Comparison of Citrate Buffer with Sodium Fluoride as Additives in Determining Glycemia.

BACKGROUND: The objectives of this study are to compare the effect of sodium fluoride and citrate on the stability of glucose in samples maintained at room temperature up to three hours, and to assess the clinical impact in the O'Sullivan test results after changing the additives in the collecting tubes. METHODS: The selected population was pregnant women between the 24th and 28th week of gestation, who were at the health center to undergo the O'Sullivan test as part of the screening program for GDM (gestacional diabetes mellitus). Two blood samples were extracted from each patient: one using a tube with citrate and sodium fluoride buffer (tubes Vacuette Glucomedics citrate, 2 mL, Ref 454347) (tube C) and another containing just sodium fluoride (BD Vacationer tubes FX fluoride, 2 mL, Ref 368920) (tube F). The statistical treatment of the data was performed using SPSS version 24 and Method validator. Finally, we assessed the real clinical impact of replacing tubes C for tubes F in the classification of pregnant women. To do so, we collected the results of O'Sullivan tests conducted in our hospital during a year, all of them done in tubes F, and we applied the mean difference calculated in T = 1 to estimate the number of pregnant women that should be reclassified. RESULTS: The average glycaemia in tubes C are significantly greater than average glycaemia in tubes F (p < 0.05) at all time points. The clinical impact assessment was done over the 6,526 O'Sullivan test results with a prevalence of positive tests of 21.35%. The prevalence using tubes C instead of tubes F estimated with mean differences previously calculated is 33.45%. CONCLUSIONS: The glucose concentrations in tubes F stored at room temperature up to 3 hours were significantly lower (p < 0.05) than those measured in tubes C stored under the same conditions. We observed that it is in the first minutes after extraction, while the samples are collected and aliquots done, that the glucose consumption occurs in tubes F, but not in tubes C. There is a need to change the preanalytical conditions to prevent any loss of glucose. This will enable more accurate diagnosis and management of diabetes mellitus.

Prevención de la infección quirúrgica utilizando sutura reabsorbible antibacteriana (Vicryl Plus) en lugar de la sutura reabsorbible convencional en hernioplastias. Estudio experimental en animales / Prevention of surgical infection using reabsorbable antibacterial suture (Vicryl Plus) versus reabsorbable conventional suture in hernioplasty. An experimental study in animals

Introducción. En nuestra práctica diaria quirúrgica nos enfrentamos a infecciones del propio sitio quirúrgico con frecuencia. Uno de los grandes retos para el cirujano hoy en día es la prevención y el tratamiento de las infecciones, y en especial las infecciones de material protésico. En la actualidad disponemos de una nueva sutura (Vicryl Plus) que ha demostrado in vitro y en modelo experimental su capacidad para inhibir el crecimiento bacteriano y por lo tanto prevenir la tan temida infección posquirúrgica. Objetivos. Nos proponemos en nuestro estudio experimental realizar una comparación entre una infección provocada en una prótesis para tratar la enfermedad herniaria fijada con sutura reabsorbible convencional y la nueva sutura motivo del estudio, sutura reabsorbible con impregnación antiséptica. Material y método. Utilizamos como modelo animal ratas Wistar blancas (20), a las cuales les practicamos dos hernioplastias. Una fijada con Vicryl Plus y otra con Vicryl normal. Posteriormente se infecta cada malla de polipropileno con Staphylococcus aureus, y permanece en su jaula individual una semana. A la semana procedemos al sacrificio de las ratas y la extracción de las mallas para su estudio macroscópico, microscópico y mibrobiológico. Resultados. Comprobamos que la mayoría de las mallas fijadas con la nueva sutura (Vicryl Plus) presentaban macroscópicamente menos indicios de infección, sin abscesos ni dehiscencia de la hernioplastia, en contra de lo observado en aquellas fijadas con sutura convencional. En el estudio microbiológico cuantitativo bacteriano el número de bacterias cuantificadas por gramo de muestra es menor también en las prótesis fijadas con Vicryl Plus. En la anatomía patológica de la muestra observamos menor colonización de la malla y menor respuesta inflamatoria con la fijación con Vicryl Plus que con Vicryl normal. En el estudio estadístico se comprueba la menor tasa de infección al comparar las medianas de ambos grupos y los rangos intercuartílicos de la cuantificación microbiana. Conclusiones. Es posible disminuir el índice de infección del sitio quirúrgico tras la colocación de material protésico realizando su fijación con este nuevo tipo de sutura antimicrobiana (Vicryl Plus). Pensamos que es un nuevo aliado en la lucha contra la infección postoperatoria, y es de especial interés su uso en cirugía con hernioplastia, cirugía de urgencia y cirugía sucia o potencialmente contaminada (AU)

Introduction. Surgical site infections are frequent in daily surgical practice. One of the main challenges currently facing surgeons is the prevention and treatment of infections, especially those involving prosthetic material. A new suture (Vicryl Plus) has become available. In vitro studies and experimental models have demonstrated the ability of this suture to inhibit bacterial growth and consequently prevent postsurgical infection. Objectives. To compare infections provoked in prosthetic implants fixed with reabsorbable conventional sutures with those in meshes fixed with reabsorbable sutures with antiseptic impregnation. Material and method. Twenty white Wistar rats were used. In each rat, two hernioplasties were performed: one fixed with Vicryl Plus and the other with normal Vicryl. Subsequently, each polypropylene mesh was infected with S. aureus, and the rats remained in individual cages for a week. After 1 week, the rats were sacrificed and the meshes were extracted for macroscopic, microscopic and microbiologic study. Results. Most of the meshes fixed with the new suture (Vicryl Plus) showed macroscopically fewer infections than those fixed with conventional suture, without abscesses and without dehiscence of the hernioplasty. In the microbiological quantitative bacterial study, the number of bacteria quantified per gram of sample was also lower in prostheses fixed with Vicryl Plus. Pathological analysis showed lesser colonization of the mesh and lower inflammatory response with Vicryl Plus than with normal Vicryl. In the statistical analysis, comparison of the medians of both groups and the interquartile ranges of microbial quantification revealed a lower infection rate in the Vicryl Plus group. Conclusions. The infection rate in the surgical site can be reduced by mesh fixation using the new antimicrobial suture (Vicryl Plus). We believe that this type of suture constitutes a new weapon in the fight against postoperative infection, especially in hernioplasty, emergency surgery, and dirty or potentially contaminated surgery (AU)