A Guttmacher Institute survey of abortion providers estimated that medication abortions accounted for 17% of all abortions and slightly over 25% of abortions before 9 weeks gestation in the United States in 2008 (94% of nonhospital medication abortions used mifepristone and misoprostol, 6% used methotrexate and misoprostol). Medication abortions accounted for 32% of first trimester abortions at Planned Parenthood clinics in the United States in 2008. Considering abortions performed in non-hospital facilities, medication abortions accounted for 24% in 2011 and 31% in 2014. In 2014, facilities that provided a relatively small number of abortions (fewer than 400 procedures per year) were more likely to perform them with medication. Medication abortions accounted for 39% of all U.S. abortions in 2017, and 54% in 2020.
In diagnostics, the development of point-of-care tests (POCT) is receiving considerable attention. Usually, the validation of POCT is focused on various types of samples and matrices such as blood, serum, sputum, urine, nose swabs, throat swabs and wound swabs, as well as the anatomical sites to be sampled (e.g. Maffert et al. 2017; Rozand 2014; Senn et al. 2012). Most POCT use swabs for sampling and/or for applying a sample on the test; however, usually the validation of POCT with various swabs is not usually performed. Swabs commercially available can differ in tip materials, such as nylon, rayon, cotton, polyester, polyurethane, calcium alginate and the chemical or physical characteristics can influence the specimen collection and release; moreover also the structure of the tips can vary (i.e. flocked fiber, tightly wound and knitted). Most studies related to various types of swabs have focused on environmental samples and collection of samples from different types of surfaces (e.g. Dadhania et al. 2013; Hansson et al. 2009; You et al. 2019). In clinical diagnostics, the evaluation of swabs was performed mainly based on CFU which provides information only about living bacterial cells (Dube et al. 2013; Warnke et al. 2014a, b). Usually POCT are not used for cultivated microorganisms, but more often for the detection of analytes such as nucleic acids and antigens.
Absorption is considered as a key parameter of sampling swabs (Harry and Madhusudhan 2014; Panpradist et al. 2014). In our study, the evaluated swabs revealed significant differences in the ability to absorb water; however, this parameter was poorly related to the ability of releasing an analyte present in the sample. The highest absorption was revealed for flocked nylon swabs, which are the most efficient for DNA extraction and bacterial culture (Dadhania et al. 2013; Dube et al. 2013; Warnke et al. 2014b). The DNA extraction efficiency for flocked nylon swabs was 3.5 times higher than from rayon swabs in our study, consistent with other past studies Hernes et al. (2011) in which was tested the efficiency of viral DNA extraction from clinical samples comparing flocked nylon swabs and rayon swabs. Interestingly, among the examined swabs, the DNA extraction efficiency was comparable between flocked nylon swabs which showed the highest absorption capacity and polyurethane foam swabs which showed the lowest absorption capacity. However, diphtheria toxoid recovery from flocked nylon swabs was 33.5 times lower that from rayon swabs. Moreover, it was even much more lower than the diphtheria toxoid recovery obtained from polyurethane foam swabs, which was 43.6 times lower than from rayon swabs. Note that the diphtheria toxoid recovery efficiency was comparable for both rayon swabs and dacron swabs.
The recovery of living bacterial cells, investigated by other researchers, was usually more efficient from flocked nylon swabs and polyurethane foam swabs compared to rayon and dacron swabs (Panpradist et al. 2014; Warnke et al. 2014b). Rayon and dacron swabs are fiber-wrapped swabs, which are hydrophilic but with poor release characteristic because a sample is trapped within the fiber matrix (Dube et al. 2013; Hedin et al. 2010). Unlike bacterial cells experiments, the release of proteins such as diphtheria toxoid was much more efficient from rayon and dacron swabs compared to flocked nylon and polyurethane foam swabs. The flocked swab has been designed for the uptake of a large volume of liquid sample, which stays close to the surface and elutes out rapidly and spontaneously (Rapid Microbiology 2010). This assumption can be true for water; however, the absorption and release of liquid might not be related to the release of a specific analyte present in the liquid.
This work was supported by grants to A.A.Z. from National Science Centre under the decision no. UMO-2014/15/B/NZ6/01771 and to R.Z. from National Centre for Research and Development under the decision no. LIDER/35/0041/L-7/NCBR/2016.
1. U.S. Pharmacopeia/National Formulary [current revision]. Rockville, MD: U.S. Pharmacopeial Convention, Inc; April 2021.2. Allen LV Jr. Summary of quality-control testing for sterile and nonsterile compounded preparations, part 1: physical and chemical testing. IJPC. 2019;23(3):211-216.3. Allen LV Jr. Summary of quality-control testing for sterile and nonsterile compounded preparations, part 2: microbiological testing. IJPC. 2019;23(4):299-303.4. PubChem. Atomoxetine. Accessed April 5, 2021.5. Electronic Medicines Compendium. Strattera 4 mg/mL oral solution. www.medicines.org.uk/emc/product/6827/smpc. Accessed April 26, 2021.6. Brayfield A, ed. Martindale: The Complete Drug Reference. 38th ed. London, England: Pharmaceutical Press; 2014:2214.7. Ora-Plus product information. Allegan, MI: Perrigo; 2018.8. Ora-Sweet product information. Allegan, MI: Perrigo; 2018.9. Ora-Sweet SF product information. Allegan, MI: Perrigo; 2018. 2b1af7f3a8