Neuroblastoma—When are Urinary Catecholamines and Their Metabolites ‘Normal’?

1988 ◽  
Vol 25 (6) ◽  
pp. 620-626 ◽  
Author(s):  
D J Worthington ◽  
E M Hammond ◽  
B B Eldeeb ◽  
A Green ◽  
G M Addison ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
The Other ◽  
Published Data ◽  
Single Test ◽  
Creatinine Concentration ◽  
Urinary Catecholamines ◽  
Clinical Sensitivity ◽  
Reference Limit ◽  
Upper Reference Limit ◽  
The Individual

The overproduction of catecholamines and their metabolites is a well recognised feature of neuroblastoma. Published data are scarce for their urinary excretion in children with neuroblastoma and in ill children in whom this diagnosis may be considered. We have determined a graphical upper reference limit for total catecholamines, total metadrenalines and HMMA in urine, expressed as a ratio to the creatinine concentration, for a group of 174 children with neuroblastoma and 704 hospitalised children with other disorders. This graph has been determined by examining the overlap region between the results for the two groups of children and avoids the irregularities caused by statistical outliers. The sensitivity and specificity of the individual tests indicate that total catecholamines is marginally the best single test to perform when trying to diagnose neuroblastoma, with the best clinical sensitivity being achieved by examining both total catecholamines and HMMA. Only two of the 174 children with neuroblastoma would not have been detected using these two tests. Total metadrenalines did not appear to add any further information and could be dropped from the repertoire in favour of the other two measurements.

scholarly journals Improved detection of minor ischemic myocardial injury with measurement of serum cardiac troponin I

1997 ◽  
Vol 43 (11) ◽  
pp. 2047-2051 ◽  
Author(s):  
Fred S Apple ◽  
Alireza Falahati ◽  
Pamela R Paulsen ◽  
Elizabeth A Miller ◽  
Scott W Sharkey
Keyword(s):  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Clinical Sensitivity ◽  
Reference Limit ◽  
Normal Limits ◽  
Serial Serum ◽  
Upper Reference Limit ◽  
Serum Cardiac Troponin

Abstract This study compared the diagnostic accuracy of the measurement of serum cardiac troponin I (cTnI) with creatine kinase (CK) MB mass in patients with minor myocardial injury whose measured total CK activity did not exceed twice the upper reference limit (300 U/L for men; 200 U/L for women). Forty-eight consecutive patients presenting with chest pain and with in-hospital documentation of myocardial injury were enrolled. Electrocardiogram, echocardiogram, and serial serum CK-MB mass, cTnI, and total CK were measured over 36 h after admission. Peak total CK activity was within normal limits in 28 patients (58%). The mean (±SD) peak CK-MB mass and cTnI concentrations were: 16.4 (11.8) μg/L and 132 (13.0) μg/L; respectively. The peak biochemical marker index (defined as CK-MB or cTnI divided by its respective upper reference limit) was significantly (P <0.05) higher for cTnI than for CK-MB from 7 to 36 h. The clinical sensitivity for detection of myocardial injury for cTnI was 100% [95% confidence interval (CI): 87.2% to 100%], compared with 81.8% (CI: 67.3% to 91.8%) for CK-MB. Thus, cTnI was more sensitive than CK-MB mass for detection of myocardial injury in patients with small increases of total CK.

scholarly journals Measurement of urinary 5-HIAA: correlation between spot versus 24-h urine collection

2019 ◽  
Vol 8 (8) ◽  
pp. 1082-1088 ◽  
Author(s):  
Matilde Calanchini ◽  
Michael Tadman ◽  
Jesper Krogh ◽  
Andrea Fabbri ◽  
Ashley Grossman ◽  
...  
Keyword(s):  
Reference Method ◽  
Neuroendocrine Neoplasms ◽  
Urine Collection ◽  
Creatinine Concentration ◽  
Spot Urine ◽  
Reference Limit ◽  
Spot Urine Sample ◽  
Hydroxyindoleacetic Acid ◽  
Upper Reference Limit

Background The 24-h urinary output of 5-hydroxyindoleacetic acid (5-HIAA) is used to monitor disease progression and treatment responses of neuroendocrine neoplasms (NENs). Several conditions are required for 5-HIAA assay, involving urine collection/preservation and food/drug restrictions. Aim To evaluate the correlation between 5-HIAA concentration in a spot urine sample and the output in a 24-h urine collection, and whether spot urine specimens can replace 24-h collection. Methods Patients with NENs or symptoms suggestive of NENs were asked to provide a separate spot urine at the end of the 24-h urine collection for 5-HIAA assessment. The upper reference limit for 24-h urinary 5-HIAA was 40 µmol/24 h. 5-HIAA measurements in spot urine samples were corrected for variation in urine flow rate by expressing results as a ratio to creatinine concentration. Results We included 136 paired urinary samples for 5-HIAA assessment from 111 patients (100 NENs). The correlation between 5-HIAA values measured in 24-h and spot urines was r = +0.863 (P < 0.001) and r = +0.840 (P < 0.001) including only NEN patients. Using the 24-h urinary 5-HIAA as reference method, the AUC on ROC analysis for spot urinary 5-HIAA was 0.948 (95% CI, 0.914–0.983; P < 0.001), attaining a sensitivity of 83% and specificity of 95% using 5.3 mol/mmol as cut-off for the spot urine. The AUC among NEN patients alone was 0.945 (95% CI, 0.904–0.987; P < 0.001). Conclusions The ratio of 5-HIAA to creatinine in a spot urine could replace the measurement of 5-HIAA output in a 24-h urine collection, especially for follow-up of patients with known elevated 5-HIAA levels.

A PRELIMINARY INVESTIGATION OF STEROID EXCRETION IN DEPRESSED PATIENTS BEFORE AND AFTER ELECTRO-CONVULSIVE THERAPY

1964 ◽  
Vol 47 (1) ◽  
pp. 58-68 ◽  
Author(s):  
H. C. Ferguson ◽  
A. C. G. Bartram ◽  
H. C. Fowlie ◽  
D. M. Cathro ◽  
K. Birchall ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Normal Values ◽  
Preliminary Investigation ◽  
Depressive Illness ◽  
The Other ◽  
Convulsive Therapy ◽  
Before And After ◽  
The Individual ◽  
Steroid Excretion ◽  
Electro Convulsive Therapy

ABSTRACT Using a method dependent upon paper chromatography, the urinary excretion of the individual corticosteroids and the individual 17-oxosteroids has been studied before and after electro-convulsive therapy in five female patients suffering from a depressive illness. The corticosteroids, which are normally associated with stress, were found to show a fall in excretion from abnormally high levels before treatment to normal levels thereafter. The 11-deoxy-17-oxosteroids, on the other hand, showed a low level of excretion prior to treatment which was followed by a rise to normal values in clinical remission. These findings are discussed.

scholarly journals Sensitive Assays for Urinary Retinol-Binding Protein and β-2-Glycoprotein-1 Based on Commercially Available Standards

1998 ◽  
Vol 35 (1) ◽  
pp. 115-119 ◽  
Author(s):  
M Lapsley ◽  
K Akers ◽  
A G W Norden
Keyword(s):  
Reference Range ◽  
Binding Protein ◽  
Healthy Adults ◽  
Retinol Binding Protein ◽  
Healthy Children ◽  
Creatinine Concentration ◽  
Reference Limit ◽  
Renal Tubular ◽  
Upper Reference Limit

Measurements of urinary retinol-binding protein (RBP) and β-2-glycoprotein-1 (β2G1) provide sensitive indicators of proximal renal tubular malfunction. β2G1 is very stable in urine but RBP, which is much less stable, has been more extensively studied. We have designed two similar immunoassays allowing measurement of both proteins from one urine dilution. The assays both use widely available commercial standards and permit accurate measurement throughout most of the reference range. We measured both proteins in the urine of 70 healthy adults and 80 healthy children aged between three and 16 years, expressing the results as a ratio to creatinine concentration. Using the 98th centile as the upper reference limit, adults excreted up to 17 μg/mmol RBP (median 8) and up to 30 μg/mmol β2G1 (median 15) with no difference between the sexes. Children had different ranges to adults with excretion of up to 22 μg/mmol RBP (median 10) and up to 80 μg/mmol β2G1 (median 24).

Assays of serum lipase: analytical and clinical considerations.

1986 ◽  
Vol 32 (7) ◽  
pp. 1290-1302 ◽  
Author(s):  
J A Lott ◽  
S T Patel ◽  
A K Sawhney ◽  
S C Kazmierczak ◽  
J E Love
Keyword(s):  
Acute Pancreatitis ◽  
Serum Amylase ◽  
Comparative Method ◽  
Analytical Sensitivity ◽  
Serum Lipase ◽  
Clinical Sensitivity ◽  
Reference Limit ◽  
Analytical Properties ◽  
Clinical Considerations ◽  
Upper Reference Limit

Abstract We evaluated three commercially available methods for determining lipase (EC 3.1.1.3) in serum--the Du Pont aca, Boehringer Mannheim Diagnostics (BMD), and Kodak Ektachem (EK) procedures--for their analytical properties and diagnostic efficiencies. Titrimetry was used as the comparative method. The BMD and EK methods showed better agreement with the titrimetric method, owing to the presence of the necessary cofactor, colipase, in their reagents. Colipase also increased the analytical sensitivity of the BMD and EK procedures as compared with the aca method. Determinations of serum lipase, by all methods, had a clinical sensitivity in excess of 80% for acute pancreatitis; the specificity of the lipase test was about 60%, or twice that of serum amylase. Serum lipase determinations with the current, simpler technology are superior to total amylase in the diagnosis of patients with acute pancreatitis. When a colipase-supplemented method is used, a serum lipase value greater than 10-fold the upper reference limit appears to be pathognomonic for acute pancreatitis or inflammation of organs close to the pancreas.

Cardiac troponin assays: a review of quantitative point-of-care devices and their efficacy in the diagnosis of myocardial infarction

2015 ◽  
Vol 53 (5) ◽  
Author(s):  
Beret E. Amundson ◽  
Fred S. Apple
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Troponin ◽  
Point Of Care ◽  
Hospital Costs ◽  
Sample Type ◽  
Clinical Sensitivity ◽  
Reference Limit ◽  
Negative Results ◽  
Analytical Imprecision ◽  
Upper Reference Limit

AbstractCardiac troponin (cTn) I and T are released from myocardial cells following necrosis, i.e., cell death. An accurate measure of cTn concentrations in a patient’s blood following ischemia/chest pain can enable providers to determine whether or not a myocardial infarction (MI) has occurred. Point-of-care (POC) devices that measure blood cTn concentrations in under 30 min may help to significantly reduce hospital costs by managing and triaging patients out of the emergency department as quickly as possible. The use of POC devices that measure cTnI and cTnT with a coefficient of variation (CV) ≤20% at the 99th percentile upper reference limit (URL) limits both false positive and negative results and provides clinically acceptable findings to assist in appropriate diagnoses. This article reviews nine POC devices that measure cTn in terms of their clinical sensitivity and specificity, analytical imprecision, sample type and preparation, and each assay’s principle of analysis.

scholarly journals Cardiac troponin I release after a basketball match in elite, amateur and junior players

2016 ◽  
Vol 54 (2) ◽  
Author(s):  
Isaac López-Laval ◽  
Alejandro Legaz-Arrese ◽  
Keith George ◽  
Olga Serveto-Galindo ◽  
José María González-Rave ◽  
...  
Keyword(s):  
Cardiac Troponin ◽  
Troponin I ◽  
Intermittent Exercise ◽  
Individual Variability ◽  
Scientific Data ◽  
Cardiac Troponin I ◽  
Post Exercise ◽  
Reference Limit ◽  
Upper Reference Limit ◽  
The Individual

AbstractAvailable scientific data related to cardiac troponin I (cTnI) release after intermittent exercise is limited. It is also of interest to determine what personal or environmental factors mediate the exercise-induced release of cTnI. This study had two objectives: 1) to examine the individual release of cTnI to a basketball match; and 2) to establish the influence of athlete status as well as biological age on cTnI release.Thirty-six basketball players (12 adult elite [PBA]: 27.3±4.1 years, 12 adult amateur [ABA]: 29.6±2.9 years, and 12 junior elite [JBA]: 16.6±0.9 years) participated in a simulated basketball match with serial assessment of cTnI at rest, immediately post- and at 1, 3, 6, 12, and 24 h post-exercise.The basketball match increased cTnI levels (pre: median [range]; 0.006 [0.001–0.026]; peak post: 0.024 [0.004–0.244] μg/L; p=0.000), with substantial individual variability in peak values. PBA and JBA players showed higher baseline and post-exercise cTnI values than ABA (all p<0.05). Peak cTnI exceeded the upper reference limit (URL) in the 26% of players (3 PBA; 6 JBA).The current results suggest that intermittent exercise can promote the appearance of cTnI and that this is potentially mediated by athlete status.

Writing in Aphasia Rehabilitation: Cursive vs Manuscript

1976 ◽  
Vol 41 (4) ◽  
pp. 523-529 ◽  
Author(s):  
Daniel R. Boone ◽  
Harold M. Friedman
Keyword(s):  
Correct Response ◽  
The Other ◽  
Read Aloud ◽  
Writing Style ◽  
Reading And Writing ◽  
Manual Responses ◽  
Significant Difference ◽  
Written Form ◽  
The Individual ◽  
Read Number

Reading and writing performance was observed in 30 adult aphasic patients to determine whether there was a significant difference when stimuli and manual responses were varied in the written form: cursive versus manuscript. Patients were asked to read aloud 10 words written cursively and 10 words written in manuscript form. They were then asked to write on dictation 10 word responses using cursive writing and 10 words using manuscript writing. Number of words correctly read, number of words correctly written, and number of letters correctly written in the proper sequence were tallied for both cursive and manuscript writing tasks for each patient. Results indicated no significant difference in correct response between cursive and manuscript writing style for these aphasic patients as a group; however, it was noted that individual patients varied widely in their success using one writing form over the other. It appeared that since neither writing form showed better facilitation of performance, the writing style used should be determined according to the individual patient’s own preference and best performance.

Margaret Mahy: An Adlerian Reading

2008 ◽  
Vol 1 (2) ◽  
pp. 187-199
Author(s):  
KATHRYN WALLS
Keyword(s):  
Young Female ◽  
The Other ◽  
Individual Psychology ◽  
The Novel ◽  
Alfred Adler ◽  
Female Protagonists ◽  
Magical Power ◽  
Margaret Mahy ◽  
The Individual

According to the ‘Individual Psychology’ of Alfred Adler (1870–1937), Freud's contemporary and rival, everyone seeks superiority. But only those who can adapt their aspirations to meet the needs of others find fulfilment. Children who are rejected or pampered are so desperate for superiority that they fail to develop social feeling, and endanger themselves and society. This article argues that Mahy's realistic novels invite Adlerian interpretation. It examines the character of Hero, the elective mute who is the narrator-protagonist of The Other Side of Silence (1995) , in terms of her experience of rejection. The novel as a whole, it is suggested, stresses the destructiveness of the neurotically driven quest for superiority. Turning to Mahy's supernatural romances, the article considers novels that might seem to resist the Adlerian template. Focusing, in particular, on the young female protagonists of The Haunting (1982) and The Changeover (1984), it points to the ways in which their magical power is utilised for the sake of others. It concludes with the suggestion that the triumph of Mahy's protagonists lies not so much in their generally celebrated ‘empowerment’, as in their transcendence of the goal of superiority for its own sake.

Gewalt und Kommunikation

2011 ◽  
Vol 2011 (1) ◽  
pp. 5-28
Author(s):  
Jens Bonnemann
Keyword(s):  
Twentieth Century ◽  
Moral Philosophy ◽  
The Other ◽  
Practical Philosophy ◽  
Valuable Contribution ◽  
Human Species ◽  
Normal Case ◽  
Jean Paul ◽  
Philosophy Of Dialogue ◽  
The Individual

In ethics, when discussing problems of justice and a just social existence one question arises obviously: What is the normal case of the relation between I and you we start from? In moral philosophy, each position includes basic socio-anthropological convictions in that we understand the other, for example, primarily as competitor in the fight for essential resources or as a partner in communication. Thus, it is not the human being as isolated individual, or as specimen of the human species or socialised member of a historical society what needs to be understood. Instead, the individual in its relation to the other or others has been studied in phenomenology and the philosophy of dialogue of the twentieth century. In the following essay I focus on Martin Buber’s and Jean-Paul Sartre’s theories of intersubjectivity which I use in order to explore the meaning of recognition and disrespect for an individual. They offer a valuable contribution to questions of practical philosophy and the socio-philosophical diagnosis of our time.

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