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Flow cytometric lyophilised reagent tube assay for peripheral blood neutrophil myeloperoxidase expression to rule out myelodysplastic neoplasms at a university hospital: a diagnostic accuracy study

Por: Planta · C. · Scheffen · L. · Jacob · M.-C. · Szymanski · G. · Chevalier · S. · Tondeur · S. · Bulabois · B. · Meunier · M. · Lefebvre · C. · Gonnet · N. · Garban · F. · Molina · L. · Paradis · C. · Seigneurin · A. · Chiriac · R. · Merle · R. · Labarere · J. · Park · S. · Raskovalova · T.
Objectives

Although flow cytometric analysis of peripheral blood neutrophil myeloperoxidase expression can accurately rule out myelodysplastic neoplasms (MDS), it lacks reliability and efficiency due to the practical limitations of laboratory-developed liquid reagent-based assays. This study aimed to quantify the agreement and comparative discriminatory accuracy between a single-use flow cytometric lyophilised reagent tube (BD Lyotube Stain 468) and its laboratory-developed liquid reagent counterpart.

Design

Cross-sectional diagnostic accuracy study of two index tests against a reference diagnosis.

Setting

A university hospital in France.

Participants

Consecutive adult patients with an indication for bone marrow aspiration due to suspected MDS and unexplained peripheral blood cytopenia.

Primary outcome

MDS confirmed by cytomorphological evaluation of the bone marrow aspirate performed in duplicate by experienced haematopathologists blinded to the index test.

Results

Of 103 participants enrolled between July 2020 and August 2021, 37 had MDS (prevalence, 36%). The median intra-individual robust coefficient of variation (RCV) for myeloperoxidase expression was 30.9% using the BD Lyotube Stain 468 and 31.2% using the laboratory-developed liquid reagent assay, with an intraclass correlation coefficient of 0.94 (95% CI 0.91 to 0.96). The areas under the receiver operating characteristic curves were 0.83 (95% CI 0.74 to 0.90) and 0.82 (95% CI 0.73 to 0.89), respectively. Using a prespecified threshold of 30.0%, the corresponding sensitivity estimates were 89% (95% CI 75% to 97%) and 95% (95% CI 82% to 99%).

Conclusion

BD Lyotube Stain 468 performs as well as its laboratory-developed liquid reagent counterpart for the quantification of myeloperoxidase expression by peripheral blood neutrophils. It may obviate the need for invasive bone marrow aspiration in up to 40% of patients with suspected MDS.

Trials registration number

NCT04399018.

Psychosocial impact of the COVID-19 pandemic on children with chronic health conditions in Germany: a qualitative interview study

Por: Lukes · S. · Schäfer · T. · Dessauer · E. · Diefenbach · C. · Urschitz · M. S. · Boll · T. · Hammerle · F.
Objectives

To investigate the psychosocial impact of the COVID-19 pandemic on children with chronic health conditions (CHC) and their legal guardians (LG) living in Germany.

Design

Qualitative interview study based on the transcripts of semistructured individual telephone interviews.

Methods

Data were collected from October to December 2021 and the time frame of reference was January–June 2021 with two interviewers. Discussed aspects were, for example, socioeconomic information, daily life, thoughts and feelings of both children and LG, as well as family communication, unmet needs and possible advantages. Data were analysed using qualitative content analysis. The category system and subsequent coding schemes with anchor examples were based on interviews and the interview guide. It was tested for integrity and feasibility with one interview and finalised. To ensure classification reliability within all 11 interviews, 1 specifically trained rater (who did not participate in the interviewing to separate data collection and analysis) coded all transcripts.

Participants

11 LG of children with CHC participating in the ikidS (ich komme in die Schule) study.

Results

The three aspects that were mentioned most often in the interviews were a psychological impact on children, a psychological impact on LG and an impact on the daily routines of LG. The majority of children and LG were burdened, had changed their activities and spent more time together, while having more conflicts. Children did not worry about becoming infected with COVID-19, but were worried about the health of their relatives. It was further reported that children had become more autonomous. LG additionally reported unmet needs such as opportunities for childcare or psychotherapy.

Conclusions

While the changes brought about by the COVID-19 pandemic and their impact were often seen as negative, the LG in our study also perceived some opportunities for personal development both in their children and themselves, underlining that future research on the impact of the COVID-19 pandemic should focus not only on negative consequences but also on opportunities and positive change. Qualitative methods can be used on an exploratory basis to inform quantitative studies, as they are able to delve deeper into the area being examined and provide greater insight into which aspects interviewees focus on.

The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany

Breastfeeding is beneficial for both mother and child. A breastfed child can benefit from improved mental developments, protection against infectious diseases and infectious disease mortality, and a decreased risk of overweight and obesity(Whalen and Cramton 2010) (Regional Office for Europe (World Health Organisation) 2019). Furthermore, there is evidence on protection against type 1 and 2 diabetes, allergic rhinitis, asthma or wheezing, atopic dermatitis, childhood leukemia, hypercholesterolemia later in life, sudden infant death syndrome (Whalen and Cramton 2010) and malocclusion (Victora et al.
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