No / The aim of this review was to examine whether the measurement of lactate in capillary blood samples using point-of-care handheld analysers corresponds sufficiently closely with arterial and venous whole-blood samples analysed by hospital central laboratory or blood gas analyser to be used interchangeably. A systematic search, informed by focused inclusion/exclusion criteria, was performed using multiple databases up to October 2015. A total of 65 articles were considered to have potential relevance and were evaluated in full text, of which ultimately five articles met all inclusion/exclusion criteria, and a final four were selected after data extraction and quality appraisal. All four studies found a predominantly upward bias in the measurement of lactate in capillary samples tested using a handheld point-of-care device over arterial or venous samples tested by laboratory methods or blood gas analyser. In terms of correlation, there was consensus between the studies that the strength of association between the two methods of measurement was statistically significant. Three studies directly examined the extent of agreement between point-of-care capillary lactate measurements and those of laboratory or blood gas analyser reference determined to ±2 standard deviations; 95% confidence intervals, and report contextually broad limits of agreement, identifying a potential for both over triage and, to a lesser extent, under triage. The findings of the review do not support interchangeable use of handheld fingertip point-of-care lactate measurement with laboratory or blood gas analyser methods in the identification of sepsis.

Theses (Msc.(Med.)(Pharmacy))--University of Limpopo, 2010. / With the availability of Highly Active Antiretroviral Therapy (HAART), one of the limitations of treatment safety is the occurrence of adverse events associated with antiretroviral agents. The aim of this study was to establish whether stavudine dosage reduction prevents toxicity from developing and minimizes the incidence of symptomatic hyperlactataemia/lactic acidosis (LA) in adults female HIV/AIDS infected patients. This retrospective study covered adult patients treated at the adult ARV clinic, Dr George Mukhari Hospital. The records of 88 patients aged between 27 and 59 years, initiated and treated from August 2004 to January 2006, were analyzed ( 67 females and 21 males). Twenty nine females started their treatment on a regimen containing 40 mg stavudine while 38 females were started on 30 mg stavudine. A group of male patients (n=21) were included for comparison. Seven males started on 40 mg stavudine and 14 were on 30 mg stavudine. Ten out of twenty nine females who started treatment on 40 mg stavudine developed elevated lactate levels while nineteen received 30 mg stavudine as reduced dose. Eight out of nineteen further developed elevated lactate levels when on 30 mg stavudine but eleven out of nineteen remained stable on treatment with 30 mg stavudine as reduced dose. In the group started on 30 mg stavudine, thirteen females out of thirty seven developed elevated lactate levels while twenty four were stable on their treatment. Key words: stavudine, dosage reduction, lactate levels, hyperlactataemia, lactic acidosis.