[Relationship between red blood cell parameters and hemoglobin A1c levels based on a retrospective evaluation of 10 years of data]

Bevezetés: A hemoglobin-A1c (HbA1c)-szint mérését általánosan használják a betegek anyagcserekontrolljának értékelésére. Több megfigyelés szerint a HbA1c-szintet azonban befolyásolja a súlyos anaemia, illetve annak típusa. Célkitűzés: Munkánk során azt értékeltük, hogy az általános orvosi gyakorlatban figyelembe kell-e venni a HbA1c-szint értékelése során a betegeknél a rutinszerűen kért, anaemiát is tükröző vörösvérsejt-paramétereket. Módszer: A 2008 és 2018 közötti időszakból 60 225 beteg adatait válogattuk le, akiknél egy (első) alkalommal HbA1c-szint-mérés és vérképvizsgálat történt. Először a paraméterek diszkrét tartományaiban értékeltük a HbA1c-megoszlást. A vörösvérsejtek (RBC) száma, az átlagos vörösvérsejt-térfogat (MCV), a hemoglobin (HB) szintje, a hematokrit (HCT) és a vörösvérsejtméret-eloszlás (RDW) közötti kapcsolat értékelésére többszörös regressziós modellt alkalmaztunk. A paraméterek és a HbA1c-szint közötti hatás mértékét az adatok z-score-szerű transzformációja alapján „coefficient of estimates” (CE-) értékkel jellemeztük. A változók HbA1c-re gyakorolt együttes hatásának jellemzésére becslő képleteket dolgoztunk ki. Eredmények: Az életkor a HbA1c-értékek legerősebb determinánsa. Mindkét nemben az MCV, férfiakban az RDW negatív, nőkben az RBC pozitív irányú kapcsolatot mutatott a HbA1c-vel. A CE-értékek alapján egyik vizsgált paraméter sem fejt ki a HbA1c-re nagyobb hatást, mint az életkor. Az MCV, RDW, HB diszkrét tartományokban felvett hisztogramja azonos. A becslő képlettel kapott és a mért HbA1c-értékek nagymértékben eltértek. Megbeszélés: Bár egyes vörösvérsejt-paraméterek szignifikánsan összefüggenek a HbA1c-szinttel, ez klinikailag nem jelentős hatást tükröz. Következtetés: A rutin klinikai gyakorlatban a súlyos vérképző szervi eltéréssel járó esetektől eltekintve nem kell az MCV értékét figyelembe venni a HbA1c értékelése során. Orv Hetil. 2024; 165(7): 243–248.

Interrelationship of hemoglobin A1c level lipid profile, uric acid, C-reactive protein levels and age in a large hospital database

INTRODUCTION

Hemoglobin A1c (HbA1c) is used to monitor glucose homeostasis and to identify risk for diabetes. As diabetic patients are frequently present with dyslipidaemia, low-grade inflammation and hyperuricemia, we tested whether HbA1c levels can be estimated having the information about lipid profile, uric acid (UA) and C-reactive protein (CRP) levels. We developed formulas to describe the association of these parameters with HbA1c levels.

METHODS

Data of 9599 male and 10,817 female patients, measured between 2008 and 2018, were analysed. Patients represented a general hospital patient population with overrepresentation of those with elevated HbA1c over 5.6%. The impact of gender, age, CRP, lipid profile and UA levels on HbA1c % on HbA1c levels was tested with multiple linear regression model. The magnitude of effects of individual factors was used to develop formulas to describe the association between HbA1c and other cardiometabolic parameters. With these formulas we estimated median HbA1c values in each age in both gender and compared them to measured HbA1c levels.

RESULTS

The developed formulas are as follow: HbA1c (estimated) in women = 0.752 + 0.237*log10(HDL/cholesterol) + 0.156*log10 (cholesterol) + 0.077*log10 (triglyceride) + 0.025*log10(CRP) +0.001*log10 (age) -0.026*log10(HDL/LDL) -0.063*log10 (uric acid)-0.075*log10 (LDL)-0.199*log10(HDL); HbA1c (estimated) in men = 1.146 + 0.08*log10 (triglyceride) + 0.046*log10(CRP) + 0.01*log10 (cholesterol) + 0.001*log10 (age) -0.014*log10(HDL)-0.018*log10(HDL/LDL)-0.025*log10(HDL/cholesterol) -0.068*log10 (LDL)-0.159*log10 (uric acid) Between 20 and 70 years of age, estimated HbA1c matched perfectly to measured HbA1c in.

CONCLUSION

At population level, HbA1c levels can be estimated almost exactly based on lipid profile, CRP and uric acid levels in female patients between 20 and 70 years.

Acute SARS-CoV-2 infection and seropositivity among healthcare workers and medical students in summer 2020, Hungary

OBJECTIVES

The aim was to compare the prevalence of acute infection and seropositivity of SARS-CoV-2 among healthcare workers (HCWs) and medical students.

MATERIAL AND METHODS

A high-volume, single-center analysis was conducted in the period of July 1‒August 1, 2020, at the Semmelweis University. Naso- and oropharyngeal samples were collected for polymerase chain reaction (PCR), and blood samples for anti-SARS-CoV-2 IgG. A questionnaire was also administered about the infection symptoms and the obtained results were assessed by profession and site of care delivery.

RESULTS

From the total cohort (N = 7948), 4478 (56%) and 3470 (44%) were health professionals and medical students, respectively. They were mainly female (67%), and the mean age of HCWs and students was 40 and 25 years, respectively. By profession, physicians (1.5%) and other HCWs (1.8%) showed a comparable SARS-CoV-2 exposure. International students had the highest (2.1%), whereas Hungarian students had the lowest (0.6%) prevalence of seropositivity. The highest prevalence was detected among the staff of COVID-19 wards (12.1%). By PCR, medical students showed the lowest occurrence of active infection with a prevalence of 0.17%, while physicians and other HCWs had a higher prevalence (1.46% and 1.71%, respectively). By site of care delivery, positive test results were the most frequent at COVID-19 wards (3.8%).

CONCLUSIONS

Physicians and other HCWs showed comparable SARS-CoV-2 seropositivity prevalence, approximately twice as high as in the general population of Budapest. Hungarian students had lower prevalence of seropositivity than this reference. High prevalence among international students suggests that they had imported the infection. The very high prevalence of documented exposure among staff members at COVID-19 wards urges for improving the safety measures. Int J Occup Med Environ Health. 2022;35(2):209-16.

A proline tRNA(CGG) gene encompassing the attachment site of temperate phage 16-3 is functional and convertible to suppressor tRNA

Several temperate bacteriophage utilize chromosomal sequences encoding putative tRNA genes for phage attachment. However, whether these sequences belong to genes which are functional as tRNA is generally not known. In this article, we demonstrate that the attachment site of temperate phage 16-3 (attB) nests within an active proline tRNA gene in Rhizobium meliloti 41. A loss-of-function mutation in this tRNA gene leads to significant delay in switching from lag to exponential growth phase. We converted the putative Rhizobium gene to an active amber suppressor gene which suppressed amber mutant alleles of genes of 16-3 phage and of Escherichia coli origin in R. meliloti 41 and in Agrobacterium tumefaciens GV2260. Upon lysogenization of R. meliloti by phage 16-3, the proline tRNA gene retained its structural and functional integrity. Aspects of the co-evolution of a temperate phage and its bacterium host is discussed. The side product of this work, i.e. construction of amber suppressor tRNA genes in Rhizobium and Agrobacterium, for the first time widens the options of genetic study.

Multicenter retrospective evaluation of capsule endoscopy in clinical routine

BACKGROUND AND STUDY AIMS

The small bowel is anatomically difficult to examine; disease conditions are rarely located in it, but can be serious. Neither conventional radiography nor push enteroscopy has sufficient sensitivity and specificity to detect distinct lesions. Wireless capsule endoscopy can theoretically allow imaging of the entire small bowel, with only minimal discomfort for the patient.

PATIENTS AND METHODS

Between November 2001 and May 2003, 191 patients received 195 capsules. Data were collected retrospectively from consecutive patients in three centers. The indications for capsule endoscopy were obscure or occult bleeding, suspected Crohn's disease, or other reasons in 151, 25, and 15 patients, respectively. The clinical outcome after 6 months was evaluated on the basis of interviews with patients or relatives.

RESULTS

Visualization of the entire small bowel was adequate in 78.4 % of the examinations. The colon was not reached in 16.9 % of cases, and there were minor technical problems in 4.6 %. Relevant pathological findings were identified in 56.2 % of 151 patients with obscure bleeding or iron-deficiency anemia (64 % of whom received blood transfusions). The most common findings were angiodysplasia in 39.7 % of cases and ulcers of the small bowel in 7.3 %. In addition, individual cases of tumors and parasitic worms were detected. Seven of the 25 patients with suspected Crohn's disease (28 %) had the disease confirmed. Three of five patients with polyposis syndrome of the colon were found to have polyps in the small bowel.

CONCLUSIONS

Wireless capsule endoscopy can be recommended as part of the routine work-up in patients with obscure bleeding or iron-deficiency anemia. In patients with Crohn's disease, the method may be helpful in establishing or ruling out the diagnosis.

Integrative plasmid vector for constructing single-copy reporter systems to study gene regulation in Rhizobium meliloti and related species

The integrative system of phage 16-3 of Rhizobium meliloti 41 was shown to function in several bacterial species belonging to the Rhizobium, Bradyrhizobium, Azorhizobium, and Agrobacterium genera. It might also function in many other bacterial species provided that both the target site (attB) and the required host factor(s) are present. Here we report on the construction of a new integrative vector that can be utilized in gene regulation studies. It provides an opportunity to create a single-copy set-up for characterizing DNA-protein interactions in vivo, in a wide range of bacteria. To demonstrate the usefulness of the vector, transcription repression by binding of the C repressor protein of phage 16-3 to wild type operators was studied. The assay system provided highly reproducible quantitative data on repression.

Site-specific integrative elements of rhizobiophage 16-3 can integrate into proline tRNA (CGG) genes in different bacterial genera

The integrase protein of the Rhizobium meliloti 41 phage 16-3 has been classified as a member of the Int family of tyrosine recombinases. The site-specific recombination system of the phage belongs to the group in which the target site of integration (attB) is within a tRNA gene. Since tRNA genes are conserved, we expected that the target sequence of the site-specific recombination system of the 16-3 phage could occur in other species and integration could take place if the required putative host factors were also provided by the targeted cells. Here we report that a plasmid (pSEM167) carrying the attP element and the integrase gene (int) of the phage can integrate into the chromosomes of R. meliloti 1021 and eight other species. In all cases integration occurred at so-far-unidentified, putative proline tRNA (CGG) genes, indicating the possibility of their common origin. Multiple alignment of the sequences suggested that the location of the att core was different from that expected previously. The minimal attB was identified as a 23-bp sequence corresponding to the anticodon arm of the tRNA.

Refractive index of NH(4)Cl-H2O as a function of wavelength: the effect of temperature and concentration

The refractive index of NH(4)Cl-H(2)O solutions has been measured over a wavelength range from 496.5 to 690 nm. The NH(4)Cl concentration was varied from 15 to 30 wt. % over a temperature range from 10 to 35 °C. We obtained mathematical equations relating the refractive index to wavelength, temperature, and concentration using the least-squares method. A knowledge of these properties is important for analyzing and modeling the dendritic growth of this system.