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Omega-3 Fatty Acids and NO from Flax Intervention in Atherosclerosis and Chronic Systemic Inflammation
Published in Robert Fried, Richard M. Carlton, Flaxseed, 2023
Robert Fried, Richard M. Carlton
C-Reactive protein (CRP) is an acute-phase protein of liver origin found in plasma that increases following interleukin-6 secretion by macrophages and T cells. Its circulating concentrations rise in response to inflammation. CRP is usually measured in milligrams of CRP per liter of blood (mg/L). Normal CRP levels are typically below 3.0 mg/L. But, the normal reference range often varies between labs.
Eclampsia and Pre-Eclampsia with Severe Features
Published in Sanjeewa Padumadasa, Malik Goonewardene, Obstetric Emergencies, 2021
Sanjeewa Padumadasa, Malik Goonewardene
It is important to investigate evidence of target organ damage by performing the investigations mentioned earlier. Derangement of liver enzymes in the presence of pre-eclampsia and in the absence of any other explanation for the abnormality indicates liver involvement and requires delivery before worsening of the condition. This is especially true if these are >70 IU/l. If the liver is involved, it is vital to perform a coagulation profile before delivery. Similarly, renal involvement, as evident by derangements in renal profile, especially a serum creatinine of >1.1 mg/dl, requires delivery. It is important that pregnancy-specific reference ranges are used for the interpretation of the results. Thrombocytopaenia, which is a platelet count less than 100,000/ml may occur. Spontaneous haemorrhage is unlikely if the platelet count is above 20,000/ml. However, delivery, either vaginally or abdominally, requires a platelet count of at least 50,000/ml, and peripartum or perioperative platelet transfusions should be given to achieve this. If the HELLP syndrome is suspected by liver enzymes and thrombocytopaenia, lactate dehydrogenase and blood picture can be performed to look for haemolysis, although this does not influence the management thereof.
Managing Pain in the Presence of Autoimmune Disease
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
On every blood test report there are three columns. The column on the left-hand side of the page is the name of the test run. The middle column is the specific results for the patient. And on the right side is the reference range. This may also be listed as a “normal range.” The reference range is usually treated as the “ideal” range by most practitioners. Patients are often told, “your results are in the reference range. You are good. You are fine. You are healthy. Don’t worry.” Often times the patient may say “I feel pretty crummy for someone whose labs say they are healthy. What’s the deal?” Well, the deal is, the reference range is not where the healthy people are, even though it is usually treated that way. This is why we need to write down for the patient where the healthy people are. If their result is not where the healthy people are, then we will wonder, “if we get them to where the healthy people are, will they feel like a healthy person again?”
Current status and challenges in establishing reference intervals based on real-world data
Published in Critical Reviews in Clinical Laboratory Sciences, 2023
Sijia Ma, Juntong Yu, Xiaosong Qin, Jianhua Liu
In addition to well-known stratifications by sex and age, ethnicity and region are other potential factors for stratification [50,51,81]. Many studies have shown the influence of racial factors on reference ranges [82–87]; however, most RI studies do not stratify according to racial factors. Most countries are ethnically heterogeneous, and individuals of different ethnicity may exhibit differences in reference values of some indicators due to genetic factors, lifestyle habits, and others. Standard reference individuals for existing RIs are mostly European/American Caucasians, although other ethnic populations form the worldwide majority. For instance, the median creatine kinase activity of healthy Black men is approximately twice that of Caucasians [88]; thus, RI studies must take ethnicity into account. In addition, different countries and regions often have varied geographical characteristics and different topographies can also affect RIs; for example, the average hemoglobin level of people living in high-altitude areas is higher than that of people in other areas. Therefore, the establishment of RIs must be tailored, and the use of RIs that do not match the characteristics of the local population may lead to misinterpretation of test results.
A new decade awaits sticky platelet syndrome: where are we now, how do we manage and what are the complications?
Published in Expert Review of Hematology, 2022
Jan Stasko, Pavol Holly, Peter Kubisz
The post-analytic phase is hindered by the result interpretation continuing to rely on the human expert examination of aggregation patterns from a patient and their comparison with healthy control patterns. It leaves space for subjective errors and inconsistencies in interpretation and underlines the need for experienced personnel. The unresolved differences among aggregometry methods, laboratories, and tested populations limit the use of single, universal range values. Therefore, it is recommended to establish a unique range for each laboratory, methodology, and tested population [81,82]. The local reference ranges are also necessary to account for possible, although discussed age, gender, and ethnic differences. However, their determination is timely and methodically demanding. The persisting differences also make the interlaboratory comparison of results challenging. The statistical analysis might be a possible solution, though it requires close multicenter collaboration, a multidisciplinary approach with the involvement of statistics experts, and the modification in result reporting.
The use of blood biomarkers in precision medicine for the primary prevention of atherosclerotic cardiovascular disease: a review
Published in Expert Review of Precision Medicine and Drug Development, 2021
Ty Sweeney, Renato Quispe, Thomas Das, Stephen P Juraschek, Seth S. Martin, Erin D. Michos
It is worth noting that the establishment of biomarker reference ranges typically involves the calculation of statistics as they apply to defined populations, e.g. the catchment area of a hospital laboratory. This should not be confused with what are considered to be clinically relevant serum biomarker ranges. For example, in patients at elevated ASCVD risk receiving lipid lowering therapy, target LDL-C levels are generally recommended to be 50% of initial values or <70 mg/dL, even though the typical laboratory reference range sets the upper limit of ‘normal’ (i.e. the 99th percentile for the general population of ‘healthy’ adults) at around 100 mg/dL [20]. In seeking to establish clinically useful biomarkers, one should recognize that reference ranges for use in laboratories may not necessarily coincide with ranges considered to be clinically meaningful.