scholarly journals Preliminary study on the correlation of plasma hemolysis index and potassium measurement of inpatient in the Biochemistry Laboratory of General Hospital Kuala Lumpur

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Chia Zhen Zhan ◽  
Asma Harun ◽  
Mohd Nazil Salleh ◽  
◽  
◽  
...  
Keyword(s):  
Extracellular Fluid ◽  
Critical Discussion ◽  
Medical Laboratory ◽  
Electrolyte Balance ◽  
Kuala Lumpur ◽  
H Index ◽  
Blood Samples ◽  
Clinically Significant ◽  
Mean Differences ◽  
Bias Range

Background: Potassium (K+) is the essential micronutrient and major intracellular fluid cation which involves in various cellular metabolism activities, maintaining fluid and electrolyte balance. Measurement of blood concentration in a medical laboratory has often encountered disturbances such as hemolysis, which may lead to the elevation in measurement and affects the medical diagnosis and treatment of the patient, conceivably fatal. Hemolysis can be decided using hemolysis index (H-index) through automation. Methods: In this study, H-index and concentration of fifty hospitalized patients (n=50) hemolysed blood samples were measured and correlated. Freezing-and-thaw method was used to hemolyse the blood samples. Different concentrations were diluted and analyzed using COBAS 8000 biochemistry analyser. Data were collected and analyzed using SPSS version 25. Results: Our findings showed significant mean differences, 0.001 (p ≤ 0.05) and strong positive linear relationship between two variables (H-index and ) (r=0.764, p ≤ 0.05). By applying calculated linear equation [y = 0.0048x + 5.146, = 0.5838], critical value of 6.0 mmol/l gives H-index of 178, H-index above 178 is suggested to be critical. Discussion and Conclusion: concentration increases in proportion to H-index. A greater degree of hemolysis causes more ions to be released into extracellular fluid, respectively. In conclusion, when H-index less than 178 in measurement and there is no analytical significance bias generated, the result is acceptable, whilst H-index with analyte variation between clinically significant bias range can be released with a comment regarding the potential of data alteration. Meanwhile, result with H-index exceeding the cut-offs should be suppressed and recollection of sample is required.

Alcohol Use Disorder

2018 ◽  
Author(s):  
Igor Ponomarev
Keyword(s):  
Alcohol Use ◽  
Alcohol Use Disorder ◽  
Critical Discussion ◽  
Epigenetic Mechanisms ◽  
Future Directions ◽  
Clinically Significant ◽  
Early Life Exposures ◽  
The Brain ◽  
Epigenetic Research

Alcohol use disorder (AUD) is characterized by clinically significant impairments in health and social function. Epigenetic mechanisms of gene regulation may provide an attractive explanation for how early life exposures to alcohol contribute to the development of AUD and exert lifelong effects on the brain. This chapter provides a critical discussion of the role of epigenetic mechanisms in AUD etiology and the potential of epigenetic research to improve diagnosis, evaluate risks for alcohol-induced pathologies, and promote development of novel therapies for the prevention and treatment of AUD. Challenges of the current epigenetic approaches and future directions are also discussed.

scholarly journals Extracellular Acid-Base Balance and Ion Transport Between Body Fluid Compartments

Physiology ◽  
2017 ◽  
Vol 32 (5) ◽  
pp. 367-379 ◽  
Author(s):  
Julian L. Seifter ◽  
Hsin-Yun Chang
Keyword(s):  
Ion Transport ◽  
Ph Regulation ◽  
Extracellular Fluid ◽  
Transport Processes ◽  
Electrolyte Balance ◽  
Ph Homeostasis ◽  
Acid Base Balance ◽  
Acid Base ◽  
Base Balance ◽  
Fluid Compartments

Clinical assessment of acid-base disorders depends on measurements made in the blood, part of the extracellular compartment. Yet much of the metabolic importance of these disorders concerns intracellular events. Intracellular and interstitial compartment acid-base balance is complex and heterogeneous. This review considers the determinants of the extracellular fluid pH related to the ion transport processes at the interface of cells and the interstitial fluid, and between epithelial cells lining the transcellular contents of the gastrointestinal and urinary tracts that open to the external environment. The generation of acid-base disorders and the associated disruption of electrolyte balance are considered in the context of these membrane transporters. This review suggests a process of internal and external balance for pH regulation, similar to that of potassium. The role of secretory gastrointestinal epithelia and renal epithelia with respect to normal pH homeostasis and clinical disorders are considered. Electroneutrality of electrolytes in the ECF is discussed in the context of reciprocal changes in Cl−or non Cl−anions and [Formula: see text].

scholarly journals KADAR KLORIDA SERUM PADA LATIHAN FISIK INTENSITAS SEDANG MAHASISWA FAKULTAS KEDOKTERAN UNIVERSITAS SAM RATULANGI

2014 ◽  
Vol 2 (1) ◽  
Author(s):  
Roy Johannes ◽  
Diana S. Purwanto ◽  
Stefana H. M. Kaligis
Keyword(s):  
Sampling Method ◽  
Extracellular Fluid ◽  
T Test ◽  
Moderate Intensity ◽  
Electrolyte Balance ◽  
Moderate Intensity Exercise ◽  
Paired Sample ◽  
Purposive Sampling ◽  
Serum Chloride ◽  
Before And After

Abstract: Chloride as the major anion in the extracellular fluid plays a role in maintaining fluid and electrolyte balance. One of the factors that influence the levels of serum chloride is sweating during physical exercise. This study aimed to determine  the differenceof serum chloride levels before and after moderate intensity exercise in the students of Faculty of Medicine year 2010 Sam Ratulangi University. This is a pre-exsperimental research with pretest and posttest design with 30 students as samples. The samples were chosen using purposive sampling method and the results were analyzed using paired-sample t-test. The results showed the average levels of serum chloride before and after moderate intensity exercise are 106,10 mEq/L and 107,37 mEq/L while paired-sample t-test significance value (p) is 0,000. From the results can be concluded that there is a significant differences in serum chloride levels before and after moderate intensity exercise in the students of Faculty of Medicine year 2010 Sam Ratulangi University. Keyword: serum chloride, moderate intensity exercise, student of Faculty of Medicine Sam Ratulangi University   Abstrak: Klorida sebagai anion utama dalam cairan ekstraselular berperan dalammemelihara keseimbangan cairan dan elektrolit. Salah satu faktor yang mempengaruhi kadar klorida serum yaitu keluarnya keringat saat melakukan latihan fisik. Tujuan penelitian ini untuk mengetahui perbedaan kadar klorida serum sebelum dan sesudah latihan fisik intensitas sedang pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi angkatan 2010. Penelitian ini merupakan penelitian pre-eksperimental dengan pretest-posttest design, dengan jumlah sampel 30 orang. Sampel penelitian dipilih dengan purposive sampling dan dianalisis dengan uji t berpasangan. Hasil yang diperoleh menunjukkan bahwa rata-rata kadar klorida serum sebelum melakukan latihan fisik intensitas sedang adalah 106,10mEq/L, sedangkan rata-rata kadar klorida serum sesudah melakukan latihan fisik intensitas sedang adalah 107,37 mEq/L. Nilai signifikansi uji t berpasangan pada penelitian ini adalah p=0,000. Dari penelitian ini dapat disimpulkan bahwa terdapat perbedaan signifikan kadar klorida serum sebelum dan sesudah latihan fisik intensitas sedang pada mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi Angkatan 2010. Kata kunci: klorida serum, latihan fisik intensitas sedang, mahasiswa Fakultas Kedokteran Universitas Sam Ratulangi

scholarly journals No Effect of a Single Supratherapeutic Dose of Lersivirine, a Next-Generation Nonnucleoside Reverse Transcriptase Inhibitor, on Corrected QT Interval in Healthy Subjects

2012 ◽  
Vol 56 (5) ◽  
pp. 2408-2413 ◽  
Author(s):  
Manoli Vourvahis ◽  
Rong Wang ◽  
Marie-Noella Ndongo ◽  
Melissa O'Gorman ◽  
Margaret Tawadrous
Keyword(s):  
Upper Bound ◽  
Healthy Subjects ◽  
Vital Signs ◽  
Transcriptase Inhibitor ◽  
Qtc Interval ◽  
Adult Males ◽  
Supratherapeutic Dose ◽  
Nonnucleoside Reverse Transcriptase Inhibitor ◽  
Clinically Significant ◽  
Mean Differences

ABSTRACTThe objective of this study was to investigate the effect of a supratherapeutic dose of lersivirine (LRV) on corrected QT (QTc) interval using Fridericia's equation (QTcF) in healthy subjects. In this randomized, single-dose, placebo- and active-controlled 3-way crossover study, healthy adult males (n= 48) were randomized to receive LRV (2,400 mg), moxifloxacin (400 mg), or placebo for each treatment period. Triplicate 12-lead electrocardiogram measurements were performed, PK samples were collected, and vital signs were measured. Adverse event monitoring and safety laboratory testing were performed. All subjects were white (mean age, 39 years; body mass index [BMI], 25.6 kg/m2) and completed the study. Following LRV administration, the upper bound of the 90% confidence interval (CI) for time-matched adjusted mean differences to placebo QTcF at each time point postdose was below the regulatory threshold of 10 ms, satisfying the criteria for a negative thorough QT/QTc study. The highest upper bound of QTcF 90% CI occurred at 6 h for LRV (3.32 ms; 90% CI, 1.47 to 5.17 ms). The study was deemed adequately sensitive as the lower bound of the 90% CI for the adjusted mean QTcF differences between moxifloxacin and placebo at the moxifloxacin historicalTmaxof 3 h was >5 ms (15.29 ms; 90% CI, 13.44 to 17.14 ms). There was no statistically significant relationship between LRV exposure and placebo-adjusted change from baseline QTcF or clinically significant changes in QRS complex, pulse rate (PR) interval, heart rate, or blood pressure. LRV (2,400 mg) did not prolong the QTcF interval, and no clinically relevant electrocardiogram or vital sign changes were observed in healthy subjects.

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.

Renal function in the laboratory rat: a student exercise.

1995 ◽  
Vol 268 (6) ◽  
pp. S49 ◽  
Author(s):  
R L Walker ◽  
M E Olson
Keyword(s):  
Renal Function ◽  
Fluid Intake ◽  
Tap Water ◽  
Extracellular Fluid ◽  
Control Group ◽  
Blood Samples ◽  
Treatment Groups ◽  
Laboratory Rats ◽  
Group A

Because of the increased concern over use of human body fluids in physiology teaching laboratories, we developed an exercise in renal function that utilizes laboratory rats. The purpose is to demonstrate the role of the kidneys in the homeostatic control of extracellular fluid volume, plasma ionic concentrations, and osmolarity. Three treatment groups are utilized: a volume-expanded (access to 1 g/100 ml sucrose) group, a volume-expanded and salt-loaded (access to 0.9 g/100 ml NaCl) group, and a volume-depleted (water-deprived) group. A normovolemic control group (access to tap water) is also included. Rats are housed individually in metabolic cages that allow accurate measurement of fluid intake and urine output. Blood samples are removed via cardiac puncture. The animals recover from this procedure and can be reutilized within 2-3 wk. When class data are pooled, clear trends are seen that demonstrate the volume-, osmo-, and ionoregulatory abilities of the kidneys.

Energy cost, fluid and electrolyte balance in subarctic survival situations

1964 ◽  
Vol 19 (1) ◽  
pp. 1-8 ◽  
Author(s):  
Terence A. Rogers ◽  
James A. Setliff ◽  
John C. Klopping
Keyword(s):  
Body Weight ◽  
Cold Exposure ◽  
Technical Assistance ◽  
Urine Volume ◽  
Extracellular Fluid ◽  
Electrolyte Balance ◽  
Acid Base Balance ◽  
Ambient Temperatures ◽  
Base Balance ◽  
The Cost

In two experiments a total of 12 men were subjected to 5 days of starvation under survival conditions in the winter subarctic. They wore flying clothing rated at 3.5 clo. The caloric cost, as calculated from oxygen consumption, was 2,300 kcal/m2 for the first day and 2,000 kcal/m2 for subsequent days at ambient temperatures of -30 C. At -10 C the cost of subsequent days fell to 1,500 kcal/m2. The subjects lost 8% of body weight but regained 5% body weight after 5 days refeeding on a barely maintenance diet. One-third of the original (8%) weight loss was due to an isotonic contraction of extracellular fluid. Changes in heart rate, pulse pressure, and hematocrit consistent with this fluid contraction were observed. Although the water intake did not exceed the 5-day urine volume (5 liters), the subjects did not experience thirst until after return to the warm. Note:(With the Technical Assistance of William P. Esser and Kermitt R. Skrettingland) caloric cost; cold exposure; electrolyte balance in starvation; fasting; fluid balance in starvation; IMP, integrating motor pneumotachograph; fat carbohydrate and protein catabolism in cold exposure and starvation; cold diuresis; sodium, potassium and acid-base balance in acute starvation Submitted on June 3, 1963

Restraint vs. hindlimb suspension on fluid and electrolyte balance in rats

1996 ◽  
Vol 80 (6) ◽  
pp. 1993-2001 ◽  
Author(s):  
F. Bouzeghrane ◽  
S. Fagette ◽  
L. Somody ◽  
A. M. Allevard ◽  
C. Gharib ◽  
...  
Keyword(s):  
Plasma Volume ◽  
Extracellular Fluid ◽  
Fluid Volume ◽  
Extracellular Fluid Volume ◽  
Hindlimb Suspension ◽  
Sodium Thiocyanate ◽  
Electrolyte Balance ◽  
Experimental Protocol ◽  
Osmotic Load ◽  
Atrial Natriuretic

To determine the effect of hindlimb suspension on body fluid volume, salt and water balance, and relevant hormones, two series of experiments were performed in an experimental protocol including periods of isolation (7 days), horizontal attachment (7 days), and suspension (14 days). 1) During the first experiment, water and electrolyte balance, arginine vasopressin (AVP), and guanosine 3',5'- cyclic monophosphate (cGMP) were determined in urine, atrial natriuretic peptide in plasma and atria, and renin concentration and AVP in plasma in 30 rats. 2) During the second experiment, blood volume and extracellular fluid volume were measured by a dilution technique (Evans blue and sodium thiocyanate) in another 30 rats. We observed a pronounced and early effect of horizontal attachment on the renal variables. After 48 h, diuresis (49%), natriuresis (44%), kaliuresis (36%), osmotic load (39%), creatinine (28%), and AVP excretion (155%) were significantly increased in attached rats (P < 0.05). There was no short-term (24-h) effect of suspension on urine flow and Na+, K+, creatinine, and AVP excretion, but the urine cGMP decreased significantly (45%; P < 0.05). Significant decreases in natriuresis, kaliuresis, urine creatinine, and osmotic load occurred in the suspension group 7 days after suspension. After the 14-day tail suspension, plasma volume and extracellular fluid volume measured in suspended rats were not different from isolated rat values, whereas plasma volume increased by 15% (P < 0.05) in the attached rats. Plasma immunoreactive plasma atrial natriuretic levels of suspended rats were significantly reduced by 35% vs. isolated rats (P < 0.001) and by 18% vs. attached rats (P < 0.05). By using this experimental protocol, the physiological alterations revealed that suspension produced some acute and long-term effects, but the fixation to the suspension device, restraint, and confinement have their own influence on fluid distribution and renal function.

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.

The Antidiuretic Effect of Chronic Hydrochlorothiazide Treatment in Rats with Diabetes Insipidus: Water and Electrolyte Balance

1982 ◽  
Vol 63 (6) ◽  
pp. 525-532 ◽  
Author(s):  
S. J. Walter ◽  
J. Skinner ◽  
J. F. Laycock ◽  
D. G. Shirley
Keyword(s):  
Diabetes Insipidus ◽  
Extracellular Volume ◽  
Urine Volume ◽  
Extracellular Fluid ◽  
Urinary Sodium Excretion ◽  
Sodium Concentration ◽  
Sodium Balance ◽  
Plasma Sodium ◽  
Electrolyte Balance ◽  
Antidiuretic Effect

1. The antidiuretic effect of hydrochlorothiazide in diabetes insipidus was investigated in rats with the hereditary hypothalamic form of the disease (Brattleboro rats). 2. Administration of hydrochlorothiazide in the food resulted in a marked fall in urine volume and a corresponding rise in osmolality. These effects persisted throughout the period of treatment (6–7 days). 3. Body weight and extracellular volume were significantly reduced in the thiazide-treated rats. 4. Hydrochlorothiazide caused an increase in urinary sodium excretion only on the first day of treatment. The resulting small negative sodium balance (in comparison with untreated rats) remained statistically significant for 2 days only. Thiazide-treated rats gradually developed a potassium deficit which was statistically significant from the fourth day of treatment. 5. Total exchangeable sodium, measured after 7 days of thiazide treatment, was not significantly different from that of untreated rats. However, plasma sodium was reduced in thiazide-treated animals, whereas erythrocyte sodium concentration was elevated. 6. It is concluded that the antidiuresis resulting from chronic hydrochlorothiazide administration is associated with a reduction in extracellular volume, but not with a significant overall sodium deficit. Hydrochlorothiazide appears to cause a redistribution of the body's sodium such that the amount of sodium in the extracellular fluid compartment is reduced.

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