrome metabólico. A pesar del tratamiento, existe una clara asociación entre el síndrome metabólico y la cardiopatía isquémica tanto en varones como en mujeres (AU)

Prevalencia de malnutrición entre ancianos institucionalizados en la comunidad valenciana / Malnutrition prevalence in institutionalized elderly people in Valencia Community, Spain

FUNDAMENTO: Conocer la prevalencia de malnutrición en población anciana institucionalizada estratificada por percentiles de edad y sexo. PACIENTES Y MÉTODO: Se estudiaron un total de 615 ancianos institucionalizados, con una edad media (DE) de 79,33 (9,07) años. Los parámetros antropométricos medidos fueron peso, talla, distancia rodilla-talón, pliegues tricipital y subescapular, y perímetro del brazo y de la cintura. Se calcularon el perímetro y el área muscular del brazo y la masa grasa. Los parámetros bioquímicos determinados fueron colesterol, triglicéridos, albúmina, prealbúmina, transferrina, proteína fijadora de retinol, C3 y recuento de linfocitos. Se diagnosticó malnutrición cuando al menos dos de los parámetros estudiados eran patológicos, inferiores al percentil 25, y determinaciones analíticas inferiores a la normalidad. RESULTADOS: La prevalencia de malnutrición fue del 26,87 por ciento (IC del 95 por ciento, 23,15-30,86): del 29,08 por ciento (IC del 95 por ciento, 22,82-35,97) en varones y del 25,59 por ciento (IC del 95 por ciento, 25,1-30,61) en mujeres. Los parámetros antropométricos estudiados se encuentran reducidos en todos los casos en los pacientes con malnutrición. Sin embargo, los parámetros bioquímicos no presentan, en general, diferencias significativas entre estos pacientes y los sujetos con buen estado nutricional si se comparan de forma bivariante, pero sí ofrecen diferencias significativas si se aplica un análisis multivariante controlando los parámetros edad y sexo. CONCLUSIÓN: En nuestro estudio encontramos una prevalencia de malnutrición elevada en un rango inferior de lo esperado, según los estudios realizados con grupos de edad similar. Los parámetros antropométricos se encuentran asociados con malnutrición en ancianos, y de los datos bioquímicos destaca el descenso de la prealbúmina (AU)