Laboratory Test Reference Range Upper Limit Standard Unit

Objective: To establish serum TSH reference values for a population of Brazilian elderly, and to compare them to those found in the adult population. Subjects and methods: Healthy volunteers aged 70 to 85 years, without known thyroid disease or risk factors for thyroid dysfunction, who did not use any medication that could potentially interfere with TSH, were selected. Subjects with goiter, palpable thyroid nodules, anti-thyroperoxidase antibodies, or altered free T4 were excluded. The sample consisted of 360 older adults (180 per sex). Results: TSH values corresponding to the 2.5th and 97.5th percentile of the sample were 0.2 and 4.62 mIU/L, respectively. TSH > 2.5 mIU/L was seen in 25.26% of the volunteers, > 3 mIU/L in 15.26%, and > 4 mIU/L in 6.1% of them. TSH values were slightly higher than those previously reported for adults (18-60 years). Conclusion: This study suggests an upper limit for normal TSH of approximately 4.6 mIU/L for the Brazilian elderly population.

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Physical health examination in outpatients with schizophrenia: the cost effectiveness of laboratory screening tests

Annals of General Psychiatry ◽

10.1186/s12991-020-00321-3 ◽

2020 ◽

Vol 19 (1) ◽

Author(s):

Saana Eskelinen ◽

Janne V. J. Suvisaari ◽

Jaana M. Suvisaari

Keyword(s):

Cost Effectiveness ◽

Laboratory Test ◽

Reference Range ◽

Health Examination ◽

Abnormal Result ◽

Gamma Glutamyltransferase ◽

Hydroxyvitamin D ◽

Laboratory Screening ◽

25 Hydroxyvitamin D ◽

The Cost

Abstract Background Guidelines on laboratory screening in schizophrenia recommend annual monitoring of fasting lipids and glucose. The utility and the cost effectiveness of more extensive laboratory screening have not been studied. Methods The Living Conditions and the Physical Health of Outpatients with Schizophrenia Study provided a comprehensive health examination, including a laboratory test panel for 275 participants. We calculated the prevalence of the results outside the reference range for each laboratory test, and estimated the cost effectiveness to find an aberrant test result using the number needed to screen to find one abnormal result (NNSAR) and the direct cost spent to find one abnormal result (DCSAR, NNSAR x direct cost per test) formulas. In addition, we studied whether patients who were obese or used clozapine had more often abnormal results. Results A half of the sample had 25-hydroxyvitamin D below, and almost one-fourth cholesterol, triglycerides or glucose above the reference range. One-fifth had sodium below and gamma glutamyltransferase above the reference range. NNSAR was highest for potassium (137) and lowest for 25-hydroxyvitamin D (2). DCSAR was below 5€ for glucose, all lipids and sodium, and below 10€ for creatinine and gamma glutamyltransferase. Potassium (130€), pH-adjusted ionized calcium (33 €) and thyroid stimulating hormone (33€) had highest DCSARs. Several abnormal results were more common in obese and clozapine using patients. Conclusions An annual laboratory screening panel for an outpatient with schizophrenia should include fasting glucose, lipids, sodium, creatinine, a liver function test and complete blood count, and preferably 25-hydroxyvitamin D.

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Assessment of the Effects of SARS-Cov-2 Infection on Multiple Organs Using Laboratory Indices

AL-Kindy College Medical Journal ◽

10.47723/kcmj.v17i2.429 ◽

2021 ◽

Vol 17 (2) ◽

pp. 73-78

Author(s):

Jianwei Zhou ◽

Yu Li ◽

Cui Kong ◽

Yizhao Li ◽

Yao Liang

Keyword(s):

Reference Range ◽

Normal Range ◽

Causative Mechanism ◽

Gamma Glutamyltransferase ◽

Multiple Organs ◽

Upper Limit ◽

Laboratory Results ◽

Heart Injury ◽

Beta 2 Microglobulin ◽

Biochemical Indices

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is still a severe threaft for human health currently, and the researches about it is a focus topic worldwide. Aim of the study: In this study, we will collect some laboratory results of the patients with coronavirus disease (COVID-19) to assess the function of liver, heart, kidney and even pancreas. Subjects and Methods: Laboratory results of the patients with COVID-19 are collected. The biochemical indices are classified and used to assess the according function of liver, heart, kidney; meantime, and blood glucose is also observed and taken as an index to roughly evaluate pancreas. Results: There were some indices exhibited abnormal. For patient 1, the ratio of albumin and globulin slightly was lower than the down-limit of reference range. For patient 2, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase (GGT), creatine kinase (CK), creatinine kinase-MB isoenzyme (CK-MB), lactate dehydrogenase (LDH), alpha-hydroxybutyric dehydrogenase (HBDH), and beta-2 microglobulin (β2-MG) were respectively higher than the according upper limit of the reference range, while prealbumin (PA) was lower than the down limit. For patient 3, GGT, CK, PA were high than normal range. For patient 4, CK, LDH, HBDH were higher than the upper range. Conclusion: Infection of SARS-Cov-2 could cause liver and heart injury, and it is suggested that clinicians and researchers should pay more attention on the prevention, treatment and causative mechanism of such an injury.

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A Modification of the Standard Weather Bureau Rain Gage for Summer and Winter Use 1

Bulletin of the American Meteorological Society ◽

10.1175/1520-0477-42.5.311 ◽

1961 ◽

Vol 42 (5) ◽

pp. 311-313

Author(s):

F. B. Gomm

Keyword(s):

Laboratory Test ◽

Field Tests ◽

Rubber Stopper ◽

Standard Unit ◽

Weather Bureau ◽

Rain Gage ◽

Collection Tube ◽

Standard Collection ◽

Measuring Tube ◽

Vent Tube

This article describes a modified collection unit for the standard Weather Bureau-type rain gage. The described unit, consisting of a polyethylene bottle, rubber stopper, vent tube and adapter funnel, replaces the metal collection tube of the standard gage. In a laboratory test, evaporation from the modified system was not great enough in a 30-day period to measure with a standard measuring tube. Field tests showed the described unit superior to the standard collection unit and equal to the standard unit with a 0.20-inch oil film in the reduction of evaporation. The described unit, which eliminates recharging with oil or antifreeze after each reading, has been in field use for two years without damage from freezing.

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An adolescent girl with coexisting ovarian mature cystic teratoma and HAIR-AN syndrome, an extreme subtype of polycystic ovarian syndrome

Endocrinology Diabetes and Metabolism Case Reports ◽

10.1530/edm-20-0195 ◽

2021 ◽

Vol 2021 ◽

Author(s):

Jin Hui Ho ◽

Ana Vetriana Abd Wahab ◽

Yin Khet Fung ◽

Serena Sert Kim Khoo

Keyword(s):

Insulin Resistance ◽

Testosterone Level ◽

Acanthosis Nigricans ◽

Polycystic Ovarian Syndrome ◽

Reference Range ◽

Cystic Teratoma ◽

Serum Testosterone ◽

Total Serum ◽

Upper Limit ◽

Ovarian Syndrome

Summary Polycystic ovarian syndrome (PCOS) is associated with menstrual irregularities, ovulatory dysfunction, hirsutism, insulin resistance, obesity and metabolic syndrome but is rarely associated with severe hyperandrogenaemia and virilisation resulting in male pattern baldness and clitoromegaly. Total serum testosterone greater than twice the upper limit of the reference range or free androgen index of over five-fold elevated suggests a diagnosis other than PCOS. We reported a case of a 15 years old obese girl presented with secondary amenorrhoea, virilising signs: frontal baldness, clitoromegaly and prominent signs of insulin resistance and marked acanthosis nigricans. Her total testosterone level was markedly elevated at 9.4 nmol/L (0.5–1.7 nmol/L) and MRI pelvis revealed a right ovarian mass with fat and cystic component and a left polycystic ovary. The patient underwent laparoscopic right ovarian cystectomy and histologically confirmed mature cystic teratoma. Post-operatively, her testosterone level declined but did not normalise, menses resumed but remained irregular. Her fasting insulin was elevated 85.2 mIU/L (3–25 mIU/L) and HOMA-IR was high at 13.1 (>2) with persistent acanthosis nigricans suggesting co-existing HAIR-AN syndrome, an extreme phenotype of polycystic ovarian syndrome. Learning points Rapid onset of hyperandrogenic symptoms, especially if associated with signs of virilisation must raise the suspicion of an androgen-secreting tumour. Total serum testosterone greater than twofold the upper limit of the reference range or free androgen indices over fivefold suggest a diagnosis other than polycystic ovarian syndrome (PCOS). High levels of testosterone with normal levels of the DHEA-S suggest an ovarian source. Ovarian androgen-secreting tumour and HAIR-AN syndrome, an extreme spectrum of PCOS can co-exist.

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The evolution of clot strength in critically-ill COVID-19 patients: a prospective observational thromboelastography study

Thrombosis Journal ◽

10.1186/s12959-021-00331-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Colette Neethling ◽

Gregory Calligaro ◽

Malcolm Miller ◽

Jessica J. S. Opie

Keyword(s):

Critically Ill ◽

Reference Range ◽

Maximum Amplitude ◽

Clot Lysis ◽

Clot Strength ◽

Mechanically Ventilated ◽

Time Points ◽

Normal Platelet ◽

Upper Limit ◽

Intravascular Coagulopathy

Abstract Background Few studies detail the evolution of COVID-19 associated coagulopathy. We performed serial thromboelastography (TEG) and laboratory coagulation studies in 40 critically-ill, mechanically ventilated COVID-19 patients over a 14-day period and analysed differences between 30-day survivors and non-survivors. Methods Single-center prospective, observational study including 40 patients with severe COVID-19 pneumonia admitted to the intensive care unit (ICU) for mechanical ventilation. TEG analysis was performed on days 1, 7 and 14 of ICU admission and laboratory coagulation studies were performed on days 1 and 14. Coagulation variables were evaluated for change over the 14-day observation period. Differences between survivors and non-survivors at 30-days were analysed and compared. Results On admission, TEG maximum amplitude (MA) with heparinase correction was above the upper limit of the reference range in 32 (80%) patients while 33 (82.5%) presented with absent clot lysis at 30 min. The functional fibrinogen MA was also elevated above the upper limit of the reference range in 37 (92.5%) patients. All patients had elevated D-dimer and fibrinogen levels, mildly prolonged prothrombin times (PT), normal platelet counts and normal activated partial thromboplastin times (aPTT). The heparinase MA decreased significantly with time and normalised after 14 days (p = < 0.001) while the increased fibrin contribution to clot strength persisted with time (p = 0.113). No significant differences in TEG analysis were noted between 30-day survivors and non-survivors at all time points. No patients developed disseminated intravascular coagulopathy (DIC) after 14-days, however thrombosis and bleeding were each reported in 3 (7.5%) patients. Conclusion Critically-ill patients with COVID-19 present in a hypercoagulable state characterised by an increased clot strength. This state normalises after 14 days despite a persistently increased fibrin contribution to clot strength. We were unable to demonstrate any significant differences in TEG parameters between 30-day survivors and non-survivors at all time points.

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Discrepancies in measurement of aspartate aminotransferase by continuous-flow analysis.

Clinical Chemistry ◽

10.1093/clinchem/29.12.2086 ◽

1983 ◽

Vol 29 (12) ◽

pp. 2086-2088

Author(s):

P West

Keyword(s):

Quality Control ◽

Aspartate Aminotransferase ◽

Continuous Flow ◽

Reaction Rate ◽

Reference Range ◽

Flow Analysis ◽

Independent Data ◽

Positive Bias ◽

Upper Limit ◽

Continuous Flow Analysis

Abstract I compared results for aspartate aminotransferase (EC 2.6.1.1) obtained with a reaction-rate analyzer (LKB 2086 Mark Two), based on IFCC methodology, and a continuous-flow analyzer (the Technicon SMA 2) for 115 patients' sera and seven commercial quality-control sera. The data from the SMA 2 showed a clear positive bias in those sera with activities exceeding 40 U/L (the upper limit of the reference range). Independent data to support the bias of the SMA 2 and other continuous-flow analyzer systems are presented. Application of a correction factor to the SMA 2 data above the upper limit of the range significantly decreased this bias. Failure to apply such a factor to data obtained from continuous-flow analyzers could lead to serious clinical misinterpretation.

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