Effect of Times to Blood Processing on the Stability of Blood Proteins Associated with Dementia.

BACKGROUND: The stability of proteins in the collecting tubes after blood draw is critical to the measured concentrations of the proteins. Although the guidelines issued by the Clinical and Laboratory Standards Institute (CLSI) suggest centrifugation should take place within 2 h of drawing blood, it is very difficult to follow these guidelines in hospitals or clinics. It is necessary to study the effect of times to blood processing on the stability of the proteins of interest. METHODS: In this work, the plasma proteins of interest were those relevant to dementia, such as amyloid ß 1-40 (Aß1-40), Aß1-42, Tau protein (Tau), and α-synuclein. The times to blood processing after blood draw ranged from 0.5 to 8 h. The storage temperatures of blood were room temperature (approx. 25°C) and 30°C. After storage, blood samples were centrifuged at room temperature to obtain plasma samples. Ultrasensitive immunomagnetic reduction was applied to assay these proteins in the plasma. RESULTS: The levels of plasma Aß1-40, Tau, and α-synuclein did not significantly change until 8 h after blood draw when stored at room temperature. Plasma Aß1-42 levels did not change significantly after 8 h of storage at room temperature before blood processing. Higher storage temperatures, such as 30°C, for blood samples accelerated the significant variations in the measured concentrations of Aß1-40, Tau, and α-synuclein in plasma. CONCLUSION: According to these results, for clinical practice, it is suggested that blood samples be stored at room temperature for no longer than 4.5 h after blood draw until centrifugation for the assay of dementia biomarkers in plasma.

Effect of different floatation solutions on E. tenella oocyst purification and optimization of centrifugation conditions for improved recovery of oocysts and sporocysts.

Saturated salt floatation method is widely used for coccidian oocyst purification. However, the repeated procedures and inefficient oocysts recovery rate are a continuous challenge. This study aimed to investigate the best suitable floatation solution, along with optimal centrifugation speed and time for Eimeria tenella (E. tenella) oocyst and sporocyst purification. Different floatation solutions i-e, saturated salt, Sheather's sugar and sodium hypochlorite (NaClO) at 20-60% concentrations were used to purify oocyst. It was found that about 96.99% oocysts (8609×g for 10 min) were recovered under these conditions without any effect on the viability of sporocysts. The recovery rate of oocysts using 50% NaClO (V/V) was significantly higher than 35% saturated salt flotation solution (P < 0.05). The optimal method for purification of oocysts based our experimentation was centrifugation at 8609×g for 3 min using 50% NaClO floatation solution, and the optimized centrifugation conditions for improved recovery of sporocysts (about 99.3%) were at 2152×g for 5 min. The present study provided a better method for the coccidian oocyst purification, which could be successfully adopted as a better alternative to existing techniques commonly used for investigations/research pertaining to coccidia.

Strict Preanalytical Oral Glucose Tolerance Test Blood Sample Handling Is Essential for Diagnosing Gestational Diabetes Mellitus.

OBJECTIVE: Preanalytical processing of blood samples can affect plasma glucose measurement because ongoing glycolysis by cells prior to centrifugation can lower its concentration. In June 2017, ACT Pathology changed the processing of oral glucose tolerance test (OGTT) blood samples for pregnant women from a delayed to an early centrifugation protocol. The effect of this change on the rate of gestational diabetes mellitus (GDM) diagnosis was determined. RESEARCH DESIGN AND METHODS: All pregnant women in the Australian Capital Territory (ACT) are recommended for GDM testing with a 75-g OGTT using the World Health Organization diagnostic criteria. From January 2015 to May 2017, OGTT samples were collected into sodium fluoride (NaF) tubes and kept at room temperature until completion of the test (delayed centrifugation). From June 2017 to October 2018, OGTT samples in NaF tubes were centrifuged within 10 min (early centrifugation). RESULTS: A total of 7,509 women were tested with the delayed centrifugation protocol and 4,808 with the early centrifugation protocol. The mean glucose concentrations for the fasting, 1-h, and 2-h OGTT samples were, respectively, 0.24 mmol/L (5.4%), 0.34 mmol/L (4.9%), and 0.16 mmol/L (2.3%) higher using the early centrifugation protocol (P < 0.0001 for all), increasing the GDM diagnosis rate from 11.6% (n = 869/7,509) to 20.6% (n = 1,007/4,887). CONCLUSIONS: The findings of this study highlight the critical importance of the preanalytical processing protocol of OGTT blood samples used for diagnosing GDM. Delay in centrifuging of blood collected into NaF tubes will result in substantially lower rates of diagnosis than if blood is centrifuged early.

Different Re-centrifugation Conditions for Infectious Disease Screening Using the Abbott I2000.

We investigated whether an ordinary centrifuge can achieve the standard centrifugal effect required according to specifications for infectious disease screening using the Abbott i2000. Samples were collected and centrifuged following a standard operating procedure (SOP). They were then divided into three groups according to the results of the initial screening tests: a negative group, weak-positive group, and positive group. Twenty negative samples and all weak-positive and positive samples were re-analyzed. Two tubes for each re-analyzed sample were centrifuged simultaneously, one for 10 min at 10 000 × g, per recommendations, and one for 10 min at 2750 × g. No significant difference was found between the groups using different centrifugal forces. There was a strong correlation in the quantitative values between the two conditions of centrifugation. Consistency analysis showed a Cronbach's alpha > 0.8 for detection of Treponema pallidum, human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B surface antigen in the three groups (negative group, weak-positive group, and positive group) under different centrifugation conditions. Strong consistency was found under different centrifugal conditions, regardless of the initial testing results. In conclusion, we conducted centrifugation steps in duplicate, according to infectious disease screening protocols. Our study showed that all samples should be centrifuged using a recommended relative centrifugal force after a proper clotting time, as in the standard operating procedure of our laboratory. In this way, we were able to obtain the same results using an ordinary centrifuge as those obtained using a high-speed centrifuge, such as the Abbott i2000.

Rapid Centrifugation in the Routine Hemostasis Laboratory.

BACKGROUND: The use of short and uniform centrifugation schemes contributes significantly to the successful automation of laboratory procedures. It is however unclear if this is applicable to the hemostasis laboratory. OBJECTIVES: This article assesses the accuracy of measurements obtained with a rapid, high-speed centrifugation scheme in a large set of hemostasis tests, covering the full spectrum of values obtained in clinical practice, and using meaningful statistical measures. METHODS: Two citrated plasma samples were obtained from consecutive patients of a tertiary hospital with suspected abnormal hemostasis tests and processed with two centrifugation schemes in parallel: 1,500 × g for 10 minutes and 3,137 × g for 7 minutes. The following tests were conducted: prothrombin time (n = 125), international normalized ratio (n = 146), activated partial thromboplastin time (n = 119), thrombin time (n = 105), fibrinogen (n = 125), factor (F)II (n = 69), FV (n = 64), FVII (n = 64), FX (n = 67), FVIII (n = 55), FIX (n = 37), FXI (n = 35), and FXIII (n = 20), D-dimer (n = 34), antithrombin (n = 31), anti-Xa activity (n = 30), von Willebrand antigen (n = 25), and von Willebrand activity (VWF:GPIbM; n = 27). RESULTS: A wide range of results were obtained in all tests. Spearman's rank correlation coefficient was at least 0.95 for all tests except FV, FIX, and FXI. The coverage probability π at a given deviation index κ of 15% was above 0.9 for all tests except FV, FVII, FX, FVIII, FIX, FXI, and VWF:GPIbM, suggesting a lack of agreement. CONCLUSION: Our results suggest that high-speed centrifugation is applicable to the majority of routine hemostasis parameters. The coverage probability was more sensitive than Spearman's rank correlation to detect disagreement among centrifugation schemes.

A standardized, incremental protocol to increase human tolerance to the cross-coupled illusion.

BACKGROUND: Humans can adapt to the "Coriolis" cross-coupled illusion with repeated exposure, improving the tolerability of faster spin rates and enabling short-radius, intermittent centrifugation for artificial gravity implementation. OBJECTIVE: This investigation assesses the criticality of personalization in acclimation to the cross-coupled illusion. METHODS: We used the median stimulus sequence of our previous effective and tolerable personalized, threshold-based protocol to develop a standardized (non-personalized) approach. During each of 10, 25-minute sessions, the spin rate was incremented independent of whether each subject reported experiencing the cross-coupled illusion. RESULTS: In comparison to the previous personalized protocol, the standardized protocol resulted in significantly reduced acclimation to the cross-coupled illusion (17.7 RPM threshold for the personalized protocol versus 11.8 RPM threshold for the standardized) and generally increased motion sickness reports (average reporting of 1.08/20 (personalized) versus 1.98/20 (standardized)), on average. However, the lack of individualization also leads to significantly less variance in subjects' acclimation. CONCLUSIONS: These findings are critical for future missions that may require several astronauts to be acclimated concurrently, due to resource and time constraints. Assessing feasibility of fast spin rate, short-radius centrifugation is crucial for the future of artificial gravity implementation during spaceflight.

Turn down - turn up: a simple and low-cost protocol for preparing platelet-rich plasma.

OBJECTIVE: To describe and analyze a new protocol for the extraction of platelet-rich plasma (PRP) for use in clinical practice and compare this technique with methods that have been previously described in the medical literature. METHODS: We extracted PRP from 20 volunteers using four different protocols (single spin at 1600 ×g, single spin at 600 ×g, double spin at 300 and 700 ×g, and double spin at 600 and 900 ×g). In another group of 12 individuals, we extracted PRP with our new technique (named 'turn down-turn up') consisting of a double spin (200 ×g and 1600 ×g) closed system using standard laboratory equipment (including an ordinary benchtop centrifuge), where the blood remained in the same tube during all processes, reducing the risk of contamination. Platelet counts adjusted to baseline values were compared using analysis of covariance (ANCOVA). RESULTS: Using the four previously described protocols (mentioned above), we obtained concentrations of platelets that were 1.15-, 2.07-, 2.18-, and 3.19-fold greater than the baseline concentration, respectively. With the turn down-turn up technique, we obtained a platelet count that was 4.17-fold (95% confidence interval (CI): 3.09 to 5.25) greater than the baseline platelet count (p=0.063 compared with the double spin at 600 and 900 ×g method). The total cost of the disposable materials used in the extraction process was less than US$10.00 per individual. CONCLUSION: In the present study, we described a simple and safe method for obtaining PRP using low-cost devices.

Turn down - turn up: a simple and low-cost protocol for preparing platelet-rich plasma

OBJECTIVE: To describe and analyze a new protocol for the extraction of platelet-rich plasma (PRP) for use in clinical practice and compare this technique with methods that have been previously described in the medical literature. METHODS: We extracted PRP from 20 volunteers using four different protocols (single spin at 1600 ×g, single spin at 600 ×g, double spin at 300 and 700 ×g, and double spin at 600 and 900 ×g). In another group of 12 individuals, we extracted PRP with our new technique (named 'turn down-turn up') consisting of a double spin (200 ×g and 1600 ×g) closed system using standard laboratory equipment (including an ordinary benchtop centrifuge), where the blood remained in the same tube during all processes, reducing the risk of contamination. Platelet counts adjusted to baseline values were compared using analysis of covariance (ANCOVA). RESULTS: Using the four previously described protocols (mentioned above), we obtained concentrations of platelets that were 1.15-, 2.07-, 2.18-, and 3.19-fold greater than the baseline concentration, respectively. With the turn down-turn up technique, we obtained a platelet count that was 4.17-fold (95% confidence interval (CI): 3.09 to 5.25) greater than the baseline platelet count (p=0.063 compared with the double spin at 600 and 900 ×g method). The total cost of the disposable materials used in the extraction process was less than US$10.00 per individual. CONCLUSION: In the present study, we described a simple and safe method for obtaining PRP using low-cost devices.

Protocol for Efficient Generation and Characterization of Adeno-Associated Viral Vectors.

Adeno-associated virus vectors are a powerful tool for gene transfer approaches. We have established a simple and fast plasmid-based production system for achieving high adeno-associated virus titers within 6 working days. The same procedure can be used for all serotypes and thus allows direct comparability of different serotypes. In this protocol we describe a step-by-step procedure that results in well-characterized vectors suitable for both in vitro approaches and preclinical studies.

Novel centrifugal technology for measuring sperm concentration in the home.

OBJECTIVE: To evaluate the analytical performance and usability of the Trak Male Fertility Testing System, a semiquantitative (categorical) device recently US Food and Drug Administration (FDA)-cleared for measuring sperm concentration in the home by untrained users. DESIGN: A three-site clinical trial comparing self-reported lay user results versus reference results obtained by computer-aided semen analysis (CASA). SETTING: Simulated home use environments at fertility centers and urologist offices. PATIENT(S): A total of 239 untrained users. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Sperm concentration results reported from self-testing lay users and laboratory reference method by CASA were evaluated semiquantitatively against the device's clinical cutoffs of 15 M/mL (current World Health Organization cutoff) and 55 M/mL (associated with faster time to pregnancy). Additional reported metrics include assay linearity, precision, limit of detection, and ease-of-use ratings from lay users. RESULT(S): Lay users achieved an accuracy (versus the reference) of 93.3% (95% confidence interval [CI] 84.1%-97.4%) for results categorized as ≤15 M/mL, 82.4% (95% CI 73.3%-88.9%) for results categorized as 15-55 M/mL, and 95.5% (95% CI 88.9%-98.2%) for results categorized as >55 M/mL. When measured quantitatively, Trak results had a strong linear correlation with CASA measurements (r = 0.99). The precision and limit of detection studies show that the device has adequate reproducibility and detection range for home use. Subjects generally rated the device as easy to use. CONCLUSION(S): The Trak System is an accurate tool for semiquantitatively measuring sperm concentration in the home. The system may enable screening and longitudinal assessment of sperm concentration at home. CLINICAL TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02475395.

Effects of time and temperature on 48 routine chemistry, haematology and coagulation analytes in whole blood samples.

Background Phlebotomy for the purpose of blood analysis is often performed at remote locations, and samples are usually temporarily stored before transport to a central laboratory for analysis. The circumstances during storage and shipment may not meet the necessary requirements. If analysed anyway, false results may be generated. We therefore examined the influence of precentrifugation time and temperature of the most frequently requested tests in whole blood. Methods Healthy volunteers donated blood in which 48 analytes were tested. Routine chemistry was performed in lithium heparin tubes, haematology in ethylenediaminetetraacetic acid tubes, coagulation in citrate tubes and glucose in sodium fluoride tubes. One tube was measured directly. The others were kept at different temperatures (4, 8, 20 or 30℃) and stored for 4, 6, 8 or 24 h before analysis. Additionally, some analytes were examined at 12, 16, 24 and 28℃. The mean percentage deviation was compared with different decision levels, including the total allowable error. Results When using the total allowable error as an acceptable limit, most of the investigated analytes remained stable. However, bicarbonate is unstable at almost all tested time-points and temperatures. Calcium, lactate dehydrogenase, potassium and sodium are particularly affected at low temperatures, while phosphate is mainly affected at and above room temperature after 8 h. Conclusion We established the influence of time and temperature on a broad range of analytes, which may be applied to set the limits in transportation and storage of whole blood samples.

A simple tube adapter to expedite and automate thawing of viably frozen cells.

Although cryopreserved cell specimens are used throughout biomedical research, the process for thawing samples is labor-intensive and prone to error. Here we describe a small laboratory device that couples an uncapped vial of frozen cells to a conical tube containing warm cell culture media. The entire complex is loaded directly into a centrifuge; within 5min, cells are thawed and diluted out of toxic cryopreservation medium. The recovery and viability of cells are slightly reduced compared to the common (traditional) method. However, antigen-specific T-cell function is not affected. Since no technician time is required (beyond uncapping of vials), our device allows the parallel processing of as many samples as a centrifuge can hold (up to 96, in some models). Moreover, since the samples are not thawed manually in a water bath, the problems associated with technician-to-technician differences in sample handling are minimized, as is the potential for contamination. Importantly, the elimination of substantial labor involving subjective decisions standardizes this process and can reduce variability in results from cryopreserved specimens.

Evaluation of the Microcentrifuge Dissolution Method as a Tool for Spray-Dried Dispersion.

Although using spray-dried dispersions (SDDs) to improve the bioavailability of poorly water-soluble compounds has become a common practice in supporting the early phases of clinical studies, their performance evaluation, whether in solid dosage forms or alone, still presents significant challenges. A microcentrifuge dissolution method has been reported to quickly assess the dissolution performance of SDDs. While the microcentrifuge dissolution method has been used in the SDD community, there is still a need to understand the mechanisms about the molecular species present in supernatant after centrifugation, the molecular nature of active pharmaceutical ingredients (APIs), as well as the impact of experimental conditions. In this paper, we aim to assess the effect of API and polymer properties on the dissolution behavior of SDDs along with centrifuging parameters, and for this, two poorly water-soluble compounds (indomethacin and ketoconazole) and two commonly used polymers in the pharmaceutical industry (PVP and HPMC-AS) were chosen to prepare SDDs. A typical microcentrifuge dissolution procedure as reported in the publication (Curatolo et al., Pharm Res 26:1419-1431, 2009) was followed. In addition, after separation of the supernatant from precipitation, some of the samples were filtered through filters of various sizes to investigate the particulate nature (particle size) of the supernatant. Furthermore, the centrifuge speed was varied to study sedimentation of API, SDD, or polymer particles. The results indicated that for the SDDs of four drug-polymer pairs, microcentrifuge dissolution exhibited varied behaviors, depending on the polymer and the drug used. The SDDs of indomethacin with either PVP or HPMC-AS showed a reproducible dissolution with minimum variability even after filtration and subjecting to varied centrifugation speed, suggesting that the supernatant behaved solution-like. However, ketoconazole-PVP and ketoconazole-HPMC-AS SDDs displayed a significant variation in concentration as the speed of centrifugation and the pore sizes of filters were altered, indicating that their supernatant was heterogeneous with the presence of particulates. In conclusion, microcentrifuge dissolution method was more suitable for indomethacin-PVP and indomethacin-HPMC-AS systems compared with ketoconazole-PVP and ketoconazole-HPMC-AS. Therefore, the use of microcentrifuge dissolution method depends on both compounds and polymers selected, which should be examined case by case.

Standardization of a Protocol for Obtaining Platelet Rich Plasma from blood Donors; a Tool for Tissue Regeneration Procedures.

BACKGROUND: To develop a protocol for obtaining autologous platelet rich plasma in healthy individuals and to determine the concentration of five major growth factors before platelet activation. This protocol could be integrated into the guidelines of good clinical practice and research in regenerative medicine. METHODS: Platelet rich plasma was isolated by centrifugation from 38 healthy men and 42 women ranging from 18 to 59 years old. The platelet count and quantification of growth factors were analyzed in eighty samples, stratified for age and gender of the donor. Analyses were performed using parametric the t-test or Pearson's analysis for non-parametric distribution. P < 0.05 was considered statistically significant. RESULTS: Our centrifugation protocol allowed us to concentrate basal platelet counts from 1.6 to 4.9 times (mean = 2.8). There was no correlation between platelet concentration and the level of the following growth factors: VEGF-D (r = 0.009, p = 0.4105), VEGF-A (r = 0.0068, p = 0.953), PDGF subunit AA (p = 0.3618; r = 0.1047), PDGF-BB (p = 0.5936; r = 0.6095). In the same way, there was no correlation between donor gender and growth factor concentrations. Only TGF-ß concentration was correlated to platelet concentration (r = 0.3163, p = 0.0175). CONCLUSIONS: The procedure used allowed us to make preparations rich in platelets, low in leukocytes and red blood cells, and sterile. Our results showed biological variations in content of growth factors in PRP. The factors influencing these results should be further studied.

Comparison of concentration methods for rapid detection of hookworm ova in wastewater matrices using quantitative PCR.

Hookworm infection contributes around 700 million infections worldwide especially in developing nations due to increased use of wastewater for crop production. The effective recovery of hookworm ova from wastewater matrices is difficult due to their low concentrations and heterogeneous distribution. In this study, we compared the recovery rates of (i) four rapid hookworm ova concentration methods from municipal wastewater, and (ii) two concentration methods from sludge samples. Ancylostoma caninum ova were used as surrogate for human hookworm (Ancylostoma duodenale and Necator americanus). Known concentration of A. caninum hookworm ova were seeded into wastewater (treated and raw) and sludge samples collected from two wastewater treatment plants (WWTPs) in Brisbane and Perth, Australia. The A. caninum ova were concentrated from treated and raw wastewater samples using centrifugation (Method A), hollow fiber ultrafiltration (HFUF) (Method B), filtration (Method C) and flotation (Method D) methods. For sludge samples, flotation (Method E) and direct DNA extraction (Method F) methods were used. Among the four methods tested, filtration (Method C) method was able to recover higher concentrations of A. caninum ova consistently from treated wastewater (39-50%) and raw wastewater (7.1-12%) samples collected from both WWTPs. The remaining methods (Methods A, B and D) yielded variable recovery rate ranging from 0.2 to 40% for treated and raw wastewater samples. The recovery rates for sludge samples were poor (0.02-4.7), although, Method F (direct DNA extraction) provided 1-2 orders of magnitude higher recovery rate than Method E (flotation). Based on our results it can be concluded that the recovery rates of hookworm ova from wastewater matrices, especially sludge samples, can be poor and highly variable. Therefore, choice of concentration method is vital for the sensitive detection of hookworm ova in wastewater matrices.

Detection of African animal trypanosomes: the haematocrit centrifugation technique compared to PCR with samples stored on filter paper or in DNA protecting buffer.

The present study aimed at comparing the trypanosome specific 18S-PCR-RFLP using samples stored either on Whatman filter papers (PCR-RFLP-fp) or in a commercial cell lysis and DNA protecting buffer (PCR-RFLP-pb) with the haematocrit centrifugation technique (HCT), a method widely used for the diagnosis of African Animal Trypanosomosis. Out of 411 head of cattle, 49 (11.92%) (CI=8.95-15.45) scored positive for the presence of trypanosomes by HCT whereas 75 (18.25%) (CI=14.63-22.33) and 124 (30.17%) (CI=25.77-34.86) scored positive using PCR-RFLP-fp and PCR-RFLP-pb, respectively. Out of the 49 positives by HCT, 14 (28.57%) (CI=16.58-43.26) and 28 (57.14%) (CI=42.21-71.18) were concordant by PCR-RFLP-fp and PCR-RFLP-pb, respectively. None of the PCR techniques detected parasites from the Trypanozoon group. Although HCT detected more cases of Trypanosoma vivax (33), species identification using PCR-RFLP-fp and PCR-RFLP-pb were significantly different (p<0.001) from the HCT technique. The use of DNA protective buffer is thus recommended as the output of the PCR-RFLP-pb is improved and the risk of contamination between samples is reduced.

[Comparison between the centrifugation on MPA C10 (Roche Diagnostics) and the centrifugation according recommendations of GEHT (Groupe d'étude de l'hémostase et de la thrombose) for the daily hemostasis assays]. / Comparaison de la centrifugation sur MPA C10 (Roche Diagnostics) et de la centrifugation selon les préconisations du Groupe d'étude de l'hémostase et de la thrombose pour les analyses d'hémostase du quotidien.

Actually, many laboratories tend to acquire pre analytic automates to prepare specimens for analysis. For haemostasis, these pre analytical modules are not always in agreement with the recommendations from the Groupe d'étude de l'hémostase et de la thrombose (GEHT). For example in the MPA C10 module (Roche Diagnostics) the speed of centrifugation was not rather fast compared with the GEHT recommandations. Then, to be able to use this automate for routine coagulation assays, we compared results of Quick time, activated partial prothombin time, fibrinogen, factor II, factor V, factor VII, factor X and antithrombin levels and unfractioned heparin anti-Xa activity measurement after MPA (1,885 g - 999 sec) or GEHT (2,500 g - 900 sec) protocol of centrifugation. First, we verified platelet counts: in 82% of specimens, the platelet counts were under 10.10(9)/L after centrifugation on MPA module. Moreover, a good correlation was observed in all comparisons. Then we concluded the MPA C10 module was usable for routine coagulation tests.

The evaluation and comparison of consecutive high speed centrifugation and LipoClear® reagent for lipemia removal.

BACKGROUND: The aim of this study was to evaluate and compare the efficiency of high speed centrifugation and LipoClear® reagent for lipemia removal in plasma samples spiked with Intralipid®, for 26 biochemistry analytes. MATERIALS AND METHODS: A plasma pool was collected. Aliquots of the pool were spiked with Intralipid® (final concentrations of 300mg/dL and 500mg/dL Intralipid®). The lipemia was removed from the aliquots by high speed centrifugation or LipoClear® reagent. 26 analytes were determined in native, lipemic plasma and in samples after lipemia removal. The bias from the concentration in the native sample was calculated for each parameter for Intralipid® concentrations, 300 and 500mg/dL of Intralipid®, respectively. Also, the recovery for each parameter after processing the samples using high speed centrifugation and LipoClear® was calculated. The biases and test recoveries were compared with the desirable specification for imprecision (DSI) according to Ricos available at the Wesgard's website. The bias and recovery for procalcitonin were compared with DSI according to Barassi and colleagues. RESULTS: The bias of the spiked samples exceeded the DSI at 300mg/L Intralipid® for creatinine, glucose, total protein, iron and albumin; and for all previously mentioned parameters including CK-MB, sodium, potassium, chlorides, magnesium and ALP at concentration of 500mg/L Intralipid®. For the test recovery the DSI criteria were not met for calcium, total protein, sodium and chlorides after high speed centrifugation and for glucose, calcium, phosphates, magnesium, sodium, potassium, chlorides, ALP, GGT, CK-MB, total protein, albumin and troponin T after using LipoClear®. CONCLUSIONS: LipoClear® is not suitable for lipemia removal from samples designated for glucose, sodium, potassium, chlorides, phosphates, magnesium, CK-MB, ALP, GGT, total protein, albumin, CRP and troponin T measurements. High speed centrifugation should be used for lipemia removal instead for glucose, potassium, phosphates, magnesium, CK-MB, ALP, GGT, albumin, CRP and TnT measurements.

Influences of nasal lavage collection-, processing- and storage methods on inflammatory markers--evaluation of a method for non-invasive sampling of epithelial lining fluid in cystic fibrosis and other respiratory diseases.

BACKGROUND: Non-invasive sampling of airway epithelial-lining-fluid by nasal lavage (NL) is an emerging method to monitor allergy, infection and inflammation in patients with respiratory diseases. However, the influences of collection-, processing- and storage-methods have not been sufficiently evaluated and standardized. METHODS: Influences of repeated NL, centrifugation setups, repeated freezing and thawing, and protease inhibitors on mediator concentration were evaluated in healthy controls and CF patients, which serve as a model for chronic bacterial infection and inflammation. Polymorphonuclear leukocyte elastase (NE)/myeloperoxidase (MPO)/interleukin (IL)-1/IL-6/IL-8 and tumour necrosis factor alpha (TNF) concentrations were measured using ELISA and Multiplex Bead-Arrays. RESULTS: NL-repetition within 0.5-4h markedly decreased NE, IL-8 and MPO-concentrations for up to 70%. NL centrifugation up to 250×g for cellular differentiation did not significantly influence mediator concentration in native and processed NL fluid. NL freezing and thawing markedly decreased IL-8 and MPO concentrations by up to 50% while NE remained stable. In contrast to preceding reports, storing at -70°C for ≥5 years led to significantly reduced mediator concentrations in NL compared to contemporary analyses, being most pronounced for IL-1ß, IL-6 and TNFa. Storing of samples in the presence of protease inhibitors led to an increase in marker concentration for IL-8 (+27%) and MPO (+15%) even after one year of storage. CONCLUSIONS: NL is an easy and robust technique for inflammation monitoring of the upper airways. For the first time we have shown that diagnostic NL should be performed only once daily to get comparable results. Whereas NL-fluid can be stored unprocessed at -70°C for cytokine analysis over 1-2 years with protease inhibitors supporting stability, ≥5 years storage as well as repeated freezing and thawing should be avoided.

The impact of centrifugation in primary care on pseudohyperkalaemia: a retrospective evaluation.

BACKGROUND: Spurious hyperkalaemia is a relatively common occurrence in samples originating from primary care. Failure to identify spurious hyperkalaemia carries a significant risk of patient mismanagement. We have carried out a retrospective evaluation to review the impact of the use of centrifuges in primary care for biochemistry blood samples on the management of hyperkalaemia. METHODS: Serum potassium concentrations in samples received from primary care were reviewed for six months prior to and after the implementation of on-site centrifugation. Samples exhibiting significant hyperkalaemia (serum potassium >6.0 mmol/L) were further investigated to ascertain the degree of patient follow-up. RESULTS: There was a significant decrease in the number of samples exhibiting marked hyperkalaemia following the implementation (2244 versus 524; P < 0.0001). In terms of patient follow-up, we observed a reduction in the number of patients exhibiting pseudohyperkalaemia that previously had led to inappropriate hospital admissions over the same time period (6 cases postimplementation versus 22 cases preimplementation). We also observed an increase in the number of patients exhibiting true hyperkalaemia during the six-month period postimplementation (33 cases postimplementation versus 6 cases preimplementation). CONCLUSIONS: The centrifugation of serum samples in primary care improves the sample quality and the integrity of the potassium results reported. We have also demonstrated evidence of an improvement in patient management and quality of care.