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排序方式: 共有613条查询结果,搜索用时 15 毫秒
51.
Skeie S Perich C Ricos C Araczki A Horvath AR Oosterhuis WP Bubner T Nordin G Delport R Thue G Sandberg S 《Clinical chemistry》2005,51(7):1145-1153
BACKGROUND: Diabetes mellitus (DM) is diagnosed and monitored worldwide by blood glucose (BG) and glycohemoglobin A(1c) (HbA(1c)) testing, respectively. Methods for quality assessment of clinician interpretations of changes in these laboratory results have been developed. This study uses survey responses from general practitioners (GPs) in different countries to investigate possible differences in interpretation of results, as well as the feasibility of performing international postanalytical external quality assessment surveys (P-EQAS). METHODS: GPs recruited from 7 countries received questionnaires requesting interpretation of changes in a potentially diagnostic capillary BG result and an HbA(1c) value obtained during monitoring of a patient with type 2 DM. GPs were asked to estimate clinically significant differences between 2 consecutive laboratory results [critical difference (CD)/reference change value] for both BG and HbA(1c). The CDs reported by GPs were used to calculate the analytical variation (CV(a)), which was taken as the quality specification for analytical imprecision. Participants received national benchmarking feedback reports after the survey. RESULTS: The study included responses from 2538 GPs. CDs in BG results showed the same pattern and were comparable among countries. Calculated median CV(a) values would be possible to attain at 80% confidence but not at the conventional 95% confidence. For HbA(1c), the same pattern was shown across countries, but with lower changes considered true when HbA(1c) increased than when it decreased. Despite the consistent pattern, variations among GPs were considerable in all countries. CONCLUSIONS: Assessments of CDs for BG and HbA(1c) were similar internationally, and quality specifications for these analytes based on clinicians' opinions are therefore interchangeable among countries. International P-EQAS may contribute to a more rational use of laboratory services and clinical guidelines. 相似文献
52.
Histamine levels in stored platelet concentrates. Relationship to white cell content 总被引:1,自引:0,他引:1
The histamine levels in samples from platelet concentrates (PC) were measured at various storage times by a radioenzymatic assay. Elevated histamine levels were detected in 5 of 14 PC after 3 days of storage (range, less than 1 to 13.3 ng/ml) and in 9 of 14 PC after 5 days (range, less than 1 to 22.2 ng/ml). A very good linear correlation (r = 0.913) was found between the initial white cell content of the PC and the histamine level at 5 days of storage. The rise in histamine content was not influenced by the type of plastic container. The results indicate a process of histamine release by the white cells during storage. Although histamine is metabolized rapidly in vivo, a critical histamine threshold could be reached in man by the rapid infusion of stored PC containing high levels of histamine. This could explain some unexpected transfusion reactions in patients receiving PC. 相似文献
53.
Walker AS; Peto TE; Babiker AG; Darbyshire JH 《QJM : monthly journal of the Association of Physicians》1998,91(6):423-438
The Concorde trial compared immediate (Imm) with deferred (Def) AZT
monotherapy in asymptomatic HIV-positive participants. Haematological and
immunological markers and weight were measured throughout, and correlated
with clinical endpoints. Markers associated with disease progression (CD4
lymphocyte count and percentage, platelets, p24 antigen and beta 2
microglobulin favoured Imm: those associated with toxicity (haemoglobin,
neutrophils and white cell count) favoured Def. CD8 and total lymphocyte
count did not differ significantly between groups. In multivariate
analysis, the combination of baseline CD4, p24 antigen and beta 2m was the
best baseline predictor of disease. Including change in CD4 and beta 2m at
12 weeks, or changes over follow- up in these markers significantly
improved the fit. Markers were also incorporated into the definition of
'clinical' endpoints. Hazard ratio estimates from end-points that included
CD4 < 50 and CD4 < 25 were closest to those for AIDS or death alone,
but added very few extra events. Use of other landmark CD4 counts (100 or
greater) or relative decreases in counts (25% or more) increased the number
of events, but overestimated the effect of immediate AZT. Although AZT had
a beneficial effect on the surrogate markers of efficacy evaluated, these
changes did not predict clinical outcome, nor could the markers be usefully
incorporated into an endpoint definition.
相似文献
54.
J B Ubbink A van der Merwe R Delport R H Allen S P Stabler R Riezler W J Vermaak 《The Journal of clinical investigation》1996,98(1):177-184
Homocysteine, an atherogenic amino acid, is either remethylated to methionine or metabolized to cysteine by the transsulfuration pathway. The biochemical conversion of homocysteine to cysteine is dependent upon two consecutive, vitamin B-6-dependent reactions. To study the effect of a selective vitamin B-6 deficiency on transsulfuration, we performed oral methionine load tests on 22 vitamin B-6-deficient asthma patients treated with theophylline (a vitamin B-6 antagonist) and 24 age- and sex-matched controls with a normal vitamin B-6 status. Both groups had normal circulating vitamin B-12 and folate concentrations. Methionine loading resulted in significantly higher increases in circulating total homocyst(e)ine (P < 0.01) and cystathionine (P < 0.05) concentrations in vitamin B-6-deficient patients compared with controls. 6 wk of vitamin B-6 supplementation (20 mg/d) significantly (P < 0.05) reduced post-methionine load increases in circulating total homocyst(e)ine concentrations in deficient subjects, but had no significant effect on the increase in total homocyst(e)ine concentrations in controls. The increases in post-methionine load circulating cystathionine concentrations were significantly (P < 0.01) reduced in both groups after vitamin supplementation. It is concluded that a vitamin B-6 deficiency may contribute to impaired transsulfuration and an abnormal methionine load test, which is associated with premature vascular disease. 相似文献
55.
56.
Angela AG van Tilborg Chris H Bangma Ellen C Zwarthoff 《International journal of urology》2009,16(1):23-30
Early detection of bladder cancer and its recurrences is essential for improved prognosis and long-term survival. The detection and follow-up of these patients is currently based on cystoscopy, which is expensive and invasive, and, in most cases, cytology, which is non-invasive but not very sensitive. During recent years, many urine-based tests have been developed and tested in different patient populations. In this review we discuss new developments for biomarkers in bladder cancer that have potential use in surveillance and screening. In almost all publications authors compare sensitivity of the test with a concomitantly executed cystoscopy, for example, determine cross-sectional sensitivity. However, it has also been shown that false positive test results may be followed by a positive cystoscopy in the near future, showing that cystoscopy itself does not provide 100% sensitivity. This suggests that for a proper evaluation of urine-based tests, longitudinal studies should be carried out and the results communicated to the urologist. 相似文献
57.
The transmission of Helicobacter pylori: the effects of analysis method and study population on inference 总被引:1,自引:0,他引:1
Although much is known about the virulence of Helicobacter pylori, the transmission pathways for this bacterium are still unresolved. Transmission has been addressed through: (1) prevalence within families; (2) detection in fecal/oral environments; (3) detection in the abiotic/biotic environment; and (4) direct inference from strain similarity. Here, we review the molecular and biochemical methods used and discuss the relative merits of each. Furthermore, as there are differences between developing and developed nations, we discuss the results obtained from transmission studies in light of the study population. We conclude that H. pylori is probably transmitted person-to-person, facilitated by fecal-oral transmission during episodes of diarrhea or gastro-oral contact during periods of vomiting. The persistence of H. pylori in abiotic and biotic environments remains unproven but possible reactivation from viable, non-culturable coccoid forms should be further investigated. Finally, we speculate on the effect of host-pathogen interactions in confounding the inference of transmission. 相似文献
58.
AG Stewart 《British journal of pharmacology》2009,158(4):933-935
The active resolution of inflammation is recognized as offering new opportunities to generate novel anti-inflammatory agents. The emerging appreciation of the importance of active resolution in regulation of inflammation also creates an imperative to examine developing and existing agents for their potential to influence these pathways. This themed issue of the British Journal of Pharmacology contains papers that discuss the roles of annexin-1, lipoxins and related lipid products of fish oils as well as other mechanisms involved in active resolution and their receptor targets.This article is part of a themed issue on Mediators and Receptors in the Resolution of Inflammation. To view this issue visit http://www3.interscience.wiley.com/journal/121548564/issueyear?year=2009 相似文献
59.
Background and purpose:
In the mammalian brain, histaminergic neurotransmission is mediated by the postsynaptic histamine H1 and H2 receptors and the presynaptic H3 autoreceptor, which also acts as a heteroreceptor. The H1 receptor has been implicated in spatial learning and memory formation. However, pharmacological and lesion studies have revealed conflicting results. To examine the involvement of histamine H1 receptor in spatial reference and working memory formation, H1 receptor knockout mice (KO) were tested in the eight-arm radial maze. Previously, we found that the H1 receptor-KO mice showed reduced emotionality when confronted with spatial novelty. As it is known that emotions can have an impact on spatial learning and memory performance, we also evaluated H1 receptor-KO mice in terms of emotional behaviour in the light–dark box.Experimental approach:
Mice lacking the H1 receptor and wild-type mice (WT) were tested for spatial reference and working memory in an eight-arm radial maze with three arms baited and one trial per day. Emotional behaviour was measured using the light–dark test.Key results:
The H1 receptor-KO mice showed impaired spatial reference and working memory in the radial maze task. No significant differences between H1 receptor-KO and WT mice were observed in the light–dark test.Conclusions and implications:
The spatial memory deficits of the H1 receptor-KO mice might be due to the reported changes in cholinergic neurochemical parameters in the frontal cortex and the CA1 subregion of the hippocampus, to impaired synaptic plasticity in the hippocampus, and/or to a dysfunctional brain reward/reinforcement system. 相似文献60.
Patty H Spruit Sabine Siesling Marloes AG Elferink Ernest JA Vonk Carel JM Hoekstra 《Radiation oncology (London, England)》2007,2(1):1-6