An Alternative Method for Adrenal Venous Sampling in Cases in Which Right Adrenal Vein Sampling is Difficult

PurposeCatheterization of the right adrenal vein (rt.AdV) to obtain blood samples can often be difficult. The aim of the present study was to investigate whether blood sampling from the inferior vena cava (IVC) at its juncture with the rt.AdV can be an alternative to sampling of blood directly from the rt.AdV.Materials and MethodsThis study included 44 patients diagnosed with primary aldosteronism (PA) in whom AVS with adrenocorticotropic hormone (ACTH) was performed, resulting in a diagnosis of idiopathic hyperaldosteronism (IHA) (n=24), and patients diagnosed with unilateral aldosterone-producing adenoma (APA) (n=20; rt.APA=8, lt.APA=12). In addition to regular blood sampling, blood was also sampled from the IVC, as the substitute rt.AdV [S-rt.AdV]. Diagnostic performance with the conventional lateralized index (LI) and the modified LI using the S-rt.AdV was compared to examine the utility of the modified LI.ResultsThe modified LI of the rt.APA (0.4±0.4) was significantly lower than those of the IHA (1.4±0.7) (p<0.001) and the lt.APA (3.5±2.0) (p<0.001). The modified LI of the lt.APA was significantly higher than those of the IHA (p<0.001) and rt.APA (p<0.001). Sensitivity and specificity to diagnose rt.APA and lt.APA using the modified LI with threshold values of 0.7 and 2.2, respectively, they were 87% and 75%, respectively, and 94% and 94%, respectively.ConclusionThe modified LI has the potential to be an alternative method for rt.AdV sampling in cases in which rt.AdV sampling is difficult. Obtaining the modified LI is extremely simple, which might complement conventional AVS.

Improving the Quality of EDTA-treated Blood Specimens from Mice

Nonterminal blood sampling in laboratory mice is a very common procedure. With the goal of improving animal welfare, different sampling sites and methods have been compared but have not achieved a consensus. Moreover, most of these studies overlooked the quality of blood specimens collected. The main preanalytical concern with EDTA-treated blood specimens for hematology analyses is platelet aggregation, which is known to cause analytical errors. Our objective was to find a nonterminal blood sampling method with minimal adverse effects on mice and few or no platelet aggregates. We tested and compared 2 collection sites, 4 sampling methods, and 3 antithrombotic drugs in 80 C57BL6/j male and female mice by evaluating platelet aggregates on blood smears and platelet, WBC, and RBC counts. In addition, the blood collection process was carefully evaluated, and adverse effects were recorded. Platelet aggregation was lower in specimens collected from the jugular vein than from the facial vein, with no effect of the sampling device or the presence of an antithrombotic additive. Highly aggregated specimens were significantly associated with lower platelet counts, whereas aggregation had no effect on WBC or RBC counts. Adverse events during sampling were significantly associated with more numerous platelet aggregates. The jugular vein is thus a satisfactory sampling site in mice in terms of both animal welfare and low platelet aggregation. Using antithrombotic agents appears to be unnecessary, whereas improving sampling conditions remains a key requirement to ensure the quality of EDTA-treated blood specimens from mice.

Comparison of the effects of open-tube and evacuated tube–assisted sampling methods on thromboelastography variables for blood samples from healthy dogs

OBJECTIVE To compare the effects of open-tube blood sampling with previously investigated blood sampling methods via evacuated tube on thromboelastography variables for blood samples from dogs. ANIMALS 10 healthy Beagles from the research colony owned by the Clinic of Small Animal Internal Medicine, University Veterinary of Medicine, Vienna, were used. PROCEDURES In this prospective study, blood was sampled from each dog serially into citrate solution–containing tubes via 20-gauge needle. One evacuated tube was filled from a jugular vein via the evacuated tube port, and the second tube was opened and filled by catching blood flowing through the needle from a lateral saphenous vein. Venipuncture quality was scored with a previously described method. Thromboelastography was performed for each sample. RESULTS Inferential statistics used with the Wilcoxon signed rank test showed significant differences in reaction time (R) of 3.43 ± 0.84 minutes versus 4.53 ± 0.62 minutes (mean ± SD) between evacuated tube assisted and open-tube sampling, respectively. No other significant differences were identified. CLINICAL RELEVANCE The sampling methods compared have a small but significant effect on R in thromboelastographic analysis for blood samples from healthy dogs. Shear stress by vacuum sampling seems to accelerate coagulation in jugular blood samples harvested by evacuated tube, resulting in a shortened R. Results suggested that the open-tube method avoids shear stress induced activation of coagulation and is an appropriate sampling method for thromboelastography when used within a standardized protocol.

Situasi Filariasis Limfatik di Daerah Pasca Pemberian Obat Pencegahan Massal (POPM) dan Pasca Eliminasi di Kabupaten Tanjung Jabung Timur dan Belitung

East Tanjung Jabung Regency, Jambi did not pass in the Pre-Transmission Assessment Survey (Pre-TAS) in 2017, while Belitung, Bangka Belitung has a microfilaria rate (Mf rate) >1% even though it has passed TAS 1,2, and 3. The purpose of this study is to identify the program implementation control of lymphatic filariasis in East Tanjung Jabung Regency and Belitung Regency. The research was conducted in four villages, namely of Rantau Rasau 2, Nibung Putih (East Tanjung Jabung), Lasar, and Suak Gual (Belitung). Blood sampling was conducted on 1,919 people aged 5-70 years, while interviews were conducted on 900 people aged >16 years. The results of blood tests in East Tanjung Jabung were not found positive for mf, while in Belitung, 33 people were found positive for mf. The results of the risk estimate analysis of the respondent's knowledge, attitude and behavior factors indicate that respondents who live in East Tanjung Jabung Regency have a better level of knowledge, attitudes, and behaviour towards lymphatic filariasis t han respondents who live in Belitung Regency. Keywords: lymphatic filariasis, elimination, risk factor Abstrak Kabupaten Tanjung Jabung Timur, Jambi tidak lulus dalam Survei Penilaian Pra Transmisi (Pre-TAS) tahun 2017, sedangkan Belitung, Bangka Belitung memiliki angka mikrofilaria (Mf rate) >1% padahal sudah lolos TAS 1,2, dan 3. Tujuan penelitian ini adalah untuk mengidentifikasi pelaksanaan program pengendalian penyakit filariasis limfatik di Kabupaten Tanjung Jabung Timur dan Kabupaten Belitung. Penelitian dilakukan di empat desa, yaitu Rantau Rasau, Nibung Putih (Tanjung Jabung Timur), Lasar dan Suak Gual (Belitung). Pengambilan sampel darah dilakukan pada 1.919 orang berusia 5-70 tahun, sedangkan wawancara dilakukan pada 900 orang berusia >16 tahun. Hasil tes darah di Tanjung Jabung Timur tidak ditemukan positif mf, sedangkan di Belitung, 33 orang ditemukan positif mf. Hasil analisis estimasi risiko faktor pengetahuan, sikap dan perilaku responden menunjukkan bahwa responden yang berdomisili di Kabupaten Tanjung Jabung Timur memiliki tingkat pengetahuan, sikap, dan perilaku yang lebih baik terhadap filariasis limfatik dibandingkan responden yang berdomisili di Kabupaten Belitung. Kata kunci: filariasis limfatik, eliminasi, faktor risiko