Observational studies on macroprolactin in a routine clinical laboratory

2018 ◽  
Vol 56 (8) ◽  
pp. 1259-1262 ◽  
Author(s):  
Julian H. Barth ◽  
Carys M. Lippiatt ◽  
Stephen G. Gibbons ◽  
Robert A. Desborough
Keyword(s):  
Retrospective Study ◽  
Polyethylene Glycol ◽  
Observational Studies ◽  
Clinical Laboratory ◽  
Median Period ◽  
History Of ◽  
Routine Clinical Laboratory ◽  
Subsequent Sample ◽  
Over Time ◽  
Made In

Abstract Background: It is now recommended that all samples with raised prolactin should be examined for the presence of macroprolactin. We performed a retrospective review of our experience of macroprolactin to determine the incidence and the natural history of macroprolactin. Methods: A retrospective study of macroprolactin was made in a large clinical laboratory. Macroprolactin was measured on those samples where it is requested and where the total prolactin is >1000 mIU/L. Prolactin was measured using the Siemens Centaur and macroprolactin was measured following polyethylene glycol (PEG)-precipitation. Results: The incidence of macroprolactin in samples where the total prolactin was >1000 mIU/L was 36/670 (5.4%). During this period, 12,064 samples were received for prolactin analysis. Over the period since 2006, 22 subjects had a sample with an isolated macroprolactin measurement followed by another sample without macroprolactin after a median period of 0.46 years. Twenty-five subjects had multiple consecutive measurements of macroprolactin lasting a median period of 2.1 years. Fourteen subjects had more than six samples which had been subjected to PEG precipitation. In these subjects, the reproducibility of PEG precipitation over a median of 6 years was 1.1% CV (recovery 75% [26–110] (median [range])). Conclusions: The presence of macroprolactin can change over time and we cannot advise that once a test for macroprolactinemia has been performed that it is not necessary to repeat the investigation if a subsequent sample is hyperprolactinemic; nor can one assume that macroprolactin will not develop even if it has been excluded previously.

scholarly journals A single-centre, retrospective study of the incidence of invasive fungal infections during 85 years of autopsy service in Brazil

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kátia Cristina Dantas ◽  
Thais Mauad ◽  
Carmen D. Saldiva de André ◽  
Ana Luiza Bierrenbach ◽  
Paulo Hilário Nascimento Saldiva
Keyword(s):  
Retrospective Study ◽  
Essential Role ◽  
Fungal Infections ◽  
Invasive Fungal Infections ◽  
Single Centre ◽  
Historical Trends ◽  
Aids Pandemic ◽  
History Of ◽  
Frequent Infection ◽  
Over Time

AbstractAutopsy continues to play an essential role in monitoring opportunistic fungal infections. However, few studies have analysed the historical trends of fungal infections in autopsies. Here, we analyse available data on fungal infections obtained from autopsy reports during 85 years of autopsies performed by the largest autopsy service in Brazil. All invasive fungal infections presented in autopsy reports between 1930 and 2015 were included. Of the 158,404 autopsy reports analysed, 1096 involved invasive fungal infections. In general, paracoccidioidomycosis (24%) was the most frequent infection, followed by candidiasis (18%), pneumocystosis (11.7%), cryptococcosis (11%), aspergillosis (11%) and histoplasmosis (3.8%). Paracoccidioidomycosis decreased after the 1950s, whereas opportunistic fungal infections increased steadily after the 1980s during the peak of the AIDS pandemic. The lung was the most frequently affected organ (73%). Disseminated infection was present in 64.5% of cases. In 26% of the 513 cases for which clinical charts were available for review, the diagnosis of opportunistic fungal infections was performed only at autopsy. Our unique 85-year history of autopsies showed a transition from endemic to opportunistic fungal infections in São Paulo, Brazil, reflecting increased urbanization, the appearance of novel diseases, such as AIDS in the 1980s, and advances in medical care over time.

Introduction

2019 ◽  
pp. 1-26
Author(s):  
Sean Akerman
Keyword(s):  
Narrative Approaches ◽  
History Of ◽  
Over Time ◽  
Made In ◽  
Tibetan Exile

This chapter introduces the author’s fieldwork and the focus of the book: using narrative approaches to understand and represent exile. The chapter reviews the progress narrative work has made in the discipline of psychology and how it provides a useful approach to the study of exile for reasons that are theoretical, methodological, and rhetorical. The author sketches the history of the Tibetan exile and explains how it provides a useful site to investigate the issues that are at the heart of the book, including the transmission of stories, and traumas, over time. Finally, the author introduces the informants who feature significantly in the book.

scholarly journals Score for Predicting Active Cancer in Patients with Ischemic Stroke: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Jiwei Jiang ◽  
Xiuli Shang ◽  
Jinming Zhao ◽  
Meihui Cao ◽  
Jirui Wang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Study ◽  
Clinical Laboratory ◽  
Elevated Serum ◽  
Clinical Score ◽  
Predictive Score ◽  
Bayesian Decision ◽  
History Of ◽  
D Dimer ◽  
Active Cancer

Background. We aimed to examine the differences of clinical characteristics between patients with ischemic stroke with active cancer and those without cancer to develop a clinical score for predicting the presence of occult cancer in patients with ischemic stroke. Methods. This retrospective study enrolled consecutive adult patients with acute ischemic stroke who were admitted to our department between December 2017 and January 2019. The demographic, clinical, laboratory, and neuroimaging characteristics were compared between patients with ischemic stroke with active cancer and those without cancer. Multivariate analysis was performed to identify independent factors associated with active cancer. Subsequently, a predictive score was developed using the areas under the receiver operating characteristic curves based on these independent factors. Finally, Bayesian decision theory was applied to calculate the posterior probability of active cancer for finding the best scoring system. Results. Fifty-three (6.63%) of 799 patients with ischemic stroke had active cancer. The absence of a history of hyperlipidemia (odds ratio OR = 0.17 , 95% confidence interval (CI): 0.06–0.48, P < 0.01 ), elevated serum fibrinogen ( OR = 1.72 , 95% CI: 1.33–2.22, P < 0.01 ) and D-dimer levels ( OR = 1.43 , 95% CI: 1.24–1.64, P <0.01), and stroke of undetermined etiology ( OR = 22.87 , 95% CI: 9.91–52.78, P < 0.01 ) were independently associated with active cancer. A clinical score based on the absence of hyperlipidemia, serum fibrinogen level of ≥4.00 g/L, and D-dimer level of ≥2.00 μg/mL predicted active cancer with an area under the curve of 0.83 (95% CI: 0.77–0.89, P < 0.01 ). The probability of active cancer was 59% at a supposed prevalence of 6.63%, if all three independent factors were present in a patient with ischemic stroke. Conclusions. We devised a clinical score to predict active cancer in patients with ischemic stroke based on the absence of a history of hyperlipidemia and elevated serum D-dimer and fibrinogen levels. The use of this score may allow for early intervention. Further research is needed to confirm the implementation of this score in clinical settings.

scholarly journals Introduction

2018 ◽  
Vol 4 (1) ◽  
pp. 186-198
Author(s):  
Mirjam de Bruijn ◽  
Jonna Both
Keyword(s):  
West Africa ◽  
Social Conflicts ◽  
Normal Life ◽  
The Social ◽  
History Of ◽  
Political Structures ◽  
Over Time ◽  
Made In ◽  
As If

The enduring experience of hardship, in the form of layers of various crises, can become deeply ingrained in a society, and people can come to act and react under these conditions as if they lead a normal life. This process is explored through the analytical concept of duress, which contains three elements: enduring and accumulating layers of hardship over time, the normalization of this hardship, and a form of deeply constrained agency. We argue that decisions made in duress have a significant impact on the social and political structures of society. This concept of duress is used as a lens to understand the lives of individual people and societies in Central and West Africa that have a long history of ecological, political, and social conflicts and crises.

scholarly journals Two significant moments in the history of Kaaps

2018 ◽  
Vol 3 (2) ◽  
pp. 53-61
Author(s):  
Christo Van Rensburg
Keyword(s):  
True Story ◽  
Regional Dialects ◽  
History Of ◽  
Over Time ◽  
Made In

Two matters are considered in this paper.(i) The identification of the first version of Kaaps, the progenitor of Afrikaans. The earliestversion of Kaaps was recorded during the first period of the history of Afrikaans – theperiod prior to 1652. This period commences with the first visits to the Cape by Dutchmariners. The written records of Kaaps dating from that period are older than anyother manifestation of forms in Afrikaans. Some of these early words are currently stillin use among speakers of Kaaps, while others have been incorporated into StandardAfrikaans, or appear in dictionaries and the AWS (Afrikaanse Woordelys en Spelreëls –Wordlist and Spelling rules for Afrikaans). Some even continue to survive in the spokenAfrikaans of a number of regional dialects. Reference is also made in this chapter tohow Kaaps eventually developed and played an important role in the shaping of othervarieties of Afrikaans.(ii) The circumstances leading to the incorporation of elements of other varieties into the coredescription of Afrikaans. In describing Afrikaans, language historians usually ask whereparticular words and constructions come from. But the question how is actually ofgreater value when investigating the development of Afrikaans. Ek (I) is a word inKaaps which was, over time, absorbed into general use in Afrikaans. An analysis ofhow this process took place reveals that the ‘how’ questions are of greater importancein the history of the language than the ‘when’ and ‘where’ questions. The true story ofAfrikaans is a socio-historical one. Destigmatization, and the circumstances leading tochanging norms, are evoked by the ‘how’ questions.

scholarly journals Universal Nominations Samples in Main Languages

2015 ◽  
Vol 3 (1) ◽  
pp. 38
Author(s):  
Kulzhanova Bakytgul ◽  
Sagyndykuly Berikbay
Keyword(s):  
Broad Sense ◽  
Great Opportunity ◽  
World Languages ◽  
Turkic Languages ◽  
History Of ◽  
Over Time ◽  
Made In

Significant discoveries are made in Turkology in recent years. As a result, there is a great opportunity to explore in-depth of the history of the word. If to be exact, the most important things, the archetypes of consonant of Turkic languages (including world languages in its broad sense) are identified. Significant results are made due to the fact of clarification of original and archaic types of sounds. The importance of the restoration of archetype of consonants and vowels in retrospective direction or, on the contrary, the replacement of their synchronic variants that were formulated over time in perspective direction is the following: if etymology of any word is analyzed, it will be easier to explore its origin.

scholarly journals Score for Predicting Active Cancer in Patients with Ischemic Stroke: A Retrospective Study

2020 ◽  
Author(s):  
Jiwei Jiang ◽  
Jirui Wang ◽  
Meihui Cao ◽  
Jinming Zhao ◽  
Xiuli Shang
Keyword(s):  
Ischemic Stroke ◽  
Retrospective Study ◽  
Clinical Laboratory ◽  
Characteristic Curve ◽  
Elevated Serum ◽  
Area Under The Curve ◽  
Clinical Score ◽  
History Of ◽  
D Dimer ◽  
Active Cancer

Abstract Background: We aimed to examine the differences between the clinical characteristics of patients with ischemic stroke and active cancer and those without cancer and develop a clinical score for predicting occult cancer in patients with ischemic stroke.Methods: This retrospective study enrolled consecutive adult patients with acute ischemic stroke, who were admitted to our department between December 2017 and January 2019. The demographic, clinical, laboratory, and neuroimaging characteristics of patients with ischemic stroke with active cancer and those without cancer were compared. Multivariate analysis was performed to identify independent factors associated with active cancer. Subsequently, a predictive cancer-risk score was developed using the area under the receiver operating characteristic curve.Results: Fifty-three (6.63%) of 799 patients with ischemic stroke had active cancer. The absence of a history of hyperlipidemia [odds ratio (OR)=0.17, 95% confidence interval (CI): 0.06–0.48, P<0.01], elevated serum fibrinogen (OR=1.72, 95% CI: 1.33–2.22, P<0.01) and D-dimer levels (OR=1.43, 95% CI: 1.24–1.64, P<0.01), and stroke of undetermined etiology (OR=22.87, 95% CI: 9.91–52.78, P<0.01) were independently associated with active cancer. Thus, a score based on the absence of hyperlipidemia and serum fibrinogen ≥4.00 g/L and D-dimer ≥2.00 μg/mL predicted active cancer with an area under the curve of 0.83 (95% CI: 0.77–0.89, P<0.01). The probability of active cancer was 59% at a supposed prevalence of 6.63%, if all three independent factors were present in a patient with ischemic stroke.Conclusions: We devised a score to predict active cancer in patients with ischemic stroke based on the absence of a history of hyperlipidemia and elevated serum D-dimer and fibrinogen that highlights the importance of hypercoagulability in these patients and may help determine early intervention and management.

scholarly journals OPTIMUM ALLOCATION OF DIFFERENT SOURCES OF IRRIGATION

2020 ◽  
pp. 31-33
Author(s):  
Dr. Shailja
Keyword(s):  
Agricultural Development ◽  
Irrigation Management ◽  
Policy Implications ◽  
Irrigation Potential ◽  
Rational Allocation ◽  
History Of ◽  
Different Sources ◽  
Minor Irrigation ◽  
Over Time ◽  
Made In

Discovery of agriculture was no doubt the greatest development in the history of mankind. Irrigation, being one of the most crucial input in the process of agricultural development, has been sought to be developed. In India, although significant efforts have been made to develop the irrigation potential through major and minor irrigation, yet there has been rather inadequate awareness of the economics of irrigation. Particularly, very few comparable attempts have been made to examine the rational allocation of water between different regions, crops and over time. Most of the studies that have been made in this field, have examined the different sources of irrigation in isolation from one another. In the present study, it is intended to examine the different sources of irrigation in an integrated manner and thus provide a macro-prospective as a guide to formulation of rational policies for irrigation management. In the present study, it is proposed to study the allocation of water by regions and crops and also over time. An attempt will be made to draw out policy implications and make some specific recommendations.

scholarly journals Natural History of Clinical, Laboratory, and Echocardiographic Parameters of a Primary Hyperoxaluria Cohort on Long Term Hemodialysis

2021 ◽  
Vol 8 ◽  
Author(s):  
David J. Sas ◽  
Felicity T. Enders ◽  
Tina M. Gunderson ◽  
Ramila A. Mehta ◽  
Julie B. Olson ◽  
...  
Keyword(s):  
Natural History ◽  
Clinical Laboratory ◽  
Global Longitudinal Strain ◽  
Primary Hyperoxaluria ◽  
Multiple Organ ◽  
Left Ventricular ◽  
Organ Systems ◽  
Echocardiographic Parameters ◽  
History Of ◽  
Over Time

Background: Primary hyperoxaluria type 1 (PH1) is a rare monogenic disorder characterized by excessive hepatic production of oxalate leading to recurrent nephrolithiasis, nephrocalcinosis, and progressive kidney damage, often requiring renal replacement therapy (RRT). Though systemic oxalate deposition is well-known, the natural history of PH1 during RRT has not been systematically described. In this study, we describe the clinical, laboratory, and echocardiographic features of a cohort of PH1 patients on RRT.Methods: Patients with PH1 enrolled in the Rare Kidney Stone Consortium PH Registry who progressed to require RRT, had ≥2 plasma oxalate (pOx) measurements 3–36 months after start of RRT, and at least one pair of pOx measurements between 6 and 18 months apart were retrospectively analyzed. Clinical, echocardiographic, and laboratory results were obtained from the Registry.Results: The 17 PH1 patients in our cohort had a mean total HD hours/week of 17.4 (SD 7.9; range 7.5–36) and a range of age of RRT start of 0.2–75.9 years. The average change in plasma oxalate (pOx) over time on RRT was −0.74 [−2.9, 1.4] μmol/L/month with the mean pOx never declining below 50 μmol/L. Over time on RRT, oxalosis progressively developed in multiple organ systems. Echocardiography performed on 13 subjects showed worsening of left ventricular global longitudinal strain correlated with pOx (p &lt; 0.05).Conclusions: Even when a cohort of PH1 patients were treated with intensified RRT, their predialysis pOx remained above target and they developed increasing evidence of oxalosis. Echocardiographic data suggest that cardiac dysfunction could be related to elevated pOx and may worsen over time.

scholarly journals Assessing the Need for Multiplex and Multifunctional Tick-Borne Disease Test in Routine Clinical Laboratory Samples from Lyme Disease and Febrile Patients with a History of a Tick Bite

2021 ◽  
Vol 6 (1) ◽  
pp. 38
Author(s):  
Kunal Garg ◽  
T. Sakari Jokiranta ◽  
Sanna Filén ◽  
Leona Gilbert
Keyword(s):  
Lyme Disease ◽  
Clinical Laboratory ◽  
Diagnostic Tools ◽  
Testing System ◽  
Test Results ◽  
System A ◽  
History Of ◽  
Tick Borne Disease ◽  
Routine Clinical Laboratory ◽  
Missed Opportunity

Human polymicrobial infections in tick-borne disease (TBD) patients is an emerging public health theme. However, the requirement for holistic TBD tests in routine clinical laboratories is ambiguous. TICKPLEX® PLUS is a holistic TBD test utilized herein to assess the need for multiplex and multifunctional diagnostic tools in a routine clinical laboratory. The study involved 150 specimens categorized into Lyme disease (LD)-positive (n = 48), LD-negative (n = 30), and febrile patients from whom borrelia serology was requested (n = 72, later “febrile patients”) based on reference test results from United Medix, Finland. Reference tests from DiaSorin, Immunetics, and Mikrogen Diagnostik followed the two-tier LD testing system. A comparison between the reference tests and TICKPLEX® PLUS produced 86%, 88%, and 87% positive, negative, and overall agreement, respectively. Additionally, up to 15% of LD and 11% of febrile patients responded to TBD related coinfections and opportunistic microbes. The results demonstrated that one (TICKPLEX® PLUS) test can aid in a LD diagnosis instead of four tests. Moreover, TBD is not limited to just LD, as the specimens produced immune responses to several TBD microbes. Lastly, the study indicated that the screening of febrile patients for TBDs could be a missed opportunity at reducing unreported patient cases.

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