Mclaughlin Berry (queendecade3)

There is interest in measuring total mercury (THg) and methylmercury (MeHg) in dried blood spots (DBS) though more research is required to evaluate mercury (Hg) speciation in DBS and to validate the agreement between blood sources (venous vs capillary) and matrices (whole blood vs DBS). Therefore, the present study aimed to develop, evaluate, and validate a DBS-based method to assess MeHg and inorganic mercury (InHg) exposure in human population studies. First, we used volume-controlled (40 μL) paired DBS-whole blood samples to develop an analytical method that involved the extraction and quantification of MeHg and InHg with gas chromatography-cold vapor atomic fluorescence spectrometry (GC-CVAFS). Next, we carried out a validation study using paired DBS-whole blood samples from venous and capillary sources from 49 volunteers with Hg exposures similar to background populations (i.e., MeHg in venous whole blood ranged from 0.2 to 3 μg/L with a median value of 0.8). The limits of detection were higher for InHg (1.9 and 1.1 μg/L in DBS and whole blood, respectively) than MeHg (0.3 and 0.2 μg/L in DBS and whole blood, respectively). The MeHg concentrations among blood sources and matrices were highly correlated (r ranged from 0.85 to 0.95), with no constant bias (intercept ranged from -0.05 to 0.13 μg/L) and small proportional bias (slopes ranged from 0.92 to 1.08). Bland-Altman plots indicated little bias between MeHg measurements with 82-98% of the cases meeting the analytical acceptance criterion of 35% maximum allowed difference. Our results indicate that measures of MeHg in capillary DBS reflect concentrations in the gold standard (i.e., venous whole blood) and that DBS is a suitable tool for assessing MeHg exposure in human population studies, but that more work is required to assess InHg exposures.OBJECTIVE The fungal infections remain an important problem in the allogeneic stem cell trasnsplantation (allo-SCT) setting and thus, anti-fungal prophylaxis is commonly used. The antifungal drug should offer activity, at least against Candida and Aspergillus spp., a good safety profile and low probability interactions. Micafungin could theoretically fulfill these requisites. The aim of the study was to describe the experience with micafungin as primary prophylaxis in patients undergoing allo-SCT in a cohort of Spanish centres, and to evaluate its efficacy and tolerability in this population. METHODS Retrospective multicentre observational study including all consecutive adult patients admitted for allo-SCT in participating centres of the Grupo Español de Trasplante Hematopoyético (GETH), from January 2010 to December 2013, who received micafungin as primary prophylaxis during the neutropenic period. RESULTS A total of 240 patients from 13 centres were identified and 159 patients were included for the analysis. Most patients (95.6%) received 50 mg/day of micafungin. During the follow-up, 7 (4.4%) patients developed breakthrough invasive fungal disease, 1 proven and 6 probable; one patient discontinued the drug because of serious drug interactions. Prophylaxis with micafungin was considered effective in 151 (94.9%) patients. CONCLUSIONS According to our experience, micafungin is an appropriate alternative for antifungal prophylaxis in patients undergoing an allo-HSCT, because its efficacy, its low profile of drug interactions and side-effects. ©The Author 2020. Published by Sociedad Española de Quimioterapia. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)(https//creativecommons.org/licenses/by-nc/4.0/).Background It was reported that hemodialysis (HD) with either a new or reused dialyzer raises medical problems that require therapeutic regimens. This study aimed to investigate the medical problems and their management in patients undergoing HD. Methods This study was conducted by prospectively observing patients with chronic kidney disease undergoing