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HIV and Its Complications and Needlestick Injuries
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Dried blood spot monitoring for viral load has been used in some humanitarian settings but relies on availability of testing facilities and transport. Point-of-care CD4 count tests can be used alongside clinical status to monitor treatment failure. If neither viral load nor CD4 count testing is available, use indirect methods – that is, self-report, pill count and clinical assessment.
Muscle Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Kourosh Rezania, Peter Pytel, Betty Soliven
The diagnosis of acid maltase deficiency is usually established by finding of an abnormal activity of acid α-glucosidase (GAA) enzyme, which is generally used as a screening test, followed by confirmation of a disease-causing mutations using DNA analysis of the GAA gene. Finding of homozygous pathologic mutations confirms the diagnosis without testing the enzymatic activity. On the other hand, if genetic testing shows one or two variants of unclear significance, proving abnormal enzyme activity on dried blood spot, skin fibroblast culture, and blood lymphocyte culture will become necessary to conform the diagnosis. A muscle biopsy is usually not necessary to make the diagnosis of acid maltase deficiency.28, 29
Genetics and Genetic Testing in Hypertrophic Cardiomyopathy
Published in Srilakshmi M. Adhyapak, V. Rao Parachuri, Hypertrophic Cardiomyopathy, 2020
Genetic testing for HCM in India has become more accessible in the last decade. The costs associated with a genetic panel or a clinical exome have consistently fallen over the years and genetic testing in these patients has now become a practical mode of investigation. The sample of choice for genetic testing is peripheral blood, although other sources of DNA such as buccal swab, dried blood spot, and saliva are viable options.
Therapeutic drug monitoring: applying the ‘Goldilocks Principle’ to clinical pharmacology
Published in Expert Review of Clinical Pharmacology, 2023
Peter E Penson, Alice P McCloskey
Recent developments in TDM include new ways of measuring drug concentrations in the body. Laboratory-analysis of blood samples taken via phlebotomy can give very precise and accurate determinations of plasma concentrations of drugs. However, the process is invasive for the patient (not ideal for routine care), and inevitably involves a delay between taking the sample, and getting the result (not practical in emergency situations). Therefore, advancements in techniques to measure the concentrations of drugs in the body are welcome. In this issue, Touw provides a comprehensive update as to the status of saliva sampling methods, as an alternative to blood in TDM [3]. Owing to its noninvasive nature, saliva sampling is likely to be much more acceptable to patients and may increase the range of situations in which TDM is feasible. Challenges to saliva sampling include problems of sample treatment and contamination (saliva may be viscous and contains micro-organisms), and the fact that whilst blood contains both protein-bound and free drug, only the free drug can be detected in saliva. As such saliva monitoring is unlikely to replace blood monitoring in all TDM situations, but it represents an important area of development in the field [3]. Where it is necessary to use blood in drug monitoring, the process can be made less invasive by using smaller volumes of blood, and by employing capillary sampling rather than venipuncture to obtain the sample. In a comprehensive review, Muller et al. describe the benefits and challenges associated with the use of dried blood-spot sampling in TDM [4].
Prospective prediction of plasma pharmacokinetics of a novel immune-modulating agent in cancer patients after intra-tumoral administration: translation from non-clinical species to humans
Published in Xenobiotica, 2021
Ragini Vuppugalla, Ramola Sane, Michael Wichroski, Ashvini Kumar Gavai, Sarandeep Boyanapalli, Zheng Yang
For evaluating the bioavailability of Compound A following the I-TUMOUR dosing, two (2) groups of MC38 tumour bearing animals (n = 9 per group, 20–25 g) received Compound A either as an intravenous (IV) bolus dose (1 mg/kg) via the tail vein or as I-TUMOUR dose via the implanted tumour (1 mg/kg). IV and I-TUMOUR dosing were initiated when the tumours reached a median tumour volume of 100 mm3. Blood (retro-orbital bleeding) and tumour samples (∼0.2 mL) were collected at 0.083, 2, and 24 h post-dose. Within each group, 3 animals were bled at 0.083 h, the other three mice at 2 h, and the last three mice were bled at 24 h to yield a composite PK profile (3 mice per time point). Blood samples were transferred onto dried blood spot cards (10 µL × 2) and stored until analysis by LC/MS/MS method. Weighed flash-frozen tumours were homogenized in a known volume of serum. Aliquots of tumour homogenate (50 µL) were treated with acetonitrile containing internal standard (150 µL). The samples were shaken at 350 rpm for 5 min and centrifuged at 3000 rpm for 10 min. The supernatant (100 µL) was transferred to a deep well plate containing equal volume of water (100 µL) and stored at −80 °C until analysis by LC/MS/MS method. The standard curves and quality control samples were prepared in the same fashion as the study samples.
Effectiveness of intermittent preventive treatment with Sulfadoxine-Pyrimethamine in pregnant women in San Pedro, Côte D’Ivoire
Published in Pathogens and Global Health, 2021
Akoua Valérie Bedia-Tanoh, Abibatou Konaté, Akpa Paterne Gnagne, Assohoun Jean Sebastien Miezan, Pulcherie Christiane Marie Kiki-Barro, Kpongbo Etienne Angora, Kondo Fulgence Kassi, Abo Henriette Vanga-Bosson, Vincent Djohan, Eby Ignace Hervé Menan, William Yavo
In the one-month duration of this study, 200 parturients were visited at the maternity wards of the Regional Hospital Center and Terre-Rouge in San-Pedro city. Dried blood spot samples collected from three of these women were rejected because of poor quality. The average age of the participating women was 27.07 (standard deviation (SD) = 6.7 years) ranging from 15 to 45 years. The 18–40-year age range was the most represented (86.2%) (Table 2). The majority of the women were living with a partner (88.5%). Analysis of the professional characteristics of the study participants showed that among the 197 women, 55.3% were housewives, and 28% were traders (The remaining proportions are in Table 2). However, traders received more doses (three doses) of IPT-SP than the housewives, as recommended by the WHO. Most women were illiterate (56.9%); among these, 48 (43%) followed the IPT-SP correctly (Table 2).