Clinically and temporally specific diagnostic thresholds for plasma ACTH in the horse

ABSTRACT In order to determine if an adrenergic mechanism is involved in the secretion of corticotrophin (ACTH), the effect of adrenergic-blocking or -stimulating agent on plasma ACTH, cortisol and glucose levels was studied in normal human subjects. The intravenous infusion of methoxamine, an alpha adrenergic-stimulating agent, caused a rise in plasma ACTH and cortisol. This increase in plasma ACTH and cortisol was significantly inhibited by the simultaneous administration of phentolamine, an alpha adrenergic-blocking agent, in combination with methoxamine. The intravenous infusion of propranolol, a beta adrenergic-blocking agent, caused no significant change in plasma ACTH and cortisol, although it enhanced the plasma ACTH response to insulin-induced hypoglycaemia. On the other hand, alpha adrenergicblockade by intravenous infusion of phentolamine significantly suppressed the plasma ACTH response to insulin-induced hypoglycaemia. These studies suggest a stimulatory effect of alpha receptors and a possible inhibitory effect of beta receptors on ACTH secretion in man.

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SUPPRESSIBILITY OF PLASMA ACTH AND INTERMEDIARY STEROIDS IN CONGENITAL ADRENAL HYPERPLASIA.

Acta Endocrinologica ◽

10.1530/acta.0.091s048 ◽

1979 ◽

Vol 92 (2_Supplb) ◽

pp. S48-S56

Author(s):

J. Girard ◽

J.B. Baumann ◽

K. Zuppinger ◽

R. Zurbrügg

Keyword(s):

Congenital Adrenal Hyperplasia ◽

Adrenal Hyperplasia ◽

Plasma Acth

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Short-term angiotensin II infusion does not alter plasma ACTH in man

Acta Endocrinologica ◽

10.1530/acta.0.107s113 ◽

1984 ◽

Vol 104 (4_Supplb) ◽

pp. S113-S114

Author(s):

H. HALLER ◽

P. EXNER ◽

V. BÄHR ◽

W. OELKERS

Keyword(s):

Angiotensin Ii ◽

Plasma Acth ◽

Short Term

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84-OR: Index60 and 2-Hour Glucose Diagnostic Thresholds: Comparison of Type 1 Diabetes (T1D) Marker Profiles

Diabetes ◽

10.2337/db19-84-or ◽

2019 ◽

Vol 68 (Supplement 1) ◽

pp. 84-OR

Author(s):

MARIA JOSE REDONDO ◽

BRANDON M. NATHAN ◽

LAURA E. BOCCHINO ◽

SUSAN GEYER ◽

LAURA M. JACOBSEN ◽

...

Keyword(s):

Type 1 Diabetes ◽

Diagnostic Thresholds

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Faculty Opinions recommendation of When does depression become a disorder? Using recurrence rates to evaluate the validity of proposed changes in major depression diagnostic thresholds.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717996662.793474064 ◽

2013 ◽

Author(s):

Malcolm Lader

Keyword(s):

Major Depression ◽

Recurrence Rates ◽

Diagnostic Thresholds

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The diagnostic threshold of Cornell assessment of pediatric delirium in detection of postoperative delirium in pediatric surgical patients

BMC Pediatrics ◽

10.1186/s12887-021-02538-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hong Hong ◽

Chao Guo ◽

Zhi-Hua Liu ◽

Bo-Jie Wang ◽

Shu-Zhe Zhou ◽

...

Keyword(s):

Pediatric Patients ◽

Assessment Instrument ◽

Surgical Patients ◽

Reference Standard ◽

Diagnostic And Statistical Manual ◽

Diagnostic Thresholds ◽

Diagnostic Threshold ◽

Effective Instrument ◽

Sensitivity Specificity ◽

Selective Surgery

Abstract Background Cornell assessment of pediatric delirium (CAPD) showed advantage in diagnosis of pediatric delirium in Chinese critically ill patients. But its performance in surgical patients is still unclear. The present study was designed to validate the diagnostic performance of CAPD in surgical pediatric patients. Methods This is a prospective validation study. Pediatric patients who underwent selective surgery and general anesthesia were enrolled. Primary outcome was the incidence of delirium within postoperative three days. CAPD Chinese version was used to evaluate if the patient had delirium one time per day. At the meantime, a psychiatrist employed Diagnostic and Statistical Manual of Mental Disorders fifth edition to diagnose delirium, which was the “gold standard”, and the result was considered as reference standard. Sensitivity, specificity and area under receiver operating characteristic (ROC) curve were calculated to investigate the performance of CAPD. Results A total of 170 patients were enrolled. Median age was 4 years old. As diagnosed by psychiatrist, 23 (13.5 %) patients experienced at least one episode of delirium during the follow-up period. When diagnostic threshold was set at 9, CAPD showed the optimal sensitivity (87.0 %, 95 %CI 65.3 %-96.6 %) and specificity (98.0 %, 95 %CI 93.7 %-99.5 %) in comparison with other diagnostic thresholds. ROC analysis showed that CAPD was a good delirium assessment instrument with area under curve of 0.911 (95 % CI 0.812 to 1.000, P < 0.001). Agreement between CAPD and reference standard was 0.849 (Kappa coefficient, P < 0.001). Conclusions This study found that Cornell assessment of pediatric delirium could be used as an effective instrument in diagnosis of delirium in pediatric surgical patients. Trial registration www.chictr.org.cn Identifier: ChiCTR-DDD-17,012,231, August 3, 2017.

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ESR and CRP Diagnostic Thresholds for Prosthetic Joint Infection in Hip Hemiarthroplasty

The Journal of Hip Surgery ◽

10.1055/s-0040-1719115 ◽

2020 ◽

Vol 4 (04) ◽

pp. 187-192

Author(s):

Jared A. Warren ◽

Oliver Scotting ◽

Hiba K. Anis ◽

James Bircher ◽

Alison K. Klika ◽

...

Keyword(s):

Prosthetic Joint Infection ◽

Joint Infection ◽

Area Under The Curve ◽

Roc Curves ◽

Musculoskeletal Infection ◽

Hip Hemiarthroplasty ◽

Diagnostic Thresholds ◽

Diagnostic Threshold ◽

Prosthetic Joint ◽

The Mean

AbstractDiagnostic thresholds used to standardize the definition for prosthetic joint infection (PJI) have largely focused on total joint arthroplasty (TJA). Established PJI thresholds exist for serum erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in TJA; however, they do not exist for revision hip hemiarthroplasty (rHHA). The purpose of this study was to establish thresholds for (1) ESR and (2) CRP to diagnose PJI in rHHA. Data were collected on a prospective cohort of 69 rHHA patients undergoing orthopaedic surgery between 1/2017 and 2/2019 in a single health care system. Procedures were categorized as septic or aseptic revisions using Musculoskeletal Infection Society (MSIS) criteria (2013). There were 44 ESRs (n = 28 aseptic, n = 16 septic) and 46 CRPs (n = 29 aseptic, n = 17 septic) available for analysis. Two tailed t-tests were performed to compare the mean ESR and CRP in aseptic and septic cases. Receiver operator characteristic (ROC) curves were generated to obtain diagnostic cutoff thresholds using the Youden's Index (J) for ESR and CRP. The mean ESR was 50.3 ± 30.6 mm/h versus 15.4 ± 17.7 mm/h (p < 0.001), while the mean CRP was 29.9 ± 24.8 mg/L versus 4.1 ± 8.2 mg/L (p < 0.001) for septic and aseptic revisions, respectively. The diagnostic threshold for PJI determined by the ROC curve was 44 mm/h for ESR (sensitivity = 56.3%; specificity = 100.0%; J = 0.563; area under the curve (AUC) = 0.845), while it was 12.5 mg/L for CRP (sensitivity = 70.6%; specificity = 96.6%; J = 0.672; AUC = 0.896). For patients with HHA, an ESR of 44 mm/h was and a CRP of 12.5 mg/L was highly specific for PJI. The thresholds are similar to the MSIS thresholds currently published. Larger prospective trials are needed to establish more robust and conclusive diagnostic criteria for PJI in HHA, including investigations not only of ESR and CRP but synovial white blood cell count and synovial polymorphonuclear leukocytes % as well.

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Endocrine and Electrolyte Balances during Periovulatory Period in Cycling Mares

Animals ◽

10.3390/ani11020520 ◽

2021 ◽

Vol 11 (2) ◽

pp. 520 ◽

Cited By ~ 1

Author(s):

Katiuska Satué ◽

Esterina Fazio ◽

Ana Muñoz ◽

Pietro Medica

Keyword(s):

Estrous Cycle ◽

Hpa Axis ◽

Adrenocorticotropic Hormone ◽

Venous Blood ◽

Competitive Elisa ◽

Direct Relation ◽

Plasma Acth ◽

Blood Samples ◽

Hypothalamic Pituitary Adrenal ◽

Stimulation Of

In cycling females, the periovulatory period is characterized by stimulation of the hypothalamic pituitary adrenal (HPA) axis. The aim of present study was to analyze the pattern and interrelationships among adrenocorticotropic hormone (ACTH), cortisol (CORT), aldosterone (ALD) and electrolytes (sodium—Na+, potassium—K+ and chloride—Cl−) during periovulatory period in cycling mares. Venous blood samples were obtained daily from a total of 23 Purebred Spanish broodmares, aged 7.09 ± 2.5 years, from day −5 to day +5 of estrous cycle, considering day 0, the day of ovulation. Plasma ACTH was measured by a fluorescent immunoassay kit, serum CORT and ALD by means of a competitive ELISA immunoassay, and plasma Na+, K+ and Cl− were quantified by an analyzer with selective electrodes for the three ions. ACTH showed higher concentrations at day 0 compared to days −5 to −1 and +1 to +3 (p < 0.05). CORT showed higher concentrations at day 0 compared to days −5 to −2 and +1 to +5 (p < 0.05). ALD showed higher concentrations at day 0 compared to days −5 to −2 (p < 0.05) and +2 (p < 0.05). Na+ and Cl− showed higher concentrations at day 0, compared to day −5 and +5. K+ showed lower concentrations at day 0 compared to day +1 (p < 0.05). The significant correlations obtained between ACTH and CORT (r = 0.20) and between ACTH and ALD (r = 0.32) suggest that although ACTH may have an effect both on CORT and ALD, there are other very important determinants that could be considered. Hence, it is possible to presume that the pituitary adrenocortical response and ALD may be involved in the ovulatory mechanisms without a direct relation with electrolyte pattern.

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