bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measurement of cardiac troponin I in striated muscle using three experimental methods
Authors: Fredericks Salim , Bainbridge Katie , Murray Joanne F , Collinson Paul O , Carter Nicholas D , Holt David W 
Published: May 2003

Background: Qualitative and quantitative measures of cardiac troponin I (cTnI) in striated muscle have been reported as part of diverse investigations. However, there is disparity in the literature regarding the findings of these analyses. The cTnI molecule can exist in phosphorylated, non-phosphorylated, reduced, non-reduced, complexed or non-complexed forms. Each of these forms can change the antigenicity of cTnI, resulting in different antibody-antigen interactions in different experimental formats, thereby giving rise to the disparities in the literature. Methods: cTnI in heart and skeletal muscles were investigated by three techniques employing the same specific cTnI antibodies: the recently revised Dade-Behring Dimension RXL assay, immunoblotting and immunohistochemistry. Results: cTnI was detected in heart muscle but not skeletal muscle using the quantitative assay and immunoblotting. Unexpectedly, using the same antibodies, cTnI was not immunolocalized to either heart or skeletal muscle. Conclusion: The antibody-cTnI interaction might be impeded on fixed immunohistochemistry sections. Our findings reflect those of a previous study, showing that cTnI was not detected in skeletal muscle extracts using a quantitative assay. The behaviour of cTnI antibodies varies depending on experimental design. Conclusions drawn from experiments using qualitative methods cannot necessarily be extrapolated to the quantitative assay and vice versa.
Interference caused by the contents of serum separator tubes in the Vitros CRP assay
Authors: Chang Chia-Yu , Lu Jin-Ying , Chien Tzu-I , Kao Jau-Tsuen , Lin Mei-Chun , Shih Pei-Chun , Yan Shiao-Ni 
Published: May 2003

Background: We have observed discrepancies between C-reactive protein (CRP) measured in serum prepared from a serum separator tube (SST) and that obtained from a plain tube, when using the Vitros CRP assay. Our study aimed at elucidating the cause of these discrepancies. Methods: Eighty-seven specimens from hospitalized patients with various types of inflammatory disease were analysed using a fixed-point immuno-rate method on a Vitros CRP slide. The serum was prepared simultaneously in both vacuum and SSTs. We also performed mixing tests by adding 47 samples of serum prepared from plain tubes to SSTs and incubating for 15 min before CRP analysis. Results: Lower values of CRP were found in serum prepared from plain tubes than in serum from SSTs. Addition of serum prepared from plain tubes to SSTs and incubating for 15 min increased the CRP values significantly. The ratio of CRP measured in serum prepared from plain tubes and from SSTs did not differ significantly from the ratio obtained when serum was prepared in a plain tube then added to an SST. Discussion: We propose that SSTs can adsorb some macromolocules that form complexes with CRP. The addition of SST gel to serum results in the release of CRP molecules from these complexes, which enhances the antigen-antibody reaction on the Vitros CRP slide and increases the measured CRP concentrations.
A sensitive and practical competitive radioassay for plasma biotin
Authors: Harthé Catherine , Claustrat Bruno 
Published: May 2003

Background: Biotin is a water-soluble vitamin which plays an important biochemical role in a variety of carboxylase-mediated metabolic reactions. Determination of biotin status for the diagnosis of biotin deficiency is crucial. Methods: We describe a solid-phase protein-binding assay involving [125I]iodostreptavidin as a tracer for the determination of biotin in plasma. The assay was conducted in one step by incubation of a fixed amount of [125I]iodostreptavidin as binding reagent with varying amounts of biotin, diluted in biotin-free plasma (standard curve) or unknown samples in tubes previously coated with biotin linked to goat antirabbit IgG. Increasing amounts of biotin in the standard or unknown samples in tubes previously coated with biotin occupy more sites on iodostreptavidin, resulting in fewer counts bound to tubes. The effects of the incubation time and temperature on the competitive binding of biotin with iodostreptavidin were tested. Results: The detection limit of the plasma assay for biotin was 100 pmol/L. Only 100 µL of plasma were necessary for the assay, which was performed within 6 h. The dilutions of plasma and synthetic biotin gave a parallel response. Plasma biotin levels ranged from 0·49 to 1·33 nmol/L (mean 0·76 nmol/L) in healthy subjects. The intraand inter-assay coefficients of variation were 3·5% and 10%, respectively, at a concentration of 0·27 nmol/L. Conclusions: This assay was suitable for the direct measurement of biotin in human plasma and was robust and sensitive enough for screening for biotin deficiency.
Definitive angiographic detection of subarachnoid haemorrhage compared with laboratory assessment of intracranial bleed in CT-negative patients
Authors: O'Connell Daniel M , Watson Ian D 
Published: May 2003

Background: Between 2·5% and 5% of cases of subarachnoid haemorrhage (SAH) give negative results for computed tomography (CT) scanning. Recent UK guidelines make recommendations as to standardization of laboratory methodology for the detection of SAH in individuals with a negative CT scan. We have compared this approach with our routine assessment using first-order derivative spectrophotometry, a recently reported iterative computer prediction model and measurement of cerebrospinal fluid (CSF) ferritin concentration. All methods were judged against cerebral angiography as the definitive means of determining patient outcome. Methods: Scanning spectrophotometry of CSF is necessary for both the UK guidelines and our in-house method. Absorbance measurements at 360, 405, 414 and 455 nm are required for the computer model. CSF ferritin concentration was measured using a serum method on a DPC Immulite 2000. This gave a value of <12 µg/L for normal CSF. Ethical approval and informed patient consent to additional investigation were obtained. Results: The sensitivity and specificity for the UK guidelines method, derivative spectrophotometry (in-house), iterative computer model and CSF ferritin were, respectively: 0·8, 1·0; 0·9, 1·0; 0·9, 0·5; 1·0, 0·78. Conclusion: First-order derivative spectrophotometry had best concordance with angiography. Combination of this with CSF ferritin measurement may improve sensitivity, although the zero-order method recommended in the UK guidelines for the detection of an intracranial bleed is more amenable and has comparable performance.
Laboratory results in the elderly: the Sydney Older Persons Study
Authors: Janu Margaret R , Creasey Helen , Grayson David A , Cullen John S , Whyte Scott , Brooks William S , Waite Louise M , Broe G Anthony 
Published: May 2003

Background: The use of laboratory intervals based on younger and healthier populations is of questionable validity in older populations. The aim of this study was to examine haematological and biochemical profiles in a sample of community-dwelling older people and to study the impact of age, disease, disability and medications. Methods: Basic haematological and biochemical values were obtained for 338 survivors of a random sample of community-living people aged 75 years or over at time of recruitment. These values were compared to the laboratory reference intervals and the effects of age, disease, medication and disability examined. Results: The distribution of the 35 parameters measured differed from those described by the laboratory reference intervals in all but four of the variables. The values showed few significant age associations but did show associations with disease, disability and drug use. Conclusions: Abnormalities identified in haematological and biochemical testing are not due to age but to age-related illnesses. This is contrary to previous studies reporting a change in haematological and biochemical parameters purely on the basis of age. In the presence of abnormalities, identification and clarification of disease states should be made.
Hypercarotenaemia or hypercarotenoidaemia
Authors: Saldana Chaparro R , Carr E , Barron JL 
Published: May 2003

Background: Serum carotenoids consist of a variety of different compounds. Xanthoderma may result from an increased concentration of any of the carotenoids. Method and results: High-performance liquid chromatography of serum carotenoids shows that a normal chromatogram contains mainly β-carotene, lutein and lycopene. Serum α- and β-carotene, β-cryptoxanthin, lycopene, lutein and zeaxanthin were found to be increased in the investigation of hypercarotenaemia. Conclusion: Patients presenting with possible xanthoderma should have a dietary history taken and serum sent for carotenoid analysis.
Clinical biochemical tissue monitoring during ischaemia and reperfusion in major vascular surgery
Authors: Klaus S , Staubach KH , Eichler W , Gliemroth J , Heringlake M , Schmucker P , Bahlmann L 
Published: May 2003

Background: Major vascular surgery with aortic cross-clamping is associated with temporary ischaemia of the lower limb due to lack of tissue blood flow. The present study was designed to determine if the short-term changes in cellular metabolism occurring during this situation can be detected by subcutaneous microdialysis. It was also hoped to ascertain if this new technique is useful in the continuous bedside monitoring of metabolism during aortic surgery. Methods: In a controlled clinical study 20 patients undergoing elective aortic surgery were monitored using microdialysis probes that were inserted in the subcutaneous tissue of the left lower limb and a non-ischaemic region (shoulder). Interstitial fluid was obtained and the concentrations of glucose and lactate during lower limb ischaemia and during reperfusion were measured and compared with concentrations observed in fluid obtained from the non-ischaemic control tissue. Results: Circulatory occlusion caused an immediate and significant decrease in the glucose/lactate ratio from 3·1±1·3 to 0·48±0·5 (P<0·05) that returned to preocclusion values within 2 h of commencing reperfusion. Conclusion: We suggest that microdialysis may be used both to assess acute changes in tissue metabolism during ischaemic periods and also to act as an additional tool for the detection of peri-operative acute variations in limb blood flow.
An evaluation of functional outcomes (speech, swallowing) in patients attending speech pathology after head and neck cancer treatment(s): results and analysis at 12 months post-intervention
Authors: Perry Alison R. , Shaw Margaret A. , Cotton Susan 
Published: May 2003

We have earlier reported establishing a computerized database to audit functional outcomes in patients who underwent head and neck cancer treatment in Victoria, Australiaand attended speech pathology services from April 1997–April 1999. This paper presents the statistical analyses and results from this study.Speech pathologists collected, prospectively, functional outcome data on 293 patients who underwent head and neck cancer treatment, and sent these for analysis to La Trobe University. Clinician and patient assessments of outcomes: speech, swallowing, activity, pain, employment, health, QOL status were made.Initial data on 293 patients were collected and data on mortality and morbidity were compiled at three, six and 12 months post-treatment. Within twelve months, 74 patients had died. Three, six and/or 12-month follow-up data was available on 219 patients, with both clinician and patient assessments of status completed. The status forms are presented as appendices to this paper. Complete status forms on 179 patients at 12 months were obtained.This clinical audit of functional outcomes represents the first study of this kind, collecting data from speech pathologists and patients in a multi-centre study of patients with head and neck cancer. We present data to demonstrate optimal recovery of function at six months, such that this may represent a good reference point for reporting and comparison of functional outcomes.
Repair of anterior floor of mouth defects by a central or paramedian island tongue flap
Authors: Fischinger Janez , Žargi Miha 
Published: May 2003

One method for restoring the anterior floor of mouth defects resulting from T1 and especially T2 cancer excision involves the creation of a myomucosal island flap from the dorsal median portion of the tongue and transferring it as a transit flap to the floor of the mouth.We are not the first to advocate this method. In this paper we present a previously unreported, slightly modified technique utilizing this tongue flap. The modification consists of a 90° twisting of the flap to achieve a more appropriate adaptation to the defect. In the case ofspreading carcinoma from the floor of the mouth to the central portion of the tongue, a similarparamedian one-sided tongue flap was created instead of a central island tongue flap. Our present experience consists of a small series of 12 patients. The procedures were successful in all patients. No remarkable disturbances of speech or deglutition were observed in any of the patients. There were two complications: one haematoma and one partial necrosis of the tip of the tongue. In our opinion, the reconstruction of the anterior floor of mouth defects using a central island tongue flap has not gained the popularity it deserves.
Bilateral sudden sensorineural hearing loss caused by Charcot-Marie-Tooth disease
Authors: Papadakis Chariton E. , Hajiioannou Jiannis K. , Kyrmizakis Dionysios E. , Bizakis John G. 
Published: May 2003

Charcot-Marie-Tooth (CMT) disease or hereditary motor and sensory neuropathy (HMSN) is a relatively common neurological syndrome, which has seldom been associated with hearing dysfunction, particularly sudden sensorineural hearing loss (SNHL). Families with autosomal dominant, autosomal recessive and X-linked forms of inheritance have been described.Sudden sensorineural hearing loss is a frustrating and frightening condition, especially if the hearing loss is bilateral. Regarding the site of the lesion, the evidence from the literature on HMSN suggests that either the VIIIth nerve or central auditory pathways are primarily involved in patients with hearing loss.We report the first case in the English literature of a patient with Charcot-Marie-Tooth type II disease presenting bilateral SNHL in the course of his disease. The patient was hospitalized for 15 days, and undergoing treatment without any audiological improvement. Detailed clinical, audiological and laboratory examination was performed.The aetiology and prognostic indicators of bilateral SNHL are discussed, as well as, the incidence of hearing loss in CMT patients.
Safety and Pharmacokinetics of an Endotoxin-Binding Phospholipid Emulsion
Authors: Gordon Bruce R , Parker Thomas S , Levine Daniel M , Saal Stuart D , Hudgins Lisa Cooper , Sloan Betty-Jane , Chu Cindy , Stenzel Kurt H , Rubin Albert L 
Published: May 2003

BACKGROUND: Lipids and lipoproteins have been shown to bind and neutralize endotoxin and to improve outcomes in animal models of sepsis. OBJECTIVE: To provide safety and pharmacokinetic data for a protein-free, phospholipid-rich emulsion developed as an agent to neutralize endotoxin, and to study the changes in lipids and lipoproteins following emulsion administration. METHODS: Thirty healthy male volunteers (aged 18–45 y) were given an emulsion containing 92.5% soy phospholipid, 7.5% soy triglyceride, and 18 mM sodium cholate using a double-blind, placebo-controlled crossover protocol. Emulsion at 3 escalating doses (75, 150, 300 mg/kg) based on phospholipid content was administered by intravenous infusion over 2 hours in the low- and mid-dose groups and 6 hours in the high-dose group. RESULTS: All subjects completed the protocol without significant toxicities. A slight dose-dependent increase in indirect bilirubin at the 24-hour time point was observed in the emulsion treatment period, with a maximum difference between placebo and emulsion of 0.9 mg/dL. Mean ± SD peak phospholipid levels were 316 ± 30, 533 ± 53, and 709 ± 86 mg/dL, and phospholipid half-lives were 5.4 ± 0.6, 5.4 ± 0.5, and 8.0 ± 0.8 hours for the low, mid, and high doses, respectively. Increases in total cholesterol, low-density lipoprotein cholesterol and apolipoprotein A-I and B levels were observed. High-density lipoprotein cholesterol decreased immediately following emulsion infusion, but rebounded to above placebo levels by 24 hours. CONCLUSIONS: A unique phospholipid-rich emulsion was shown to have a favorable safety profile and to expand the blood lipid and lipoprotein pool without the use of human-derived blood products. Lipid levels expected to protect against the physiologic effects of bacterial endotoxin were achieved.
Argatroban Dosing in Patients with Heparin-Induced Thrombocytopenia
Authors: Verme-Gibboney Catherine N , Hursting Marcie J 
Published: May 2003

OBJECTIVE: To retrospectively evaluate clinical experiences with argatroban dosing, particularly incremental dosage adjustments, during a clinical trial of argatroban anticoagulation in heparin-induced thrombocytopenia (HIT). METHODS: Records of 304 patients with HIT administered argatroban during a prospective study were reviewed to determine each dose, incremental dosage adjustment, and duration of therapy. Dosing information (stratified by patient initial dose) and incremental adjustments (overall, and stratified by dose from which adjustment occurred) were summarized. The relationship between median incremental adjustments and adverse outcomes, including bleeding, was investigated. RESULTS: Two hundred seventy-one (89%) patients received initial doses of 1.9–2.1 μg/kg/min (group B). Twenty-six (9%) patients were started at a lower dose. Group B's median (5–95th percentile) final dose was 1.6 (0.25–4.0) μg/kg/min. During a median of 6 days of argatroban therapy, patients underwent a median of 3.0 dosage adjustments using a median and mode incremental adjustment of 0.5 μg/kg/min (5–95th percentile, 0.1–2.0 μg/kg/min). Fifty-two (17%) patients required no dosage adjustment. Incremental adjustments decreased with decreasing current dose (e.g., median 0.25 μg/kg/min from doses of 0.26–0.75 μg/kg/min). Outcomes were similar between patients with no adjustment or with median incremental adjustments of ≤0.4, 0.41–0.75, or >0.75 μg/kg/min. CONCLUSIONS: Based on this clinical experience, together with the established linear pharmacokinetics and pharmacodynamics of argatroban, appropriate dosage increments may be proposed for argatroban-treated patients with HIT. Incremental adjustments of 0.5 μg/kg/min are reasonable for most patients. Smaller adjustments (e.g., 0.25 μg/kg/min) should be used when modifying lower doses, such as those recommended for use in hepatically impaired patients.
Effect of Pictograms on Readability of Patient Information Materials
Authors: Mansoor Leila E , Dowse Ros 
Published: May 2003

OBJECTIVE: To design, develop, and evaluate a simple, understandable medicine label and patient information leaflet (PIL) for nystatin suspension, and to assess the effect of incorporating pictograms on understanding in low-literate participants. METHODS: Patient information materials were designed and pretested in a pilot study (n = 20), and were subjected to the Fry's readability test. The final evaluation was conducted with 60 low-literate participants who had a maximum of 7 years of formal schooling and for whom English was their second language. Demographic data were collected. Participants were randomly allocated to a control (text-only information) or experimental (text + pictogram information) group, shown the medicine label and PIL, and asked to read them. A series of questions was asked about the instructions and an understanding level was calculated in each case. A second series of questions assessed patient acceptability of the materials. Differences in understanding were determined by χ2 tests. RESULTS: Both sets of these simple written materials were generally well understood. However, the presence of pictograms was shown to improve the comprehension of more complex information, resulting in significantly more participants in the experimental group obtaining a score for understanding >80% for both the medicine label and PIL. A clear preference for the materials incorporating pictograms was expressed. CONCLUSIONS: The presence of pictograms had a positive effect in the acquisition and comprehension of drug information.
Levofloxacin-Associated Achilles Tendon Rupture
Authors: Mathis A Scott , Chan Vicky , Gryszkiewicz Margaret , Adamson Robert T , Friedman Gary S 
Published: May 2003

OBJECTIVE: To describe a case of levofloxacin-induced partial Achilles tendon rupture; this occurred in the presence of known risk factors and acute renal failure. CASE SUMMARY: A 79-year-old white man received levofloxacin for presumed pneumonia, developed acute renal failure in the setting of dehydration, and began having ankle pain on the 12th day of admission. Levofloxacin was discontinued, and magnetic resonance imaging revealed a 6-cm partial tear and degenerative changes. DISCUSSION: The Naranjo probability scale indicates a possible association between levofloxacin and tendon rupture because the event occurred in the setting of known risk factors such as steroid use, renal failure, older age, and male gender. CONCLUSIONS: Levofloxacin, like other fluoroquinolones, may cause Achilles tendon rupture, and this may be particularly likely with known risk factors.
The prevalence and predictors of psychological distress in men with prostate cancer who are seeking support
Authors: Balderson Neil , Towell Tony 
Published: May 2003

Objective: The incidence of prostate cancer has risen sharply in the last decade, yet knowledge about the psychological health of men with this disease is still limited. A study was therefore undertaken to identify (1) the prevalence of psychological distress in these males, and (2) factors predicting psychological distress.Design: Retrospective cross‐sectional survey design by means of a self‐administered questionnaire.Method: A sample of 94 men with various stages of prostate cancer completed the Functional Assessment of Cancer Therapy—Prostate Instrument (FACT‐P), the Hospital Anxiety Depression Scale (HADS) and items measuring satisfaction with medical care.Results: We detected a prevalence rate of 38% of participants reporting psychological distress corresponding to a HADS cut‐off score at or above 15. A standard multivariate regression analysis revealed social/family well‐being, physical well‐being and functional well‐being as significant inverse predictors of psychological distress.Conclusions: Health professionals should be aware of the potential for psychological distress in patients exhibiting poor physical functioning and those with apparent deficits in social or family support in this under‐studied group of patients. Strategies for psychosocial intervention are implied.