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PubMedDate not supplied

A neonatal screening in Lebanon: Results of five years' experience.

BACKGROUND: Neonatal screening programs for common disorders like phenylketonuria, congenital hypothyroidism, and glucose-6-phosphate dehydrogenase (G6PD) deficiency are not fully established at the national level in Lebanon. Screening for the above disorders was carried out for newborns delivered at the American University of Beirut Medical Center over a period of five years. SUBJECTS AND METHODS: Blood specimens collected 2-3 days after birth were applied to neonatal screening blood collection cards. A total of 9117 newborns were screened using phenylalanine, thyroid-stimulating hormone, and G6PD activity measurements on blood spots. RESULTS: One case of phenylketonuria and another of hyperphenylalaninemia were detected. We also detected 5 cases of permanent type of congenital hypothyroidism, giving an incidence of 5:9117 (1:1823). The age range at initiation of hormonal replacement therapy was 9-46 days. The overall incidence of G6PD was 106:9117 (1:86 or 1.16%), of which 84 had complete deficiency (1:109 or 0.92%), and 22 with intermediate activity. CONCLUSION: The incidence of these disorders found in this Lebanese sub-population warrants consideration of a comprehensive nationwide neonatal screening program.

Journal Article↗
PubMed1994

Isopropanol interference with breath alcohol analysis: a case report.

The presence of interfering substances, particularly acetone, has historically been a concern in the forensic measurement of ethanol in human breath. Although modern infrared instruments employ methods for distinguishing between ethanol and acetone, false-positive interferant results can arise from instrumental or procedural problems. The case described gives the analytical results of an individual arrested for driving while intoxicated and subsequently providing breath samples in two different BAC Verifier Datamaster infrared breath alcohol instruments. The instruments recorded ethanol results ranging from 0.09 to 0.17 g/210 L with corresponding interferant results of 0.02 to 0.06 g/210 L over approximately three hours. Breath and venous blood specimens collected later were analyzed by gas chromatography and revealed in the blood: isopropanol 0.023 g/100 mL, acetone 0.057 g/100 mL and ethanol 0.076g/100 mL. Qualitative analysis of the breath sample by GCMS also showed the presence of all three compounds. This individual had apparently consumed both ethanol and isopropanol with acetone resulting from the metabolism of isopropanol. An important observation is that the breath test instruments detected the interfering substances on each breath sample and yet they did not show tendencies to report false interferences when compared with statewide interferant data.

1-Propanol↗
PubMed1988

Transfusion therapy in emergency medicine.

Volume replacement is critical to the resuscitation of the hemorrhaging patient, but this usually can be accomplished quickly and safely with crystalloid and/or colloid solutions. Red cells should be used in addition to asanguinous fluids in the treatment of tissue hypoxia due to anemia. The need for whole blood as opposed to packed red blood cells is controversial. However, plasma should not be used as a volume expander, and its use to supplement coagulation factors during the massive transfusion of red cells should be guided by laboratory tests that document a coagulopathy. Similarly, platelet transfusions are indicated to correct documented thrombocytopenia or platelet dysfunction, and routine prophylaxis after fixed volumes of red cells results is unwarranted. Many anticipated complications of massive transfusions, including hemostatic abnormalities, acid-base imbalances, hyperkalemia, and hypocalcemia, are uncommon or of limited clinical significance. The risks of immune hemolysis and transfusion-transmitted diseases, on the other hand, are significant, and argue for judicious use of blood components. In emergencies in which blood is required immediately before compatibility testing can be completed, O-negative uncrossmatched blood can be requested. Careful blood specimen collection and patient identification prior to transfusion are critical. Practices that emphasize blood conservation, including the use of autologous salvaged blood, are always to the patient's advantage.

Blood Grouping and Crossmatching↗
PubMedDate not supplied

Amateur radio operators and exposure to polychlorinated biphenyls.

In September, 1982, the Special Studies Branch, Chronic Diseases Division, Center for Environmental Health, Centers for Disease Control, was alerted to the possibility that oils in certain oil-filled devices used by amateur radio operators throughout the country were contaminated with polychlorinated biphenyls (PCBs). To evaluate the possible exposures and concomitant health risks, we conducted an exposure assessment study in two phases: an evaluation of the prevalence of environmental contaminations and an assessment of human exposure. Of 77 oil samples collected, only 2 were contaminated above a 50-ppm level; analyses of blood specimens collected from these two owner-operators showed serum PCB-levels which were well within a "normal" or expected background range. Although, on the basis of these limited data, PCBs from contaminated oils do not appear to be a hazard to amateur radio operators, we recommend that PCB-contaminated oils should not be used because of the continuing potential for exposure from either inhalation or direct contamination.

Adult↗
PubMed1994

Detection of a wide range of medically important fungi by the polymerase chain reaction.

A polymerase chain reaction (PCR) method was developed that was capable of detecting a wide range of medically important fungi from clinical specimens. The primer pair was designed in conserved sequences of 18S-ribosomal RNA genes shared by most fungi. The lower limit of detection of this PCR technique was 1 pg of Candida albicans genomic DNA by ethidium bromide staining and 100 fg after Southern analysis. A 687-bp product was amplified successfully by PCR from all 78 strains of 25 medically important fungal species studies, including Candida spp., Hansenula spp., Saccharomyces cerevisiae, Cryptococcus neoformans, Trichosporon beigelii, Malassezia furfur, Pneumocystis carinii, Aspergillus spp., and Penicillium spp., but not from any strains of Mucor spp., Escherichia coli, or methicillin-resistant Staphylococcus aureus (MRSA), calf thymus or human placenta. This specificity was subsequently confirmed by Southern analysis. PCR analysis of blood specimens collected from mice systemically infected with C. albicans and clinical samples including blood, cerebrospinal fluid and sputum appeared to be a more sensitive diagnostic method for invasive fungal infections than a conventional blood culture technique.

Animals↗
PubMed2001

Real-Time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) for the measurement of prostate-specific antigen mRNA in the peripheral blood of patients with prostate carcinoma using the taqman detection system.

Circulating prostate cells can be detected in peripheral blood of patients with clinically localized or advanced prostate carcinoma. Traditionally, nested reverse transcriptase-polymerase chain reaction (RT-PCR) is used for this as a sensitive, but qualitative only, detection system. We developed a quantitative real-time RT-PCR method for measuring prostate-specific antigen (PSA) mRNA in peripheral blood of prostate cancer patients. A quantitative assay was developed using an external standard reference curve generated with RNA from the human prostate cell line LNCaP. Basal blood samples were collected from 44 patients without evidence of distant metastases and from 30 healthy controls. In 29 patients surgically treated with radical prostatectomy, the measurement of PSA mRNA was performed in blood samples collected before, at the end and 6 days after surgery. In 14 patients treated with radiotherapy, the measurements were repeated at 3-month intervals to evaluate time-related changes during therapy. The measurements were also performed for one year at 3-month intervals in one patient treated with anti-androgen therapy. We found detectable PSA mRNA in 14/44 (32%) basal blood samples. A wide range of values were observed in these patients, ranging from 0.5 to 1724 pg of total LNCaP RNA/ml blood. In patients undergoing radical prostatectomy, circulating PSA mRNA was detectable in eight patients in basal samples, and in seven of them also in blood specimens collected at the end of surgery, showing an increase in only two patients. In blood samples collected 6 days later, PSA mRNA was dramatically reduced in all patients, but still present in seven of them. In four patients, whose basal samples were negative, PSA mRNA was detectable in samples collected at the end of surgery and three of them were negative after 6 days. In patients who did not receive surgical treatment, a rapid decrease in PSA mRNA was demonstrated in five patients treated with radiotherapy and in one patient undergoing androgen deprivation. No detectable PSA mRNA was found in healthy controls. The levels of PSA mRNA in peripheral blood from patients with prostate carcinoma can be easily measured by this sensitive, quantitative and reliable procedure. This assay is a promising tool for the detection and follow-up of these patients.

Adenocarcinoma↗
PubMed1995

Aprotinin prolongs whole blood activated partial thromboplastin time but not whole blood prothrombin time in patients undergoing cardiac surgery.

Aprotinin is being used increasingly to limit cardiopulmonary bypass (CPB)-induced coagulation derangements. Since whole blood prothrombin time (PT) and activated partial thromboplastin time (APTT) assays are beneficial in the treatment of bleeding after CPB, we studied the potential effect of aprotinin on these whole blood assays. Blood specimens from 151 cardiac surgical patients were obtained in two phases: prior to heparin administration, before CPB, and subsequent to heparin neutralization after CPB. After collection, blood specimens were divided into two aliquots and mixed with either normal saline (NS) or aprotinin (A, 200 or 400 Kallikrein inhibiting units (KIU)/mL). Whole blood specimens were used to measure whole blood PT and APTT using CoaguChek Plus instruments. Whole blood PT results were similar between normal saline. (NS)- and aprotinin-spiked specimens before CPB (A, 12.9 +/- 1.5s; NS, 12.8 +/- 1.5s; P = 0.76) and after CPB (A, 17.5 +/- 2.4s; NS, 17.7 +/- 2.4s; P = 0.58). In contrast, whole blood APTT results were prolonged in aprotinin-spiked specimens prior to CPB (A, 63.3 +/- 32.2s; NS, 38.6 +/- 16.3s; P < 0.0001) and after CPB (A, 65.9 +/- 23.7s; NS, 45.7 +/- 14.4s; P < 0.0001). A dose-dependent prolongation of whole blood APTT by aprotinin was demonstrated by a greater mean difference in APTT (P = 0.0001) between specimens spiked with NS or 200 KIU (17.5 +/- 12.2s) vs 400 KIU (27.8 +/- 21.5s) of aprotinin.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1977

The blood groups and other heriditary blood factors of Yemenite and Kurdish Jews.

Blood specimens collected fro Yemenite and Kurdish Jews living in Israel were tested for 11 blood group systems 5 plasma protein systems and 9 systems of red-cell enzymes. The results of these tests were combined with those of tests on other Yemenite and Kurdish Jews, reported by Godber et al. (1973), the total data sorted according to the place of origin of the subjects or their parents in the Yemen Arab Republic and Kurdistan respectively. Gene frequencies were calculated for each of the local populations so defined. It is confirmed that the Yemenite Jews show a close relationship to the Yemenite Arabs, but those from the southern part of the Yemen Arab Republic have a higher frequency of African marker genes than those in the north. The Habbanite Jews have a similar rather high frequency of African genes (Bonné et al., 1970). The Kurdish Jews from Iran and northern-western Iraq show a moderate genetic resemblance to the indigenous Kurds of Iran, while those from south-eastern Iraq differ considerably, especially in their low frequency of A1, high B, high CDe (R1) and low cde (r).

Blood Group Antigens↗
PubMed1993

Sequence analysis of human T cell lymphotropic virus type I strains from southern India: gene amplification and direct sequencing from whole blood blotted onto filter paper.

Human T cell lymphotropic virus type I (HTLV-I) infection in India has been found to be associated with adult T cell leukaemia/lymphoma (ATLL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP) among life-long residents of southern India. To examine the heterogeneity of HTLV-I strains from southern India and to determine their relationship with the sequence variants of HTLV-I from Melanesia, 1149 nucleotides spanning selected regions of the HTLV-I gag, pol, env and pX genes were amplified and directly sequenced from DNA extracted from whole blood blotted onto filter paper and from peripheral blood mononuclear cells, obtained from one patient with HAM/TSP, two with ATLL and eight asymptomatic carriers from Andhra Pradesh, Kerala and Tamil Nadu. Sequence alignments and comparisons indicated that the 11 HTLV-I strains from southern India were 99.2% to 100% identical among themselves and 98.7% to 100% identical to the Japanese prototype HTLV-I ATK. The majority of base substitutions were transitions and silent. No frameshifts, insertions, deletions or possibly disease-specific base changes were found in the regions sequenced. The observed clustering of the Indian HTLV-I strains with those from Japan, as determined by the maximum parsimony method, suggested a common source of HTLV-I infection with subsequent parallel evolution. Amplification of DNA from blood specimens collected on filter paper may be useful for the study of other blood-borne pathogens.

Adolescent↗
PubMed2006

Nonsteroidal antiinflammatory drugs, cyclooxygenase polymorphisms, and the risk of developing breast carcinoma among women with benign breast disease.

BACKGROUND: Biopsy-proven benign breast disease (BBD) is a risk factor for developing breast carcinoma; however, to the authors' knowledge, little is known regarding factors related to progression to carcinoma. A cohort study was conducted to examine the role of cyclooxygenase (COX) polymorphisms and nonsteroidal anti-inflammatory drugs (NSAIDs) in the progression of BBD to breast carcinoma. METHODS: Among participants in an ongoing cohort study, 1467 women underwent a breast biopsy for BBD. Of these women, 91 subsequently developed breast carcinoma. Medication data were collected in 1989 and in 1996. COX genotypes were determined using DNA extracted from blood specimens collected in 1989. RESULTS: A decrease in breast carcinoma risk was observed among women who reported using aspirin in 1989 (odds ratio [OR] of .46; 95% confidence interval [95% CI], .22-.98) and in 1996 (OR of .47, 95% CI, .18-1.21). Furthermore, a higher frequency, dose, and longer duration of aspirin use were associated with a decrease in the odds of developing breast carcinoma. Overall, no association was observed between COX genotypes and the subsequent development of breast carcinoma. However, among women not using NSAIDs, one COX-2 polymorphism (rs2143416) was found to be significantly associated with the development of breast carcinoma. CONCLUSIONS: Findings from the current study suggest that inflammation through COX-2 pathways may play a role in the progression of BBD to breast carcinoma and that aspirin may help to lower the risk of progression to breast carcinoma among women with BBD.

Adult↗
PubMed1992

Management of the feline blood donor.

The feline blood donor should be considered a valuable asset to the veterinary clinic. As public awareness increases, so will the demand for high-quality blood products. Meeting this demand will require planning and a blood donor management program tailored to the clinic's needs. Consideration should be given to the areas of blood value, donor selection, blood collection, and maintaining donor health when developing a donor management program. Suggestions for reducing the stress and aggravation often associated with feline blood collection are provided.

Animals↗