scholarly journals Identification and quantification of hemoglobins A, F, S, and C by automated chromatography

1996 ◽  
Vol 42 (1) ◽  
pp. 57-63 ◽  
Author(s):  
C Papadea ◽  
J C Cate
Keyword(s):  
Patient Population ◽  
Population Studies ◽  
Beta Thalassemia ◽  
Testing System ◽  
Traditional Methods ◽  
Blood Samples ◽  
Satisfactory Performance ◽  
Short Program ◽  
Automated Hplc ◽  
Clinically Significant

Abstract The Bio-Rad Variant Hemoglobin Testing System is an automated HPLC analyzer marketed with a Beta-thalassemia Short Program to quantify hemoglobins (Hbs) F and A2 and assist in detecting Hbs A, S, C, D, and E. We evaluated this system to replace several traditional methods for Hb in our hospital laboratory. Analytical performance relevant to quantifying Hbs A, S, C, and F was assessed with blood samples obtained from our local patient population. Studies of precision (CVs < 3%) and analytical limits (% of total Hb) of Hbs A (2-86%), F (1-89%), S (5-90%), and C (3-92%) demonstrated results comparable with or exceeding those of traditional methods. Results for patients' samples (n) for Hbs A (107), F (157), S (128), and C (27) correlated well (r > 0.93) with results by traditional methods. The satisfactory performance and efficiency led us to implement this system for routine quantification of clinically significant Hbs.

scholarly journals Prenatal and postnatal diagnoses of thalassemias and hemoglobinopathies by HPLC

1998 ◽  
Vol 44 (4) ◽  
pp. 740-748 ◽  
Author(s):  
Suthat Fucharoen ◽  
Pranee Winichagoon ◽  
Raewadee Wisedpanichkij ◽  
Busara Sae-Ngow ◽  
Rungrat Sriphanich ◽  
...  
Keyword(s):  
Southeast Asia ◽  
Cord Blood ◽  
Beta Thalassemia ◽  
Qualitative And Quantitative ◽  
Alpha Thalassemia ◽  
Alternative Approach ◽  
Short Program ◽  
Automated Hplc ◽  
Quantitative Analyses ◽  
Hb Bart's

Abstract The conventional approach to qualitative and quantitative analyses of hemoglobin (Hb) molecules for the diagnoses of hemoglobinopathies requires a combination of tests. We used an automated HPLC (VARIANT™) system to study α-thalassemia and β-thalassemia syndromes in Thailand. The beta-thalassemia short program is applicable to the diagnosis of α-thalassemia and β-thalassemia disorders, including Hb H, EA Bart’s disease, and EF Bart’s disease, in adults, newborns, and fetuses. The system cannot quantify accurately certain Hb molecules, such as Hb H and Hb Bart’s. The alpha-thalassemia short program was therefore developed and used to quantify Hb Bart’s to detect α-thalassemia genotypes in cord blood. This automated HPLC system is an alternative approach to the diagnosis of complicated thalassemia syndromes in Thailand and Southeast Asia.

scholarly journals Videoconference Administration of the Western Aphasia Battery–Revised: Feasibility and Validity

2020 ◽  
Vol 29 (2) ◽  
pp. 673-687 ◽  
Author(s):  
Maria Dekhtyar ◽  
Emily J. Braun ◽  
Anne Billot ◽  
Lindsey Foo ◽  
Swathi Kiran
Keyword(s):  
Rapid Growth ◽  
Patient Population ◽  
Speech Language Pathology ◽  
Traditional Methods ◽  
Link Type ◽  
Language And Communication ◽  
Language Pathology ◽  
Chronic Aphasia ◽  
Highly Correlated ◽  
Domain Scores

Purpose There is a rapid growth of telepractice in both clinical and research settings; however, the literature validating translation of traditional methods of assessments and interventions to valid remote videoconference administrations is limited. This is especially true in the field of speech-language pathology where assessments of language and communication can be easily conducted via remote administration. The aim of this study was to validate videoconference administration of the Western Aphasia Battery–Revised (WAB-R). Method Twenty adults with chronic aphasia completed the assessment both in person and via videoconference with the order counterbalanced across administrations. Specific modifications to select WAB-R subtests were made to accommodate interaction by computer and Internet. Results Results revealed that the two methods of administration were highly correlated and showed no difference in domain scores. Additionally, most participants endorsed being mostly or very satisfied with the videoconference administration. Conclusion These findings suggest that administration of the WAB-R in person and via videoconference may be used interchangeably in this patient population. Modifications and guidelines are provided to ensure reproducibility and access to other clinicians and scientists interested in remote administration of the WAB-R. Supplemental Material https://doi.org/10.23641/asha.11977857

scholarly journals Clostridium difficile colonization among patients with clinically significant diarrhea and no identifiable cause of diarrhea

2018 ◽  
Vol 39 (11) ◽  
pp. 1330-1333 ◽  
Author(s):  
Erik R. Dubberke ◽  
Kimberly A. Reske ◽  
Tiffany Hink ◽  
Jennie H. Kwon ◽  
Candice Cass ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Patient Population ◽  
Tertiary Care ◽  
Clinical Microbiology Laboratory ◽  
Care Hospital ◽  
Toxigenic Culture ◽  
Stool Samples ◽  
Stool Specimens ◽  
Clinically Significant ◽  
Culture Negative

AbstractObjectiveTo determine the prevalence of Clostridium difficile colonization among patients who meet the 2017 IDSA/SHEA C. difficile infection (CDI) Clinical Guideline Update criteria for the preferred patient population for C. difficile testing.DesignRetrospective cohort.SettingTertiary-care hospital in St. Louis, Missouri.PatientsPatients whose diarrheal stool samples were submitted to the hospital’s clinical microbiology laboratory for C. difficile testing (toxin EIA) from August 2014 to September 2016.InterventionsElectronic and manual chart review were used to determine whether patients tested for C. difficile toxin had clinically significant diarrhea and/or any alternate cause for diarrhea. Toxigenic C. difficile culture was performed on all stool specimens from patients with clinically significant diarrhea and no known alternate cause for their diarrhea.ResultsA total of 8,931 patients with stool specimens submitted were evaluated: 570 stool specimens were EIA positive (+) and 8,361 stool specimens were EIA negative (−). Among the EIA+stool specimens, 107 (19% of total) were deemed eligible for culture. Among the EIA− stool specimens, 515 (6%) were eligible for culture. One EIA+stool specimen (1%) was toxigenic culture negative. Among the EIA− stool specimens that underwent culture, toxigenic C. difficile was isolated from 63 (12%).ConclusionsMost patients tested for C. difficile do not have clinically significant diarrhea and/or potential alternate causes for diarrhea. The prevalence of toxigenic C. difficile colonization among EIA− patients who met the IDSA/SHEA CDI guideline criteria for preferred patient population for C. difficile testing was 12%.

Effects of a Pneumatic Tube System on Routine and Novel Hematology and Coagulation Parameters in Healthy Volunteers

2007 ◽  
Vol 131 (2) ◽  
pp. 293-296
Author(s):  
Alexander Kratz ◽  
Raneem O. Salem ◽  
Elizabeth M. Van Cott
Keyword(s):  
Healthy Volunteers ◽  
Prothrombin Time ◽  
Partial Thromboplastin Time ◽  
Activated Partial Thromboplastin Time ◽  
Tube System ◽  
Blood Samples ◽  
Pneumatic Tube ◽  
The Mean ◽  
Clinically Significant ◽  
Pneumatic Tube System

Abstract Context.—Technologic advances affecting analyzers used in clinical laboratories have changed the methods used to obtain many laboratory measurements, and many novel parameters are now available. The effects of specimen transport through a pneumatic tube system on laboratory results obtained with such modern instruments are unclear. Objective.—To determine the effects of sample transport through a pneumatic tube system on routine and novel hematology and coagulation parameters obtained on state-of-the-art analyzers. Design.—Paired blood samples from 33 healthy volunteers were either hand delivered to the clinical laboratory or transported through a pneumatic tube system. Results.—No statistically significant differences were observed for routine complete blood cell count and white cell differential parameters or markers of platelet activation, such as the mean platelet component, or of red cell fragmentation. When 2 donors who reported aspirin intake were excluded from the analysis, there was a statistically, but not clinically, significant impact of transport through the pneumatic tube system on the mean platelet component. There were no statistically significant differences for prothrombin time, activated partial thromboplastin time, waveform slopes for prothrombin time or activated partial thromboplastin time, fibrinogen, or fibrin monomers. Conclusions.—Although further study regarding the mean platelet component may be required, transport through a pneumatic tube system has no clinically significant effect on hematology and coagulation results obtained with certain modern instruments in blood samples from healthy volunteers.

Lack of Clinically Significant Interactions Between the Subcutaneously Administered Direct Thrombin Inhibitor Desirudin and Orally Administered Warfarin Upon the International Normalized Ratio.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3131-3131
Author(s):  
Jerrold Levy ◽  
Michael Kurz ◽  
Andrew Whelton
Keyword(s):  
Healthy Adult ◽  
International Normalized Ratio ◽  
Thrombin Inhibitors ◽  
Clin Pathol ◽  
Once Daily ◽  
Blood Samples ◽  
Absolute Value ◽  
The Absolute ◽  
The Difference ◽  
Clinically Significant

Abstract Abstract 3131 Poster Board III-68 Background Direct thrombin inhibitors (DTIs) have heterogeneous effects on the international normalized ratio (INR). Argatroban, in particular, has a clinically significant impact on the INR that complicates transition to warfarin therapy (Hirsh J. Chest 2008;133:141-149). Desirudin is a potent, subcutaneously administered DTI approved for the prophylaxis of deep vein thrombosis (DVT), in patients undergoing elective hip replacement surgery. While the pharmacologic effects and clinical utility of desirudin have been extensively studied, the quantitative pharmacodynamic effects associated with the concomitant use of desirudin and warfarin have not been previously reported. The primary objective of this phase 1 study was to determine the safety and tolerability of the combination of desirudin when coadministered with warfarin. Methods This was an open-label, nonrandomized, single-center trial involving 12 healthy adult male volunteers. Potential pharmacodynamic interactions between desirudin and warfarin were assessed by comparing the effects of each drug on prothrombin time (PT; as measured by INR) and activated partial thromboplastin time (aPTT) when each drug was administered alone and during coadministration. The study was divided into 2 dosing periods, A and B. In dosing period A, aPTT and PT (INR) profiles were assessed for warfarin 10 mg given once daily for 3 days. In dosing period B, aPTT and PT (INR) profiles were assessed for a single SC 0.3 mg/kg dose of desirudin given alone, then for the coadministration of SC desirudin 0.3 mg/kg twice daily with orally administered warfarin 10 mg once daily for 3 days. A 2-week washout period occurred between dosing periods. During dosing period A, venous blood samples were collected prior to dosing on day 1 and at 4, 8, 12, and 24 hours postdose on days 1–3; a final sample was obtained 48 hours after the last dose of warfarin. During dosing period B, blood samples were collected prior to the first dose of desirudin given alone and at 4, 8, 12, and 24 hours postdose. During the 3 days of concomitant drug administration, samples were collected at 4, 8, and 12 hours after each dose of desirudin and warfarin; final samples were obtained at 24 and 48 hours after the last dose of desirudin. With regards to the coagulation parameters (aPTT and PT), summary statistics (mean, standard deviation, median, minimum and maximum) were calculated for the absolute value and the ratio of the absolute value to baseline for each evaluated time point, the difference to baseline and the difference between desirudin treatment alone and in combination with warfarin. Results An additive effect was observed with the coadministration of desirudin and warfarin. The aPTT increased by a median of 18.3 seconds (range: 1.5–26.3 seconds, P<.01) during coadministration of desirudin and warfarin compared with the administration of desirudin alone. The INR also increased by a median of 1.1 (range: 0.6–1.8, P<.01) during the coadministration of the study drugs. Both study drugs were well tolerated, and the observed effects of coadministration on aPTT and INR were not considered by investigators to be clinically significant. Conclusion The coadministration of desirudin and warfarin has a moderate effect on aPTT and INR levels in healthy adult males. The observed effects on aPTT and INR are similar to those reported for lepirudin on these parameters. Desirudin appears to have lesser effects on INR compared with argatroban (Gosselin RC et al. Am J Clin Pathol, 2004;121:593-599), that may facilitate transitioning to warfarin in patients requiring longer term anticoagulation. Disclosures Kurz: Canyon Pharmaceuticals: Employment, Equity Ownership. Whelton:Canyon Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees.

Iron Studies in Hemochromatosis During Pregnancy.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 5099-5099 ◽  
Author(s):  
Alisa Sokoloff ◽  
Scott Brook ◽  
Marvin Cooper
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Prolapse ◽  
Patient Population ◽  
Iron Supplementation ◽  
Hereditary Hemochromatosis ◽  
Transferrin Saturation ◽  
The United States ◽  
Normal Vaginal Delivery ◽  
Hfe Gene ◽  
Clinically Significant

Abstract Abstract 5099 Hereditary hemochromatosis is usually caused by a mutation in HFE gene that regulates iron uptake from the diet. The two most common mutations in the HFE gene are the well described C282Y and H63D mutations. Homozygous inheritance of either one of these mutations as well as compound heterozygous inheritance of one of each of the mutant alleles may result in a spectrum of phenotypic variants of the disease ranging from asymptomatic to multi-organ compromise. One half of a percent of the United States population carries two copies of the mutant HFE gene therefore making hemochromatosis the most common genetically inherited disease. On average one half of these patients will develop clinically significant disease. Usually hemochromatosis is a clinical diagnosis, however genetic testing as well as liver biopsy are utilized as confirmatory diagnostic modalities. Besides, hemochromatosis should be suspected in females with transferrin saturation over 45% and males over >50%. It is well established that in females hemochromatosis is usually identified later in life, likely secondary to menstruation, childbirth, and breastfeeding. We hypothesized that hemochromatotic women with elevated ferritin levels at time of conception probably do not require phlebotomies during the course of their pregnancies. In addition, this patient population likely does not require iron supplementation, otherwise indicated during pregnancy and breastfeeding. We are reporting a case of 36-year-old female found to be homozygous for C282Y mutation five months prior to becoming pregnant. This patient's transferrin saturation at the time of diagnosis was 75% and her ferritin level was 320ng/ml. Her past medical history is only significant for mitral valve prolapse. Her physical exam at the time of diagnosis was normal, except for a known II/IV systolic murmur. Although asymptomatic at presentation, this patient was found to have increased iron deposition in the liver detected with abdominal MRI. During the course of her pregnancy this patient received no iron supplementation and likewise she did not receive any phlebotomy treatments. Her iron studies were carefully monitored on average every four weeks to assess for phlebotomy or iron supplementation needs. The patient never became symptomatic from either iron overload or anemia during this pregnancy. Evidently the fetus was able to utilize maternal iron sufficiently with secondary benefit of decreasing maternal ferritin levels. Besides, despite withholding iron supplementation during pregnancy this patient did not develop a clinically significant degree of anemia. Likewise she did not develop any evidence of exacerbation of mitral valve prolapse symptoms – this complication is not uncommon during pregnancy secondary to anemia. A healthy child was delivered at term via normal vaginal delivery, with minimal complications secondary to umbilical cord enlargement without compression and a 1st degree perianal laceration with minimal blood loss. The iron panel on the child was not obtained. Date 7/28/08 at diagnosis 12/11/08 7 weeks of gestation 1/12/09 13 weeks of gestation 1/26/09 15 weeks of gestation 2/23/09 19 weeks of gestation 3/16/09 22 weeks of gestation 4/13/09 26 weeks of gestation 5/11/09 30 weeks of gestation 6/08/09 34 weeks of gestation 7/02/09 37 weeks of gestation 7/20/09 6 days postpartum Hemoglobin/Hematocrit (g/dL/%) 14.3/40.0 13.7/38.4 12.9/36.0 12.1/34.1 11.7/33.5 11.6/34.0 13.2/36.1 13.1/36.7 12.6/35.4 13.2/37.0 13.3/38.3 Serum Iron (μg/dL) 153 169 207 214 233 260 260 247 285 287 95 TIBC (μg/dL) 203 220 217 234 243 270 311 295 295 310 307 Ferritin (ng/mL) 320 258 268 220 180 147 95 75 66 145 174 Transferrin Saturation (%) 75 77 92 91 92 93 84 92 94 93 31 Maternal ferritin levels decreased significantly during the course of this pregnancy, reaching a nadir of 66ng/mL by 34 weeks of gestation, with subsequent rise to 145ng/mL two weeks prior to delivery. In conclusion, the favorable outcome of this case supports our stated hypothesis in at least the homozygous C282Y HFE gene mutation patient population with elevated preconception ferritin levels (to at least 320 ng/mL) and increased preconception transferrin saturations (to at least 75%). Further studies of hemochromatotic pregnant women with the aforementioned genotype (most common) as well as other hereditary hemochromatosis genotypes during both pregnancy, and breastfeeding may be warranted. Disclosures No relevant conflicts of interest to declare.

Analytical evaluation of the Tosoh HLC-723 G8 automated HPLC analyzer for hemoglobin analysis in beta-thalassemia mode

2011 ◽  
Vol 44 (5-6) ◽  
pp. 441-443 ◽  
Author(s):  
Françoise Merono ◽  
Imane Agouti ◽  
Nathalie Bonello-Palot ◽  
Chantal Paolasso ◽  
Nicolas Levy ◽  
...  
Keyword(s):  
Beta Thalassemia ◽  
Analytical Evaluation ◽  
Automated Hplc

Tracheostomy and Dysphagia: True, True, and Unrelated?

2014 ◽  
Vol 23 (3) ◽  
pp. 116-122
Author(s):  
David Francis ◽  
Alexander Gelbard
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Patient Population ◽  
Care Setting ◽  
Adult Patients ◽  
Medical Illness ◽  
Intensive Care Setting ◽  
Underlying Illness ◽  
Clinically Significant ◽  
The Relationship

The relationship between tracheostomy and dysphagia remains controversial. Many centers require swallow evaluations for all patients after tracheostomy because of the assumed increased rate of dysphagia and aspiration that they are thought to promote. Tracheostomies are now most commonly placed in the intensive care setting in adult patients with polytrauma or severe medical illness who are on mechanical ventilation. While tracheostomy and dysphagia often coexist in this population, they may not be directly related, as physiologic alterations observed in tracheostomized patients have not demonstrably translated into clinically significant complications of dysphagia. Instead, there is growing evidence that chronicity and severity of underlying illness, comorbidities, and recent intubation are the major arbiters of dysphagia in patient population. This brief report reviews the literature investigating the association between tracheostomy and dysphagia in adults, and discusses the role that illness severity, comorbidity, and intubation play in dysphagia etiology and how they confound the tracheostomy-dysphagia relationship.

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