Summary. Aim: Currently there are some large-scale studies of elevated total vitamin B12 in relation to diseases and their prognosis. Aim of this retrospective study was to determine association of increased B12 as an additional diagnostic marker of oncohematological diseases by a statistical analysis of clinical data of 79,524 patients. Materials and Methods: Overall Latvian population representative data on B12 testing in 79,524 patients were obtained from laboratory database. The following exclusion criteria were applied: fluctuating B12 results within a three-month period, elevated (> 100 U/L) alanine transaminase or aspartate transaminase, hepatitis (HAV, HBV, and HCV) infection, reduced glomerular filtration rate (< 45 mL/min/1.73 m2). As a control group, individuals with normal B12 level and any oncologic diagnosis (solid cancer or hematological malignancies) were selected. Results: After application of step-by-step exclusion filters, 1,373 patients were left with significantly increased level of plasma B12 (> 1,700 pg/mL). Odds ratios for oncohematological diseases in total and myeloid leukemia (including acute, chronic and unspecified) in patient group with elevated B12 were found to be 6.0 (95% CI 4.7–7.6; p < 0.0001) and 19.2 (95% CI 13.1–28.0; p <0.0001), respectively, as compared to the control group. Conclusion: Elevated total B12 could be considered as a potential marker for oncohematological disorders.
There is an urgency for the rapid and simple SARS-CoV-2 detection method. Our study aimed to demonstrate that saliva can be used as a specimen for SARS-CoV-2 detection notably for the screening of extensive population groups via pooling. We collected paired nasopharyngeal/oropharyngeal swabs (NPS) and saliva and performed 36 serial measurements of 8 SARS-CoV-2 positive saliva samples to confirm the stability of the specimen. We also completed 37 pools by adding one positive saliva specimen per pool. A field study including 3,660 participants was performed between September 29 and October 1, 2020. Saliva specimens were stable for testing for up to 24 hours. Overall, 1.2% of the saliva samples tested positive for SARS-CoV-2. The results of saliva samples were consistent with those obtained from NPS with 90% sensitivity (95% CI 68.3%-98.7%) and 100% specificity during the first two weeks after the onset of symptoms. All pools showed 100% positivity in different pooling proportions. Our findings demonstrate that saliva is an appropriate specimen for pooling and SARS-CoV-2 screening with accurate diagnostic performance. Patient-performed specimen collection allows testing an extensive number of people rapidly, obtaining results of the spread of SARS-CoV-2 and allowing authorities to take timely measures.
The aim of our study was to demonstrate that saliva can be used as an effective material for SARS-CoV-2 testing and screening of large population groups to identify Covid-19 clusters. The most important aspect of saliva sampling approach is the convenience of obtaining material by self- sampling that is even possible at home. In our experiments, saliva was sufficiently stable for testing for at least 24 hours after collection. The results obtained from the saliva of a SARS-CoV-2 positive patient were consistent with those obtained from nasopharyngeal and oropharyngeal swabs from the same patient with the sensitivity 90% and specificity 100% during the first two weeks after the onset of symptoms. To demonstrate the usefulness of testing saliva material for mass screening, crowd sampling with pooling was performed on 3660 people in 3-day time (44 samples were tested positive). We conclude that saliva testing is an appropriate tool for screening campaigns and cluster detection, that is able to detect more infected people in a shorter period of time with little human resources and thus help to stop the epidemic spread more quickly.
This study compared the reference intervals (RI) of B12 vitamin concentration in blood found in the literature with RIs extracted from data accumulated from a large number of patients by E. Gulbis Laboratory in Latvia. This paper investigated and demonstrated the possibility of using large amounts of random patient data to establish the RI for clinical laboratory tests. The blood level of B12 vitamin was selected as the model system for this study. The study used blind data for B12 blood level measurements from 132 379 patients accumulated in E. Gulbis Laboratory over a period of 15 years. In order to establish the reference intervals, the frequency distribution of log transformed B12 values was fit to a Gaussian distribution. The established B12 reference interval of 196 pg/ml and 942 pg/ml was found to be in good agreement with RIs reported elsewhere.
BackgroundThe number of COVID-19 cases is increasing globally and there is an urgency for a simple non-invasive method for the detection of SARS-CoV-2. Our study aimed to demonstrate that saliva can be used as a specimen for SARS-CoV-2 detection notably for the screening of extensive population groups via pooling. MethodsWe performed 36 serial measurements of 8 SARS-CoV-2 positive saliva samples to confirm the stability of the specimen and completed 37 pools of saliva samples by adding one positive specimen per pool. We collected paired nasopharyngeal/oropharyngeal swabs (NPS) and saliva specimens and processed them within 24 hours of collection. To demonstrate that saliva is an appropriate specimen for SARS-CoV-2 detection a field study including 3,660 participants was performed between September 29 and October 1, 2020. A new solution for distribution and collection of self-sampled saliva was designed, produced and installed. All methods were performed in accordance with the relevant guidelines and regulations.ResultsSaliva specimens were stable for testing for up to 24 hours. The results of saliva samples were consistent with those obtained from NPS from the same patient with 90% sensitivity (95% CI 68.3%-98.7%) and 100% specificity during the first two weeks after the onset of symptoms. Using pooling strategy 796 RT-PCR tests were performed. All pools showed 100% positivity in different pooling proportions. Overall, 44 saliva samples (1.2%) tested positive for SARS-CoV-2 during the field study. In total, between September 29 and April 10, 415 673 RT-PCR saliva tests were performed. The contactless self-service terminals were placed in hospitals, factories and municipalities as an additional way to submit self-collected saliva for testing.ConclusionOur findings demonstrate that saliva is an appropriate specimen for pooling and SARS-CoV-2 screening with accurate diagnostic performance. Patient-performed simple specimen collection allows testing an extensive number of people rapidly, obtaining results of the spread of SARS-CoV-2 and allowing authorities to take timely measures. Automated sample distribution and collection points are accessible 24/7 allowing safe, contactless and more efficient way to submit various kind of samples for testing.
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