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Blood collection is an important facet of anti‐doping testing, forming the basis of the Athlete Biological Passport (ABP). Traditional blood collection via venipuncture can be uncomfortable for athletes, especially those who are tested frequently or close to competition. Athletes may also have negative perceptions of venipuncture due to past experiences or the risks of adverse health events such as bruising, hematomas, syncope, and general discomfort that has the potential to affect performance. Advances in capillary whole blood collection technology now affords the ability to collect micro‐volumetric capillary whole blood from the upper arm (or other suitable vascular location such as the abdomen) that is "needle‐free" and virtually painless using devices such as the Tasso+. The present study extends previous work, by collecting microliter capillary whole blood samples via the Tasso+ EDTA device in an official anti‐doping setting prior to competition, as well as requiring temperature‐monitored cold chain shipping by air to the laboratory before analysis. Fifty‐eight matched capillary and venous blood samples were collected under official doping control conditions by certified Doping Control Officers. No impact of sample shipment by air under cool conditions was observed on sample integrity. Provided that no visible clots were identified prior to analysis, capillary and venous blood samples showed excellent laboratory agreement for all CBC parameters, with the exception of platelets. Micro capillary blood collection provides a valid alternative to venous blood collection for ABP purposes, with the advantage of providing a more athlete‐friendly experience, particularly close to competition. [ABSTRACT FROM AUTHOR]

This study was performed to analyze fingertip capillary blood sampling in pediatric patients using microcapillary blood collection tubes and microhematocrit tubes and to compare the blood cell analysis results obtained via these two blood collection methods. Finger capillary blood was collected from 110 outpatients using microcapillary blood collection tubes and microhematocrit tubes and complete blood count analysis was performed with a Sysmex XS-900i hematology analyzer and manual microscopy for blood cell morphology. Paired data was evaluated for agreement and bias using the microhematocrit samples as the reference group and the samples from the microcapillary blood collection tubes as the observation group. The two blood collection methods demonstrated good agreement for measuring red blood cell (RBC) parameters (i.e., RBC, Hb, Hct, MCV, MCH and MCHC), wherein the relative bias was > allowable total error (TEa) in 0.91%, 1.82%, 11.82%, 1.82%, 0.91% and 8.18% of the parameter measures, respectively. According to industry requirements, the proportion of samples meeting the acceptable bias level should be > 80%. Additionally, the estimated biases at each medical decision level were within clinically acceptable levels for RBC, Hb, Hct, and MCV. However, the proportion of WBC and PLT counts with relative bias > TEa was 25.45% and 35.45%, respectively. Furthermore, the relative bias of the WBC count at the medical decision level of 0.5 × 109/L and that of the PLT counts at the medical decision levels of 10 × 109/L and 50 × 109/L were clinically significant. Bland–Altman analysis further showed a mean bias of 0.66 × 109/L (95% LoA, − 0.79 to 2.11) for the WBC count and 39 × 109/L (95% LoA, − 46 to 124) for the PLT count from the blood samples collected in the microcapillary blood collection tubes compared with the counts of those collected in the microhematocrit tubes. Neutrophil, monocyte, lymphocyte, eosinophil, and PLT counts increased significantly in the microcapillary blood collection tubes compared with those in the microhematocrit tubes, along with an elevated number of instrument false alarms (P < 0.05). The two capillary blood collection devices exhibit performance differences. Therefore, clinicians should pay attention to the variation in results caused by different blood collection methods. [ABSTRACT FROM AUTHOR]

Background The remote performance of thyroid function blood tests is complicated because it requires blood collection. Objective To compare TSH and free thyroxine (FT4) levels between capillary and venous blood and assess the adequacy of measuring each value in capillary blood. Methods This prospective intervention study was conducted at Ito Hospital and was based on the clinical research method. The participants were 5 healthy female volunteers and 50 patients (41 females and 9 males) between the ages of 23 and 81 years. To measure TSH and FT4 levels in capillary and venous blood, a digital immunoassay (d-IA) method capable of measuring trace samples was used. Chemiluminescence measurements were used as controls. Values obtained for each assay system were compared using Spearman's correlation analysis. Capillary blood was collected using an autologous device (TAP II; not approved in Japan). Results Capillary plasma volume obtained using TAP II was 125 µL or more in 26 cases, 25 µL to 124 µL in 24 cases, and less than 25 µL in 5 cases. Strong correlations were noted in the TSH and FT4 levels between capillary and venous blood, with correlation coefficients of rs = 0.99 and rs = 0.97, respectively. Conclusion Capillary TSH and FT4 levels strongly correlate with venous blood values. Trace samples can be used in high-precision d-IA methods. These results may promote telemedicine in assessing thyroid function. [ABSTRACT FROM AUTHOR]

Background: Despite the emergence of diverse programs in Mexico to address anemia and micronutrient deficiencies in disadvantaged groups, progress on reducing their prevalence has stagnated. In Mexico, anemia surveillance at the population level is conducted through the National Health and Nutrition Survey ENSANUT (for its acronym in Spanish). Objective: To overview the trends in anemia and iron deficiency (ID) from 1999 to 2018-19 in the Mexican population before COVID-19 pandemic. Methods: Data from five nationwide surveys in Mexico were used. Where available, data on anemia, ID, and ID anemia (IDA) were extracted from ENSANUTs 1999, 2006, 2012, 2016, and 2018-19 in participants from 1 to 99 years old. Blood sample collection methods were similar across surveys (1999-2018) where capillary drop blood was used to estimate Hb using a HemoCue and serum blood samples to measure ferritin and C-reactive protein concentration. Results: The trend in anemia prevalence shows a U-shape from 1999 to 2018-19 in <60 years old. In older adults (≥60 years), an increasing trend was observed. Anemia declined progressively from 1999 to 2012 but increased from 2016 to 2018-19 in comparison with 2012. In contrast, ID declined from 2006 to 2018-19, mainly in children, while IDA did not change over this period. In older adults, ID prevalence remained constant over time. Conclusions: The shifting trend in anemia prevalence across ENSANUTs 1999 through 2018-19 did not mimic the decreasing trend of ID over the same period of time. Other noncausal factors seem to play an important role in the variability of hemoglobin measurements. Plain language title: Overview of Trends in the Prevalence of Anemia and Iron Deficiency in the Mexican Population From 1999 to 2018-19 Plain language summary: In Mexico, anemia surveillance has been monitored through the National Health and Nutrition Survey since 1999. Nonetheless, progress on reducing their prevalence seems to be stagnated despite the emergence of diverse social programs in Mexico to tackle micronutrient deficiencies in children and women. The main cause of anemia in children and women is iron deficiency (ID). Any progress in tackling ID should be reflected in anemia prevalence. To investigate the prevalence trend, we used information about anemia (based on hemoglobin concentration) and ID (based on serum ferritin levels) where available, from 5 nationwide surveys in Mexico among participants from 1 to 99 years old, to discuss some of the potential factors behind anemia and ID trends. From 1999 to 2018-19, we observed an ¨U" shape in the prevalence of anemia in all age groups <60 years old, contrasting with the prevalence of ID, which trend is in decline. No major changes in terms of social programs can explain the trend in anemia. In fact, other nutritional indicators seem to have improved in Mexican children. A major difference in the measurement of anemia and ID is that hemoglobin was measured in situ using drop of capillary blood in HemoCue, a portable photometer, while ferritin was measured in venous blood in the central laboratory. While many external factors might influence the hemoglobin measurement in the field setting, it seems that the technique of finger prick capillary introduces more errors to the measurement of hemoglobin than other techniques (e.g., pool capillary or venous blood using HemoCue). This difference, in turn, affects anemia diagnosis. Since the drop of capillary blood has been widely acceptable, we did not perform any validation of hemoglobin measurement in those past surveys, so we cannot role out the contribution of other factors that affected hemoglobin measurement. Future studies should use venous blood to improve anemia classification; otherwise, validation studies should be carried out to improve hemoglobin measurement when using capillary blood. [ABSTRACT FROM AUTHOR]

Paclitaxel is an anticancer agent efficacious in various tumors. There is large interindividual variability in drug plasma concentrations resulting in a wide variability in observed toxicity in patients. Studies have shown the time the concentration of paclitaxel exceeds 0.05 µM is a predictive parameter of toxicity, making dose individualization potentially useful in reducing the adverse effects. To determine paclitaxel drug concentration, a venous blood sample collected 24 h following the end of infusion is required, often inconvenient for patients. Alternatively, using a microsampling device for self-sampling would facilitate paclitaxel monitoring regardless of the patient's location. We investigated the feasibility of collecting venous and capillary samples (using a Mitra® device) from cancer patients to determine the paclitaxel concentrations. The relationship between the venous plasma and whole blood and venous and capillary blood (on Mitra®) paclitaxel concentrations, defined by a Passing–Bablok regression, were 0.8433 and 0.8569, respectively. Demonstrating a clinically acceptable relationship between plasma and whole blood paclitaxel concentration would reduce the need to establish new target concentrations in whole blood. However, in this study, comparison of venous and capillary blood using Mitra® for sampling displayed wide confidence intervals suggesting the results from the plasma and whole blood on this device may not be interchangeable. [ABSTRACT FROM AUTHOR]

China lacks a standard for reference intervals (RIs) of complete blood cell (CBC) counts in newborns. This study aimed to determine local haematological RIs for newborns. This prospective study was conducted from January 2020 to December 2020 in Nanjing Maternity and Child Health Care Hospital. We collected capillary blood specimens from 497 healthy newborns aged 5–28 days. We calculated the RIs as nonparametric 2.5th to 97.5th percentiles and 90% confidence intervals following the EP28-A3c guideline. We validated the RIs in another 20 specimens from healthy newborns. The RIs for the 18 CBC parameters were: white blood cell count 7.17–15.69 × 109/L; monocytes# 0.52–1.66 × 109/L; Mono% 5.7–14.1; eosinophils# 0.16–1.08 × 109/L; Eos% 1.5–8.9; Lymphocytes# 4.04–8.08 × 109/L; Lymph% 40.1–67.8; Neutrophils# 1.59–6.41 × 109/L; Neut% 18.1–46.7; Basophils# 0.00–0.04 × 109/L; Baso% 0.0–0.4; red blood cell count 3.38–5.89 × 1012/L; haemoglobin (Hb) 116–198 g/L; Hematocrit % 35.2–61.2; mean corpuscular Hb (MCH) 30.9–36.3 pg/L; MCH concentration 310–341 g/L; mean corpuscular volume 94.5–112.2 fL; and platelets 210–610 × 109/L. The RIs had a conformity rate of 90%–100% in the validation specimens. We established region-specific RIs for CBC parameters in healthy newborns to help diagnose haematological disease in neonates. [ABSTRACT FROM AUTHOR]

Remote self-collected capillary blood samples have been proposed as alternative to venous blood samples as an aid in telemedicine. The aim of this work is to compare the preanalytical and analytical performance of these two types of samples and to study the stability of common measurands in capillary blood. Capillary and venous blood samples were collected in parallel from 296 patients in serum tubes to analyze 22 common biochemistry magnitudes after centrifugation and in EDTA tubes to analyze 15 hematologic magnitudes. Quality of the preanalytical process was assessed applying the model of quality indicator. 24 h stability at room temperature was studied by obtaining paired capillary samples. A questionnaire of assessment was conducted. Mean hemolysis index was higher in capillary samples compared to venous blood samples (p<0.001). Regression analysis and difference analysis showed no bias for all studied biochemistry parameters and hematologic parameters, except mean corpuscular volume (MCV), between capillary and venous blood samples. Regarding sample stability, percentage deviation was higher than the corresponding minimum analytical performance specification for ferritin, vitamin D, hematocrit, MCV, mean corpuscular hemoglobin concentration, platelets distribution wide, mean platelet volume and basophils. Finger pricking was perceived as less painful (p<0.05) than venipuncture in participants who undergo more than one blood test per year. Capillary blood can be used as an alternative to venous blood for the studied parameters in automated common clinical analyzers. Cautious should be taken if samples are not analyzed within 24 h from the collection. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 has led to a significant increase in demand for remote blood sampling in clinical trials. This study aims to ascertain the concordance between venous versus capillary samples, processed immediately or exposed to various pre-analytical conditions. Methods: Participants (≥12 years old) provided a venous blood sample (processed immediately) and capillary samples allocated to one of the following conditions: processed immediately or exposed to 12-, 24-, or 36-h delays at room temperature or 36-h delays with a freeze-thaw cycle. The analytes of interest included SARS-CoV-2 IgG, 25-hydroxy vitamin D (25(OH)D), alkaline phosphate (ALP), calcium (Ca), phosphate (Ph), and c-reactive protein (CRP). Paired samples were considered interchangeable if they met three criteria: minimal within-subject mean difference, 95% of values within desirable total errors, and inter-class correlation (ICC) > 0.90. Results: 90 participants (44.1% male) were enrolled. When comparing rapidly processed venous with capillary samples, 25(OH)D, ALP, and CRP met all three criteria; SARS-CoV-2 IgG met two criteria (mean difference and ICC); and Ca and Ph met one criterion (mean difference). When considering all three criteria, concentrations of 25(OH)D, CRP, and ALP remained unchanged after delays of up to 36 h; SARS-CoV-2 IgG met two criteria (mean difference and ICC); Ca and Ph met one criterion (mean difference). Conclusion: These findings suggest that remote blood collection devices can be used to measure anti-SARS-CoV-2 IgG, 25(OH)D, CRP, and ALP. Further analysis is required to evaluate the interchangeability between venous and capillary testing in Ca and Ph levels, which are more sensitive to pre-analytical conditions. [ABSTRACT FROM AUTHOR]

Background: More than 250 million people are infected by malaria parasites annually while around one million children less than 5 years of age die every year due to malaria. We aimed to assess the seasonal trends and usefulness of capillary and venous blood for rapid diagnosis of malaria. Methods: This cross-sectional study of 18 months duration was conducted at the National Institute of Child Health (NICH), Karachi. All patients reporting fever as chief complaint were recruited as study subjects. A semi-structured questionnaire was used to collect demographic information, presenting complaints, awareness of caregivers regarding malaria, preventive measures and history of malaria fever. Three ml Venous (2-3ml) as well as peripheral blood (3-4 drops) samples of all patients were collected for microscopy and rapid diagnostic tests (RDTs). Results: Out of total 477 patients with fever Venous and Capillary Blood RDTs methods detected 33(6.9%) and 30(6.3%) as the malaria positive while Venous and Capillary Blood Microscopy detected 30(6.1%) and 32(6.7%) cases respectively. Plasmodium Vivax infection was the most prevalent (87.9%) and majority (39.39%) of the cases occurred in the quarter, July to September. Conclusion: July to September is the peak season for malaria and P. Vivax (87.9%) is the predominant strain in Karachi. Venous and capillary blood are equally useful for malaria diagnosis however, convenience and less invasiveness may justify the preference of capillary blood over venous blood for early diagnosis of malaria. [ABSTRACT FROM AUTHOR]

Differences between capillary and venous glucose concentrations have been reported in the past. In continuous glucose monitoring (CGM) system performance studies, comparator measurements are often performed in venous samples, despite CGM systems typically aiming at providing capillary-like values. In this study, differences between venous, capillary and interstitial glucose concentrations, measured with a laboratory analyzer, a self-monitoring of blood glucose (SMBG) system and an intermittent-scanning CGM system were investigated in subjects without diabetes after glucose load. During the study, an oral glucose tolerance test (oGTT) was performed with 41 participants who had no known history of diabetes (mean age 25.5 ± 9.7 years). Venous blood samples for measurement with a laboratory analyzer were collected before drinking the standardized 75 g glucose solution and after 60 and 120 min. In parallel, capillary blood was obtained for measurement with a laboratory analyzer and an SMBG system, and interstitial glucose values were measured with an intermittent-scanning CGM system. Glucose concentrations in the fasting state were slightly different for the three different compartments whereas considerable differences (some median differences exceeding 30 %) in glucose concentration were observed 60 and 120 min after the start of the oGTT. Marked differences with a high inter-individual variability between venous, capillary, and interstitial fluid glucose concentrations were found especially after glucose load. These differences can affect perceived CGM accuracy in performance studies depending on the specific comparator method used, and they are potentially relevant in clinical practice, like diabetes diagnosis. [ABSTRACT FROM AUTHOR]

It is well known that acute hypoxia has negative effects on balance performance. An attempt to compensate for the influence of hypoxia on competition performance was made by the application of hyperoxic gases (inspiratory fraction of oxygen > 0.2095) prior to exercise. Purpose: To investigate whether hyperoxic preconditioning (pure-oxygen supplementation prior to exercise) improves balance ability and postural stability during normobaric hypoxia (3500 m) in highly skilled skiers. Methods: In this single-blind randomized, crossover study, 19 subjects perlormed a 60-s balance test (MFT S3-Check) in a normobaric hypoxic chamber. After a short period of adaptation to hypoxia (60 min), they received either pure oxygen or chamber air for 5 min prior to a balance test (hyperoxic preconditioning vs nonhyperoxic preconditioning). Capillary blood was collected 3 times. Results: Balance performance, indexed by sensory (P = .097), stability (P = .937), and symmetry (P = .202) scores, was not significantly different after the hyperoxic preconditioning phase. Balance performance decreased over time (no group difference). After hyperoxic preconditioning, arterial partial pressure of oxygen increased from 52.7 (4.5) mm Hg to 212.5 (75.8) mm Hg, and oxygen saturation of hemoglobin increased from 85.8% (3.5%) to 98.9% (0.7%) and remained significantly elevated to 90.1% (2.0%) after the balance test. Conclusion: A hyperoxic preconditioning phase does not affect balance performance under hypoxic environmental conditions. A performance-enhancing effect, at least in terms of coordinative functions, was not supported by this study. [ABSTRACT FROM AUTHOR]

Volumetric absorptive microsampling (VAMS) is a recently developed sample collection method that enables single-drop blood collection in a minimally invasive manner. Blood biomolecules can then be extracted and processed for analysis using several analytical platforms. The integration of VAMS with conventional mass spectrometry (MS)-based metabolomics approaches is an attractive solution for human studies representing a less-invasive procedure compared to phlebotomy with the additional potential for remote sample collection. However, as we recently demonstrated, VAMS samples require long-term storage at −80 °C. This study investigated the stability of VAMS samples during short-term storage and compared the metabolome obtained from capillary blood collected from the fingertip to those of plasma and venous blood from 22 healthy volunteers. Our results suggest that the blood metabolome collected by VAMS samples is stable at room temperature only for up to 6 h requiring subsequent storage at −80 °C to avoid significant changes in the metabolome. We also demonstrated that capillary blood provides better coverage of the metabolome compared to plasma enabling the analysis of several intracellular metabolites presented in red blood cells. Finally, this work demonstrates that with the appropriate pre-analytical protocol capillary blood can be successfully used for untargeted metabolomics studies. [ABSTRACT FROM AUTHOR]

Population-based surveys matched by time but using different methodologies for determining hemoglobin (Hb) concentration have shown inconsistencies in estimating anemia prevalence. This study aimed to estimate measurement errors in Hb quantification in HemoCue 201+ using venous blood (VB) and capillary blood both drops (DCB) and pools (PCB), and compare the results against those of a reference method (VB analyzed in hematology analyzers based on the cyanmethemoglobin method). Children (n = 49), adult females (n = 50), and older adults (n = 50) were randomly allocated to donate VB (4 mL) and either DCB (three drops) or PCB (350 µL). Results in HemoCue were analyzed through Bland Altman and Lyn's concordance against Hb concentration by the reference method. A positive average bias (systematic error) was found for the HemoCue (0.31 g/dL) using the same VB samples. This value was then subtracted from all readings carried out in the device. After this adjustment, DCB still produced a positive bias (0.42 ± 0.81 g/dL), and the variation of single results was ±1.6 g/dL (95% CI). PCB and VB performed similarly; the average bias was negligible (−0.02 ± 0.36 and 0.00 ± 0.33 g/dL, respectively) and the variation of the results (95% CI) was ±0.7 g/dL or lower. Lyn's concordance values were 0.86, 0.96, and 0.98 for DCB, PCB, and VB, respectively. Random variation using DCB is too large to approximate the true Hb values, and therefore DCB should be discontinued for diagnosing anemia both in individuals and in populations. [ABSTRACT FROM AUTHOR]

Objectives: Haemoglobin mass (Hbmass) assessment with the carbon monoxide rebreathing method is a more accurate estimate than other measures of oxygen-carrying capacity. Blood may be collected by several means and differences in the measured variables may exist as a result. The present study assessed the validity and reliability of calculated Hbmass and intravascular volumes obtained from capillary blood (CAP) when compared to venous blood (VEN) draws. Methods: Twenty-two adults performed a carbon monoxide rebreathing procedure with paired VEN and CAP draws at baseline, pre-rebreathing and post-rebreathing (POST). Thirteen of these participants performed this protocol on two occasions to assess the data reliability from both blood sampling sites. In a second experiment, 14 adults performed a 20-min seated and a 20-min supine rest to assess for the effect of posture on haematological parameters. Results: Haemoglobin mass (CAP = 948.8 ± 156.8 g; VEN = 943.4 ± 157.3 g, p = 0.108) and intravascular volume (CAP = 6.5 ± 1 L; VEN = 6.5 ± 0.9 L, p = 0.752) were statistically indifferent, had low bias (Hbmass bias = 14.45 ± 40.42 g, LoA -64.78 g—93.67 g) and were highly correlated between sampling techniques. Reliability analysis demonstrated no difference in the mean change in variables calculated from both sampling sites and good to excellent intraclass correlation coefficients (>0.700), however, typical measurement error was larger in variables measured using CAP (VEN Hbmass TE% = 2.1%, CAP Hbmass TE % = 5.5%). The results indicate that a supine rest prior to the rebreathing protocol would have a significant effect on haemoglobin concentration and haematocrit values compared to a seated rest, with no effect on carboxyhaemoglobin %. Conclusion: The present study demonstrates that CAP and VEN were comparable for the calculation of Hbmass and intravascular volumes in terms of accuracy. However, reduced reliability and increased error in the CAP variables indicates that there are methodological considerations to address when deciding which blood drawing technique to utilise. To reduce this CAP error, increased replicate analyses are required. [ABSTRACT FROM AUTHOR]

Population-based surveys commonly use point-of-care (POC) methods with capillary blood samples for estimating Hb concentrations; these estimates need to be validated by comparison with reference methods using venous blood. In a cross-sectional study in 748 participants (17–86 years, 708 women, Hb: 5·1 to 18·2 g/dl) from Hyderabad, India, we validated Hb measured from a pooled capillary blood sample by a POC autoanalyser (Horiba ABX Micros 60OT, Hb-C-AA) by comparison with venous blood Hb measured by two reference methods: POC autoanalyser (Hb-V-AA) and cyanmethemoglobin method (Hb-V-CM). These comparisons also allowed estimation of blood sample-related and equipment-related differences in the Hb estimates. We also conducted a longitudinal study in 426 participants (17–21 years) to measure differences in the Hb response to iron folate (IFA) treatment by the capillary blood POC method compared with the reference methods. In the cross-sectional study, Bland–Altman analyses showed trivial differences between source of blood (Hb-C-AA and Hb-V-AA; mean difference, limits of agreement: 0·1, −0·8 to 1·0 g/dl) and between analytical methods (Hb-V-AA and Hb-V-CM; mean difference, limits of agreement: < 0·1, −1·8 to 1·8 g/dl). Cross-sectional anaemia prevalence estimated using Hb-C-AA did not differ significantly from Hb-V-CM or Hb-V-AA. In the longitudinal study, the Hb increment in response to IFA intervention was not different when using Hb-C-AA (1·6 ± 1·7 g/dl) compared with Hb-V-AA (1·7 ± 1·7 g/dl) and Hb-V-CM (1·7 ± 1·7 g/dl). The pooled capillary blood–autoanalyzer method (Hb-C-AA) offers a practical and accurate way forward for POC screening of anaemia. [ABSTRACT FROM AUTHOR]

Background: The measurement of blood glucose in critically ill patients is still performed in many ICUs with glucose meters and capillary samples. Several prevalent factors in these patients affect the accuracy of the results and should be interpreted with caution. A weak recommendation from the Surviving Sepsis Campaign (SSC) suggests the use of arterial blood rather than capillary blood for point of care testing using glucose meters. Aims and objectives: To analyse the agreement between arterial, central venous, and capillary blood samples of glucose values measured by glucose meter in critically ill patients and study potential confounding factors. Design: Prospective cross‐sectional study in a general intensive care unit (ICU). Patients needing insulin treatment (subcutaneous or intravenous) and blood glucose control were included. Methods: Standardized collection of blood samples and measurement of glucose values with a glucometer. Agreement was studied by the Bland–Altman method and stratified analysis of disagreement‐survival plots was used to study the influence of haematocrit, pH range, SOFA score, capillary refilling time, intravenous insulin infusion, and lactic acid. Results: A total of 297 measurements from 54 patients were included. The mean arterial blood glucose was 150.42 (range 31–345 mg/dL). In the graphical analysis, there is a poor agreement both in capillary and venous central to arterial samples, but in opposite direction (underestimation of capillary and overestimation of central venous). Factors associated with a reduction in the agreement between arterial and capillary samples were elevated lactate, poor capillary refilling, and hemodynamic failure. Patients without hemodynamic compromise have an acceptable agreement with values for absolute differences of 16 mg/dL for a disagreement of 10%. Conclusions: In critically ill patients, the measurement of blood glucose with a glucose meter should be performed with arterial samples whenever possible. Capillary samples do not accurately estimate arterial blood glucose values in patients with shock and/or vasoactive drugs and underestimate the values in the range of hypoglycemia. Venous samples are subject to error because of potential contamination. Relevance to clinical practice: This study adds support to the recommendation of using arterial blood rather than capillary or venous blood when using glucose meters in critically ill patients, especially in those with hemodynamic failure. [ABSTRACT FROM AUTHOR]

The Coronavirus Disease 2019 (COVID-19) pandemic forced researchers to reconsider in-person assessments due to transmission risk. We conducted a pilot study to evaluate the feasibility of using the Tasso-SST (Tasso, Inc, Seattle, Washington) device for blood self-collection for use in SARS-CoV-2 antibody testing in an ongoing COVID-19 prevalence and immunity research study. 100 participants were recruited between January and March 2021 from a previously identified sub-cohort of the Cabarrus County COVID-19 Prevalence and Immunity (C3PI) Study who were under-going bimonthly COVID-19 antibody testing. Participants were given a Tasso-SST kit and asked to self-collect blood during a scheduled visit where trained laboratory personnel performed routine phlebotomy. All participants completed an after-visit survey about their experience. Overall, 70.0% of participants were able to collect an adequate sample for testing using the device. Among those with an adequate sample, there was a high concordance in results between the Tasso-SST and phlebotomy blood collection methods (Cohen's kappa coefficient = 0.88, Interclass correlation coefficient 0.98 [0.97, 0.99], p < 0.0001). The device received a high-level (90.0%) of acceptance among all participants. Overall, the Tasso-SST could prove to be a valuable tool for seroprevalence testing. However, future studies in larger, diverse populations over longer periods may provide a better understanding of device usability and acceptance among older participants and those with comorbidities in various use scenarios. [ABSTRACT FROM AUTHOR]

Background: The HEART score is a validated risk stratification tool for chest pain patients presenting to the emergency department and was recently investigated for implementation in a pre-hospital setting. Fingerstick (capillary blood) point-of-care (POC) troponin testing enables quick measurements outside the hospital and seems easier to implement than the current venous blood sampling techniques. This study investigates the diagnostic accuracy of the modified HEART score, integrating fingerstick POC troponin testing, in ruling out acute coronary syndrome (ACS). Methods: The data of 96 patients with chest pain, included in a study investigating a novel POC troponin device under development at the cardiac emergency department, were analysed retrospectively. Based on the patients' admission data and capillary POC high-sensitivity troponin I (hs-cTnI) results, the modified HEART score was determined. The outcome measure, for evaluating the diagnostic accuracy of the modified HEART score, was the occurrence of ACS. Results: Of the total study population, 33 patients (34%) were diagnosed with ACS. Seventeen patients (18%) were classified as low risk (0–3 points) and one patient (6%) in this group was diagnosed with ACS. The sensitivity and negative predictive value of the modified HEART score was 97.0 and 97.6%, respectively. Conclusion: The modified HEART score, integrating capillary POC hs-cTnI results, is a promising tool for ruling out ACS in patients with chest pain presenting to the cardiac emergency department. These results encourage prospective investigation into the integration of fingerstick POC troponin testing in the modified HEART score in a pre-hospital setting. [ABSTRACT FROM AUTHOR]

The hematological module of the Athlete Biological Passport (ABP) represents an important tool in the pursuit to detect blood doping in athletes. Currently, collecting blood samples for ABP analysis can be cumbersome, invasive, and expensive, involving a venous blood draw performed by a trained phlebotomist followed by cold‐chain monitored shipping to the analysis laboratory. Developing innovative methods to collect and transport ABP blood samples while adhering to strict preanalytical and analytical requirements has the potential to greatly increase testing frequency and, consequently, the effectiveness of the ABP program globally. The focus of this study was to compare venous blood collections with capillary blood collections to determine if capillary samples could be used for ABP analysis without sacrificing the analytical integrity required for antidoping testing procedures. In this study, capillary blood was collected using the Tasso+ EDTA device (Tasso, Inc.), a novel microvolumetric device that collects liquid, whole blood from skin capillaries on the upper arm. Excellent laboratory agreement was observed between venous and capillary blood samples for the three main ABP parameters: HGB, RET%, and OFF‐Score. Additionally, the stability of capillary samples after storage at 4°C, similar to what would be required during transport, was acceptable for up to 72 h following collection. Finally, we generated individual ABP profiles using the adaptive model for 10 participants and observed excellent agreement between venous and capillary profiles. These results indicate capillary blood collection is a viable alternative to venous blood collections for ABP analysis. [ABSTRACT FROM AUTHOR]

A multiphase study was designed to examine the detectability of human growth hormone (GH) use in capillary dried blood spots (DBS). First, 13 subjects self‐injected a single, 2‐mg dose of somatropin and collected capillary DBS samples for 24 h. Next, nine subjects self‐injected 2‐mg somatropin, six times over the course of 11 days; DBS were collected intermittently following dosing. Finally, a nondrug, large‐scale field study involved DBS collections from an athlete and staff population over 3 years. All DBS samples were self‐collected using the Tasso M20 device and were analyzed for the presence of GH using the WADA‐approved GH isoforms test. Following the single dose, positive detection within 12 h of dosing was 86% and 56% sensitive on Kits 1 and 2, respectively. In the multidose study, detection within 12 h was 85% and 69% sensitive on Kits 1 and 2, respectively. No positives were detected outside the 12‐h window following a single dose, wherein detection was 5.6% sensitive at 24‐h in the multidose study. Combining the 12‐h windows from both studies, 100% of samples had measurable recombinant (REC) and pituitary (PIT) GH concentrations above the assay LoD, 0.041 ng/ml. Finally, 1213 samples were collected in the large‐scale field study: 189 showed REC and PIT concentrations above the LoD; none returned positive results. GH is detectable in capillary DBS using the isoforms method for 12–24 h following use. While detection is short lived, transitioning to a DBS self‐collection method can allow more frequent testing and increase deterrence to GH abuse. [ABSTRACT FROM AUTHOR]

Venous serum and plasma are optimal specimens for serological testing but may be logistically infeasible. Dried blood spots (DBS) are a feasible alternative, provided results are adequately sensitive and specific. We aimed to assess the diagnostic accuracy of DBS to measure IgG and IgM antibodies for vaccine-preventable diseases and compare test validity of DBS with venous blood. In October 2020, we searched seven databases for peer-reviewed studies assessing the diagnostic accuracy of DBS specimens compared with serum in detecting antibodies to VPDs in humans. We extracted data and assessed risk of bias in all included studies. We calculated sensitivity and specificity with 95% confidence intervals for each index-reference test comparison. We narratively synthesized the identified evidence on diagnostic accuracy and blood collection and processing methods for DBS. Studies on measles and rubella IgG and IgM were the most frequently identified and reported generally high sensitivity and specificity. Lack of standardization in collection, storage, and testing methods limited systematic comparison across studies. Our findings indicate a need for additional validation studies on the diagnostic accuracy of DBS to expand their use in serological surveillance. We recommend practical considerations to improve standardized reporting for DBS validation studies. [ABSTRACT FROM AUTHOR]

The purpose of this study is to compare whether or not there is a difference between venous and capillary blood samples in blood glucose measurements and investigate the effects of different aseptic methods used in skin cleaning before collecting blood samples on measurement results. This quasi-experimental study was conducted with 109 patients. The capillary first and second blood drop values taken from the patients after fasting and at 2 hours following 75 g oral glucose tolerance test (OGTT) and capillary and venous blood glucose values were compared. There was no significant difference between the median venous blood glucose value and the capillary second blood drop value taken after wiping the finger with alcohol. There was no significant difference between the first and second blood drop values of capillary blood glucose 2 hours after OGTT. [ABSTRACT FROM AUTHOR]

Background: Reference intervals (RIs) are normal ranges of clinical indicators established from healthy subjects, and comparing test results with RIs is the first step for clinicians in differentiating between healthy and diseased subjects. Capillary blood is widely used in complete blood count (CBC) tests in children; however, capillary blood‐based RIs for the CBC parameters are still lacking for all pediatric populations. The aim of this study was to establish capillary blood‐based RIs for the CBC parameters in children aged 3 months to 18 years in Beijing. Methods: A total of 6799 capillary blood specimens from children were collected, including 3832 males and 2967 females aged 3 months to 18 years, and CBC parameters were analyzed. Data analysis, RI calculations, and 90% confidence interval (CI) calculations were performed according to CLSI C28‐A3 guidelines. Results: Capillary blood RIs for 22 CBC parameters were established in children aged 3 months to 18 years. The levels of most red blood cell‐related parameters increased with age and were generally higher in males than in females. White blood cell counts were relatively stable, with no obvious upward or downward trends from 3 months to 18 years of age. Platelet levels decreased within the first year and tended to be stable thereafter. Further validation with 458 healthy children illustrated that the verified results were within the established RIs with a 90%‐100% proportion. Conclusion: We established capillary blood RIs for 22 CBC parameters in children across a broad age range in Beijing. [ABSTRACT FROM AUTHOR]

We assessed the accuracy of tranexamic acid (TXA) concentrations measured in capillary whole blood using volumetric absorptive micro-sampling (VAMS) devices. Paired venous and VAMS capillary blood samples were collected from 15 healthy volunteers participating in a pharmacokinetic study of alternative routes (oral, IM and IV) of administering TXA. To assess accuracy across a range of concentrations, blood was drawn at different times after TXA administration. We measured TXA concentrations in plasma, whole blood from samples collected by venepuncture and whole blood from venous and capillary samples collected using VAMS devices. TXA was measured using a validated high sensitivity liquid chromatography - mass spectrometry method. We used Bland-Altman plots to describe the agreement between the TXA concentrations obtained with the different methods. In the 42 matched samples, the mean plasma TXA concentration was 14.0 mg/L (range 2.6–36.5 mg/L) whereas the corresponding whole blood TXA concentration was 7.7 mg/L (range 1.6–17.5 mg/L). When comparing TXA concentrations in VAMS samples of venous and capillary whole blood, the average bias was 0.07 mg/L (lower and upper 95% limits of agreement: −2.1 and 2.2 mg/L respectively). When comparing TXA concentrations in venous whole blood and VAMS capillary whole blood, the average bias was 0.7 mg/L (limits of agreement: −2.7 and 4.0 mg/L). Volumetric absorptive micro-sampling devices are sufficiently accurate for use in pharmacokinetic studies of tranexamic acid treatment in the range of plasma concentrations relevant for the assessment of fibrinolysis inhibition. [ABSTRACT FROM AUTHOR]

Blood glucose measurement is one of the most commonly performed clinical diagnostic tests used to monitor glycaemia in several animal diseases. Usually, these laboratory analyses are performed on blood venous samples in remote laboratories, and the results are delayed, at best. The use of portable glucometers could evidently solve many constraints but veterinary‐use glucometers are not usually available. The present study aimed to compare blood glucose levels obtained by Bionime glucometer to the reference method using glucose oxidase. Venous blood was collected from a total number of 140 healthy dogs (72 males and 68 females), of different breeds (28 German Shepherd, 27 Pitt bull, 21 Boxer, 24 Rottweiler and 40 cross‐bred dogs) and different ages (range: 3 months–14 years) for glucose measurement using the reference laboratory method. Capillary blood samples were used to conduct a glucose measurement with a human‐use glucometer. Our results revealed that there was no significant difference between the mean capillary blood glucose (CBG) measured with the human‐use glucometer (5.06 ± 0.84 mmol/L) and the mean venous blood glucose (VBG) measured with the laboratory reference method (4.90 ± 0.73 mmol/L) (p = 0.42). Similarly, there was no significant difference of the mean CBG and VBG in male dogs (5.11 ± 0.88 and 4.97 ± 0.75 mmol/L, respectively) and female dogs (5.01 ± 0.81 and 5.07 ± 0.72 mmol/L, respectively) (p = 0.73 and 0.21, respectively), and no correlation to neither age (5.43 ± 0.90 and 5.20 ± 0.70 mmol/L in 3 to 6 month‐old dogs, 5.03 ± 0.82 and 4.94 ± 0.79 mmol/L in 6 months to 1 year‐old, 4.94 ± 0.67 and 5.13 ± 0.66 mmol/L in 1 to 4 year‐old dogs; 4.88 ± 0.94 and 4.80 ± 0.75 mmol/L in dogs older than 4 years, respectively, p < 0.05), nor to breed (4.94 ± 1.01 and 4.99 ± 0.79 mmol/L in German Shepherd, 5.13 ± 0.84 and 4.99 ± 0.79 mmol/L in Pitt Bull, 5.07 ± 0.94 and 5.07 ± 0.77 mmol/L in Boxer, 5.40 ± 0.59 and 5.48 ± 0.55 mmol/L in Rottweiler and 4.89 ± 0.75 and 4.77 ± 0.59 mmol/L in cross‐bred dogs, respectively, p < 0.05). The present study confirms that human glucometer can be used to measure glucose in dogs with a good accuracy. [ABSTRACT FROM AUTHOR]

Introduction: We evaluated the analytical performance of CoaguChek Pro II (Roche Diagnostics GmbH, Mannheim, Germany), a new point‐of‐care device measuring the international normalized ratio (INR) values, in comparison with CoaguChek XS Plus (Roche Diagnostics GmbH) and STA‐R Max using STA‐Neoplastine CI Plus (Diagnostica Stago SAS, Asnières‐sur‐Seine, France). Methods: The precision of Pro II was analyzed, according to the Clinical and Laboratory Standards Institute guidelines (CLSI POCT14‐A2 and EP15‐A3). In 105 clinical samples, the Pro II INR values were compared with those of XS Plus and STA‐R Max using STA‐Neoplastine CI Plus (CLSI EP09‐A3 and EP35). We also compared the Pro II INR values between capillary blood (CB) and venous blood (VB; CLSI EP35). Results: The precision of Pro II was acceptable (within‐run and between‐run CV%: 2.71% and 3.28% at normal level; 1.52% and 4.47% at abnormal level, respectively). The Pro II INR values showed very high correlation and almost perfect agreement with those of XS Plus and STA‐R Max using STA‐Neoplastine CI Plus (r =.97 and κ =.94; r =.95 and κ =.91). The mean difference between Pro II and STA‐R Max using STA‐Neoplastine CI Plus increased as INR values increased, with 60% of samples showing differences >0.5 in the supratherapeutic range. The Pro II INR values showed very high correlation between CB and VB (r =.98). Conclusion: Pro II INR values are accurate and reliable using both CB and VB; however, they should be confirmed by laboratory analyzers in the supratherapeutic range. [ABSTRACT FROM AUTHOR]

Ticks are frequently polyinfected and can thus transmit numerous microorganisms. A large number of bacteria, parasites and viruses are transmitted by tick bites and could cause different signs and symptoms in patients. The main goal of this study was to search for these numerous microorganisms in patients presenting with persistent polymorphic syndrome possibly due to a tick bite (SPPT). The following microorganisms were searched for in saliva, urine, venous and capillary blood by using real time PCR: Borrelia burgdorferi sensu lato, Borrelia miyamotoi, Borrelia hermsii, Bartonella spp., Bartonella quintana, Bartonella henselae, Ehrlichia spp., Anaplasma spp., Rickettsia spp., Coxiella burnetii, Brucella spp., Francisella tularensis, Mycoplasma spp., Chlamydia spp., Babesia spp., Theileria spp. 104 patients were included. 48% of the patients were poly-infected, and 25% harboured at least three different microorganisms. Borrelia spp. were not the most frequent bacteria observed, observed far behind Mycoplasma spp., Rickettsia spp. and Ehrlichia spp. which were the most frequent microorganisms observed. Piroplasms were found in a significant number of patients. The most sensitive matrix was saliva, followed by urine, capillary blood and venous blood. Our prospective study has shown that patients with SPPT, a syndrome close to fibromyalgia, could harbour several tick borne microorganisms. [ABSTRACT FROM AUTHOR]

Background: Both capillary and venous blood samples have been interchangeably used for the diagnosis of malaria in Ethiopia. However, Plasmodium parasites are thought to be more concentrated in capillary than in venous blood. Hence, selecting a sample source where parasites are more concentrated is indispensable approach in order to maximize the accuracy of blood film microscopy. Therefore, the present study aimed to compare the detection rate and the parasitemia level of Plasmodium species from conventional capillary and venous blood films, and buffy coat preparations.Methods: A facility based cross-sectional study was conducted from Feburary to March 2020 among 210 febrile patients attending Hamusite health center, northwest Ethiopia. Capillary and venous blood samples were collected and buffy coat was prepared from each sample. Thin and thick blood films were prepared, stained, and examined microscopically following standard protocol. Data were analysed using Statistical Package for Social Sciences Software version 20 and Med-Calc software version 19.3.Results: Capillary blood buffy coat (61/210, 29.0%) had significantly higher detection rate as compared to capillary (48/210, 22.9%) and venous (42/210, 20.0%) blood films (p < 0.001). However, no significant difference was observed between capillary and venous blood films (p = 0.070) in detecting Plasmodium species. The highest and the lowest mean asexual stage parasite counts were found in capillary blood buffy coat (4692.88) and venous blood (631.43) films, respectively showing significant variations (p < 0.001). Mean gametocyte count was also highest in capillary blood buffy coat (3958.44). As compared to capillary blood buffy coat, the sensitivity of venous blood buffy coat, capillary blood film and venous blood film were 73.8, 78.7, 68.9%, respectively.Conclusion: Capillary blood buffy coat samples showed the highest sensitivity in detecting and quantitating malaria parasites that its use should be promoted in clinical settings. However, conventional capillary and venous blood films could be used interchangeably. [ABSTRACT FROM AUTHOR]

Background: Rapid and sensitive diagnostics are critical tools for clinical case management and public health control efforts. Both capillary and venous blood are currently used for malaria detection and while diagnostic technologies may not be equally sensitive with both materials, the published data on this subject are scarce and not conclusive. Methods: Paired clinical samples of venous and capillary blood from 141 febrile individuals in Bo, Sierra Leone, were obtained between January and May 2019 and tested for the presence of Plasmodium parasites using two multiplexed PCR assays: the FilmArray-based Global Fever Panel (GFP) and the TaqMan-based Malaria Multiplex Sample Ready (MMSR) assay. Results: No significant differences in Plasmodium parasite detection between capillary and venous blood for both assays were observed. The GFP assay was more sensitive than MMSR for all markers that could be compared (Plasmodium spp. and Plasmodium falciparum) in both venous and capillary blood. Conclusions: No difference was found in malaria detection between venous and capillary blood using two different PCR-based detection assays. This data gives support for use of capillary blood, a material which can be obtained easier by less invasive methods, for PCR-based malaria diagnostics, independent of the platform. [ABSTRACT FROM AUTHOR]

Objectives: Patient compliance with laboratory testing is one of the most underrecognized challenges in developing a treatment plan for acute and chronically ill patients. The ability to offer alternatives to standard venipuncture blood draws would greatly increase a laboratory's ability to provide testing to patients and health care providers.Methods: We performed a prospective observational study on paired venous and fingerstick capillary blood samples from admitted patients undergoing vancomycin therapy. Paired specimens were analyzed for vancomycin and a basic metabolic panel (BMP: calcium, carbon dioxide, chloride, potassium, sodium, creatinine, glucose, serum urea nitrogen) on the core laboratory's automated chemistry and immunochemistry platforms.Results: A total of 59 paired fingerstick and venous blood specimens from 56 unique inpatients were analyzed. Paired samples were comparable for all the analytes tested with the exception of bicarbonate and potassium, which were significantly different among the capillary sample group. Patients required multiple fingers be lanced in 15% of cases to obtain sufficient blood to carry out the testing. Capillary sample rejection rates due to insufficient volumes were as high as 30% in the initial 30 patients enrolled in the study.Conclusions: Vancomycin and the BMP, with the exception of potassium and bicarbonate, were determined to be analytically comparable. However, significant preanalytical issues should preclude laboratories and providers from more widespread adoption of fingerstick-derived capillary blood as an alternative sampling method except in the most extenuating of circumstances. [ABSTRACT FROM AUTHOR]

Introduction: Venous blood (VB) sampling for complete blood count (CBC) via venipuncture is the basic method for the daily evaluation of hematological patients. However, several issues during this process, such as venipuncture difficulty and repetitive attempts, may cause pain, phlebitis, hematomas, inadequate sampling, and patient discomfort. Capillary blood (CB) sampling could be an alternative and less painful solution for the patient. The purpose of this study was the comparative evaluation of basic CBC parameters, as counted from venous and capillary blood samples. Methods: During the period 06/2016‐06/2019 in which the study was conducted, 1634 automated counts of VB or CB were performed, derived from 425 hematological hospitalized patients. Bland‐Altman plots were performed to show the agreement of VB and CB counts of common hematological parameters (Hb, Hct, WBC, absolute neutrophil count‐[ANC], RBC, Plt, MCV, MCH), using two different hematology analyzers (Mindray BC‐3000 Plus Auto and Sysmex XE‐5000). Clinical significance of CB sampling was assessed by applying specific clinically significant cutoffs for Hb, ANC, and Plt. Results: All measured parameters revealed a significant correlation (r >.9) between CB and VB samples, irrelatively of the hematology analyzer used. CB measurements of Hb, ANC, and Plt, at different clinically important cutoff levels, showed excellent sensitivity (87%‐100%), specificity (95%‐100%), positive predictive value, and negative predictive value (87%‐100% and 90%‐100%, respectively). Conclusion: Capillary blood and VB counts in hematological patients were equivalent for most basic hematological parameters. Hb, ANC, and Plt CB counts revealed clinically significant performance, indicating that they can reliably substitute VB sampling in the day work. [ABSTRACT FROM AUTHOR]

Introduction: Clinical reference intervals represent the normal range of clinical parameters for distinguishing healthy and sick individuals, and they show some variation among different populations. Many reference intervals are still lacking for the pediatric population in China. Thus, the aim of this study was to establish and validate pediatric reference intervals for capillary blood cell counts. Methods: A total of 9942 children were enrolled from 10 medical institutions in Beijing, China, for capillary complete blood count (CCBC) values according to the EP28‐A3c guideline issued by the Clinical and Laboratory Standards Institute. Results: Pediatric reference intervals for 17 CCBC parameters were established for children aged 6 months to 7 years. The red blood cell count and red blood cell distribution width were generally higher in males than in females, and the mean corpuscular hemoglobin and mean corpuscular volume were higher in females than in males. The red blood cell, hemoglobin, hematocrit, and neutrophil percentages increased while the percentage of lymphocytes decreased with age. The overall trends for each reference interval were relatively similar in different ethnic groups and regions in the world, but with variation in the upper and lower limits, which confirms the existence of racial and geographical differences. Further validation with 508 healthy subjects showed that the verified proportions were within 90.9%‐100% of the reference intervals. Conclusions: This study offers local reference intervals for CCBC values for the pediatric population in Beijing, China, and thus provides basic criteria for the diagnosis, treatment, and health assessment of childhood diseases in China. [ABSTRACT FROM AUTHOR]

Objectives: Iron depletion is common around the world and among certain risk groups in developed countries. The overall purpose was to test the suitability of a novel plasma collection card for minimally invasive iron status assessment. Methods: Twenty participants (10 f/10 m) participated in this cross‐sectional study. Ferritin and hemoglobin were measured from blood collected from a forearm vein, serving as reference method. Blood was also collected from the fingertip using the NoviplexTM Plasma Prep Card as well as capillary collection tubes. Results: There was substantial concordance between ferritin measured from samples collected via NoviplexTM and venous ferritin (concordance correlation coefficient (CCC) = 0.96) with a mean bias of −0.8 ng/mL. Storing NoviplexTM cards at room temperature for 2 weeks resulted in slightly lower but good concordance when compared to venous ferritin (CCC = 0.95). Capillary hemoglobin (CCC = 0.42) and hematocrit (CCC = 0.25) were in poor agreement with venous data. Conclusions: NoviplexTM cards offer a suitable alternative for a minimally invasive ferritin screening in the field when compared to capillary collection tubes. Despite overall substantial concordance with the reference method, findings indicative of iron status abnormalities should be confirmed in venous samples. [ABSTRACT FROM AUTHOR]

Purpose: Dried blot spot (DBS) analysis of drugs or clinical parameters offers many advantages. We investigated the feasibility of using DBS for analysis of anti-diabetic drugs concomitantly with the estimated creatinine clearance (Clcrea). Methods: The cross-sectional study involved physicians in an enabling analysis with 70 diabetic patients and community pharmacists in a field investigation with 84 participants. All 154 DBS samples were analyzed for creatinine, metformin, and sitagliptin. Results: The diabetic patients revealed of a wide range of age (32–88 years), BMI values (19.8–54.7 kg/m2), and extent of polypharmacotherapy (1–21 drugs). A correlation factor to convert capillary blood creatinine from DBS into plasma concentrations was determined. Patients' Clcrea ranged from 21.6–155.9 mL/min. The results indicated statistically significant correlations (p < 0.05) between the use of two or three particular drug classes (diuretics, NSAIDs, renin-angiotensin system blockers) and a decreased renal function. DBS concentrations of metformin ranged between 0.23–4.99 μg/mL. The estimated elimination half-life (t ½) of metformin was 11.9 h in patients with a ClCrea higher than 60 mL/min and 18.5 h for diabetics with lower ClCrea. Sitagliptin capillary blood concentrations ranged between 11.12–995.6 ng/mL. Calculated t ½ of sitagliptin were 8.4 h and 13.0 h in patients with a ClCrea above and below 60 mL/min, respectively. Conclusions: DBS allow for the analysis of concentrations of predominantly renally eliminated drugs and community pharmacists can provide a valuable contribution to DBS sampling. [ABSTRACT FROM AUTHOR]

The purpose of the study was to determine differences and correlations between the blood glucose values of venous blood and the first and second drops of capillary blood samples taken in three different ways. Blood samples were (a) venous blood, (b) the first and second drops of capillary blood from the middle finger of the right hand (only washed with soap and water), and (c) the first and second drops of capillary blood from the middle finger of the left hand (washed with soap and water and cleaned with alcohol). It was concluded that the fasting capillary blood glucose values could be used in place of venous blood glucose values, that only washing the hands with neutral soap and water for 30 s could be sufficient for capillary blood glucose measurement, and that the first or second blood drop from a clean hand could be used for capillary blood glucose measurement. [ABSTRACT FROM AUTHOR]

MicroRNAs (miRNAs) hold great promise as blood-borne and circulating biomarkers for numerous diseases. However, the reliability of such liquid biopsies is particularly impacted by problems associated with the handling of biological liquids in the pre-analytical stage of biomarker processing. Dried blood spots (DBS) and other capillary blood microsampling devices offer a way to circumvent many of these complications. DBS are supposed to be far less sensitive to collection protocols, storage conditions, and transport processes, while offering the possibility for a decentralized sample collection. In addition, DBS are minimally invasive and require very small amounts of blood, thereby facilitating blood collection from small children or patients at risk by blood drawing. Here, we summarize the current state of knowledge about DBS-derived miRNAs. Experimental studies on miRNA from DBS especially emphasize the influence of the adsorptive material and the importance of drying and rehydration protocols. The present studies are, however, difficult to compare as they use different readout-systems, ranging from PCR-based quantification of single miRNAs to next-generation sequencing (NGS) of the entire miRNome. The data underscore the need for procedure standardization and the development of general guidelines on handling and evaluating miRNA biomarkers derived from DBS. [ABSTRACT FROM AUTHOR]

Objective  Normal initial blood glucose values in healthy newborns are not well defined and are subject to controversy. Despite substantive research, there is no single initial value of glucose that can be used with certainty of safety in newborns, and thus various protocols and cutoffs have been proposed. Study Design  We sought to characterize the normal values of blood glucose levels in a large cohort of neonates admitted to the well-baby nursery in Shaare Zedek Medical Center. The blood glucose levels were measured with a point of care (POC) glucometer (Accu-Chek Performa) within 180 minutes after birth. Results  The study population included 3,912 newborns with a mean birth weight of 3,322 ± 439 g and a mean gestational age of 39.4 ± 1.3 weeks. Sampling was performed at a median age of 73 minutes (interquartile range [IQR], 55–92 minutes). Median glucose concentration was 58 (IQR, 51–67) mg/dL, and first, third, and fifth percentiles were 34, 39, and 41 mg/dL, respectively. Conclusion  Our data describe the normal range of POC blood glucose levels in healthy neonates on admission to the nursery. Extreme low levels were rare. [ABSTRACT FROM AUTHOR]

Background: To determine the effect of food intake on complete blood count (CBC) results. Method: We analyzed the CBC in whole capillary blood specimens collected from 33 adult volunteers into microtubes between 8:00 AM and 11:00 AM. Blood specimens were drawn from patients who had been fasting 12 hours and then 1 and 2 hours after consumption of a light meal containing carbohydrates, protein, and lipids. All measurements were performed using the hematologic analyzer Sysmex XN-1000. Results: The red blood cell count, hemoglobin concentration, hematocrit level, and platelet count decreased 2 hours after meal consumption (P = .007, P = .008, P = .003, and P = .03, respectively). The lymphocyte number decreased after the first and second hour following meal consumption (P = .004 and P = .001); the number of neutrophils had increased 1 and 2 hours after food intake (P = .003 and P = .006, respectively). Conclusions: Food consumption impacts CBC results. To ensure the consistency, quality, and repeatability of CBC analysis, blood should be drawn from fasting patients. [ABSTRACT FROM AUTHOR]

Background: Neonatal hypoglycemia (NH) and cutoffs remain undefined. Our center screens all cesarean-delivered (CD) neonates for NH. We sought to define standards of admission capillary blood glucose levels (ACBGLs) in CD neonates who were at the lowest risk for hypoglycemia. Methods: Of 4947 neonates, 519 met all 14 inclusion criteria. These highly-selected neonates were apparently the healthiest, least-stressed, earliest to be admitted to nursery and at lowest-risk for hypoglycemia. For each CD, cord blood gases and glucose were determined and each infant was screened for blood glucose at nursery admission. Results: Sampling age was 41.6±15.3 minutes, a mean ACBGL of 52.3±10.7 mg/dL, and percentiles as follows: 1st percentile, 29.2; 3rd, 33.6; 5th, 35.0; 10th, 39.0; 25th, 46.0; 50th, 51.0; 75th, 58.0; 90th, 67.0; 95th, 71.0; 97th, 73.0, and 99th, 84.4. ACBGL rose significantly with increasing gestational age ( P=0.004), increasing cord blood glucose ( P<0.001), decreasing cord blood pH ( P<0.001) and decreasing sampling age ( P=0.027). Conclusions: Setting uniform ACBGL cutoffs for NH definition is unachievable due to the enormous heterogeneity among newborns. Hence, we provide group-based ACBGL standards in CD neonates. We propose setting ACBGL cutoffs for use in CD neonates: 1) hypoglycemia: ACBGL <5th percentile (<35 mg/dL); and 2) interventional hypoglycemia: ACBGL <1st percentile (<30 mg/dL). [ABSTRACT FROM AUTHOR]

Clinically, blood sample analysis has been widely used for health monitoring. In hospitals, arterial and venous blood are utilized to detect various disease biomarkers. However, collection methods are invasive, painful, may result in injury and contamination, and skilled workers are required, making these methods unsuitable for use in a resource-limited setting. In contrast, capillary blood is easily collected by a minimally invasive procedure and has excellent potential for use in point-of-care (POC) health monitoring. In this review, we first discuss the differences among arterial blood, venous blood, and capillary blood in terms of the puncture sites, components, sample volume, collection methods, and application areas. Additionally, we review the most recent advances in capillary blood-based commercial products and microfluidic instruments for various applications. We also compare the accuracy of microfluidic-based testing with that of laboratory-based testing for capillary blood-based disease diagnosis at the POC. Finally, we discuss the challenges and future perspectives for developing capillary blood-based POC instruments. [ABSTRACT FROM PUBLISHER]

Background: Dairy cows have a massive demand for glucose at the onset of lactation. A poor adaption to this period leads to an excessive negative energy balance with an increased risk for ketosis and impaired animal health and production. Besides the measurement of ketones, analysing the glucose concentration in blood is reported as helpful instrument for diagnosis and differentiation of ketosis. Monitoring metabolic parameters requires multiple blood sampling. In other species, new blood sampling techniques have been introduced in which small amounts of blood are rapidly analysed using electronic hand-held devices. The objective of this study was to evaluate the suitability of capillary blood for blood glucose measurement in dairy cows using the hand-held devices FreeStyle Precision (FSP, Abbott), GlucoMen LX Plus (GLX, A. Menarini) and the WellionVet GLUCO CALEA, (WGC, MED TRUST). In total, 240 capillary blood samples were obtained from dry and fresh lactating Holstein-Friesian cows. Blood was collected from the skin of the exterior vulva by using a lancet. For method comparison, additional blood samples were taken from a coccygeal vessel and analyzed in a laboratory. Glucose concentrations measured by a standard laboratory method were defined as the criterion standard. Results: The Pearson correlation coefficients between the glucose concentrations analyzed in capillary blood with the devices and the reference were 73 % for the FSP, 81 % for the GLX and 41 % for the WGC. Bland-Altman plots showed biases of -18.8 mg/dL for the FSP, -11.2 mg/dL for the GLX and +20.82 mg/dL for the WGC. The optimized threshold determined by a Receiver Operating Characteristics analysis to detect hyperglycemia using the FSP was 43 mg/dL with a sensitivity (Se) and specificity (Sp) of 76 and 80 %. Using the GLX and WGC optimized thresholds were 49 mg/dL (Se = 92 %, Sp = 85 %) and 95 mg/dL (Se = 39 %, Sp = 92 %). Conclusions: The results of this study demonstrate good performance characteristics for the GLX and moderate for the FSP to detect hyperglycemia in dairy cows using capillary blood. With the study settings, the WGC was not suitable for determination of glucose concentrations. [ABSTRACT FROM AUTHOR]

Objectives: Blood obtained via fingerprick is commonly used in point-of-care assays, but few studies have assessed variability in parameters obtained from successive drops of fingerprick blood, which may cause problems for clinical decision making and for assessing accuracy of point-of-care tests.Methods: We used a hematology analyzer to analyze the hemoglobin concentration, total WBC count, three-part WBC differential, and platelet count in six successive drops of blood collected from one fingerprick from each of 11 donors, and we used a hemoglobinometer to measure the hemoglobin concentration of 10 drops of fingerprick blood from each of 7 donors.Results: The average percent coefficient of variation (CV) for successive drops of fingerprick blood was higher by up to 3.4 times for hemoglobin, 5.7 times for WBC count, 3 times for lymphocyte count, 7.7 times for granulocyte count, and 4 times for platelets than in venous controls measured using a hematology analyzer. The average percent CV for fingerprick blood was up to 5 times higher for hemoglobin than venous blood measured using a point-of-care hemoglobinometer. Fluctuations in blood parameters with increasing volume of fingerprick blood are within instrument variability for volumes equal to or greater than 60 to 100 μL.Conclusions: These data suggest caution when using measurements from a single drop of fingerprick blood. [ABSTRACT FROM AUTHOR]

Background. Reliable reverse transcription polymerase chain reaction (RT-PCR)-based diagnosis of Ebola virus infection currently requires a blood sample obtained by intravenous puncture. During the current Ebola outbreak in Guinea, we evaluated the usability of capillary blood samples collected from fingersticks of patients suspected of having Ebola virus disease (EVD) for field diagnostics during an outbreak emergency. Methods. A total of 120 venous and capillary blood samples were collected from 53 patients admitted to the Ebola Treatment Centre in Guéckédou, Guinea, between July and August 2014. All sample specimens were analyzed by RT-PCR using the RealStar Filovirus Screen RT-PCR Kit 1.0 from altona Diagnostics (Germany). We compared samples obtained by venipuncture and those obtained by capillary blood sampling absorbed onto swab devices. Results. The resulting sensitivity and specificity of tests performed with capillary blood samples were 86.8% (95% confidence interval [CI], 71.9%-95.6%; 33/38 patients) and 100% (95% CI, 84.6%-100%; 22/22 patients), respectively. Conclusions. Our data suggest that capillary blood samples could serve as an alternative to venous blood samples for the diagnosis of EVD in resource-limited settings during a crisis. This can be of particular advantage in cases when venipuncture is difficult to perform--for example, with newborns and infants or when adult patients reject venipuncture for cultural or religious reasons. [ABSTRACT FROM AUTHOR]

Introduction The research demonstrated the way to compare performances of five capillary blood collection tubes for capillary blood collections among patients with pediatrics utilizing the Clinical and Laboratory Standards Institute ( CLSI) document EP9-A2. Methods A questionnaire survey was distributed to evaluate the accessibility and reliability of capillary blood collection tubes from different sources. Visual examination, microscopic examination of blood smears, and instrumental analysis were performed to evaluate the blood sample quality in different tubes. The background test, comparison test, and reliability test were used to analyze the engineering quality and the performance of additives in the tubes, and to determine the reliability of the tubes in routine blood tests. Results The tubes of brand A were found to be easy to access, with a shorter blood collection time and greater acceptability by users, and the quality of blood samples in those tubes was superior, with no coagulation and less blood cell disruption. Conclusion Commercially available capillary blood collection tubes were superior to 'in-house' tubes. In clinical practice, 'in-house' capillary blood collection tubes are not recommended. The guideline of 'method comparison and bias estimation using patient samples' from CLSI could also be used in comparing the performances of capillary blood collections. [ABSTRACT FROM AUTHOR]

Topical progesterone creams and gels can be obtained over the counter and/or by prescription from custom-compounding pharmacies and are used by thousands of postmenopausal women for hormonal treatment. However, the effectiveness of these preparations for protecting the endometrium from unopposed estrogen is controversial, due largely to the very low serum progesterone levels that are achieved. Despite these low serum levels, salivary and capillary blood levels are very high and a protective endometrium has been reported in a limited number of studies. Topical alcohol-based, but not water-based, gels appear to yield luteal-phase serum progesterone levels but studies with these preparations are scant. Long-term studies with percutaneous progesterone creams and gels are likely to provide valuable information for treatment of postmenopausal women with this popular route of administration. [ABSTRACT FROM AUTHOR]

To investigate the kinetics of cell-free DNA (cfDNA) due to exercise, we established a direct real-time PCR for the quantification of cfDNA from unpurified capillary plasma by amplification of a 90- and a 222-bp multilocus L1PA2 sequence. Twenty-six male athletes performed an incremental treadmill test. For cfDNA measurement, capillary samples were collected serially from the fingertip preexercise, during, and several times postexercise. Venous blood was drawn before and immediately after exercise to compare capillary and venous cfDNA values. To elucidate the strongest association of cfDNA accumulations with either cardiorespiratory or metabolic function during exercise, capillary cfDNA values were correlated with standard measures like heart rate, oxygen consumption, or lactate concentrations. The venous cfDNA concentrations were significantly higher compared with the capillary plasma, but in both fractions cfDNA increased 9.8-fold and the values correlated significantly (r = 0.796). During incremental treadmill running, the capillary cfDNA concentrations increased nearly parallel to the lactate values. The values correlated best with heart rate and energy expenditure, followed by oxygen consumption, Borg values, and lactate levels (0.710 ≤ r ≥ 0.808). With this article, we present a sensitive procedure for the direct quantification of cfDNA in unpurified capillary plasma instead of purified venous plasma. Further studies should investigate the differences between capillary and venous cfDNA that might mirror different physiological mechanisms. Enhanced cardiorespiratory function during exercise might lead to the accumulation of cfDNA via the release of stress hormones that already increase at intensities below the anaerobic threshold. Furthermore, cfDNA might be released by neutrophil extracellular traps. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to quantify the relationship between venous and capillary blood sampling methods for the measurement of plasma interleukin-6 (IL-6). A parallel study was conducted to determine the possibility of measuring IL-6 in sweat using an enzyme-linked immunosorbent assay (ELISA) and investigate the relationship between plasma- and sweat-derived measures of IL-6. Methods: Twelve male participants were recruited for the measurement of IL-6 at rest and during exercise (study 1). An additional group of five female participants was recruited for the measurement of IL-6 in venous blood versus sweat at rest and following exercise (study 2). In study 1, venous and capillary blood samples were collected at rest and in response to exercise. In study 2, venous and sweat samples were collected following exercise. Results: Mean plasma IL-6 concentration was not different between venous and capillary blood sampling methods either at rest (4.27 ± 5.40 vs. 4.14 ± 4.45 pg ml), during (5.40 ± 5.17 vs. 5.58 ± 6.34 pg ml), or in response to exercise (6.95 ± 6.37 vs. 6.99 ± 6.74 pg ml). There was no IL-6 detectable in sweat either at rest or following exercise. Conclusion: There are no differences in the measurement of plasma IL-6 using either venous or capillary blood sampling methods. Capillary measurement represents a minimally invasive way of measuring IL-6 and detecting changes in IL-6, which are linked to fatigue and overtraining. [ABSTRACT FROM AUTHOR]

An increasing number of studies examining gene expression associated with diseases in children is likely, in the near future, to provide simple and easy to use methods for the isolation of RNA for gene expression profiling. Prerequisites for such studies are likely to encompass the use of small amounts of blood, as well as less invasive blood collection methods. In the current study, RNA was isolated from 20 μl capillary blood samples from the earlobes of 10 adults for quantitative PCR experiments. The results were compared with RNA isolated from venipuncture samples of the 10 samples. The expression of 4 mRNAs and 1 microRNA (miRNA), miRNA-126, was measured. The quantitative PCR results obtained with the capillary blood probes were similar to results using venous blood samples. The few differences observed may result from a variation in the blood cell composition. The use of capillary blood samples from the earlobe for gene expression analysis is likely to allow this method to be used in newborns, babies and children. In addition, such a method, using microliters of blood samples, may also be useful for other medical studies e.g., in cases where repetitive blood sampling is necessary or in patients with bleeding disorders. [ABSTRACT FROM AUTHOR]

The review describes a new method of therapeutic drug monitoring (TDM) based on direct infusion of low-molecular fraction of blood into an electrospray ionization source of mass spectrometer. This technique allows performing TDM of almost all drugs used in clinical practice. Universality and a high-throughput mode of the method significantly simplify wide application of this method. Moreover, the possibility of method application in most cases of drug therapy has been argued as a tool for control of drug doses, rationality of drug therapy, and quality of drugs used. In conclusion, prospects for application of the method as primary means of improving the quality and personalization of drug therapy have been discussed. [ABSTRACT FROM AUTHOR]