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Background: Adopting the WHO protocol for glucose analysis is arguably impractical in the routine clinical setting. Deviations may develop due to a lack of understanding regarding the impact of glycolysis on the accuracy of results. Aim: We sought to assess the stability of glucose in two different blood collection tubes (BCT), BD Vacutainer® FX 'Fl-Ox' and Greiner Vacuette® FC-Mix 'FC-Mix' stored at room temperature (RT:18–22°C) and 4°C over 8.5 days. Method: Each participant provided venous whole blood collected into 51 BCTs; 'Fl-Ox' (n = 26) and 'FC-Mix' (n = 25). One Fl-Ox sample from each participant was handled according to the WHO recommended method. The remaining BCTs were stored at 4°C/RT prior to analyses at designated study timepoints. Glucose was measured using the hexokinase assay on the Cobas® 8000 platform. Results: Participants (n = 8, Male = 2) were aged 24–56 years. Plasma glucose measured in FI-Ox BCTs according to the WHO sample-handling method had a median concentration of 5.73 mmol/L (Range: 5.39–10.37 mmol/L). Glucose decreased by greater than minimal difference (>0.26 mmol/L) in blood collected into Fl-Ox and stored @4°C/RT within 24 h of phlebotomy. FC-Mix BCT maintained glucose <0.26 mmol/L @4°C over a period of 8.5 days and up to 4 days @RT when compared to the WHO recommended method. Conclusion: Glucose in FC-Mix BCT stored @4°C demonstrated the best agreement with results determined using the WHO specifications. When FC-Mix tubes were stored @RT, glucose was stable for 4 days. These findings suggest that the FC-Mix BCT effectively inhibits glycolysis and should be introduced into routine clinical practice. [ABSTRACT FROM AUTHOR]

This research is a cross-sectional study of young adult gay men (YAGM), ages 18 to 29, that aims to understand their health-care access including: having a primary care provider (PCP), frequency of health-care visits, and instances of foregone health care. Surveys were conducted with a modified time-space sample of 800 YAGM in New York City (NYC). Surveys were conducted between November 2015 and June 2016. This study examined associations between sociodemographic characteristics and health-care access using multivariable logistic regression models. In multivariable logistic regression models, there were higher odds of having a PCP among participants enrolled in school (Adjusted Odds Ratio [AOR] = 1.85, 95% CI [1.18, 2.91], p < .01) and covered by insurance (AOR = 21.29, 95% CI [11.77, 38.53], p < .001). Modeling indicated higher odds of more than one health visit in the past 12 months for non-White participants (AOR = 2.27, 95% CI [1.43, 3.63], p < .001), those covered by insurance (AOR = 3.10, 95% CI [1.06, 9.04], p < .05), and those who disclosed their sexual orientation to their PCP (AOR = 2.99, 95% CI [1.58, 5.69], p < .001). Participants with insurance were less likely to report instances of foregone care (AOR = 0.21, 95% CI [0.21, 0.13], p < .001). Understanding the facilitators and barriers to health-care access among YAGM populations is of critical importance, as many YAGM between the ages of 18 and 29 are establishing their access to health care without parental guidance. Health-care access, including the decision to forego care, can represent a missed opportunity for primary prevention and early diagnosis of health issues, as well as more effective, less invasive, and less costly treatments.

Many low-income people of color living with HIV are not virally suppressed. More research is needed to understand how socially marginalized, disengaged, or inconsistently engaged people living with HIV (PLWH) contend with antiretroviral therapy (ART)-related challenges, particularly in the context of interactions with HIV care providers. Twenty-seven semi-structured interviews were conducted with low-income Black and Hispanic PLWH in the New York City area who were currently, or recently, disengaged from outpatient HIV health care at the time of the interview. Participants valued patient-centered health care in which they felt genuinely heard and cared for by their HIV clinicians. This desire was particularly pronounced in the context of wanting to change one's ART regimen. Participant emphasis on wanting to manage ART-related challenges with their providers suggests that HIV providers have an instrumental role in helping their patients feel able to manage their HIV. [ABSTRACT FROM AUTHOR]

Importance: Transient hypocalcemia is a well-recognized occurrence after total thyroidectomy. It has been hypothesized that underlying vitamin D deficiency may increase the risk of this complication, although to date there are few data in the literature supporting this hypothesis., Objective: To investigate whether perioperative vitamin D levels have any effect on postthyroidectomy hypocalcemia., Design, Setting, and Participants: We performed a retrospective review of a prospectively maintained database of thyroidectomies from November 1, 2009, through September 30, 2012, at an academic teaching hospital. The study included 121 patients with available vitamin D levels undergoing total or completion thyroidectomy. Patients with preexisting hypercalcemia or hyperparathyroidism were excluded., Interventions: All patients underwent total removal of all thyroid tissue by a capsular dissection technique. Routine calcium or vitamin D supplementation was not administered. Biochemical hypocalcemia was defined as any single postoperative corrected calcium level less than 8.0 mg/dL (to convert to millimoles per liter, multiply by 0.25) and symptomatic hypocalcemia as any symptoms of hypocalcemia., Main Outcomes and Measures: Outcome measures were incidence of postoperative hypocalcemia and association with vitamin D levels. A multivariate analysis was performed to study the effect of other variables, including performance of central neck dissection, incidental parathyroidectomy, and hyperthyroidism, on the incidence of postoperative hypocalcemia., Results: The incidence of transient biochemical hypocalcemia was 24% (n = 29/121). There was no correlation between vitamin D levels and risk of postoperative hypocalcemia. On univariate analysis, performance of concomitant central compartment neck dissection revealed an increased risk of hypocalcemia (P = .06), but this finding was not significant on multivariate analysis., Conclusions and Relevance: Vitamin D levels do not appear to have a significant effect on the risk of postthyroidectomy hypocalcemia.