The Role of the Clinical Laboratory in Nutritional Assessment
Aruna Bakhru in Nutrition and Integrative Medicine, 2018
Vitamin B12 testing is common when macrocytic anemia and when certain neurologic conditions or malabsorption are suspected or diagnosed. The evaluation of vitamin B12 deficiency starts with a thorough medical history and examination. The complete blood count is the starting place for clinical laboratory testing. Vitamin B12 and folate levels can be followed with measurement of homocysteine and methylmalonic acid.105 Using both homocysteine and methylmalonic acid to define vitamin B12 deficiency improves sensitivity. Accordingly, the prevalence of vitamin B12 deficiency in the elderly may be 15%–20%. Levels of intrinsic factor are detectable in approximately 85% of all patients with pernicious anemia. Parietal cell antibodies are present in approximately 90% of patients with pernicious anemia but they are less specific than intrinsic factor antibodies. Often the two types of antibodies are interpreted together to provide a better assessment.106
Anorectal Conditions Requiring Urgent or Emergency Intervention
Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams in Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
The clinical presentation of perianal sepsis in many immunocompromised patients can be very different from immunocompetent patients, as the usual presenting symptoms and physical exam findings may be masked by the associated immunocompromised state.34,37 For example, the diagnosis is only accurately arrived at in 50% of neutropaenic patients, due to the absence of granulocytes that are able to localise the infection.34 Immunosuppressed patients can present with a multitude of symptoms, including perianal pain, perianal swelling, bleeding per rectum, change in bowel habit, perianal drainage or fever.36 When evaluating these patients, a thorough history is necessary, with special attention directed to factors influencing their immune status, such as recent chemotherapy, toxicity from systemic therapy, radiation therapy, steroid use and trends in neutrophil counts, as well as their potential ongoing need for cancer treatment and oncologic prognosis.34,37 Laboratory evaluation should usually include a complete blood count in order to evaluate the patient’s white blood cell count, looking at the neutrophil count in particular as well as the haemoglobin and platelet count.
Gastric perforation
Prem Puri in Newborn Surgery, 2017
Infants with gastric perforation develop septic parameters and need to be resuscitated accordingly. Neonates may become unstable prior to the development of free intra-abdominal air. Infants who develop respiratory distress require intubation, and increased ventilator support is needed as the abdomen becomes more distended. Appropriate laboratory investigations include blood cultures, white blood cell count, hemoglobin, hematocrit, platelet count, electrolyte profile, and blood gas analysis. Broad-spectrum antibiotics should be initiated. Fluid boluses and blood transfusions are given to achieve hemodynamic stability and adequate urine output. An oro- or nasogastric tube should be carefully passed and placed on low intermittent suction. Once free intra-abdominal air is identified, the patient is stabilized and a laparotomy should be performed. Aspiration of the peritoneum with an i.v. cannula when an overly distended abdomen is impeding ventilation can be a lifesaving measure.20 In select cases, peritoneal drainage has been reported with resolution of the peritonitis and healing of the perforation.43
Head-out immersion in hot water increases serum BDNF in healthy males
Published in International Journal of Hyperthermia, 2018
Daisuke Kojima, Takeshi Nakamura, Motohiko Banno, Yasunori Umemoto, Tokio Kinoshita, Yuko Ishida, Fumihiro Tajima
Total blood cell count was determined using a cell counter. Hematocrit (Hct) was measured by centrifugation. Other venous blood samples were drawn into pre-chilled serum venipuncture tubes and glass tubes containing ethylenediaminetetraacetic acid. The tubes were spun immediately at 3500 rpm for 10 min at 4 °C. The prepared sera and plasma were stored at −80 °C until analysis. Plasma cortisol levels were assayed using a competitive solid phase 125I radioimmunoassay technique (Dainabot Lab, Tokyo, Japan). BDNF was measured by enzyme-linked immunosorbent assay (ELISA) for BDNF (R&D Systems, Minneapolis, MN) with assay sensitivity <20 pg/ml and intra- and inter-assay coefficients of variability (average CV of different concentrations) of 5.0 and 9.0%, respectively. S100β was assayed using ELISA for S100β (BioVendor, Candler, NC) with assay sensitivity <5 pg/ml and intra- and inter-assay coefficients of variability (average CV of different concentrations) of 3.1 and 5.2%, respectively. BDNF and S100β immunoassays were performed in duplicate according to the recommendations of the manufacturers, by investigators blinded to the clinical data and origin of the blood sample.
Glycated albumin as a glycaemic marker in patients with advanced chronic kidney disease and anaemia: a preliminary report
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2019
Chiara Bellia, Chiara Cosma, Bruna Lo Sasso, Giulia Bivona, Luisa Agnello, Martina Zaninotto, Marcello Ciaccio
All blood samples were obtained in a fasting state. Routine clinical chemistry parameters, including creatinine, FPG and complete blood count, were measured at the recruitment site immediately after sample collection. Creatinine and FPG were measured by the enzymatic method and the hexokinase one, respectively. Complete blood count was determined by an automated cell counter analyzer. HbA1c was determined by the D100 instrument and reagents (BioRad, Hercules, CA) at the University Hospital of Palermo and by the HA8180V instrument and reagents (Menarini Diagnostics, Florence, Italy) at the University Hospital of Padova. Both assays are based on an ion exchange high-performance liquid chromatography (HPLC) method. A high grade of correlation between these two assays has been described [29].
Extensive characterization of the composition and functional activities of five preparations of human platelet lysates for dedicated clinical uses
Published in Platelets, 2021
Liling Delila, Yu-Wen Wu, Ouada Nebie, Rifa Widyaningrum, Ming-Li Chou, David Devos, Thierry Burnouf
The study was approved by the Institutional Review Board of Taipei Medical University (TMU-JIRB N201802052). Clinical-grade, non-leukoreduced, allogeneic PCs suspended in 100% plasma and anticoagulated with citrate-phosphate-dextrose were collected by apheresis using the MCS+ platelet collection system (Haemonetics, Braintree, MA, USA) from three different donors at the Taipei Blood Center (Guandu, Taiwan). Upon reaching the expiry date (5 days after collection), the PCs were transported to the laboratory (90 min) at Taipei Medical University at a controlled temperature. Upon receipt, the PCs were placed on a slow-speed platelet agitator at 22 ± 2°C before being processed on the same or next day into HPLs. Prior to processing, a sample was taken aseptically to determine the blood cell count using the ABC Vet blood cell count (ABC Diagnostics, Montpellier, France).
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