Annales de biologie clinique最新文献

Nosocomial infections (NI) are a major concern of healthcare professionals. To propose targeted awareness-raising campaigns, we put in place NI monitoring of laboratory data. The positive bacteriological results after 48 hours hospitalisation are subject of a report via the Infection Control Team, to the physician corresponding in the department, for the clinical validation of diagnostic of NI. At hospital level and specialty activity, we measured NI incidence rates for 1 000 hospital days and for 100 admissions every month since October 1, 2016. Results were then declined by specialties and by infected anatomical site and investigation allowed to describe the microbial flora responsible for these infections. The request began in october 2016. Average results were stable over the year despite monthly fluctuations. For 2023, incidence rates are IAS 2,8 for 1 000 JH and IAS 1,2 for 100 admissions. The detail of the results is transmitted to the physicians and is the subject of internal communications. They will be allowed to follow up more closely with the NI epidemiology and propose targeted corrective measures as appropriate.

Polycythemia, characterized by an abnormal increase in red blood cells, can manifest as primary polycythemia (PV) or secondary polycythemia, often due to conditions like obstructive sleep apnea (OSA) and high-altitude polycythemia (HAP). Understanding the molecular mechanisms underlying these conditions is crucial for developing targeted therapies. Transcriptome analysis was performed to identify differentially expressed genes (DEGs), significant modules, and immune cell infiltration. We identified 370 DEGs and four significant gene co-expression modules closely related to HAP. Modules were associated with neutrophil migration, glycoprotein metabolism, UDP-N-acetylglucosamine synthesis, and red pulp cells. These modules showed the same directions of change in OSA but were reversed when treated with continuous positive airway pressure therapy. Comparison with GWAS showed that overlapping genes were related to oxygen transport in the DEGs. PRDM1 and NCOA1, NFE2 were identified as key transcription factors. Noca1 knockout mice showed elevated levels of red blood cell count (RBC), hemoglobin (HGB), and hematocrit (HCT). Lomustine and hydralazine emerged as potential candidate drugs for treating polycythemia. Abdominal breathing training for three months improved symptoms and reduced RBC, HGB, and HCT in 33 HAP patients. These findings elucidate HAP's molecular mechanisms and suggest new therapeutic directions.

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by loss of B cell tolerance to self antigens resulting in the production of a wide variety of auto antibodies. The objective of this study was the assessment of serum free light chains (FLC) assay in patients with SLE. In this study, 156 patients (142 women and 14 men, mean age 35.6 years) and 60 healthy subjects (55 women and 5 men, mean age 36.4 years) were included. The kappa (κ) and lambda (λ) FLC were measured by turbidimetry method. The analysis of our results showed that the FLC rates κ and λ were significantly higher in patients compared to controls (44.52 vs. 8,55 mg/L, P = 0.0001 for FLC κ and 33.43 vs. 12,99 mg/L, P = 0.0001 for FLC λ). In addition, significant associations were noted between the increase in FLC κ, λ and disease activity (P = 0.006 and P = 0.008 respectively), as well as with the presence of lupus nephritis (P = 0.044 and p = 0.045). The increase of the serum FLC during SLE could be a useful marker for assessing the disease activity and the risk of lupus nephritis.

Available data on the potential use of thrombin generation (TG) assays in clinical practice is promising but larger studies involving several centers are needed to confirm this added-value for clinical purposes. The objective of this evaluation was to assess the analytical performances of the ST Genesia using STG-ThromboScreen, STG-BleedScreen, and STG-DrugScreen reagents across three centers to support its use in multicenter studies. Repeatability and reproducibility have been evaluated using commercial plasmas and quality control (QC) samples. Accuracy was assessed by calculating QC biases from the manufacturer's assigned values. Frozen plasma samples from healthy donors and patients having thrombophilia, hemorrhagic disorders, or taking anticoagulants allowed the comparison of TG parameters between the analyzers from two French centers. Repeatability and reproducibility CVs were respectively below 5% and 10% whatever the reagent and the sample used. The later fell under 6% after normalization. Mean biases between observed and assigned QC values provided by the manufacturer were less than 5% for most TG parameters. We found a good agreement for all TG parameters between the two evaluating centers. Relative bias was below 5% for all combination of parameters and reagents except for Peak height (+14.2%), ETP (+7.3%), and ETP inhibition (-12.0%) using STG-ThromboScreen. We found satisfactory repeatability, reproducibility, accuracy, and inter-laboratory variability for TG parameters using the three available reagents across three centers, supporting the use of ST Genesia in multicenter clinical trials.

The "Emergency Biology" working group of the French Society of Clinical Biology (SFBC) presents in this article its recommendations for the application of article L6211-18 of the Public Health Code, when the analytical phase of a medical biology examination cannot be carried out in a medical laboratory within a time frame compatible with the patient's state of health. A proposal for a list of examinations that may be carried out outside the laboratory (point-of-care testing - POCT) is made, by associating the elements justifying this delocalization: clinical contexts concerned and maximum time limits for carrying out the examination in these contexts if the examination is carried out within the LBM. These recommendations are to be adapted within the framework of local clinic biological agreements.

HBA1c testing is a health indicator for pre-diabetes identification or diabetes detection and follow-up. Simplifying collection and transport of blood samples for HBA1c measurement remains of great interest. Capillary dried blood spots (DBS) sampling has been proposed as a potential alternative to classical whole blood (WB) venipuncture, however, international analytical and clinical validation of DBS use is necessary before implementation. We aimed in the present study to assess the performance, clinical acceptability and analyte stability (at 20-25°C, +4°C, -20°C) of DBS sampling method compared to WB. The study enrolled 40 participants. Obtained WB were applied to Whatman 903 protein blotting paper. Prepared DBS samples were compared to WB samples kept in EDTA collection tubes using the Bio-Rad D-10 IEX-HPLC instrument. Statistical analysis was carried out using IBM SPSS Statistics 29.0.1.0 and NCSS v23-0-2 software programs. Agreement (LCCC = 0.982; limits of agreement M ± 1.96SD: -0.45; 0.48) and correlation (PCC = 0.990) between DBS and WB results were excellent. Also, repeatability (CV = 1.13) and clinical conformity (K = 0.80) of the values obtained on DBS were found to be highly satisfactory. Our results clearly showed that DBS sampling could be an efficient alternative to WB venipuncture for HBA1c measurement.

Preparation for the national pharmacy internship competition is a demanding challenge that requires rigor and tenacity. At the Bordeaux university, student tutoring is available to support candidates through this challenge, relying on kindness and mutual aid. Led by volunteer interns or future interns who have already successfully navigated this stage, this system provides regular guided lessons, access to shared educational resources and mock training sessions. It's structured around the courses taught by university professors and complements them. But beyond learning, the tutoring is also a space for exchange and support, where students can find methodological guidance, a structured framework and essential psychological support in the face of the pressure of the exam. Thanks to this collective commitment, the university of Bordeaux boasts an impressive success rate, reflecting the positive impact of this initiative based on knowledge-sharing and solidarity.

Despite its central role in modern medicine, medical biology tends to attract fewer future physicians. The reasons for this disinterest are varied: a lack of awareness about the specialty among students, the medico-technical nature of the field, the financialization of private healthcare structures, and regulatory requirements, such as the implementation of demanding quality systems that distance students from medical issues. Since the 2018-2019 academic year, a medical biology workshop has been integrated into the problem-based learning sessions of semiology for second-year medical students (DFGSM2) at the Health Faculty of Caen. This interactive workshop uses a clinical case as a framework to introduce students to the specialties of hematology, biochemistry, bacteriology, and immunology. To assess students' perceptions of the workshop, a questionnaire was distributed at the end of the session. Two hundred and seven students responded, with most reporting that the session helped them better understand the specialty. Prior to attending the workshop, 28% of students (n = 58) were considering choosing the specialty, compared to 54% (n = 112) after the workshop (p-value < 0.0001). Among the five least chosen specialties in the National Competitive Exams (ECN) - general medicine, psychiatry, medical biology, public health, and occupational medicine-medical biology ranked third in students' preferences. This study highlights that the preconceived notion of "de-medicalization" can be overcome through targeted educational efforts that increase the appeal of this specialty.