[Evaluation of D10 hemoglobin testing system for hemoglobin A1C assay]. / Evaluation de l'analyseur D10 pour le dosage de l'hémoglobine A1C.

Bio-Rad D10 hemoglobin testing system with rack loader for hemoglobinA1C assay was evaluated. Analytical qualities were satisfactory. Imprecision was good (within-run cv was 0,5% for 4,5% of HBA(1C), 0,63% for 7,4% of HBA1C, 0,46% for 11,1% of HBA1C, between-run cv was 1,16% for 4,7% of HBA1C, 1,01% for 7,6% of HBA1C, 1,04% for 11,2% of HBA1C). Results were very well correlated with those obtained on Bio-Rad Variant II (r = 0,998). Bland and Altman graph showed good agreement between the two methods for HbA1C under 15%. The measuring range was up to 18,3% of HBA1C. There was no specimen related carry over. Triglycerides under 5,5 mmol/L and bilirubin under 734 mumol/L did not interfere. Carbamylation of HBA1C did not interfere for urea concentration under 14 mmol/L. Practicability was very good. Detection of common hemoglobin variants (HbS, C, D, E, O) is available. Fast and easy switching between short and long program allows to perform HBA1C determination for patients with hemoglobin variants. So, D10 is an interesting and easy to use small HPLC automate witch offers accurate HBA1C quantification certified by NGSP.

Plasma itraconazole concentrations in neutropenic patients after repeated high-dose treatment.

Two different treatments with repeated oral high doses of itraconazole were tested for 10 days in 20 neutropenic patients, 10 receiving 400 mg per day and 10 receiving 600 mg per day. In each group 5 patients were treated for acute leukaemia and 5 patients were recipients of autologous bone-marrow transplantation (ABMT). Itraconazole plasma concentrations were assayed by high-performance liquid chromatography. Statistical analysis disclosed a significant interaction between the dispensed dose and the patient types. The difference between the two doses of itraconazole was greater in the ABMT than in the leukaemia patients. After 10 days at 600 mg per day all the ABMT patients had an itraconazole plasma concentration higher than 250 micrograms/l. Therefore, 600 mg per day seems more efficient to obtain a therapeutic level of itraconazole in ABMT patients but this needs to be confirmed for all the neutropenic patients.

[Interference of digoxin like immunoreactive substances with four recent reagents for digoxin determination]. / Interférence des substances digoxine like immunoréactives avec quatre réactifs récents de dosage de la digoxine.

The sensitivity of four new digoxin assay methods (on mini-Vidas bioMérieux, with Cedia reagent on Hitachi 911, with Syva Emit 2000 third generation reagent on Cobas-Mira and with Roche digoxin Online reagent on Cobas-Mira) to interference by digoxin like immunoreactive substances (DLIS) was studied in sera from 21 healthy controls, 18 pregnant women (9th month of pregnancy), 26 newborn infants and 42 patients with chronic renal failure undergoing hemodialysis. None of these individuals had been treated with digoxin or others cardiotonic drugs. For each method, results are different according to the population being studied, suggesting that the nature of DLIS is not the same. On the whole, interferences with DLIS seem to be more important in samples from newborn infants (for three methods out of four, the mean concentration of digoxin is significantly different from those observed in control samples). Digoxin assay on mini-Vidas and with Cedia reagent seems to be more sensitive to interference by DLIS, especially in samples from newborn infants and less in samples from pregnant women and patients with chronic renal failure. Online and Emit 2000 reagents seem to be poorly sensitive to interference by DLIS. However, for Emit 2000, the mean concentration of digoxin in samples from newborn infants is significantly different from the one observed in control samples. These results show that testing the sensitivity of new digoxine assay methods to interference by DLIS is very important because it can be a limitation to the use of a reagent independently of its analytical qualities.

[Determination of Hb A1c in chronic renal failure. Contribution of new methodologies]. / Dosage de l'HbA1c chez l'insuffisant rénal chronique. Apports des nouvelles méthodologies.

Carbamylated haemoglobin arises from the non-enzymatic modification of haemoglobin by cyanate derived from spontaneous dissociation of urea. We studied the in vitro and in vivo interference of carbamylated haemoglobin in the assay of HbA1c by CLHP (ion exchange), affinity chromatography (IMX, Abbott) and immunoturbidimetry (Tina-Quant, Boehringer). For patients with chronic renal failure on continuous ambulatory peritoneal dialysis, CLHP assay of HbA1c gave an error of about +0.35% per 10 mmol/L of urea serum concentration. The IMX and especially Tina-Quant assays for measuring HbA1c were not sensitive to cyanate interference and constitute interesting alternatives for monitoring glycaemic balance in patients with chronic renal failure.

[Comparative study of lipids, apoproteins and lipoproteins in patients with coronary disease and in a control population]. / Etude comparative des lipides, apoprotéines et lipoprotéines dans un groupe de sujets coronariens et dans une population témoin.

We carried out a comparative study of various lipid parameters (apo AI and B, LpAI, Lp(a) and LpBCIII) in coronary heart disease patients (19 males and 4 females, mean age 61 +/- 11 years) and in controls (18 males and 14 females, mean age 55 +/- 3 years) selected so that cholesterol and triglycerides levels be beneath 6 and 2.3 mmol/l in both populations. Apo AI and B were analysed by immunonephelometry and lipoparticles by electroimmunodiffusion. Nonparametric statistics tests were performed on account of the small numbers in both groups. Our study confirms the protective effect of Lp AI but did not show an obvious superiority of Lp AI quantification compared to apo AI. It highlights the interest of Lp(a) as an independent and additional risk factor for atherogenesis: no obvious correlation with any other lipidic parameter was demonstrated. An increase in Lp(a) beyond 0.30 g/l increases atherogenic risk 2.5 fold. We did not show any benefit of LpBCIII quantification in 'normolipemic' coronary patients. In conclusion, a discriminant analysis including the apo B/apo AI and apo B/LpAI ratios and Lp(a) allows an accurate classification of 67% of the patients.

[Otomycosis: a microbiological study of 147 cases of otitis externa]. / Otomicosis: estudio microbiologico sobre 147 casos de otitis externa.

An accurate and systematic myco- and bacteriological appraisal of each case, should comport the lowering of wrong diagnosis and also therapeutic failures in those patients. The target of the AA. is to verify the frequency and the identification as well, of bacteria and/or fungi, unique or in association, responsible for the otitis. And the objective is to start with the most appropriate treatment in spite of the laboratory answer and also to schedule a laboratory protocol to follow in suspected cases of otomycosis.

[Secretory otitis media: current aspects and therapeutic role of adenoidectomy]. / Otite media secretoria: aspetti attuali e ruolo terapeutico della adenoidectomia.

The prognostic influence of adenoidectomy on the clinical course of secretory otitis media (S.O.M.) was evaluated in 46 children with abnormal tympanometry, i.e. a flat curve (type B tympanogram) or a middle ear pressure less than 100 mm H2O (type C tympanogram). The children were divided by randomized, blind allocation into one group of 22 subjected to myringotomy with adenoidectomy and another group of 24 subjected to myringotomy without adenoidectomy. All 46 children were followed up by impedance audiometry, pure tone audiometry and otomicroscopy 1, 3, 6 and 15 months after surgery. No significant differences were found between the two groups. Possible pathogenetic mechanisms leading to the development of S.O.M. in the presence of large adenoids are discussed.

Enantioselective analysis of methadone in sweat as monitored by liquid chromatography/ion spray-mass spectrometry.

In recent years, remarkable advances in sensitive analytical techniques have enabled the analysis of drugs in unconventional samples, such as sweat. In a study conducted during a methadone maintenance program, PharmChek sweat patches were applied to 20 subjects. The subjects were orally administered methadone in 1 dosage/day, and doses ranged from 80 to 100 mg. The sweat patch was applied 10 minutes before administration and removed 72 hours later just before a new administration of methadone. The absorbent pad was stored at -20 degrees C until analysis in plastic tubes. Methadone was extracted in 5 ml methanol in presence of 200 ng of racemic methadone-d3, used as internal standard. After a 30-minute agitation, the methanol solution was evaporated to dryness. Enantioselective separation of methadone was obtained using an alpha-1-acid glycoprotein column (100 x 4 mm ID) and liquid chromatography/ion spray-mass spectrometry. In all 20 specimens obtained from subjects under racemic methadone treatment, R- (the active form) and S-enantiomers of methadone were identified with the following concentrations: 26 to 1118 ng/patch for R-methadone and 28 to 1114 ng/patch for S-methadone. The ratio between R- and S-methadone was in the range of 0.72 to 2.66 and was higher than 1.00 in 15 samples. No correlation between the doses of methadone administered and the concentrations of methadone in sweat was observed.