S. Aeschbacher1, T. Schoen1, M. Risch2, L. Risch2, D. Conen1
1University Hospital Basel, Department of Internal Medicine, Basel, Switzerland, 2Labormedizinisches Zentrum Dr Risch, Schaan, Liechtenstein
Purpose: Several studies have shown a strong relationship between smoking and type 2 diabetes. However, it is unclear whether smoking is related to changes in glucose homeostasis in young adults without prevalent type 2 diabetes and with a relatively short smoking history. We aimed to assess the association between smoking and prediabetes in young and healthy adults. Method: The GAPP study is a population based cohort of healthy adults aged 25-40 years in the Principality of Liechtenstein. Individuals with diabetes, body mass index >35 kg/m² and prevalent cardiovascular disease were excluded. Smoking behaviour was assessed by self-report. Pack years (py) of smoking were calculated by multiplying the number of years smoked by the average number of cigarette packs smoked per day. HbA1c was assayed from fasting venous blood samples using HPLC (Bio-Rad D-10). Prediabetes was defined as an HbA1c between 5.7 and 6.4%. Results: Of 857 participants, 231 (27%) had prediabetes. Compared to normoglycemic subjects, prediabetics were significantly older (40 vs 38 years, p=0.0002), more often male (57 vs 43%, p=0.001), and they had a higher BMI (24.9 vs 23.9 kg/m²,p=0.0001). The prevalence of active smokers among prediabetic and normoglycemic subjects was 29% and 19%, respectively (p=0.0003), with a median number of pack years among current smokers of 11.3 (5.8-18.8) and 5.9 (3.8-13.5), respectively (p=0.003). In age- and sex-adjusted logistic regression models using prediabetes as the outcome variable, current smoking was significantly associated with prediabetes (OR 1.79 (95% CI 1.24-2.59), p=0.002). This association remained significant after additional adjustment for BMI, hypertension, alcohol consumption and cholesterol (1.73 (1.19-2.51), p=0.004). Former smoking was not significantly related to prediabetes (0.76 (0.51-1.13),p=0.18). Compared to never and past smokers, current smokers with<5, 5 to 10 and >10 py had an OR (95% CI) of 1.07 (0.53-2.13), p=0.86; 2.09 (1.08-4.07), p=0.03; and 2.22 (1.34-3.68), p=0.002, respectively. Conclusion: Accumulating as few as 5-10py of smoking carries a more than 2-fold increased risk of having prediabetes in healthy young adults.
S. Belhadj1, R. Dabboubi1, E. Kaouech1, K. Kallel1, E. Chaker1
1Laboratoire de Parasitologie-Mycologie Hôpital La Rabta 1007 Tunis, Tunisie
Les parasitoses intestinales occupent une place non négligeable en pratique médicale courante. Le profil étiologique de ces parasitoses n’est jamais définitif ;il subit constamment des modifications liées au développement socio-économique et à l’amélioration des conditions d’hygiène de la population tunisienne. L’étude rétrospective de 9961 examens parasitologiques des selles ,1467 scotch-test anaux et 131 écouvillonnages rectaux réalisés durant une période de 5 ans (2007-2011) chez des patients adressés par les différents services hospitaliers et les dispensaires de la région de Tunis, nous a permis de constater que:
- La prévalence des parasitoses intestinales dans la région de Tunis est de 11,56 %.
- La majorité des parasites identifiés sont des protozoaires : 65,63 %.
- 69,02 % des parasites identifiés sont potentiellement pathogènes.
- 61656; Oxyure (32,81 %), Giardia lamblia (12,68 %) et Dientamoeba fragilis (17,15 %) sont les parasites pathogènes les plus rencontrés.
La comparaison de nos résultats avec ceux rapportés dans la littérature tunisienne a montré une nette diminution de la prévalence globale de parasitoses intestinales, une diminution de la prévalence de la giardiase et une augmentation significative de la prévalence de l’oxyurose.
N. Donzé1, L. Fornerod2, A. Chiolero2, R. Bonvin2, M. F. Rossier1, M. Augsburger3
1Central Institute of Valais Hospital (ICHV), Switzerland, 2Observatoire valaisan de la santé (OVS), Sion, Switzerland, 3University Center of Legal Medicine, Lausanne, Switzerland
Introduction: Inspired by the "DAWN" which presents an estimation of drug-related visits to hospital emergency departments (EDs) in USA, we assessed the number of drug-related visits to hospital emergency departments in one canton of Switzerland, in Valais were about 300'000 people are living. Aims: This study aims at characterizing the drug-related visits to Valais Hospital emergency departments (EDs) between 2007 and 2011, based on data from the ICHV and the OVS. Methods: All patients entered into the ED since 2007 to 2011 in the Valais Hospital’s sites of Brig, Visp, Sierre, Sion (pediatric and general ED) and Martigny were considered. Two kinds of requested toxicological analyses were analyzed: screenings of drugs of abuse (DOA: acetominophen, amphetamine, metamphetamine, barbiturates, benzodiazepines, cannabinoids (THC), cocaine, methadone, opiates, PCP, TCA) by immunological test (Triage®, Biosite) in urine and measure of ethanol in serum with colorimetric method (Cobas 6000 Roche®). The results for DOA test were qualitative (positive or negative) and the result for alcohol was quantitative (g/kg). Results: The total number of ED visits between 2007 and 2011, increased from 64'725 to 69'867 (8 %). The number of requests for DOA or/and alcohol increased from 1922 to 2381 (24 %) as well. It has been observed that the percentage of requests for DOA or/and alcohol among ED visits presents a light increase (3.0 % to 3.4 %). The number of requests for DOA only presents an increase of 71 % between 2007 and 2011. The two drugs most frequently detected are the THC and the benzodiazepines. When a request for alcohol is demanded, a positive result appears in about 70 % of the cases. Conclusions: In Valais Hospital, the percentage of drug-related visits to hospital emergency increased from 3.0 % to 3.4 % of all ED visits between 2007 and 2011. Alcohol was the drug most frequently investigated and found. The number of DOA investigations increased between 2007 and 2011, and benzodiazepines and THC were the two drugs the most frequently found. The rate of positivity was stable during this period. Key Words: DOA, blood alcohol, emergency departments.
B. Büchel1, J. Sistonen1, Y. Aebi1, C. R. Largiadèr1
1Institute of Clinical Chemistry, Inselspital, Bern University Hospital, and University of Bern, Bern, Switzerland
5-Fluorouracil (5-FU) is one of the most commonly used drugs for the treatment of solid carcinomas. Substantial inter-patient variability has been observed in the 5-FU blood levels at standard doses leading to reduced efficacy of the treatment as well as to severe to life-threatening toxicities. Monitoring the 5-FU blood levels and guiding the dosing of the drug accordingly can help to reach the optimal drug levels (area under the curve of 20-25 mg*h/L in plasma (1)), and therefore, to improve the treatment efficacy and to decrease the amount of serious adverse effects. This study aimed to evaluate the performance of the My5-FU™ immunoassay (Saladax Biomedical Inc.) on the Cobas Integra® 800 (Roche Diagnostics) in terms of intra- and inter-assay accuracies (%bias) and precisions (%CV), and two- to ten-fold dilution integrity. Results obtained from plasma samples containing 5-FU using the My5-FU™ assay were compared to those obtained with a validated LC-MS/MS assay. Proportional and constant bias was determined by Passing-Bablok regression analysis. Intra- and inter-assay accuracies and precisions of the My5-FU™ assay were within the generally accepted range of ±15%. The assay displayed linearity over a concentration range of 53-1800 ng/mL, which includes typical drug levels observed in patients (e.g. in 48 h of 5-FU infusion; typical range 180-900 ng/mL after 2 h of infusion). Dilution integrity was met up to ten-fold. The results obtained with the immunoassay and the LC-MS/MS methods showed a correlation of r = 0.998. Passing-Bablok regression analysis yielded an equation of 1.03*LC-MS/MS (ng/mL) -12.3 (95% CI intercept: -19.3 to 2.22; 95% CI slope: 1.01 to 1.05). In conclusion, the My5-FU™ immunoassay showed acceptable validation measures and the results from human plasma samples were comparable to those obtained using LC-MS/MS. The short turnaround time and the feasibility of the My5-FU™ assay make it an optimal choice for routine clinical diagnostics. 1. Gamelin E, Delva R, Jacob J, Merrouche Y, Raoul JL, Pezet D, Dorval E, Piot G, Morel A, Boisdron-Celle M. J Clin Oncol 2008;26:2099-105.
R. Fingerhut1, W. Röschinger2, M. Heck3
1University Children`s Hospital, Zurich, Switzerland, 2Laboratory Becker, Olgemöller & Colleagues, Munich, Germany, 3Waters, Baden-Dättwil, Switzerland
Newborn screening for maple syrup urine disease (MSUD) is a special challenge since patients with MSUD can metabolically decompensate rapidly without adequate treatment within the first two weeks of life. However, the screening method does not detect the actual marker metabolite (allo-isoleucine) specifically, but only as part of the group of the other isobaric amino acids leucine, isoleucine and hydroxyproline. We describe a sensitive and rapid second-tier UPLC method by which the branched-chain amino acids can be determined already within the initial extraction of the screening sample. Quantification is based on a 7-point calibration curve. The method can also be used for therapy monitoring in patients with MSUD. Reference ranges (mean ± SD in µmol/L) were determined from 179 normal, not pre-selected samples from the newborn screening: Leucine: 72 ± 27; isoleucine: 37 ± 19; valine: 98 ± 46; hydroxyprolin: 23 ± 13. The concentration of allo-isoleucine was in about 55% of the cases below the detection limit, the highest concentration was 1.9 µmol/L. In all 23 retrospectively studied screening samples from patients with confirmed MSUD the concentration of allo-isoleucine was significantly increased. In 9 samples with false-positive newborn screening due to significantly increased concentration of leucine + isoleucine (400 to >4000 µmol/L) allo-isoleucine could not be detected.
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