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Sample records for tsh reference interval

  1. Establishment of a serum thyroid stimulating hormone (TSH) reference interval in healthy adults

    DEFF Research Database (Denmark)

    Jensen, Esther; Hyltoft Petersen, Per; Blaabjerg, Ole

    2004-01-01

    It has previously been shown that thyroid antibodies affect thyroid stimulating hormone (TSH) concentrations in men and women and that TSH levels are predictive of future thyroid disease. We investigated the validity of the National Academy of Clinical Biochemistry (NACB) guidelines regarding...

  2. Korean pediatric reference intervals for FT4, TSH, and TPO Ab and the prevalence of thyroid dysfunction: A population-based study.

    Science.gov (United States)

    Lim, Han Hyuk

    2017-12-01

    The appropriate age-related reference intervals for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) are important in interpreting the results of thyroid function tests in children and adolescents. However, these reference intervals are scanty. This study aimed to establish the reference intervals for FT4, TSH, and thyroid peroxidase antibody (TPO Ab), and identify the epidemiological prevalence of thyroid dysfunction in a Korean pediatric population. The data from a sample of 2042 children and adolescents aged 10-18years who underwent a nationwide Korean representative sampling and cross-sectional survey with blood collection for a thyroid function test using an electrochemiluminescence immunoassay were evaluated. Based on the National Academy of Clinical Biochemistry (NACB) criteria, the median and range (2.5th - 97.5th percentile) for FT4 and TSH in total were 16.47pmol/L (12.61-21.49pmol/L) and 2.48mIU/L (0.63-7.03mIU/L), respectively. Positive TPO Ab (3.1%) by NACB was >19.16kIU/L (boys) and >29.30kIU/L (girls) for adolescents aged 10-18years. FT4 and TSH were associated with increasing and decreasing age, respectively. Boys' FT4 and girls' TPO Ab levels were greater than for the other sex, respectively. Using the new reference interval, overt hypothyroidism, subclinical hypothyroidism, subclinical hyperthyroidism, and overt hyperthyroidism were found in 0.5%, 2.1%, 1.3%, and 1.2%, respectively, of Korean children and adolescents. This study provides evidence-based age- and sex-specific reference intervals for thyroid hormones and autoantibodies, and identifies the current prevalence of thyroid dysfunction in a Korean pediatric group. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Age- and gender-specific reference intervals of TSH and free T4 in an iodine-replete area: Data from Korean National Health and Nutrition Examination Survey IV (2013–2015)

    Science.gov (United States)

    Kim, Hae In; Oh, Hyun-Kyung; Kim, Tae Hyuk; Jang, Hye Won; Chung, Jae Hoon

    2018-01-01

    Background Establishment of the reference interval of thyroid-stimulating hormone (TSH) is critical in the diagnosis of thyroid dysfunction and is affected by age, gender, iodine nutrition, and ethnicity. The aim of this study was to determine the reference intervals of TSH and free thyroxin (FT4) from a large, nationwide data of Korea where iodine intake is more than adequate. Methods We analyzed data from the Korea National Health and Nutrition Examination Survey VI that measured serum TSH, FT4, and thyroid peroxidase antibody from 7,061 individuals (urinary iodine measurement in 6,565). Age- and gender-specific reference intervals were established from 95% confidence limits from the 2.5 to 97.5 percentile of TSH (log-transformed) and FT4 in reference populations. Results The geometric mean of TSH was 2.16 ± 0.01 mIU/L, with the lowest value found in the middle aged group (2.04 ± 0.02 mIU/L) and higher values noted in age groups of 10–19 and over 70 years (2.38 ± 0.02 and 2.32 ± 0.07 mIU/L, respectively). The association of TSH and age was U-shaped. The overall reference interval of TSH was 0.59–7.03 mIU/L. Mean FT4 was 1.25 ± 0.003 ng/dL (16.09 ± 0.039 pmol/L), and it showed a small but continuous decrease after 20 years of age (P reference interval of TSH in Korea, where iodine intake is above the requirement, was 0.59–7.03 mIU/L and showed U-shaped change with age, which was a similar pattern to iodine intake. The reference interval of FT4 was 0.92–1.60 ng/dL. The geometric mean and upper limit of TSH were higher than those of Western populations, reflecting the paramount importance of iodine intake on thyroid function. PMID:29390008

  4. Reference interval of thyroxine and thyrotropin of healthyterm ...

    African Journals Online (AJOL)

    Objective: To establish a local Reference Interval of Serum Thyroxine (T4) and Serum Thyroid stimulating Hormone(TSH) of healthy Nigerian Newborns in Jos University Teaching Hospital Jos. Materials and Methods: One hundred and sixty healthy term Nigerian Newborns who fulfilled the criteria for inclusion were ...

  5. Weight Gain and Serum TSH Increase within the Reference Range after Hemithyroidectomy Indicate Lowered Thyroid Function

    DEFF Research Database (Denmark)

    Toft Kristensen, Tina; Larsen, Jacob; Pedersen, Palle Lyngsie

    2014-01-01

    Background. Weight gain is frequently reported after hemithyroidectomy but the significance is recently discussed. Therefore, the aim of the study was to examine changes in body weight of hemithyroidectomized patients and to evaluate if TSH increase within the reference range could be related...... to weight gain. Methods. In a controlled follow-up study, two years after hemithyroidectomy for benign euthyroid goiter, postoperative TSH and body weight of 28 patients were compared to preoperative values and further compared to the results in 47 matched control persons, after a comparable follow......-up period. Results. Two years after hemithyroidectomy, median serum TSH was increased over preoperative levels (1.23 versus 2.08 mIU/L, P gained weight (75.0 versus 77.3 kg, P = 0.02). Matched healthy controls had unchanged median serum TSH (1.70 versus 1.60 mIU/L, P = 0...

  6. Dynamics and Predictors of Serum TSH and fT4 Reference Limits in Early Pregnancy

    DEFF Research Database (Denmark)

    Laurberg, Peter; Andersen, Stine Linding; Hindersson, Peter

    2016-01-01

    CONTEXT: Thyroid hormones are important developmental factors and levels should be adequate both in the pregnant woman and in the fetus. However, there is no consensus on maternal thyroid test reference limits in early pregnancy. OBJECTIVE: Estimation of week-to-week changes in and predictors...... of TSH and free T4 (fT4) reference limits in the first trimester of pregnancy. DESIGN: Measurement of TSH and fT4 in biobank sera collected in pregnancy weeks 5-19 from a random sample of the Danish National Birth Cohort that enrolled 101 032 pregnant in 1996-2002. SETTING: National cohort of pregnant...... women. PARTICIPANTS: Healthy participants (n = 6671) were identified and individual characteristics retrieved using interview data and data from Danish national health registers. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Reference limits for TSH and fT4 in each first trimester pregnancy week...

  7. Haemostatic reference intervals in pregnancy

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Jørgensen, Maja; Klajnbard, Anna

    2010-01-01

    Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age......-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13...

  8. Haemostatic reference intervals in pregnancy

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Jørgensen, Maja; Klajnbard, Anna

    2010-01-01

    Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age-specific refe......Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age......-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13......-20, 21-28, 29-34, 35-42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S...

  9. Haemostatic reference intervals in pregnancy.

    Science.gov (United States)

    Szecsi, Pal B; Jørgensen, Maja; Klajnbard, Anna; Andersen, Malene R; Colov, Nina P; Stender, Steen

    2010-04-01

    Haemostatic reference intervals are generally based on samples from non-pregnant women. Thus, they may not be relevant to pregnant women, a problem that may hinder accurate diagnosis and treatment of haemostatic disorders during pregnancy. In this study, we establish gestational age-specific reference intervals for coagulation tests during normal pregnancy. Eight hundred one women with expected normal pregnancies were included in the study. Of these women, 391 had no complications during pregnancy, vaginal delivery, or postpartum period. Plasma samples were obtained at gestational weeks 13-20, 21-28, 29-34, 35-42, at active labor, and on postpartum days 1 and 2. Reference intervals for each gestational period using only the uncomplicated pregnancies were calculated in all 391 women for activated partial thromboplastin time (aPTT), fibrinogen, fibrin D-dimer, antithrombin, free protein S, and protein C and in a subgroup of 186 women in addition for prothrombin time (PT), Owren and Quick PT, protein S activity, and total protein S and coagulation factors II, V, VII, VIII, IX, X, XI, and XII. The level of coagulation factors II, V, X, XI, XII and antithrombin, protein C, aPTT, PT remained largely unchanged during pregnancy, delivery, and postpartum and were within non-pregnant reference intervals. However, levels of fibrinogen, D-dimer, and coagulation factors VII, VIII, and IX increased markedly. Protein S activity decreased substantially, while free protein S decreased slightly and total protein S was stable. Gestational age-specific reference values are essential for the accurate interpretation of a subset of haemostatic tests during pregnancy, delivery, and puerperium.

  10. Haemostatic reference intervals in pregnancy

    DEFF Research Database (Denmark)

    Szecsi, Pal Bela; Jørgensen, Maja; Klajnbard, Anna

    2010-01-01

    , and protein C and in a subgroup of 186 women in addition for prothrombin time (PT), Owren and Quick PT, protein S activity, and total protein S and coagulation factors II, V, VII, VIII, IX, X, XI, and XII. The level of coagulation factors II, V, X, XI, XII and antithrombin, protein C, aPTT, PT remained...... largely unchanged during pregnancy, delivery, and postpartum and were within non-pregnant reference intervals. However, levels of fibrinogen, D-dimer, and coagulation factors VII, VIII, and IX increased markedly. Protein S activity decreased substantially, while free protein S decreased slightly and total...

  11. Establishment of Trimester-Specific Reference Intervals for Thyroid Hormones in Korean Pregnant Women

    Science.gov (United States)

    Moon, Hee-Won; Chung, Hee-Jung; Park, Chul-Min; Hur, Mina

    2015-01-01

    Background Establishment of trimester- and assay-specific reference intervals for every population is recommended. The aim of this study was to establish a trimester- and assay-specific reference interval for thyroid-stimulating hormone (TSH) and free thyroxine (FT4) in Korean pregnant women. Methods From April 2012 to December 2012, 531 pregnant women receiving prenatal care and 238 age-matched, non-pregnant women were enrolled in this study. After excluding patients with pregnancy-associated complications or thyroid-specific autoantibody, 465 pregnant and 206 non-pregnant women were included. Non-parametric analysis (2.5-97.5th percentile) was performed to determine the reference interval. Levels of TSH and FT4 were determined by electrochemiluminescence immunoassay (Elecsys thyroid tests, Roche Diagnostics, Germany). Results The TSH reference intervals were 0.01-4.10, 0.01-4.26, and 0.15-4.57 mIU/L for the first, second, and third trimester, respectively. From the first trimester to the third trimester, the median TSH levels showed a significantly increasing trend (Preference intervals were 0.83-1.65, 0.71-1.22, and 0.65-1.13 ng/dL for the first, second, and third trimester, respectively, showing a significantly decreasing trend (Preference intervals in pregnant women is essential for accurate assessment of thyroid function. Our population-specific and method-specific reference intervals will be useful for screening Korean pregnant women for thyroid disease. PMID:25729721

  12. Reference intervals for thyreotropin and thyroid hormones for healthy adults based on the NOBIDA material and determined using a Modular E170

    DEFF Research Database (Denmark)

    Friis-Hansen, Lennart; Hilsted, Linda

    2008-01-01

    BACKGROUND: The aim of the present study was to establish Nordic reference intervals for thyreotropin (TSH) and the thyroid hormones in heparinized plasma. METHODS: We used 489 heparinized blood samples, collected in the morning, from the Nordic NOBIDA reference material, from healthy adults...... for the thyroid hormones, but not TSH, followed a Gaussian distribution. There were more TPO-ab and Tg-ab positive women than men. After exclusion of the TPO-ab and the Tg-ab positive individuals, the reference interval TSH was 0.64 (0.61-0.72) to 4.7 (4.4-5.0) mIU/L. The exclusion of these ab-positive samples...... also minimized the differences in TSH concentrations between the sexes and the different Nordic countries. For the thyroid hormones, there were only minor differences between the reference intervals between the Nordic populations and between men and women. These reference intervals were unaffected...

  13. Composite reference interval for thyroid-stimulating hormone and free thyroxine, comparison with common cutoff values, and reconsideration of subclinical thyroid disease.

    NARCIS (Netherlands)

    Ross, H.A.; Heijer, M. den; Hermus, A.R.M.M.; Sweep, C.G.J.

    2009-01-01

    BACKGROUND: Examination of the 2-dimensional probability distribution of thyroid-stimulating hormone (TSH) and free thyroxine (FT(4)) shows that the widths of the TSH and FT(4) reference intervals derived from this bivariate distribution are mutually interdependent, an aspect commonly ignored when

  14. Physiology and its Importance for Reference Intervals

    Science.gov (United States)

    Sikaris, Kenneth A

    2014-01-01

    Reference intervals are ideally defined on apparently healthy individuals and should be distinguished from clinical decision limits that are derived from known diseased patients. Knowledge of physiological changes is a prerequisite for understanding and developing reference intervals. Reference intervals may differ for various subpopulations because of differences in their physiology, most obviously between men and women, but also in childhood, pregnancy and the elderly. Changes in laboratory measurements may be due to various physiological factors starting at birth including weaning, the active toddler, immunological learning, puberty, pregnancy, menopause and ageing. The need to partition reference intervals is required when there are significant physiological changes that need to be recognised. It is important that laboratorians are aware of these changes otherwise reference intervals that attempt to cover a widened inter-individual variability may lose their usefulness. It is virtually impossible for any laboratory to directly develop reference intervals for each of the physiological changes that are currently known, however indirect techniques can be used to develop or validate reference intervals in some difficult situations such as those for children. Physiology describes our life’s journey, and it is only when we are familiar with that journey that we can appreciate a pathological departure. PMID:24659833

  15. Establishment of self-sequential longitudinal reference intervals of maternal thyroid function during pregnancy.

    Science.gov (United States)

    Yu, Bin; Wang, Qiu-Wei; Huang, Rui-Ping; Cao, Fang; Zhu, Zi-Qiang; Sun, Da-Cheng; Zhou, Hong; Zhang, Yi-Ming

    2010-10-01

    The objective of this study is to establish self-sequential longitudinal reference intervals of thyroid function in normal pregnant women. According to the selection criteria, 301 cases were taken as the normal pregnant population to establish a normal reference range. Meanwhile, 150 healthy women were selected as the normal non-pregnant control group. To establish their own self-sequential longitudinal reference intervals, we collected samples five times in every case throughout the gestation (including first trimester, second trimester, third trimester, prenatal and postpartum), and detected the levels of thyroid stimulating hormone (TSH), free thyroxine (FT4), thyroid peroxidase antibodies (TPO-Ab), and then established the self-sequential longitudinal reference intervals. The levels of TSH, FT4 and TPO-Ab were quantified by electrochemistry immunoassay (ECL) and statistically analyzed using SPSS 13.0 software. Serum TSH of normal pregnant women was at a low level in the first trimester (P 0.05). During pregnancy, serum FT4 of normal pregnant women were consistently lower than non-pregnant levels (P < 0.05) and kept at low levels. Serum TPO-Ab increased significantly in the third trimester and prenatal phase (P < 0.05). Of normal pregnant women, 6.5% were TPO-Ab positive. In conclusion, the reference intervals in our case will reflect the changes of thyroid function in pregnant women more realistically, resulting in a more accurate value for clinical diagnosis and therapy.

  16. Establishing reference intervals in the coagulation laboratory.

    Science.gov (United States)

    Castellone, D D

    2017-05-01

    Obtaining a reference interval (RI) is a challenge for any laboratory and becomes more complicated in the coagulation laboratory due to testing on samples with limited stability on reagents that are poorly standardized. Reference intervals are required to be able to evaluate results in relation to a patients' hemostatic disorder. This becomes one of the most important tasks conducted in the coagulation laboratory. However, many laboratories lack the time, finances and in many cases the expertise to conduct this study. Many RI are obtained from package inserts, or from publications written by experts in lieu of laboratories conducting their own studies. An overview of validating reference intervals and options for verifying or transference of reference intervals is discussed. Based on the confidence interval and the acceptability of risk laboratories are willing to accept, coagulation laboratories have options to conduct robust studies for their RI. Data mining or global reference studies may help to provide data for age specific ranges. Pre-analytical variables and selection of healthy subjects have the largest impact on coagulation testing outcomes and need to be well controlled during the establishment of reference intervals. Laboratories have options in lieu of conducting a full validation on how to verify RI based on smaller RI studies or transference of RI after determining compatibility of the original RI study. © 2017 John Wiley & Sons Ltd.

  17. Population based reference intervals for common blood ...

    African Journals Online (AJOL)

    Population based reference intervals for common blood haematological and biochemical parameters in the Akuapem north district. K.A Koram, M.M Addae, J.C Ocran, S Adu-amankwah, W.O Rogers, F.K Nkrumah ...

  18. The Case for Common Reference Intervals

    Science.gov (United States)

    Jones, Graham RD; Barker, Antony; Tate, Jill; Lim, Chen-Fee; Robertson, Ken

    2004-01-01

    The current paradigm for pathology reference intervals is for each laboratory to determine its own interval for use with each test offered by the laboratory. It is our contention that this approach does not best serve the medical community, especially at a time when electronic databases of health information are being expanded and integrated. We also believe that this approach is not performed well in many laboratories and is excessively expensive in practice. In contrast, we believe that the preferable option is to develop and apply common reference intervals throughout Australia and New Zealand, together with common reporting formats and assay standardisation wherever this is possible. We are aware that these are neither trivial nor simple issues, however we believe that failure to achieve this goal where technically possible will be a failure of the pathology profession to meet the challenges of the modern health community. PMID:18458709

  19. Selecting clinically relevant populations for reference intervals.

    Science.gov (United States)

    Ritchie, Robert F; Palomaki, Glenn

    2004-01-01

    The selection of individuals to represent a group for any purpose can commit the effort to success or failure from the very outset. The description of this group must reflect what is, in reality, the purpose for which the group is being studied. Considering that reference intervals are designed to assist clinicians during diagnostic triage, criteria must reflect the nature of the subjects entering the system for care. The majority of people seeking care have non-life-threatening, yet troublesome complaints. In other words, persons who are in a reasonable state of health and who are not suffering from significant illness. Therefore the relevant cohort should fit this description, not individuals who lack any clinical or laboratory issues. Our focus is to employ reference intervals to exclude disease and not to define normality. Normality in the eyes of statisticians is quite different from the word as viewed by clinical staff, yet the term is used interchangeably without concern for its ultimate use. As a result medicine today stumbles over this issue at every turn. Scientists and artists do not speak the same language. Compounding this awkward situation has been the conviction that by increasing laboratory precision and accuracy, the utility of laboratory data, reference intervals in particular, will improve clinical understanding. This has, after many years, not proven to be the case. What has become very evident, however, is that unsustainably large sums of money are being devoted to improving laboratory performance. To what end, when we are unable to grasp the significance of what is available now including published reference intervals for common test values? A realistic perspective on the value of prevailing laboratory performance, as illustrated by reference intervals, must be adopted. The obligation of laboratories, its regulators and professional groups is to create a sustainable mechanism to provide clinically usable information, in a timely and affordable

  20. Haematological reference intervals in a multiethnic population.

    Directory of Open Access Journals (Sweden)

    Angeli Ambayya

    Full Text Available Similar to other populations, full blood count reference (FBC intervals in Malaysia are generally derived from non-Malaysian subjects. However, numerous studies have shown significant differences between and within populations supporting the need for population specific intervals.Two thousand seven hundred twenty five apparently healthy adults comprising all ages, both genders and three principal races were recruited through voluntary participation. FBC was performed on two analysers, Sysmex XE-5000 and Unicel DxH 800, in addition to blood smears and haemoglobin analysis. Serum ferritin, soluble transferrin receptor and C-reactive protein assays were performed in selected subjects. All parameters of qualified subjects were tested for normality followed by determination of reference intervals, measures of central tendency and dispersion along with point estimates for each subgroup.Complete data was available in 2440 subjects of whom 56% (907 women and 469 men were included in reference interval calculation. Compared to other populations there were significant differences for haemoglobin, red blood cell count, platelet count and haematocrit in Malaysians. There were differences between men and women, and between younger and older men; unlike in other populations, haemoglobin was similar in younger and older women. However ethnicity and smoking had little impact. 70% of anemia in premenopausal women, 24% in postmenopausal women and 20% of males is attributable to iron deficiency. There was excellent correlation between Sysmex XE-5000 and Unicel DxH 800.Our data confirms the importance of population specific haematological parameters and supports the need for local guidelines rather than adoption of generalised reference intervals and cut-offs.

  1. Reference intervals of thyroid hormones during pregnancy in Korea, an iodine-replete area.

    Science.gov (United States)

    Kim, Hye Jeong; Cho, Yoon Young; Kim, Sun Wook; Kim, Tae Hyuk; Jang, Hye Won; Lee, Soo-Youn; Choi, Suk-Joo; Roh, Cheong-Rae; Kim, Jong-Hwa; Chung, Jae Hoon; Oh, Soo-Young

    2017-02-08

    Maternal thyroid dysfunction has been associated with adverse pregnancy outcomes. The purpose of our study was to establish trimester-specific reference intervals for thyroid hormones in pregnant women in Korea, where iodine intake is more than adequate and to examine pregnancy and perinatal outcomes in their offspring. Among 459 healthy pregnant women who were screened, we enrolled 417 subjects who had negative results for thyroid autoantibodies. Serum thyroid stimulating hormone (TSH) and free thyroxine were measured using an immunoradiometric assay. Urine iodine concentration was measured using inductively coupled plasma-mass spectrometry in 275 women. Reference ranges of thyroid hormones were determined according to the guidelines of the National Academy of Clinical Biochemistry. Pregnancy and perinatal outcomes were compared according to maternal thyroid function. The reference ranges of serum TSH were 0.03 to 4.24 mIU/L in the first trimester, 0.13 to 4.84 mIU/L in the second trimester, and 0.30 to 5.57 mIU/L in the third trimester. Pregnancy and perinatal outcomes did not vary in mothers with subtle changes in thyroid function. Trimester-specific thyroid hormone reference intervals in Korean pregnant women differ from those of other countries with different iodine nutrition status and ethnicity. The establishment of population-based, reliable trimester-specific reference intervals is critical for the interpretation of thyroid function in pregnant women to avoid unnecessary tests and treatments.

  2. Hematology reference intervals for neonatal Holstein calves.

    Science.gov (United States)

    Panousis, Nikolaos; Siachos, Nektarios; Kitkas, Georgios; Kalaitzakis, Emmanouil; Kritsepi-Konstantinou, Maria; Valergakis, Georgios E

    2018-01-09

    Data regarding hematologic reference intervals (RI) for neonatal calves have not been published yet. The aims of this study were: a) to establish hematology RIs for neonatal Holstein calves, b) to compare them with the RIs for lactating cows, and c) to investigate the relationship of age and gender with the hematologic profile of calves. Two-hundred and fifty-four clinically healthy Holstein calves (1-9days old, from 30 farms) and 82 healthy Holstein cows (between 30 and 150days in milk, from 10 farms) were blood sampled once for a complete blood count evaluation, using the ADVIA 120 hematology analyzer. An additional blood sample was collected from each calf for serum total protein concentration measurement. RIs and age-related RIs were calculated with the Reference Value Advisor freeware. Comparisons between calves and cows and between male and female calves were performed with t-test or Mann-Whitney test. Red blood cell count (RBC), white blood cell count (WBC), neutrophil, lymphocyte and platelet counts in calves were higher, while mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) were lower than in cows. Lymphocyte and platelets showed a notable increase through age. Finally, female calves had higher RBC, hematocrit and hemoglobin concentration than males. Age-specific RIs should be used for the interpretation of the complete blood count in Holstein calves. Copyright © 2018 Elsevier Ltd. All rights reserved.

  3. RCPAQAP First Combined Measurement and Reference Interval Survey

    OpenAIRE

    Jones, Graham RD; Koetsier, Sabrina DA

    2014-01-01

    Reference intervals are commonly considered to allow for between-laboratory bias. The RCPAQAP Liquid Serum Chemistry Program has collected data on laboratory measurements as well as reference intervals. This allows assessment of the between-laboratory variation in results, reference intervals and the information transmitted by the combination of these factors. For the majority of common chemistry analytes, the between-laboratory variation in reference intervals is greater than the variation i...

  4. Trimester specific reference intervals for thyroid function tests in normal Indian pregnant women

    Science.gov (United States)

    Sekhri, Tarun; Juhi, Juhi Agarwal; Wilfred, Reena; Kanwar, Ratnesh S.; Sethi, Jyoti; Bhadra, Kuntal; Nair, Sirimavo; Singh, Satveer

    2016-01-01

    Context: Accurate assessment of thyroid function during pregnancy is critical, for initiation of thyroid hormone therapy, as well as for adjustment of thyroid hormone dose in hypothyroid cases. Aims: We evaluated pregnant women who had no past history of thyroid disorders and studied their thyroid function in each trimester. Settings and Design: 86 normal pregnant women in the first trimester of pregnancy were selected for setting reference intervals. All were healthy, euthyroid and negative for thyroid peroxidase antibody (TPOAb). These women were serially followed throughout pregnancy. 124 normal nonpregnant subjects were selected for comparison. Material and methods: Thyrotropin (TSH), free thyroxine (FT4), free triiodothyronine (FT3) and anti-TPO were measured using Roche Elecsys 1010 analyzer. Urinary iodine content was determined by simple microplate method. The 2.5th and 97.5th percentiles were calculated as the reference intervals for thyroid hormone levels during each trimester. Statistical Analysis: SPSS (version 14.0, SPSS Inc., Chicago, IL, USA) was used for data processing and analysis. Results: The reference intervals for the first, second and third trimesters for the following parameters: TSH 0.09-6.65, 0.51-6.66, 0.91-4.86 µIU/mL, FT4 9.81-18.53, 8.52-19.43, 7.39-18.28 pM/L and FT3 3.1-6.35, 2.39-5.12, 2.57-5.68 pM/L respectively. Thyroid hormone concentrations significantly differed during pregnancy at different stages of gestation. The pregnant women in the study had median urinary iodine concentration of 150-200 µg/l during each trimester. Conclusions: The trimester-specific reference intervals for thyroid tests during pregnancy have been established for pregnant Indian women serially followed during pregnancy using 2.5th and 97.5th percentiles. PMID:26904477

  5. TSH test

    Science.gov (United States)

    ... results. If you are being treated for a thyroid disorder, your TSH level will likely be kept between ... Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, ...

  6. Definition of reference ranges for free T4, TSH, and thyroglobulin levels in healthy subjects of the Jaén Health District.

    Science.gov (United States)

    Olmedo Carrillo, Pablo; Santiago Fernández, Piedad; García Fuentes, Eduardo; Ureña Fernández, Tomás; Gutiérrez Alcántara, Carmen; Sánchez-Malo, Carolina; Gassó Campos, Manuela; Martínez Ramírez, María José

    2017-10-01

    The treatment guidelines for thyroid dysfunction recommend defining reference ranges for thyroid hormones in each area through assessment of local population data considering the iodine nutritional status. The aim of this study was to define the reference ranges of free thyroxine (FT4), TSH, and thyroglobulin levels in a general population from Jaen, an area of southern Spain with an adequate iodine nutritional status, and whether they were associated with urinary iodine levels. A cross-sectional study was conducted in 1,003 subjects of the general population of the Jaen Health District. Levels of urinary iodine, FT4, TSH, thyroglobulin, and thyroid peroxidase (TPO) antibodies were measured according to age and sex. Median and mean urinary iodine levels were 110.59μg/L and 130.11μg/L respectively. Median TSH level was 1.83μIU/mL (p2.5=0.56μIU/mL, p97.5=4.66μIU/mL). Median FT4 level was 0.84ng/dL (p2.5=0.62ng/dL, p97.5=1.18ng/dL). TPO antibodies were detected in 5.7% of subjects. There was no correlation between urinary iodine levels and FT4, TSH or TPO antibodies. Subjects with positive TPO antibodies had higher TSH levels (3.34μIU/L versus 2.14μIU/mL, P=.001; odds ratio=2.42). Urinary iodine levels in Jaen are optimal according to World Health Organization standards. Reference ranges of FT4, TSH, and thyroglobulin do not differ from those reported in the literature and are no associated to urinary iodine levels. The prevalence of positive TPO antibodies was similar to that reported in other Spanish areas. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  7. Reference intervals data mining: no longer a probability paper method.

    Science.gov (United States)

    Katayev, Alexander; Fleming, James K; Luo, Dajie; Fisher, Arren H; Sharp, Thomas M

    2015-01-01

    To describe the application of a data-mining statistical algorithm for calculation of clinical laboratory tests reference intervals. Reference intervals for eight different analytes and different age and sex groups (a total of 11 separate reference intervals) for tests that are unlikely to be ordered during routine screening of disease-free populations were calculated using the modified algorithm for data mining of test results stored in the laboratory database and compared with published peer-reviewed studies that used direct sampling. The selection of analytes was based on the predefined criteria that include comparability of analytical methods with a statistically significant number of observations. Of the 11 calculated reference intervals, having upper and lower limits for each, 21 of 22 reference interval limits were not statistically different from the reference studies. The presented statistical algorithm is shown to be an accurate and practical tool for reference interval calculations. Copyright© by the American Society for Clinical Pathology.

  8. Reference intervals for the P-Albumin bromocresol purple method.

    Science.gov (United States)

    Christensen, Peter Astrup

    2017-10-01

    Correct reference intervals are an important part of test results. As establishing own reference intervals is a very expensive task, the NORIP reference intervals are often transferred for use in Nordic laboratories. The NORIP reference interval on P-Albumin was here compared to current results for laboratories using the bromocresol purple (BCP) method for P-Albumin. External quality control reports were used to investigate the change in levels between the BCP and BCG methods on P-Albumin. An algorithm was built for extracting and isolating the laboratory's healthy subject population. The algorithm was used to extract test results from the laboratory information system. Parametric and non-parametric statistical methods were used to evaluate the P-Albumin test result populations. The indirect method used here clearly shows that the NORIP reference intervals for P-Albumin are not fit for the current bromocresol purple methods. The method was also used to suggest new reference interval limits.

  9. Closing the Gaps in Paediatric Reference Intervals: The CALIPER Initiative

    Science.gov (United States)

    Schnabl, Kareena; Chan, Man Khun; Gong, Yanping; Adeli, Khosrow

    2008-01-01

    Screening, diagnosis and monitoring of paediatric diseases relies on the measurement of a spectrum of disease biomarkers in clinical laboratories to guide important clinical decisions. Physicians rely on the availability of suitable and reliable reference intervals to accurately interpret laboratory test results with data collected during medical history and physical examination. However, critical gaps currently exist in accurate and up-to-date reference intervals (normal values) for accurate interpretation of laboratory tests performed in children and adolescents. These gaps in the available paediatric laboratory reference intervals have the clear potential of contributing to erroneous diagnosis or misdiagnosis of many diseases of childhood and adolescence. Most of the available reference intervals for laboratory tests were determined over two decades ago on older instruments and technologies, and are no longer relevant considering the current testing technology used by clinical laboratories. It is thus critical and of utmost urgency that a more acceptable and comprehensive database be established. There are however many challenges when attempting to establish paediatric reference intervals. Paediatric specimen collection is a major concern for health care providers as it is frequently difficult to obtain sufficient volumes of blood or urine from paediatric patients. Common reference intervals have not been widely implemented due to lack of harmonisation of methods and differences in patient populations. Consequently, clinical laboratory accreditation organisations and licensing agencies require that each laboratory verify or establish reference intervals for each method. To provide such reference intervals requires selection criteria for suitable reference individuals, defined conditions for specimen collection and analysis, method selection to determine reference limits and validation of the reference interval. The current review will provide a brief

  10. Comparison of the Reference Intervals Used for the Evaluation of Maternal Thyroid Function During Pregnancy Using Sequential and Nonsequential Methods

    Science.gov (United States)

    Fan, Jian-Xia; Yang, Shuai; Qian, Wei; Shi, Feng-Tao; Huang, He-Feng

    2016-01-01

    Background: Maternal thyroid dysfunction is common during pregnancy, and physiological changes during pregnancy can lead to the overdiagnosis of hyperthyroidism and misdiagnosis of hypothyroidism with nongestation-specific reference intervals. Our aim was to compare sequential with nonsequential methods for the evaluation of thyroid function in pregnant women. Methods: We tested pregnant women who underwent their trimester prenatal screening at our hospital from February 2011 to September 2012 for serum thyroid stimulating hormone (TSH) and free thyroxine (FT4) using the Abbott and Roche kits. There were 447 and 200 patients enrolled in the nonsequential and sequential groups, respectively. The central 95% range between the 2.5th and the 97.5th percentiles was used as the reference interval for the thyroid function parameter. Results: The nonsequential group exhibited a significantly larger degree of dispersion in the TSH reference interval during the 2nd and 3rd trimesters as measured using both the Abbott and Roche kits (all P reference intervals were significantly larger in the nonsequential group than in the sequential group during the 3rd trimester as measured with both the Abbott (4.95 vs. 3.77 mU/L, P reference interval as measured with the Abbott kit during all trimesters (12.64 vs. 5.82 pmol/L; 7.96 vs. 4.77 pmol/L; 8.10 vs. 4.77 pmol/L, respectively, all P reference interval was only observed during the 2nd trimester with the Roche kit (7.76 vs. 5.52 pmol/L, P = 0.002). Conclusions: It was more reasonable to establish reference intervals for the evaluation of maternal thyroid function using the sequential method during each trimester of pregnancy. Moreover, the exclusion of pregnancy-related complications should be considered in the inclusion criteria for thyroid function tests. PMID:26996472

  11. Trimester-specific reference interval for thyroid hormones during pregnancy at a Tertiary Care Hospital in Haryana, India.

    Science.gov (United States)

    Rajput, Rajesh; Singh, Bhagat; Goel, Vasudha; Verma, Amit; Seth, Shashi; Nanda, Smiti

    2016-01-01

    Reference intervals for thyroid hormone during pregnancy need to be gestational age, method, and population specific and there is need to establish trimester-specific thyroid levels for the different population across the world. The aim of this study was to establish trimester-specific reference range for thyroid hormone during pregnancy in a tertiary care center in Haryana. A total of 1430 pregnant women were recruited for the study. Participants having any history of chronic illness, goiter on physical examination, thyroid illness in the past or present, consuming thyroid medications, family history of thyroid illness, presence of anti-thyroid peroxidase antibody, poor obstetrics history were excluded from the study and reference population was identified to calculate serum free triiodothyronine (FT3), free thyroxine (FT4) and thyrotropin (TSH) for each trimester of pregnancy. The 2.5-97.5 th percentiles for FT3, FT4, and TSH obtained in this study were 2.53-4.54 pg/ml, 0.88-1.78 ng/ml and 0.37-3.69 μIU/ml in the first trimester, 2.0-4.73 pg/ml, 0.91-1.78 ng/ml and 0.54-4.47 μIU/ml in the second trimester, 2.01-4.01 pg/ml, 0.83-1.73 ng/ml, and 0.70-4.64 μIU/ml in the third trimester of pregnancy. Mean TSH increased and mean FT3 decreased significantly with the progression of gestational period. FT4 decreased from trimester 1-3 rd , but the decrease was nonsignificant from 2 nd to 3 rd trimester. Existing results for trimester-specific reference intervals for thyroid hormones are inconsistent and cannot be extrapolated due to differences in ethnicity, maternal iodine status, laboratory assay method, and rigor for selection of reference population. Thus, establishment of reference intervals in each region is of great importance.

  12. Trimester- and Assay-Specific Thyroid Reference Intervals for Pregnant Women in China

    Directory of Open Access Journals (Sweden)

    Jinfang Xing

    2016-01-01

    Full Text Available Objective. The guidelines of the American Thyroid Association (ATA recommend an upper limit reference interval (RI of thyroid stimulating hormone (TSH of 2.5 mIU/L in the first trimester of pregnancy and 3.0 mIU/L in subsequent trimesters, but some reported ranges in China are significantly higher. Our study aimed to establish trimester- and assay-specific RIs for thyroid hormones in normal pregnant Chinese women. Methods. In this cross-sectional study, 2540 women with normal pregnancies (first trimester, n=398; second trimester, n=797; third trimester, n=1345 and 237 healthy nonpregnant control subjects were recruited. Serum TSH, free thyroxin (FT4, thyroid peroxidase antibody (TPOAb, and thyroglobulin antibody (TgAb levels were determined by automated chemiluminescence with an Immulite 2000 system (Siemens, Erlangen, Germany. After outliers were excluded, the 2.5–97.5th percentiles were used to define the RIs. Results. The RIs of thyroid function in the first, second, and third trimesters of pregnancy and in nonpregnant controls were 0.07–3.96, 0.27–4.53, 0.48–5.40, and 0.69–5.78 mIU/L for TSH and 9.16–18.12, 8.67–16.21, 7.80–13.90, and 8.24–16.61 pmol/L for FT4, respectively. Conclusion. The trimester- and assay-specific RIs of thyroid function during pregnancy differed between trimesters, which suggests that it is advisable to detect and avoid misclassification of thyroid dysfunction during pregnancy for women in Henan, China.

  13. Reference intervals for serum lipids in coastal males from Fangchenggang.

    Science.gov (United States)

    Qin, Xue; Mo, Cuiju; Zeng, Zhiyu; Chen, Zhiping; Deng, Yan; Peng, Qiliu; Gao, Yong; Yi, Zhen; Li, Shan; Mo, Zengnan

    2013-01-01

    We aimed to establish the reference intervals for serum lipids in coastal residents of the Chinese male population. A total of 1436 subjects, aged between 19 and 86 years, were selected from the Fangchenggang Area for Male Health and Examination Survey (FAMHES). Reference intervals of serum lipids were measured by enzymatic endpoint colorimetry and information was obtained using a standard questionnaire. The total nonparametric reference intervals for TC 1.90 mmol/L (73.08 mg/dL), and LDL-C serum lipid levels were correlated with older age, higher body mass index (BMI), and more smoking, but not with alcohol consumption. The established reference intervals of serum lipids for coastal Chinese male residents would be helpful for assessing risk of cardiovascular disease. We recommend establishing population-based reference intervals for serum lipids in clinical laboratories.

  14. BIOCHEMISTRY PANEL REFERENCE INTERVALS FOR JUVENILE GOLDFISH (CARASSIUS AURATUS).

    Science.gov (United States)

    Adamovicz, Laura A; Trosclair, Macy R; Lewbart, Gregory A

    2017-09-01

    Reference intervals for diagnostic tests are vitally important for clinical decision making. Despite the popularity of pet goldfish (Carassius auratus), reference intervals have not been generated for routine biochemistry panel analytes in this species. This study establishes de novo reference intervals for packed cell volume and total solids, using 47 apparently healthy immature goldfish, and for 11 common chemistry panel analytes (albumin, aspartate aminotransferase, calcium, creatine kinase, globulin, blood glucose, sodium, potassium, phosphorous, total protein, and uric acid) using 39 immature goldfish. Robust reference intervals were generated following recommendations of the American Society for Veterinary Clinical Pathology. Linear regression was used to demonstrate a statistically significant relationship between body weight and calcium, albumin, total protein, potassium, packed cell volume, and total solids. The results of this study serve as a useful baseline for future reference interval generation in goldfish.

  15. Hematological Reference Intervals for Healthy Iranian Blood Donors.

    Science.gov (United States)

    Rasouli, Mahboubeh; Pourmokhtar, Mojgan; Sarkardeh, Shaghayegh

    2017-10-01

    Background: Development of locally-derived hematological reference intervals is necessary for improving the quality of health care and clinical trials. However hematological reference intervals are affected by several variables including age, gender and environmental factors. Therefore this study was conducted to determine the gender and age-specific hematological reference intervals of healthy Iranian blood donors. Materials and Methods: Selected hematological indices of 394 healthy blood donor volunteers, donating blood at Tehran Blood Transfusion Center were analyzed. Hematological reference intervals, stratified by age and gender were compared. The results of current study were also compared with those of US population. Results: There were significant gender-related differences for mean values of hematological indices, with males having higher mean values of RBC, HCG, HCT and MCV than females. While the mean of PLT and MCH were higher in women. Age-related differences for mean values of RBC and MCH were also significant. The comparison of reference intervals, stratified by both gender and age showed that RBC, HGB and HCT values were higher in males than females in all age groups. But MCH values of females in all age groups and WBC and PLT counts in females older than 30 years were higher compared to the males in the same age group. The results of this study showed some similarity with US population, with narrower intervals. Conclusion: This study suggests that gender and age-specific, locally derived hematological reference intervals should be referred to, before interpretation of any laboratory test result.

  16. Estimation of individual reference intervals in small sample sizes

    DEFF Research Database (Denmark)

    Hansen, Ase Marie; Garde, Anne Helene; Eller, Nanna Hurwitz

    2007-01-01

    of that order of magnitude for all topics in question. Therefore, new methods to estimate reference intervals for small sample sizes are needed. We present an alternative method based on variance component models. The models are based on data from 37 men and 84 women taking into account biological variation...... presented in this study. The presented method enables occupational health researchers to calculate reference intervals for specific groups, i.e. smokers versus non-smokers, etc. In conclusion, the variance component models provide an appropriate tool to estimate reference intervals based on small sample...

  17. Recommended Nordic paediatric reference intervals for 21 common biochemical properties

    DEFF Research Database (Denmark)

    Hilsted, Linda; Rustad, Pål; Aksglæde, Lise

    2013-01-01

    Abstract Paediatric reference intervals based on samples from healthy children are difficult to establish and consequently data are often from hospitalized children. Furthermore, biases may present in published data due to differences in the analytical methods employed. Blood samples from 1429...... healthy Danish children were collected for establishing reference intervals for 21 common biochemical properties (Alanine transaminase, Albumin, Alkaline phosphatase, Aspartate transaminase, Bilirubin, Calcium, Cholesterol, Creatinine, Creatine kinase, HDL-Cholesterol, Iron, Lactate dehydrogenase, LDL...... values of X for the properties and statistical calculations carried out as performed in the NORIP study. Thus commutable (regarding analytical method) reference intervals for 20 properties were established and for LDL-Cholesterol reference intervals were reported for the specific analytical method...

  18. Clinical laboratory reference intervals in pediatrics: the CALIPER initiative.

    Science.gov (United States)

    Jung, Benjamin; Adeli, Khosrow

    2009-11-01

    Reference intervals provided on laboratory reports are essential for appropriate interpretation of test results, and can significantly impact clinical decision-making and the quality of patient care. Careful determination and/or validation of reference intervals by the laboratory for use in the patient population it serves are therefore important to ensure their proper utility. Unfortunately, critical gaps currently exist in accurate and up-to-date pediatric reference intervals for accurate interpretation of laboratory tests performed in children and adolescents. These critical gaps in the available pediatric laboratory reference intervals have the clear potential of contributing to erroneous diagnosis or misdiagnosis of many diseases of childhood and adolescence. Most of the available "normal" ranges for laboratory tests were determined over 2 decades ago on older instruments and technologies, and are no longer relevant considering the current testing technology used by clinical laboratories. It is thus critical and of utmost urgency that a more acceptable and comprehensive database be established. In the present review, we discuss the considerations and challenges faced when generating and validating reference intervals in accordance to the current guidelines published by the Clinical Laboratory Standards Institute (CLSI). We raise particular attention to the present-day deficiencies in available pediatric reference intervals, and highlight the special issues and unique difficulties that are additionally faced when establishing reference intervals in children. Finally, we highlight a recent Canadian initiative, the CALIPER project, whose mandate is to establish and maintain a database of comprehensive and up-to-date pediatric reference intervals to be eventually made available to all clinical laboratories worldwide.

  19. Establishment of reference intervals and transfusion criterion for Sonoclot analysis.

    Science.gov (United States)

    Zhang, Zhen-Lu; Chen, You-Ping; Tao, Cui-Hua; Liu, Xiao-Hui; Li, Meng-Ya; Zhou, Xin

    2016-08-01

    Sonoclot analyzer has been widely used in many countries. But the reference intervals provided by the manufacturer were derived from only 45 participants, and there was no cut-off value for transfusion for Sonoclot analysis. This study aimed to establish reference intervals and transfusion criterion for Sonoclot analysis. Volunteers were recruited from healthy Chinese adults and patients undergoing cardiac surgery. Blood samples were withdrawn from forearm vein and measured for activated clotting time (ACT), clot rate (CR), platelet function (PF), activated partial thromboplastin time (APTT), fibrinogen concentration (FIB), and platelet count (PLT). The reference intervals were determined by the nonparametric method. Cut-off values were determined by the receiver operating characteristics curve. A total of 135 healthy volunteers and 281 patients were enrolled. The 95% reference intervals were 96-195 s, 22-51 signal U/min, >1.6 for ACT, CR, PF respectively. In the 281 patients, the results of APTT, FIB, PLT, ACT, CR, and PF ranged from 20.5-300.0 s, 0.28-4.11 g/L, (19.0-387.3)×109/L, 80-514 s, 2.9-74 signal U/min, and 0.1-5.1 respectively. The cut-off values for transfusion were >208, ≤14, and ≤1.3 for ACT, CR, PF respectively. The cut-off values of Sonoclot analysis were within the manufacturer's reference intervals, while they were outside the reference intervals established in this study. The results suggested that the manufacturer's reference intervals were not suitable for Chinese. The reference intervals and cut-off values established in this study will be helpful to Chinese patients.

  20. Reference intervals for serum total cholesterol, HDL cholesterol and ...

    African Journals Online (AJOL)

    Reference intervals of total cholesterol, HDL cholesterol and non-HDL cholesterol concentrations were determined on 309 blood donors from an urban and peri-urban population of Botswana. Using non-parametric methods to establish 2.5th and 97.5th percentiles of the distribution, the intervals were: total cholesterol 2.16 ...

  1. Evidence-based approach to harmonised reference intervals.

    Science.gov (United States)

    Koerbin, Gus; Sikaris, Ken Andrew; Jones, Graham Ross Dallas; Ryan, Julie; Reed, Maxine; Tate, Jill

    2014-05-15

    Although we are in the era of evidence-based medicine, there is still a substantial gap between theory and current practice with the application of reference intervals as decision making tools. Different laboratories may have different reference intervals for the same tests using the same analytical methods and platforms. These differences have the potential to confuse physicians making the assessment and monitoring of patients more difficult by providing discordant information. This paper attempts to demonstrate how to use evidence-based approach for harmonising reference intervals. In order to consider harmonisation we must first have an appreciation of the various factors that influence the determination of that reference interval such as the choice of individuals within the population studied, biological variability of the analyte studied, partitioning, sample collection, analytical aspects such as bias and statistical models. An a priori approach for determining reference intervals, whilst recommended, may be beyond the scope of most laboratories and consideration should be given to the use of a validated indirect a posteriori approach. Regardless of method used, the continuing application of an evidence-based approach in harmonised reference intervals to meet the quality expectations of physicians should be pursued. © 2013.

  2. Establishment of hematological reference intervals for healthy adults in Asmara.

    Science.gov (United States)

    Siraj, Nejat; Issac, John; Anwar, Mohammed; Mehari, Yohannes; Russom, Shushan; Kahsay, Semere; Frezghi, Haben

    2018-01-22

    Clinical laboratory reference intervals used in a specific area should be derived from the local population as they are influenced by many factors. The purpose of this quantitative cross sectional study was to establish hematological reference intervals for healthy adults in Asmara and to determine whether the currently used reference interval do represent the adult population in the city. In addition, the established reference intervals were compared to findings from similar studies conducted in selected countries in Africa. There was a significant difference between males and females in the reference intervals for erythrocyte count, hemoglobin, hematocrit, mean cell volume, mean cell hemoglobin, mean cell hemoglobin concentration and differential white blood cell count. All the evaluated hematological analytes were found to be higher in males than in females except for platelet count. The out of range percentage for the parameters extends from 3.5 to 46.7%; with red blood cell count having the lowest while mean cell volume having the highest out of range percentage. The results indicated that the currently used reference interval does not represent the population in Asmara and are different from those obtained elsewhere in Africa.

  3. Complete blood count reference intervals for healthy Han Chinese adults.

    Directory of Open Access Journals (Sweden)

    Xinzhong Wu

    Full Text Available Complete blood count (CBC reference intervals are important to diagnose diseases, screen blood donors, and assess overall health. However, current reference intervals established by older instruments and technologies and those from American and European populations are not suitable for Chinese samples due to ethnic, dietary, and lifestyle differences. The aim of this multicenter collaborative study was to establish CBC reference intervals for healthy Han Chinese adults.A total of 4,642 healthy individuals (2,136 males and 2,506 females were recruited from six clinical centers in China (Shenyang, Beijing, Shanghai, Guangzhou, Chengdu, and Xi'an. Blood samples collected in K2EDTA anticoagulant tubes were analyzed. Analysis of variance was performed to determine differences in consensus intervals according to the use of data from the combined sample and selected samples.Median and mean platelet counts from the Chengdu center were significantly lower than those from other centers. Red blood cell count (RBC, hemoglobin (HGB, and hematocrit (HCT values were higher in males than in females at all ages. Other CBC parameters showed no significant instrument-, region-, age-, or sex-dependent difference. Thalassemia carriers were found to affect the lower or upper limit of different RBC profiles.We were able to establish consensus intervals for CBC parameters in healthy Han Chinese adults. RBC, HGB, and HCT intervals were established for each sex. The reference interval for platelets for the Chengdu center should be established independently.

  4. Complete Blood Count Reference Intervals for Healthy Han Chinese Adults

    Science.gov (United States)

    Mu, Runqing; Guo, Wei; Qiao, Rui; Chen, Wenxiang; Jiang, Hong; Ma, Yueyun; Shang, Hong

    2015-01-01

    Background Complete blood count (CBC) reference intervals are important to diagnose diseases, screen blood donors, and assess overall health. However, current reference intervals established by older instruments and technologies and those from American and European populations are not suitable for Chinese samples due to ethnic, dietary, and lifestyle differences. The aim of this multicenter collaborative study was to establish CBC reference intervals for healthy Han Chinese adults. Methods A total of 4,642 healthy individuals (2,136 males and 2,506 females) were recruited from six clinical centers in China (Shenyang, Beijing, Shanghai, Guangzhou, Chengdu, and Xi’an). Blood samples collected in K2EDTA anticoagulant tubes were analyzed. Analysis of variance was performed to determine differences in consensus intervals according to the use of data from the combined sample and selected samples. Results Median and mean platelet counts from the Chengdu center were significantly lower than those from other centers. Red blood cell count (RBC), hemoglobin (HGB), and hematocrit (HCT) values were higher in males than in females at all ages. Other CBC parameters showed no significant instrument-, region-, age-, or sex-dependent difference. Thalassemia carriers were found to affect the lower or upper limit of different RBC profiles. Conclusion We were able to establish consensus intervals for CBC parameters in healthy Han Chinese adults. RBC, HGB, and HCT intervals were established for each sex. The reference interval for platelets for the Chengdu center should be established independently. PMID:25769040

  5. Bone turnover marker reference intervals in young females.

    Science.gov (United States)

    Callegari, Emma T; Gorelik, Alexandra; Garland, Suzanne M; Chiang, Cherie Y; Wark, John D

    2017-07-01

    Background The use of bone turnover markers in clinical practice and research in younger people is limited by the lack of normative data and understanding of common causes of variation in bone turnover marker values in this demographic. To appropriately interpret bone turnover markers, robust reference intervals specific to age, development and sex are necessary. This study aimed to determine reference intervals of bone turnover markers in females aged 16-25 years participating in the Safe-D study. Methods Participants were recruited through social networking site Facebook and were asked to complete an extensive, online questionnaire and attend a site visit. Participants were tested for serum carboxy-terminal cross-linking telopeptide of type 1 collagen and total procollagen type 1 N-propeptide using the Roche Elecsys automated analyser. Reference intervals were determined using the 2.5th to 97.5th percentiles of normalized bone turnover marker values. Results Of 406 participants, 149 were excluded due to medical conditions or medication use (except hormonal contraception) which may affect bone metabolism. In the remaining 257 participants, the reference interval was 230-1000 ng/L for serum carboxy-terminal cross-linking telopeptide of type 1 collagen and 27-131  µg/L for procollagen type 1 N-propeptide. Both marker concentrations were inversely correlated with age and oral contraceptive pill use. Therefore, intervals specific to these variables were calculated. Conclusions We defined robust reference intervals for cross-linking telopeptide of type 1 collagen and procollagen type 1 N-propeptide in young females grouped by age and contraceptive pill use. We examined bone turnover markers' relationship with several lifestyle, clinical and demographic factors. Our normative intervals should aid interpretation of bone turnover markers in young females particularly in those aged 16 to 19 years where reference intervals are currently provisional.

  6. Chinese Pediatric Reference Intervals for Serum Cortisol on IMMULITE 2000.

    Science.gov (United States)

    Wang, Ling Li; Zhang, Li Yue; Wang, Hui Yan; Wen, Huai Kai; Tao, Hong Qun; Zhao, Xiao Wei

    2018-01-01

    Clinical interpretation of the test results for cortisol based on continuous reference intervals with appropriate partitions improves pediatric diagnosis; however, these values are available only for Caucasians. To develop the pediatric reference intervals for Chinese population, we examined the serum cortisol levels in 1,143 healthy Chinese children aged 4-18 years (566 boys and 577 girls), using an IMMULITE 2000 Immunoassay System (Siemens Healthcare GmbH). Phlebotomy was performed at 7-9 a.m. for 284 boys and 287 girls and at 1-3 p.m. for the others. They were divided into four age groups according to the Clinical and Laboratory Standards Institute guideline EP28-A3c, with the last group further stratified according to sampling time. Separate reference intervals of 49.6-323.7, 70.9-395.3, and 90.1-448.7 nmol/L were established for children aged 4-8, 9-12, and 13-15 years, respectively. Further, reference intervals of 118.2-464.7 and 71.4-446.7 nmol/L were established for morning and afternoon cortisol levels, respectively, in children aged 16-18 years. Further studies are necessary to transfer and validate these reference intervals in other analytical systems and pediatric populations, and to allow for broader applications. © The Korean Society for Laboratory Medicine.

  7. Coordinates and intervals in graph-based reference genomes.

    Science.gov (United States)

    Rand, Knut D; Grytten, Ivar; Nederbragt, Alexander J; Storvik, Geir O; Glad, Ingrid K; Sandve, Geir K

    2017-05-18

    It has been proposed that future reference genomes should be graph structures in order to better represent the sequence diversity present in a species. However, there is currently no standard method to represent genomic intervals, such as the positions of genes or transcription factor binding sites, on graph-based reference genomes. We formalize offset-based coordinate systems on graph-based reference genomes and introduce methods for representing intervals on these reference structures. We show the advantage of our methods by representing genes on a graph-based representation of the newest assembly of the human genome (GRCh38) and its alternative loci for regions that are highly variable. More complex reference genomes, containing alternative loci, require methods to represent genomic data on these structures. Our proposed notation for genomic intervals makes it possible to fully utilize the alternative loci of the GRCh38 assembly and potential future graph-based reference genomes. We have made a Python package for representing such intervals on offset-based coordinate systems, available at https://github.com/uio-cels/offsetbasedgraph . An interactive web-tool using this Python package to visualize genes on a graph created from GRCh38 is available at https://github.com/uio-cels/genomicgraphcoords .

  8. [Reference Intervals of Thyroid Hormones in Normal Pregnant Women and Effects of Thyroid Autoantibodies on Thyroid Hormone Levels in Pregnant Women in Chengdu Area].

    Science.gov (United States)

    Chen, Yu-Min; Zeng, Jing; Yan, Yue-Rong; Luo, Dan; Huang, Lu; Huang, Hui

    2017-05-01

    To establish the reference intervals of thyroid hormones in normal pregnant women in Chengdu area of China, and to investigate the effects of thyroid autoantibodies on thyroid function in pregnant women. We included 696 pregnant women who had gestation data from June 2013 to March 2014 in Chengdu Women & Children's Central Hospital. Every subject under went questionnaire survey, physical examination, thyroid ultrasound and measurement of thyroid hormone and thyroid autoantibodies. The normal reference intervals were established according to the percentiles (P 2.5 -P 97.5 ) of the healthy pregnant women in the same trimester. Another 50 non-pregnant women were selected as the control group. Of the 696 pregnant women, 579 subjects had negative thyroid autoantibodies and 117 subjects had positive thyroid autoantibodies. The positive rate of thyroid autoantibodies was 16.81%. Of the 579 subjects with negative thyroid autoantibodies, 257 were in the first trimester, 202 in the second trimester and 120 in the third trimester. In the first trimester of normal pregnancy, the reference intervals of serum thyrotropin (TSH) , free triiodothyronine (FT3) and free thyroxine (FT4) were 0.02-4.03 mIU/L, 3.85-6.27 pmol/L and 11.93-21.04 pmol/L respectively. In the second trimester, the reference intervals of serum TSH, FT3 and FT4 were 0.02-4.05 mIU/L, 3.51-5.82 pmol/L and 11.23-19.22 pmol/L respectively. In the thirdtrimester, the reference intervals for serum TSH, FT3 and FT4 were 0.24-5.41 mIU/L, 3.18-4.97 pmol/L and 11.10-17.00 pmol/L, respectively. When compared with non-pregnant women, the median TSH value was increasingly consisted with the progress of pregnancy period, while the median FT4 and FT3 values were decreasing accordingly. The similar tendencies of TSH, FT3, and FT4 were found in pregnant women with positive thyroid autoantibodies, but the trends were more remarkable when compared with those with negative thyroid autoantibodies. In pregnant women with positive

  9. Opinion Paper: Deriving Harmonised Reference Intervals – Global Activities

    Science.gov (United States)

    Koerbin, Gus; Adeli, Khosrow

    2016-01-01

    Harmonisation of reference intervals (RIs) refers to use of the same or common RI across different platforms and /or assays for a specified analyte. It occurs optimally for those analytes where there is sound calibration and traceability in place and evidence from a between-method comparison shows that bias would not prevent the use of a common RI. The selection of the RI will depend on various sources of information including local formal RI studies, published studies from the literature, laboratory surveys, manufacturer’s product information, relevant guidelines, and mining of databases. Pre-analytical and partitioning issues, significant figures and flagging rates, are assessed for each analyte. Several countries and regions including the Nordic countries, United Kingdom, Japan, Turkey, and Australasia are using common RIs that have been determined either by direct studies or by a consensus process. In Canada, the Canadian Society of Clinical Chemists Taskforce is assessing the feasibility of establishing common reference values using the CALIPER (Canadian Laboratory Initiative on Pediatric Reference Intervals) and CHMS (The Canadian Health Measures Survey) databases as the basis. Development of platform-specific common reference values for each of the major analytical systems may be a more practical approach especially for the majority of analytes that are not standardised against a primary reference method and are not traceable to a primary or secondary reference material. We encourage laboratories to consider adopting reference intervals consistent with those used by other laboratories in your region where it is possible and appropriate for your local population. Local validation of the adopted reference interval is also recommended as per CLSI guidelines. PMID:27683506

  10. Opinion Paper: Deriving Harmonised Reference Intervals - Global Activities.

    Science.gov (United States)

    Tate, Jillian R; Koerbin, Gus; Adeli, Khosrow

    2016-02-01

    Harmonisation of reference intervals (RIs) refers to use of the same or common RI across different platforms and /or assays for a specified analyte. It occurs optimally for those analytes where there is sound calibration and traceability in place and evidence from a between-method comparison shows that bias would not prevent the use of a common RI. The selection of the RI will depend on various sources of information including local formal RI studies, published studies from the literature, laboratory surveys, manufacturer's product information, relevant guidelines, and mining of databases. Pre-analytical and partitioning issues, significant figures and flagging rates, are assessed for each analyte. Several countries and regions including the Nordic countries, United Kingdom, Japan, Turkey, and Australasia are using common RIs that have been determined either by direct studies or by a consensus process. In Canada, the Canadian Society of Clinical Chemists Taskforce is assessing the feasibility of establishing common reference values using the CALIPER (Canadian Laboratory Initiative on Pediatric Reference Intervals) and CHMS (The Canadian Health Measures Survey) databases as the basis. Development of platform-specific common reference values for each of the major analytical systems may be a more practical approach especially for the majority of analytes that are not standardised against a primary reference method and are not traceable to a primary or secondary reference material. We encourage laboratories to consider adopting reference intervals consistent with those used by other laboratories in your region where it is possible and appropriate for your local population. Local validation of the adopted reference interval is also recommended as per CLSI guidelines.

  11. Establishment of hormone reference intervals for infants born gestation.

    Science.gov (United States)

    Greaves, Ronda F; Zacharin, Margaret R; Donath, Susan M; Inder, Terrie E; Doyle, Lex W; Hunt, Rodney W

    2014-10-01

    Preterm infants, especially those born very preterm (gestation), suffer a number of morbidities. Immaturity of the endocrine system and its potential impact on morbidity is the subject of numerous studies. Hormone concentrations are sometimes measured in very preterm infants, however there are little normative data available to be able to interpret the results. The aim of this study was to describe age appropriate hormone reference intervals for babies born less than 30 weeks' gestation. Samples were collected at 1, 4, 7, 14, 21, 28 and 42 days after birth from babies born 23-29 weeks' gestation. The serum was analyzed for seven hormones by automated chemiluminescent immunoassay (Siemens Immulite 2000). Results from the 107 infants who survived beyond 40 weeks' corrected gestational age were included in the data analysis. Cortisol, dehydroepiandrosterone sulfate, growth hormone and progesterone levels were highest during the first seven days with levels up to 10,801nmol/L; 26.6μmol/L; 343mU/L; and >63.6nmol/L respectively. Free thyroxine levels were as low as established as the levels were below the analyzer's sensitivity. There were no differences in reference intervals between male and female infants. We describe gestation appropriate reference intervals for six hormones measured in babies born gestation. Utilization of these reference intervals permits the correct and timely interpretation of results to the clinician. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  12. Trimester-specific reference interval for thyroid hormones during pregnancy at a Tertiary Care Hospital in Haryana, India

    Directory of Open Access Journals (Sweden)

    Rajesh Rajput

    2016-01-01

    Full Text Available Background: Reference intervals for thyroid hormone during pregnancy need to be gestational age, method , and population specific and there is need to establish trimester-specific thyroid levels for the different population across the world. The aim of this study was to establish trimester-specific reference range for thyroid hormone during pregnancy in a tertiary care center in Haryana. Materials and Methods: A total of 1430 pregnant women were recruited for the study. Participants having any history of chronic illness, goiter on physical examination, thyroid illness in the past or present, consuming thyroid medications, family history of thyroid illness, presence of anti-thyroid peroxidase antibody, poor obstetrics history were excluded from the study and reference population was identified to calculate serum free triiodothyronine (FT3, free thyroxine (FT4 and thyrotropin (TSH for each trimester of pregnancy. Results: The 2.5–97.5th percentiles for FT3, FT4, and TSH obtained in this study were 2.53–4.54 pg/ml, 0.88–1.78 ng/ml and 0.37–3.69 μIU/ml in the first trimester, 2.0–4.73 pg/ml, 0.91–1.78 ng/ml and 0.54–4.47 μIU/ml in the second trimester, 2.01–4.01 pg/ml, 0.83–1.73 ng/ml, and 0.70–4.64 μIU/ml in the third trimester of pregnancy. Mean TSH increased and mean FT3 decreased significantly with the progression of gestational period. FT4 decreased from trimester 1–3rd, but the decrease was nonsignificant from 2nd to 3rd trimester. Conclusions: Existing results for trimester-specific reference intervals for thyroid hormones are inconsistent and cannot be extrapolated due to differences in ethnicity, maternal iodine status, laboratory assay method, and rigor for selection of reference population. Thus, establishment of reference intervals in each region is of great importance.

  13. Gestational age-specific reference intervals for serum thyroid hormone levels in a multi-ethnic population.

    Science.gov (United States)

    Ho, Clement K M; Tan, Edward T H; Ng, Mor Jack; Yeo, George S H; Chern, Bernard; Tee, Nancy W S; Kwek, Kenneth Y C; Tan, Kok Hian

    2017-10-26

    Thyroid disorders are common during pregnancy. To date, a limited number of studies have reported differences in serum thyroid hormone concentrations between different ethnic groups. We sought to establish gestational age-specific reference intervals for serum levels of thyroid hormones in a multi-ethnic population and investigate whether separate reference intervals should be used for different ethnic groups. A total of 926 pregnant women from multiple ethnic groups attended four separate study visits spanning the three trimesters. Venous blood samples were taken at 9 to 14 weeks, 18 to 22 weeks, 28 to 32 weeks, and 34 to 39 weeks of gestation. Serum concentrations of thyroid-stimulating hormone (TSH), free thyroxine (T4), free triiodothyronine (T3), total T4, total T3, thyroid peroxidase antibody and thyroglobulin antibody were measured using Abbott Architect immunoassays. A total of 562 women with singleton pregnancies were found to be negative for both thyroid autoantibodies at all four study visits and thus included in the reference sample group for the establishment of reference intervals (2.5th to 97.5th percentiles). Reference intervals for serum thyroid hormones at 9-14 weeks of gestation derived from the combined group of pregnant women are as follows: TSH, 0.01-2.39 mIU/L; free T4, 11.4-19.5 pmol/L; free T3, 4.23-6.69 pmol/L; total T4, 77.8-182.4 nmol/L; total T3, 1.39-2.97 nmol/L. No differences in the five thyroid parameters' reference intervals are detectable among the ethnic groups except that at study visit 3 (28-32 weeks of gestation), the upper reference limit of total T3 in Malays (3.20 nmol/L; 90% CI, 2.99-3.76 nmol/L) is slightly higher than that in Chinese (2.86 nmol/L; 90% CI, 2.70-2.98 nmol/L). The findings from this study on a multi-ethnic cohort highlight the importance of establishing locally derived and gestational age-specific reference intervals for the five thyroid hormone parameters.

  14. Establishment of complete blood count reference intervals for Chinese preschoolers.

    Science.gov (United States)

    Wang, Guo-Cheng; Li, Na; Niu, Cui; Ma, Wei-Bo; Wang, Zhu-Liang; Guo, Hao; Han, Li-Hong

    2017-09-01

    Reference intervals are critical for interpreting test results of a clinical laboratory. The aim of this study was to establish local reference intervals of complete blood count for healthy preschoolers in China. Three thousand eight hundred and twenty-one blood specimens from children aged 4 months to 6 years were collected and analyzed. Complete blood counts were determined by Sysmex XT-4000i Automated Hematology Analyzer. The nonparametric 2.5th to 97.5th percentile reference ranges were calculated according to CLSI EP28-A3c guideline. Reference intervals for each blood cell parameter are determinded as follows: total WBC 4.86-12.1×10 9 /L for males and 4.73-12.3×10 9 /L for females; RBC 4.13-5.32×10 12 /L for males and 4.08-5.24×10 12 /L for females; HGB 109-145 g/L for males and 111-143 g/L for females; HCT 33.1-41.2% for males and 33.3-41.1% for females; MCH 23.5-29.7 pg for males and 24.6-30.0 pg for females; MCHC 320-365 g/L for males and 321-362 g/L for females; MCV 71.4-85.1 fL for males and 73.8-86.9 fL for females; RDW-SD 33.5-41.9 fL for males and 33.5-41.0 fL for females; RDW-CV 12.0-15.2% for males and 11.8-14.5% for females; PLT 181-475×10 9 /L for males and 179-456×10 9 /L for females; PCT 0.18-0.44% for males and 0.18-0.43% for females; MPV 8.20-11.6 fL for males and 8.20-11.5 fL for females; PDW 8.40-14.4 fL for males and 8.40-14.0 fL for females; P-LCR 12.0-36.6% for males and 11.8-35.6% for females. We established local complete blood count reference intervals for apparent healthy preschoolers in China. It is necessary to establishing region-specific reference intervals of complete blood count for preschoolers. © 2016 Wiley Periodicals, Inc.

  15. Serum thyroid stimulating hormone, total and free T4 during the neonatal period: Establishing regional reference intervals

    Directory of Open Access Journals (Sweden)

    Sara Sheikhbahaei

    2014-01-01

    Full Text Available Context: Congenital hypothyroidism (CH, the most common etiology of preventable mental retardation in children, is estimated to be more prevalent among Asian population. Aims: Since thyroid function tests (TFTs varied among different ages and geographical regions, in this study, the neonatal thyroid reference intervals in a healthy neonatal population is determined for the first time in Iran. Settings and Design: A cross-sectional study performed on 246 healthy term newborns aged between 2 days and 1 month. Materials and Methods: Blood samples were obtained by venipuncture from all subjects. The median, 2.5 th , 5 th , 95 th , and 97.5 th percentile of serum thyroid-stimulating hormone (TSH, as well as the total and free T4 were assessed among different age groups. Statistical Analysis Used: Predictive Analytics Software (PASW Statistics 18 was used for the analysis. Results: Serum TSH, total and free T4 concentration peaked in 5 th to 7 th days of life, continued over 2 weeks, then decreased and started reaching to adult reference range. A significant negative correlation between age and serum concentration of TSH (P = 0.02, total T4 (P = 0.01 and free T4 (P = 0.01 was found. Conclusion: This study yielded fairly different values for TFTs compared compared values found in other countries and also different from values reported for laboratory kits we used. These differences were assumed to be due to variations in ethnicity, age, and laboratory methods used. Due to the lack of international standardization, conducting multicenter studies helps in making a more precise evaluation of thyroid status in neonates.

  16. Reference intervals: current status, recent developments and future considerations

    Science.gov (United States)

    Ozarda, Yesim

    2016-01-01

    Reliable and accurate reference intervals (RIs) for laboratory analyses are an integral part of the process of correct interpretation of clinical laboratory test results. RIs given in laboratory reports have an important role in aiding the clinician in interpreting test results in reference to values for healthy populations. Since the 1980s, the International Federation of Clinical Chemistry (IFCC) has been proactive in establishing recommendations to clarify the true significance of the term ‘RIs, to select the appropriate reference population and statistically analyse the data. The C28-A3 guideline published by the Clinical and Laboratory Standards Institute (CLSI) and IFCC is still the most widely-used source of reference in this area. In recent years, protocols additional to the Guideline have been published by the IFCC, Committee on Reference Intervals and Decision Limits (C-RIDL), including all details of multicenter studies on RIs to meet the requirements in this area. Multicentric RIs studies are the most important development in the area of RIs. Recently, the C-RIDL has performed many multicentric studies to obtain common RIs. Confusion of RIs and clinical decision limits (CDLs) remains an issue and pediatric and geriatric age groups are a significant problem. For future studies of RIs, the genetic effect would seem to be the most challenging area.
The aim of the review is to present the current theory and practice of RIs, with special emphasis given to multicenter RIs studies, RIs studies for pediatric and geriatric age groups, clinical decision limits and partitioning by genetic effects on RIs. PMID:26981015

  17. Lymphocyte subset reference intervals in blood donors from northeastern Brazil

    Directory of Open Access Journals (Sweden)

    ALEX J.L. TORRES

    2015-06-01

    Full Text Available The reference intervals for leukocytes and lymphocytes currently used by most clinical laboratories present limitations as they are primarily derived from individuals of North American and European origin. The objective this study was to determine reference values for peripheral blood B lymphocytes, T lymphocyte subsets (CD4+, CD8+, naïve, memory, regulatory, TCRαβ and TCRγδ+ and NK cells from blood donors in Salvador-Bahia, Brazil. Results: The proportion of included male subjects was 73.7% and the median ages of males (34 and females (35 were found to be similar. Absolute counts total lymphocytes subsets to both gender was 1,956 (1,060-4,186 cells and relative values 34%. The T CD4+ and T CD8+ lymphocytes relative values was 51% (20-62 and 24% (9-28, respectively. The most statistically significant finding observed was a higher percentage of B lymphocytes (p=0.03 in females. Commonly cited subset reference intervals were found to be consistent with values in several populations from different geographic areas.

  18. Reference intervals of echocardiographic measurements in healthy adult dairy goats.

    Science.gov (United States)

    Szaluś-Jordanow, Olga; Czopowicz, Michał; Witkowski, Lucjan; Mickiewicz, Marcin; Frymus, Tadeusz; Markowska-Daniel, Iwona; Bagnicka, Emilia; Kaba, Jarosław

    2017-01-01

    To determine references intervals for echocardiographic measurements in adult dairy goats. 125 clinically healthy, adult dairy goats aged 2-9 years, belonging to two breeds-Polish Fawn Improved (PFI, n = 64, weight range from 46 to 73, median of 58.5kg) and Polish White Improved (PWI, n = 61, weight range from 48 to 80 kg, median of 67.9kg), closely related to French Alpine and Saanen, respectively. Non-invasive transthoracic echocardiography examination was performed in unsedated goats in a standing position. Two-dimensional, M-mode and pulsed wave Doppler measurements were obtained. A non-parametric method was applied for determination of reference intervals. Measurements for the two breeds were compared using an analysis of covariance to control for their body weight. Repeatability was assessed using a between-day coefficient of variation and a coefficient of repeatability. Following reference intervals were determined: aortic diameter in diastole 2.2-3.3, left atrial diameter in systole 2.5-4.3cm cm, the ratio of the left atrial diameter to the aortic diameter 0.96-1.5, right ventricular internal diameter in diastole 0.4-1.7cm, left ventricular internal diameter in systole and diastole 1.8-3.2 and 3.2-5.6 cm, respectively, inter-ventricular septum thickness in systole and diastole 0.7-1.5 and 0.5-1.1cm, respectively, left ventricular posterior-wall in systole and diastole 0.8-1.6 and 0.5-1.2cm, respectively, E-point to septal separation 0.3-0.8cm, left ventricular fractional shortening 28-54%, left ventricular ejection fraction 55-86%, maximum Left and Right Ventricular Outflow Tract velocity 80-140 cm/s and 70-130 cm/s, respectively Left and Right Ventricular Outflow Tract pressure gradient 2.5-8.9mmHg and 1.9-6.5mmHg, respectively. Most of the differences between the two breeds could be attributed to different body weight. The study provides echocardiographic reference intervals determined on the highest sample of apparently healthy goats so far enrolled.

  19. Prevalence of normal TSH value among patients with autonomously functioning thyroid nodule.

    Science.gov (United States)

    Treglia, Giorgio; Trimboli, Pierpaolo; Verburg, Frederik A; Luster, Markus; Giovanella, Luca

    2015-07-01

    International guidelines significantly diverge on the effectiveness of thyroid scintigraphy (TS) in the initial work-up of thyroid nodules. In particular, the role of TS to detect or exclude the presence of autonomously functioning thyroid nodules (AFTN) in patients with normal serum thyrotropin (TSH) is still a matter to debate. Here, we aimed to review the literature on the prevalence of normal TSH value among patients with AFTN and meta-analyse data of the retrieved eligible papers. A comprehensive literature search of studies published from January 2000 to December 2014 on AFTN detected by TS was performed. Records reporting serum TSH values in AFTN were selected. Pooled prevalence of AFTN with normal TSH values was calculated on a per-patient analysis including 95% confidence intervals (95% CI). Eight records including 2761 AFTN were selected for the meta-analysis. Pooled prevalence of AFTN with normal TSH detected by TS was 50% (95% CI: 32-68%). Selection bias in the included studies and heterogeneity among studies were potential limitations of the meta-analysis. Present meta-analysis shows that about one in two patients with AFTN demonstrated by TS has a TSH value within normal references. As a consequence, TSH measurement may not be considered as effective as a single tool to detect or exclude AFTN, and TS remains mandatory. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  20. Reference intervals in evaluation of maternal thyroid function of Manipuri women

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    Felix K Jebasingh

    2016-01-01

    Full Text Available Context: The population of Manipur is of different ethnic background from the rest of the country. Several authors have suggested population/ethnic and laboratory specific reference range of maternal thyroid profile of different trimesters. Aims: To find the reference range of thyroid stimulating hormone (TSH, total thyroxine (TT4 and total tri-iodothyronine (TT3 levels for normal pregnant women of native Manipur descendants. Settings and Design: The cross-sectional study was conducted at a teaching Institute after ethical clearance was obtained. Subjects and Methods: A reference populations of 375 normal pregnant women were established after screening about 600 pregnant women. The study excluded patients with hyperemesis gravid arum, past history or family history of thyroid disorders as well as the connective tissue disorders, WHO grade 1 or 2 goiter, or any medications that alter thyroid functions. The serum levels of TSH, TT4, and TT3 were measured using chemiluminescence assay. Statistical Analysis Used: Data for TT3 and TT4 were expressed as mean ± standard deviation, median and 5–95th percentiles. Results: The mean TSH in the three trimesters was 1.06 + 0.45, 1.23 + 0.30, and 1.25 + 0.36, respectively. The normal reference range thus was different from that of the kit reference range. On comparing to the Indian normative reference for the pregnant women, our results were not similar. However, the values were near similar to that of the American Thyroid Association guidelines. Conclusions: We conclude our study results with a new reference range for the pregnant population in Manipur and also emphasis the use of trimester-specific reference range of thyroid hormone.

  1. National Survey of Adult and Pediatric Reference Intervals in Clinical Laboratories across Canada: A Report of the CSCC Working Group on Reference Interval Harmonization.

    Science.gov (United States)

    Adeli, Khosrow; Higgins, Victoria; Seccombe, David; Collier, Christine P; Balion, Cynthia M; Cembrowski, George; Venner, Allison A; Shaw, Julie

    2017-11-01

    Reference intervals are widely used decision-making tools in laboratory medicine, serving as health-associated standards to interpret laboratory test results. Numerous studies have shown wide variation in reference intervals, even between laboratories using assays from the same manufacturer. Lack of consistency in either sample measurement or reference intervals across laboratories challenges the expectation of standardized patient care regardless of testing location. Here, we present data from a national survey conducted by the Canadian Society of Clinical Chemists (CSCC) Reference Interval Harmonization (hRI) Working Group that examines variation in laboratory reference sample measurements, as well as pediatric and adult reference intervals currently used in clinical practice across Canada. Data on reference intervals currently used by 37 laboratories were collected through a national survey to examine the variation in reference intervals for seven common laboratory tests. Additionally, 40 clinical laboratories participated in a baseline assessment by measuring six analytes in a reference sample. Of the seven analytes examined, alanine aminotransferase (ALT), alkaline phosphatase (ALP), and creatinine reference intervals were most variable. As expected, reference interval variation was more substantial in the pediatric population and varied between laboratories using the same instrumentation. Reference sample results differed between laboratories, particularly for ALT and free thyroxine (FT4). Reference interval variation was greater than test result variation for the majority of analytes. It is evident that there is a critical lack of harmonization in laboratory reference intervals, particularly for the pediatric population. Furthermore, the observed variation in reference intervals across instruments cannot be explained by the bias between the results obtained on instruments by different manufacturers. Copyright © 2017 The Canadian Society of Clinical Chemists

  2. A Multicenter Reference Intervals Study for Specific Proteins in China

    Science.gov (United States)

    Qin, Xuzhen; Tang, Guodong; Qiu, Ling; Li, Peng Chang; Xia, Liangyu; Chen, Ming; Tao, Zhihua; Li, Shijun; Liu, Min; Wang, Liang; Gao, Shang; Yu, Songlin; Cheng, Xinqi; Han, Jianhua; Hou, Li’an; Kawano, Reo; Ichihara, Kiyoshi

    2015-01-01

    Abstract A multicenter study conducted in healthy population of 6 cities from the 4 corners and central China for 7 serum-specific proteins to identify the sources of variation and establish the reference intervals on 2 automation platforms. A total of 3148 subjects aged 19 to 64 years old were enrolled in this study to ensure at least 120 participants in each 10-year age group and each city. The majority of samples were transported to central laboratory and measured on both Beckman AU5800 and Immage 800 analytical systems. Three-level nested ANOVA, multiple regression analysis, and the scatter plot were used to explore the variations from sex, age, region, BMI, cigarette smoking, and so on. The latent abnormal value exclusion (LAVE) method was applied at the time of computing RIs as a method for secondary exclusion. Regionality was not observed in any of the immunoassay in China. Variations for sex were significant for IgM among the immune analytes. For CRP and hsCRP results with turbidimetry method (Beckman Coulter AU5800) were lower than the nephelometry method (Beckman Immage). The LAVE method did not affect the RIs computed for the majority of analytes except C4, CRP, and hsCRP. In the scatter plot at the age of 45 years old C3, C4, and IgM reached an inflection point, accordingly RIs were separated by the age group. With the lack of regional differences and the well-standardized status of test results, the RIs of C3, IgG, IgA, IgM derived from this nationwide study can be used for the entire Chinese population. C4, CRP, and hsCRP were affected by different platforms and gender was a significant source of variation for IgM, so they had separated RIs. PMID:26656356

  3. Pediatric Reference Intervals for Biochemical Markers: Gaps and Challenges, Recent National Initiatives and Future Perspectives.

    Science.gov (United States)

    Tahmasebi, Houman; Higgins, Victoria; Fung, Angela W S; Truong, Dorothy; White-Al Habeeb, Nicole M A; Adeli, Khosrow

    2017-03-01

    Reference intervals provide valuable information to medical practitioners in their interpretation of quantitative laboratory test results, and are critical in the assessment of patient health and in clinical decision-making. The reference interval serves as a health-associated benchmark with which to compare an individual test result. While the concept of reference intervals and their utility appear straightforward, the process of establishing accurate and reliable reference intervals is considerably complex and involved. Currently, many pediatric laboratory tests are inappropriately interpreted using reference intervals derived from either adult populations, hospitalized pediatric populations, or from outdated and/or inaccurate technology. Thus, many pediatric reference intervals used in diagnostic laboratories are incomplete and may be inappropriate for clinical use. The use of inappropriate reference intervals impacts clinical decision-making and has potential detrimental effects on the quality of patient healthcare including misdiagnosis, delayed diagnosis, inappropriate treatments, and patient risk. These are critical gaps in pediatric healthcare and it is imperative to update and establish appropriate reference intervals for pediatric populations based on specific age- and sex-stratifications. In the present review, specific issues, challenges and deficiencies in pediatric reference intervals for biochemical markers will be discussed. Early studies using hospitalized patients will be examined, followed by a review of recent national and global initiatives on establishing reference intervals from healthy pediatric population. We will highlight the achievements and milestones of the Canadian CALIPER project, including the establishment of a comprehensive biobank and database which has addressed several of these critical gaps. CALIPER's mandate is to establish and provide comprehensive, up-to-date pediatric reference intervals to all biochemical markers of

  4. Validity of establishing pediatric reference intervals based on hospital patient data: a comparison of the modified Hoffmann approach to CALIPER reference intervals obtained in healthy children.

    Science.gov (United States)

    Shaw, Julie L V; Cohen, Ashley; Konforte, Danijela; Binesh-Marvasti, Tina; Colantonio, David A; Adeli, Khosrow

    2014-02-01

    To compare pediatric reference intervals calculated using hospital-based patient data with those calculated using samples collected from healthy children in the community as part of the CALIPER study. Hospital-based data for 13 analytes (calcium, phosphate, iron, ALP, cholesterol, triglycerides, creatinine, direct bilirubin, total bilirubin, ALT, AST, albumin and magnesium), measured on the Vitros 5600, collected between 2007 and 2011 were obtained. The data for each analyte were partitioned by age and gender as previously defined by the CALIPER study. Outliers in each partition were removed using the Tukey method. The cumulative distribution function (cdf) was then determined for each analyte value following which, the inverse cdf values of a standard Gaussian distribution were calculated. The analyte values were plotted against the inverse cdf of the standard Gaussian distribution. Piece-wise regression determined the linear portion of the resulting graph using the statistical software R. Linear regression determined an equation for the linear portion in each partition and reference intervals were calculated by extrapolating to identify the 2.5th and 97.5th centiles in each partition based on the inverse cdf values (which would correspond to the values -1.96 and 1.96 of the Gaussian distribution). Using the 90% confidence intervals for the reference intervals defined by CALIPER and the Reference Change Value (RCV) as the criteria, these calculated reference intervals were compared to those reported previously by CALIPER. Reference samples were also measured on the Vitros 5600 analyzer in an attempt to validate the calculated reference intervals. In general, the reference intervals calculated from hospital-based data were generally wider than those calculated by CALIPER. None of the reference intervals calculated using the Hoffmann approach fell completely within the 90% confidence intervals calculated by CALIPER. These results suggest that calculating pediatric

  5. [Harmonization of TSH Measurements.

    Science.gov (United States)

    Takeoka, Keiko; Hidaka, Yoh; Hishinuma, Akira; Ikeda, Katsuyoshi; Okubo, Shigeo; Tsuchiya, Tatsuyuki; Hashiguchi, Teruto; Furuta, Koh; Hotta, Taeko; Matsushita, Kazuyuki; Matsumoto, Hiroyuki; Murakami, Masami; Maekawa, Masato

    2016-05-01

    The measured concentration of thyroid stimulating hormone (TSH) differs depending on the reagents used. Harmonization of TSH is crucial because the decision limits are described in current clinical practice guide- lines as absolute values, e.g. 2.5 mIU/L in early pregnancy. In this study, we tried to harmonize the report- ed concentrations of TSH using the all-procedure trimmed mean. TSH was measured in 146 serum samples, with values ranging from 0.01 to 18.8 mIU/L, using 4 immunoassays. The concentration of TSH was highest with E test TOSOH and lowest with LUMIPULSE. The concentrations with each reagent were recalculated with the following formulas: E test TOSOH 0.855x-0.014; ECLusys 0.993x+0.079; ARCHITECT 1.041x- 0.010; and LUMIPULSE 1.096x-0.015. Recalculation eliminated the between-assay discrepancy. These formulas may be used until harmonization of TSH is achieved by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC).

  6. CLSI-based transference of CALIPER pediatric reference intervals to Beckman Coulter AU biochemical assays.

    Science.gov (United States)

    Abou El Hassan, Mohamed; Stoianov, Alexandra; Araújo, Petra A T; Sadeghieh, Tara; Chan, Man Khun; Chen, Yunqi; Randell, Edward; Nieuwesteeg, Michelle; Adeli, Khosrow

    2015-11-01

    The CALIPER program has established a comprehensive database of pediatric reference intervals using largely the Abbott ARCHITECT biochemical assays. To expand clinical application of CALIPER reference standards, the present study is aimed at transferring CALIPER reference intervals from the Abbott ARCHITECT to Beckman Coulter AU assays. Transference of CALIPER reference intervals was performed based on the CLSI guidelines C28-A3 and EP9-A2. The new reference intervals were directly verified using up to 100 reference samples from the healthy CALIPER cohort. We found a strong correlation between Abbott ARCHITECT and Beckman Coulter AU biochemical assays, allowing the transference of the vast majority (94%; 30 out of 32 assays) of CALIPER reference intervals previously established using Abbott assays. Transferred reference intervals were, in general, similar to previously published CALIPER reference intervals, with some exceptions. Most of the transferred reference intervals were sex-specific and were verified using healthy reference samples from the CALIPER biobank based on CLSI criteria. It is important to note that the comparisons performed between the Abbott and Beckman Coulter assays make no assumptions as to assay accuracy or which system is more correct/accurate. The majority of CALIPER reference intervals were transferrable to Beckman Coulter AU assays, allowing the establishment of a new database of pediatric reference intervals. This further expands the utility of the CALIPER database to clinical laboratories using the AU assays; however, each laboratory should validate these intervals for their analytical platform and local population as recommended by the CLSI. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  7. Hematology and biochemistry reference intervals for Ontario commercial nursing pigs close to the time of weaning.

    Science.gov (United States)

    Perri, Amanda M; O'Sullivan, Terri L; Harding, John C S; Wood, R Darren; Friendship, Robert M

    2017-04-01

    The evaluation of pig hematology and biochemistry parameters is rarely done largely due to the costs associated with laboratory testing and labor, and the limited availability of reference intervals needed for interpretation. Within-herd and between-herd biological variation of these values also make it difficult to establish reference intervals. Regardless, baseline reference intervals are important to aid veterinarians in the interpretation of blood parameters for the diagnosis and treatment of diseased swine. The objective of this research was to provide reference intervals for hematology and biochemistry parameters of 3-week-old commercial nursing piglets in Ontario. A total of 1032 pigs lacking clinical signs of disease from 20 swine farms were sampled for hematology and iron panel evaluation, with biochemistry analysis performed on a subset of 189 randomly selected pigs. The 95% reference interval, mean, median, range, and 90% confidence intervals were calculated for each parameter.

  8. An Improved Auto-Generation System to Obtain Reference Intervals for Laboratory Medicine

    OpenAIRE

    Kim, Hyung Hoi; Hong, Hae Sook; Kim, Shine Young; Tran, Tung; Lee, Ji Min; Kim, Hwa Sun; Cho, Hune

    2010-01-01

    Objectives Reference values are highly required parameters for all tests in the clinical laboratory, and the supplementary provision of reliable reference intervals is an important task for both clinical laboratories and diagnostic test manufacturers. Despite the progress that has been made in the conceptual aspects of reference intervals, in practice their use is still not completely satisfactory. Most of the laboratories have used various methods to calculate statistic-based reference inter...

  9. Uptake of recommended common reference intervals for chemical pathology in Australia.

    Science.gov (United States)

    Jones, Graham Rd; Koetsier, Sabrina

    2017-05-01

    Background Reference intervals are a vital part of reporting numerical pathology results. It is known, however, that variation in reference intervals between laboratories is common, even when analytical methods support common reference intervals. In response to this, in Australia, the Australasian Association of Clinical Biochemists together with the Royal College of Pathologists of Australasia published in 2014 a set of recommended common reference intervals for 11 common serum analytes (sodium, potassium, chloride, bicarbonate, creatinine male, creatinine female, calcium, calcium adjusted for albumin, phosphate, magnesium, lactate dehydrogenase, alkaline phosphatase and total protein). Methods Uptake of recommended common reference intervals in Australian laboratories was assessed using data from four annual cycles of the RCPAQAP reference intervals external quality assurance programme. Results Over three years, from 2013 to 2016, the use of the recommended upper and lower reference limits has increased from 40% to 83%. Nearly half of the intervals in use by enrolled laboratories in 2016 have been changed in this time period, indicating an active response to the guidelines. Conclusions These data support the activities of the Australasian Association of Clinical Biochemists and Royal College of Pathologists of Australasia in demonstrating a change in laboratory behaviour to reduce unnecessary variation in reference intervals and thus provide a consistent message to doctor and patients irrespective of the laboratory used.

  10. Population-Based Pediatric Reference Intervals in General Clinical Chemistry: A Swedish Survey.

    Science.gov (United States)

    Ridefelt, Peter

    2015-01-01

    Very few high quality studies on pediatric reference intervals for general clinical chemistry and hematology analytes have been performed. Three recent prospective community-based projects utilising blood samples from healthy children in Sweden, Denmark and Canada have substantially improved the situation. The Swedish survey included 701 healthy children. Reference intervals for general clinical chemistry and hematology were defined.

  11. Age- and sex-dependent reference intervals for D-dimer

    DEFF Research Database (Denmark)

    Haase, Christine; Joergensen, Maja; Ellervik, Christina

    2013-01-01

    A low D-dimer is commonly used to exclude venous thromboembolism in low risk patients. However, the reference intervals are poorly defined and D-dimer has been shown to increase by patient age. We aimed to establish age- and sex-dependent D-dimer reference intervals and to test the consequence of...... of different cut-off limits....

  12. A combined approach to generate laboratory reference intervals using unbalanced longitudinal data.

    Science.gov (United States)

    Vogel, Mandy; Kirsten, Toralf; Kratzsch, Jürgen; Engel, Christoph; Kiess, Wieland

    2017-07-26

    The interpretation of individual laboratory test results requires the availability of population-based reference intervals. In children, reference interval estimation has to consider frequently the strong age-dependency. Generally, for the construction of reference intervals, a sufficiently large number of independent measurement values is required. Data selections from hospitals or cohort studies often comprise dependencies violating the independence assumption. In this article, we propose a combination of LMS-like (mean, M; coefficient of variation, S; skewness, λ or L) and resampling methods to overcome this drawback. The former is recommended by the World Health Organization (WHO) for the construction of continuous reference intervals of anthropometric measurements in children. The approach allows the inclusion of dependent measurements, for example, repeated measurements per subject. It also provides pointwise confidence envelopes as a measure of reliability. The combination of LMS-type methods and resampling provides a feasible approach to estimate age-dependent percentiles and reference intervals using unbalanced longitudinal data.

  13. An unsupervised learning method to identify reference intervals from a clinical database.

    Science.gov (United States)

    Poole, Sarah; Schroeder, Lee Frederick; Shah, Nigam

    2016-02-01

    Reference intervals are critical for the interpretation of laboratory results. The development of reference intervals using traditional methods is time consuming and costly. An alternative approach, known as an a posteriori method, requires an expert to enumerate diagnoses and procedures that can affect the measurement of interest. We develop a method, LIMIT, to use laboratory test results from a clinical database to identify ICD9 codes that are associated with extreme laboratory results, thus automating the a posteriori method. LIMIT was developed using sodium serum levels, and validated using potassium serum levels, both tests for which harmonized reference intervals already exist. To test LIMIT, reference intervals for total hemoglobin in whole blood were learned, and were compared with the hemoglobin reference intervals found using an existing a posteriori approach. In addition, prescription of iron supplements were used to identify individuals whose hemoglobin levels were low enough for a clinician to choose to take action. This prescription data indicating clinical action was then used to estimate the validity of the hemoglobin reference interval sets. Results show that LIMIT produces usable reference intervals for sodium, potassium and hemoglobin laboratory tests. The hemoglobin intervals produced using the data driven approaches consistently had higher positive predictive value and specificity in predicting an iron supplement prescription than the existing intervals. LIMIT represents a fast and inexpensive solution for calculating reference intervals, and shows that it is possible to use laboratory results and coded diagnoses to learn laboratory test reference intervals from clinical data warehouses. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Determination of haematological and biochemical reference intervals for infants and children in Gabon

    OpenAIRE

    Humberg, Alexander

    2011-01-01

    Previously studies show ethnic differences in haematological reference values, but the reference intervals used in African countries often derive from Caucasian or Western populations. The main aim of this thesis was to establish haematological and biochemical reference intervals for children in Lambaréné, Gabon, aged 4 weeks to 9 weeks and 1 year to 6 years. The children found healthy by physical examination were seen at the Medical Research Unit at the Albert Schweitzer Hospital in Lamb...

  15. The Canadian laboratory initiative on pediatric reference intervals: A CALIPER white paper.

    Science.gov (United States)

    Adeli, Khosrow; Higgins, Victoria; Trajcevski, Karin; White-Al Habeeb, Nicole

    2017-09-01

    Laboratory investigations provide physicians with objective data to aid in disease diagnosis, clinical decision making, and patient follow up. Clinical interpretation of laboratory test results relies heavily on the availability of appropriate population-based reference intervals (i.e. normative values) or decision limits developed through clinical outcome studies. Although reference intervals are fundamental to accurate laboratory test interpretation, and thus critically important to healthcare, the need for sound evidence-based reference intervals has been largely overlooked, particularly in the pediatric population. In the field of pediatric laboratory medicine, accurate age- and sex-specific reference intervals established using samples from healthy children and adolescents have not been readily available, forcing many clinical laboratories to report adult reference intervals with pediatric test results. When pediatric reference intervals are available, they have often been established with a small sample size, inpatient or outpatient samples, outdated methodologies, and/or inappropriate statistical procedures. To address these unacceptable limitations, several national and global initiatives have begun to close the critical evidence gaps in pediatric reference intervals. Notably, the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) has made significant strides towards improving pediatric healthcare in Canada and globally. The present report is a white paper summarizing CALIPER, and provides a comprehensive compendium of the data generated through this project over the past decade as a single resource for clinical laboratory specialists, clinicians, and other healthcare workers. CALIPER launched an outreach campaign in 2008 to recruit healthy community children and adolescents, and developed a robust statistical algorithm, in accordance with the Clinical and Laboratory Standards Institute (CLSI) guidelines, to develop accurate age- and

  16. ESTABLISHMENT OF A FIBRINOGEN REFERENCE INTERVAL IN ORNATE BOX TURTLES (TERRAPENE ORNATA ORNATA).

    Science.gov (United States)

    Parkinson, Lily; Olea-Popelka, Francisco; Klaphake, Eric; Dadone, Liza; Johnston, Matthew

    2016-09-01

    This study sought to establish a reference interval for fibrinogen in healthy ornate box turtles ( Terrapene ornata ornata). A total of 48 turtles were enrolled, with 42 turtles deemed to be noninflammatory and thus fitting the inclusion criteria and utilized to estimate a fibrinogen reference interval. Turtles were excluded based upon physical examination and blood work abnormalities. A Shapiro-Wilk normality test indicated that the noninflammatory turtle fibrinogen values were normally distributed (Gaussian distribution) with an average of 108 mg/dl and a 95% confidence interval of the mean of 97.9-117 mg/dl. Those turtles excluded from the reference interval because of abnormalities affecting their health had significantly different fibrinogen values (P = 0.313). A reference interval for healthy ornate box turtles was calculated. Further investigation into the utility of fibrinogen measurement for clinical usage in ornate box turtles is warranted.

  17. Evaluation of locally established reference intervals for hematology and biochemistry parameters in Western Kenya.

    Science.gov (United States)

    Odhiambo, Collins; Oyaro, Boaz; Odipo, Richard; Otieno, Fredrick; Alemnji, George; Williamson, John; Zeh, Clement

    2015-01-01

    Important differences have been demonstrated in laboratory parameters from healthy persons in different geographical regions and populations, mostly driven by a combination of genetic, demographic, nutritional, and environmental factors. Despite this, European and North American derived laboratory reference intervals are used in African countries for patient management, clinical trial eligibility, and toxicity determination; which can result in misclassification of healthy persons as having laboratory abnormalities. An observational prospective cohort study known as the Kisumu Incidence Cohort Study (KICoS) was conducted to estimate the incidence of HIV seroconversion and identify determinants of successful recruitment and retention in preparation for an HIV vaccine/prevention trial among young adults and adolescents in western Kenya. Laboratory values generated from the KICoS were compared to published region-specific reference intervals and the 2004 NIH DAIDS toxicity tables used for the trial. About 1106 participants were screened for the KICoS between January 2007 and June 2010. Nine hundred and fifty-three participants aged 16 to 34 years, HIV-seronegative, clinically healthy, and non-pregnant were selected for this analysis. Median and 95% reference intervals were calculated for hematological and biochemistry parameters. When compared with both published region-specific reference values and the 2004 NIH DAIDS toxicity table, it was shown that the use of locally established reference intervals would have resulted in fewer participants classified as having abnormal hematological or biochemistry values compared to US derived reference intervals from DAIDS (10% classified as abnormal by local parameters vs. >40% by US DAIDS). Blood urea nitrogen was most often out of range if US based intervals were used: 83% by US based reference intervals. Differences in reference intervals for hematological and biochemical parameters between western and African populations

  18. Comparison of method-related reference intervals for thyroid hormones: studies from a prospective reference population and a literature review.

    Science.gov (United States)

    Barth, Julian H; Luvai, Ahai; Jassam, Nuthar; Mbagaya, Wycliffe; Kilpatrick, Eric S; Narayanan, Deepa; Spoors, Shirley

    2018-01-01

    Introduction Reference intervals are dependent on the reference population, the analytical methods and the way the data are handled statistically. Individual method-related differences have been studied but the comparative differences in reference intervals have not. Methods We studied a reference population of healthy adult subjects and measured free thyroxine and thyroid-stimulating hormone by the four most commonly used analytical platforms used in the UK. Subjects were excluded if they were > 65 years or had positive thyroid peroxidase antibodies. We also performed a systematic literature review of thyroid hormone reference interval studies in non-pregnant adults. Results In total, 303 subjects were recruited and 42 excluded. The central 95th centile values for thyroid-stimulating hormone (mIU/L) were Abbott Architect (0.51-3.67); Beckman Unicel DxI (0.57-3.60); Roche Cobas (0.60-4.31) and Siemens Advia Centaur XP (0.63-4.29). The 95th centile values for thyroxine (pmol/L) were Abbott Architect (10.6-15.5); Beckman Unicel DxI (7.9-13.0); Roche Cobas (12.5-19.6) and Siemens Advia Centaur XP (11.8-19.0). We identified 55 papers describing thyroid reference intervals in male and non-pregnant female adults. The values for upper and lower reference intervals by manufacturer varied but were not significantly different for thyroid-stimulating hormone but were for thyroxine. Discussion Our study demonstrates clearly that there are marked variations in the reference intervals for thyroid hormones between analytical platforms. There is an urgent need for standardization of thyroid hormone assays to permit transferability of results. Until then, guidelines will need to reflect this method-related difference.

  19. Collaborative derivation of reference intervals for major clinical laboratory tests in Japan.

    Science.gov (United States)

    Ichihara, Kiyoshi; Yomamoto, Yoshikazu; Hotta, Taeko; Hosogaya, Shigemi; Miyachi, Hayato; Itoh, Yoshihisa; Ishibashi, Midori; Kang, Dongchon

    2016-05-01

    Three multicentre studies of reference intervals were conducted recently in Japan. The Committee on Common Reference Intervals of the Japan Society of Clinical Chemistry sought to establish common reference intervals for 40 laboratory tests which were measured in common in the three studies and regarded as well harmonized in Japan. The study protocols were comparable with recruitment mostly from hospital workers with body mass index ≤28 and no medications. Age and sex distributions were made equal to obtain a final data size of 6345 individuals. Between-subgroup differences were expressed as the SD ratio (between-subgroup SD divided by SD representing the reference interval). Between-study differences were all within acceptable levels, and thus the three datasets were merged. By adopting SD ratio ≥0.50 as a guide, sex-specific reference intervals were necessary for 12 assays. Age-specific reference intervals for females partitioned at age 45 were required for five analytes. The reference intervals derived by the parametric method resulted in appreciable narrowing of the ranges by applying the latent abnormal values exclusion method in 10 items which were closely associated with prevalent disorders among healthy individuals. Sex- and age-related profiles of reference values, derived from individuals with no abnormal results in major tests, showed peculiar patterns specific to each analyte. Common reference intervals for nationwide use were developed for 40 major tests, based on three multicentre studies by advanced statistical methods. Sex- and age-related profiles of reference values are of great relevance not only for interpreting test results, but for applying clinical decision limits specified in various clinical guidelines. © The Author(s) 2015.

  20. Age-dependent reference intervals for estimated and measured glomerular filtration rate.

    Science.gov (United States)

    Pottel, Hans; Delanaye, Pierre; Weekers, Laurent; Selistre, Luciano; Goffin, Karolien; Gheysens, Olivier; Dubourg, Laurence

    2017-08-01

    Defining mean and reference intervals for glomerular filtration rate (GFR) has been the subject of only a limited number of studies and review articles, with contradicting statements about the mean. Normal measured GFR (mGFR) values of ∼120-130 mL/min/1.73 m 2 have long been the referenced values for young adults but seem to be too high according to recent studies. Reference intervals are difficult to define because of the age decline of GFR, which is also observed in healthy subjects. Little data are available for subjects >70 years of age. Based on the reference intervals for serum creatinine (SCr) and the recently published full-age spectrum (FAS) equation, we define simple age-dependent equations for the reference limits of GFR. The mGFR of 633 living potential kidney donors was used to validate the new formulae that define the reference interval. The reference limits for estimated GFR (eGFR), calculated by entering the reference limits for SCr into the FAS equation closely correspond with published reference limits for mGFR. Of the mGFRs of potential living kidney donors, 97.2% lie between the newly defined reference limits for GFR. SCr reference limits may serve to define age-dependent reference limits for eGFR and mGFR.

  1. Establishing reference intervals for galectin-3 concentrations in serum requires careful consideration of its biological determinants.

    Science.gov (United States)

    Krintus, Magdalena; Kozinski, Marek; Fabiszak, Tomasz; Kubica, Jacek; Panteghini, Mauro; Sypniewska, Grazyna

    2017-07-01

    Appropriately established reference intervals for laboratory biomarkers may help the interpretation of their results and facilitate clinical utilization. i) To determine reference intervals for serum galectin-3 measured using the Architect STAT immunoassay, and ii) to identify factors affecting galectin-3 concentrations. We recruited 533 questionnaire-identified apparently healthy individuals, in which laboratory biomarkers were used to detect asymptomatic myocardial injury and dysfunction, ongoing inflammation, hyperglycemia, dyslipidemia, and renal dysfunction. A final reference group of 180 subjects was selected. 2.5th and 97.5th percentiles of distribution of galectin-3 concentrations in the reference group (90% confidence interval) were 5.9 (5.0-6.8) and 18.1 (17.2-19.0) μg/L, respectively. Older age contributed to higher galectin-3 concentrations, but influenced derived reference intervals to a lesser extent. Other major determinants of galectin-3 concentrations observed in the questionnaire-screened population were not linked to galectin-3 in reference individuals. In aiming to decide if reference limits should be partitioned by age, we compared galectin-3 concentrations in subjects reference intervals for galectin-3 in which the effects of biological determinants were irrelevant. Although in healthy subjects age may affect galectin-3 release, this does not appear to necessitate age-related reference limits. Copyright © 2017. Published by Elsevier Inc.

  2. Pediatric Reference Intervals for Transferrin Saturation in the CALIPER Cohort of Healthy Children and Adolescents.

    Science.gov (United States)

    Higgins, Victoria; Chan, Man Khun; Adeli, Khosrow

    2017-03-01

    Transferrin saturation reference intervals specific for age and sex have not been previously reported for the pediatric population. The reference values for transferrin saturation have been previously reported to be lower in children compared to adults, caused by a combination of low serum iron and high serum transferrin levels in children, warranting specific reference intervals. Here we use the original iron and transferrin data from the CALIPER cohort to establish age- and sex-specific pediatric reference intervals for transferrin saturation. Iron and transferrin concentrations were measured in serum samples from the CALIPER cohort of healthy children and adolescents on the Abbott Architect c8000. Transferrin saturation was subsequently calculated and statistically relevant age- and sex-partitions were determined. After removing outliers, age- and sex-specific reference intervals with corresponding 90% confidence intervals were calculated using CLSI C28-A3 guidelines. Transferrin saturation required 3 separate age partitions, with an additional sex partition for 14-<19 year olds. Transferrin saturation was more variable during the first year of life, evident by a wider reference interval, which subsequently narrowed at one year until adolescence. Upon adolescence, a sex difference was apparent with females having lower percent transferrin saturation than males. Age- and sex-specific pediatric reference intervals for transferrin saturation were established based on a large cohort of healthy pediatric subjects. Transference studies suggest that these intervals established using Abbott assays are comparable to those on Beckman, Ortho, Roche, and Siemens assays. Individual laboratories should however verify these reference intervals for their individual instrument and local population as per CLSI guidelines.

  3. Parathyroid hormone: Data mining for age-related reference intervals in adults.

    Science.gov (United States)

    Farrell, Christopher-John L; Nguyen, Lan; Carter, Andrew C

    2018-02-01

    Age-related changes in parathyroid hormone (PTH) have been previously documented in adults. However, because of the limitations of traditional approaches to establishing reference intervals, age-related reference intervals have not been defined. We sought to use a data mining approach to derive age-related PTH reference intervals. Results from patients undergoing PTH testing over a 4-year period were extracted from the database of a private pathology laboratory in New South Wales, Australia. Patients were included in the study if they were 18 years or older and had simultaneous determination of PTH, serum calcium, estimated glomerular filtration rate and 25-hydroxyvitamin D (25-OHD). Patients with abnormalities of serum calcium or renal function were excluded. Bhattacharya analysis of log-transformed data was used to derive age-related PTH reference intervals across adulthood. Results were available for 33 652 subjects. Among patients with optimal 25-OHD status, older age was associated with higher PTH concentrations. Age-related reference intervals were derived and showed a 63% increase in the upper and lower reference limits between the youngest (18-29 years of age) and the oldest (80 years of age or older) age partitions. The appropriateness of using a single reference interval for patients of all ages was evaluated against objective criteria and was found to be unsatisfactory. Data mining was demonstrated to be a useful tool for establishing age-related PTH reference intervals. The technique demonstrated that increasing age is associated with higher PTH concentrations and that age-related reference intervals are important for accurate result interpretation. © 2017 John Wiley & Sons Ltd.

  4. Quality specifications for the extra-analytical phase of laboratory testing: Reference intervals and decision limits.

    Science.gov (United States)

    Ceriotti, Ferruccio

    2017-07-01

    Reference intervals and decision limits are a critical part of the clinical laboratory report. The evaluation of their correct use represents a tool to verify the post analytical quality. Four elements are identified as indicators. 1. The use of decision limits for lipids and glycated hemoglobin. 2. The use, whenever possible, of common reference values. 3. The presence of gender-related reference intervals for at least the following common serum measurands (besides obviously the fertility relate hormones): alkaline phosphatase (ALP), alanine aminotransferase (ALT), creatine kinase (CK), creatinine, gamma-glutamyl transferase (GGT), IgM, ferritin, iron, transferrin, urate, red blood cells (RBC), hemoglobin (Hb) and hematocrit (Hct). 4. The presence of age-related reference intervals. The problem of specific reference intervals for elderly people is discussed, but their use is not recommended; on the contrary it is necessary the presence of pediatric age-related reference intervals at least for the following common serum measurands: ALP, amylase, creatinine, inorganic phosphate, lactate dehydrogenase, aspartate aminotransferase, urate, insulin like growth factor 1, white blood cells, RBC, Hb, Hct, alfa-fetoprotein and fertility related hormones. The lack of such reference intervals may imply significant risks for the patients. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  5. Hematologic and serum chemistry reference intervals for free-ranging lions (Panthera leo).

    Science.gov (United States)

    Maas, Miriam; Keet, Dewald F; Nielen, Mirjam

    2013-08-01

    Hematologic and serum chemistry values are used by veterinarians and wildlife researchers to assess health status and to identify abnormally high or low levels of a particular blood parameter in a target species. For free-ranging lions (Panthera leo) information about these values is scarce. In this study 7 hematologic and 11 serum biochemistry values were evaluated from 485 lions from the Kruger National Park, South Africa. Significant differences between sexes and sub-adult (≤ 36 months) and adult (>36 months) lions were found for most of the blood parameters and separate reference intervals were made for those values. The obtained reference intervals include the means of the various blood parameter values measured in captive lions, except for alkaline phosphatase in the subadult group. These reference intervals can be utilized for free-ranging lions, and may likely also be used as reference intervals for captive lions. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. An unsupervised learning method to identify reference intervals from a clinical database

    OpenAIRE

    Poole, Sarah; Schroeder, Lee Frederick; Shah, Nigam

    2015-01-01

    Reference intervals are critical for the interpretation of laboratory results. The development of reference intervals using traditional methods is time consuming and costly. An alternative approach, known as an a posteriori method, requires an expert to enumerate diagnoses and procedures that can affect the measurement of interest. We develop a method, LIMIT, to use laboratory test results from a clinical database to identify ICD9 codes that are associated with extreme labor...

  7. Systematic review of serum steroid reference intervals developed using mass spectrometry.

    Science.gov (United States)

    Tavita, Nevada; Greaves, Ronda F

    2017-12-01

    The aim of this study was to perform a systematic review of the published literature to determine the available serum/plasma steroid reference intervals generated by mass spectrometry (MS) methods across all age groups in healthy subjects and to suggest recommendations to achieve common MS based reference intervals for serum steroids. MEDLINE, EMBASE and PubMed databases were used to conduct a comprehensive search for English language, MS-based reference interval studies for serum/plasma steroids. Selection of steroids to include was based on those listed in the Royal College of Pathologists of Australasia Quality Assurance Programs, Chemical Pathology, Endocrine Program. This methodology has been registered onto the PROSPERO International prospective register of systematic reviews (ID number: CRD42015029637). After accounting for duplicates, a total of 60 manuscripts were identified through the search strategy. Following critical evaluation, a total of 16 studies were selected. Of the 16 studies, 12 reported reference intervals for testosterone, 11 for 17 hydroxy-progesterone, nine for androstenedione, six for cortisol, three for progesterone, two for dihydrotestosterone and only one for aldosterone and dehydroepiandrosterone sulphate. No studies established MS-based reference intervals for oestradiol. As far as we are aware, this report provides the first comparison of the peer reviewed literature for serum/plasma steroid reference intervals generated by MS-based methods. The reference intervals based on these published studies can be used to inform the process to develop common reference intervals, and agreed reporting units for mass spectrometry based steroid methods. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  8. Reference intervals for serum concentrations of three bone turnover markers for men and women.

    Science.gov (United States)

    Michelsen, J; Wallaschofski, H; Friedrich, N; Spielhagen, C; Rettig, R; Ittermann, T; Nauck, M; Hannemann, A

    2013-12-01

    Bone turnover markers (BTMs) reflect the metabolic activity of bone tissue and can be used to monitor osteoporosis therapy. To adequately interpret BTMs, method-specific reference intervals are needed. We aimed to determine reference intervals for serum concentrations of intact amino-terminal propeptide of type I procollagen (PINP), bone-specific alkaline phosphatase (BAP) and carboxy-terminal telopeptide of type I collagen (CTX). We established a healthy reference population of 1107 men as well as 382 pre- and 450 postmenopausal women, who participated in the first follow-up of the Study of Health in Pomerania. Serum PINP, BAP and CTX concentrations were measured on the IDS-iSYS Automated System (Immunodiagnostic Systems, Frankfurt am Main, Germany). The reference interval was defined as the central 95% range. We determined age-specific reference intervals for PINP, BAP, and CTX for men by quantile regression. Reference intervals for women were age-independent. Reference intervals for men for PINP and CTX decreased with age (25-29year-old men: PINP 31.1-95.9ng/mL, CTX 0.12-0.83ng/mL; 75-79year-old men: PINP 15.7-68.1ng/mL, CTX 0.05-0.58ng/mL). The reference interval for men for BAP did not significantly change with age (25-29year-old men: 7.4-27.7ng/mL; 75-79year-old men: 7.6-24.4ng/mL). The reference intervals for 30-54year-old premenopausal women were: PINP 19.3-76.3ng/mL, BAP 6.0-22.7ng/mL, and CTX 0.05-0.67ng/mL. The reference intervals for 50-79year-old postmenopausal women were: PINP 18.2-102.3ng/mL, BAP 8.1-31.6ng/mL, and CTX 0.09-1.05ng/mL. An intensively characterized, large reference population free of bone-related diseases allowed us to determine robust reference intervals for serum concentrations of PINP, BAP and CTX. Our normative data may aid to interpret bone turnover in adult men and pre- and postmenopausal women. © 2013.

  9. Gestational age-specific reference intervals for 15 biochemical measurands during normal pregnancy in China.

    Science.gov (United States)

    Dai, Yanpeng; Liu, Junjie; Yuan, Enwu; Li, Yushan; Wang, Quanxian; Jia, Liting; Wang, Linkai; Su, Yanhua

    2017-01-01

    Aims Physiological changes that occur during pregnancy can influence biochemical parameters. Therefore, using reference intervals based on specimens from non-pregnant women to interpret laboratory results during pregnancy may be inappropriate. This study aimed to establish the essential reference intervals for a range of analytes during pregnancy. Methods A cross-sectional study was performed in 13,656 healthy pregnant and 2634 non-pregnant women. Fifteen biochemical measurands relating to renal and hepatic function were analysed using an Olympus AU5400 analyzer (Olympus, Tokyo, Japan). All the laboratory results were checked for outliers using Dixon's test. Reference intervals were established using a non-parametric method. Results Alanine aminotransferase, aspartate aminotransferase, albumin, cholinesterase, creatinine, direct bilirubin, gamma-glutamyl transpeptidase, total bilirubin, total bile acid and total protein showed a decrease during the whole gestational period, while alkaline phosphatase and uric acid increased. Urea nitrogen, β 2 -microglobulin and cystatin-C fell significantly during the first trimester and then remained relatively stable until third trimester. Reference intervals of all the measurands during normal pregnancy have been established. Conclusions The reference intervals established here can be adopted in other clinical laboratories after appropriate validation. We verified the importance, for some measurands, of partitioning by gestational age when establishing reference intervals during pregnancy.

  10. Reference Intervals for Plasma Amyloid β in Korean Adults Without Cognitive Impairment.

    Science.gov (United States)

    Kim, Min Young; Kim, Kyu Nam; Cho, Hye Min; Lee, Duck Joo; Cho, Doo Yeoun

    2016-11-01

    Amyloid β (Aβ) peptides are important components of plaques in patients with Alzheimer's disease (AD). Recent studies suggest that a low plasma ratio of Aβ42 to Aβ40 may precede the development of the sporadic form of AD. The aim of this study was to establish reference intervals for plasma Aβ in Korean adults. A total of 370 apparently healthy individuals (181 males and 189 females aged 40-69 yr) without cognitive impairment were enrolled. Plasma concentrations of Aβ40 and Aβ42 were measured by using a human amyloid β assay kit (Immuno-Biological Laboratories, Japan). Reference intervals were established according to the "CLSI guidelines for defining, establishing, and verifying reference intervals in the clinical laboratory". There was no need to partition the data with respect to gender or age group. The 95th percentile reference intervals for Aβ40 and Aβ42 were 127-331 pg/mL and 2.31-19.84 pg/mL, respectively. The reference interval for the Aβ42/Aβ40 ratio was 0.011-0.092. Plasma Aβ concentrations obtained in this study could be used as reference intervals for clinical purposes.

  11. Reference Intervals of Alpha-Fetoprotein and Carcinoembryonic Antigen in the Apparently Healthy Population.

    Science.gov (United States)

    Zhang, Gao-Ming; Guo, Xu-Xiao; Ma, Xiao-Bo; Zhang, Guo-Ming

    2016-12-12

    BACKGROUND The aim of this study was to calculate 95% reference intervals and double-sided limits of serum alpha-fetoprotein (AFP) and carcinoembryonic antigen (CEA) according to the CLSI EP28-A3 guideline. MATERIAL AND METHODS Serum AFP and CEA values were measured in samples from 26 000 healthy subjects in the Shuyang area receiving general health checkups. The 95% reference intervals and upper limits were calculated by using MedCalc. RESULTS We provided continuous reference intervals from 20 years old to 90 years old for AFP and CEA. The reference intervals were: AFP, 1.31-7.89 ng/ml (males) and 1.01-7.10 ng/ml (females); CEA, 0.51-4.86 ng/ml (males) and 0.35-3.45ng/ml (females). AFP and CEA were significantly positively correlated with age in both males (r=0.196 and r=0.198) and females (r=0.121 and r=0.197). CONCLUSIONS Different races or populations and different detection systems may result in different reference intervals for AFP and CEA. Continuous reference intervals of age changes are more accurate than age groups.

  12. SENIORLAB: a prospective observational study investigating laboratory parameters and their reference intervals in the elderly.

    Science.gov (United States)

    Risch, Martin; Nydegger, Urs; Risch, Lorenz

    2017-01-01

    In clinical practice, laboratory results are often important for making diagnostic, therapeutic, and prognostic decisions. Interpreting individual results relies on accurate reference intervals and decision limits. Despite the considerable amount of resources in clinical medicine spent on elderly patients, accurate reference intervals for the elderly are rarely available. The SENIORLAB study set out to determine reference intervals in the elderly by investigating a large variety of laboratory parameters in clinical chemistry, hematology, and immunology. The SENIORLAB study is an observational, prospective cohort study. Subjectively healthy residents of Switzerland aged 60 years and older were included for baseline examination (n = 1467), where anthropometric measurements were taken, medical history was reviewed, and a fasting blood sample was drawn under optimal preanalytical conditions. More than 110 laboratory parameters were measured, and a biobank was set up. The study participants are followed up every 3 to 5 years for quality of life, morbidity, and mortality. The primary aim is to evaluate different laboratory parameters at age-related reference intervals. The secondary aims of this study include the following: identify associations between different parameters, identify diagnostic characteristics to diagnose different circumstances, identify the prevalence of occult disease in subjectively healthy individuals, and identify the prognostic factors for the investigated outcomes, including mortality. To obtain better grounds to justify clinical decisions, specific reference intervals for laboratory parameters of the elderly are needed. Reference intervals are obtained from healthy individuals. A major obstacle when obtaining reference intervals in the elderly is the definition of health in seniors because individuals without any medical condition and any medication are rare in older adulthood. Reference intervals obtained from such individuals cannot be

  13. Reference Intervals of Fibrosis Index Based on Four Indicators in Healthy Elderly Chinese.

    Science.gov (United States)

    Zhang, Guo-Ming; Xia, Yong-Jie

    2016-09-01

    The establishment of reference intervals of total bilirubin, Alanine aminotransferase (ALT), aspartate aminotransferases (AST), and creatinine provided necessary reference in screening and diagnosis of various kidney and liver diseases. However, these reference intervals were not available to estimate liver fibrosis degree. The purpose of this study is to establish the reference intervals of fibrosis index based on the four indicators (FIB-4) in apparently healthy elderly Chinese. A total of 24,949 blood specimens were collected by the standard procedures, and ALT, AST, and PLT were determined. FIB-4 were calculated by the following formula: FIB-4 = (age [years] × AST [U/l])/((PLT [10(9) /l]) × (ALT [U/l])(1/2) ).The elderly's FIB-4 were analyzed between the same age of different sexes and different ages of the same sex. Statistical data were analyzed by SPSS18.0 software. Reference intervals of FIB-4 index, established for the healthy elderly, were 0.9923-4.5424 for males and 0.9007-4.1934 for females. We established reference intervals of FIB-4 index. This research provided reference value that can be used by relevant clinicians and inspection officers. © 2016 Wiley Periodicals, Inc.

  14. Reference Intervals of Hematology and Clinical Chemistry Analytes for 1-Year-Old Korean Children.

    Science.gov (United States)

    Lee, Hye Ryun; Shin, Sue; Yoon, Jong Hyun; Roh, Eun Youn; Chang, Ju Young

    2016-09-01

    Reference intervals need to be established according to age. We established reference intervals of hematology and chemistry from community-based healthy 1-yr-old children and analyzed their iron status according to the feeding methods during the first six months after birth. A total of 887 children who received a medical check-up between 2010 and 2014 at Boramae Hospital (Seoul, Korea) were enrolled. A total of 534 children (247 boys and 287 girls) were enrolled as reference individuals after the exclusion of data obtained from children with suspected iron deficiency. Hematology and clinical chemistry analytes were measured, and the reference value of each analyte was estimated by using parametric (mean±2 SD) or nonparametric methods (2.5-97.5th percentile). Iron, total iron-binding capacity, and ferritin were measured, and transferrin saturation was calculated. As there were no differences in the mean values between boys and girls, we established the reference intervals for 1-yr-old children regardless of sex. The analysis of serum iron status according to feeding methods during the first six months revealed higher iron, ferritin, and transferrin saturation levels in children exclusively or mainly fed formula than in children exclusively or mainly fed breast milk. We established reference intervals of hematology and clinical chemistry analytes from community-based healthy children at one year of age. These reference intervals will be useful for interpreting results of medical check-ups at one year of age.

  15. Haematological and biochemical reference intervals for free-ranging brown bears (Ursus arctos) in Sweden

    Science.gov (United States)

    2014-01-01

    Background Establishment of haematological and biochemical reference intervals is important to assess health of animals on individual and population level. Reference intervals for 13 haematological and 34 biochemical variables were established based on 88 apparently healthy free-ranging brown bears (39 males and 49 females) in Sweden. The animals were chemically immobilised by darting from a helicopter with a combination of medetomidine, tiletamine and zolazepam in April and May 2006–2012 in the county of Dalarna, Sweden. Venous blood samples were collected during anaesthesia for radio collaring and marking for ecological studies. For each of the variables, the reference interval was described based on the 95% confidence interval, and differences due to host characteristics sex and age were included if detected. To our knowledge, this is the first report of reference intervals for free-ranging brown bears in Sweden. Results The following variables were not affected by host characteristics: red blood cell, white blood cell, monocyte and platelet count, alanine transaminase, amylase, bilirubin, free fatty acids, glucose, calcium, chloride, potassium, and cortisol. Age differences were seen for the majority of the haematological variables, whereas sex influenced only mean corpuscular haemoglobin concentration, aspartate aminotransferase, lipase, lactate dehydrogenase, β-globulin, bile acids, triglycerides and sodium. Conclusions The biochemical and haematological reference intervals provided and the differences due to host factors age and gender can be useful for evaluation of health status in free-ranging European brown bears. PMID:25139149

  16. Continuous age- and sex-adjusted reference intervals of urinary markers for cerebral creatine deficiency syndromes: a novel approach to the definition of reference intervals.

    Science.gov (United States)

    Mørkrid, Lars; Rowe, Alexander D; Elgstoen, Katja B P; Olesen, Jess H; Ruijter, George; Hall, Patricia L; Tortorelli, Silvia; Schulze, Andreas; Kyriakopoulou, Lianna; Wamelink, Mirjam M C; van de Kamp, Jiddeke M; Salomons, Gajja S; Rinaldo, Piero

    2015-05-01

    Urinary concentrations of creatine and guanidinoacetic acid divided by creatinine are informative markers for cerebral creatine deficiency syndromes (CDSs). The renal excretion of these substances varies substantially with age and sex, challenging the sensitivity and specificity of postanalytical interpretation. Results from 155 patients with CDS and 12 507 reference individuals were contributed by 5 diagnostic laboratories. They were binned into 104 adjacent age intervals and renormalized with Box-Cox transforms (Ξ). Estimates for central tendency (μ) and dispersion (σ) of Ξ were obtained for each bin. Polynomial regression analysis was used to establish the age dependence of both μ[log(age)] and σ[log(age)]. The regression residuals were then calculated as z-scores = {Ξ - μ[log(age)]}/σ[log(age)]. The process was iterated until all z-scores outside Tukey fences ±3.372 were identified and removed. Continuous percentile charts were then calculated and plotted by retransformation. Statistically significant and biologically relevant subgroups of z-scores were identified. Significantly higher marker values were seen in females than males, necessitating separate reference intervals in both adolescents and adults. Comparison between our reconstructed reference percentiles and current standard age-matched reference intervals highlights an underlying risk of false-positive and false-negative events at certain ages. Disease markers depending strongly on covariates such as age and sex require large numbers of reference individuals to establish peripheral percentiles with sufficient precision. This is feasible only through collaborative data sharing and the use of appropriate statistical methods. Broad application of this approach can be implemented through freely available Web-based software. © 2015 American Association for Clinical Chemistry.

  17. Hematologic and biochemical reference intervals for wild osprey nestlings (Pandion haliaetus).

    Science.gov (United States)

    Meredith, Anna; Surguine, Katie; Handel, Ian; Bronsvoort, Mark; Beard, Philippa; Thornton, Susan M; Wesche, Petra; Hart, Mike; Anderson, David; Dennis, Roy

    2012-09-01

    A retrospective study of blood samples from 95 osprey (Pandion haliaetus) nestlings from Scotland and England, collected opportunistically over a 10-yr period, was performed to determine hematologic and plasma biochemistry reference intervals. The age of the sampled nestlings was estimated to be between 4 and 8 wk. Ninety-five percent reference intervals were determined for all hematologic and biochemical variables using parametric and nonparametric methods as appropriate. No blood parasites were detected. This is the first published study providing baseline reference data for osprey nestlings, and it is hoped the data will be of use to wildlife veterinarians and biologists in assessing the health of this species.

  18. An automated and objective method for age partitioning of reference intervals based on continuous centile curves.

    Science.gov (United States)

    Yang, Qian; Lew, Hwee Yeong; Peh, Raymond Hock Huat; Metz, Michael Patrick; Loh, Tze Ping

    2016-10-01

    Reference intervals are the most commonly used decision support tool when interpreting quantitative laboratory results. They may require partitioning to better describe subpopulations that display significantly different reference values. Partitioning by age is particularly important for the paediatric population since there are marked physiological changes associated with growth and maturation. However, most partitioning methods are either technically complex or require prior knowledge of the underlying physiology/biological variation of the population. There is growing interest in the use of continuous centile curves, which provides seamless laboratory reference values as a child grows, as an alternative to rigidly described fixed reference intervals. However, the mathematical functions that describe these curves can be complex and may not be easily implemented in laboratory information systems. Hence, the use of fixed reference intervals is expected to continue for a foreseeable time. We developed a method that objectively proposes optimised age partitions and reference intervals for quantitative laboratory data (http://research.sph.nus.edu.sg/pp/ppResult.aspx), based on the sum of gradient that best describes the underlying distribution of the continuous centile curves. It is hoped that this method may improve the selection of age intervals for partitioning, which is receiving increasing attention in paediatric laboratory medicine. Copyright © 2016 Royal College of Pathologists of Australasia. Published by Elsevier B.V. All rights reserved.

  19. Comparison of haematology and biochemistry parameters in healthy South African infants with laboratory reference intervals.

    Science.gov (United States)

    Schmidt, B-M; Tameris, M; Geldenhuys, H; Luabeya, A; Bunyasi, E; Hawkridge, T; McClain, J B; Mahomed, H; Scriba, T J; McShane, H; Hatherill, M

    2018-01-01

    Paediatric laboratory reference intervals used in Africa and Asia may be derived from historical intervals of predominantly Caucasian infants in Europe or North America. These intervals may therefore not be compatible with the range of normality for developing country populations. We aimed to compare haematology and biochemistry parameters in healthy South African infants with local laboratory reference intervals. We compared the baseline haematology and biochemistry results of 634 (316 male and 318 female) HIV-unexposed infants, aged 3-6 months, living in a rural area of the Western Cape Province, South Africa, against laboratory reference intervals supplied by the South African National Health Laboratory Services (NHLS). We calculated the percentage of observed values out of bound (in terms of lower and upper limits) compared to laboratory reference intervals. Of the 634 healthy infants screened, 316 (49.84%) were male and 318 (50.16%) female. A majority (91.05%) had platelet counts above the laboratory reference interval upper limit (350 × 10 9 cells/l), while over half, 54.85% and 56.98% had mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) values below the lower limits of 77.0-105.0 fl and 26.0-34.0 pg, respectively. A small proportion were outside the reference limits for haematocrit, namely 15.71% below and 7.14% above the normal limits of 0.31-0.38 l/l. For male and female infants, 33.65% and 18.04% of alkaline phosphatase (ALP) values and 7.01% and 14.56% of alanine transaminase (ALT) values were above the upper limits, respectively. For male infants, 10.83% of gamma-glutamyl transferase (GGT) values, and for female infants, 31.11% of GGT values were below the lower limits of 12 U/l for males and 15 U/l for females. We observed no significant deviations (>10% out of bound) from NHLS reference intervals in the remaining haematology and biochemistry parameters measured. Haematology and biochemistry parameters in apparently healthy South

  20. Reference intervals for selected serum biochemistry analytes in cheetahs Acinonyx jubatus.

    Science.gov (United States)

    Hudson-Lamb, Gavin C; Schoeman, Johan P; Hooijberg, Emma H; Heinrich, Sonja K; Tordiffe, Adrian S W

    2016-02-26

    Published haematologic and serum biochemistry reference intervals are very scarce for captive cheetahs and even more for free-ranging cheetahs. The current study was performed to establish reference intervals for selected serum biochemistry analytes in cheetahs. Baseline serum biochemistry analytes were analysed from 66 healthy Namibian cheetahs. Samples were collected from 30 captive cheetahs at the AfriCat Foundation and 36 free-ranging cheetahs from central Namibia. The effects of captivity-status, age, sex and haemolysis score on the tested serum analytes were investigated. The biochemistry analytes that were measured were sodium, potassium, magnesium, chloride, urea and creatinine. The 90% confidence interval of the reference limits was obtained using the non-parametric bootstrap method. Reference intervals were preferentially determined by the non-parametric method and were as follows: sodium (128 mmol/L - 166 mmol/L), potassium (3.9 mmol/L - 5.2 mmol/L), magnesium (0.8 mmol/L - 1.2 mmol/L), chloride (97 mmol/L - 130 mmol/L), urea (8.2 mmol/L - 25.1 mmol/L) and creatinine (88 µmol/L - 288 µmol/L). Reference intervals from the current study were compared with International Species Information System values for cheetahs and found to be narrower. Moreover, age, sex and haemolysis score had no significant effect on the serum analytes in this study. Separate reference intervals for captive and free-ranging cheetahs were also determined. Captive cheetahs had higher urea values, most likely due to dietary factors. This study is the first to establish reference intervals for serum biochemistry analytes in cheetahs according to international guidelines. These results can be used for future health and disease assessments in both captive and free-ranging cheetahs.

  1. A systematic review of statistical methods used in constructing pediatric reference intervals.

    Science.gov (United States)

    Daly, Caitlin H; Liu, Xiaofeng; Grey, Vijay L; Hamid, Jemila S

    2013-09-01

    This study aims to investigate current medical literature with focus on statistical methods used to construct pediatric reference intervals and identify potential gaps within the process of reference interval estimation. A systematic review of methods was performed. Extensive search criteria were developed and search was conducted on Embase, Medline, and PubMed databases to identify relevant articles. The articles were further screened using predefined inclusion and exclusion criteria. The selected articles were then included in our final systematic review. Our review reveals that there are gaps within current methodology and reporting of pediatric reference intervals. Not all publications followed the Clinical and Laboratory Standards Institute (CLSI) guidelines, and there is a large variation in the methods used. Discrepancies particularly arose when reference intervals were calculated for partitions with small sample sizes. In addition, the dynamic nature of pediatric data was not mostly captured when certain partitioning techniques were used. There are areas within the pediatric reference interval development process that need attention. Partitioning methods particularly need to be explored with the goals of reducing subjectivity and enabling researchers to capture the best representative partitions possible. Moreover, the complicated nature of pediatric data often limits the sample size available for each partition and appropriate methods need to be considered in such cases. Researchers are also strongly encouraged to accompany their reference limits with confidence intervals to show sampling variability and demonstrate precision of their limits. These issues exemplify the need for a pediatric specific guideline that outlines a standardized way of establishing reference intervals. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  2. Reference intervals for 24 laboratory parameters determined in 24-hour urine collections.

    Science.gov (United States)

    Curcio, Raffaele; Stettler, Helen; Suter, Paolo M; Aksözen, Jasmin Barman; Saleh, Lanja; Spanaus, Katharina; Bochud, Murielle; Minder, Elisabeth; von Eckardstein, Arnold

    2016-01-01

    Reference intervals for many laboratory parameters determined in 24-h urine collections are either not publicly available or based on small numbers, not sex specific or not from a representative sample. Osmolality and concentrations or enzymatic activities of sodium, potassium, chloride, glucose, creatinine, citrate, cortisol, pancreatic α-amylase, total protein, albumin, transferrin, immunoglobulin G, α1-microglobulin, α2-macroglobulin, as well as porphyrins and their precursors (δ-aminolevulinic acid and porphobilinogen) were determined in 241 24-h urine samples of a population-based cohort of asymptomatic adults (121 men and 120 women). For 16 of these 24 parameters creatinine-normalized ratios were calculated based on 24-h urine creatinine. The reference intervals for these parameters were calculated according to the CLSI C28-A3 statistical guidelines. By contrast to most published reference intervals, which do not stratify for sex, reference intervals of 12 of 24 laboratory parameters in 24-h urine collections and of eight of 16 parameters as creatinine-normalized ratios differed significantly between men and women. For six parameters calculated as 24-h urine excretion and four parameters calculated as creatinine-normalized ratios no reference intervals had been published before. For some parameters we found significant and relevant deviations from previously reported reference intervals, most notably for 24-h urine cortisol in women. Ten 24-h urine parameters showed weak or moderate sex-specific correlations with age. By applying up-to-date analytical methods and clinical chemistry analyzers to 24-h urine collections from a large population-based cohort we provide as yet the most comprehensive set of sex-specific reference intervals calculated according to CLSI guidelines for parameters determined in 24-h urine collections.

  3. Investigation on reference intervals and regional differences of platelet indices in healthy Chinese Han adults.

    Science.gov (United States)

    Hong, Jiang; Min, Zhao; Bai-shen, Pan; Jie, Zhang; Ming-ting, Peng; Xian-zhang, Huang; Xiao-ke, Hao; Lan-lan, Wang; Xin, Zhang; Wei, Guo; Rui, Qiao; Wen-xiang, Chen; Xin-zhong, Wu; Yue-yun, Ma; Hong, Shang

    2015-01-01

    Reference intervals are important for interpretation of clinical laboratory tests. The platelet (PLT) indices such as the mean platelet volume (MPV) and platelet distribution width (PDW) are newer hematological parameters, which have been recently reported as clinically valuable biomarkers. However, there are not many studies that have estimated the reference intervals for these parameters in healthy Chinese Han adults. The objectives of this study were to establish reference values of PLT indices [including PLT count, MPV, PDW, platelet-large cell ratio (P-LCR), and plateletcrit (Pct)] for healthy Chinese Han adults. We also aimed to determine the region-based differences of PLT indices in China. A total of 4,642 volunteers with a mean age of 43 were recruited from six regions of China. PLT indices were performed on Sysmex XE-2100 hematology analyzers, whose traceability was well verified. There were significant region-based differences for all PLT indices. Reference people in Chengdu had the lowest mean PLT count and Pct, but the highest MPV, PDW, and P-LCR among the six regions. Therefore, we derived the reference intervals in Chinese Han population excluding Chengdu reference people for PLT indices as PLT count: (127-341) × 10(9)/l; MPV: (9.20-13.30) fl; PDW: 9.90-19.00%; P-LCR: 18.10-52.00%; Pct: 16.00-41.00%. Region-specific reference intervals are essential as there were statistically significant region-related differences in the PLT parameters. The reference intervals established in this study differed from the existing reference values. Chengdu region may need proper specific reference ranges, which apply to their people, for all PLT parameters. © 2014 Wiley Periodicals, Inc.

  4. Adult reference intervals for IgG subclasses with Siemens immunonephelometric assays in Chinese population.

    Science.gov (United States)

    Li, Ping; Liu, Zhongjuan; Wu, Ziyan; Wen, Xiaoting; Li, Liubing; Zhang, Shulan; Xu, Yingchun; Li, Yongzhe

    2017-01-01

    To determine the adult reference intervals for the Siemens IgG subclass reagents. 636 blood samples of healthy adults were analyzed to determine the level of IgG subclass using the reagents of Siemens immunonephelometric assay with molecular biology kits. IgGSc reference intervals were as follows: IgG1 4.45-9.76 g/L, IgG2 2.07-8.57 g/L, IgG3 0.08-0.80 g/L and IgG4 0.05-1.54 g/L. There was an excellent correlation between the total IgG and the sum of the IgG subclasses. No significant gender and age differences were observed. Our data provide the missing reference intervals and enable the use of the nephelometric IgG subclass reagents in Chinese. The study can offer reference on clinic diagnose.

  5. Reference intervals for C-peptide and insulin derived from a general adult Danish population.

    Science.gov (United States)

    Larsen, Pia Bükmann; Linneberg, Allan; Hansen, Torben; Friis-Hansen, Lennart

    2017-05-01

    Despite international efforts to standardize C-peptide and insulin calibrators and immunoassays, platform dependent differences still exist, and platform specific reference intervals are hence needed for correct interpretation. We therefore wanted to establish traceable reference intervals for C-peptide and insulin. In 623 consecutively recruited participants, insulin and C-peptide were measured using the Cobas e411 (Roche Diagnostics, Switzerland). Participants with diabetes were excluded (fasting Glucose ≥7.0mmol/L or HbA1c≥6.5%/≥48mmol/L) and reference intervals were calculated with and without the inclusion of persons who were prediabetic, according to two definitions (The World Health Organization (WHO) and American Diabetes Association (ADA)). To ensure the correctness of calibration, the control pools were analyzed by a reference laboratory. The reference intervals were calculated according to the IFCC guidelines, using the RefVal software (Solberg, Oslo, Norway). Comparison of our results with those from the reference laboratory revealed equivalence for C-peptide results whereas the insulin determined on the Cobas e411 assay were 15-20% higher. The difference is attributed to an incorrect conversion factor for converting from activity to metric units. The Cobas e411 assay uses the factor 6.945 for converting from U/mL to pmol/L. This is in disagreement with the biological activity of insulin which is 166.8×10 6 IU/mol or 6.00nmol/IU. We successfully established reference intervals for C-peptide and insulin for non-diabetic and prediabetic participants. The reference intervals for fasting C-peptide and fasting insulin are ready for implementation. A recertification of the insulin standards is needed. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  6. Pediatric population reference value distributions for cancer biomarkers and covariate-stratified reference intervals in the CALIPER cohort.

    Science.gov (United States)

    Bevilacqua, Victoria; Chan, Man Khun; Chen, Yunqi; Armbruster, David; Schodin, Beth; Adeli, Khosrow

    2014-12-01

    Cancer biomarkers are commonly used in pediatrics to monitor cancer progression, recurrence, and prognosis, but pediatric reference value distributions have not been well established for these markers. The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) sought to develop a pediatric database of covariate-stratified reference value distributions for 11 key circulating tumor markers, including those used in assessment of patients with childhood or adult cancers. Healthy community children from birth to 18 years of age were recruited to participate in the CALIPER project with informed parental consent. We analyzed serum samples from 400-700 children (depending on the analyte in question) on the Abbott Architect ci4100 and established reference intervals for α-fetoprotein (AFP), antithyroglobulin (anti-Tg), human epididymis protein 4 (HE4), cancer antigen 125 (CA125), CA15-3, CA19-9, progastrin-releasing peptide (proGRP), carcinoembryonic antigen (CEA), squamous cell carcinoma antigen (SCC), and total and free prostate specific antigen (PSA) according to CLSI C28-A3 statistical guidelines. We observed significant fluctuations in biomarker concentrations by age and/or sex in 10 of 11 biomarkers investigated. Age partitioning was required for CA153, CA125, CA19-9, CEA, SCC, proGRP, total and free PSA, HE4, and AFP, whereas sex partitioning was also required for CA125, CA19-9, and total and free PSA. This CALIPER study established a database of childhood reference intervals for 11 tumor biomarkers and revealed dramatic fluctuations in tumor marker concentrations between boys and girls and throughout childhood. In addition, important differences between the adult and pediatric population were observed, further highlighting the need for pediatric-specific reference intervals. © 2014 American Association for Clinical Chemistry.

  7. Power function of the reference change value in relation to cut-off points, reference intervals and index of individuality.

    Science.gov (United States)

    Iglesias, Natàlia; Petersen, Per Hyltoft; Ricós, Carmen

    2005-01-01

    The reference change value, defined as RCV = 1.96 x 2(1/2) x(s(I)(2) +s A(2))(1/2), where s(I) is within-subject biological variation and s A is analytical variation, has been used for many years to take clinical decisions in patient monitoring. Furthermore, the index of individuality was defined as II = (s(I)(2) +s(A)(2))(1/2)/s(G) , where s(G) is the between-subject biological variation. This index has been simplified by later authors to s(I)/s(G) and has been used in monitoring situations to determine the utility of population-based reference intervals. Harris stated that when the index of individuality is lower than 0.6, the specific reference interval of the individual - when available - is better than the population-based reference interval. However, if a change within a patient is equivalent to the RCV applied for the significant difference between two measurements, the probability of detecting this change is only 50% (the same probability of missing it). Therefore, to obtain a higher probability of detecting a change by the RCV (e.g., 90%) the interpretation of the index of individuality has to be reconsidered. This contribution compares the power of the RCV to the use of cut-off points and population-based reference intervals. The benefits of the RCV compared to the distance to cut-off point or reference limit are also described in relation to the index of individuality.

  8. Reference intervals and allometric scaling of two-dimensional echocardiographic measurements in 150 healthy cats.

    Science.gov (United States)

    Karsten, Schober; Stephanie, Savino; Vedat, Yildiz

    2017-11-10

    The objective of the study was to evaluate the effects of body weight (BW), breed, and sex on two-dimensional (2D) echocardiographic measures, reference ranges, and prediction intervals using allometrically-scaled data of left atrial (LA) and left ventricular (LV) size and LV wall thickness in healthy cats. Study type was retrospective, observational, and clinical cohort. 150 healthy cats were enrolled and 2D echocardiograms analyzed. LA diameter, LV wall thickness, and LV dimension were quantified using three different imaging views. The effect of BW, breed, sex, age, and interaction (BW*sex) on echocardiographic variables was assessed using univariate and multivariate regression and linear mixed model analysis. Standard (using raw data) and allometrically scaled (Y=a × M b ) reference intervals and prediction intervals were determined. BW had a significant (Preference intervals using mean ± 2SD of raw data and mean and 95% prediction interval of allometrically-scaled variables, most prominent in larger (>6 kg) and smaller (intervals should be preferred over conventional 2D echocardiographic reference intervals in cats, in particular in small and large cats. These results are particularly relevant to screening examinations for feline hypertrophic cardiomyopathy.

  9. Reference intervals of carbohydrate antigen 19-9 in the apparently healthy adult population.

    Science.gov (United States)

    Zhang, Gao-Ming; Bai, Shu-Mei; Zhang, Guo-Ming; Ma, Xiao-Bo

    2018-01-08

    To establish reference intervals of carbohydrate antigen 19-9(CA 19-9) according to the CLSI CA28-A3 guideline and to evaluate age- and gender-related variations. Serum CA 19-9 values of 10 149 healthy subjects (from 20 years old to 60 years old) were measured from location health checkups. The relationship between CA 19-9 and age was analyzed using Spearman's approach. The reference intervals of CA19-9 were established using Q 2.5 and Q 97.5 , and the 90% confidence intervals of upper limits were calculated. The reference intervals of CA 19-9 were 1.98-25.12 U/mL for males (1.97-25.06 U/mL for 20-50 years old and 2.31-26.13 U/mL for 50-60 years old) and 2.36-29.29 U/mL for adult (20-60 years old) females. The upper limit of reference intervals for all individuals was 26.45 U/mL; the level of CA 19-9 is higher in females than males. Carbohydrate antigen (CA) 19-9 is significantly associated with aging in adult males(r = .0930, P reference intervals for CA19-9 and giving age-related reference intervals of CA19-9 using a big data of healthy adult, we first discovered that CA19-9 tends to increase with age in adult males but not in females. © 2018 Wiley Periodicals, Inc.

  10. Establishing reference intervals for sex hormones on the analytical platforms Advia Centaur and Immulite 2000XP.

    Science.gov (United States)

    Schüring, Andreas N; Kelsch, Reinhard; Pierściński, Grzegorz; Nofer, Jerzy Roch

    2016-01-01

    Reliable reference intervals for sex hormones are indispensable in evaluations of the hypothalamo-pituitary-gonadal axis. This study established reference intervals for estradiol, progesterone, luteinizing hormone, follicle-stimulating hormone, and prolactin with the immunoassay platforms Advia Centaur and Immulite 2000XP (Siemens Healthcare, Germany). We recruited healthy men (n=220), women in the follicular (n=139) or luteal (n=87) phases of the menstrual cycle, and postmenopausal women (n=103). Data was analyzed according to CLSI EP28-A3c guidelines. Although reference intervals established with both platforms showed good agreement with ranges quoted by the assay manufacturer, two discrepancies were noted. First, intervals for prolactin in women were influenced by hormonal status, and the partition analysis supported their separation into subgroups based on menstrual cycle. Second, the upper limit for estradiol in the follicular phase was nearly a half of that provided by the manufacturer. This discrepancy was attributed to the stringent definition of the follicular phase (consistently set at days 3-5 after menstruation onset). Our findings suggest that reference values for prolactin should both be gender specific and account for menstrual cycle phase. The results also emphasize that clear-cut selection criteria are required when assembling populations for establishing endocrine reference intervals.

  11. Reference intervals for transthoracic echocardiography in the English springer spaniel: a prospective, longitudinal study.

    Science.gov (United States)

    Dickson, D; Shave, R; Rishniw, M; Harris, J; Patteson, M

    2016-10-01

    To establish transthoracic echocardiographic reference intervals in adult English springer spaniel dogs. Forty-two healthy adult English springer spaniels were prospectively recruited from a general practice population in the UK. Animals were examined twice, at least 12 months apart, to exclude dogs with progressive cardiac disease. Reference intervals were calculated using Box-Cox transformations and specific variables were depicted within an expert consensus range. Relationships of body mass, age and heart rate with cardiac structure and function were examined and functional assessments were compared with previous reports. Reference intervals were compared against published ratiometric indices and allometric scaling models. Thirty-nine dogs contributed to create the reference intervals. Significant relationships with bodyweight, age and heart rate were detected, although low coefficients of determination were found. Fractional shortening values were lower than has been reported in many breeds but Simpson-derived ejection fractions were similar to previously published breed-specific values. Breed-specific reference intervals are reported allowing for more appropriate interpretation of echocardiographic assessments in the English springer spaniel. © 2016 British Small Animal Veterinary Association.

  12. Establishment of reference intervals during normal pregnancy through six months postpartum in western Kenya.

    Science.gov (United States)

    Odhiambo, Collins; Omolo, Paul; Oyaro, Boaz; Williamson, John; Kinuthia, John; Matemo, Daniel; Drake, Alison; John-Stewart, Grace; Zeh, Clement

    2017-01-01

    Pregnancy is associated with changes in hematological and biochemistry values, yet there are no African reference intervals for clinical management of pregnant women. We sought to 1) develop laboratory reference intervals during pregnancy and up to 24 weeks postpartum and 2) determine the proportion of women in a previous clinical trial who would be misclassified as having out-of-range values using reference intervals from a United States (U.S.) population. This was a longitudinal sub-study of 120 clinically healthy, HIV-uninfected, self-selected pregnant women seeking antenatal care services at either of two public hospitals in western Kenya. Blood specimens were obtained from consented women at gestational ages 28 and 36 weeks and at 2, 6, 14 and 24 weeks postpartum. Median and 95% reference intervals were calculated for immune-hematological and biochemistry parameters and compared to reference intervals from a Kenyan and United States (U.S.) population, using Wilcoxon tests. Differences with p≤0.05 were considered significant. Some hematological parameters, including hemoglobin and neutrophils showed significant variations compared to reference intervals for non-pregnant women. Hemoglobin values were significantly lower during pregnancy but were comparable to the values in non-pregnant women by 6 weeks postpartum. CD4, CD8 and platelets were significantly elevated in early postpartum but declined gradually, reaching normal levels by 24 weeks postpartum. Using the new hemoglobin reference levels from this study to estimate prevalence of 'out of range' values in a prior Kisumu research cohort of pregnant/postpartum women, resulted in 0% out of range values, in contrast to 96.3% using US non-pregnant reference values. There were substantial differences in U.S. and Kenyan values for immune-hematological parameters among pregnant/postpartum women, specifically in red blood cell parameters in late pregnancy and 2 weeks postpartum. Use of U.S. reference intervals

  13. Hematological reference intervals determination in adults at Gondar university hospital, Northwest Ethiopia.

    Science.gov (United States)

    Yalew, Aregawi; Terefe, Betelihem; Alem, Meseret; Enawgaw, Bamlaku

    2016-11-02

    Hematological reference values are important for the clinical decisions in laboratory diagnosis and monitoring of patients. The correct interpretation of laboratory results depends entirely on the reference intervals that have been established for the locality. But, in sub-Saharan African countries particularly in Ethiopia, locally derived reference intervals were not established and they are forced to use intervals established from western population. Thus this study aimed to establish locally derived hematological reference values that could be used in Northwest Ethiopia. A cross sectional study was conducted from April to May 2014 with 120 male and 120 female apparently health adult blood donors at Gondar University Hospital. A structured pretested questionnaire was used for socio demographic and clinical data collection. About 4 ml of blood was collected with EDTA test tube and analyzed using Cell-Dyn 1800 to enumerate the hematological parameters. The data were collected and entered into SPSS version 20 for analysis. Mann-Whitney U test was used to determine reference intervals and Harris and Boyd test was used to determine the reference intervals that need partition. The 95th percentile of measurements was taken as a reference interval. Median and 95th percentile of WBC for general population were lower than Caucasian population, Addis Ababa, Burkina Faso and Kenya of similar studies. The RBC, Hgb and PCV lower 95% limit values of both sex were lower than studies in Addis Ababa, Kenya, Burkina Faso and text book. While PCV upper limit values higher than the above countries. MCV values of the current study were higher than those countries while MCHC values were lower. Similarly, the absolute values of neutrophils in the current study were lower than Caucasian and Afro Caribbean but higher than African countries and Jamaica but lymphocyte count was higher. The hematological reference intervals established in this study was different from those reported in

  14. Standardization in laboratory medicine: Adoption of common reference intervals to the Croatian population.

    Science.gov (United States)

    Flegar-Meštrić, Zlata; Perkov, Sonja; Radeljak, Andrea

    2016-03-26

    Considering the fact that the results of laboratory tests provide useful information about the state of health of patients, determination of reference value is considered an intrinsic part in the development of laboratory medicine. There are still huge differences in the analytical methods used as well as in the associated reference intervals which could consequently significantly affect the proper assessment of patient health. In a constant effort to increase the quality of patients' care, there are numerous international initiatives for standardization and/or harmonization of laboratory diagnostics in order to achieve maximum comparability of laboratory test results and improve patient safety. Through the standardization and harmonization processes of analytical methods the ability to create unique reference intervals is achieved. Such reference intervals could be applied globally in all laboratories using methods traceable to the same reference measuring system and analysing the biological samples from the populations with similar socio-demographic and ethnic characteristics. In this review we outlined the results of the harmonization processes in Croatia in the field of population based reference intervals for clinically relevant blood and serum constituents which are in accordance with ongoing activity for worldwide standardization and harmonization based on traceability in laboratory medicine.

  15. Application of the Stockholm Hierarchy to Defining the Quality of Reference Intervals and Clinical Decision Limits

    Science.gov (United States)

    Sikaris, Ken

    2012-01-01

    The Stockholm Hierarchy is a professional consensus created to define the preferred approaches to defining analytical quality. The quality of a laboratory measurement can also be classified by the quality of the limits that the value is compared with, namely reference interval limits and clinical decision limits. At the highest level in the hierarchy would be placed clinical decision limits based on clinical outcome studies. The second level would include both formal reference interval studies (studies of intra and inter-individual variations) and clinical decision limits based on clinician survey. While these approaches are commonly used, they require a lot of resources to define accurately. Placing laboratory experts on the third level would suggest that although they can also define reference intervals by consensus, theirs aren’t as well regarded as clinician defined limits which drive clinical behaviour. Ideally both analytical and clinical considerations should be made, with clinicians and laboratorians both having important information to consider. The fourth level of reference intervals would be for those defined by survey or by regulatory authorities because of the focus on what is commonly achieved rather than what is necessarily correct. Finally, laboratorians know that adopting reference limits from kit inserts or textbook publications is problematic because both methodological issues and reference populations are often not the same as their own. This approach would rank fifth and last. When considering which so called ‘common’ or ‘harmonised reference intervals’ to adopt, both these characteristics and the quality of individual studies need to be assessed. Finally, we should also be aware that reference intervals describe health and physiology while clinical decision limits focus on disease and pathology, and unless we understand and consider the two corresponding issues of test specificity and test sensitivity, we cannot assure the quality of

  16. Establishment of 25-OH-vitamin D reference interval by radioimmunoassay and its clinical significance

    International Nuclear Information System (INIS)

    Chen Jianbo; Huang Xianzhong; Hu Chaohui; Zu Yuli; Zhu Qingyi

    2009-01-01

    Objective: To establish reference interval of 25-OH-vitamin D (25-OH-Vit D) by radioimmunoassay and provide suggestion for clinical applications. Method: Collecting 204 healthy persons specimens, and validating and establishing reference interval of 25-OH-Vit D by treatment of outlying observations, judgement of data distributions and analysis of test results. Results: The reference interval of 25-OH-Vit D established in our laboratory is 16.0-39.7 ng/ml for adolescents and 11.7-40.0 ng/ml for adults. Conclusions: The levels of 25-OH-Vit D in humans depend on their age, sex and life style. Some people's vitamin D intake is not enough. Doctors should pay attention to the sufficient 25-OH-Vit D needed when evaluate vitamin D intake. (authors)

  17. Verification of serum reference intervals for free light chains in a local South African population.

    Science.gov (United States)

    Zemlin, Annalise E; Rensburg, Megan A; Ipp, Hayley; Germishuys, Jurie J; Erasmus, Rajiv T

    2013-11-01

    Monoclonal serum free light chain measurements are used to follow up and manage patients with monoclonal gammopathies, and abnormal serum free light chain ratios are associated with risk of progression in certain diseases. We aimed to validate the reference intervals in our population. Reference intervals for κ and λ free light chains were established on 120 healthy adults. Creatinine levels were measured to exclude renal dysfunction and serum protein electrophoresis was performed. All creatinine values were within normal limits. After exclusion of subjects with abnormal serum protein electrophoreses, 113 subjects were available for analysis. The 95% reference interval was 6.3-20.6 mg/L for κ free light chains, 8.7-25.9 mg/L for λ free light chains and 0.46-1.23 for free light chain ratio. Most of the values fell within the manufacturer's recommended limits and therefore could be used for our population.

  18. Reference intervals and allometric scaling of echocardiographic measurements in Bengal cats.

    Science.gov (United States)

    Scansen, Brian A; Morgan, Kyla L

    2015-12-01

    The Bengal is a relatively new hybrid breed, reported to develop hypertrophic cardiomyopathy. The aim of this study was to determine reference intervals for echocardiographic measurements in Bengal cats. Sixty-six apparently healthy Bengal cats. The study included a retrospective review of echocardiograms from 39 Bengal cats evaluated from March 2004 to June 2012 and reported to be normal by a board-certified cardiologist. An additional 27 cats were enrolled prospectively from June 2012 to June 2013. The effects of sex and body weight on linear cardiac dimensions were evaluated by regression analysis. Reference intervals were determined by the robust method with bootstrapping. Allometric equations scaled to body weight were derived for each echocardiographic variable. Intra- and interobserver variability were evaluated by coefficient of variation from 6 of the prospective studies. Reference intervals were determined from all 66 Bengal cats as no significant differences were observed between the retrospective and prospective data. An effect of sex, separate from body weight, was suggested and unique reference intervals for male and female cats were determined. Body weight was a significant co-variate and 95% prediction intervals for linear dimensions were determined by allometric scaling. Coefficients of variation were less than 10% for 2-dimensional variables and less than 18% for M-mode variables. These data provide reference intervals and weight-based 95% prediction intervals for echocardiographic measurements in the Bengal cat, potentially aiding cardiologists who screen this breed in detecting pathologic variants from normal dimensions. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. The impact of change in albumin assay on reference intervals, prevalence of 'hypoalbuminaemia' and albumin prescriptions.

    Science.gov (United States)

    Coley-Grant, Deon; Herbert, Mike; Cornes, Michael P; Barlow, Ian M; Ford, Clare; Gama, Rousseau

    2016-01-01

    We studied the impact on reference intervals, classification of patients with hypoalbuminaemia and albumin infusion prescriptions on changing from a bromocresol green (BCG) to a bromocresol purple (BCP) serum albumin assay. Passing-Bablok regression analysis and Bland-Altman plot were used to compare Abbott BCP and Roche BCG methods. Linear regression analysis was used to compare in-house and an external laboratory Abbott BCP serum albumin results. Reference intervals for Abbott BCP serum albumin were derived in two different laboratories using pathology data from adult patients in primary care. Prescriptions for 20% albumin infusions were compared one year before and one year after changing the albumin method. Abbott BCP assay had a negative bias of approximately 6 g/L compared with Roche BCG method.There was good agreement (y = 1.04 x - 1.03; R(2 )= 0.9933) between in-house and external laboratory Abbott BCP results. Reference intervals for the serum albumin Abbott BCP assay were 31-45 g/L, different to those recommended by Pathology Harmony and the manufacturers (35-50 g/L). Following the change in method there was a large increase in the number of patients classified as hypoalbuminaemic using Pathology Harmony references intervals (32%) but not when retrospectively compared to locally derived reference intervals (16%) compared with the previous year (12%). The method change was associated with a 44.6% increase in albumin prescriptions. This equated to an annual increase in expenditure of £35,234. We suggest that serum albumin reference intervals be method specific to prevent misclassification of albumin status in patients. Change in albumin methodology may have significant impact on hospital resources. © The Author(s) 2015.

  20. Haematological and biochemical reference intervals for free-ranging brown bears (Ursus arctos) in Sweden

    DEFF Research Database (Denmark)

    Græsli, Anne Randi; Fahlman, Åsa; Evans, Alina L.

    2014-01-01

    BackgroundEstablishment of haematological and biochemical reference intervals is important to assess health of animals on individual and population level. Reference intervals for 13 haematological and 34 biochemical variables were established based on 88 apparently healthy free-ranging brown bears...... bears in Sweden.ResultsThe following variables were not affected by host characteristics: red blood cell, white blood cell, monocyte and platelet count, alanine transaminase, amylase, bilirubin, free fatty acids, glucose, calcium, chloride, potassium, and cortisol. Age differences were seen...... and the differences due to host factors age and gender can be useful for evaluation of health status in free-ranging European brown bears....

  1. Reference intervals for platelet aggregation assessed by multiple electrode platelet aggregometry

    DEFF Research Database (Denmark)

    Rubak, Peter; Villadsen, Kirsten; Hvas, Anne-Mette

    2012-01-01

    Abstract Introduction Analyses of platelet aggregation in hirudin whole blood using Multiplate® was validated. Reference intervals for the most commonly used agonists were established, and the association between platelet aggregation, age, gender and haematological values was analysed. Material...... and methods We included 121 healthy individuals to establish reference intervals and six healthy individuals for evaluation of the day-to-day variation. Platelet aggregation was evaluated on hirudin whole blood employing Multiplate® induced by arachidonic acid, ADP, collagen and ristocetin (RISTOlow...... after adjusting for age and gender except for RISTOhigh. A positive significant association was found between platelet count and platelet aggregation (p

  2. Cerebrospinal Fluid Total Protein Reference Intervals Derived from 20 Years of Patient Data.

    Science.gov (United States)

    McCudden, Christopher R; Brooks, John; Figurado, Priya; Bourque, Pierre R

    2017-12-01

    Reference intervals are vital for interpretation of laboratory results. Many existing reference intervals for cerebrospinal fluid total protein (CSF-TP) are derived from old literature because of the invasive nature of sampling. The objective of this study was to determine reference intervals for CSF-TP using available patient data. Twenty years of hospital database information was mined for previously reported CSF-TP results. Associated demographic, laboratory, and clinical diagnosis (International Classification of Diseases 9/10 codes) details were extracted. CSF-TP results included 3 different analytical platforms: the Siemens Vista 1500, Beckman Lx20, and Roche Hitachi 917. From an initial data set of 19591 samples, the following exclusion criteria were applied: incomplete data, white blood cells (WBCs) >5 × 10 6 /L, red blood cells (RBCs) >50 × 10 6 /L, and glucose reference intervals were determined using quantile regression. Age- and sex-partitioned intervals were established using the quantile regression equation and splitting age-groups into 5-year bins. CSF-TP showed a marked age dependence, and males had significantly higher CSF-TP than females across all ages. CSF-TP results from the 3 different instruments and manufacturers showed small (approximately 0.04 g/L), but statistically significant, differences. CSF-TP showed weak, but again statistically significant, correlation with WBC and RBC but was independent of serum total protein and creatinine. The age dependence of CSF-TP supports that age-partitioned reference intervals will be more accurate than a single cutoff, particularly in patients with advancing age. © 2017 American Association for Clinical Chemistry.

  3. Pediatric reference intervals for random urine calcium, phosphorus and total protein.

    Science.gov (United States)

    Slev, Patricia R; Bunker, Ashley M; Owen, William E; Roberts, William L

    2010-09-01

    The aim of this study was to establish age appropriate reference intervals for calcium (Ca), phosphorus (P) and total protein (UTP) in random urine samples. All analytes were measured using the Roche MODULAR P analyzer and normalized to creatinine (Cr). Our study cohort consisted of 674 boys and 728 girls between 7 and 17 years old (y.o.), which allowed us to determine the central 95% reference intervals with 90% confidence intervals by non-parametric analysis partitioned by both gender and 2-year age intervals for each analyte [i.e. boys in age group 7-9 years (7-9 boys); girls in age group 7-9 years (7-9 girls), etc.]. Results for the upper limits of the central 95% reference interval were: for Ca/Cr, 0.27 (16,17 y.o.) to 0.46 mg/mg (7-9 y.o.) for the girls and 0.26 (16,17 y.o.) to 0.43 mg/mg (7-9 y.o.) for the boys; for P/Cr, 0.85 (16,17 y.o.) to 1.44 mg/mg (7-9 y.o.) for the girls and 0.87 (16,17 y.o.) to 1.68 mg/mg (7-9 y.o.) for the boys; for UTP/Cr, 0.30 (7-9 y.o.) to 0.34 mg/mg (10-12 y.o.) for the girls and 0.19 (16,17, y.o.) to 0.26 mg/mg (13-15 y.o.) for the boys. Upper reference limits decreased with increasing age, and age was a statistically significant variable for all analytes. Eight separate age- and gender-specific reference intervals are proposed per analyte.

  4. [Investigation of reference intervals of blood gas and acid-base analysis assays in China].

    Science.gov (United States)

    Zhang, Lu; Wang, Wei; Wang, Zhiguo

    2015-10-01

    To investigate and analyze the upper and lower limits and their sources of reference intervals in blood gas and acid-base analysis assays. The data of reference intervals were collected, which come from the first run of 2014 External Quality Assessment (EQA) program in blood gas and acid-base analysis assays performed by National Center for Clinical Laboratories (NCCL). All the abnormal values and errors were eliminated. Data statistics was performed by SPSS 13.0 and Excel 2007 referring to upper and lower limits of reference intervals and sources of 7 blood gas and acid-base analysis assays, i.e. pH value, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), Na+, K+, Ca2+ and Cl-. Values were further grouped based on instrument system and the difference between each group were analyzed. There were 225 laboratories submitting the information on the reference intervals they had been using. The three main sources of reference intervals were National Guide to Clinical Laboratory Procedures [37.07% (400/1 079)], instructions of instrument manufactures [31.23% (337/1 079)] and instructions of reagent manufactures [23.26% (251/1 079)]. Approximately 35.1% (79/225) of the laboratories had validated the reference intervals they used. The difference of upper and lower limits in most assays among 7 laboratories was moderate, both minimum and maximum (i.e. the upper limits of pH value was 7.00-7.45, the lower limits of Na+ was 130.00-156.00 mmol/L), and mean and median (i.e. the upper limits of K+ was 5.04 mmol/L and 5.10 mmol/L, the upper limits of PCO2 was 45.65 mmHg and 45.00 mmHg, 1 mmHg = 0.133 kPa), as well as the difference in P2.5 and P97.5 between each instrument system group. It was shown by Kruskal-Wallis method that the P values of upper and lower limits of all the parameters were lower than 0.001, expecting the lower limits of Na+ with P value 0.029. It was shown by Mann-Whitney that the statistic differences were found among instrument

  5. Establishment of reference intervals for serum thyroid-stimulating hormone, free and total thyroxine, and free and total triiodothyronine for the Beckman Coulter DxI-800 analyzers by indirect method using data obtained from Chinese population in Zhejiang Province, China.

    Science.gov (United States)

    Wang, Yan; Zhang, Yu-Xia; Zhou, Yong-Lie; Xia, Jun

    2017-07-01

    In order to establish suitable reference intervals of thyroid-stimulating hormone (TSH), free (unbound) T4 (FT4), free triiodothyronine (FT3), total thyroxine (T4), and total triiodothyronine (T3) for the patients collected in Zhejiang, China, an indirect method was developed using the data from the people presented for routine health check-up. Fifteen thousand nine hundred and fifty-six person's results were reviewed. Box-Cox or Case Rank was used to transform the data to normal distribution. Tukey and Box-Plot methods were used to exclude the outliers. Nonparametric method was used to establish the reference intervals following the EP28-A3c guideline. Pearson correlation was used to evaluate the correlation between hormone levels and age, while Mann-Whitney U test was employed for quantification of concentration differences on the people who are younger and older than 50 years old. Reference intervals were 0.66-4.95 mIU/L (TSH), 8.97-14.71 pmol/L (FT4), 3.75-5.81 pmol/L (FT3), 73.45-138.93 nmol/L (total T4), and 1.24-2.18 nmol/L (total T3) in male; conversely, reference intervals for female were 0.72-5.84 mIU/L (TSH), 8.62-14.35 pmol/L (FT4), 3.59-5.56 pmol/L (FT3), 73.45-138.93 nmol/L (total T4), and 1.20-2.10 nmol/L (total T3). FT4, FT3, and total T3 levels in male and FT4 level in female had an inverse correlation with age. Total T4 and TSH levels in female were directly correlated. Significant differences in these hormones were also found between younger and older than 50 years old except FT3 in female. Indirect method can be applied for establishment of reference intervals for TSH, FT4, FT3, total T4, and total T3. The reference intervals are narrower than those previously established. Age factor should also be considered. © 2016 Wiley Periodicals, Inc.

  6. Age- and sex-related reference intervals of lymphocyte subsets in healthy ethnic Han Chinese children.

    Science.gov (United States)

    Jia, Liting; Li, Jing; Zhang, Yuchao; Shi, Ying; Yuan, Enwu; Liu, Junjie; Wang, Peng; Rong, Shouhua; Xing, Jinfang; Tian, Yuan; Li, Junfang

    2015-12-01

    Immunophenotyping of blood lymphocytes has become an important tool in the diagnosis of immunologic and hematologic disorders such as immunodeficiencies, lymphoproliferative and autoimmune diseases. Lymphocyte subsets include total T-cells (CD3(+)), TH (T helper, CD3(+) CD4(+)), TC (cytotoxic T cells, CD3(+) CD8(+)), B-cells (CD3(-) CD19(+)), and NK-cells (CD3(-) CD16(+) CD56(+)). Specific lymphocyte subset reference intervals should be locally established for meaningful comparison and to obtain an accurate interpretation of the results. Reference intervals of lymphocyte subsets for Chinese children are scarce. We performed dual-platform flow cytometry to determine the reference intervals of the percentages and absolute counts of lymphocyte subsets, including total T-cells, TH cells, TC cells, B-cells, and NK-cells in 1,027 ethnic Han children aged 4 months to 7 years in Henan, China. The children were divided into seven age groups. The percentages and absolute counts differed significantly with age, with the percentages of TH cells and B cells and the CD4/CD8 ratio peaking during the first year, while the percentages of total T cells, TC cells, and NK cells were obviously increased with age; girls showed a trend toward having a higher percentage of TH cells and a higher CD4/CD8 ratio than boys. The absolute counts of lymphocyte subsets peaked during first year and then decreased steadily with age. The reference intervals of lymphocyte subsets among children from China differed from the reported values in Hong Kong, the United States, Cameroon, and Italy. The differences observed could be due to genetic and environmental factors, coupled with the methodology used. The reference intervals of lymphocyte subsets could be used as initial national reference ranges in guidelines for children aged 4 months to 7 years. © 2015 International Society for Advancement of Cytometry.

  7. Resampling methods in Microsoft Excel® for estimating reference intervals

    Science.gov (United States)

    Theodorsson, Elvar

    2015-01-01

    Computer- intensive resampling/bootstrap methods are feasible when calculating reference intervals from non-Gaussian or small reference samples. Microsoft Excel® in version 2010 or later includes natural functions, which lend themselves well to this purpose including recommended interpolation procedures for estimating 2.5 and 97.5 percentiles.
The purpose of this paper is to introduce the reader to resampling estimation techniques in general and in using Microsoft Excel® 2010 for the purpose of estimating reference intervals in particular.
Parametric methods are preferable to resampling methods when the distributions of observations in the reference samples is Gaussian or can transformed to that distribution even when the number of reference samples is less than 120. Resampling methods are appropriate when the distribution of data from the reference samples is non-Gaussian and in case the number of reference individuals and corresponding samples are in the order of 40. At least 500-1000 random samples with replacement should be taken from the results of measurement of the reference samples. PMID:26527366

  8. Resampling methods in Microsoft Excel® for estimating reference intervals.

    Science.gov (United States)

    Theodorsson, Elvar

    2015-01-01

    Computer-intensive resampling/bootstrap methods are feasible when calculating reference intervals from non-Gaussian or small reference samples. Microsoft Excel® in version 2010 or later includes natural functions, which lend themselves well to this purpose including recommended interpolation procedures for estimating 2.5 and 97.5 percentiles. 
The purpose of this paper is to introduce the reader to resampling estimation techniques in general and in using Microsoft Excel® 2010 for the purpose of estimating reference intervals in particular.
 Parametric methods are preferable to resampling methods when the distributions of observations in the reference samples is Gaussian or can transformed to that distribution even when the number of reference samples is less than 120. Resampling methods are appropriate when the distribution of data from the reference samples is non-Gaussian and in case the number of reference individuals and corresponding samples are in the order of 40. At least 500-1000 random samples with replacement should be taken from the results of measurement of the reference samples.

  9. Optimal reference interval for homeostasis model assessment of insulin resistance in a Japanese population

    OpenAIRE

    Yamada, Chizumi; Mitsuhashi, Toshitake; Hiratsuka, Noboru; Inabe, Fumiyo; Araida, Nami; Takahashi, Eiko

    2011-01-01

    Abstract The aim of the present study was to establish a reference interval for homeostasis model assessment of insulin resistance (HOMA‐IR) in a Japanese population based on the C28‐A3 document from the Clinical and Laboratory Standards Institute (CLSI). We selected healthy subjects aged 20–79 years, with fasting plasma glucose 

  10. The establishment of tocopherol reference intervals for Hungarian adult population using a validated HPLC method.

    Science.gov (United States)

    Veres, Gábor; Szpisjak, László; Bajtai, Attila; Siska, Andrea; Klivényi, Péter; Ilisz, István; Földesi, Imre; Vécsei, László; Zádori, Dénes

    2017-09-01

    Evidence suggests that decreased α-tocopherol (the most biologically active substance in the vitamin E group) level can cause neurological symptoms, most likely ataxia. The aim of the current study was to first provide reference intervals for serum tocopherols in the adult Hungarian population with appropriate sample size, recruiting healthy control subjects and neurological patients suffering from conditions without symptoms of ataxia, myopathy or cognitive deficiency. A validated HPLC method applying a diode array detector and rac-tocol as internal standard was utilized for that purpose. Furthermore, serum cholesterol levels were determined as well for data normalization. The calculated 2.5-97.5% reference intervals for α-, β/γ- and δ-tocopherols were 24.62-54.67, 0.81-3.69 and 0.29-1.07 μm, respectively, whereas the tocopherol/cholesterol ratios were 5.11-11.27, 0.14-0.72 and 0.06-0.22 μmol/mmol, respectively. The establishment of these reference intervals may improve the diagnostic accuracy of tocopherol measurements in certain neurological conditions with decreased tocopherol levels. Moreover, the current study draws special attention to the possible pitfalls in the complex process of the determination of reference intervals as well, including the selection of study population, the application of internal standard and method validation and the calculation of tocopherol/cholesterol ratios. Copyright © 2017 John Wiley & Sons, Ltd.

  11. Reference intervals of spinal mobility measures in normal individuals: the mobility study

    NARCIS (Netherlands)

    Ramiro, Sofia; van Tubergen, Astrid; Stolwijk, Carmen; van der Heijde, Desiree; Royston, Patrick; Landewe, Robert

    2015-01-01

    Objectives To establish reference intervals (RIs) for spinal mobility measures as recommended for patients with axial spondyloarthritis, and to determine the effect of age, height and gender on spinal mobility, in normal individuals. Methods A cross-sectional study (MOBILITY) was conducted among

  12. CLSI-derived hematology and biochemistry reference intervals for healthy adults in eastern and southern Africa.

    Directory of Open Access Journals (Sweden)

    Etienne Karita

    Full Text Available Clinical laboratory reference intervals have not been established in many African countries, and non-local intervals are commonly used in clinical trials to screen and monitor adverse events (AEs among African participants. Using laboratory reference intervals derived from other populations excludes potential trial volunteers in Africa and makes AE assessment challenging. The objective of this study was to establish clinical laboratory reference intervals for 25 hematology, immunology and biochemistry values among healthy African adults typical of those who might join a clinical trial.Equal proportions of men and women were invited to participate in a cross sectional study at seven clinical centers (Kigali, Rwanda; Masaka and Entebbe, Uganda; two in Nairobi and one in Kilifi, Kenya; and Lusaka, Zambia. All laboratories used hematology, immunology and biochemistry analyzers validated by an independent clinical laboratory. Clinical and Laboratory Standards Institute guidelines were followed to create study consensus intervals. For comparison, AE grading criteria published by the U.S. National Institute of Allergy and Infectious Diseases Division of AIDS (DAIDS and other U.S. reference intervals were used. 2,990 potential volunteers were screened, and 2,105 (1,083 men and 1,022 women were included in the analysis. While some significant gender and regional differences were observed, creating consensus African study intervals from the complete data was possible for 18 of the 25 analytes. Compared to reference intervals from the U.S., we found lower hematocrit and hemoglobin levels, particularly among women, lower white blood cell and neutrophil counts, and lower amylase. Both genders had elevated eosinophil counts, immunoglobulin G, total and direct bilirubin, lactate dehydrogenase and creatine phosphokinase, the latter being more pronounced among women. When graded against U.S. -derived DAIDS AE grading criteria, we observed 774 (35.3% volunteers

  13. Trimester-specific coagulation and anticoagulation reference intervals for healthy pregnancy.

    Science.gov (United States)

    Cui, Chanjuan; Yang, Shuo; Zhang, Jie; Wang, Guojing; Huang, Shengkai; Li, Aiwei; Zhang, Yuncong; Qiao, Rui

    2017-08-01

    Due to the normal physiological need of pregnancy and childbirth, the haemostatic system of pregnant women is different from that of healthy non-pregnant women. The aim of this study was to establish trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China. In total 744 Han healthy pregnant women (first trimester 207 cases, second trimester 222 cases and third trimester 315 cases) and 121 healthy non-pregnant women were recruited in North China. Eight tests-activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (Fib), d-Dimer, antithrombin (AT), protein C (PC) and free protein S (fPS)-were processed on ACL TOP automated coagulation analyzer. The non-parametric 2.5th-97.5th percentiles reference intervals were calculated to establish trimester-specific reference intervals. The reference intervals for APTT, PT, TT, Fib, d-Dimer, AT, PC, and fPS at first trimester were 26.4-41.9s, 9.7-12.5s, 11.7-17.0s, 2.38-4.44g/L, 0.01-0.31μg/mL, 72-120%, 29-150%, 21-143%, respectively. At second trimester, the reference intervals were 24.4-35.8s, 8.5-13.2s, 10.0-16.0s, 2.40-5.97g/L, 0.05-0.73μg/mL, 68-125%, 20-138%, 24-155%, respectively. At third trimester, the reference intervals were 25.6-34.9s, 8.6-12.4s, 11.1-15.5s, 2.79-5.91g/L, 0.14-2.82μg/mL, 56-119%, 20-134%, 17-140%, respectively. From the first trimester to the third trimester, APTT, PT and TT presented shortened trends, Fib and d-Dimer presented increasing trends, AT, PC and fPS activity presented decreasing trends, respectively. The trimester-specific reference intervals of coagulation screening tests and thrombophilia markers in pregnancies without complications of females with Han ethnicity from North China are presented in this study, which may provide effective evidence for doctors to accurately diagnose and treat the disease during pregnancy

  14. The establishment of biological reference intervals of nontraditional glycemic markers in a Chinese population.

    Science.gov (United States)

    Zhou, Qiang; Shi, De-Bao; Lv, Li-Ying

    2017-09-01

    We established the reference intervals for glycated albumin (GA), fructosamine (FA), and 1,5-anhydroglucitol (1,5-AG) in a Chinese healthy population. This study enrolled a total of 458 eligible reference individuals, consisted of 226 men and 232 women, aged from 20~79 years (median age 43 years), who attending routine healthy checks. We stratified the subjects according to gender (males and females) and age (20-39, 40-59, and 60-79 years), and combined statistical methods with Lahti algorithm, as well as appropriate clinical consideration, to judge whether partitioning for data was needed. Glycated albumin levels between males and females were statistically different (Preference limits was only 0.31%, which was too small to be clinically relevant. GA levels across the three age groups were statistically different (Preference intervals were 10.38%-13.89% and 10.23%-14.79%, respectively. 1,5-AG levels in males were significant higher than females (PReference intervals for 1,5-AG were 107-367 μmol/L for males and 79-306 μmol/L for females. The absolute difference of the lower reference limits for FA was only 7 μmol/L between males and females. FA levels across the three age groups were not statistically different (P>.05). The reference interval for FA was 220-298 μmol/L. New reference intervals for nontraditional glycemic markers were established based on a Chinese population. © 2016 Wiley Periodicals, Inc.

  15. Leukocyte Reference Intervals for Free-Ranging Hummingbirds in Northern California.

    Science.gov (United States)

    Safra, Noa; Christopher, Mary M; Ernest, Holly B; Bandivadekar, Ruta; Tell, Lisa A

    2018-04-04

      Hummingbirds are specialized nectarivores and important ecological pollinators that are the focus of conservation efforts as well as scientific investigations of metabolism and flight dynamics. Despite their importance, basic information is lacking about hummingbird blood cells. We aimed to establish reference intervals for total and differential leukocyte counts from healthy free-ranging hummingbirds in northern California. Hummingbirds were captured in five counties in spring and summer of 2012. A drop of blood was used to prepare smears for total white blood cell estimate and 200-cell differential leukocyte counts. Reference Value Advisor was used for descriptive statistics and calculation of reference intervals. Blood smears from 42 Anna's Hummingbirds ( Calypte anna) and 33 Black-chinned Hummingbirds ( Archilochus alexandri) were included. The only significant differences in leukocyte counts were due to age, and juvenile hummingbirds had significantly higher lymphocyte counts than adult hummingbirds ( Phummingbirds.

  16. Reference Intervals for Non-Fasting CVD Lipids and Inflammation Markers in Pregnant Indigenous Australian Women.

    Science.gov (United States)

    Schumacher, Tracy L; Oldmeadow, Christopher; Clausen, Don; Weatherall, Loretta; Keogh, Lyniece; Pringle, Kirsty G; Rae, Kym M

    2017-10-14

    Indigenous Australians experience high rates of cardiovascular disease (CVD). The origins of CVD may commence during pregnancy, yet few serum reference values for CVD biomarkers exist specific to the pregnancy period. The Gomeroi gaaynggal research project is a program that undertakes research and provides some health services to pregnant Indigenous women. Three hundred and ninety-nine non-fasting samples provided by the study participants (206 pregnancies and 175 women) have been used to construct reference intervals for CVD biomarkers during this critical time. A pragmatic design was used, in that women were not excluded for the presence of chronic or acute health states. Percentile bands for non-linear relationships were constructed according to the methods of Wright and Royston (2008), using the xriml package in StataIC 13.1. Serum cholesterol, triglycerides, cystatin-C and alkaline phosphatase increased as gestational age progressed, with little change seen in high-sensitivity C-Reactive Protein and γ glutamyl transferase. Values provided in the reference intervals are consistent with findings from other research projects. These reference intervals will form a basis with which future CVD biomarkers for pregnant Indigenous Australian women can be compared.

  17. Reference intervals for six salivary cortisol measures based on the Croatian Late Adolescence Stress Study (CLASS).

    Science.gov (United States)

    Šupe-Domić, Daniela; Milas, Goran; Stanišić, Lada; Drmić Hofman, Irena; Martinović Klarić, Irena

    2018-02-15

    The aim of this nested study is to provide the reference intervals for already published measurements of salivary cortisol from the Croatian Adolescence Stress Study (CLASS). A total of 969 individuals (372 males and 597 females) were included in the reference sample (age range: 18-21 years). Salivary cortisol concentrations were determined by the enzyme immunoassay (LUCIO-Medical ELISA Salivary Cortisol Kit, Nal von Minden, Germany) in the Department of Medical Laboratory Diagnostics, University Hospital Split. Nonparametric statistics were used for calculating the reference intervals (RIs) and 90% confidence intervals (90% CIs). The lower limits of RIs determined by the direct method were higher in females (> 10%) than in males for the cortisol concentrations at awakening (SCC 0 ), 30 to 45 after awakening (SCC 30-45 ) and at bedtime (SCC bedtime ). The upper limits of RIs for the SCC bedtime were higher (> 10%) in males than in females. Females also had higher upper limits of RIs for the cortisol awakening response (CAR) and the diurnal cortisol slope (DCS) and higher lower limits of RIs for the CAR and the area under the curve with respect to ground (AUC G ). The lower limits of RIs for the DCS were higher in males than in females. Obtained reference values open the arena for introducing salivary bioscience in Croatian clinical laboratory practice and provide important data for better understanding of gender differences in adaptation to stress during late adolescence.

  18. Reference Intervals for Alpha-Fetoprotein (AFP) and Carcinoembryonic Antigen (CEA) in Guangxi Zhuang Ethnic Males from the FAMHES Project.

    Science.gov (United States)

    Lao, Xianjun; Yang, Dongmei; Mo, Zengnan; Gao, Yong; Deng, Yan; Qin, Xue; Li, Shan

    2016-01-01

    Several studies have reported the reference intervals of serum AFP and CEA levels in ethnically diverse populations, but there is a lack of such reference data among Zhuang ethnic males. The aim of this study was to establish the locally validated reference intervals for AFP and CEA in the male population of the Guangxi Zhuang ethnic group. A total of 283 Zhuang ethnic males, aged 22 to 69 years, were included from the Fangchenggang Area Male Health and Examination Survey (FAMHES) project database. The one-sided upper 95th-percentile limit was used to estimate the reference intervals for serum AFP and CEA. The total non-parametric reference intervals for Zhuang ethnic males were reference intervals for serum AFP and CEA values deviated from that reported in previous studies. Age-specific reference intervals should be performed in clinical laboratories to obtain more precise estimations for the clinical conditions of young adults and elderly people.

  19. Reference intervals and longitudinal changes in copeptin and MR-proADM concentrations during pregnancy.

    Science.gov (United States)

    Joosen, Annemiek M C P; van der Linden, Ivon J M; Schrauwen, Lianne; Theeuwes, Alisia; de Groot, Monique J M; Ermens, Antonius A M

    2017-11-27

    Vasopressin and adrenomedullin and their stable by-products copeptin and midregional part of proadrenomedullin (MR-proADM) are promising biomarkers for the development of preeclampsia. However, clinical use is hampered by the lack of trimester-specific reference intervals. We therefore estimated reference intervals for copeptin and MR-proADM in disease-free Dutch women throughout pregnancy. Apparently healthy low risk pregnant women were recruited. Exclusion criteria included current or past history of endocrine disease, multiple pregnancy, use of medication known to influence thyroid function and current pregnancy as a result of hormonal stimulation. Women who miscarried, developed hyperemesis gravidarum, hypertension, pre-eclampsia, hemolysis elevated liver enzymes and low platelets, diabetes or other disease, delivered prematurely or had a small for gestational age neonate were excluded from analyses. Blood samples were collected at 9-13 weeks (n=98), 27-29 weeks (n=94) and 36-39 weeks (n=91) of gestation and at 4-13 weeks post-partum (PP) (n=89). Sixty-two women had complete data during pregnancy and PP. All analyses were performed on a Kryptor compact plus. Copeptin increases during pregnancy, but 97.5th percentiles remain below the non-pregnant upper reference limit (URL) provided by the manufacturer. MR-proADM concentrations increase as well during pregnancy. In trimesters 2 and 3 the 97.5th percentiles are over three times the non-pregnant URL provided by the manufacturer. Trimester- and assay-specific reference intervals for copeptin and MR-proADM should be used. In addition, consecutive measurements and the time frame between measurements should be considered as the differences seen with or in advance of preeclampsia can be expected to be relatively small compared to the reference intervals.

  20. A global multicenter study on reference values: 1. Assessment of methods for derivation and comparison of reference intervals.

    Science.gov (United States)

    Ichihara, Kiyoshi; Ozarda, Yesim; Barth, Julian H; Klee, George; Qiu, Ling; Erasmus, Rajiv; Borai, Anwar; Evgina, Svetlana; Ashavaid, Tester; Khan, Dilshad; Schreier, Laura; Rolle, Reynan; Shimizu, Yoshihisa; Kimura, Shogo; Kawano, Reo; Armbruster, David; Mori, Kazuo; Yadav, Binod K

    2017-04-01

    The IFCC Committee on Reference Intervals and Decision Limits coordinated a global multicenter study on reference values (RVs) to explore rational and harmonizable procedures for derivation of reference intervals (RIs) and investigate the feasibility of sharing RIs through evaluation of sources of variation of RVs on a global scale. For the common protocol, rather lenient criteria for reference individuals were adopted to facilitate harmonized recruitment with planned use of the latent abnormal values exclusion (LAVE) method. As of July 2015, 12 countries had completed their study with total recruitment of 13,386 healthy adults. 25 analytes were measured chemically and 25 immunologically. A serum panel with assigned values was measured by all laboratories. RIs were derived by parametric and nonparametric methods. The effect of LAVE methods is prominent in analytes which reflect nutritional status, inflammation and muscular exertion, indicating that inappropriate results are frequent in any country. The validity of the parametric method was confirmed by the presence of analyte-specific distribution patterns and successful Gaussian transformation using the modified Box-Cox formula in all countries. After successful alignment of RVs based on the panel test results, nearly half the analytes showed variable degrees of between-country differences. This finding, however, requires confirmation after adjusting for BMI and other sources of variation. The results are reported in the second part of this paper. The collaborative study enabled us to evaluate rational methods for deriving RIs and comparing the RVs based on real-world datasets obtained in a harmonized manner. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Reference intervals for C-peptide and insulin derived from a general adult Danish population

    DEFF Research Database (Denmark)

    Larsen, Pia Bükmann; Linneberg, Allan René; Hansen, Torben

    2017-01-01

    calculated with and without the inclusion of persons who were prediabetic, according to two definitions (The World Health Organization (WHO) and American Diabetes Association (ADA)). To ensure the correctness of calibration, the control pools were analyzed by a reference laboratory. The reference intervals....... The difference is attributed to an incorrect conversion factor for converting from activity to metric units. The Cobas e411 assay uses the factor 6.945 for converting from U/mL to pmol/L. This is in disagreement with the biological activity of insulin which is 166.8×10(6)IU/mol or 6.00nmol/IU. CONCLUSION: We...

  2. Immunological and hematological reference intervals among HIV-seronegative pregnant women in northwest Ethiopia.

    Science.gov (United States)

    Genetu, Meaza; Damtie, Debasu; Workineh, Meseret; Mathewos Tebeje, Biniam; Enawgaw, Bamlaku; Deressa, Tekalign

    2017-01-01

    Pregnancy is a state characterized by profound physiological hematological changes. However, hematological reference intervals being used in clinical practice in Ethiopia are derived from nonlocal general populations, despite the significant variations reported previously. The aim of this study was to determine the immunological and hematological reference intervals in healthy pregnancy among HIV-seronegative pregnant women in northwest Ethiopia. A total of 200 healthy, HIV-seronegative pregnant women were enrolled from February 2015 to June 2015 in a cross-sectional study setting at Gondar University Hospital. Sociodemographic and obstetric data were collected using a structured questionnaire. Blood samples collected from each participant were used to define the immunological and hematological parameters. The mean, median, and 95% interval values were calculated for the immunological and hematological parameters. P -value reference intervals for the absolute CD4+ T-cell count and platelet count were 712.47-760.67 and 221.25-240.14, respectively. A progressive decline in the platelet count was observed as pregnancy advanced, with 95% intervals of 224.53-253.21, 209.50-237.38, and 213.70-247.86 in the first, second, and third trimesters, respectively ( P =0.27). There was a statistically significant increase in mean (±standard deviation [SD]) HCT with gestational age, being 39.18±6.70, 41.96±3.70, and 40.53±3.77 in the first, second, and third trimesters, respectively ( P =0.03). The overall 95% interval for hemoglobin (HB) concentration was 12.99-13.36 g/dL, HCT 40.19%-41.49%, mean corpuscular volume (MCV) 93.33-94.63 fL, and mean corpuscular hemoglobin (MCH) 28.88-34.81 pg. Compared with the reference ranges derived from other studies, we found considerable variations in CD4+T-cell count, HB, HCT, and MCV values. The findings of this study highlight the differences in immunohematological profile among pregnant women and nonpregnant women from Ethiopia and

  3. Reference intervals for glucose, beta-cell polypeptides and counterregulatory factors during prolonged fasting

    DEFF Research Database (Denmark)

    Højlund, Kurt; Wildner-Christensen, M; Eshøj, O

    2001-01-01

    To establish reference intervals for the pancreatic beta-cell response and the counterregulatory hormone response to prolonged fasting, we studied 33 healthy subjects (16 males, 17 females) during a 72-h fast. Glucose, insulin, C-peptide, and proinsulin levels decreased (P ... of counterregulatory factors increased during the fast [P fasting (P ... decreased from the second to third day of fasting (P = 0.03). Males had higher glucose and glucagon levels and lower FFA levels during the fast (P

  4. Reference interval determination of hemoglobin fractions in umbilical cord and placental blood by capillary electrophoresis.

    Science.gov (United States)

    Bó, Suzane Dal; de Oliveira Lemos, Fabiane Kreutz; Pedrazzani, Fabiane Spagnol; Cagliari, Cláudia Rosa; Scotti, Luciana

    2016-04-01

    Umbilical cord and placental blood (UCPB) is a rich source of hematopoietic stem cells widely used to treat diseases that did not have effective treatments until recently. Umbilical cord and placental blood banks (UCPBBs) are needed to be created to store UCPB. UCPB is collected immediately after birth, processed, and frozen until infusion. Detection of abnormal hemoglobins is one of UCPB screening tests available. The objective of the present study was to determine the reference interval for HbA, HbF, and HbA2 in UCPB using capillary electrophoresis. Methods: Observational retrospective study of UCPB samples undergoing hemoglobin electrophoresis was performed between April 2012 and May 2013. We analyzed 273 UCPB samples. All cords met the criteria of BrasilCORD. We found 19.9% (10.5–36.7%) for HbA, 80.1% (62.7–89.4%) for HbF, and 0.1% (0.0–0.6%) for HbA2. Data were expressed as median (P2.5–P97.5). Establishing specific reference intervals is the best option for most tests because such ranges reflect the status of the population in which the tests will be applied. The use of appropriate reference intervals ensures that clinical labs provide reliable information, thus enabling clinicians to correctly interpret results and choose the best approach for the target population.

  5. Population based reference intervals for common blood haematological and biochemical parameters in the akuapem north district.

    Science.gov (United States)

    Koram, Ka; Addae, Mm; Ocran, Jc; Adu-Amankwah, S; Rogers, Wo; Nkrumah, Fk

    2007-12-01

    To estimate the reference intervals for commonly used blood haematology and biochemical parameters in an adult (18-55yrs) population of residents of Mampong Akuapem. This was a population based cross sectional study of a randomly selected sample of the adult population of Mampong. The sample was selected from an updated census list of the Mampong area. Median values (95% range) for measured parameters were established as follows: Haemoglobin, (males) 14.2 g/dl (females) 12.0 g/dl Alanine aminotransferase (ALT), (female) 19.6 U/L (males) 26.1 U/L and Creatinine, (males) 108 mmol/L (females) 93 mmol/L. In comparison to reference values that are commonly used in Ghana, the haemoglobulin levels from this study were lower, and liver function parameters higher. This could be a result of genetic or environmental differences and calls for the need to establish site specific reference values applicable to our population.

  6. Immunological and hematological reference intervals among HIV-seronegative pregnant women in northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Genetu M

    2017-03-01

    Full Text Available Meaza Genetu,1 Debasu Damtie,1 Meseret Workineh,1 Biniam Mathewos Tebeje,1,2 Bamlaku Enawgaw,3 Tekalign Deressa1 1Department of Immunology and Molecular Biology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia; 2Molecular Parasitology Laboratory, Queensland Institute of Medical Research, Brisbane, Australia; 3Department of Hematology and Immunohematology, School of Biomedical and Laboratory Sciences, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia Background: Pregnancy is a state characterized by profound physiological hematological changes. However, hematological reference intervals being used in clinical practice in Ethiopia are derived from nonlocal general populations, despite the significant variations reported previously. The aim of this study was to determine the immunological and hematological reference intervals in healthy pregnancy among HIV-seronegative pregnant women in northwest Ethiopia.Materials and methods: A total of 200 healthy, HIV-seronegative pregnant women were enrolled from February 2015 to June 2015 in a cross-sectional study setting at Gondar University Hospital. Sociodemographic and obstetric data were collected using a structured questionnaire. Blood samples collected from each participant were used to define the immunological and hematological parameters. The mean, median, and 95% interval values were calculated for the immunological and hematological parameters. P-value <0.05 was considered statistically significant for all variables.Results: This study found that there were changes in CD4+ T-cell count, platelet count, and hematocrit (HCT values as pregnancy advances. The calculated combined reference intervals for the absolute CD4+ T-cell count and platelet count were 712.47–760.67 and 221.25–240.14, respectively. A progressive decline in the platelet count was observed as pregnancy advanced, with 95

  7. Establishment of reference intervals for the salivary cortisol circadian cycle, by electrochemiluminescence (ECLIA), in healthy adults.

    Science.gov (United States)

    Gagnon, Nadia; Fréchette, Isabelle; Mallet, Pierre-Luc; Dubé, Jean; Houde, Ghislaine; Fink, Guy D

    2018-02-19

    To determine salivary cortisol reference intervals in a healthy adult population, at 6 different time points during a 24-hour (h) period. In a prospective study, salivary cortisol concentrations were measured upon waking, one-hour post-waking and at specific times of the day: at 12 h00, 16 h00, 20 h00 and midnight. Samples were analyzed by the first and second-generation electrochemiluminescence assays (ECLIA) from Roche Cobas Cortisol®. Salivary cortisol values were obtained from 134 healthy volunteers. Reference intervals for the first-generation assay were 6.14-33.19 nmol/L (95% prediction interval) at waking, 5.42-28.06 nmol/L one-hour post-waking, 3.62-16.23 nmol/L at 12 h00, 2.78-15.27 nmol/L at 16 h00, 2.08-14.90 nmol/L at 20 h00 and 2.09-16.92 nmol/L at midnight. Mean salivary cortisol values were 14.63 nmol/L at waking and 6.44 nmol/L at midnight. Reference intervals for the second-generation assay were 1.50-22.02 nmol/L (2.5th to 97.5th percentiles) at waking, 1.50-20.87 nmol/L one-hour post-waking, 1.50-12.51 nmol/L at 12 h00, 1.50-13.03 nmol/L at 16 h00, 1.50-9.52 nmol/L at 20 h00 and 1.50-6.28 nmol/L at midnight. Values for the second-generation assay at all 6 different time points were almost half of the first-generation assay. The second-generation assay showed a better correlation with LC-MS/MS (r = 0,97). Our study confirms that reference intervals for salivary cortisol are not comparable across first and second-generation Roche Cobas Cortisol® assays. Furthermore, the second-generation assay has a better correlation with LC-MS/MS and a better analytical performance (accuracy and precision). Copyright © 2018. Published by Elsevier Inc.

  8. Valid analytical performance specifications for combined analytical bias and imprecision for the use of common reference intervals

    DEFF Research Database (Denmark)

    Hyltoft Petersen, Per; Lund, Flemming; Fraser, Callum G

    2018-01-01

    Background Many clinical decisions are based on comparison of patient results with reference intervals. Therefore, an estimation of the analytical performance specifications for the quality that would be required to allow sharing common reference intervals is needed. The International Federation...... of Clinical Chemistry (IFCC) recommended a minimum of 120 reference individuals to establish reference intervals. This number implies a certain level of quality, which could then be used for defining analytical performance specifications as the maximum combination of analytical bias and imprecision required...... for sharing common reference intervals, the aim of this investigation. Methods Two methods were investigated for defining the maximum combination of analytical bias and imprecision that would give the same quality of common reference intervals as the IFCC recommendation. Method 1 is based on a formula...

  9. Reference Intervals of Total Bilirubin, ALT, AST, and Creatinine in Healthy Elderly Chinese

    Science.gov (United States)

    Zhang, Guo-ming; Xia, Yong-jie; Guo, Xu-xiao; Zhu, Bao-lin; Zhang, Gao-ming; Ma, Xiao-bo; Yu, Hong; Wang, Hong-jian; Wang, Guang-sheng; Yang, Li; Zhou, Ye-ting

    2014-01-01

    Background The aim of this study was to establish the reference intervals (RIs) of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate transaminase (AST), and creatinine (CREA) for apparently healthy elderly (Han ethnicity) in Shuyang, China. Material/Methods A total of 54 912 blood specimens from elderly residents age 65–104 years were collected by standard procedures in Shuyang county of Jiangsu province. TBIL, ALT, AST, and CREA for each participant were determined by automatic biochemical analyzer. Distribution and differences of TBIL, ALT, AST, and CREA were analyzed and compared between the elderly of the same age of different sexes and different ages of the same sex. RIs of TBIL, ALT, AST, and CREA were compared with the current RIs. The RIs and 95% confidence intervals were calculated using nonparametric method (2.5th–97.5th percentiles) according to the guideline of the Clinical and Laboratory Standards Institute. Results RIs established for the healthy elderly include: TBIL 7.8~30.6 μmol/L for males and 7.3~26.1 μmol/L for females; ALT 8.7~47.3 U/L for males and 8.4~45.2 U/L for females; AST 15.7~46.9 U/L for males and 15.1~46.2 U/L for females; and CREA 45.1~100.9 μmol/L for males and 38.7~85.0 μmol/L for females. Reference intervals of TBIL, ALT, AST, and CREA for male elderly were higher than those of females, and values of CREA increased with increasing age. Conclusions We have established a panel of locally relevant RIs. It is necessary to establish scientific and reasonable RIs of TBIL, ALT, AST, and CREA for the healthy elderly in our region, which will provide a reference for clinicians and inspection officers. PMID:25272068

  10. Reference intervals for total bilirubin, ALT, AST and creatinine in healthy Chinese elderly.

    Science.gov (United States)

    Zhang, Guo-ming; Xia, Yong-jie; Guo, Xu-xiao; Zhu, Bao-lin; Zhang, Gao-ming; Ma, Xiao-bo; Yu, Hong; Wang, Hong-jian; Wang, Guang-sheng; Yang, Li; Zhou, Ye-ting

    2014-10-01

    The aim of this study was to establish the reference intervals (RIs) of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate transaminase (AST), and creatinine (CREA) for apparently healthy elderly (Han ethnicity) in Shuyang, China. A total of 54 912 blood specimens from elderly residents age 65-104 years were collected by standard procedures in Shuyang county of Jiangsu province. TBIL, ALT, AST, and CREA for each participant were determined by automatic biochemical analyzer. Distribution and differences of TBIL, ALT, AST, and CREA were analyzed and compared between the elderly of the same age of different sexes and different ages of the same sex. RIs of TBIL, ALT, AST, and CREA were compared with the current RIs. The RIs and 95% confidence intervals were calculated using nonparametric method (2.5th-97.5th percentiles) according to the guideline of the Clinical and Laboratory Standards Institute. RIs established for the healthy elderly include: TBIL 7.8~30.6 µmol/L for males and 7.3~26.1 µmol/L for females; ALT 8.7~47.3 U/L for males and 8.4~45.2 U/L for females; AST 15.7~46.9 U/L for males and 15.1~46.2 U/L for females; and CREA 45.1~100.9 µmol/L for males and 38.7~85.0 µmol/L for females. Reference intervals of TBIL, ALT, AST, and CREA for male elderly were higher than those of females, and values of CREA increased with increasing age. We have established a panel of locally relevant RIs. It is necessary to establish scientific and reasonable RIs of TBIL, ALT, AST, and CREA for the healthy elderly in our region, which will provide a reference for clinicians and inspection officers.

  11. Reference intervals for biochemical, haemostatic and haematological parameters in healthy Chinese women during early and late pregnancy.

    Science.gov (United States)

    Jin, Yi; Lu, Jie; Jin, Hong; Fei, Chunrong; Xie, Xinyou; Zhang, Jun

    2018-01-05

    Variations in maternal blood parameters, which are mostly induced by the physiological changes that occur during pregnancy, have been reported in different gestational periods. The use of the established reference intervals for healthy adult females leads to the misclassification of healthy pregnant women as abnormal. Our aim was to establish appropriate reference intervals for biochemical, haematological and haemostatic parameters in the first and third trimesters of pregnancy. We included 565 healthy pregnant women with normal pregnancies. Blood samples were collected for biochemical analyses, complete blood counts and coagulation analyses at 8-12 and 28-37 weeks of gestation. The median and reference intervals (the 2.5th and 97.5th values) were calculated for each parameter during pregnancy and then compared to the established reference intervals for healthy adult females. Significant increases in triglyceride, total cholesterol, low-density lipoprotein cholesterol, uric acid, alkaline phosphatase, white blood cell, mean platelet volume, fibrinogen and D-dimer reference intervals and clear decreases in total protein, albumin, blood urea nitrogen, creatinine, red blood cell, haemoglobin, haematocrit, platelet counts and thrombin time reference intervals were observed during pregnancy. According to the 'n%', most changes were observed beginning in the first trimester. Compared to the established reference intervals, the greatest misclassifications were observed for ALB, ALP and D-Di. Changes in maternal blood parameters during pregnancy were confirmed. We recommend that the reference intervals for most blood parameters be revised to account for the gestational period.

  12. Pediatric Reference Intervals for Several Biochemical Analytes in School Children in Central Taiwan

    Directory of Open Access Journals (Sweden)

    Dong-Shang Lai

    2009-12-01

    Conclusion: Our study provides new pediatric reference intervals (2.5th–97.5th percentiles of 60–99 mg/dL for serum glucose concentrations, 8–38 IU/L for ALT, 0.4–1.1 mg/L for Cr, 8.7–18.0 mg/L for BUN, and 10–34 for B/C ratio. The B/C ratio in children was higher than those of adults, possibily due to that children had a higher intake of protein.

  13. Pediatric reference intervals for 28 chemistries and immunoassays on the Roche cobas 6000 analyzer--a CALIPER pilot study.

    Science.gov (United States)

    Kulasingam, Vathany; Jung, Benjamin P; Blasutig, Ivan M; Baradaran, Sanaz; Chan, Man Khun; Aytekin, Mujdat; Colantonio, David A; Adeli, Khosrow

    2010-09-01

    The aim of this study was to determine age- and sex-specific pediatric reference intervals for 28 analytes on the Roche cobas 6000 analyzer. The study was conducted at the Hospital for Sick Children in Toronto, Canada. Approximately 600 outpatient samples from a pediatric population deemed to be metabolically stable were subdivided into five age classes ranging from 0 to 20 years of age and further partitioned by gender. Reference intervals were established, after removal of samples significantly affected by hemolysis, icterus and lipemia and outlier exclusion, using the Robust statistical method to obtain the 2.5th and 97.5th percentiles. Age (birth to 20 years of age) and gender-appropriate pediatric reference intervals for 28 analytes are reported. These reference intervals provide the basis for clinical interpretation of laboratory results using the Roche cobas 6000 analyzer or related instrumentation/methods, provided adequate reference interval verification studies are performed. Copyright (c) 2010. Published by Elsevier Inc.

  14. Serum biochemistry reference intervals of live wild dugongs (Dugong dugon) from urban coastal Australia.

    Science.gov (United States)

    Lanyon, Janet M; Wong, Arthur; Long, Trevor; Woolford, Lucy

    2015-06-01

    Little is known about the baseline clinical pathology of the dugong (Dugong dugon), a vulnerable marine mammal found in tropical coastal marine systems. The purpose of the study was to collect and determine reference intervals (RI) for select serum biochemical variables for dugongs, and to analyze differences between males and females and different age groups. Reference intervals were established from 103 apparently healthy, wild-caught dugongs for 31 analytes using a Beckman Coulter AU400 Automated Chemistry Analyzer and an Olympus AU680 Chemistry-Immuno Analyzer. Significant differences (P serum sodium, potassium, bicarbonate, glucose, and l-lactate concentrations and higher anion gap, compared to sub-adults. Male dugongs had higher triglyceride and l-lactate concentrations than females. Pregnant females displayed higher l-lactate levels compared to nonpregnant animals. Statistical differences in variables within the population contributed to better understanding of the physiologic differences between cohorts. Some serum biochemistry changes observed in this study here also potentially include some effects of pursuit on dugongs (eg, higher l-lactate); however, as all dugongs were subject to similar capture and handling, serum biochemistry RI should be considered as normal for captured dugongs. The serum biochemical RI documented here are considered representative of a population of healthy captured dugongs. They provide a baseline for health surveillance of this and other dugong populations. © 2015 American Society for Veterinary Clinical Pathology.

  15. TSH unresponsiveness, a case report

    Energy Technology Data Exchange (ETDEWEB)

    Aarseth, H.P.; Haug, E.; Raknerud, N.; Frey, H.M. (Aker Sykehus, Oslo (Norway))

    1983-01-01

    A patient with congenital primary hypothyroidism is presented. His thyroid gland had a normal uptake of radioiodine which was independent of endogenous or exogenous TSH, sympathetic B-receptor blockade or prostaglandin inhibition. Infusion of dibuturylcyclic AMP increased the uptake of radioiodine and stimulated release of protein bound /sup 131/I. He had no goiter even when he did not receive thyroxine, but thyroid histology showed evidence of active epithelium in the presence of adequate substitution with thyroxine. We assume that some unknown factor other than TSH stimulates part of the glandular function in this patient, without leading to adequate formation and release of thyroid hormone.

  16. Valid analytical performance specifications for combined analytical bias and imprecision for the use of common reference intervals.

    Science.gov (United States)

    Hyltoft Petersen, Per; Lund, Flemming; Fraser, Callum G; Sandberg, Sverre; Sölétormos, György

    2018-01-01

    Background Many clinical decisions are based on comparison of patient results with reference intervals. Therefore, an estimation of the analytical performance specifications for the quality that would be required to allow sharing common reference intervals is needed. The International Federation of Clinical Chemistry (IFCC) recommended a minimum of 120 reference individuals to establish reference intervals. This number implies a certain level of quality, which could then be used for defining analytical performance specifications as the maximum combination of analytical bias and imprecision required for sharing common reference intervals, the aim of this investigation. Methods Two methods were investigated for defining the maximum combination of analytical bias and imprecision that would give the same quality of common reference intervals as the IFCC recommendation. Method 1 is based on a formula for the combination of analytical bias and imprecision and Method 2 is based on the Microsoft Excel formula NORMINV including the fractional probability of reference individuals outside each limit and the Gaussian variables of mean and standard deviation. The combinations of normalized bias and imprecision are illustrated for both methods. The formulae are identical for Gaussian and log-Gaussian distributions. Results Method 2 gives the correct results with a constant percentage of 4.4% for all combinations of bias and imprecision. Conclusion The Microsoft Excel formula NORMINV is useful for the estimation of analytical performance specifications for both Gaussian and log-Gaussian distributions of reference intervals.

  17. “Are my Laboratory Results Normal?” Considerations to be Made Concerning Reference Intervals and Decision Limits

    Science.gov (United States)

    Ceriotti, Ferruccio; Henny, Joseph

    2008-01-01

    This paper looks at the topic of reference intervals from the point of view of the patient or the clinician. The differences between the concepts of reference intervals (biological characteristic of a well defined population) and the various types of decision limits are illustrated and discussed. Decision limits can be defined in different ways: based on a Bayesian approach, on epidemiological studies or on clinical experience, but differ from reference intervals because, while the latter deals with physiology, decision limits are related to some kind of disease or risk of developing it. PMID:27683305

  18. Analytical validation and reference intervals for freezing point depression osmometer measurements of urine osmolality in dogs.

    Science.gov (United States)

    Guerrero, Samantha; Pastor, Josep; Tvarijonaviciute, Asta; Cerón, José Joaquín; Balestra, Graziano; Caldin, Marco

    2017-11-01

    Urine osmolality (UOsm) is considered the most accurate measure of urine concentration and is used to assess body fluid homeostasis and renal function. We performed analytical validation of freezing point depression measurement of canine UOsm, to establish reference intervals (RIs) and to determine the effect of age, sex, and reproductive status on UOsm in dogs. Clinically healthy dogs ( n = 1,991) were retrospectively selected and stratified in groups by age (young [0-12 mo], adults [13-84 mo], and seniors [>84 mo]), sex (females and males), and reproductive status (intact and neutered). RIs were calculated for each age group. Intra- and inter-assay coefficients of variation were dogs, and 366-2,178 mOsm/kg in seniors. Senior dogs had a significantly lower UOsm than young and adult dogs ( p dogs ( p dogs.

  19. Adrenal Hormones in Common Bottlenose Dolphins (Tursiops truncatus): Influential Factors and Reference Intervals

    Science.gov (United States)

    Hart, Leslie B.; Wells, Randall S.; Kellar, Nick; Balmer, Brian C.; Hohn, Aleta A.; Lamb, Stephen V.; Rowles, Teri; Zolman, Eric S.; Schwacke, Lori H.

    2015-01-01

    Inshore common bottlenose dolphins (Tursiops truncatus) are exposed to a broad spectrum of natural and anthropogenic stressors. In response to these stressors, the mammalian adrenal gland releases hormones such as cortisol and aldosterone to maintain physiological and biochemical homeostasis. Consequently, adrenal gland dysfunction results in disruption of hormone secretion and an inappropriate stress response. Our objective herein was to develop diagnostic reference intervals (RIs) for adrenal hormones commonly associated with the stress response (i.e., cortisol, aldosterone) that account for the influence of intrinsic (e.g., age, sex) and extrinsic (e.g., time) factors. Ultimately, these reference intervals will be used to gauge an individual’s response to chase-capture stress and could indicate adrenal abnormalities. Linear mixed models (LMMs) were used to evaluate demographic and sampling factors contributing to differences in serum cortisol and aldosterone concentrations among bottlenose dolphins sampled in Sarasota Bay, Florida, USA (2000–2012). Serum cortisol concentrations were significantly associated with elapsed time from initial stimulation to sample collection (pserum concentrations of aldosterone and variables reported in previous studies (i.e., age, elapsed sampling time) were not observed in the current project (pSerum aldosterone concentrations from animals sampled at the three additional sites were compared to the detection limit, and the proportion of animals with low aldosterone concentrations was not significantly different than an expected prevalence of 16%. Although this study relied upon long-term, free-ranging bottlenose dolphin health data from a single site, the objective RIs can be used for future evaluation of adrenal function among individuals sampled during capture-release health assessments. PMID:25993341

  20. Serum Fructosamine Concentration in Uncontrolled Hyperthyroid Diabetic Cats Is within the Population Reference Interval

    Directory of Open Access Journals (Sweden)

    Arnon Gal

    2017-03-01

    Full Text Available Diabetes mellitus is a common endocrinopathy of cats that is characterized by persistent fasting hyperglycemia. However, stress induces substantial hyperglycemia in cats that poses a challenge to the veterinarian who may wrongly interpret the high serum concentration of blood glucose as evidence of diabetes mellitus. Fructosamine is a glycated serum protein that serves as an index of glycemic control in cats and is useful because it is not affected by stress hyperglycemia. However, factors such as body weight, hypoproteinemia, and increased serum thyroid hormone concentration can alter fructosamine concentration. The goal of this retrospective study was to compare the fructosamine concentrations in diabetic and nondiabetic cats with and without uncontrolled hyperthyroidism. A secondary goal was to determine the effect of sex, age, different populations of cats, and diabetes on the variability of fructosamine. We found that the mean (±SE serum fructosamine of hyperthyroid diabetic cats (332 ± 24 µmol/L, 95% CI 291–379 µmol/L was within the population-based reference interval (200–360 µmol/L and significantly lower in comparison to euthyroid diabetic cats (527 ± 10 µmol/L, 95% CI 515–553 µmol/L. Additionally, in this study, diabetes accounted only for approximately 50% of the variance in serum fructosamine, while age, sex, and population made a minor contribution to this variance. In conclusion, finding serum fructosamine that is within the population-based reference interval in an uncontrolled diabetic cat should alert the veterinarian to the possibility of concurrent hyperthyroidism. Additionally, the veterinary clinician should consider that serum fructosamine might be substantially affected by factors other than diabetes.

  1. Serum Fructosamine Concentration in Uncontrolled Hyperthyroid Diabetic Cats Is within the Population Reference Interval.

    Science.gov (United States)

    Gal, Arnon; Trusiano, Brie; French, Adrienne F; Lopez-Villalobos, Nicolas; MacNeill, Amy L

    2017-03-15

    Diabetes mellitus is a common endocrinopathy of cats that is characterized by persistent fasting hyperglycemia. However, stress induces substantial hyperglycemia in cats that poses a challenge to the veterinarian who may wrongly interpret the high serum concentration of blood glucose as evidence of diabetes mellitus. Fructosamine is a glycated serum protein that serves as an index of glycemic control in cats and is useful because it is not affected by stress hyperglycemia. However, factors such as body weight, hypoproteinemia, and increased serum thyroid hormone concentration can alter fructosamine concentration. The goal of this retrospective study was to compare the fructosamine concentrations in diabetic and nondiabetic cats with and without uncontrolled hyperthyroidism. A secondary goal was to determine the effect of sex, age, different populations of cats, and diabetes on the variability of fructosamine. We found that the mean (±SE) serum fructosamine of hyperthyroid diabetic cats (332 ± 24 µmol/L, 95% CI 291-379 µmol/L) was within the population-based reference interval (200-360 µmol/L) and significantly lower in comparison to euthyroid diabetic cats (527 ± 10 µmol/L, 95% CI 515-553 µmol/L). Additionally, in this study, diabetes accounted only for approximately 50% of the variance in serum fructosamine, while age, sex, and population made a minor contribution to this variance. In conclusion, finding serum fructosamine that is within the population-based reference interval in an uncontrolled diabetic cat should alert the veterinarian to the possibility of concurrent hyperthyroidism. Additionally, the veterinary clinician should consider that serum fructosamine might be substantially affected by factors other than diabetes.

  2. Establishing reference intervals for ALT, AST, UR, Cr, and UA in apparently healthy Chinese adolescents.

    Science.gov (United States)

    Li, Ying; Mussa, Ahmed Ebrahim; Tang, Aiguo; Xiang, Zhongyuan; Mo, Ximing

    2018-03-01

    The current child-specific reference intervals (RIs) are inadequate or even unavailable for many analyses in China. Many of the RIs used in Chinese laboratories were derived from Chinese adult standards or from foreign studies. The aim of this study was to establish specific RIs for alanine aminotransferase (ALT), aspartate aminotransferase (AST), urea (UR), creatinine (Cr) and uric acid (UA) for apparently healthy Chinese adolescents. Overall, 1682 apparently healthy adolescents were enrolled. Serum ALT, AST, UR, Cr and UA were measured by an ARCHITECT C-8000 automated chemistry analyzer. The 2.5th and 97.5th percentile RIs were determined using non-parametric methods. The established reference intervals for ALT, AST, UR, CR and UA were 7.5-42.8 U/L, 12.8-40.2 U/L, 3.12-6.38 mmol/L, 42.7-91.2 μmol/L, and 180.2-409.6 μmol/L in boys and 6.5-32.8 U/L, 10.4-32.5 U/L, 3.05-6.47 mmol/L, 40.2-88.8 μmol/L and 176.5-394.0 μmol/L in girls, respectively. The median and upper and lower limits for the RIs of ALT, AST, Cr and UA were higher in boys than they were in girls (P ALT, AST, UR, Cr and UA that are defined specifically for Chinese adolescents and are appropriate for universal use among Chinese laboratories. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Blood Biochemical Reference Intervals for Wild Ornate Box Turtles ( Terrapene ornata) during the Active Season.

    Science.gov (United States)

    Harden, Leigh Anne; Fernandez, Jennifer; Milanovich, Joseph R; Struecker, Brock P; Midway, Stephen R

    2018-03-21

    Blood biochemical and hematology analyses are helpful indicators of the physiologic health of animals, particularly when making conservation and management decisions for threatened species. In this study, we 1) established blood biochemical reference intervals for two populations of threatened, free-ranging ornate box turtles ( Terrapene ornata) in northern Illinois during their active season and 2) examined the effects of individual carapace temperature ( T c ) on blood biochemical variables by using a Bayesian hierarchic framework. Individual blood variables differed throughout the active season (May-September 2015), but there were few distinct patterns in concentrations over time. When controlling for individual variability, blood biochemical variables potassium, sodium, chloride, ionized calcium, hematocrit (percentage of packed cell volume), and osmolality showed no effect of T c (i.e., slope estimates for these variables were not credibly different from zero) and had little individual variation. Glucose and blood urea nitrogen (BUN) were found to have slopes credibly different from zero, with glucose having an estimated positive slope and BUN having an estimated negative slope, suggesting different relationships in response to T c when controlling for individual variability. These physiologic blood data will serve as important baseline reference values for the clinical evaluation of wild ornate box turtles presented for veterinary care or for comparison to other studies of wild populations. Further, this study highlights the importance of considering individual-level effects (e.g., T c ) on physiologic health variables.

  4. Adaptive Interval Type-2 Fuzzy Logic Control for PMSM Drives with a Modified Reference Frame

    KAUST Repository

    Chaoui, Hicham

    2017-01-10

    In this paper, an adaptive interval type-2 fuzzy logic control scheme is proposed for high-performance permanent magnet synchronous machine drives. This strategy combines the power of type-2 fuzzy logic systems with the adaptive control theory to achieve accurate tracking and robustness to higher uncertainties. Unlike other controllers, the proposed strategy does not require electrical transducers and hence, no explicit currents loop regulation is needed, which yields a simplified control scheme. But, this limits the machine\\'s operation range since it results in a higher energy consumption. Therefore, a modified reference frame is also proposed in this paper to decrease the machine\\'s consumption. To better assess the performance of the new reference frame, comparison against its original counterpart is carried-out under the same conditions. Moreover, the stability of the closed-loop control scheme is guaranteed by a Lyapunov theorem. Simulation and experimental results for numerous situations highlight the effectiveness of the proposed controller in standstill, transient, and steady-state conditions.

  5. Basic Evaluation of Analytical Performance and Clinical Utility of Immunoradiometric TSH Assay

    International Nuclear Information System (INIS)

    Suhy, Il Kyo; Cho, Bo Youn; Lee, Hong Kyu; Koh, Chang Soon; Min, Hun Ki; Lee, Mun Ho

    1987-01-01

    To assess the analytic performance of immunoradiometric TSH assay (IRMA TSH), assay precision determined by intra and interassay variance, assay accuracy determined by dilution and recovery study, were evaluated by using two commercial kit (Abott and Daichi). Normal range of basal serum TSH and TRH stimulated TSH increment were also determined in 234 healthy subjects (male 110, female 124; age 20-70) and 30 volunteers (male 10, female 20; age 21-26). In addition, basal TSH levels of 70 patients with untreated hyperthyroidism, 50 untreated hypothyroidism, and 60 euthyroidism were measured to assess the clinical utility of IRMA TSH. The detection limit of IRMA TSH was 0.04 mU/l and 0.08 mU/l by Abott Kit and Daichi kit respectively. Using Abott kit, intraassay variance were 2.0, 3.1 and 1.4% in mean TSH concentration 2.4, 31.6 and 98.2 mU/l repectively and interassay variance were 2.0 and 3.2% in mean TSH concentration 2.3 and 31.3 mU/l. Mean recovery rate was 92.5% and dilution study showed nearly straight line. When Daichi kit was used, intrasssay variance were 5.6, 5.2 and 6.2% in mean TSH concentration of 2.4, 31.6 and 98.2 mU/1 respectively and interassay variance were 7.1 and 7.4% in mean TSH of 2.3 and 31.3 mU,/l. Mean recovery rate was 89.9%. Normal range of basal TSH and TRH stimulated peak TSH were 0.38-4.02 mU/1 and 2.85-30.8 mU/1 repectively (95% confidence interval, Abott kit used). Sensitivity and specificity of basal TSH levels for diagnosing hypothyroidism as well as specificity for diagnosing hyperthyroidism were 100% by using both kit. Sensitivity of basal TSH level for diagnosing hyperthyroidism was 100% when TSH levels were measured by Abott kit while that was 80.9% when measured by Daichi kit. These results suggest that IRMA TSH was very precise and accurate method and might be used as a first line test in the evaluation of thyroid function

  6. Reference intervals for serum biochemistries of molting Pacific Black Brant (Branta bernicla nigricans) in Northern Alaska, USA

    Science.gov (United States)

    Franson, J. Christian; Flint, Paul L.; Schmutz, Joel A.

    2017-01-01

    We determined reference intervals for nine serum biochemistries in samples from 329 molting, after-hatch-year, Pacific Black Brant (Branta bernicla nigricans) in Alaska, US. Cholesterol and nonesterified fatty acids differed by sex, but no other differences were noted.

  7. Establishment of a paediatric age-related reference interval for the measurement of urinary total fractionated metanephrines.

    LENUS (Irish Health Repository)

    Griffin, Alison

    2011-01-01

    Normetanephrine and metanephrine are intermediate metabolites of noradrenaline and adrenaline metabolism. To assess whether normetanephrine and metanephrine analysis may aid in the diagnosis of Neuroblastoma, a reference interval for these metabolites must first be established.

  8. Reference intervals and variation for urinary epinephrine, norepinephrine and cortisol in healthy men and women in Denmark

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Garde, A H; Christensen, J M

    2001-01-01

    Reference intervals for urinary epinephrine, norepinephrine and cortisol in 120 healthy individuals performing their routine work were established according to the International Union of Pure and Applied Chemistry (IUPAC) and the International Federation of Clinical Chemistry and Laboratory...... Medicine (IFCC) for use in the risk assessment of exposure to occupational stress. Reference intervals were established for three different times of the day: in morning samples (05.45-07.15) the limit of detection (LOD) was 2.10 micromol epinephrine/mol creatinine (82 women) and 2.86 micromol epinephrine....../mol creatinine (37 men), and the reference interval was 3.6-29.1 micromol norepinephrine/mol creatinine and 2.3-52.8 micromol cortisol/mol creatinine (119 women and men); in afternoon samples (15.30-18.30) the reference interval was 0.64-10.8 micromol epinephrine/mol creatinine (82 women), 1.20-11.2 micromol...

  9. Advances in Pediatric Reference Intervals for Biochemical Markers: Establishment of the Caliper Database in Healthy Children and Adolescents.

    Science.gov (United States)

    Karbasy, Kimiya; Ariadne, Petra; Gaglione, Stephanie; Nieuwesteeg, Michelle; Adeli, Khosrow

    2015-01-01

    Clinical laboratory reference intervals provide valuable information to medical practitioners in their interpretation of quantitative laboratory test results, and therefore are critical in the assessment of patient health and in clinical decision-making. The reference interval serves as a health-associated benchmark with which to compare an individual test result. Unfortunately, critical gaps currently exist in accurate and up-to-date pediatric reference intervals for accurate interpretation of laboratory tests performed in children and adolescents. These critical gaps in the available laboratory reference intervals have the clear potential of contributing to erroneous diagnosis or misdiagnosis of many diseases. To address these important gaps, several initiatives have begun internationally by a number of bodies including the KiGGS initiative in Germany, the Aussie Normals in Australia, the AACC-National Children Study in USA, the NORICHILD Initiative in Scandinavia, and the CALIPER study in Canada. In the present article, we will review the gaps in pediatric reference intervals, challenges in establishing pediatric norms in healthy children and adolescents, and the major contributions of the CALIPER program to closing the gaps in this crucial area of pediatric laboratory medicine. We will also discuss the recently published CALIPER reference interval database (www.caliperdatabase.com) developed to provide comprehensive age and gender specific pediatric reference intervals for a larger number of biochemical markers, based on a large and diverse healthy children cohort. The CALIPER database is based on a multiethnic population examining the influence of ethnicity on laboratory reference intervals. Thus the database has proved to be of global benefit and is being adopted by hospital laboratories worldwide.

  10. Pediatric-specific reference intervals in a nationally representative sample of Iranian children and adolescents: the CASPIAN-III study.

    Science.gov (United States)

    Kelishadi, Roya; Marateb, Hamid Reza; Mansourian, Marjan; Ardalan, Gelayol; Heshmat, Ramin; Adeli, Khosrow

    2016-08-01

    This study aimed to determine for the first time the age- and gender-specific reference intervals for biomarkers of bone, metabolism, nutrition, and obesity in a nationally representative sample of the Iranian children and adolescents. We assessed the data of blood samples obtained from healthy Iranian children and adolescents, aged 7 to 19 years. The reference intervals of glucose, lipid profile, liver enzymes, zinc, copper, chromium, magnesium, and 25-hydroxy vitamin D [25(OH)D] were determined according to the Clinical & Laboratory Standards Institute C28-A3 guidelines. The reference intervals were partitioned using the Harris-Boyd method according to age and gender. The study population consisted of 4800 school students (50% boys, mean age of 13.8 years). Twelve chemistry analyses were partitioned by age and gender, displaying the range of results between the 2.5th to 97.5th percentiles. Significant differences existed only between boys and girls at 18 to 19 years of age for low density lipoprotein-cholesterol. 25(OH)D had the only reference interval that was similar to all age groups and both sexes. This study presented the first national database of reference intervals for a number of biochemical markers in Iranian children and adolescents. It is the first report of its kind from the Middle East and North Africa. The findings underscore the importance of providing reference intervals in different ethnicities and in various regions.

  11. Reference intervals for hematology, serum biochemistry, and basic clinical findings in free-ranging Chinese Pangolin (Manis pentadactyla) from Taiwan.

    Science.gov (United States)

    Khatri-Chhetri, Rupak; Sun, Ching-Min; Wu, Hung-Yi; Pei, Kurtis Jai-Chyi

    2015-09-01

    There are 8 species of Pangolins found in Asia and Africa. Among them, the Chinese Pangolin (Manis pentadactyla) is an endangered insectivorous mammal found only in Asia. Hematology and serum chemistry reference intervals are critical for evaluating an animal's well-being and can be useful for clinical diagnostic purposes. Currently, there are no such reference intervals available for any Pangolin species. The purpose of the present study was to establish reference intervals for hematology and serum biochemical analytes, and some basic clinical findings, in Chinese Pangolins. Reference intervals for the hematology and serum chemistry variables, and basic clinical findings (body weight, heart rate, body temperature, blood oxygen saturation) were collected from 100 clinically healthy Chinese Pangolins (51 males and 49 females) using parametric and nonparametric percentile methods. In addition, seasonal, age-related, and sexual differences for all variables were statistically analyzed. No significant differences in the reference intervals were found between males and females, except for body weight. However, significant seasonal differences were observed for heart rate, body temperature, serum ALT and lipase activities, and phosphate concentrations. The variables, which were significantly different between adult and sub-adult Pangolins were heart rate, MCH, creatinine, total protein, phosphate, glucose, and potassium concentration, and amylase activity. Seasonal and age group differences should be taken into consideration when using these reference intervals. The findings from the present study represent a valuable resource for assessing the health of Chinese Pangolins, and contribute toward the conservation of this endangered mammal. © 2015 American Society for Veterinary Clinical Pathology.

  12. Complex reference value distributions and partitioned reference intervals across the pediatric age range for 14 specialized biochemical markers in the CALIPER cohort of healthy community children and adolescents.

    Science.gov (United States)

    Kelly, Jacalyn; Raizman, Joshua E; Bevilacqua, Victoria; Chan, Man Khun; Chen, Yunqi; Quinn, Frank; Shodin, Beth; Armbruster, David; Adeli, Khosrow

    2015-10-23

    The CALIPER program has previously reported a comprehensive database of pediatric reference intervals for 63 biochemical and immunochemical markers. Here, covariate-stratified reference intervals were determined for a number of special assays not previously reported. A total of 1917 healthy children and adolescents were recruited and serum concentrations of 14 biochemical markers were measured using the Abbott Architect ci4100 system. Age and gender partitions were statistically determined, outliers removed and reference intervals calculated using CSLI C28-A3 guidelines. Many analytes showed dynamic changes in concentration requiring at least 3 age partitions. Unique intervals were required within the first year of life for: pancreatic amylase, C-peptide, ceruloplasmin, insulin, β-2-microglobulin, cystatin C, dehydroepiandrosterone sulfate (DHEA-S), and α-1-glycoprotein. Cholinesterase, cholinesterase-dibucaine number, and immunoglobulin E required only 2 age partitions and α-1-antitrypsin required only one. Anti-CCP and anti-TPO levels were below the detection limit of the assay. Some analytes including insulin and DHEA-S required additional gender partitions for specific age groups. Complex profiles were observed for endocrine and special chemistry markers, requiring establishment of age- and gender-specific reference intervals. These updated reference intervals will allow improved laboratory assessment of pediatric patients but should be validated for each analytical platform and local population as recommended by CLSI. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. Adrenal Hormones in Common Bottlenose Dolphins (Tursiops truncatus: Influential Factors and Reference Intervals.

    Directory of Open Access Journals (Sweden)

    Leslie B Hart

    Full Text Available Inshore common bottlenose dolphins (Tursiops truncatus are exposed to a broad spectrum of natural and anthropogenic stressors. In response to these stressors, the mammalian adrenal gland releases hormones such as cortisol and aldosterone to maintain physiological and biochemical homeostasis. Consequently, adrenal gland dysfunction results in disruption of hormone secretion and an inappropriate stress response. Our objective herein was to develop diagnostic reference intervals (RIs for adrenal hormones commonly associated with the stress response (i.e., cortisol, aldosterone that account for the influence of intrinsic (e.g., age, sex and extrinsic (e.g., time factors. Ultimately, these reference intervals will be used to gauge an individual's response to chase-capture stress and could indicate adrenal abnormalities. Linear mixed models (LMMs were used to evaluate demographic and sampling factors contributing to differences in serum cortisol and aldosterone concentrations among bottlenose dolphins sampled in Sarasota Bay, Florida, USA (2000-2012. Serum cortisol concentrations were significantly associated with elapsed time from initial stimulation to sample collection (p<0.05, and RIs were constructed using nonparametric methods based on elapsed sampling time for dolphins sampled in less than 30 minutes following net deployment (95% RI: 0.91-4.21 µg/dL and following biological sampling aboard a research vessel (95% RI: 2.32-6.68 µg/dL. To examine the applicability of the pre-sampling cortisol RI across multiple estuarine stocks, data from three additional southeast U.S. sites were compared, revealing that all of the dolphins sampled from the other sites (N = 34 had cortisol concentrations within the 95th percentile RI. Significant associations between serum concentrations of aldosterone and variables reported in previous studies (i.e., age, elapsed sampling time were not observed in the current project (p<0.05. Also, approximately 16% of

  14. Clinical chemistry reference intervals of healthy adult populations in Gojjam Zones of Amhara National Regional State, Northwest Ethiopia.

    Science.gov (United States)

    Mekonnen, Zewdie; Amuamuta, Asmare; Mulu, Wondemagegn; Yimer, Mulat; Zenebe, Yohannes; Adem, Yesuf; Abera, Bayeh; Gebeyehu, Wondemu; Gebregziabher, Yakob

    2017-01-01

    Reference interval is crucial for disease screening, diagnosis, monitoring, progression and treatment efficacy. Due to lack of locally derived reference values for the parameters, clinicians use reference intervals derived from western population. But, studies conducted in different African countries have indicated differences between locally and western derived reference values. Different studies also indicated considerable variation in clinical chemistry reference intervals by several variables such as age, sex, geographical location, environment, lifestyle and genetic variation. This study aimed to determine the reference intervals of common clinical chemistry parameters of the community of Gojjam Zones, Northwest Ethiopia. Population based cross-sectional study was conducted from November 2015 to December 2016 in healthy adult populations of Gojjam zone. Data such as, medical history, physical examination and socio-demographic data were collected. In addition, laboratory investigations were undertaken to screen the population. Clinical chemistry parameters were measured using Mindray BS 200 clinical chemistry autoanalyzer as per the manufacturer's instructions. Descriptive statistics was used to calculate mean, median and 95th percentiles. Independent sample T-test and one way ANOVA were used to see association between variables. After careful screening of a total of 799 apparently healthy adults who were consented for this study, complete data from 446 (224 females and 222 males) were included for the analysis. The mean age of both the study participants was 28.8 years. Males had high (Preference intervals of amylase, LDH, total protein and total bilirubin were not significantly different between the two sex groups (P>0.05). Mean, median, 95% percentile values of AST, ALP, amylase, LDH, creatinine, total protein, total bilirubin, and direct bilirubin across all age groups of participants were similar (P>0.05). But, there was a significant difference in the

  15. Biochemical reference intervals and intestinal microflora of free-ranging Ricord's iguanas (Cyclura ricordii).

    Science.gov (United States)

    Maria, Roberto; Ramer, Jan; Reichard, Tim; Tolson, Peter J; Christopher, Mary M

    2007-09-01

    Caribbean iguanas, including the Ricord's iguana (Cyclura ricordii) are ranked as critically endangered on the International Union of the Conservation of Nature (IUCN) Red List. The taxon is endemic to Hispaniola, where it inhabits xeric lowlands and is found in a very limited range in two subpopulations in the southwestern area of the island. The goals of this study were to obtain and analyze plasma biochemical and intestinal microbiological data from Ricord's iguanas in the subpopulation of the Neiba Valley, on Cabritos Island National Park, Dominican Republic, and to establish biochemical reference intervals. A total of 23 blood samples from clinically healthy iguanas (16 males, 7 females) and 14 fecal samples from clinically healthy iguanas were analyzed. Adult female iguanas had higher concentrations of cholesterol, phosphorus, triglycerides, urea, uric acid, and aspartate transaminase activity compared with male iguanas, although the difference was not statistically significant. Seventeen bacterial isolates were obtained, including: Salmonella sp. (serogroup B; serogroup D negative) Escherichia coli, Brevibacterium sp., Enterobacter cloacae, and Enterococcus durans. These data will help contribute to the management and recovery of Ricord's iguana populations.

  16. Resampling Approach for Determination of the Method for Reference Interval Calculation in Clinical Laboratory Practice▿

    Science.gov (United States)

    Pavlov, Igor Y.; Wilson, Andrew R.; Delgado, Julio C.

    2010-01-01

    Reference intervals (RI) play a key role in clinical interpretation of laboratory test results. Numerous articles are devoted to analyzing and discussing various methods of RI determination. The two most widely used approaches are the parametric method, which assumes data normality, and a nonparametric, rank-based procedure. The decision about which method to use is usually made arbitrarily. The goal of this study was to demonstrate that using a resampling approach for the comparison of RI determination techniques could help researchers select the right procedure. Three methods of RI calculation—parametric, transformed parametric, and quantile-based bootstrapping—were applied to multiple random samples drawn from 81 values of complement factor B observations and from a computer-simulated normally distributed population. It was shown that differences in RI between legitimate methods could be up to 20% and even more. The transformed parametric method was found to be the best method for the calculation of RI of non-normally distributed factor B estimations, producing an unbiased RI and the lowest confidence limits and interquartile ranges. For a simulated Gaussian population, parametric calculations, as expected, were the best; quantile-based bootstrapping produced biased results at low sample sizes, and the transformed parametric method generated heavily biased RI. The resampling approach could help compare different RI calculation methods. An algorithm showing a resampling procedure for choosing the appropriate method for RI calculations is included. PMID:20554803

  17. Harmonising Adult Reference Intervals in Australia and New Zealand – the Continuing Story

    Science.gov (United States)

    Koerbin, Gus; Tate, Jillian R.

    2016-01-01

    Reference intervals (RIs) are used to help clinicians determine if a patient can be classified as being in a diseased or healthy state and there are often sound scientific and clinical reasons for differences in RIs. One of the current strategic priorities for the Australasian Association of Clinical Biochemists is to encourage and assist laboratories to achieve harmonisation of RIs for common clinical chemistry analytes where sound calibration and traceability are in place. This need is based on good laboratory practice, providing the clinician with results that allow appropriate and reliable clinical interpretation and progression further toward the national e-health framework and a single electronic health record. After reviewing and considering studies related to bias as well as both a priori and a posteriori RI studies nationally and internationally and the consideration of flagging rates and clinical relevance, an initial group of 12 harmonised RIs were endorsed by the Royal College of Pathologists of Australasia in 2014. In 2015, after further stakeholder consultation, a second group of six harmonised RIs for common chemistry analytes has been proposed for adults which includes ALT and AST where methods do not use pyridoxal-5′-phosphate as an activator and lipase excluding the Ortho Clinical Diagnostics and Siemens Dimension assays. PMID:27872506

  18. Transference of CALIPER pediatric reference intervals to biochemical assays on the Roche cobas 6000 and the Roche Modular P.

    Science.gov (United States)

    Higgins, Victoria; Chan, Man Khun; Nieuwesteeg, Michelle; Hoffman, Barry R; Bromberg, Irvin L; Gornall, Doug; Randell, Edward; Adeli, Khosrow

    2016-01-01

    The Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) has recently established pediatric age- and sex-specific reference intervals for over 85 biochemical markers on the Abbott Architect system. Previously, CALIPER reference intervals for several biochemical markers were successfully transferred from Abbott assays to Roche, Beckman, Ortho, and Siemens assays. This study further broadens the CALIPER database by performing transference and verification for 52 biochemical assays on the Roche cobas 6000 and the Roche Modular P. Using CLSI C28-A3 and EP9-A2 guidelines, transference of the CALIPER reference intervals was attempted for 16 assays on the Roche cobas 6000 and 36 on the Modular P. Calculated reference intervals were further verified using 100 healthy CALIPER samples. Most assays showed strong correlation between assay systems and were transferable from Abbott to the Roche cobas 6000 (81%) and the Modular P (86%). Bicarbonate and magnesium were not transferable on either system and calcium and prealbumin were not transferable to the Modular P. Of the transferable analytes, 62% and 61% were verified on the cobas 6000 and the Modular P, respectively. This study extends the utility of the CALIPER database to two additional analytical systems, which facilitates the broad application of CALIPER reference intervals at pediatric centers utilizing Roche biochemical assays. Transference studies across different analytical platforms can later be collectively analyzed in an attempt to develop common reference intervals across all clinical chemistry instruments to harmonize laboratory test interpretation in diagnosis and monitoring of pediatric disease. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  19. Reference intervals for serum reactive oxygen metabolites, biological antioxidant potential, and oxidative stress index in adult rams.

    Science.gov (United States)

    Oikonomidis, Ioannis L; Kiosis, Evangelos A; Brozos, Christos N; Kritsepi-Konstantinou, Maria G

    2017-03-01

    OBJECTIVE To establish reference intervals for serum reactive oxygen metabolites (ROMs), biological antioxidant potential (BAP), and oxidative stress index (OSi) in adult rams by use of controlled preanalytic and analytic procedures. ANIMALS 123 healthy 1- to 4-year-old rams of 2 Greek breeds (Chios [n = 62] and Florina [61]). PROCEDURES 4 hours after rams were fed, a blood sample was obtained from each ram, and serum was harvested. Concentrations of ROMs and BAP were measured colorimetrically on a spectrophotometric analyzer. The OSi was calculated as ROMs concentration divided by BAP concentration. Combined and breed-specific reference intervals were calculated by use of nonparametric and robust methods, respectively. Reference intervals were defined as the 2.5th to 97.5th percentiles. RESULTS Reference intervals for ROMs, BAP, and OSi for all rams combined were 65 to 109 Carratelli units, 2,364 to 4,491 μmol/L, and 18.2 to 43.0 Carratelli units/(mmol/L), respectively. Reference intervals of Chios rams for ROMs, BAP, and OSi were 56 to 113 Carratelli units, 2,234 to 4,290 μmol/L, and 12.9 to 38.4 Carratelli units/(mmol/L), respectively. Reference intervals of Florina rams for ROMs, BAP, and OSi were 68 to 111 Carratelli units, 2,337 to 4,363 μmol/L, and 14.1 to 38.1 Carratelli units/(mmol/L), respectively. CONCLUSIONS AND CLINICAL RELEVANCE Reference intervals calculated in this study can be used as a guide for the interpretation of ROMs, BAP, and OSi results in rams and, under appropriate conditions, can be adopted for use by veterinary laboratories.

  20. BRIDGING GAPS BETWEEN ZOO AND WILDLIFE MEDICINE: ESTABLISHING REFERENCE INTERVALS FOR FREE-RANGING AFRICAN LIONS (PANTHERA LEO).

    Science.gov (United States)

    Broughton, Heather M; Govender, Danny; Shikwambana, Purvance; Chappell, Patrick; Jolles, Anna

    2017-06-01

    The International Species Information System has set forth an extensive database of reference intervals for zoologic species, allowing veterinarians and game park officials to distinguish normal health parameters from underlying disease processes in captive wildlife. However, several recent studies comparing reference values from captive and free-ranging animals have found significant variation between populations, necessitating the development of separate reference intervals in free-ranging wildlife to aid in the interpretation of health data. Thus, this study characterizes reference intervals for six biochemical analytes, eleven hematologic or immune parameters, and three hormones using samples from 219 free-ranging African lions ( Panthera leo ) captured in Kruger National Park, South Africa. Using the original sample population, exclusion criteria based on physical examination were applied to yield a final reference population of 52 clinically normal lions. Reference intervals were then generated via 90% confidence intervals on log-transformed data using parametric bootstrapping techniques. In addition to the generation of reference intervals, linear mixed-effect models and generalized linear mixed-effect models were used to model associations of each focal parameter with the following independent variables: age, sex, and body condition score. Age and sex were statistically significant drivers for changes in hepatic enzymes, renal values, hematologic parameters, and leptin, a hormone related to body fat stores. Body condition was positively correlated with changes in monocyte counts. Given the large variation in reference values taken from captive versus free-ranging lions, it is our hope that this study will serve as a baseline for future clinical evaluations and biomedical research targeting free-ranging African lions.

  1. Comparison of two automated assays of BTM (CTX and P1NP) and reference intervals in a Danish population.

    Science.gov (United States)

    Jørgensen, N R; Møllehave, L T; Hansen, Y B L; Quardon, N; Lylloff, L; Linneberg, A

    2017-07-01

    Bone turnover markers are used for monitoring osteoporosis treatment. Therefore, we evaluated the agreement between different assays for CTX and PINP and established reference intervals in a cohort of 2300 individuals. We found poor agreement between assays and different reference intervals. This highlights the importance of harmonization of the assays. Two reference markers for bone turnover have been proposed: CTX bone resorption and P1NP for bone formation. The purpose of the current study was to establish reference intervals for the two markers in a Danish cohort and to determine the agreement on the two platforms. Fasting sera from 2308 individuals (1250 males and 1058 females, age range 24-76 years) participating in the Health2006 study were analyzed for CTX and P1NP using the automated IDS-iSYS analyzer and the automated Cobas e411 analyzer. Participants in anti-osteoporotic treatment were excluded, while subjects on hormonal contraceptives were included. There was significant disagreement between both the two P1NP assays with a mean difference of -3 μg/L (LoA -19 to 14) (p reference intervals for each sex: 25-29, 30-39, and 40-80 years for men, and 25-29, >30 (pre-menopausal), and >30 years (post-menopausal) for women. There is significant disagreement between the IDS-iSYS and Roche Cobas assays for both reference markers. Consequently, the reference intervals for an adult, healthy population are different depending on the analysis method used. Therefore, repeated measurements of patient samples used for monitoring of treatment should be done on the same assay. Moreover, assay-specific reference intervals should be used. Harmonization of assays for BTM is highly warranted.

  2. A sensitive and rapid mass spectrometric method for the simultaneous measurement of eight steroid hormones and CALIPER pediatric reference intervals.

    Science.gov (United States)

    Kyriakopoulou, L; Yazdanpanah, M; Colantonio, D A; Chan, M K; Daly, C H; Adeli, K

    2013-05-01

    To develop an accurate assay and establish the normal reference intervals for serum cortisol, corticosterone, 11-deoxycortisol, androstenedione, 21-hydroxyprogesterone, testosterone, 17-hydroxyprogesterone, and progesterone. These steroids are commonly used as biomarkers for the diagnosis and monitoring of endocrine diseases such as congenital adrenal hyperplasia. Appropriate age- and gender-stratified reference intervals are essential in accurate interpretation of steroid hormone levels. The samples analyzed in this study were collected from healthy, ethnically diverse children in the Greater Toronto Area as part of the CALIPER program. A total of 337 serum samples from children between the ages of 0 and 18years were analyzed. The concentrations were measured by using an LC-MS/MS method. The data were analyzed for outliers and age- and gender-specific partitions were established prior to establishing the 2.5th and 97.5th percentiles for the reference intervals. Reference intervals for all hormones required significant age-dependent stratification while testosterone and progesterone required additional sex-dependent stratification. We report a sensitive, accurate and relatively fast LC-MS/MS method for the simultaneous measurement of eight steroid hormones. Detailed reference intervals partitioned based on both age and gender were also established for all eight steroid hormones. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Changing reference intervals for haemoglobin in Denmark: Clinical and financial aspects

    Science.gov (United States)

    Ryberg-Nørholt, Judith; Frederiksen, Henrik; Nybo, Mads

    2017-01-01

    Introduction Based on international experiences and altering demography the reference intervals (RI) for haemoglobin (Hb) concentrations in blood were changed in Denmark in 2013 from 113 - 161 g/L to 117 - 153 g/L for women and from 129 - 177 g/L to 134 - 170 g/L for men. The aim of this study was to determine the derived change in prevalence of anaemia and the change in yearly health care costs of diagnostic investigations associated with the expected, as we hypothesized, increased prevalence and health care costs. Materials and methods Data from 96,314 non-hospitalised patients (55,341 females and 40,973 males, aged 18 - 105 years) from general practitioners and community specialists of Funen, Denmark, were extracted from the laboratory information system. The prevalence of anaemia according to the new and the old RI were investigated, and additional costs were calculated based on estimated additional blood analyses and nationally recommended endoscopic procedures. Results Changing the Hb RI increased the number of anaemic patients by 52% (3450 patients) over a two-year period. With new RI the proportion of anaemic elderly above 80 years was 20.5% for females and 43.9% for males. Annual costs of derived additional assessments due to the altered RI were estimated to be 5.7 million €, which equals the cost of 1214 knee replacement surgeries in Denmark. Conclusions Changing the Hb RI has been expensive, despite the fact that no outcome studies have justified the alteration. The methodological approach for establishing new RI, here particularly for Hb, should be thoroughly considered. In general, physicians should use RI with caution. PMID:28900365

  4. Canine pulmonary vein-to-pulmonary artery ratio: echocardiographic technique and reference intervals.

    Science.gov (United States)

    Birettoni, F; Caivano, D; Patata, V; Moïse, N S; Guglielmini, C; Rishniw, M; Porciello, F

    2016-12-01

    The size of the pulmonary veins (PVs) and pulmonary arteries (PAs) changes in response to hemodynamic alterations caused by physiological events and disease. We sought to create standardized echocardiographic methods for imaging the right ostium of the pulmonary veins (RPVs) and the right pulmonary artery (RPA) using specific landmarks and timing to quantify vessel diameters and phasic changes during the cardiac cycle. Fifty client-owned healthy dogs prospectively recruited. M-mode and 2-dimensional images were obtained from modified right parasternal long and short axis views. Right ostium of the pulmonary veins and RPA measurements were timed with electrical [peak of the QRS complex (RPV QRS and RPA QRS ) and end of T wave (RPV T and RPA T )] or mechanical events [RPV and RPA vessels at their respective maximal (RPV MAX ; RPA MAX ) and minimal (RPV MIN ; RPA MIN ) diameters]. Right ostium of the pulmonary veins and RPA measurements were also indexed to the aorta. In normal dogs regardless of the echocardiographic view or time in the cardiac cycle, the RPV/RPA ratio approximated 1.0. Mechanically timed fractional changes (distensibility indices) in RPV and RPA diameters did not differ (p=0.99; 36.9% and 36.8%, respectively). ECG-timed fractional changes (distensibility indices) in RPV and RPA diameter were at least 50% smaller than mechanically timed changes (p<0.05). RPV:Ao and RPA:Ao ranged between 0.3 and 0.6, with lower values obtained in diastole and larger values in systole (p<0.0001). Multiple positive and negative deflections were identified on the RPV and RPA M-mode tracings. This study provides detailed methodology and 2D and M-mode reference intervals for the RPV and RPA dimensions and the phasic changes during the cardiac cycle of the dog using echocardiography. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Analytical performance, reference values and decision limits. A need to differentiate between reference intervals and decision limits and to define analytical quality specifications

    DEFF Research Database (Denmark)

    Petersen, Per Hyltoft; Jensen, Esther A; Brandslund, Ivan

    2012-01-01

    With the increasing use of decision limits (action limits, cut-off points) specified for a number of analytical components in diagnosis and for action in critical situations, formulated in national or international recommendations, the traditional interpretation of reference intervals has been...... of the values of analytical components measured on reference samples from reference individuals. Decision limits are based on guidelines from national and international expert groups defining specific concentrations of certain components as limits for decision about diagnosis or well-defined specific actions....... Analytical quality specifications for reference intervals have been defined for bias since the 1990s, but in the recommendations specified in the clinical guidelines analytical quality specifications are only scarcely defined. The demands for negligible biases are, however, even more essential for decision...

  6. Reference interval and subject variation in excretion of urinary metabolites of nicotine from non-smoking healthy subjects in Denmark

    DEFF Research Database (Denmark)

    Hansen, A M; Garde, A H; Christensen, J M

    2001-01-01

    BACKGROUND: Passive smoking has been found to be a respiratory health hazard in humans. The present study describes the calculation of a reference interval for urinary nicotine metabolites calculated as cotinine equivalents on the basis of 72 non-smokers exposed to tobacco smoke less than 25....... Parametric reference interval for excretion of nicotine metabolites in urine from non-smokers was established according to International Union of Pure and Applied Chemistry (IUPAC) and International Federation for Clinical Chemistry (IFCC) for use of risk assessment of exposure to tobacco smoke....... The reference interval for urinary cotinine was estimated to be 1.1-90.0 micromol/mol creatinine in morning samples from non-smokers. An intercomparison between the radioimmunoassay (RIA) method used for determination of nicotine metabolites and a gas chromatography-mass spectrometry (GC-MS) method...

  7. Reference interval and subject variation in excretion of urinary metabolites of nicotine from non-smoking healthy subjects in Denmark

    DEFF Research Database (Denmark)

    Hansen, A M; Garde, A H; Christensen, J M

    2001-01-01

    BACKGROUND: Passive smoking has been found to be a respiratory health hazard in humans. The present study describes the calculation of a reference interval for urinary nicotine metabolites calculated as cotinine equivalents on the basis of 72 non-smokers exposed to tobacco smoke less than 25......% of the day. METHODS: Twenty subjects (passive smokers) exposed to tobacco smoke more than 25% of the day (subjectively assessed) and 32 smokers were used to validate the estimated reference interval. Urine samples were collected three times during the day approximately at 06.30, 17.00 and 22.45 h. RESULTS....... Parametric reference interval for excretion of nicotine metabolites in urine from non-smokers was established according to International Union of Pure and Applied Chemistry (IUPAC) and International Federation for Clinical Chemistry (IFCC) for use of risk assessment of exposure to tobacco smoke...

  8. Dried Blood Spot Reference Intervals for Steroids and Amino Acids in a Neonatal Cohort of the National Children's Study.

    Science.gov (United States)

    Dietzen, Dennis J; Bennett, Michael J; Lo, Stanley F; Grey, Vijay L; Jones, Patti M

    2016-12-01

    Reference intervals from children are limited by access to healthy children and their limited blood volumes. In this study we set out to fill gaps in pediatric reference intervals for amino acids and steroid hormones using dried blood spots (DBS) from a cohort of the National Children's Study. Deidentified DBS annotated with age, birthweight, sex, and geographic location were obtained from 310 newborns aged 0-4 days and analyzed for 25 amino acids and 4 steroid hormones using LC-MS/MS. Nonparametric statistical approaches were used to generate the 2.5th-97.5th percentile distributions for newborns. Paired plasma/DBS specimens were used to mathematically transform DBS reference intervals to corresponding plasma intervals. 10 of 25 DBS amino acid distributions were dependent on sex. There was little correlation with age, birthweight, or geographic location over the first 4 days of life. In most cases, transformation of DBS distributions to plasma distributions faithfully reflected independent studies of newborn plasma amino acid distributions. In general newborn steroid distributions were negatively correlated with age and birthweight over the first 4 days of life. Data distributions for the 4 steroids were not found related to geographic location, but testosterone concentrations displayed sex dependence. Transformation of DBS distributions to plasma intervals did not faithfully replicate other neonate steroid reference intervals determined directly with plasma. These data demonstrate the feasibility and utility of deriving newborn reference intervals from large numbers of archived DBS samples such as those obtained from the National Children's Study biobank. © 2016 American Association for Clinical Chemistry.

  9. Reference intervals for mean platelet volume and immature platelet fraction determined on a sysmex XE5000 hematology analyzer

    DEFF Research Database (Denmark)

    Jørgensen, Mikala Klok; Bathum, L.

    2016-01-01

    Background New parameters describing the platelet population of the blood are mean platelet volume (MPV), which is a crude estimate of thrombocyte reactivity, and immature platelet fraction (IPF), which reflects megakaryopoietic activity. This study aimed to define reference intervals for MPV...... and IPF and to investigate whether separate reference intervals according to smoking status, age or sex are necessary.Methods Blood samples were obtained from subjects participating in The Danish General Suburban Population Study. MPV and IPF measurements were performed by the use of the Sysmex XE-5000...

  10. Three Cases With Inappropriate TSH Syndrome

    Directory of Open Access Journals (Sweden)

    Hatice Sebila Dökmetaş

    2012-12-01

    Full Text Available Inappropriate thyroid-stimulating hormone (TSH syndrome or central hyperthyroidism is a rare disorder characterized by inappropriately normal or elevated levels of TSH and elevated levels of T3 and T4. The syndrome is associated with TSH-secreting pituitary adenoma (TSHoma or thyroid hormone resistance (THR. Thyroid-releasing hormone stimulation test and T3 suppression test can be useful for the differential diagnosis of central hyperthyroidism. In the present study, we report three cases of inappropriate TSH syndrome diagnosed after TRH stimulation and T3 suppression tests. Turk Jem 2012; 16: 105-8

  11. CLSI-based transference of the CALIPER database of pediatric reference intervals to Beckman Coulter DxC biochemical assays.

    Science.gov (United States)

    Araújo, Petra A T; Thomas, Dylan; Sadeghieh, Tara; Bevilacqua, Victoria; Chan, Man Khun; Chen, Yunqi; Randell, Edward; Adeli, Khosrow

    2015-09-01

    The CALIPER program has established a comprehensive database of age- and sex-stratified pediatric reference intervals for over 85 common biochemical markers, largely using the Abbott ARCHITECT assays. To allow a broader application of the CALIPER database, we examined transference to 36 Beckman Coulter Synchron Unicel DxC800 assays, based on the CLSI C28-A3/EP9-A3 guidelines. Patient sample comparisons were performed for 36 biochemical assays using 200 serum specimens obtained from pediatric patients on the Abbott ARCHITECT ci8200 and the Beckman Coulter DxC800. For each analyte, R(2) values were calculated to assess the quality of correlation between the platforms. Statistical criteria used to assess transferability included a) regression analysis to create the equation of the line of best fit, b) standardized residual, c) Bland-Altman, and d) quantile-quantile plots. Transferred reference intervals were further verified by analyzing serum samples from 100 healthy children from the CALIPER cohort on the Beckman Coulter system. The reference intervals for most of the assessed analytes were transferable to Beckman Coulter assays (31 out of 36 studied) and the newly calculated reference intervals were verified through analysis of CALIPER reference samples (28 out of 31). Eighteen assays demonstrated excellent correlation (R(2)≥0.95), and 13 assays showed strong correlation (0.77≤R2≤0.94). The current study allowed successful transference of a large number of biochemical markers from the CALIPER database to assays on the Beckman Coulter DxC800 platform. Transference should facilitate broader application of CALIPER reference intervals at pediatric centers using DxC biochemical assays. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  12. Pediatric reference value distributions and covariate-stratified reference intervals for 29 endocrine and special chemistry biomarkers on the Beckman Coulter Immunoassay Systems: a CALIPER study of healthy community children.

    Science.gov (United States)

    Karbasy, Kimiya; Lin, Danny C C; Stoianov, Alexandra; Chan, Man Khun; Bevilacqua, Victoria; Chen, Yunqi; Adeli, Khosrow

    2016-04-01

    The CALIPER program is a national research initiative aimed at closing the gaps in pediatric reference intervals. CALIPER previously reported reference intervals for endocrine and special chemistry markers on Abbott immunoassays. We now report new pediatric reference intervals for immunoassays on the Beckman Coulter Immunoassay Systems and assess platform-specific differences in reference values. A total of 711 healthy children and adolescents from birth to CALIPER Pediatric Reference Interval database will enable accurate diagnosis and laboratory assessment of children monitored by Beckman Coulter Immunoassay Systems in health care institutions worldwide. These reference intervals must however be validated by individual labs for the local pediatric population as recommended by CLSI.

  13. Determination of thyrotropin reference values in an adult Mexican population.

    Science.gov (United States)

    Flores-Rebollar, Armando; Moreno-Castañeda, Lidia; Vega-Servín, Norman S; López-Carrasco, Guadalupe; Ruiz-Juvera, Aída

    2015-02-01

    The upper limit of TSH reference level is controversial. The purpose of our study was to determine TSH reference values in a Mexican population in accordance with the National Academy of Clinical Biochemistry (NACB) criteria and in correlation with thyroid ultrasound (US) examination. The study was conducted in volunteers with no known thyroid disease. We recruited 482 subjects, most of them medical or administrative staff from our hospital. They answered a questionnaire on demographic data, family history, co-morbidities, and drug use. Their thyroid hormone levels and thyroid antibodies were determined, and a complete physical examination and thyroid US were performed. The population used to establish the TSH reference intervals was selected according to the NACB criteria and their normal thyroid structural and echogenic characteristics in US examination. Among 482 subjects (209 males) with a median age of 26 years, prevalence rates of TPOAb and TgAb were 9.3% and 10.3% respectively. Mean TSH level in the overall population was 1.90±1.94, with a 97.5th percentile of 6.76 mIU/L. The reference population was limited to 282 subjects (41.5% were excluded) with a mean TSH of 1.86±1.63 and a 97.5th percentile of 4.88 mIU/L. No sex difference was found (p=0.287). Median urinary iodine level in the reference population was 267 μg/L IQR (161.3-482.5). The TSH reference interval in the reference population was 0.71 (CI 0.65-0.77) to 4.88 mIU/L (CI 4.5-5.3); these limits may be influenced by iodine nutritional status in this population. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  14. CLSI-based transference and verification of CALIPER pediatric reference intervals for 29 Ortho VITROS 5600 chemistry assays.

    Science.gov (United States)

    Higgins, Victoria; Truong, Dorothy; Woroch, Amy; Chan, Man Khun; Tahmasebi, Houman; Adeli, Khosrow

    2018-03-01

    Evidence-based reference intervals (RIs) are essential to accurately interpret pediatric laboratory test results. To fill gaps in pediatric RIs, the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER) project developed an age- and sex-specific pediatric RI database based on healthy pediatric subjects. Originally established for Abbott ARCHITECT assays, CALIPER RIs were transferred to assays on Beckman, Roche, Siemens, and Ortho analytical platforms. This study provides transferred reference intervals for 29 biochemical assays for the Ortho VITROS 5600 Chemistry System (Ortho). Based on Clinical Laboratory Standards Institute (CLSI) guidelines, a method comparison analysis was performed by measuring approximately 200 patient serum samples using Abbott and Ortho assays. The equation of the line of best fit was calculated and the appropriateness of the linear model was assessed. This equation was used to transfer RIs from Abbott to Ortho assays. Transferred RIs were verified using 84 healthy pediatric serum samples from the CALIPER cohort. RIs for most chemistry analytes successfully transferred from Abbott to Ortho assays. Calcium and CO 2 did not meet statistical criteria for transference (r 2 CALIPER pediatric RI database to laboratories using Ortho VITROS 5600 biochemical assays. Clinical laboratories should verify CALIPER reference intervals for their specific analytical platform and local population as recommended by CLSI. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  15. Determination of reference intervals for urinary steroid profiling using a newly validated GC-MS/MS method

    NARCIS (Netherlands)

    de Jong, Wilhelmina H. A.; Buitenwerf, Edward; Pranger, Alle T.; Riphagen, Ineke J.; Wolffenbuttel, Bruce H. R.; Kerstens, Michiel N.; Kema, Ido P.

    Background: Urinary steroid profiling (USP) is a powerful diagnostic tool to asses disorders of steroidogenesis. Preanalytical factors such as age, sex and use of oral contraceptive pills (OCP) may affect steroid hormone synthesis and metabolism. In general, USP reference intervals are not adjusted

  16. Testosterone, free testosterone, and free androgen index in women: Reference intervals, biological variation, and diagnostic value in polycystic ovary syndrome

    NARCIS (Netherlands)

    Bui, H.N.; Sluss, P.M.; Hayes, F.J.; Blincko, S.; Knol, D.L.; Blankenstein, M.A.; Heijboer, A.C.

    2015-01-01

    Objective: The objective of our study was to determine reference intervals and biologic variation for testosterone (T), free testosterone (fT), and free androgen index (FAI) in women with accurate methods and to test the discriminative value of these parameters in a polycystic ovary syndrome

  17. Testosterone, free testosterone, and free androgen index in women: Reference intervals, biological variation, and diagnostic value in polycystic ovary syndrome

    NARCIS (Netherlands)

    Bui, H. N.; Sluss, P. M.; Hayes, F. J.; Blincko, S.; Knol, D. L.; Blankenstein, M. A.; Heijboer, A. C.

    2015-01-01

    The objective of our study was to determine reference intervals and biologic variation for testosterone (T), free testosterone (fT), and free androgen index (FAI) in women with accurate methods and to test the discriminative value of these parameters in a polycystic ovary syndrome (PCOS)-population.

  18. Reference intervals for plasma free metanephrines with an age adjustment for normetanephrine for optimized laboratory testing of phaeochromocytoma

    NARCIS (Netherlands)

    Eisenhofer, G.; Lattke, P.; Herberg, M.; Siegert, G.; Qin, N.; Darr, R.; Hoyer, J.; Villringer, A.; Prejbisz, A.; Januszewicz, A.; Remaley, A.; Martucci, V.; Pacak, K.; Ross, H.A.; Sweep, F.C.; Lenders, J.W.M.

    2013-01-01

    BACKGROUND: Measurements of plasma normetanephrine and metanephrine provide a useful diagnostic test for phaeochromocytoma, but this depends on appropriate reference intervals. Upper cut-offs set too high compromise diagnostic sensitivity, whereas set too low, false-positives are a problem. This

  19. Normal Laboratory Reference Intervals among Healthy Adults Screened for a HIV Pre-Exposure Prophylaxis Clinical Trial in Botswana

    Science.gov (United States)

    Segolodi, Tebogo M.; Henderson, Faith L.; Rose, Charles E.; Turner, Kyle T.; Zeh, Clement; Fonjungo, Peter N.; Niska, Richard; Hart, Clyde; Paxton, Lynn A.

    2014-01-01

    Introduction Accurate clinical laboratory reference values derived from a local or regional population base are required to correctly interpret laboratory results. In Botswana, most reference intervals used to date are not standardized across clinical laboratories and are based on values derived from populations in the United States or Western Europe. Methods We measured 14 hematologic and biochemical parameters of healthy young adults screened for participation in the Botswana HIV Pre-exposure Prophylaxis Study using tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) (TDF2 Study). Reference intervals were calculated using standard methods, stratified by gender, and compared with the site-derived reference values used for the TDF2 study (BOTUSA ranges), the Division of AIDS (DAIDS) Grading Table for Adverse Events, the Botswana public health laboratories, and other regional references. Results Out of 2533 screened participants, 1786 met eligibility criteria for participation in study and were included in the analysis. Our reference values were comparable to those of the Botswana public health system except for amylase, blood urea nitrogen (BUN), phosphate, total and direct bilirubin. Compared to our reference values, BOTUSA reference ranges would have classified participants as out of range for some analytes, with amylase (50.8%) and creatinine (32.0%) producing the highest out of range values. Applying the DAIDS toxicity grading system to the values would have resulted in 45 and 18 participants as having severe or life threatening values for amylase and hemoglobin, respectively. Conclusion Our reference values illustrate the differences in hematological and biochemical analyte ranges between African and Western populations. Thus, the use of western-derived reference laboratory values to screen a group of Batswana adults resulted in many healthy people being classified as having out-of-range blood analytes. The need to establish accurate local or regional

  20. Establishment of reference intervals for plasma protein electrophoresis in Indo-Pacific green sea turtles, Chelonia mydas

    Science.gov (United States)

    Flint, Mark; Matthews, Beren J.; Limpus, Colin J.; Mills, Paul C.

    2015-01-01

    Biochemical and haematological parameters are increasingly used to diagnose disease in green sea turtles. Specific clinical pathology tools, such as plasma protein electrophoresis analysis, are now being used more frequently to improve our ability to diagnose disease in the live animal. Plasma protein reference intervals were calculated from 55 clinically healthy green sea turtles using pulsed field electrophoresis to determine pre-albumin, albumin, α-, β- and γ-globulin concentrations. The estimated reference intervals were then compared with data profiles from clinically unhealthy turtles admitted to a local wildlife hospital to assess the validity of the derived intervals and identify the clinically useful plasma protein fractions. Eighty-six per cent {19 of 22 [95% confidence interval (CI) 65–97]} of clinically unhealthy turtles had values outside the derived reference intervals, including the following: total protein [six of 22 turtles or 27% (95% CI 11–50%)], pre-albumin [two of five, 40% (95% CI 5–85%)], albumin [13 of 22, 59% (95% CI 36–79%)], total albumin [13 of 22, 59% (95% CI 36–79%)], α- [10 of 22, 45% (95% CI 24–68%)], β- [two of 10, 20% (95% CI 3–56%)], γ- [one of 10, 10% (95% CI 0.3–45%)] and β–γ-globulin [one of 12, 8% (95% CI 0.2–38%)] and total globulin [five of 22, 23% (8–45%)]. Plasma protein electrophoresis shows promise as an accurate adjunct tool to identify a disease state in marine turtles. This study presents the first reference interval for plasma protein electrophoresis in the Indo-Pacific green sea turtle. PMID:27293722

  1. Determination of reference intervals for urinary steroid profiling using a newly validated GC-MS/MS method.

    Science.gov (United States)

    de Jong, Wilhelmina H A; Buitenwerf, Edward; Pranger, Alle T; Riphagen, Ineke J; Wolffenbuttel, Bruce H R; Kerstens, Michiel N; Kema, Ido P

    2017-11-27

    Urinary steroid profiling (USP) is a powerful diagnostic tool to asses disorders of steroidogenesis. Pre-analytical factors such as age, sex and use of oral contraceptive pills (OCP) may affect steroid hormone synthesis and metabolism. In general, USP reference intervals are not adjusted for these variables. In this study we aimed to establish such reference intervals using a newly-developed and validated gas chromatography with tandem mass spectrometry detection method (GC-MS/MS). Two hundred and forty healthy subjects aged 20-79 years, stratified into six consecutive decade groups each containing 20 males and 20 females, were included. None of the subjects used medications. In addition, 40 women aged 20-39 years using OCP were selected. A GC-MS/MS assay, using hydrolysis, solid phase extraction and double derivatization, was extensively validated and applied for determining USP reference intervals. Androgen metabolite excretion declined with age in both men and women. Cortisol metabolite excretion remained constant during life in both sexes but increased in women 70-79 years of age. Progesterone metabolite excretion peaked in 30-39-year-old women and declined afterwards. Women using OCP had lower excretions of androgen metabolites, progesterone metabolites and cortisol metabolites. Method validation results met prerequisites and revealed the robustness of the GC-MS/MS method. We developed a new GC-MS/MS method for USP which is applicable for high throughput analysis. Widely applicable age and sex specific reference intervals for 33 metabolites and their diagnostic ratios have been defined. In addition to age and gender, USP reference intervals should be adjusted for OCP use.

  2. Pediatric reference value distributions for vitamins A and E in the CALIPER cohort and establishment of age-stratified reference intervals.

    Science.gov (United States)

    Raizman, Joshua E; Cohen, Ashley H; Teodoro-Morrison, Tracy; Wan, Betty; Khun-Chen, Man; Wilkenson, Caitlin; Bevilaqua, Victoria; Adeli, Khosrow

    2014-06-01

    Vitamin A (retinol) and vitamin E (α-tocopherol) are fat soluble micronutrients most commonly measured in the pediatric population to monitor deficiencies due to malabsorption secondary to gastrointestinal (GI) disorders. One of the major challenges of vitamin A and E testing is the lack of reliable pediatric reference intervals which limits accurate interpretation of results. Here we report new pediatric reference intervals (RI) for both vitamins as part of the Canadian Laboratory Initiative for Pediatric Reference Intervals (CALIPER). A total of 342 blood samples were collected from healthy children 1 day to 19 years of age recruited from the community. Retinol and α-tocopherol were extracted from serum using hexane before concentrations were measured with high-performance liquid chromatography (HPLC). Age and sex-specific RI were calculated with guidance from CLSI C28-A2. Non-parametric and robust methods were used to calculate the 95th percentile ranges of the reference intervals along with the 90% confidence intervals. Vitamin A demonstrated increasing levels with age necessitating four distinct age stratifications. Vitamin E levels peaked within the first year of life requiring only 2 age partitions. Ratios of vitamin E to cholesterol and triglyceride were also calculated, and correlated well to vitamin E levels. Sex-specific differences were not observed. This study establishes pediatric RI for vitamins A and E in a healthy population of children from neonates to early adulthood. These values will be beneficial in assessing accurate vitamin status when monitoring children with GI disorders or malnutrition. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Laboratory reference intervals during pregnancy, delivery and the early postpartum period

    DEFF Research Database (Denmark)

    Klajnbard, Anna; Szecsi, Pal Bela; Colov, Nina P

    2010-01-01

    Physiological changes during pregnancy may affect laboratory parameters. Reference values based on samples from non-pregnant women are not necessarily useful for clinical decisions during pregnancy. There is a need to establish reference values during pregnancy in order to recognize pathological...

  4. [Elaboration and validation of longitudinal reference intervals of fetal weight with a sample of the Brazilian population].

    Science.gov (United States)

    Furlan, Érica Luciana de Paula; Bennini, João Renato; Faro, Cristina Barros de Araújo; Marussi, Emílio Francisco; Barini, Ricardo; Peralta, Cleisson Fábio Andrioli

    2012-10-01

    To elaborate models for the estimation of fetal weight and longitudinal reference intervals of estimated fetal weight (EFW) using a sample of the Brazilian population. Prospective observational study. Two groups of patients were evaluated: Group EFW (estimation of fetal weight): to elaborate (EFW-El) and validate (EFW-Val) a model for the prediction of fetal weight; Group LRI (longitudinal reference intervals): To elaborate (LRI-El) and validate (LRF-Val) conditional (longitudinal) percentiles of EFW. Polynomial regression analysis was applied to the data from subgroup EFW-El to elaborate a model for the estimation of fetal weight. The performance of this model was compared to those of previously published formulas. Linear mixed models were used for the elaboration of longitudinal reference intervals of EFW using data from subgroup LRI-El. Data obtained from subgroup LRI-Val were used to validate these intervals. Group EFW consisted of 458 patients (EFW-El: 367; EFW-Val: 91) and Group LRI consisted of 315 patients (LRI-El: 265; LRI-Val: 50). The model obtained for EFW was: EFW=-8.277+2.146xBPDxACxFL-2.449xFLxBPD². The performances of other models were significantly worse than those obtained with our formula. Equations for the prediction of conditional percentiles of EFW were derived from the longitudinal observation of patients of subgroup LRI-El and validated with data from subgroup LRI-Val. We described a method for customization of longitudinal reference intervals of EFW obtained using formulas generated from a sample of the Brazilian population.

  5. Establishment of a paediatric age-related reference interval for the measurement of urinary total fractionated metanephrines.

    LENUS (Irish Health Repository)

    Griffin, Alison

    2012-02-01

    INTRODUCTION: Normetanephrine and metanephrine are intermediate metabolites of noradrenaline and adrenaline metabolism. To assess whether normetanephrine and metanephrine analysis may aid in the diagnosis of Neuroblastoma, a reference interval for these metabolites must first be established. AIM: The overall aim of this study was to establish a paediatric age-related reference interval for the measurement of total fractionated metanephrines. METHODS: A total of 267 urine samples were analysed following acid hydrolysis. This releases the metanephrines from their sulphate-bound metabolites. The samples were analysed using reverse phase high-performance liquid chromatography with electro-chemical detection on a Gilson automated sequential trace enrichment of dialysate sample system. RESULTS: Data were analysed using Minitab Release version 14. Outliers were removed using the Dixon\\/Reed one-third rule. Partitioning of the age groups was achieved using Harris and Boyd\\'s standard normal deviate test. Non-parametric analysis of the data was performed, followed by the establishment of the 2.5th and the 97.5th reference limits. CONCLUSIONS: The established reference intervals are described in Table 2.

  6. Reference intervals for serum sphingosine-1-phosphate in the population-based Study of Health in Pomerania.

    Science.gov (United States)

    Moritz, Eileen; Wegner, Danilo; Groß, Stefan; Bahls, Martin; Dörr, Marcus; Felix, Stephan B; Ittermann, Till; Oswald, Stefan; Nauck, Matthias; Friedrich, Nele; Böger, Rainer H; Daum, Günter; Schwedhelm, Edzard; Rauch, Bernhard H

    2017-05-01

    The bioactive signaling lipid sphingosine-1-phosphate (S1P) is a potential biomarker for cardiovascular disease (CVD). To date, no reference intervals for S1P have been defined. This study aims to establish a reference range for serum S1P in healthy individuals. We determined reference intervals for S1P levels according to gender and age in a sample of 1339 healthy participants of the Study of Health in Pomerania (SHIP)-TREND cohort after exclusion of subjects with CVD, diabetes mellitus, hypertension, metabolic syndrome, elevated liver enzymes, chronic kidney disease stadium III or IV, or body mass index (BMI)>30kg/m 2 . Serum S1P was measured by liquid chromatography-tandem mass spectrometry. The median age of the participants was 41 (25th; 75th percentile 32; 51) years, 65% were women. The median serum concentration of S1P was 0.804 (0.694; 0.920) μmol/L. No association with gender and age was observed. The overall reference interval was 0.534-1.242μmol/L (2.5th; 97.5th percentile). Further exclusion of smokers, individuals with BMI>25kg/m 2 or elevated lipid levels did not significantly affect median S1P concentrations. This study provides reference intervals for serum S1P in healthy individuals. Total serum S1P concentrations vary irrespectively of age, gender, BMI or smoking status. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Comparison of two automated assays of BTM (CTX and P1NP) and reference intervals in a Danish population

    DEFF Research Database (Denmark)

    Jørgensen, N R; Møllehave, L T; Hansen, Y B L

    2017-01-01

    -osteoporotic treatment were excluded, while subjects on hormonal contraceptives were included. RESULTS: There was significant disagreement between both the two P1NP assays with a mean difference of -3 μg/L (LoA -19 to 14) (p ... (pre-menopausal), and >30 years (post-menopausal) for women. CONCLUSIONS: There is significant disagreement between the IDS-iSYS and Roche Cobas assays for both reference markers. Consequently, the reference intervals for an adult, healthy population are different depending on the analysis method used...

  8. Temporal variance in hematologic and plasma biochemical reference intervals for free-ranging eastern box turtles (Terrapene carolina carolina).

    Science.gov (United States)

    Kimble, Steven J A; Williams, Rod N

    2012-07-01

    Eastern box turtle (Terrapene carolina carolina) populations are in decline, likely due to anthropogenic forces and disease, necessitating hematologic and biochemical data from healthy individuals for evaluation of wild populations. We repeatedly sampled 21 free-ranging eastern box turtles from May to September 2009 in the spring, summer, and fall to establish temporal hematologic and biochemical reference intervals. Packed cell volume, aspartate aminotransferase, and potassium levels declined significantly as the active season progressed. High levels of albumin, globulin, and calcium coincided with the presence of eggs in females. These reference intervals should provide baseline data for the clinical evaluation of wild box turtles presented for veterinary care or for studies of wild populations.

  9. Reference intervals for common carotid intima-media thickness measured with echotracking: relation with risk factors

    NARCIS (Netherlands)

    Engelen, L.; Ferreira, I.; Stehouwer, C.D.A.; Franco, O.H.; Grobbee, D.E.; Schouw, van der Y.T.; Twisk, J.W.R.; Dekker, J.J.A.; Feskens, E.J.M.

    2013-01-01

    Common carotid artery intima-media thickness (CCIMT) is widely used as a surrogate marker of atherosclerosis, given its predictive association with cardiovascular disease (CVD). The interpretation of CCIMT values has been hampered by the absence of reference values, however. We therefore aimed to

  10. Evaluation of a radioimmunoassay and establishment of a reference interval for salivary cortisol in healthy subjects in Denmark

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Garde, A H; Christensen, J M

    2003-01-01

    was adequate for measurement in healthy subjects. Reference intervals were estimated to be from 3.6 to 35.1 nmol/L for samples at the time of awakening (05.27-07.27), 7.6-39.4 nmol/L for peak level in saliva samples collected 20 min after awakening (05.47-07.47), and LOD 10.3 nmol/L for late afternoon samples...

  11. Evaluation of a radioimmunoassay and establishment of a reference interval for salivary cortisol in healthy subjects in Denmark

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Garde, A H; Christensen, J M

    2003-01-01

    leave during the past year, and smoking habits was established. Reference intervals for salivary cortisol in 120 healthy individuals performing their routine work were established according to the International Union of Pure and Applied Chemistry (IUPAC) and the International Federation of Clinical...... min after awakening. Salivary cortisol was not affected by age, body mass index, gender, smoking habits or days of sick leave during the past year....

  12. Reference intervals for stone risk factors in 24-h urine among healthy adults of the Han population in China.

    Science.gov (United States)

    Mai, Zanlin; Li, Xiaoxia; Cui, Zelin; Wu, Wenqi; Liu, Yongda; Ou, Lili; Liang, Yueping; Zhao, Zhijian; Liu, Yang; Mai, Xing; Zhu, Wei; Zhang, Tao; Cai, Chao; Yang, Houmeng; Zeng, Guohua

    2018-03-28

    The aim of the study was to establish reference intervals for 24-h urinary stone risk factors in the healthy Chinese Han population. From May 2013 to July 2014, we collected and analyzed 24-h urine samples from healthy adult Han population during a cross-sectional study across China. The protocol for analysis of 24-h urine included volume, pH, oxalate, citrate, sodium, potassium, chloride, calcium, phosphorous, creatinine, urate, magnesium, the ion activity products of calcium oxalate (AP(CaOx) indexs) and calcium phosphate (AP(CaP) indexs). We calculated the reference intervals according to the Clinical and Laboratory Standards Institute (CLSI) 2008 guidelines and compared them with those recorded in other studies. A total of 132 male and 123 female healthy subjects with a mean (SD, range) age of 52.4 (15.2, 19-89) years were eligible in the final analysis. Men had higher 24-h excretion of creatinine, calcium, urate and phosphorus and lower levels of citrate, magnesium, chloride, sodium and potassium than women. AP(CaOx) indexs and AP(CaP) indexs were significantly higher among men than women. When urinary findings were compared with the reference intervals, most of our data showed a high abnormality rate, especially for creatinine, calcium, citrate, magnesium, chloride, sodium and potassium. The present study revealed the normal metabolic status for stone risk factors of the Chinese Han population. It is therefore necessary for each country or region to define their own reference intervals for comparison of stone risk factors between patients and healthy subjects.

  13. Establishment of reference intervals of thyroid function tests from cord blood of neonates in two selected hospitals, Addis Ababa, Ethiopia.

    Science.gov (United States)

    Mehari, Aman; Challa, Feyssa; Gebreyesus, Goitom; Alemayehu, Dereje; Seifu, Daniel

    2016-08-02

    Reference intervals are affected by different factors such as lifestyle, ethnicity, age/developmental stage, gender, nutrition and other environmental factors (Clin Biochem Rev: 29,2008). Therefore, it is obvious that it should be established for every population in different regions even within a country. Then the aim of this study is to establish population specific reference intervals of thyroid stimulating hormone, free thyroxine and free triidothyronine levels of cord blood. One hundred twenty three cord blood samples collected from the umbilical cord of newborns were analyzed for thyroid stimulating hormone, free thyroxine and free triidothyronine values. The birth weights ranged between 2500 and 4700 g with mean (SD) value of 3241.46 (459.495) gram. Their gestational age ranged between 37 and 44 weeks with an average of 39.74 weeks. The 2.5(th) and 97.5(th) percentiles of values were found to be 3.48 mIU/L and 27.57 mIU/L for thyroid stimulating hormone, 0.89 ng/dl and 1.53 ng/dl for free thyroxine and 1.19 pg/ml and 2.51 pg/ml for free triidothyronine respectively. In the present study the reference intervals of thyroid stimulating hormone, free thyroxine and free triidothyronine were established and based on the results obtained, were 3.48-27.56 mIU/L for thyroid stimulating hormone, 0.89-1.53 ng/dl for free thyroxine and 1.19-2.51 pg/ml for free triidothyronine. It has been concluded that the result can provide us with an important baseline to establish population specific reference intervals for our country using large scale studies.

  14. Trimester-specific reference intervals for haemoglobin A(1c) (HbA(1c)) in pregnancy.

    LENUS (Irish Health Repository)

    O'Connor, Catherine

    2011-11-26

    Abstract Background: Diabetes in pregnancy imposes additional risks to both mother and infant. These increased risks are considered to be primarily related to glycaemic control which is monitored by means of glycated haemoglobin (HbA(1c)). The correlation of HbA(1c) with clinical outcomes emphasises the need to measure HbA(1c) accurately, precisely and for correct interpretation, comparison to appropriately defined reference intervals. Since July 2010, the HbA(1c) assay in Irish laboratories is fully metrologically traceable to the IFCC standard. The objective was to establish trimester-specific reference intervals in pregnancy for IFCC standardised HbA(1c) in non-diabetic Caucasian women. Methods: The authors recruited 311 non-diabetic Caucasian pregnant (n=246) and non-pregnant women (n=65). A selective screening based on risk factors for gestational diabetes was employed. All subjects had a random plasma glucose <7.7 mmol\\/L and normal haemoglobin level. Pregnancy trimester was defined as trimester 1 (T1, n=40) up to 12 weeks +6 days, trimester 2 (T2, n=106) 13-27 weeks +6 days, trimester 3 (T3, n=100) >28 weeks to term. Results: The normal HbA(1c) reference interval for Caucasian non-pregnant women was 29-37 mmol\\/mol (Diabetes Control and Complications Trial; DCCT: 4.8%-5.5%), T1: 24-36 mmol\\/mol (DCCT: 4.3%-5.4%), T2: 25-35 mmol\\/mol (DCCT: 4.4%-5.4%) and T3: 28-39 mmol\\/mol (DCCT: 4.7%-5.7%). HbA(1c) was significantly decreased in trimesters 1 and 2 compared to non-pregnant women. Conclusions: HbA(1c) trimester-specific reference intervals are required to better inform the management of pregnancies complicated by diabetes.

  15. Reference intervals for serum osteocalcin concentrations in adult men and women from the study of health in Pomerania

    Science.gov (United States)

    2013-01-01

    Background Osteocalcin (OC) is a bone-specific protein produced primarily by osteoblasts during bone formation. Besides its role in bone formation, osteocalcin may play a role in the regulation of energy metabolism and male fertility. To interpret serum OC data, reference intervals adapted to a specific laboratory method are needed. Methods A healthy reference population was selected from the first follow-up of the Study of Health in Pomerania. Serum OC concentrations were measured with the IDS-iSYS N-Mid Osteocalcin assay on the IDS-iSYS Automated System (Immunodiagnostic Systems, Frankfurt am Main, Germany). The reference interval was defined as the central 95% range (2.5th-97.5th percentile). Age-specific reference intervals were calculated by quantile regression for 1107 men (25–79 years) and 545 premenopausal women (25–54 years). The reference interval for 498 postmenopausal women (50–79 years) was calculated irrespective of age. Results Median (1st-3rd quartile) serum OC concentrations were 15.4 ng/mL (12.0-19.4 ng/mL) in men, 14.4 ng/mL (11.3-18.5 ng/mL) in premenopausal women, and 18.6 ng/mL (13.6-25.6 ng/mL) in postmenopausal women. Serum OC concentrations were highest in men and premenopausal women aged 25–29 years, were stable during midlife, and rose again after 65 years of age in men and at transition to menopause in women. Serum OC concentrations were lower in women taking oral contraceptives or who were under hormone replacement therapy after menopause and in subjects with diabetes mellitus or with body mass index  30 kg/m2 than in subjects without these conditions. Conclusions We established sex-specific adult reference intervals for the serum OC concentration measured by the IDS-iSYS N-Mid Osteocalcin assay. PMID:23497286

  16. A reference dosimetric system for dose interval of radiotherapy based on alanine/RPE

    International Nuclear Information System (INIS)

    Rodrigues Junior, Orlando; Galante, Ocimar L.; Campos, Leticia L.

    2001-01-01

    This work describes the development of a reference dosimetric system based on alanine/EPR for radiotherapy dose levels. Currently the IPEN is concluding a similar system for the dose range used for irradiation of products, 10-10 5 Gy. The objective of this work is to present the efforts towards to improve the measure accuracy for doses in the range between 1-10 Gy. This system could be used as reference by radiotherapy services, as much in the quality control of the equipment, as for routine accompaniment of more complex handling where the total doses can reach some grays. The system uses alanine as detector and electronic paramagnetic resonance - EPR as measure technique. To reach accuracy better than 5% mathematical studies on the best optimization of the EPR spectrometer parameters and methods for the handling of the EPR sign are discussed. (author)

  17. Age-related reference intervals for immunoglobulin levels and lymphocyte subsets in Indian children

    Directory of Open Access Journals (Sweden)

    Gaurav Narula

    2017-01-01

    Full Text Available Background: In children, innate and adaptive immunity varies with age, disease status, and ethnicity, reflected by lymphocyte subsets and serum immunoglobulin (Ig levels. The paucity of such data from the Indian subcontinent necessitated this study. Aims: This study aims to determine reference ranges of Ig and lymphocyte subsets in Indian children from birth to 5 years. Settings and Design: Neonates, infants, and children from a tertiary care hospital were selected and categorized into 5 groups from cord blood/newborn to 5 years. Materials and Methods: Samples were taken from cord blood and healthy children up to 5 years of age. Complete blood counts, serum Ig levels (by turbidimetry, and lymphocyte subsets (by flow cytometry were studied, and reference ranges calculated. Results: Four hundred and three samples were analyzed; 53 from cord blood and 350 from children 1 month to 5 years. High IgG levels were noted at birth, which decreased in the first 6 months followed by a rise thereafter. IgM remained low in infancy and peaked at 13–36 months. IgA levels were very low at birth but increased with age. CD4 counts were high in cord blood till 3 years of age and then declined. CD8 and CD19 counts remained steady till 5 years of age. CD56 increased after the age of 2 years. Conclusions: While our data correlated well with published literature, notable differences were higher IgM levels seen in 1–3 years' age group and higher natural killer cells through all age groups in our study. Our results provide the largest database of its kind from our country.

  18. First Definition of Reference Intervals of Liver Function Tests in China: A Large-Population-Based Multi-Center Study about Healthy Adults

    Science.gov (United States)

    Zhang, Chuanbao; Guo, Wei; Huang, Hengjian; Ma, Yueyun; Zhuang, Junhua; Zhang, Jie

    2013-01-01

    Background Reference intervals of Liver function tests are very important for the screening, diagnosis, treatment, and monitoring of liver diseases. We aim to establish common reference intervals of liver function tests specifically for the Chinese adult population. Methods A total of 3210 individuals (20–79 years) were enrolled in six representative geographical regions in China. Analytes of ALT, AST, GGT, ALP, total protein, albumin and total bilirubin were measured using three analytical systems mainly used in China. The newly established reference intervals were based on the results of traceability or multiple systems, and then validated in 21 large hospitals located nationwide qualified by the National External Quality Assessment (EQA) of China. Results We had been established reference intervals of the seven liver function tests for the Chinese adult population and found there were apparent variances of reference values for the variables for partitioning analysis such as gender(ALT, GGT, total bilirubin), age(ALP, albumin) and region(total protein). More than 86% of the 21 laboratories passed the validation in all subgroup of reference intervals and overall about 95.3% to 98.8% of the 1220 validation results fell within the range of the new reference interval for all liver function tests. In comparison with the currently recommended reference intervals in China, the single side observed proportions of out of range of reference values from our study for most of the tests deviated significantly from the nominal 2.5% such as total bilirubin (15.2%), ALP (0.2%), albumin (0.0%). Most of reference intervals in our study were obviously different from that of other races. Conclusion These used reference intervals are no longer applicable for the current Chinese population. We have established common reference intervals of liver function tests that are defined specifically for Chinese population and can be universally used among EQA-approved laboratories located all

  19. First definition of reference intervals of liver function tests in China: a large-population-based multi-center study about healthy adults.

    Directory of Open Access Journals (Sweden)

    Runqing Mu

    Full Text Available BACKGROUND: Reference intervals of Liver function tests are very important for the screening, diagnosis, treatment, and monitoring of liver diseases. We aim to establish common reference intervals of liver function tests specifically for the Chinese adult population. METHODS: A total of 3210 individuals (20-79 years were enrolled in six representative geographical regions in China. Analytes of ALT, AST, GGT, ALP, total protein, albumin and total bilirubin were measured using three analytical systems mainly used in China. The newly established reference intervals were based on the results of traceability or multiple systems, and then validated in 21 large hospitals located nationwide qualified by the National External Quality Assessment (EQA of China. RESULTS: We had been established reference intervals of the seven liver function tests for the Chinese adult population and found there were apparent variances of reference values for the variables for partitioning analysis such as gender(ALT, GGT, total bilirubin, age(ALP, albumin and region(total protein. More than 86% of the 21 laboratories passed the validation in all subgroup of reference intervals and overall about 95.3% to 98.8% of the 1220 validation results fell within the range of the new reference interval for all liver function tests. In comparison with the currently recommended reference intervals in China, the single side observed proportions of out of range of reference values from our study for most of the tests deviated significantly from the nominal 2.5% such as total bilirubin (15.2%, ALP (0.2%, albumin (0.0%. Most of reference intervals in our study were obviously different from that of other races. CONCLUSION: These used reference intervals are no longer applicable for the current Chinese population. We have established common reference intervals of liver function tests that are defined specifically for Chinese population and can be universally used among EQA

  20. Evaluation of a radioimmunoassay and establishment of a reference interval for salivary cortisol in healthy subjects in Denmark

    DEFF Research Database (Denmark)

    Hansen, Åse Marie; Garde, A H; Christensen, J M

    2003-01-01

    leave during the past year, and smoking habits was established. Reference intervals for salivary cortisol in 120 healthy individuals performing their routine work were established according to the International Union of Pure and Applied Chemistry (IUPAC) and the International Federation of Clinical...... was adequate for measurement in healthy subjects. Reference intervals were estimated to be from 3.6 to 35.1 nmol/L for samples at the time of awakening (05.27-07.27), 7.6-39.4 nmol/L for peak level in saliva samples collected 20 min after awakening (05.47-07.47), and LOD 10.3 nmol/L for late afternoon samples......A commercial radioimmunoassay (RA) for salivary cortisol was evaluated using certified reference material in water and spiked to pooled saliva in the range 2.1-89.1 nmol/L. A variance component model for describing the effects of age, body mass index (BMI), diurnal variation, gender, days of sick...

  1. Familial Longevity Is Associated With Higher TSH Secretion and Strong TSH-fT3 Relationship

    DEFF Research Database (Denmark)

    Jansen, Steffy W; Roelfsema, Ferdinand; van der Spoel, Evie

    2015-01-01

    CONTEXT: Longevity is associated with changes in circulating levels of thyroid hormone (TH) and/or TSH in animals and humans, but underlying mechanisms remain elusive. OBJECTIVE: We explored in 38 offspring of nonagenarian participants from the Leiden Longevity Study, who are enriched for longevity...... properties of TSH. The temporal relationship between TSH and free T3 at zero delay was higher in offspring (0.48 ± 0.2) compared with partners (0.26 ± 0.4) (P = .05), but the feedback and forward interplay between TSH and TH did not differ. CONCLUSIONS: Familial longevity is associated with increased basal...

  2. Pathophysiology of TSH and prolactin secretion

    International Nuclear Information System (INIS)

    Vries, R.A. de.

    1982-01-01

    This thesis deals with dynamic changes in the regulation mechanisms of thyrotropin (TSH) and prolactin release, during treatment of hyperthyroidism and primary hypothyroidism. Determination of the levels of TSH and prolactin occurred by means of radioimmunoassays. In chapter IV the results of measurements of thyroxine, triiodothyronine, basal TSH, δ TSH and Q (the quotient of basal TSH and δ TSH) during treatment of hyperthyroidism and primary hypothyroidism are presented and discussed. The course of these parameters after therapy with 131 I is compared between patients with Graves' disease and patients with hyperthyroidism on the basis of a (multi-)nodular goitre. The decrease of the thyroxine and triiodothyronine levels in patients with Graves' disease is biphasic, which is not the case in patients with a toxic nodular goitre. In chapter V the results of the measurements of basal prolactin and δ prolactin are shown and discussed. After treatment of hyperthyroidism with 131 I, only in the first two weeks changes in basal prolactin do occur; the levels decrease. After that period they remain stable. (Auth.)

  3. Reference intervals of plasma calcium, phosphorus, and magnesium for African grey parrots (Psittacus erithacus) and Hispaniolan parrots (Amazona ventralis).

    Science.gov (United States)

    de Carvalho, Fernanda M; Gaunt, Stephen D; Kearney, Michael T; Rich, Gregory A; Tully, Thomas N

    2009-12-01

    Calcium (Ca), phosphorus (P), and magnesium (Mg) are important elements for body homeostasis in several diseases associated with imbalances in the plasma concentration of these ions. This is the first published report of reference intervals for Mg in association with Ca and P levels for psittacine species. One milliliter of blood was collected from 26 Hispaniolan parrots (Amazona ventralis) and 24 African grey parrots (Psittacus erithacus). The plasma concentrations of Ca, P, and Mg were determined for each sample. Statistical analyses were performed including all data (analysis 1) and after exclusion of the subjects with Ca > or = 14.00 mg/dl (3.5 mmol) (analysis 2). The data from analysis 1 have a narrower interval than that observed in analysis 2. Following the normality test (Shapiro-Wilk, alpha = 0.05), the univariate and mean procedures were run. For the reference intervals, the lower and upper values were used, after elimination of the outliers calculated by Blom scores from the ranked variables. The analysis 1 references for the Hispaniolans were Ca = 8.80-10.40 mg/dl (2.20-2.60 mmol/L), P = 1.80-4.40 mg/dl (0.58-1.42 mmol/L), Mg = 1.80-3.10 mg/dl (0.74-1.27 mmol/L), and Ca:P ratio = 2.62-5.39; for the African greys analysis 1 references were Ca = 8.20-20.20 mg/dl (2.05-5.05 mmol/L), P = 2.50-5.90 mg/dl (0.81-1.91 mmol/L), Mg = 2.10-3.40 mg/dl (0.82-1.4 mmol/L), and Ca:P ratio = 1.81-3.77. The analysis 2 references for the Hispaniolans were Ca = 8.80-10.30 mg/dl (2.20-2.58 mmol/L), P = 1.80-3.80 mg/dl (0.58-1.23 mmol/L), Mg = 1.90-3.00 mg/dl (0.82-1.07 mmol/L), Ca:P ratio = 2.62-5.39; for the African greys analysis 2 references were Ca = 1.07 mmol/L), Ca:P ratio = 1.67-3.50. The results of this study are important for evaluating Mg concentrations in relation to the Ca and P parameters in psittacines. This information will be particularly helpful for veterinarians evaluating the hypocalcemic syndrome in African grey parrots and other disease processes

  4. Reference interval for the disc-macula distance to disc diameter ratio in a large population of healthy Japanese adults

    Science.gov (United States)

    Sato, Ken-ichi

    2017-01-01

    Abstract This study presents the calculated reference interval for the disc-to-macula distance to disc diameter ratio (DM:DD) based on a large population of healthy Japanese adults. A total of 308 consecutive, healthy Japanese adults were examined in this prospective observational study. Eighteen subjects were also excluded because of poor quality of the fundus photograph of one or both eyes; 290 (161 men and 129 women) were included in this study. For each subject, a color fundus photograph of one eye, either the right or left, was randomly selected and used for analysis. On the photograph, the distances between the fovea and the nearest temporal margin of the optic disc (Dft), and the two kinds of disc diameters (D1 and D2), which bisected at right angles and one of which was directed to the fovea (D1), were measured. DM:DD was estimated using the formula: (2Dft + D1)/(D1 + D2). The mean ± standard deviation of DM:DD was 2.91 ± 0.49 for men and 2.96 ± 0.54 for women; there was no sex difference (P = .78, Mann–Whitney U test). Also, almost no relationship was found between DM:DD and age (ρ = −.12, P = .04, Spearman's rank correlation coefficient). The data did not fit a normal distribution (P < .001, Kolmogorov–Smirnov test). The estimated reference interval for DM:DD corresponding to the 2.5th and 97.5th percentiles was 2.12 to 4.18. Using a nonparametric approach, the reference interval for DM:DD of a large population of healthy Japanese adults was calculated to be 2.12 to 4.18, regardless of age or sex. PMID:28403107

  5. Hemoglobin concentrations in 358 apparently healthy 80-year-old Danish men and women. Should the reference interval be adjusted for age?

    DEFF Research Database (Denmark)

    Milman, N.; Pedersen, Agnes Nadelmann; Ovesen, Lars

    2008-01-01

    Background and aims: In elderly Danes, reference intervals for hemoglobin (Hb) concentrations are derived from younger population groups. The aim was to examine reference intervals for Hb and cut-off limits for anemia by application of criteria for normality to a representative population of 80...

  6. Similar Reference Intervals for Total Testosterone in Healthy Young and Elderly Men. Results from the Odense Androgen Study

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, K; Nielsen, Torben Leo

    2013-01-01

    and 600 men aged 60-74 years randomly recruited from the background population. MEASUREMENTS: Sex hormones and SHBG were measured, and reference intervals were determined in healthy individuals in both groups and in elderly men stratified according to whether they were obese or lean (waist...... were higher in young men. Higher levels of androgens were found in healthy elderly men compared to those with a chronic disease or obesity. Androgens were inversely associated with central fat mass (CFM) whereas SHBG was inversely and directly associated with CFM and lower extremity fat mass (LEFM...

  7. Reference intervals, longitudinal analyses, and index of individuality of commonly measured laboratory variables in captive bald eagles (Haliaeetus leucocephalus).

    Science.gov (United States)

    Jones, Michael P; Arheart, Kristopher L; Cray, Carolyn

    2014-06-01

    The objectives of this study were to determine reference intervals, perform longitudinal analyses, and determine the index of individuality (IoI) of 8 hematologic, and 13 biochemical and electrophoretic variables for a group of captive bald eagles (Haliaeetus leucocephalus). Reference intervals were determined from blood samples collected during annual wellness examinations for 41 eagles (23 male and 18 female) with ages ranging between 6 and 43 years (18.7 +/- 7.4, mean +/- SD) at the time of sample collection. Longitudinal analyses and IoI were determined for measured hematologic, biochemical, and protein electrophoretic variables, both individually and as a group, for a subset of 16 eagles (10 male and 6 female) during a 12-year period. This smaller group of eagles ranged in age between 2 and 20 years at the start of the study period, and between 14 and 32 years (21.9 +/- 5.0, mean +/- SD) at the end of the study period. Significant increases with age within the group of 16 eagles were observed only for red blood cells, percent heterophils, total protein, and beta-globulin protein fraction, while albumin:globulin decreased significantly with age. A low IoI (> or = 1.4) was determined for all hematologic and biochemical variables except gamma globulins, which had high IoI (< or = 0.6) for 3 individuals within the subset of 16.

  8. Closing the gaps in pediatric laboratory reference intervals: a CALIPER database of 40 biochemical markers in a healthy and multiethnic population of children.

    Science.gov (United States)

    Colantonio, David A; Kyriakopoulou, Lianna; Chan, Man Khun; Daly, Caitlin H; Brinc, Davor; Venner, Allison A; Pasic, Maria D; Armbruster, David; Adeli, Khosrow

    2012-05-01

    Pediatric healthcare is critically dependent on the availability of accurate and precise laboratory biomarkers of pediatric disease, and on the availability of reference intervals to allow appropriate clinical interpretation. The development and growth of children profoundly influence normal circulating concentrations of biochemical markers and thus the respective reference intervals. There are currently substantial gaps in our knowledge of the influences of age, sex, and ethnicity on reference intervals. We report a comprehensive covariate-stratified reference interval database established from a healthy, nonhospitalized, and multiethnic pediatric population. Healthy children and adolescents (n = 2188, newborn to 18 years of age) were recruited from a multiethnic population with informed parental consent and were assessed from completed questionnaires and according to defined exclusion criteria. Whole-blood samples were collected for establishing age- and sex-stratified reference intervals for 40 serum biochemical markers (serum chemistry, enzymes, lipids, proteins) on the Abbott ARCHITECT c8000 analyzer. Reference intervals were generated according to CLSI C28-A3 statistical guidelines. Caucasians, East Asians, and South Asian participants were evaluated with respect to the influence of ethnicity, and statistically significant differences were observed for 7 specific biomarkers. The establishment of a new comprehensive database of pediatric reference intervals is part of the Canadian Laboratory Initiative in Pediatric Reference Intervals (CALIPER). It should assist laboratorians and pediatricians in interpreting test results more accurately and thereby lead to improved diagnosis of childhood diseases and reduced patient risk. The database will also be of global benefit once reference intervals are validated in transference studies with other analytical platforms and local populations, as recommended by the CLSI.

  9. Serum biochemical reference intervals for free-living Sand Tiger sharks (Carcharias taurus) from east Australian waters.

    Science.gov (United States)

    Otway, Nicholas M

    2015-06-01

    Sharks are top-order predators in ocean food chains and the star attractions in aquaria worldwide. Unfortunately, blood biochemistry reference intervals (RI) have been determined for few species. The study aims to establish serum biochemical RI for free-living Sand Tiger sharks (Carcharias taurus) off eastern Australia. Thirty-seven sharks were captured and their sex, length, weight, reproductive maturity, and health status were recorded. After blood collection, serum analytes were quantified using standard analytical and statistical methods. Reference intervals, means, medians, and 90% confidence intervals were generated. Physiologic data from live and necropsied sharks were used to enhance the study results. Thirty healthy sharks were included in the study. Albumin could not be detected. With the exception of ALP activity, values were unaffected by sex, length, weight, age, and life-history stage. The means (RI) were: sodium 258 (249-267) mmol/L, potassium 5.0 (4.3-5.7) mmol/L, chloride 242 (227-257) mmol/L, inorganic phosphate 1.8 (1.7-2.0) mmol/L, total calcium 3.9 (3.3-4.4) mmol/L, magnesium 1.9 (1.6-2.2) mmol/L, glucose 2.7 (2.2-3.2) mmol/L, urea 377 (360-394) mmol/L, ALP 20 (8-31) U/L, ALT 3 U/L (no RI), AST 29 (13-45) U/L, CK 42 (5-79) U/L, total protein 30 (24-36) g/L, triglyceride 0.3 (0.1-0.6) mmol/L, cholesterol 1.4 (0.9-2.1) mmol/L, creatinine 32 μmol/L (no RI), total bilirubin 1.5 μmol/L (no RI), and osmolarity 1082 (1027-1136) mmol/L. These preliminary RI will assist with the clinical evaluation and treatment of captive and free-living Sand Tiger sharks worldwide. Studies with more animals will increase the precision of upper and lower reference limits. © 2015 American Society for Veterinary Clinical Pathology.

  10. Preliminary reference intervals and the impact of citrate storage time for thrombelastography in cats including delta and the velocity curve.

    Science.gov (United States)

    Engelen, Carolin; Moritz, Andreas; Barthel, Franziska; Bauer, Natali

    2017-11-29

    Thrombelastography is a useful tool in assessment of hemostasis. Beside the traditional variables, the velocity curve and the variable delta have lately earned attention. The velocity curve provides knowledge about the speed of clot formation including information about thrombin generation. Delta, which only reflects enzymatic coagulation, allows the determination of the origin of hypercoagulability when compared to clot rigidity, a variable that reflects both platelet and enzymatic activity. The aim was to establish preliminary reference intervals for feline thrombelastography including the velocity curve variables and delta obtained after 60 min of storage including the assessment of coefficients of variation. Furthermore, the effect of citrate storage time (30 versus 60 min) on feline thrombelastography will be determined. Prolonged storage times significantly reduced reaction (R) (P = 0.019) and clotting (K) (P = 0.008) times, split point (SP) (P = 0.019) and time to maximum rate of thrombus generation (TMRTG) (P = 0.023) values whereas maximum rate of thrombus generation (MRTG) significantly increased (P = 0.040). Preliminary reference intervals: R (min): 2.7-18.1; K (min): 0.8-3.9; alpha (°): 27.6-75.2; maximum amplitude (mm): 18.5-62.5; clot rigidity (dyn/cm 2 ): 1.2-8.2; coagulation index: -4.6 - 2.6; SP (min): 2.4-15.4; delta (min): 0.3-3.1; thrombus generation (mm/min): 255.3-751.2; MRTG (mm/min): 4.0-19.3; TMRTG (min): 3.5-22.0; maximum rate of lysis (mm/min): 0.0-4.7 and time to maximum rate of lysis (min): 0.4-55.8. Storage for 60 versus 30 min induces hypercoagulable tracings including the velocity curve, some of which variables (MRTG, TMRTG) might function as sensitive markers for changes in the coagulation activity. Because of the impact of citrate storage time on thrombelastography, reference intervals have to be established using a specific and constant storage time in each laboratory.

  11. Pediatric reference intervals for 29 Ortho VITROS 5600 immunoassays using the CALIPER cohort of healthy children and adolescents.

    Science.gov (United States)

    Higgins, Victoria; Fung, Angela W S; Chan, Man Khun; Macri, Joseph; Adeli, Khosrow

    2018-01-26

    Accurate reference intervals (RIs) based on a healthy pediatric population are essential for pediatric test result interpretation. The CALIPER project has recruited a large healthy cohort and completed a series of a priori studies to address gaps in pediatric RIs. As immunoassays from different manufacturers for endocrine and special chemistry markers are not standardized and show marked intermethod differences, direct RI studies are needed for each major analytical platform. Here, we report age- and sex-specific pediatric RIs for 29 immunoassays on the Ortho Clinical Diagnostics (Ortho) VITROS® 5600 analyzer. Health information and blood samples were collected from healthy pediatric subjects. Using the Ortho VITROS 5600 Integrated System MicroWell Technology, 29 biomarkers were measured. Analyte concentrations were partitioned by age and sex according to the Harris and Boyd method. After removing outliers, age- and sex-specific RIs and corresponding 90% confidence intervals were calculated according to CLSI guidelines. All analytes required age partitioning except β-human chorionic gonadotropin (β-hCG), cancer antigen 15-3 (CA15-3), rubella immunoglobulin G (rubella IgG), and vitamin D. Several analytes including estradiol, progesterone, testosterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), free triiodothyronine (FT3), total triiodothyronine (TT3), total thyroxine (TT4), thyroid uptake, ferritin, intact parathyroid hormone (iPTH), total prostate-specific antigen (tPSA), free prostate-specific antigen (fPSA), cancer antigen 125 (CA125), creatine kinase MB (CK-MB), and myoglobin showed sex differences, observed mostly with the onset of puberty. Complex reference value trends were observed across the pediatric age range for several biomarkers examined on Ortho VITROS immunoassays. The availability of VITROS immunoassay RIs will enable accurate laboratory test interpretation and diagnosis for the pediatric population. As recommended by the

  12. Reference intervals for plasma concentrations of adrenal steroids measured by LC-MS/MS: Impact of gender, age, oral contraceptives, body mass index and blood pressure status

    NARCIS (Netherlands)

    Eisenhofer, G.; Peitzsch, M.; Kaden, D.; Langton, K.; Pamporaki, C.; Masjkur, J.; Tsatsaronis, G.; Mangelis, A.; Williams, T.A.; Reincke, M.; Lenders, J.W.M.; Bornstein, S.R.

    2017-01-01

    BACKGROUND: Mass spectrometric-based measurements of the steroid metabolome have been introduced to diagnose disorders featuring abnormal steroidogenesis. Defined reference intervals are important for interpreting such data. METHODS: Liquid chromatography-tandem mass spectrometry was used to

  13. 'Aussie Normals': an a priori study to develop reference intervals in a healthy Australian population using the Beckman Coulter LH 750 Haematology Analyser as candidates for harmonised values.

    Science.gov (United States)

    Koerbin, G; Potter, J M; Andriolo, K; West, N P; Glasgow, N; Hawkins, C; Cavanaugh, J A; Hickman, P E

    2017-08-01

    Reference limits or intervals are important benchmarks or tools that help the clinician to distinguish between a result that is most likely to lie within a 'healthy' or diseased category. It has been suggested that a review of haematology reference intervals is long overdue. In this study we report on our findings for analytes routinely measured in a complete blood count (CBC) performed on the Beckman Coulter LH 750 analyser and an additional comparative study using the Beckman Coulter LH 750, the Sysmex XN and Abbott Sapphire. The results from the comparative study indicate that bias would not prevent harmonisation of reference intervals for these common haematology parameters. The results offered by the Aussie Normals study represent good candidates as the basis for harmonisation reference intervals. Copyright © 2017 Royal College of Pathologists of Australasia. All rights reserved.

  14. Intervalos de referência longitudinais de parâmetros doplervelocimétricos materno-fetais Longitudinal reference intervals of maternal-fetal Doppler parameters

    Directory of Open Access Journals (Sweden)

    Nelsilene Mota Carvalho Tavares

    2013-01-01

    Full Text Available OBJETIVO: Criar intervalos de referência longitudinais para os valores de índices de pulsatilidade (IP dos fluxos nas artérias umbilicais (AU, cerebral média (ACM e uterinas (AUt e IP venoso do fluxo no ducto venoso (DV com uma amostra da população brasileira. MÉTODOS: Estudo observacional longitudinal realizado de fevereiro de 2010 a maio de 2012. Gestantes de baixo risco foram submetidas a exames ultrassonográficos quinzenais da 18ª a 40ª semana para obtenção dos IP das AU, AUt, ACM e IP venoso do DV. Modelos lineares mistos foram usados para elaboração de intervalos de referência longitudinais (percentis 5, 50 e 95 dos IP dos vasos mencionados. Os IP das porções placentária e abdominal do cordão umbilical foram comparados por meio do teste t de amostras independentes. Valores de p bilaterais menores do que 0,05 foram considerados significativos. RESULTADOS: Cento e sessenta e quatro gestantes foram submetidas a 1.242 exames ultrassonográficos. Houve redução significativa nos valores de todos esses parâmetros com o avançar da IG. Entre a 18ª e a 40ª semana de gravidez, as medianas de IP da AU (porções abdominal e placentária do cordão, da ACM, do DV e do IP médio das AUt variaram de 1,19 a 0,74; 1,33 a 0,78; 1,56 a 1,39; 0,58 a 0,41; e 0,98 a 0,66, respectivamente. As equações obtidas para predição das medianas foram: IP-AU=1,5602786 - (0,020623 x IG; Logaritmo do IP-ACM=0,8149111 - (0,004168 x IG - [0,002543 x (IG - 28,7756²]; Logaritmo do IP-DV=-0,26691- (0,015414 x IG; IP-AUt=1,2362403 - (0,014392 x IG. Houve diferença significativa entre os IP-AU obtidos nas extremidades placentária e abdominal fetal (pPURPOSE: To create longitudinal reference intervals for pulsatility index (PI of the umbilical (UA, middle cerebral (MCA, uterine (UtA arteries and ductus venosus (DV in a Brazilian cohort. METHODS: A longitudinal observational study performed from February 2010 to May 2012. Low risk pregnancies were

  15. Thyroid Function Within the Reference Range and the Risk of Stroke: An Individual Participant Data Analysis

    Science.gov (United States)

    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P. J.; Collet, Tinh-Hai; Ikram, M. Arfan; Blum, Manuel R.; Dehghan, Abbas; Drechsler, Christiane; Luben, Robert N.; Portegies, Marileen L. P.; Iervasi, Giorgio; Medici, Marco; Stott, David J.; Dullaart, Robin P.; Ford, Ian; Bremner, Alexandra; Newman, Anne B.; Wanner, Christoph; Sgarbi, José A.; Dörr, Marcus; Longstreth, W. T.; Psaty, Bruce M.; Ferrucci, Luigi; Maciel, Rui M. B.; Westendorp, Rudi G.; Jukema, J. Wouter; Ceresini, Graziano; Imaizumi, Misa; Hofman, Albert; Bakker, Stephan J. L.; Franklyn, Jayne A.; Khaw, Kay-Tee; Bauer, Douglas C.; Walsh, John P.; Razvi, Salman; Gussekloo, Jacobijn; Völzke, Henry; Franco, Oscar H.; Cappola, Anne R.; Rodondi, Nicolas

    2016-01-01

    Context: The currently applied reference ranges for thyroid function are under debate. Despite evidence that thyroid function within the reference range is related with several cardiovascular disorders, its association with the risk of stroke has not been evaluated previously. Design and Setting: We identified studies through a systematic literature search and the Thyroid Studies Collaboration, a collaboration of prospective cohort studies. Studies measuring baseline TSH, free T4, and stroke outcomes were included, and we collected individual participant data from each study, including thyroid function measurements and incident all stroke (combined fatal and nonfatal) and fatal stroke. The applied reference range for TSH levels was between 0.45 and 4.49 mIU/L. Results: We collected individual participant data on 43 598 adults with TSH within the reference range from 17 cohorts, with a median follow-up of 11.6 years (interquartile range 5.1–13.9), including 449 908 person-years. Age- and sex-adjusted pooled hazard ratio for TSH was 0.78 (95% confidence interval [CI] 0.65–0.95 across the reference range of TSH) for all stroke and 0.83 (95% CI 0.62–1.09) for fatal stroke. For the free T4 analyses, the hazard ratio was 1.08 (95% CI 0.99–1.15 per SD increase) for all stroke and 1.10 (95% CI 1.04–1.19) for fatal stroke. This was independent of cardiovascular risk factors including systolic blood pressure, total cholesterol, smoking, and prevalent diabetes. Conclusion: Higher levels of TSH within the reference range may decrease the risk of stroke, highlighting the need for further research focusing on the clinical consequences associated with differences within the reference range of thyroid function. PMID:27603906

  16. Targeting thyroid diseases with TSH receptor analogs.

    Science.gov (United States)

    Galofré, Juan C; Chacón, Ana M; Latif, Rauf

    2013-12-01

    The thyroid-stimulating hormone (TSH) receptor (TSHR) is a major regulator of thyroid function and growth, and is the key antigen in several pathological conditions including hyperthyroidism, hypothyroidism, and thyroid tumors. Various effective treatment strategies are currently available for many of these clinical conditions such as antithyroid drugs or radioiodine therapy, but they are not devoid of side effects. In addition, treatment of complications of Graves' disease such as Graves' ophthalmopathy is often difficult and unsatisfactory using current methods. Recent advances in basic research on both in vitro and in vivo models have suggested that TSH analogs could be used for diagnosis and treatment of some of the thyroid diseases. The advent of high-throughput screening methods has resulted in a group of TSH analogs called small molecules, which have the potential to be developed as promising drugs. Small molecules are low molecular weight compounds with agonist, antagonist and, in some cases, inverse agonist activity on TSHR. This short review will focus on current advances in development of TSH analogs and their potential clinical applications. Rapid advances in this field may lead to the conduct of clinical trials of small molecules related to TSHR for the management of Graves' disease, thyroid cancer, and thyroid-related osteoporosis in the coming years. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  17. CLSI-based transference of the CALIPER database of pediatric reference intervals from Abbott to Beckman, Ortho, Roche and Siemens Clinical Chemistry Assays: direct validation using reference samples from the CALIPER cohort.

    Science.gov (United States)

    Estey, Mathew P; Cohen, Ashley H; Colantonio, David A; Chan, Man Khun; Marvasti, Tina Binesh; Randell, Edward; Delvin, Edgard; Cousineau, Jocelyne; Grey, Vijaylaxmi; Greenway, Donald; Meng, Qing H; Jung, Benjamin; Bhuiyan, Jalaluddin; Seccombe, David; Adeli, Khosrow

    2013-09-01

    The CALIPER program recently established a comprehensive database of age- and sex-stratified pediatric reference intervals for 40 biochemical markers. However, this database was only directly applicable for Abbott ARCHITECT assays. We therefore sought to expand the scope of this database to biochemical assays from other major manufacturers, allowing for a much wider application of the CALIPER database. Based on CLSI C28-A3 and EP9-A2 guidelines, CALIPER reference intervals were transferred (using specific statistical criteria) to assays performed on four other commonly used clinical chemistry platforms including Beckman Coulter DxC800, Ortho Vitros 5600, Roche Cobas 6000, and Siemens Vista 1500. The resulting reference intervals were subjected to a thorough validation using 100 reference specimens (healthy community children and adolescents) from the CALIPER bio-bank, and all testing centers participated in an external quality assessment (EQA) evaluation. In general, the transferred pediatric reference intervals were similar to those established in our previous study. However, assay-specific differences in reference limits were observed for many analytes, and in some instances were considerable. The results of the EQA evaluation generally mimicked the similarities and differences in reference limits among the five manufacturers' assays. In addition, the majority of transferred reference intervals were validated through the analysis of CALIPER reference samples. This study greatly extends the utility of the CALIPER reference interval database which is now directly applicable for assays performed on five major analytical platforms in clinical use, and should permit the worldwide application of CALIPER pediatric reference intervals. Copyright © 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  18. Age modifies the pituitary TSH response to thyroid failure

    DEFF Research Database (Denmark)

    Carlé, Allan; Laurberg, Peter; Pedersen, Inge B.

    2007-01-01

    Objective: To investigate the association between serum TSH, total T4 and various patient characteristics when hypothyroidism is diagnosed in a population, and to study how age, sex and serum T4 levels influenced pituitary TSH response. Design: A computer-based register linked to laboratory...... patients with spontaneous autoimmune hypothyroidism (n = 578). Main outcome: In untreated primary, spontaneous autoimmune hypothyroidism, we observed a four fold difference in average serum TSH levels between the youngest (0-20 years: TSH = 100 mU/l) and the oldest (80+ years: TSH = 24.4 mU/l) group...... of patients. No age dependent variation was observed in serum total T4. Log TSH showed an inverse linear correlation with age. An inverse linear correlation was present between log TSH and total T4 in both young and old patients, but for all total T4 values we observed lower median serum TSH values in elderly...

  19. [Analysis of serum lipids levels and the establishment of reference intervals for serum lipids in middle and late pregnancy].

    Science.gov (United States)

    Ying, Chunmei; Yue, Chaoyan; Zhang, Chunyi; Li, Xiaotian

    2015-12-01

    To explore the serum lipids levels in healthy pregnant women, and to establish the reference intervals of serum lipids in middle and late pregnancy. Triglyceride (TG), total cholesterol (TCH), high density lipoprotein (HDL), low density lipoprotein (LDL), apo-lipoprotein-A(APO-A) and apo-lipoprotein-B (APO-B) were measured in 3 200 pregnant women and 3 200 healthy women of childbearing age(the control group) from January 2014 to Febuary 2015 in Obstetrics and Gynecology Hospital of Fudan University. In the healthy pregnant women, serum lipids were measured at 14-20, 24-28 and 37-40 gestational weeks, respectively. All the parameters were detected by Hitachi 7180 automatic biochemical analyzer. The test results were calculated and determined by the C28-A3 standard of the National Clinical and Laboratory Standards Institute. And the normal reference intervals of serum lipids in middle and late pregnancy were defined as 2.5%-97.5%. (1) The levels of TG, TCH, HDL, LDL, APO-A and APO-B in the control group were 0.8, 4.2, 1.0, 2.7 mmol/L and 1.1, 0.8 g/L, respectively. The levels of TG, TCH, HDL, LDL, APO-A and APO-B in middle and late pregnancy were significantly higher than those in the control group (Plipids levels at 14-20, 24-28 and 37-40 gestational weeks in healthy pregnant women were compared with the control group as following. The TG levels were 1.9, 3.8 and 4.4 folds of the control group; the TCH levels were 1.1, 1.5 and 1.5 folds of the control group; the HDL levels were 1.2, 1.6 and 1.5 folds of the control group; the LDL levels were 1.1, 1.4 and 1.4 folds of the control group; the APO-A levels were 1.3, 1.4 and 1.5 folds of the control group; and the APO-B levels were 1.1, 1.5 and 1.5 fold of the control group respectively. The TG level was the most increased, and it increased gradually with gestational age (Plipids at 14-20, 24-28 and 37-40 gestational weeks in healthy pregnant women were as following. The TG levels were 0.7-3.9, 1.7-6.3 and 1.6-8.1 mmol

  20. Reference intervals and physiologic alterations in hematologic and biochemical values of free-ranging desert tortoises in the Mojave Desert

    Science.gov (United States)

    Christopher, Mary M.; Berry, Kristin H.; Wallis, I.R.; Nagy, K.A.; Henen, B.T.; Peterson, C.C.

    1999-01-01

    Desert tortoise (Gopherus agassizii) populations have experienced precipitous declines resulting from the cumulative impact of habitat loss, and human and disease-related mortality. Evaluation of hematologic and biochemical responses of desert tortoises to physiologic and environmental factors can facilitate the assessment of stress and disease in tortoises and contribute to management decisions and population recovery. The goal of this study was to obtain and analyze clinical laboratory data from free-ranging desert tortoises at three sites in the Mojave Desert (California, USA) between October 1990 and October 1995, to establish reference intervals, and to develop guidelines for the interpretation of laboratory data under a variety of environmental and physiologic conditions. Body weight, carapace length, and venous blood samples for a complete blood count and clinical chemistry profile were obtained from 98 clinically healthy adult desert tortoises of both sexes at the Desert Tortoise Research Natural area (western Mojave), Goffs (eastern Mojave) and Ivanpah Valley (northeastern Mojave). Samples were obtained four times per year, in winter (February/March), spring (May/June), summer (July/August), and fall (October). Years of near-, above- and below-average rainfall were represented in the 5 yr period. Minimum, maximum and median values, and central 95 percentiles were used as reference intervals and measures of central tendency for tortoises at each site and/or season. Data were analyzed using repeated measures analysis of variance for significant (P < 0.01) variation on the basis of sex, site, season, and interactions between these variables. Significant sex differences were observed for packed cell volume, hemoglobin concentration, aspartate transaminase activity, and cholesterol, triglyceride, calcium, and phosphorus concentrations. Marked seasonal variation was observed in most parameters in conjunction with reproductive cycle, hibernation, or seasonal

  1. Circadian changes in pulsatile TSH release in primary hypothyroidism

    NARCIS (Netherlands)

    Adriaanse, R.; Brabant, G.; Prank, K.; Endert, E.; Wiersinga, W. M.

    1992-01-01

    We evaluated pulsatile and circadian TSH secretion in primary hypothyroidism. In a prospective study, blood was sampled every 10 minutes during 24 hours for assay of TSH (IRMA). Thyroid hormones and TSH responsiveness to TRH were then measured. Nine patients with overt primary hypothyroidism, seven

  2. Derivation of gender and age-specific reference intervals from fully normal Japanese individuals and the implications for health screening.

    Science.gov (United States)

    Yamakado, Minoru; Ichihara, Kiyoshi; Matsumoto, Yoshiyuki; Ishikawa, Yoshiki; Kato, Kiminori; Komatsubara, Yusuke; Takaya, Norihide; Tomita, Shohken; Kawano, Reo; Takada, Keisuke; Watanabe, Kiyoaki

    2015-07-20

    With nationwide standardization of laboratory tests among institutions for health screening in Japan, common reference intervals (RIs) were derived from records of 1,500,000 health check attendees. Targets were 20 basic laboratory tests including body mass index (BMI) and systolic and diastolic blood pressures (SBP, DBP). Individuals fulfilling the following strict criteria were chosen: SBPmediation with no remarkable current/past illnesses. The latent abnormal values exclusion (LAVE) method was applied to ensure fully normal results. RIs were derived by parametric method using modified Box-Cox power transformation. Among all attendees, 23% fulfilled the criteria. Application of the LAVE method further reduced the dataset by 40%-50%. Age-related charts of test results differed greatly between genders in almost all tests. Comparison of derived RIs with clinical decision limits (CDLs) revealed that the upper limits of RIs differed from CDLs according to gender and age. Implementation of gender and age-specific RIs derived from individuals with fully normal health attributes will (1) enable appropriate interpretation of test results in health screening and (2) promote judicious application of CDLs for therapeutic intervention, taking into account gender, age and other health attributes. Copyright © 2015 Elsevier B.V. All rights reserved.

  3. Reference intervals for absolute and percentage immature platelet fraction using the Sysmex XN-10 automated haematology analyser in a UK population.

    Science.gov (United States)

    Ali, Usman; Knight, Gavin; Gibbs, Roz; Tsitsikas, Dimitris A

    2017-12-01

    Immature platelet fraction (IPF) estimation is a non-invasive and sensitive test that is available on recently introduced Sysmex XN-series of automated haematology analysers. It is a direct cellular indicator of thrombopoiesis. The aim of this study was to establish reference intervals for IPF, for both absolute (A-IPF) and percentage (%-IPF) measurements. A total of 2366 samples that met the inclusion criteria were assayed for full blood count on the Sysmex XN-10 and a non-parametric percentile method was used for calculating the reference intervals. After the outliers were excluded, the reference interval for %-IPF and A-IPF on Sysmex XN-10 were 1.6-10.1% and 4.37-23.21 × 10 9 /L in total individuals, respectively. There was a statistical significance noted between the sexes (p = .004) for %-IPF, therefore a sex-specific reference interval was established, which was 1.8-10.0% for the males and 1.5-10.1% for females. No significant difference in sex status for A-IPF and age status for both %-IPF and A-IPF was observed. A very poor correlation was estimated between age versus %-IPF, ρ = 0.0156, and age versus A-IPF, ρ = -0.0023, indicating that there is no overall biological relationship between age and these parameters. As expected, a strong correlation between %-IPF and A-IPF was noted which could be attributed to their inter-relatedness. This large-scale study showed comparable reference intervals with the previous studies for %-IPF and A-IPF in a UK population. It found the need to establish sex-specific reference intervals for %-IPF, but not for A-IPF, whereas reference intervals were found to be stable across the age range.

  4. Ethnic differences in TSH but not in free T4 concentrations or TPO antibodies during pregnancy

    NARCIS (Netherlands)

    Benhadi, N.; Wiersinga, W. M.; Reitsma, J. B.; Vrijkotte, T. G. M.; van der Wal, M. F.; Bonsel, G. J.

    2007-01-01

    OBJECTIVE: To describe the TSH, free T4 and thyroid peroxidase antibody (TPO-Ab) concentrations during pregnancy among four ethnic groups and to determine reference values for these parameters during normal pregnancy. METHODS: Cross-sectional study of a cohort of 3270 pregnant women living in the

  5. Preconception TSH and pregnancy outcomes: a population-based cohort study in 184 611 women.

    Science.gov (United States)

    Chen, Shi; Zhou, Xiang; Zhu, Huijuan; Yang, Hongbo; Gong, Fengying; Wang, Linjie; Zhang, Man; Jiang, Yu; Yan, Chengsheng; Li, Jianqiang; Wang, Qing; Zhang, Shikun; Pan, Hui

    2017-06-01

    Whether subclinical hypothyroidism adversely impacts pregnancy outcomes is inconclusive, and limited data are available on the optimal TSH range in women planning pregnancy. To investigate the association between maternal preconception TSH levels and pregnancy outcomes. Population-based cohort study. From 2010 to 2012, the free National Pre-pregnancy Checkups Project recruited 248 501 pairs of volunteer couples across China, of which 184 611 women, who subsequently became pregnant, were studied. Maternal TSH was measured within 6 months prior to conception. Participants were grouped according to TSH: 0·48-2·49 mIU/l (n = 133 232, 72%), 2·50-4·28 mIU/l (n = 44 239, 24%) and 4·29-10·0 mIU/l (n = 7140, 4%). Multivariable logistic regression models were used to study the association between TSH and pregnancy outcomes. Pregnancy loss, gestational age (GA), delivery modes and birthweight. The overall incidence of adverse pregnancy outcomes was 28·6%. Compared with TSH 0·48-2·50 mIU/l, TSH 2·50-4·29 mIU/l was associated with spontaneous abortion [aOR: 1·10, 95% confidence interval (CI): 1·03-1·18], preterm birth (aOR: 1·09, 95% CI: 1·04-1·15) and operative vaginal delivery (aOR: 1·15, 95% CI: 1·09-1·21), while TSH 4·29-10 mIU/l was correlated with spontaneous abortion (aOR: 1·15, 95% CI: 1·10-1·22), stillbirth (aOR: 1·58, 95% CI: 1·10-2·28), preterm birth (aOR: 1·20, 95% CI: 1·08-1·34), caesarean section (aOR: 1·15, 95% CI: 1·10-1·22) and large for gestational age (LGA) infants (aOR: 1·12, 95% CI: 1·04-1·21). Preconception TSH elevation was associated with increased risk of adverse pregnancy outcomes, even within the normal nonpregnant range. © 2017 John Wiley & Sons Ltd.

  6. Marked biological variance in endocrine and biochemical markers in childhood: establishment of pediatric reference intervals using healthy community children from the CALIPER cohort.

    Science.gov (United States)

    Bailey, Dana; Colantonio, David; Kyriakopoulou, Lianna; Cohen, Ashley H; Chan, Man Khun; Armbruster, David; Adeli, Khosrow

    2013-09-01

    Reference intervals are indispensable in evaluating laboratory test results; however, appropriately partitioned pediatric reference values are not readily available. The Canadian Laboratory Initiative for Pediatric Reference Intervals (CALIPER) program is aimed at establishing the influence of age, sex, ethnicity, and body mass index on biochemical markers and developing a comprehensive database of pediatric reference intervals using an a posteriori approach. A total of 1482 samples were collected from ethnically diverse healthy children ages 2 days to 18 years and analyzed on the Abbott ARCHITECT i2000. Following the CLSI C28-A3 guidelines, age- and sex-specific partitioning was determined for each analyte. Nonparametric and robust methods were used to establish the 2.5th and 97.5th percentiles for the reference intervals as well as the 90% CIs. New pediatric reference intervals were generated for 14 biomarkers, including α-fetoprotein, cobalamin (vitamin B12), folate, homocysteine, ferritin, cortisol, troponin I, 25(OH)-vitamin D [25(OH)D], intact parathyroid hormone (iPTH), thyroid-stimulating hormone, total thyroxine (TT4), total triiodothyronine (TT3), free thyroxine (FT4), and free triiodothyronine. The influence of ethnicity on reference values was also examined, and statistically significant differences were found between ethnic groups for FT4, TT3, TT4, cobalamin, ferritin, iPTH, and 25(OH)D. This study establishes comprehensive pediatric reference intervals for several common endocrine and immunochemical biomarkers obtained in a large cohort of healthy children. The new database will be of global benefit, ensuring appropriate interpretation of pediatric disease biomarkers, but will need further validation for specific immunoassay platforms and in local populations as recommended by the CLSI.

  7. The log TSH-free T4 relationship in a community-based cohort is nonlinear and is influenced by age, smoking and thyroid peroxidase antibody status.

    Science.gov (United States)

    Brown, Suzanne J; Bremner, Alexandra P; Hadlow, Narelle C; Feddema, Peter; Leedman, Peter J; O'Leary, Peter C; Walsh, John P

    2016-11-01

    The TSH-T4 relationship was thought to be inverse log-linear, but recent cross-sectional studies of selected populations report a complex, nonlinear relationship. The TSH-T4 relationship has not been evaluated in an unselected, community-based cohort, and there are limited data regarding clinical factors which affect it. To analyse the TSH-free T4 relationship in a community-based cohort. In a cross-sectional, retrospective study, we analysed serum TSH and free T4 concentrations from 4427 participants (55% female) in the 1994 Busselton Health Study who were not taking thyroxine. Simple linear, segmented-linear and nonlinear regression models of log 10 TSH on free T4 were compared for goodness of fit. All 5 log TSH-free T4 models tested (separate lines, segmented conterminal line, quartic, error function, double-sigmoid curve) fitted significantly better than a simple linear model (each P smoking and TPOAb status each significantly influenced the TSH-free T4 relationship, whereas BMI category and diabetes did not. A sex difference in the TSH-free T4 relationship was apparent only in the lower part of the free T4 reference range. In a community-based setting, the relationship between log TSH and free T4 is complex, nonlinear and influenced by age, smoking and TPOAb status. © 2016 John Wiley & Sons Ltd.

  8. [Survey and analysis on sources of reference intervals and distribution of medical decision levels in NT-proBNP, BNP and homocysteine].

    Science.gov (United States)

    Zhang, Lu; Wang, Wei; Zhong, Kun; He, Falin; Wang, Zhiguo

    2015-11-01

    To analyze the sources of reference intervals and distribution of medical decision levels in NT-proBNP, BNP and homocysteine (Hcy) based on the feedback of laboratories which participated in the 2014 External Quality Assessment (EQA) program in China. Information of reference intervals and medical decision levels was collected from the 2014 EQA programs in NT-proBNP, BNP and Hcy.All the abnormal values and errors were eliminated.Data were analyzed by SPSS 13.0 and Microsoft Excel 2007 in terms of referring to sources of reference intervals and distribution of medical decision levels.Values were further grouped based on instrument system for NT-proBNP and BNP, reagent manufacturers for Hcy. There were 330, 119 and 339 laboratories submitting the data on the reference intervals of NT-proBNP, BNP and Hcy. Only 133, 54 and 102 laboratories provided information about medical decision levels.Most reference sources were derived from reagent manufactures (NT-proBNP 76.97%(254/330), BNP 89.08%(106/119), Hcy 83.19%(282/339)). Approximately, 36.53%(122/334), 45.38%(54/119) and 47.95%(164/342) of the laboratories validated the reference intervals of NT-proBNP, BNP and Hcy.According to the surveys, the mean and median values were not close to each other (NT-proBNP 507.99 ng/L and 300.00 ng/L, BNP 342.72 ng/L and 100.00 ng/L, Hcy 17.34 µmol/L and 15.00 µmol/L). Variation of P2.5 and P97.5 was as follows: (NT-proBNP 125.00-1 800.00 ng/L, BNP 87.50-4562.50 ng/L, Hcy 4.15-50.00 µmol/L). The ranges were NT-proBNP 60.00-7 000.00 ng/L, and BNP 80.00-7 000.00 ng/L, and Hcy 1.5-52.00 µmol/L.P values of rank sum test for NT-proBNP, BNP and Hcy were 0.449, 0.208 and 0.754. Medical decision levels of NT-proBNP, Hcy and BNP showed large variation among laboratories and the sources of reference interval were not unified.Thus, urgent efforts should be made to establish appropriate reference intervals for Chinese people and promote harmonization and standardization of reference intervals

  9. Simpson's method of discs in Salukis and Whippets: Echocardiographic reference intervals for end-diastolic and end-systolic left ventricular volumes.

    Science.gov (United States)

    Seckerdieck, M; Holler, P; Smets, P; Wess, G

    2015-12-01

    Sighthound breeds are known to have different cardiac sizes and dimensions from other breeds; therefore, breed-specific references are required to avoid misinterpretation of echocardiographic findings. End-diastolic volume (EDV) and end-systolic volume (ESV) reference intervals derived from Simpson's method of discs (SMOD) do not exist for Salukis or Whippets. To establish EDV and ESV reference intervals for SMOD in Salukis and Whippets. 110 Salukis and 119 Whippets. Reference intervals for SMOD with and without normalization to body surface area (BSA) were established using the right parasternal and left apical views in 93 healthy Salukis and 82 healthy Whippets. Volumes were compared between both echocardiographic views, genders, and racing and show pedigree dogs. The 90% reference intervals were calculated using the robust method. Agreement between right-sided and left-sided echocardiographic views was good. Reference intervals indexed to body surface area (BSA) for Whippets were 59-109 mL/m² for end-diastolic volume index and 18-53 mL/m² for end-systolic volume index. Corresponding values for Salukis were 68-126 mL/m² for end-diastolic volume index and 27-64 mL/m² for end-systolic volume index. There were no indexed volume differences between male and female or racing and show pedigree dogs in both breeds. The non-normalized volumes significantly differed between genders. Whippets and Salukis had larger systolic and diastolic left ventricular volumes compared with other breeds. This study provided echocardiographic reference intervals for SMOD-derived left ventricular volumes for these athletic breeds. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Harmonization of Serum Thyroid-Stimulating Hormone Measurements Paves the Way for the Adoption of a More Uniform Reference Interval.

    Science.gov (United States)

    Thienpont, Linda M; Van Uytfanghe, Katleen; De Grande, Linde A C; Reynders, Dries; Das, Barnali; Faix, James D; MacKenzie, Finlay; Decallonne, Brigitte; Hishinuma, Akira; Lapauw, Bruno; Taelman, Paul; Van Crombrugge, Paul; Van den Bruel, Annick; Velkeniers, Brigitte; Williams, Paul

    2017-07-01

    The IFCC Committee for Standardization of Thyroid Function Tests developed a global harmonization approach for thyroid-stimulating hormone measurements. It is based on a multiassay method comparison study with clinical serum samples and target setting with a robust factor analysis method. Here we describe the Phase IV method comparison and reference interval (RI) studies conducted with the objective to recalibrate the participating assays and demonstrate the proof-of-concept. Fourteen manufacturers measured the harmonization and RI panel; 4 of them quantified the harmonization and first follow-up panel in parallel. All recalibrated their assays to the statistically inferred targets. For validation, we used desirable specifications from the biological variation for the bias and total error (TE). The RI measurements were done with the assays' current calibrators, but data were also reported after transformation to the new calibration status. We estimated the pre- and postrecalibration RIs with a nonparametric bootstrap procedure. After recalibration, 14 of 15 assays met the bias specification with 95% confidence; 8 assays complied with the TE specification. The CV of the assay means for the harmonization panel was reduced from 9.5% to 4.2%. The RI study showed improved uniformity after recalibration: the ranges (i.e., maximum differences) exhibited by the assay-specific 2.5th, 50th, and 97.5th percentile estimates were reduced from 0.27, 0.89, and 2.13 mIU/L to 0.12, 0.29, and 0.77 mIU/L. We showed that harmonization increased the agreement of results from the participating immunoassays, and may allow them to adopt a more uniform RI in the future. © 2017 American Association for Clinical Chemistry.

  11. Circulating intact and cleaved forms of the urokinase-type plasminogen activator receptor: biological variation, reference intervals and clinical useful cut-points.

    Science.gov (United States)

    Thurison, Tine; Christensen, Ib J; Lund, Ida K; Nielsen, Hans J; Høyer-Hansen, Gunilla

    2015-01-15

    High levels of circulating forms of the urokinase-type plasminogen activator receptor (uPAR) are significantly associated to poor prognosis in cancer patients. Our aim was to determine biological variations and reference intervals of the uPAR forms in blood, and in addition, to test the clinical relevance of using these as cut-points in colorectal cancer (CRC) prognosis. uPAR forms were measured in citrated and EDTA plasma samples using time-resolved fluorescence immunoassays. Diurnal, intra- and inter-individual variations were assessed in plasma samples from cohorts of healthy individuals. Reference intervals were determined in plasma from healthy individuals randomly selected from a Danish multi-center cross-sectional study. A cohort of CRC patients was selected from the same cross-sectional study. The reference intervals showed a slight increase with age and women had ~20% higher levels. The intra- and inter-individual variations were ~10% and ~20-30%, respectively and the measured levels of the uPAR forms were within the determined 95% reference intervals. No diurnal variation was found. Applying the normal upper limit of the reference intervals as cut-point for dichotomizing CRC patients revealed significantly decreased overall survival of patients with levels above this cut-point of any uPAR form. The reference intervals for the different uPAR forms are valid and the upper normal limits are clinically relevant cut-points for CRC prognosis. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Thyroid Function within the Reference Range and the Risk of Stroke

    DEFF Research Database (Denmark)

    Chaker, Layal; Baumgartner, Christine; den Elzen, Wendy P J

    2016-01-01

    cohorts, with median follow-up of 11.6 years (interquartile range 5.1-13.9), including 449,908 person-years. Age- and sex-adjusted pooled HR for TSH was 0.78 (95% Confidence Interval [CI], 0.65-0.95, across the reference range of TSH) for all stroke and 0.83 (95% CI, 0.62-1.09) for fatal stroke......CONTEXT: The currently applied reference ranges for thyroid function are under debate. Despite evidence that thyroid function within the reference range is related with several cardiovascular disorders, its association with the risk of stroke has not been evaluated previously. DESIGN AND SETTING...... Data (IPD) from each study, including thyroid function measurements and incident all stroke (combined fatal and non-fatal) and fatal stroke. The applied reference range for TSH levels was between 0.45-4.49 mIU/L. RESULTS: We collected IPD on 43,598 adults with TSH within the reference range from 17...

  13. A multicenter study on PIVKA reference interval of healthy population and establishment of PIVKA cutoff value for hepatocellular carcinoma diagnosis in China.

    Science.gov (United States)

    Qin, X; Tang, G; Gao, R; Guo, Z; Liu, Z; Yu, S; Chen, M; Tao, Z; Li, S; Liu, M; Wang, L; Hou, L; Xia, L; Cheng, X; Han, J; Qiu, L

    2017-08-01

    The aim of this study was to investigate the reference interval of protein-induced vitamin K absence or antagonist-II (PIVKA-II) in China population and to evaluate its medical decision level for hepatocellular carcinoma (HCC) diagnosis. To determine the reference range for Chinese individuals, a total of 855 healthy subjects in five typical regions of China were enrolled in this study to obtain a 95% reference interval. In a case-control study which recruited the subjects diagnosed with HCC, metastatic liver cancer, bile duct cancer, hepatitis, cirrhosis, other benign liver diseases and the subjects administrated anticoagulant, receiver operating characteristic analysis was used to determine PIVKA-II cutoff value for a medical decision. The concentration of PIVKA-II had no relationship with age or gender and that region was a significant factor associated with the level of PIVKA-II. The 95% reference interval determined in this study for PIVKA-II in Chinese healthy individuals was 28 mAU/mL, and the cutoff value which to distinguish patients with HCC from disease control groups is 36.5 mAU/mL. In clinical applications, it is recommended that each laboratory chooses their own reference interval based on the regional population study or cutoff value for disease diagnosis. © 2017 John Wiley & Sons Ltd.

  14. Value of diagnostic radioiodine scintigraphy and thyroglobulin measurements after rhTSH injection

    Energy Technology Data Exchange (ETDEWEB)

    Verburg, F.A.; Keizer, B. de; Isselt, J.W. van [University Medical Center Utrecht (Netherlands). Dept. of Nuclear Medicine; Klerk, J.M.H. de [University Medical Center Utrecht (Netherlands). Dept. of Nuclear Medicine]|[Meander Medical Center, Amersfoort (Netherlands). Nuclear Medicine; Lentjes, E.G.W.M. [University Medical Center Utrecht (Netherlands). Dept. of Clinical Chemistry and Haematology; Lips, C.J.M. [University Medical Center Utrecht (Netherlands). Dept. of Endocrinology

    2009-07-01

    Measurements of thyroglobulin (Tg) levels 72 h after administration of recombinant human thyrotropin (rhTSH) are recommended by the manufacturer in the follow-up of patients with differentiated thyroid carcinoma (DTC). In our department, Tg measurements are performed both 24 h and 72 h after administration of rhTSH, together with 72 h post rhTSH {sup 131}I whole body scintigraphy (WBS). The objective of this study is to compare the diagnostic usefulness of Tg measurements 24 and 72 h after rhTSH administration, and {sup 131}I WBS. 181 patients were included who had been referred to our Nuclear Medicine Department for follow-up after {sup 131}I ablation of DTC. Tg measurements 24 h (Tg24) and 72 h (Tg72) after rhTSH, and {sup 131}I WBS, were done in all patients. The lower detection limit of Tg was 0,2 {mu}g/l. 47 patients (26%) had detectable Tg levels: in 4/47 cases (8%) only Tg24 was detectable (always <1 {mu}g/l), and in 6/47 cases (11%), only Tg72 was detectable. In 10/47 patients with detectable Tg-levels, Tg24 and Tg72 tested equally. In 27/47 cases, Tg24 was lower, and in 10/47 higher, than Tg72. Two patients with one or two positive Tg-test results also had a positive {sup 131}I WBS. In 8 patients (14%) only the {sup 131}I WBS was positive; an anatomical substrate for such a Tg-negative positive WBS was confirmed in only 2 patients. Tg-measurement 72 hours after rhTSH injection reveals all clinically relevant detectable Tg-levels. Diagnostic {sup 131}I scintigraphy may be omitted, even in high-risk patients. (orig.)

  15. Serum prolactin revisited: parametric reference intervals and cross platform evaluation of polyethylene glycol precipitation-based methods for discrimination between hyperprolactinemia and macroprolactinemia.

    Science.gov (United States)

    Overgaard, Martin; Pedersen, Susanne Møller

    2017-10-26

    Hyperprolactinemia diagnosis and treatment is often compromised by the presence of biologically inactive and clinically irrelevant higher-molecular-weight complexes of prolactin, macroprolactin. The objective of this study was to evaluate the performance of two macroprolactin screening regimes across commonly used automated immunoassay platforms. Parametric total and monomeric gender-specific reference intervals were determined for six immunoassay methods using female (n=96) and male sera (n=127) from healthy donors. The reference intervals were validated using 27 hyperprolactinemic and macroprolactinemic sera, whose presence of monomeric and macroforms of prolactin were determined using gel filtration chromatography (GFC). Normative data for six prolactin assays included the range of values (2.5th-97.5th percentiles). Validation sera (hyperprolactinemic and macroprolactinemic; n=27) showed higher discordant classification [mean=2.8; 95% confidence interval (CI) 1.2-4.4] for the monomer reference interval method compared to the post-polyethylene glycol (PEG) recovery cutoff method (mean=1.8; 95% CI 0.8-2.8). The two monomer/macroprolactin discrimination methods did not differ significantly (p=0.089). Among macroprolactinemic sera evaluated by both discrimination methods, the Cobas and Architect/Kryptor prolactin assays showed the lowest and the highest number of misclassifications, respectively. Current automated immunoassays for prolactin testing require macroprolactin screening methods based on PEG precipitation in order to discriminate truly from falsely elevated serum prolactin. While the recovery cutoff and monomeric reference interval macroprolactin screening methods demonstrate similar discriminative ability, the latter method also provides the clinician with an easy interpretable monomeric prolactin concentration along with a monomeric reference interval.

  16. Impact of recombinant TSH on quality of life in thyroid carcinoma patients undergoing remnant ablation or diagnostic whole body scanning

    International Nuclear Information System (INIS)

    Schroeder, Pamela R.; Ladenson, Paul W.; for the Members of the Thyrogen Trials

    2005-01-01

    Full text: Thyroid remnant ablation with 131 I is often necessary in the initial treatment of thyroid carcinoma. A recent study demonstrated that use of recombinant TSH (rh TSH) was equivalently effective to withdrawal from levothyroxine (L-T 4 ) for postoperative remnant ablation. Quality of life was also shown to be negatively impacted in patients withdrawn from L-T 4 , but not those maintained euthyroid and treated after rh TSH. In this study, we compare the impact of rh TSH on quality of life in patients undergoing remnant ablation versus those undergoing diagnostic whole body scanning (WBS) in a previous trial. Health-related quality of life was measured using the SF-36 survey, which consists of 8 domains describing the physical and mental functioning of patients and 2 physical and mental summary domains, in both trials at baseline on L-T 4 , after rh TSH while on L-T 4 and after L-T 4 withdrawal. Mean SF-36 scores declined from the rh TSH treatment versus L-T 4 withdrawal in both trials to a similar extent in all 8 domains and the 2 summary domains, as evidenced by overlapping 95% confidence intervals. Further SF-6D scores, which summarize all 8 domains in a single zero-to-one metric, were used to characterize the overall quality of life among patients in the two trials. The SF-6D scores for patients after rh TSH administration in the diagnostic and ablation trials were 0.803 and 0.714, respectively. In contrast, SF-6D scores for patients undergoing L-T 4 withdrawal in the diagnostic and ablation trials were 0.637 and 0.548, respectively (p 4 withdrawal both experience a comparable decrease in quality of life, which can be prevented by use of rh TSH in the euthyroid state. (author)

  17. TSH Measurement and Its Implications for Personalised Clinical Decision-Making

    Directory of Open Access Journals (Sweden)

    Rudolf Hoermann

    2012-01-01

    Full Text Available Advances in assay technology have promoted thyrotropin (TSH measurements from participation in a multi-analyte assessment of thyroid function to a statistically defined screening parameter in its own right. While this approach has been successful in many ways, it has some grave limitations. This includes the basic question of what constitutes an agreed reference range and the fact that the population-based reference range by far exceeds the variation of the intraindividual set point. Both problems result in a potential misdiagnosis of normal and pathological thyroid function in a substantial proportion of patients. From a physiological perspective, TSH plays an integrated role in thyroid homeostasis. Few attempts have been made to adopt physiological insights into thyroid homeostasis for medical decision-making. Some emerging novel findings question the widely assumed log-linear TSH-FT4 relationship over the entire thyroid function spectrum. This data favours more complex hierarchically structured models. With a better understanding of its role in thyroid homeostasis in thyroid health and disease, TSH can be revisited in the context of thyroid regulation. This, in turn, could help overcome some of the limitations arising from its isolated statistical use and offer new prospects towards a more personalised interpretation of thyroid test results.

  18. TSH levels and risk of miscarriage in women on long-term levothyroxine: a community-based study.

    Science.gov (United States)

    Taylor, Peter N; Minassian, Caroline; Rehman, Anis; Iqbal, Ahmed; Draman, Mohd Shazli; Hamilton, William; Dunlop, Diana; Robinson, Anthony; Vaidya, Bijay; Lazarus, John H; Thomas, Sara; Dayan, Colin M; Okosieme, Onyebuchi E

    2014-10-01

    Thyroid dysfunction is associated with adverse obstetric outcomes, but there is limited information on pregnancy outcomes in women established on levothyroxine. The objective of the study was to determine the relationship between TSH levels and pregnancy outcomes in levothyroxine-treated women in a large community-based database. This was a historical cohort analysis. Individuals with a first prescription of levothyroxine from 2001 through 2009 (n = 55 501) were identified from the UK General Practice Research Database (population 5 million). Of these, we identified 7978 women of child-bearing age (18-45 y) and 1013 pregnancies in which levothyroxine had been initiated at least 6 months before conception. TSH, miscarriage/delivery status, and obstetric outcomes were measured. Forty-six percent of levothyroxine-treated women aged 18-45 years had a TSH level greater than 2.5 mU/L (recommended upper level in the first trimester). Among pregnant women who had their TSH measured in the first trimester, 62.8% had a TSH level greater than 2.5 mU/L, with 7.4% greater than 10 mU/L. Women with TSH greater than 2.5 mU/L in the first trimester had an increased risk of miscarriage compared with women with TSH 0.2-2.5 mU/L after adjusting for age, year of pregnancy, diabetes, and social class (P = .008). The risk of miscarriage was increased in women with TSH 4.51-10 mU/L [odds ratio (OR) 1.80, 95% confidence interval (CI) 1.03, 3.14)] and TSH greater than 10 mU/L (OR 3.95, 95% CI 1.87, 8.37) but not with TSH 2.51-4.5 mU/L (OR 1.09, 95% CI 0.61, 1.93). The majority of levothyroxine-treated women have early gestational TSH levels above the recommended targets (>2.5 mU/L) with a strong risk of miscarriage at levels exceeding 4.5 mU/L. There is an urgent need to improve the adequacy of thyroid hormone replacement in early pregnancy.

  19. Measurement of amino terminal propeptide of type III procollagen (PIIINP) employing the ADVIA Centaur platform. Validation, reference interval and comparison to UniQ RIA

    DEFF Research Database (Denmark)

    Knudsen, Cindy Soendersoe; Heickendorff, Lene; Nexo, Ebba

    2014-01-01

    UniQ PIIINP RIA assay (Orion Diagnostica, Espoo, Finland) using 55 patient samples (range=3.7-43.3 µg/L). Furthermore, we established a reference interval based on samples from 287 blood donors. Results: In the concentration range 2.5-11.9 µg/L, the total imprecision was below 8%. Comparison...

  20. Original articles published in Revista Española de Enfermedades Digestivas (1993-1998): authorship, interval between acceptance and publication, and bibliographic references.

    Science.gov (United States)

    Acea Nebril, B; Figueira Moure, A; Gómez Freijoso, C

    2000-09-01

    To study changes in authorship, interval between acceptance and publication, and bibliographic references of original articles published in Revista Española de Enfermedades Digestivas (REED) between 1993 and 1998. This was a descriptive retrospective study of 359 original research articles published in REED between 1993 and 1998. The variables assessed were: number of authors (author/article index), interval between acceptance of the manuscript and publication in the journal, and degree of obsolescence of articles based on the age of the references cited (Burton-Kleber and Price indexes). The author/article index was 6.1, and increased from 5.9 in 1993 to 6.5 in 1998. The interval between acceptance and publication increased from 251 days to 436 days in this period (p < 0.0001). English was the language of publication used most commonly, followed by Spanish (10.7%). Citations to Spanish references decreased from 12.5% in 1993 to 8.7% in 1998. The half-life of articles was 7 years, and Price index was 41.5%. REED's bibliometric characteristics are similar to those of other national journals, but this study shows changes in bibliographic indicators from 1993 to 1998; increases in the number of authors per article, the interval to publication, the use of foreign references and the degree of obsolescence.

  1. Assessment of HIV-1 patient recruitability in the Republic of Guinea-Bissau using African versus North American hematology and biochemistry reference intervals

    DEFF Research Database (Denmark)

    Gómez Román, Victor Raúl; Jensen, Sanne Skov; Leo-Hansen, Christian

    2012-01-01

    Hematology and biochemistry reference intervals have been derived from healthy, HIV-negative populations to guide clinical trials worldwide. However, it is less clear how such values may be applied to clinical trials involving HIV-infected individuals. We show that contradictory interpretations...

  2. Age- and Gender-Specific Reference Intervals for Fasting Blood Glucose and Lipid Levels in School Children Measured With Abbott Architect c8000 Chemistry Analyzer.

    Science.gov (United States)

    Tamimi, Waleed; Albanyan, Esam; Altwaijri, Yasmin; Tamim, Hani; Alhussein, Fahad

    2012-04-01

    Reference intervals for pubertal characteristics are influenced by genetic, geographic, dietary and socioeconomic factors. Therefore, the aim of this study was to establish age-specific reference intervals of glucose and lipid levels among local school children. This was cross-sectional study, conducted among Saudi school children. Fasting blood samples were collected from 2149 children, 1138 (53%) boys and 1011 (47%) girls, aged 6 to 18 years old. Samples were analyzed on the Architect c8000 Chemistry System (Abbott Diagnostics, USA) for glucose, cholesterol, triglycerides, HDL and LDL. Reference intervals were established by nonparametric methods between the 2.5th and 97.5th percentiles. Significant differences were observed between boys and girls for cholesterol and triglycerides levels in all age groups (P levels were found to be significant (P levels except at age 12 to 13 years. Saudi children have comparable serum cholesterol levels than their Western counterparts. This may reflect changing dietary habits and increasing affluence in Saudi Arabia. Increased lipid screening is anticipated, and these reference intervals will aid in the early assessment of cardiovascular and diabetes risk in Saudi pediatric populations.

  3. Sex-specific reference intervals of hematologic and biochemical analytes in Sprague-Dawley rats using the nonparametric rank percentile method.

    Science.gov (United States)

    He, Qili; Su, Guoming; Liu, Keliang; Zhang, Fangcheng; Jiang, Yong; Gao, Jun; Liu, Lida; Jiang, Zhongren; Jin, Minwu; Xie, Huiping

    2017-01-01

    Hematologic and biochemical analytes of Sprague-Dawley rats are commonly used to determine effects that were induced by treatment and to evaluate organ dysfunction in toxicological safety assessments, but reference intervals have not been well established for these analytes. Reference intervals as presently defined for these analytes in Sprague-Dawley rats have not used internationally recommended statistical method nor stratified by sex. Thus, we aimed to establish sex-specific reference intervals for hematologic and biochemical parameters in Sprague-Dawley rats according to Clinical and Laboratory Standards Institute C28-A3 and American Society for Veterinary Clinical Pathology guideline. Hematology and biochemistry blood samples were collected from 500 healthy Sprague-Dawley rats (250 males and 250 females) in the control groups. We measured 24 hematologic analytes with the Sysmex XT-2100i analyzer, 9 biochemical analytes with the Olympus AU400 analyzer. We then determined statistically relevant sex partitions and calculated reference intervals, including corresponding 90% confidence intervals, using nonparametric rank percentile method. We observed that most hematologic and biochemical analytes of Sprague-Dawley rats were significantly influenced by sex. Males had higher hemoglobin, hematocrit, red blood cell count, red cell distribution width, mean corpuscular volume, mean corpuscular hemoglobin, white blood cell count, neutrophils, lymphocytes, monocytes, percentage of neutrophils, percentage of monocytes, alanine aminotransferase, aspartate aminotransferase, and triglycerides compared to females. Females had higher mean corpuscular hemoglobin concentration, plateletcrit, platelet count, eosinophils, percentage of lymphocytes, percentage of eosinophils, creatinine, glucose, total cholesterol and urea compared to males. Sex partition was required for most hematologic and biochemical analytes in Sprague-Dawley rats. We established sex-specific reference

  4. Pediatric reference intervals for 1,25-dihydroxyvitamin D using the DiaSorin LIAISON XL assay in the healthy CALIPER cohort.

    Science.gov (United States)

    Higgins, Victoria; Truong, Dorothy; White-Al Habeeb, Nicole M A; Fung, Angela W S; Hoffman, Barry; Adeli, Khosrow

    2018-02-01

    1,25-dihydroxyvitamin D (1,25(OH)2D), the biologically active vitamin D metabolite, plays a critical role in calcium and phosphate homeostasis. 1,25(OH)2D is measured to assess calcium and phosphate metabolism, particularly during periods of profound growth and development. Despite its importance, no reliable pediatric reference interval exists, with those available developed using adult populations or out-dated methodologies. Using the fully automated chemiluminescence immunoassay by DiaSorin, we established 1,25(OH)2D pediatric reference intervals using healthy children and adolescents from the CALIPER cohort. Serum samples from healthy subjects (0 to <19 years) were analyzed for 1,25(OH)2D using the DiaSorin LIAISON XL assay and age-specific reference intervals were established. The Mann-Whitney U-test was used to determine seasonal differences. Pooled neonatal and infantile samples were quantified using liquid chromatography tandem mass spectrometry (LC-MS/MS) to determine if elevated concentrations during the first year of life may be attributed to cross-reacting moieties. Three reference interval age partitions were required with highest levels in subjects 0 to <1 year (77-471 pmol/L), which declined and narrowed after 1 year (113-363 pmol/L) and plateaued at 3 years (108-246 pmol/L). 1,25(OH)2D concentration was not significantly affected by seasonal variation or sex. Elevated 1,25(OH)2D concentrations in neonatal and infantile samples may be the result of an interfering substance. The absence of 3-epi-1,25-dihydroxyvitamin D in the pooled samples makes it unlikely to be the interfering moiety. Pediatric reference intervals for 1,25(OH)2D were established to improve test result interpretation in children and adolescents. 1,25(OH)2D is elevated in a proportion of neonates and infants, which may be the result of a cross-reacting moiety.

  5. The use of regression analysis in determining reference intervals for low hematocrit and thrombocyte count in multiple electrode aggregometry and platelet function analyzer 100 testing of platelet function.

    Science.gov (United States)

    Kuiper, Gerhardus J A J M; Houben, Rik; Wetzels, Rick J H; Verhezen, Paul W M; Oerle, Rene van; Ten Cate, Hugo; Henskens, Yvonne M C; Lancé, Marcus D

    2017-11-01

    Low platelet counts and hematocrit levels hinder whole blood point-of-care testing of platelet function. Thus far, no reference ranges for MEA (multiple electrode aggregometry) and PFA-100 (platelet function analyzer 100) devices exist for low ranges. Through dilution methods of volunteer whole blood, platelet function at low ranges of platelet count and hematocrit levels was assessed on MEA for four agonists and for PFA-100 in two cartridges. Using (multiple) regression analysis, 95% reference intervals were computed for these low ranges. Low platelet counts affected MEA in a positive correlation (all agonists showed r 2 ≥ 0.75) and PFA-100 in an inverse correlation (closure times were prolonged with lower platelet counts). Lowered hematocrit did not affect MEA testing, except for arachidonic acid activation (ASPI), which showed a weak positive correlation (r 2 = 0.14). Closure time on PFA-100 testing was inversely correlated with hematocrit for both cartridges. Regression analysis revealed different 95% reference intervals in comparison with originally established intervals for both MEA and PFA-100 in low platelet or hematocrit conditions. Multiple regression analysis of ASPI and both tests on the PFA-100 for combined low platelet and hematocrit conditions revealed that only PFA-100 testing should be adjusted for both thrombocytopenia and anemia. 95% reference intervals were calculated using multiple regression analysis. However, coefficients of determination of PFA-100 were poor, and some variance remained unexplained. Thus, in this pilot study using (multiple) regression analysis, we could establish reference intervals of platelet function in anemia and thrombocytopenia conditions on PFA-100 and in thrombocytopenia conditions on MEA.

  6. Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted/seated patients.

    Science.gov (United States)

    Casey, R; Griffin, T P; Wall, D; Dennedy, M C; Bell, M; O'Shea, P M

    2017-01-01

    Background The Endocrine Society Clinical Practice Guideline on Phaeochomocytoma and Paraganglioma recommends phlebotomy for plasma-free metanephrines with patients fasted and supine using appropriately defined reference intervals. Studies have shown higher diagnostic sensitivities using these criteria. Further, with seated-sampling protocols, for result interpretation, reference intervals that do not compromise diagnostic sensitivity should be employed. Objective To determine the impact on diagnostic performance and financial cost of using supine reference intervals for result interpretation with our current plasma-free metanephrines fasted/seated-sampling protocol. Methods We conducted a retrospective cohort study of patients who underwent screening for PPGL using plasma-free metanephrines from 2009 to 2014 at Galway University Hospitals. Plasma-free metanephrines were measured using liquid chromatography-tandem mass spectrometry. Supine thresholds for plasma normetanephrine and metanephrine set at 610 pmol/L and 310 pmol/L, respectively, were used. Results A total of 183 patients were evaluated. Mean age of participants was 53.4 (±16.3) years. Five of 183 (2.7%) patients had histologically confirmed PPGL (males, n=4). Using seated reference intervals for plasma-free metanephrines, diagnostic sensitivity and specificity were 100% and 98.9%, respectively, with two false-positive cases. Application of reference intervals established in subjects supine and fasted to this cohort gave diagnostic sensitivity of 100% with specificity of 74.7%. Financial analysis of each pretesting strategy demonstrated cost-equivalence (€147.27/patient). Conclusion Our cost analysis, together with the evidence that fasted/supine-sampling for plasma-free metanephrines, offers more reliable exclusion of PPGL mandates changing our current practice. This study highlights the important advantages of standardized diagnostic protocols for plasma-free metanephrines to ensure the highest

  7. Rat TSH: Radioimmunological verification and secretion in vitro

    International Nuclear Information System (INIS)

    Rief-Mohs, G.

    1983-01-01

    The rat TSH radioimmunoassay with 125 I was worked up and validated. Measurement area: 300-10 4 ng TSH/ml, lower detection limit 200 ng/ml, intra-assay variance 3-5%, inter-assay variance 11-18%. For the study of TSH secretion in dispersed anterior pituitary cells, these cells were subjected to an one-hour incubation with a changing TRH concentration. This system, however, did not prove to be sensitive enough for a TRH-in vitro-bioassay. A culture of vital, functioning cells in micro-titer plates up to 30 days was possible. After stimulation with 10 -11 to 10 -6 M TRH over 2 hours a linear dose-dependent increased secretion of TSH with a maximum TSH response of 300% was shown. After fractionation of the anterior pituitary cells after a sedimentation over an albumin gradient it was shown that after fraction 40 there was an increase in the TSH content with a massive increase in TSH cells around fraction 60. The TSH content lay here around the factor 200 above that of the original suspension. A culture of pure TSH cells is therefore possible and for further studies accessible. (orig.) [de

  8. Functional TSH receptor antibodies in children with autoimmune thyroid diseases.

    Science.gov (United States)

    Stożek, Karolina; Bossowski, Artur; Ziora, Katarzyna; Bossowska, Anna; Mrugacz, Małgorzata; Noczyńska, Anna; Walczak, Mieczysław; Petriczko, Elżbieta; Pyrżak, Beata; Kucharska, Anna; Szalecki, Mieczysław; Diana, Tanja; Kahaly, George J

    2018-03-01

    The diagnostic value of the level of TSH receptor antibodies (TSHR-Ab) in the population of children with autoimmune thyroid diseases (AITDs) is still unknown. The aim of this cross-sectional study was to investigate the prevalence of TSHR-Ab in a paediatric cohort with AITD and healthy controls. A total of 240 serum samples were obtained from 205 patients with AITD, type 1 diabetes (T1D), juvenile arthritis (JA), and healthy controls (C). TSHR stimulating (TSI) and -blocking (TBI) immunoglobulins were measured in cell-based bioassays using CHO cells expressing a chimeric TSHR and a c-AMP response-element-dependent luciferase. TSI was reported as percentage of specimen-to-reference ratio (cutoff 140SRR%). Blocking activity was defined as percent inhibition of luciferase expression relative to induction with bovine TSH alone (40% inhibition). C as well as children with JA and T1D were both TSI and TBI negative. In contrast, children with Graves' disease (GD) were positive for TSI in 47/53 samples (88.7%) while those with thyroidal and orbital GD showed TSI positivity in 95.8% (23/24 samples). Serum TSI levels were SRR% 320 ± 157 and 417 ± 135 in GD and GD + orbitopathy, respectively (p = .02). Children with Hashimoto's thyroiditis (HT) were TSI positive in 4/83 (4.8%) samples, including two with orbital involvement. TSI levels were increased in HT children with vs. those without eye disease (SRR% 177 vs. 51, p TSI is prevalent in children with GD while the highest serum TSI levels were noted in children with AITD and orbitopathy.

  9. The biomedical piglet: establishing reference intervals for haematology and clinical chemistry parameters of two age groups with and without iron supplementation.

    Science.gov (United States)

    Ventrella, Domenico; Dondi, Francesco; Barone, Francesca; Serafini, Federica; Elmi, Alberto; Giunti, Massimo; Romagnoli, Noemi; Forni, Monica; Bacci, Maria L

    2017-01-17

    The similarities between swine and humans in physiological and genomic patterns, and the great correlation in size and anatomy, make pigs extremely useful in preclinical studies. New-born piglets can represent a model for congenital and genetic diseases in new-born children. It is known that piglets may have significant differences in clinicopathological results compared to adult pigs. Therefore, adult laboratory reference intervals cannot be applied to piglets. The aim of this study was to compare haematological and chemical variables in piglets of two ages and determinate age-related reference intervals for commercial hybrid young pigs. Blood samples were collected under general anaesthesia from 130 animals divided into five- (P5) and 30- (P30) day-old piglets. Only P30 animals were treated with parenteral iron after birth. Samples were analysed using automated haematology (ADVIA 2120) and chemistry analysers, and age-related reference intervals were calculated. Significant higher values of RBC, Hb and HCT were observed in P30 animals when compared to P5, with an opposite trend for MCV. These results were associated with a reduction of the RBC regeneration process and the thrombopoietic response. The TSAT and TIBC were significantly higher in P30 compared to P5; however, piglets remained iron deficient compared to adult reference intervals reported previously. In conclusion, this paper emphasises the high variability occurring in clinicopathological variables between new-born and 30-day-old pigs, and between piglets and adult pigs. This study provides valuable reference data for piglets at precise ages and could be used in the future as historical control improving the Reduction in animal experiments, as suggested by the 3Rs principle.

  10. Harmonising Adult and Paediatric Reference Intervals in Australia and New Zealand: An Evidence-Based Approach for Establishing a First Panel of Chemistry Analytes

    Science.gov (United States)

    Tate, Jillian R; Sikaris, Ken A; Jones, Graham RD; Yen, Tina; Koerbin, Gus; Ryan, Julie; Reed, Maxine; Gill, Janice; Koumantakis, George; Hickman, Peter; Graham, Peter

    2014-01-01

    Scientific evidence supports the use of common reference intervals (RIs) for many general chemistry analytes, in particular those with sound calibration and traceability in place. Already the Nordic countries and United Kingdom have largely achieved harmonised RIs. Following a series of workshops organised by the Australasian Association of Clinical Biochemists (AACB) between 2012 and 2014 at which an evidence-based approach for determination of common intervals was developed, pathology organisations in Australia and New Zealand have reached a scientific consensus on what adult and paediatric intervals we should use across Australasia. The aim of this report is to describe the processes that the AACB and the Royal College of Pathologists of Australasia have taken towards recommending the implementation of a first panel of common RIs for use in Australasia. PMID:25678727

  11. Long-term efficacy of modified-release recombinant human TSH (MRrhTSH) augmented radioiodine (131I) therapy for benign multinodular goiter. Results from a multicenter international, randomized, placebo-controlled dose-selection study

    DEFF Research Database (Denmark)

    Fast, Søren; Hegedus, Laszlo; Pacini, Furio

    2014-01-01

    with 131I-therapy. Methods: In this phase II, single-blinded, placebo-controlled study, 95 patients (57.2±9.6 years old, 85% women, 83% Caucasians) with MNG (median size 96.0 ml (31.9 - 242.2 ml)) were randomized to receive placebo (n=32), 0.01 mg MRrhTSH (n=30) or 0.03 mg MRrhTSH (n=33), 24 hours before...... a calculated 131I activity. Thyroid volume (TV) and smallest cross-sectional area of trachea (SCAT) were measured (by CT-scan) at baseline, month 6 and month 36. Thyroid function and quality of life (QoL) was evaluated at 3 month and yearly intervals, respectively. Results: At 6 months, TV reduction...... was enhanced in the 0.03 mg MRrhTSH group (32.9% versus 23.1% in the placebo group, p=0.03), but not in the 0.01 mg MRrhTSH group. At month 36 the mean percent TV reduction from baseline was 44 ± 12.7% (SD) in the placebo group, 41 ± 21.0% in the 0.01 mg MRrhTSH-group and 53 ± 18.6% in the 0.03 mg MRrh...

  12. Hematology and Clinical Chemistry Measures During and After Pregnancy and Age- and Sex-Specific Reference Intervals in African Green Monkeys (Chlorocebus aethiops sabaeus).

    Science.gov (United States)

    Chichester, Lee; Gee, Melaney K; Jorgensen, Matthew J; Kaplan, Jay R

    2015-07-01

    Clinical decisions and experimental analyses often involve the assessment of hematology and clinical chemistry. Using clinical pathology to assess the health status of NHP in breeding colonies or data from studies than involve pregnancy can often be complicated by pregnancy status. This study had 2 objectives regarding the hematology and clinical chemistry of African green monkeys (AGM, Chlorocebus aethiops sabaeus): 1) to compare pregnant or recently postpartum animals with nonpregnant, nonlactating animals and 2) to create age- and sex-specific reference intervals. Subjects in this study were 491 AGM from the Vervet Research Colony of the Wake Forest University Primate Center. Results indicated that changes in BUN, serum total protein, albumin, ALP, GGT, calcium, phosphorus, sodium, potassium, cholesterol, total CO2, globulins, lipase, amylase, WBC, neutrophils, lymphocytes, platelets, RBC, Hgb, and Hct occur during pregnancy and the postpartum period. Age- and sex-specific reference intervals consistent with guidelines from the American Society for Veterinary Clinical Pathology were established and further expand the understanding of how to define health in AGM on the basis of clinical pathology. The combination of understanding the changes that occur in pregnancy and postpartum and expansive reference intervals will help guide clinical and experimental decisions.

  13. Hematology and Clinical Chemistry Measures During and After Pregnancy and Age- and Sex-Specific Reference Intervals in African Green Monkeys (Chlorocebus aethiops sabaeus)

    Science.gov (United States)

    Chichester, Lee; Gee, Melaney K; Jorgensen, Matthew J; Kaplan, Jay R

    2015-01-01

    Clinical decisions and experimental analyses often involve the assessment of hematology and clinical chemistry. Using clinical pathology to assess the health status of NHP in breeding colonies or data from studies than involve pregnancy can often be complicated by pregnancy status. This study had 2 objectives regarding the hematology and clinical chemistry of African green monkeys (AGM, Chlorocebus aethiops sabaeus): 1) to compare pregnant or recently postpartum animals with nonpregnant, nonlactating animals and 2) to create age- and sex-specific reference intervals. Subjects in this study were 491 AGM from the Vervet Research Colony of the Wake Forest University Primate Center. Results indicated that changes in BUN, serum total protein, albumin, ALP, GGT, calcium, phosphorus, sodium, potassium, cholesterol, total CO2, globulins, lipase, amylase, WBC, neutrophils, lymphocytes, platelets, RBC, Hgb, and Hct occur during pregnancy and the postpartum period. Age- and sex-specific reference intervals consistent with guidelines from the American Society for Veterinary Clinical Pathology were established and further expand the understanding of how to define health in AGM on the basis of clinical pathology. The combination of understanding the changes that occur in pregnancy and postpartum and expansive reference intervals will help guide clinical and experimental decisions. PMID:26224434

  14. Plasma electrophoretic profiles and hemoglobin binding protein reference intervals in the eastern box turtle (Terrapene carolina carolina) and influences of age, sex, season, and location.

    Science.gov (United States)

    Flower, Jennifer E; Byrd, John; Cray, Carolyn; Allender, Matthew C

    2014-12-01

    Evaluation of plasma electrophoretic profiles and acute phase protein concentrations may play a valuable role in health assessment of reptiles; however, little is known about reference intervals in free-ranging eastern box turtles (Terrapene carolina carolina). The purpose of this study was to establish reference intervals of protein electrophoretic profiles and hemoglobin binding protein ([HBP] as determined by a haptoglobin assay) in free-ranging eastern box turtles and to assess any possible correlations between varying age class (adults vs. juvenile), sex (male, female, or unknown), season (spring, summer, or fall), or location (Tennessee vs. Illinois). Blood samples were obtained from 324 eastern box turtles from 2010 to 2012 at three sites in Illinois and one site in Tennessee, USA. Significant differences were observed with total protein (sex, season, state, Illinois location), albumin (age class, season, state, Illinois location), α-1 globulins (sex, season, Illinois location), α-2 globulins (sex, season, state, Illinois location), β globulins (age class, sex, season, state, Illinois location), γ globulins (sex, season state, Illinois location), and hemoglobin binding protein (age class, sex, state, Illinois location). The use of electrophoretic profiles and acute phase proteins is a relatively new concept in reptilian medicine, and this study allowed for establishment of references intervals in the eastern box turtle and emphasized differences that occured based on age, sex, season, and location. Future research in this area can now build on these data to determine changes in population health over time or alterations due to specific environmental or disease threats.

  15. Recombinant human TSH in radioiodine treatment of differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Kovatcheva, R. D.; Kirilov, G. G.; Lozanov, B. S.; Hadjieva, T.D.

    2004-01-01

    Recombinant human TSH (rhTSH) has been developed to facilitate the follow-up for persistent or recurrent differentiated thyroid cancer (DTC), avoiding the hypothyroid symptoms after the withdrawal of Levothyroxine (L-T 4 ) suppressive therapy. To analyse the effect of rhTSH in providing stimulation of radioiodine uptake (RAIU) for the ablation of thyroid remnant and/or malignant thyroid tissue in patients with metastatic DTC. Ten subjects (4 women, 6 men), mean age 53 years, with DTC (7 papillary, 2 follicular and 1 Huerthle-cell), requiring radioiodine therapy (RIT) were studied. Nine of them had a positive diagnostic whole body scan (dWBS) or CT for thyroid remnant, lymph nodes and/or distant metastases. One patient with an invasive tall cell PTC had an increased serum Tg and a negative dWBS. Serum TSH was measured before and two days after the rhTSH injection. Thyroglobulin measurements were performed before the rhTSH administration, 3 and 6 months after RIT. There were no serious side effects of the rhTSH application. Serum TSH after the rhTSH injection rose to 156.5 ± 60.9 mIU/L and induced RAIU in 8 out of 10 patients. Basal serum Tg was increased in 6 patients and decreased three months later in 2 of them. The post-therapy WBS (pthWBS) showed: 1) additional metastatic lesions in 3 patients with positive dWBS, 2) lung nodular metastases in 1 patient with negative dWBS, 3) similar image as the dWBS in 4 patients, 4) negative image in 1 patient with positive dWBS. RhTSH is a safe and promising method for the stimulation of RAIU in patients with thyroid remnant and/or persistent or recurrent DTC, avoiding L-T 4 withdrawal. (author)

  16. Hematologic and serum biochemical reference intervals for free-ranging common bottlenose dolphins (Tursiops truncatus) and variation in the distributions of clinicopathologic values related to geographic sampling site.

    Science.gov (United States)

    Schwacke, Lori H; Hall, Ailsa J; Townsend, Forrest I; Wells, Randall S; Hansen, Larry J; Hohn, Aleta A; Bossart, Gregory D; Fair, Patricia A; Rowles, Teresa K

    2009-08-01

    To develop robust reference intervals for hematologic and serum biochemical variables by use of data derived from free-ranging bottlenose dolphins (Tursiops truncatus) and examine potential variation in distributions of clinicopathologic values related to sampling sites' geographic locations. 255 free-ranging bottlenose dolphins. Data from samples collected during multiple bottlenose dolphin capture-release projects conducted at 4 southeastern US coastal locations in 2000 through 2006 were combined to determine reference intervals for 52 clinicopathologic variables. A nonparametric bootstrap approach was applied to estimate 95th percentiles and associated 90% confidence intervals; the need for partitioning by length and sex classes was determined by testing for differences in estimated thresholds with a bootstrap method. When appropriate, quantile regression was used to determine continuous functions for 95th percentiles dependent on length. The proportion of out-of-range samples for all clinicopathologic measurements was examined for each geographic site, and multivariate ANOVA was applied to further explore variation in leukocyte subgroups. A need for partitioning by length and sex classes was indicated for many clinicopathologic variables. For each geographic site, few significant deviations from expected number of out-of-range samples were detected. Although mean leukocyte counts did not vary among sites, differences in the mean counts for leukocyte subgroups were identified. Although differences in the centrality of distributions for some variables were detected, the 95th percentiles estimated from the pooled data were robust and applicable across geographic sites. The derived reference intervals provide critical information for conducting bottlenose dolphin population health studies.

  17. Recombinant human TSH (rhTSH)-aided radioiodine therapy in patients with metastatic differentiated thyroid carcinoma. Results 2002-2004

    International Nuclear Information System (INIS)

    Schwarzbartl-Pevec, A.; Vidergar-Kralj, B.; Zagar, I.; Besic, N.

    2005-01-01

    Full text: A serum TSH level of > 30 mU/L, which is necessary for reliable testing and efficient radioiodine therapy in patients with differentiated thyroid carcinoma, may be achieved by: a 4-6 weeks L-thyroxine withdrawal or by application of recombinant human TSH (rh TSH).The purpose of our study was to test the efficacy of 131-I therapy (RAIT) using recombinant human TSH (rhTSH) as an alternative in patients with differentiated thyroid carcinoma (DTC) in whom endogenous TSH stimulation was not an option due to the poor patient's physical condition during the hypothyroid state or due to the disease progression during L-thyroxine withdrawal. The study comprised 14 patients (12 females, 2 males, aged 63- 81, median 73 years), with histologically proven DTC, in whom the primary diagnosis was established 1993-2000, who already have undergone total or near-total thyroidectomy and who have received radioiodine ablation and 3-12 (median 6) RAITs after L-thyroxine withdrawal, with a cumulative dose ranging 15.65- 68.34 GBq. Patients were given 28 RAITs (7/14 patients received two, 2 received 3 and 1 received 4) while on L-thyroxine after rhTSH administration (rhTSH RAIT). RhTSH (0.9 mg, i.m.) was administered on two consecutive days, followed by 131-I therapeutic dose (5.2-7.6 GBq) administration on the third day and a post-therapeutic whole-body scan (PTWBS) 2-5 days later. The efficacy of rhTSH RAIT was evaluated by thyroglobuline (Tg) measurement 3 - 6 months after rhTSH RAIT. Serum TSH levels after rhTSH administration were 61 - 305 mU/l. Altogether 36 131-I-avid lesions were detected on PTWBS. In one patient who underwent two rhTSH RAITs a decrease of 131-I uptake in one lesion was seen on the second PTWBS. In all patients serum Tg concentrations were elevated before rhTSH RAIT (25 -17248 ng/ml). Three months after therapy serum Tg decreased by 24 -91% in 6 cases (4 patients), in 3 patients serum Tg stagnation was achieved, while in 7 cases the disease progressed

  18. Thyroid Function Tests in the Reference Range and Fracture: Individual Participant Analysis of Prospective Cohorts.

    Science.gov (United States)

    Aubert, Carole E; Floriani, Carmen; Bauer, Douglas C; da Costa, Bruno R; Segna, Daniel; Blum, Manuel R; Collet, Tinh-Hai; Fink, Howard A; Cappola, Anne R; Syrogiannouli, Lamprini; Peeters, Robin P; Åsvold, Bjørn O; den Elzen, Wendy P J; Luben, Robert N; Bremner, Alexandra P; Gogakos, Apostolos; Eastell, Richard; Kearney, Patricia M; Hoff, Mari; Le Blanc, Erin; Ceresini, Graziano; Rivadeneira, Fernando; Uitterlinden, André G; Khaw, Kay-Tee; Langhammer, Arnulf; Stott, David J; Westendorp, Rudi G J; Ferrucci, Luigi; Williams, Graham R; Gussekloo, Jacobijn; Walsh, John P; Aujesky, Drahomir; Rodondi, Nicolas

    2017-08-01

    Hyperthyroidism is associated with increased fracture risk, but it is not clear if lower thyroid-stimulating hormone (TSH) and higher free thyroxine (FT4) in euthyroid individuals are associated with fracture risk. To evaluate the association of TSH and FT4 with incident fractures in euthyroid individuals. Individual participant data analysis. Thirteen prospective cohort studies with baseline examinations between 1981 and 2002. Adults with baseline TSH 0.45 to 4.49 mIU/L. Primary outcome was incident hip fracture. Secondary outcomes were any, nonvertebral, and vertebral fractures. Results were presented as hazard ratios (HRs) with 95% confidence interval (CI) adjusted for age and sex. For clinical relevance, we studied TSH according to five categories: 0.45 to 0.99 mIU/L; 1.00 to 1.49 mIU/L; 1.50 to 2.49 mIU/L; 2.50 to 3.49 mIU/L; and 3.50 to 4.49 mIU/L (reference). FT4 was assessed as study-specific standard deviation increase, because assays varied between cohorts. During 659,059 person-years, 2,565 out of 56,835 participants had hip fracture (4.5%; 12 studies with data on hip fracture). The pooled adjusted HR (95% CI) for hip fracture was 1.25 (1.05 to 1.49) for TSH 0.45 to 0.99 mIU/L, 1.19 (1.01 to 1.41) for TSH 1.00 to 1.49 mIU/L, 1.09 (0.93 to 1.28) for TSH 1.50 to 2.49 mIU/L, and 1.12 (0.94 to 1.33) for TSH 2.50 to 3.49 mIU/L (P for trend = 0.004). Hip fracture was also associated with FT4 [HR (95% CI) 1.22 (1.11 to 1.35) per one standard deviation increase in FT4]. FT4 only was associated with any and nonvertebral fractures. Results remained similar in sensitivity analyses. Among euthyroid adults, lower TSH and higher FT4 are associated with an increased risk of hip fracture. These findings may help refine the definition of optimal ranges of thyroid function tests. Copyright © 2017 Endocrine Society

  19. Reference intervals for hemoglobin and hematocrit in a low-risk pregnancy cohort: implications of racial differences.

    Science.gov (United States)

    Chiossi, Giuseppe; Palomba, Stefano; Costantine, Maged M; Falbo, Angela I; Harirah, Hassan M; Saade, George R; La Sala, Giovanni B

    2018-03-23

    As anemia in pregnancy is associated with adverse perinatal outcomes, we sought to define the mean and the fifth percentile of Hb and Ht using a contemporary multiethnic large cohort of low-risk pregnancies, and assess potential racial differences. We conducted a retrospective cohort study on women who delivered between 1 January 2008 and 31 December 2013 in Reggio Emilia County, Italy. Linear mixed effects models were used to describe changes in mean Hb and Ht, while quantile regression with matrix-design bootstrap defined changes in the fifth percentile of Hb and Ht, controlling for race, maternal age, smoking, and pregnancy number. We analyzed 23,657 hemograms from 7318 pregnancies and 6870 women. Multivariate analysis showed that when compared to Caucasians', African women's mean Hb and Ht were respectively 0.24 (95%CI 0.3-0.17) g/dl and 0.7 (95%CI 0.8-0.5) % lower, while Asian mothers' were 0.11 (95%CI 0.19-0.03) g/dl and 0.3 (95%CI 0.5-0.1) % inferior. Similarly, both African and Asian women had lower fifth Ht percentiles (-1, 95%CI -1.3 to -0.6, and -0.4, 95%CI -0.7 to -0.04) than Caucasians, while African mothers also had lower fifth Hb percentile (0.3, 95%CI 0.5-0.1). The fifth percentile for Hb and Ht were, respectively, 11.3 (95%CI 11-11.5) g/dl and 32.8 (95%CI 32.3-33.4) % in the first trimester, 10.4 (95%CI 10.1-10.6) g/dl and 30.2 (95%CI 29.6-30.8) % in the second trimester, 10.1 (95%CI 9.8-10.3) g/dl and 30.6 (95%CI 30-31.1) % in the third trimester. We provided contemporary references to define anemia in pregnancy, and we confirmed that even in pregnancy, African and Asian women have lower Hb and Ht than Caucasian. Racial and population-specific references may have significant clinical and public health implication for more accurate disease diagnosis and appropriate treatment.

  20. Severe TSH Elevation and Pituitary Enlargement After Changing Thyroid Replacement to Compounded T4/T3 Therapy

    Directory of Open Access Journals (Sweden)

    Adlai L. Pappy BA

    2016-07-01

    Full Text Available We present the first case of iatrogenic hypothyroidism as a result of compounded thyroid hormone (T4/T3 therapy. The thyroid replacement was changed from 175 µg levothyroxine (LT4 to 57/13.5 µg compounded T4/T3 daily in order to improve the T3 level, despite normal thyroid-stimulating hormone (TSH. This resulted in clinical manifestations of hypothyroidism and high TSH level (150 µIU/mL. Six months later, the patient was referred to our clinic for abnormal pituitary magnetic resonance imaging. On reinitiating a physiologic dose of LT4, clinical and biochemical abnormalities resolved and the pituitary gland size decreased. Our case emphasizes the importance of using TSH level to gauge dose adjustments in primary hypothyroidism. Also, it underscores the current American Thyroid Association recommendation against routine use of compounded thyroid hormone therapy.

  1. Complex biological pattern of fertility hormones in children and adolescents: a study of healthy children from the CALIPER cohort and establishment of pediatric reference intervals.

    Science.gov (United States)

    Konforte, Danijela; Shea, Jennifer L; Kyriakopoulou, Lianna; Colantonio, David; Cohen, Ashley H; Shaw, Julie; Bailey, Dana; Chan, Man Khun; Armbruster, David; Adeli, Khosrow

    2013-08-01

    Pediatric endocrinopathies are commonly diagnosed and monitored by measuring hormones of the hypothalamic-pituitary-gonadal axis. Because growth and development can markedly influence normal circulating concentrations of fertility hormones, accurate reference intervals established on the basis of a healthy, nonhospitalized pediatric population and that reflect age-, gender-, and pubertal stage-specific changes are essential for test result interpretation. Healthy children and adolescents (n = 1234) were recruited from a multiethnic population as part of the CALIPER study. After written informed parental consent was obtained, participants filled out a questionnaire including demographic and pubertal development information (assessed by self-reported Tanner stage) and provided a blood sample. We measured 7 fertility hormones including estradiol, testosterone (second generation), progesterone, sex hormone-binding globulin, prolactin, follicle-stimulating hormone, and luteinizing hormone by use of the Abbott Architect i2000 analyzer. We then used these data to calculate age-, gender-, and Tanner stage-specific reference intervals according to Clinical Laboratory Standards Institute C28-A3 guidelines. We observed a complex pattern of change in each analyte concentration from the neonatal period to adolescence. Consequently, many age and sex partitions were required to cover the changes in most fertility hormones over this period. An exception to this was prolactin, for which no sex partition and only 3 age partitions were necessary. This comprehensive database of pediatric reference intervals for fertility hormones will be of global benefit and should lead to improved diagnosis of pediatric endocrinopathies. The new database will need to be validated in local populations and for other immunoassay platforms as recommended by the Clinical Laboratory Standards Institute.

  2. Reference interval for the disc-macula distance to disc diameter ratio in a large population of healthy Japanese adults: A prospective, observational study.

    Science.gov (United States)

    Sato, Ken-Ichi

    2017-04-01

    This study presents the calculated reference interval for the disc-to-macula distance to disc diameter ratio (DM:DD) based on a large population of healthy Japanese adults.A total of 308 consecutive, healthy Japanese adults were examined in this prospective observational study. Eighteen subjects were also excluded because of poor quality of the fundus photograph of one or both eyes; 290 (161 men and 129 women) were included in this study. For each subject, a color fundus photograph of one eye, either the right or left, was randomly selected and used for analysis. On the photograph, the distances between the fovea and the nearest temporal margin of the optic disc (Dft), and the two kinds of disc diameters (D1 and D2), which bisected at right angles and one of which was directed to the fovea (D1), were measured. DM:DD was estimated using the formula: (2Dft + D1)/(D1 + D2).The mean ± standard deviation of DM:DD was 2.91 ± 0.49 for men and 2.96 ± 0.54 for women; there was no sex difference (P = .78, Mann-Whitney U test). Also, almost no relationship was found between DM:DD and age (ρ = -.12, P = .04, Spearman's rank correlation coefficient). The data did not fit a normal distribution (P < .001, Kolmogorov-Smirnov test). The estimated reference interval for DM:DD corresponding to the 2.5th and 97.5th percentiles was 2.12 to 4.18.Using a nonparametric approach, the reference interval for DM:DD of a large population of healthy Japanese adults was calculated to be 2.12 to 4.18, regardless of age or sex.

  3. Reference intervals for free t/sub 3/ and free t/sub 4/ in pakistani euthyroid patients: effect of age and gender on thyroid function

    International Nuclear Information System (INIS)

    Abbas, R.; Abbas, H.G.

    2014-01-01

    To establish reference intervals for Free Triiodothyronine (FT3) and Free Thyroxine (FT4) in euthyroid subjects and to assess the effect of age and gender on FT3 and FT4. Study Design: Cross-sectional, analytical study. Place and Duration of Study: Institute of Nuclear Medicine and Oncology (INMOL), Lahore, from January 2009 to April 2011. Methodology: FT3 and FT4 were measured in 852 euthyroid patients. Those with previous thyroid surgery, on thyroid related medication and severe non-thyroid illness were excluded. Results: There were 215 males and 637 females with mean age of 46 years. The reference intervals, revealed by this study, for FT3 and FT4 were 2.80 - 5.39 pmol/L and 11.9 - 22.2 pmol/L respectively. The mean difference between gender groups and age groups was found statistically significant for FT3 (gender: p = 0.001; age: p = 0.001) but statistically insignificant for FT4 (gender: p=0.147; age: p=0.201). Conclusion: There was no effect of gender and age on FT3 and FT4. The age with serum FT3 and FT4 significantly negatively correlated but this correlation was stronger for FT3 as compared to FT4 levels. Reference intervals of FT3 and FT4 for male (2.99 - 5.63 pmol/L, 12.3 - 22.6 pmol/L) and female (2.77 - 5.29 pmol/L, 11.7 - 22.1 pmol/L) respectively are suggested. (author)

  4. Variability in the detection of macro TSH in different immunoassay systems.

    Science.gov (United States)

    Hattori, Naoki; Ishihara, Takashi; Shimatsu, Akira

    2016-01-01

    Macro TSH is a large molecular-sized TSH that is mostly a complex of TSH and IgG. Patients with macro TSH have elevated serum TSH and normal free thyroxine levels, mimicking subclinical hypothyroidism. The aim of this study was to clarify the degree of cross-reactivity of macro TSH to different commercial immunoassay systems. Screening for macro TSH was done using a polyethylene glycol (PEG) method and confirmed with gel filtration chromatography in serum samples from 1901 patients with subclinical hypothyroidism. Interference due to human anti-mouse antibodies (HAMA) was examined using HAMA blockers. TSH was measured with an enzyme immunoassay for the analysis of macro TSH. Serum TSH values in patients with macro TSH were also determined with the widely used commercial immunoassay platforms Elecsys, Centaur and Architect, and the detectability of macro TSH was compared among them. Gel filtration chromatography was performed with 174 serum samples with PEG-precipitable TSH ratios >75%. Twenty serum samples were found to contain large molecular-sized TSH, five of which were due to interference by HAMA. The prevalence of macro TSH was eventually 0.79% (15/1901). Commercial immunoassay systems variably recognized macro TSH. The Architect TSH immunoassay platform was the least reactive to macro TSH, but still recognized it in 60% of macro TSH-containing serum samples. There were no commercial TSH immunoassay platforms that did not cross-react with macro TSH. Screening for macro TSH should be performed before hormone replacement therapy is initiated for subclinical hypothyroidism. © 2016 European Society of Endocrinology.

  5. Comprehensive haematological indices reference intervals for a healthy Omani population: First comprehensive study in Gulf Cooperation Council (GCC) and Middle Eastern countries based on age, gender and ABO blood group comparison.

    Science.gov (United States)

    Al-Mawali, Adhra; Pinto, Avinash Daniel; Al-Busaidi, Raiya; Al-Lawati, Rabab H; Morsi, Magdi

    2018-01-01

    Reference intervals for venous blood parameters differs with age, gender, geographic region, and ethnic groups. Hence local laboratory reference intervals are important to improve the diagnostic accuracy of health assessments and diseases. However, there have been no comprehensive published reference intervals established in Oman, the Gulf Cooperation Council or Middle Eastern countries. Hence, the aim of this study was to establish reference intervals for full blood count in healthy Omani adults. Venous blood specimens were collected from 2202 healthy individuals aged 18 to 69 years from January 2012 to April 2017, and analysed by Sysmex XS-1000i and Cell-Dyn Sapphire automated haematology analysers. Results were statistically analysed and compared by gender, age, and ABO blood group. The lower and upper reference limits of the haematology reference intervals were established at the 2.5th and 97.5th percentiles respectively. Reference intervals were calculated for 17 haematology parameters which included red blood cell, white blood cell, and platelet parameters. Red blood cell (RBC), haemoglobin (HGB), haematocrit (HCT), platelet and platelet haematocrit counts of the healthy donors were significantly different between males and females at all ages (p blood count parameters showed no significant differences between genders, age groups, instruments, or blood groups. Our study showed a lower haemoglobin limit for the normal reference interval in males and females than the currently used in Oman. Data from this study established specific reference intervals which could be considered for general use in Oman. The differences in haematology reference intervals highlights the necessity to establish reference intervals for venous blood parameters among the healthy population in each country or at least in each region.

  6. Comprehensive haematological indices reference intervals for a healthy Omani population: First comprehensive study in Gulf Cooperation Council (GCC) and Middle Eastern countries based on age, gender and ABO blood group comparison

    Science.gov (United States)

    Pinto, Avinash Daniel; Al-Busaidi, Raiya; Al-Lawati, Rabab H.; Morsi, Magdi

    2018-01-01

    Background Reference intervals for venous blood parameters differs with age, gender, geographic region, and ethnic groups. Hence local laboratory reference intervals are important to improve the diagnostic accuracy of health assessments and diseases. However, there have been no comprehensive published reference intervals established in Oman, the Gulf Cooperation Council or Middle Eastern countries. Hence, the aim of this study was to establish reference intervals for full blood count in healthy Omani adults. Methods Venous blood specimens were collected from 2202 healthy individuals aged 18 to 69 years from January 2012 to April 2017, and analysed by Sysmex XS-1000i and Cell-Dyn Sapphire automated haematology analysers. Results were statistically analysed and compared by gender, age, and ABO blood group. The lower and upper reference limits of the haematology reference intervals were established at the 2.5th and 97.5th percentiles respectively. Results Reference intervals were calculated for 17 haematology parameters which included red blood cell, white blood cell, and platelet parameters. Red blood cell (RBC), haemoglobin (HGB), haematocrit (HCT), platelet and platelet haematocrit counts of the healthy donors were significantly different between males and females at all ages (p values of RBC, HGB and HCT than females. Other complete blood count parameters showed no significant differences between genders, age groups, instruments, or blood groups. Our study showed a lower haemoglobin limit for the normal reference interval in males and females than the currently used in Oman. Conclusions Data from this study established specific reference intervals which could be considered for general use in Oman. The differences in haematology reference intervals highlights the necessity to establish reference intervals for venous blood parameters among the healthy population in each country or at least in each region. PMID:29621271

  7. Establishment of trimester-specific reference range for thyroid hormones during pregnancy.

    Science.gov (United States)

    Nazarpour, Sima; Ramezani Tehrani, Fahimeh; Simbar, Masoumeh; Minooee, Sonia; Rahmati, Maryam; Mansournia, Mohammad Ali; Azizi, Fereidoun

    2018-03-01

    Physiological gestational changes are associated with alterations in thyroid function which require different biochemical interpretation from that of non-pregnant women and necessitate established pregnancy-specific reference ranges. We aimed to identify the trimester-specific ranges of thyroid markers in a healthy population of pregnant Iranian women. In this self-sequential study, data were extracted from The Tehran Thyroid and Pregnancy Study; a total of 314 women were tested during the 1st, 2nd and 3rd trimesters for serum levels of thyrotropin (TSH), thyroxine (T4), free thyroxine index (FT4I) and thyroid peroxidase antibody (TPOAb). Trimester-specific reference intervals for TSH, T4 and FT4I and first trimester reference range for TPOAb were estimated. The normal and modulus exponential-normal models were fitted by maximum likelihood using STATA software. The 2.5th and 97.5th percentiles of thyroid parameters were determined and used as reference intervals. Mean±SD age of participants was 26.8±5.2years. Estimated reference intervals for TSH, T4 and FT4I in the 1st, 2nd and 3rd trimesters corresponding to the 2.5th and 97.5th percentiles were 0.14-6.14, 0.43-4.64, 0.63-3.9μIU/ml; 78.01-215.19, 93.23-243.87, 89.61-211.37nmol/L; and 1.73-4.53, 1.96-5.64, 1.72-4.30, respectively. Reference interval for TPOAb in the 1st trimester was 1.40-38.02IU/mL. Median of TSH was low in the 1st trimester, and gradually increased until 2nd trimester, followed by a slight decrease onward. A decreasing trend in TSH levels was observed in higher centiles with advancing gestational age. This study provides trimester-specific reference ranges for some common thyroid markers among healthy Iranian women in an iodine sufficient area, to prevent biochemical misinterpretations during pregnancy. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  8. Serum thyrotropin (TSH) levels in patients with suppressed pituitary function

    International Nuclear Information System (INIS)

    Vasavada, P.; Chen, I.; Maxon, H.; Barnes, E.; Sperling, M.

    1984-01-01

    The diagnosis of borderline hyperthyroidism is difficult. A sensitive radioimmunoassay capable of detecting subnormal levels of serum TSH may be of value in confirming this diagnosis because of the suppressed pituitary function in this disease state. This sensitive assay may also be useful in monitoring the suppression of pituitary function in thyroid cancer patients receiving thyroid hormone therapy. A sensitive radioimmunoassay capable of detecting serum TSH levels as low as 0.25 μU/m1 with coefficients of variation less than 17.2% was used to measure serum TSH levels in 80 healthy subjects, 44 hyperthyroid patients, and 25 athyrotic thyroid cancer patients on daily suppressive doses of thyroxine. All healthy subjects had detectable TSH levels with a mean value of 1.17 and two standard deviation ranges of 0.41 - 2.70 μU/m1 (lognormal distribution). Although the mean +-1 SEM value of 0.63 +- 0.003 μUm1 for hyperthyroid patients and 0.76 +- 0.08 μU/ml for thyroid cancer patients were significantly lower than that of healthy subjects (t-test, p<0.05), subnormal levels of serum TSH were found in only 28.6% (12/42) and 24% (6/25) of hyperthyroid and thyroid cancer patients, respectively. TSH stimulation tests performed in 6 of the cancer patients all gave suppressed responses. Because of considerable overlap, serum TSH levels alone cannot distinguish hyperthyroidsm from euthyroidism. However, a sensitive TSH radioimmunoassay such as the one described here may be of value in evaluating the extent of pituitary suppression in thyroid cancer therapy

  9. Impact of light exposure on thyroid-stimulating hormone results using the Siemens Advia Centaur TSH-3Ultra assay.

    Science.gov (United States)

    Armer, Jane; Giles, Diane; Lancaster, Ian; Brownbill, Kathryn

    2017-09-01

    Background Thyroid-stimulating hormone (TSH) is used as the first-line test of thyroid function. Siemens Healthcare Diagnostics recommend that Siemens Centaur reagents must be protected from light in the assay information and on reagent packaging. We have compared the effect of light exposure on results using Siemens TSH-3Ultra and follicle-stimulating hormone reagents. The thyroid-stimulating hormone reagent includes fluoroscein thiocyanate whereas the follicle-stimulating hormone reagent does not. Methods Three levels of quality controls were analysed using SiemensTSH-3Ultra and follicle-stimulating hormone reagent packs that had been kept protected from light or exposed to light at 6-h intervals for 48 h and then at 96 h. Results Thyroid-stimulating hormone results were significantly lower after exposure of TSH-3Ultra reagent packs to light. Results were >15% lower at all three levels of quality control following 18 h of light exposure and continued to decrease until 96 h. There was no significant difference in follicle-stimulating hormone results whether reagents had been exposed to or protected from light. Conclusions Thyroid-stimulating hormone results but not follicle-stimulating hormone results are lowered after exposure of reagent packs to light. Laboratories must ensure that TSH-3Ultra reagents are not exposed to light and analyse quality control samples on every reagent pack to check that there has not been light exposure prior to delivery. The labelling on TSH-3Ultra reagent packs should reflect the significant effect of light exposure compared with the follicle-stimulating hormone reagent. We propose that the effect of light exposure on binding of fluoroscein thiocyanate to the solid phase antibody causes the falsely low results.

  10. The TSH levels and risk of hypothyroidism: Results from a population based prospective cohort study in an Iranian adult's population.

    Science.gov (United States)

    Aminorroaya, Ashraf; Meamar, Rokhsareh; Amini, Massoud; Feizi, Awat; Nasri, Maryam; Tabatabaei, Azamosadat; Faghihimani, Elham

    2017-06-01

    The aim of current study was to assess the relationship between serum TSH levels and hypothyroidism risk in the euthyroid population. In a population-based cohort study, a total of 615 individuals with a normal baseline TSH, from of total population (n=2254) in 2006, were followed up for 6years. TSH, total T4, thyroid peroxidase antibody (TPOAb), and thyroglobulin antibody (TgAb) were measured. The relative risk (RR) and 95% confidence interval (95%CI) were calculated based on logistic regression. The Receiver Operating Characteristic (ROC) analysis along with area under the curve (AUC) was used to prediction of future hypothyroidism. TSH level in 2006 was a significant predictor for overt hypothyroidism, in the total population (RR=3.5) and female (RR=1.37) (all, P valuehypothyroidism from euthyroid. However, this cut off was not observed when we included only negative TPO and TgAbs people in 2006. The RR of hypothyroidism increased gradually when TSH level increased from 2.06-3.6mIU/L to >3.6mIU/L in the total population and both sexes. In women, the risk of overt hypothyroidism was significantly higher in subjects with TSH above 3.6 than those subject with THS levels≤2.05 [RR: (CI95 %), 20.57(2.-207.04), P valuehypothyroidism in future. However, it was not applicable for people with negative TPOAb and negative TgAb. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  11. Levothyroxine medication is associated with adiposity independent of TSH.

    Science.gov (United States)

    Ruhla, S; Arafat, A M; Osterhoff, M; Weickert, M O; Mai, K; Spranger, J; Schöfl, C; Pfeiffer, A F H; Möhlig, M

    2012-06-01

    In euthyroidism, higher TSH levels are weakly associated with increased BMI. Furthermore, a considerable number of patients complain of weight gain during thyroid hormone replacement after thyroidectomy. We therefore investigated the association between levothyroxine medication and BMI in a large cross-sectional study group. We included euthyroid participants from the MeSyBePo study group (TSH between 0.3 and 4.5 μU/ml) that did not take thyreostatic drugs. Linear regression analyses were performed to address the association between levothyroxine medication and obesity. Additionally, pairs matched by sex, age and TSH but discordant in levothyroxine medication were compared. 1663 subjects (569 males) were eligible for inclusion. 151 participants were taking levothyroxine. Adjusted for sex and age both TSH (standardised beta 0.1, plevothyroxine medication (standardised beta 0.05, p=0.03) were significantly associated with BMI. There was no significant interaction between TSH and levothyroxine medication with respect to BMI. Further adjustment for smoking and the restriction to those subjects with normal glucose metabolism (947 participants (314 males, 82 on levothyroxine medication) did not alter the result. In matched pair analysis (133 pairs), BMI was significantly increased in subjects taking levothyroxine compared to controls. Independently from TSH, levothyroxine medication was associated with a higher BMI. The mechanisms, however, responsible for this association need to be elucidated. © J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York.

  12. Radioimmunoassay of TSH subunits in thyroid diseases and endocrine opthalmopahty

    International Nuclear Information System (INIS)

    Eder, W.

    1982-01-01

    Highly sensitive radioimmunoassays of hTSH sub-units were developed. The hormone preparations were labelled with 125-iodine according to a modified chloramine -T method, and purified by chromatography using biogel P6 and P60. Rabbit antisera were used as antibodies. Separation of the antibody-bound and of the free antigens was carried out via the double antibody method. The antiserum required for this purpose was obtained from a goat. The sensitivity of the assay was influenced by changing the protein content of the buffer, the incubation volume, the tracer amounts, the incubation time and the incubation temperature. For hTSH-α, the lowest detectable limit was found to be 50 pg/ml, for hTSH-#betta# 20 pg/ml. Thus, the sub-units could be determined for 98% of the patients under review. The #betta#-TSH radioimmunoassay is largely specific, TSH cross-reacts to a degree of 5%. The computerized evoluation was carried out by means of Spline approximation using the Siemens 4004 computer. Precision and accurateness are in compliance with generally accpted criteria. The serum levels of α and #betta# sub-units showed no discordancy with regard to TSH. In all groups of patients examined, the levels of the hormone-specific #betta#-chain were found to be exclusively dependent upon the actual thyroid activity. (orig.) [de

  13. Establishing Reference Intervals for Bone Turnover Markers in the Healthy Shanghai Population and the Relationship with Bone Mineral Density in Postmenopausal Women

    Directory of Open Access Journals (Sweden)

    Wei-Wei Hu

    2013-01-01

    Full Text Available The reference ranges of bone turnover markers (BTMs were important during the treatment of osteoporosis, and the associations with bone mineral density (BMD were controversial. The aim of this study was to establish the reference ranges of N-terminal procollagen of type l collagen (P1NP, osteocalcin (OC, and beta C-terminal cross-linked telopeptides of type I collagen (β-CTX in Shanghai area and to investigate the relationships between BTMs and BMD in postmenopausal women. 2,799 subjects recruited in Shanghai City were measured BTMs to establish the reference ranges. Additional 520 healthy postmenopausal women were also measured BTMs, these women measured BMD in addition. BTMs were measured using the Roche electrochemiluminescence system. We used the age range of 35 to 45-year-olds to calculate reference intervals. The reference range of OC was 4.91 to 13.90 ng/mL for women and 5.58 to 16.57 ng/mL for men, P1NP was 13.72 to 32.90 ng/mL for women and 16.89 to 42.43 ng/mL for men, and β-CTX was 0.112 to 0.210 ng/mL for women and 0.100 to 0.378 ng/mL for men. BTMs significantly negatively correlated with lumbar spine and femoral and total hip in postmenopausal women ( = −0.157 ~ −0.217, P < 0.001. We established the normal reference ranges of P1NP, OC, and β-CTX in the Shanghai area. This study also found that BTMs correlated with BMD and suggested that BTMs were the key determining factors of early BMD decreases.

  14. Hemoglobin concentrations in 358 apparently healthy 80-year-old Danish men and women. Should the reference interval be adjusted for age?

    DEFF Research Database (Denmark)

    Milman, N.; Pedersen, A.N.; Ovesen, L.

    2008-01-01

    -95 percentile 114-147 g/L in women (panemia, as defined by World Health Organization (WHO) criteria, was 18% in men and 17% in women. Apparently healthy iron-replete men (n=129) and women (n=141) had median Hb of 141 g/L and 131 g/L. Median Hb levels were higher in 10-year surviving...... or supplemental iron intake. In men, Hb was correlated to meat consumption. Conclusions: WHO decision limits for anemia should not be lowered in 80-year-old subjects. "Optimal" Hb concentrations with respect to survival appear to be at least 140 g/L in men and 131 g/L in women. Further research should evaluate......Background and aims: In elderly Danes, reference intervals for hemoglobin (Hb) concentrations are derived from younger population groups. The aim was to examine reference intervals for Hb and cut-off limits for anemia by application of criteria for normality to a representative population of 80...

  15. Reference intervals for N-terminal pro-B-type natriuretic peptide in amniotic fluid between 10 and 34 weeks of gestation.

    Directory of Open Access Journals (Sweden)

    Waltraut M Merz

    Full Text Available BACKGROUND: In adult and pediatric cardiology, n-terminal pro-B-type natriuretic peptide (nt-proBNP serves as biomarker in the diagnosis and management of cardiovascular dysfunction. Elevated levels of circulating nt-proBNP are present in fetal conditions associated with myocardial pressure or volume load. Compared to fetal blood sampling, amniocentesis is technically easier and can be performed from early pregnancy onwards. We aimed to investigate amniotic fluid (AF nt-proBNP concentrations in normal pregnancies between 10 and 34 weeks of gestation. METHODS: Nt-proBNP and total protein (TP was measured in AF by chemiluminescence assay (photometry, respectively. To adjust for a potential dilutional effect, the AF-nt-proBNP/AF-TP ratio was analyzed. Reference intervals were constructed by regression modeling across gestational age. RESULTS: 132 samples were analyzed. A negative correlation between AF-nt-proBNP/AF-TP ratio and gestational age was observed. Curves for the mean and the 5% and 95% reference interval between 10 and 34 weeks of gestation were established. CONCLUSION: In normal pregnancy, nt-proBNP is present in AF and decreases during gestation. Our data provide the basis for research on AF-nt-proBNP as biomarker in fetal medicine.

  16. Endogenous TSH levels at the time of {sup 131}I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality

    Energy Technology Data Exchange (ETDEWEB)

    Vrachimis, Alexis; Riemann, Burkhard [University Hospital Muenster, Department of Nuclear Medicine, Muenster (Germany); Maeder, Uwe; Reiners, Christoph [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); Verburg, Frederik A. [University of Wuerzburg, Department of Nuclear Medicine, Wuerzburg (Germany); RWTH University Hospital Aachen, Department of Nuclear Medicine, Aachen (Germany)

    2016-02-15

    Based on a single older study it is established dogma that TSH levels should be ≥30 mU/l at the time of postoperative {sup 131}I ablation in differentiated thyroid cancer (DTC) patients. We sought to determine whether endogenous TSH levels, i.e. after levothyroxine withdrawal, at the time of ablation influence ablation success rates, recurrence-free survival and DTC-related mortality. A total of 1,873 patients without distant metastases referred for postoperative adjuvant {sup 131}I therapy were retrospectively included from 1991 onwards. Successful ablation was defined as stimulated Tg <1 μg/l. Age, gender and the presence of lymph node metastases were independent determinants of TSH levels at the time of ablation. TSH levels were not significantly related to ablation success rates (p = 0.34), recurrence-free survival (p = 0.29) or DTC -elated mortality (p = 0.82), but established risk factors such as T-stage, lymph node metastases and age were. Ablation was successful in 230 of 275 patients (83.6 %) with TSH <30 mU/l and in 1,359 of 1,598 patients (85.0 %) with TSH ≥30 mU/l. The difference was not significant (p = 0.55). Of the whole group of 1,873 patients, 21 had recurrent disease. There were no significant differences in recurrence rates between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.16). Ten of the 1,873 patients died of DTC. There were no significant differences in DTC-specific survival between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.53). The precise endogenous TSH levels at the time of {sup 131}I ablation are not related to the ablation success rates, recurrence free survival and DTC related mortality. The established dogma that TSH levels need to be ≥30 mU/l at the time of {sup 131}I ablation can be discarded. (orig.)

  17. Endogenous TSH levels at the time of 131I ablation do not influence ablation success, recurrence-free survival or differentiated thyroid cancer-related mortality

    International Nuclear Information System (INIS)

    Vrachimis, Alexis; Riemann, Burkhard; Maeder, Uwe; Reiners, Christoph; Verburg, Frederik A.

    2016-01-01

    Based on a single older study it is established dogma that TSH levels should be ≥30 mU/l at the time of postoperative 131 I ablation in differentiated thyroid cancer (DTC) patients. We sought to determine whether endogenous TSH levels, i.e. after levothyroxine withdrawal, at the time of ablation influence ablation success rates, recurrence-free survival and DTC-related mortality. A total of 1,873 patients without distant metastases referred for postoperative adjuvant 131 I therapy were retrospectively included from 1991 onwards. Successful ablation was defined as stimulated Tg <1 μg/l. Age, gender and the presence of lymph node metastases were independent determinants of TSH levels at the time of ablation. TSH levels were not significantly related to ablation success rates (p = 0.34), recurrence-free survival (p = 0.29) or DTC -elated mortality (p = 0.82), but established risk factors such as T-stage, lymph node metastases and age were. Ablation was successful in 230 of 275 patients (83.6 %) with TSH <30 mU/l and in 1,359 of 1,598 patients (85.0 %) with TSH ≥30 mU/l. The difference was not significant (p = 0.55). Of the whole group of 1,873 patients, 21 had recurrent disease. There were no significant differences in recurrence rates between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.16). Ten of the 1,873 patients died of DTC. There were no significant differences in DTC-specific survival between patients with TSH <30 mU/l and TSH ≥30 mU/l (p = 0.53). The precise endogenous TSH levels at the time of 131 I ablation are not related to the ablation success rates, recurrence free survival and DTC related mortality. The established dogma that TSH levels need to be ≥30 mU/l at the time of 131 I ablation can be discarded. (orig.)

  18. Serum zinc reference intervals and its relationship with dietary, functional, and biochemical indicators in 6- to 9-year-old healthy children

    Directory of Open Access Journals (Sweden)

    Camila Xavier Alves

    2016-04-01

    Full Text Available Background: Zinc is an important cause of morbidity, particularly among young children. The dietary, functional, and biochemical indicators should be used to assess zinc status and to indicate the need for zinc interventions. Objective: The purpose of this study was to determine the zinc status and reference intervals for serum zinc concentration considering dietary, functional, and biochemical indicators in apparently healthy children in the Northeast Region of Brazil. Design: The cross-sectional study included 131 healthy children: 72 girls and 59 boys, aged between 6 and 9 years. Anthropometric assessment was made by body mass index (BMI and age; dietary assessment by prospective 3-day food register, and an evaluation of total proteins was performed. Zinc in the serum samples was analyzed in triplicate in the same assay flame, using atomic absorption spectrophotometry. Results: With respect to dietary assessment, only the intake of fiber and calcium was below the recommendations by age and gender. All subjects were eutrophic according to BMI and age classification. Zinc intake correlated with energy (p=0.0019, protein (p=0.0054, fat (p<0.0001, carbohydrate (p=0.0305, fiber (p=0.0465, calcium (p=0.0006, and iron (p=0.0003 intakes. Serum zinc correlated with protein intake (p=0.0145 and serum albumin (p=0.0141, globulin (p=0.0041, and albumin/globulin ratio (p=0.0043. Biochemical parameters were all within the normal reference range. Reference intervals for basal serum zinc concentration were 0.70–1.14 µg/mL in boys, 0.73–1.17 µg/mL in girls, and 0.72–1.15 µg/mL in the total population. Conclusions: This study presents pediatric reference intervals for serum zinc concentration, considering dietary, functional, and biochemical indicators, which are useful to establish the zinc status in specific groups. In this regard, there are few studies in the literature conducted under these conditions, which make it an innovative methodology.

  19. Value of preoperative serum LC3 and MMPs combined with TSH detection in diagnosis of papillary thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Yan-Fei Lu

    2016-03-01

    Full Text Available Objective: To study the value of preoperative serum LC3 and MMPs combined with TSH detection in diagnosis of papillary thyroid carcinoma and provide reference for clinical diagnosis and treatment. Methods: A total of 80 cases of patients with papillary thyroid carcinoma treated in our hospital from March 2010 to March 2014 were analyzed, and serum TSH, MMP2/9, TIMP1/2 and LC3 levels of patients before operation were detected by ELISA. Healthy subjects and patients with benign neoplasm of thyroid during the same period were taken as control. Results: Serum TSH, MMP2, MMP9 and LC3 levels in patients with papillary thyroid carcinoma significantly increased, TIMP1 and TIMP2 levels significantly decreased, and compared with healthy subjects and patients with benign neoplasm of thyroid, there were significant statistical differences; at the same time, above parameters in serum were not related to gender, but closely related to age, clinical stage and diameter of tumor as well as lymph node. Conclusion: Preoperative detection of serum LC3 and MMPs combined with TSH levels has important reference significance in diagnosis of papillary thyroid carcinoma.

  20. De evaluatie van Corning "MAGIC TSH-RIA" en de mogelijke toepassing van deze kit voor de bepaling van TSH in hielprikbloed van pasgeborenen

    NARCIS (Netherlands)

    Elvers LH; Loeber JG

    1985-01-01

    Bij de evaluatie van de Corning "MAGIC TSH-RIA"-kit voor de RIA van hTSH in serum werd nagegaan of met deze kit, na modificatie, het TSH- gehalte in hielprikbloed van pasgeborenen kan worden gemeten. De ijkcurven van de bloedvlek- en serumcalibratoren kwamen goed met elkaar overeen. Het

  1. Influence of urinary iodine excretion on thyroid technetium-99m pertechnetate uptake with and without TSH suppression: what happens when iodine supply increases?

    International Nuclear Information System (INIS)

    Reinhardt, M.J.; Hoegerle, S.; Trupkovic, T.; Krause, T.M.; Moser, E.

    1998-01-01

    This study examines how thyroid pertechnetate uptake with and without thyroid-stimulating hormone (TSH) suppression changes as a function of increasing iodine supply. This is of special interest in countries at the threshold of sufficient iodine supply, where thyroid scintigraphy plays a key role in thyroid examination, especially for the diagnosis of Plummer's disease. From 1995 to 1997, a total of 1069 patients with euthyroid goitre, Plummer's disease or Graves' disease were included in the study. All patients underwent thyroid examination including sonography, scintigraphy with technetium-99m pertechnetate, and determination of free triiodothyronine, free thyroxine, TSH and urinary iodine excretion. Iodine excretion in the range from 0 to 500 μg iodine/g creatinine showed an inverse correlation with thyroid pertechnetate uptake, but no correlation with TSH was observed. There was no correlation between thyroid pertechnetate uptake and iodine excretion when TSH stimulation was eliminated, with two exceptions: thyroid pertechnetate uptake was significantly increased for iodine excretion values below 50 and 100 μg iodine/g creatinine in patients with Graves' and Plummer's disease, respectively. When iodine excretion exceeded 500 μg iodine/g creatinine, pertechnetate uptake was reduced to a basal level independent of the TSH. In conclusion, the influence of TSH on the thyroid pertechnetate uptake seems to be secondary compared with the influence of the iodine supply. It can be concluded further that the reference range of thyroid pertechnetate uptake under TSH suppression will not change significantly when the iodine supply increases from conditions of mild iodine deficiency to iodine sufficiency. Thyroid pertechnetate uptake with and without TSH suppression cannot be reliably interpreted beyond an iodine excretion of 500 μg iodine/g creatinine. (orig.)

  2. Incidence of hemoglobinopathies and thalassemias in Northern Alberta. Establishment of reference intervals for HbF and HbA2.

    Science.gov (United States)

    Rodriguez-Capote, Karina; Higgins, Trefor N

    2015-07-01

    The aims of this study were to identify the incidence of hemoglobinopathies and thalassemias in Northern Alberta and calculate the reference intervals (RI) for hemoglobin (Hb) HbF and HbA2. A retrospective ad-hoc analysis of the structural Hb variants and thalassemias identified on patients who had a hemoglobinopathy/thalassemia investigation performed between February 1 to December 31, 2013. Results were extracted from the Laboratory Information System. Statistical analysis was performed using MedCalc® version 11.4.2.0 for Windows software. 6616 hemoglobinopathy/thalassemia investigations and HbS screens were physician requested and 602 Hb variants were fortuitously found during HbA1c analysis. 3438 were interpreted as "normal" and 532 were classified as iron deficient. 3306 individuals, with age ranging from 3 to 92 years were included in the RI calculation. HbA2 RI was 2.3% to 3.4% and HbF 0.0% to 1.8%. 524 and 423 α and β thalassemia traits respectively were identified. Additionally ten δβ thalassemia traits and twelve cases of HbH disease were identified. Regarding hemoglobinopathies, 7% were classified as α-chain variants and 93% as β-chain variants with HbS (46%), HbE (16%), HbD Punjab (8%) and HbC (7%) traits being the most prevalent. We also documented 20 homozygous hemoglobinopathies and 36 compound/double heterozygous hemoglobinopathies. A wide diversity of hemoglobinopathies is found in the Northern Alberta population, 80% of the hemoglobinopathies were found as a reflex to HbA1c testing. Reference intervals for HbF and HbA2 were established. Copyright © 2015 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Clinical pathology reference intervals for an in-water population of juvenile loggerhead sea turtles (Caretta caretta in Core Sound, North Carolina, USA.

    Directory of Open Access Journals (Sweden)

    Terra R Kelly

    Full Text Available The loggerhead sea turtle (Caretta caretta is found throughout the waters of the Atlantic, Pacific, and Indian Oceans. It is a protected species throughout much of its range due to threats such as habitat loss, fisheries interactions, hatchling predation, and marine debris. Loggerheads that occur in the southeastern U.S. are listed as "threatened" on the U.S. Endangered Species List, and receive state and federal protection. As part of an on-going population assessment conducted by the National Marine Fisheries Service, samples were collected from juvenile loggerhead sea turtles in Core Sound, North Carolina, between 2004 and 2007 to gain insight on the baseline health of the threatened Northwest Atlantic Ocean population. The aims of the current study were to establish hematologic and biochemical reference intervals for this population, and to assess variation of the hematologic and plasma biochemical analytes by season, water temperature, and sex and size of the turtles. Reference intervals for the clinical pathology parameters were estimated following Clinical Laboratory Standards Institute guidelines. Season, water temperature, sex, and size of the turtles were found to be significant factors of variation for parameter values. Seasonal variation could be attributed to physiological effects of decreasing photoperiod, cooler water temperature, and migration during the fall months. Packed cell volume, total protein, and albumin increased with increasing size of the turtles. The size-related differences in analytes documented in the present study are consistent with other reports of variation in clinical pathology parameters by size and age in sea turtles. As a component of a health assessment of juvenile loggerhead sea turtles in North Carolina, this study will serve as a baseline aiding in evaluation of trends for this population and as a diagnostic tool for assessing the health and prognosis for loggerhead sea turtles undergoing

  4. Clinical Pathology Reference Intervals for an In-Water Population of Juvenile Loggerhead Sea Turtles (Caretta caretta) in Core Sound, North Carolina, USA

    Science.gov (United States)

    Kelly, Terra R.; McNeill, Joanne Braun; Avens, Larisa; Hall, April Goodman; Goshe, Lisa R.; Hohn, Aleta A.; Godfrey, Matthew H.; Mihnovets, A. Nicole; Cluse, Wendy M.; Harms, Craig A.

    2015-01-01

    The loggerhead sea turtle (Caretta caretta) is found throughout the waters of the Atlantic, Pacific, and Indian Oceans. It is a protected species throughout much of its range due to threats such as habitat loss, fisheries interactions, hatchling predation, and marine debris. Loggerheads that occur in the southeastern U.S. are listed as “threatened” on the U.S. Endangered Species List, and receive state and federal protection. As part of an on-going population assessment conducted by the National Marine Fisheries Service, samples were collected from juvenile loggerhead sea turtles in Core Sound, North Carolina, between 2004 and 2007 to gain insight on the baseline health of the threatened Northwest Atlantic Ocean population. The aims of the current study were to establish hematologic and biochemical reference intervals for this population, and to assess variation of the hematologic and plasma biochemical analytes by season, water temperature, and sex and size of the turtles. Reference intervals for the clinical pathology parameters were estimated following Clinical Laboratory Standards Institute guidelines. Season, water temperature, sex, and size of the turtles were found to be significant factors of variation for parameter values. Seasonal variation could be attributed to physiological effects of decreasing photoperiod, cooler water temperature, and migration during the fall months. Packed cell volume, total protein, and albumin increased with increasing size of the turtles. The size-related differences in analytes documented in the present study are consistent with other reports of variation in clinical pathology parameters by size and age in sea turtles. As a component of a health assessment of juvenile loggerhead sea turtles in North Carolina, this study will serve as a baseline aiding in evaluation of trends for this population and as a diagnostic tool for assessing the health and prognosis for loggerhead sea turtles undergoing rehabilitation. PMID

  5. Baseline morbidity in 2,990 adult African volunteers recruited to characterize laboratory reference intervals for future HIV vaccine clinical trials.

    Directory of Open Access Journals (Sweden)

    Wendy Stevens

    2008-04-01

    Full Text Available An understanding of the health of potential volunteers in Africa is essential for the safe and efficient conduct of clinical trials, particularly for trials of preventive technologies such as vaccines that enroll healthy individuals. Clinical safety laboratory values used for screening, enrolment and follow-up of African clinical trial volunteers have largely been based on values derived from industrialized countries in Europe and North America. This report describes baseline morbidity during recruitment for a multi-center, African laboratory reference intervals study.Asymptomatic persons, aged 18-60 years, were invited to participate in a cross-sectional study at seven sites (Kigali, Rwanda; Masaka and Entebbe, Uganda; Kangemi, Kenyatta National Hospital and Kilifi, Kenya; and Lusaka, Zambia. Gender equivalency was by design. Individuals who were acutely ill, pregnant, menstruating, or had significant clinical findings were not enrolled. Each volunteer provided blood for hematology, immunology, and biochemistry parameters and urine for urinalysis. Enrolled volunteers were excluded if found to be positive for HIV, syphilis or Hepatitis B and C. Laboratory assays were conducted under Good Clinical Laboratory Practices (GCLP.Of the 2990 volunteers who were screened, 2387 (80% were enrolled, and 2107 (71% were included in the analysis (52% men, 48% women. Major reasons for screening out volunteers included abnormal findings on physical examination (228/603, 38%, significant medical history (76, 13% and inability to complete the informed consent process (73, 13%. Once enrolled, principle reasons for exclusion from analysis included detection of Hepatitis B surface antigen (106/280, 38% and antibodies against Hepatitis C (95, 34%. This is the first large scale, multi-site study conducted to the standards of GCLP to describe African laboratory reference intervals applicable to potential volunteers in clinical trials. Approximately one-third of all

  6. Clinical pathology reference intervals for an in-water population of juvenile loggerhead sea turtles (Caretta caretta) in Core Sound, North Carolina, USA.

    Science.gov (United States)

    Kelly, Terra R; McNeill, Joanne Braun; Avens, Larisa; Hall, April Goodman; Goshe, Lisa R; Hohn, Aleta A; Godfrey, Matthew H; Mihnovets, A Nicole; Cluse, Wendy M; Harms, Craig A

    2015-01-01

    The loggerhead sea turtle (Caretta caretta) is found throughout the waters of the Atlantic, Pacific, and Indian Oceans. It is a protected species throughout much of its range due to threats such as habitat loss, fisheries interactions, hatchling predation, and marine debris. Loggerheads that occur in the southeastern U.S. are listed as "threatened" on the U.S. Endangered Species List, and receive state and federal protection. As part of an on-going population assessment conducted by the National Marine Fisheries Service, samples were collected from juvenile loggerhead sea turtles in Core Sound, North Carolina, between 2004 and 2007 to gain insight on the baseline health of the threatened Northwest Atlantic Ocean population. The aims of the current study were to establish hematologic and biochemical reference intervals for this population, and to assess variation of the hematologic and plasma biochemical analytes by season, water temperature, and sex and size of the turtles. Reference intervals for the clinical pathology parameters were estimated following Clinical Laboratory Standards Institute guidelines. Season, water temperature, sex, and size of the turtles were found to be significant factors of variation for parameter values. Seasonal variation could be attributed to physiological effects of decreasing photoperiod, cooler water temperature, and migration during the fall months. Packed cell volume, total protein, and albumin increased with increasing size of the turtles. The size-related differences in analytes documented in the present study are consistent with other reports of variation in clinical pathology parameters by size and age in sea turtles. As a component of a health assessment of juvenile loggerhead sea turtles in North Carolina, this study will serve as a baseline aiding in evaluation of trends for this population and as a diagnostic tool for assessing the health and prognosis for loggerhead sea turtles undergoing rehabilitation.

  7. TSH-CHECK-1 test: diagnostic accuracy and potential application to initiating treatment for hypothyroidism in patients on anti-tuberculosis drugs.

    Directory of Open Access Journals (Sweden)

    Cara S Kosack

    Full Text Available BACKGROUND: Thyroid-stimulating hormone (TSH promotes expression of thyroid hormones which are essential for metabolism, growth, and development. Second-line drugs to treat tuberculosis (TB can cause hypothyroidism by suppressing thyroid hormone synthesis. Therefore, TSH levels are routinely measured in TB patients receiving second-line drugs, and thyroxin treatment is initiated where indicated. However, standard TSH tests are technically demanding for many low-resource settings where TB is prevalent; a simple and inexpensive test is urgently needed. METHODS: As a proof of concept study TSH was measured in routinely collected sera at the University Medical Center Utrecht, Netherlands, using the TSH-CHECK-1 (VEDALAB, Alençon, France, a lateral-flow rapid immunochromatographic assay with a TSH cut-off value of 10 µIU/mL, the standard threshold for initiating treatment. These results were compared with TSH levels measured by a reference standard (UniCel DXi 800 imunoassay system, Beckman Coulter, USA. Sensitivity, specificity, and likelihood ratios were then calculated. RESULTS: A total of 215 serum samples were evaluated: 107 with TSH values <10 µIU/mL and 108 with values ≥10 µIU/mL. TSH-CHECK-1 test sensitivity was found to be 100.0% (95% CI: 96.6-100.0 and specificity was 76.6% (95% CI: 67.5-84.3. Predictive values (PV were modelled for different levels of prevalence. For a prevalence of 10% and 50%, the positive PV was 32.2% (95% CI: 25.0-39.7% and 81.1% (95% CI: 75.0-85.5%, respectively; the negative PV was 100% (95% CI: 98.9-100% and 100% (95% CI: 91.3-100% respectively. DISCUSSION/CONCLUSIONS: The TSH-CHECK-1 rapid test was practical and simple to perform but difficult to interpret on weak positive results. All sera with TSH≥10 µIU/mL were correctly identified, but the test lacked sufficient specificity. Given its excellent negative PV in this evaluation, the test shows promise for ruling out hypothyroidism. However, so far it

  8. Common reference intervals for aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) in serum: results from an IFCC multicenter study.

    Science.gov (United States)

    Ceriotti, Ferruccio; Henny, Joseph; Queraltó, Josep; Ziyu, Shen; Özarda, Yeşim; Chen, Baorong; Boyd, James C; Panteghini, Mauro

    2010-11-01

    Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and γ-glutamyl transferase (GGT) measurements are important for the assessment of liver damage. The aim of this study was to define the reference intervals (RIs) for these enzymes in adults, paying attention to standardization of the methods used and careful selection of the reference population. AST, ALT and GGT were measured with commercial analytical systems standardized to the IFCC-recommended reference measurement systems. Three centers (two in Italy and one in China) measured their own freshly collected samples; one of these centers also measured frozen samples from the Nordic Countries RI Project and from a Turkish center. RIs were generated using non-parametric techniques from the results of 765 individuals (411 females and 354 males, 18-85 years old) selected on the basis of the results of other laboratory tests and a specific questionnaire. AST results from the four regions (Milan, Beijing, Bursa and Nordic Countries) were statistically different, but these differences were too small to be clinically relevant. Likewise, differences between the upper reference limits for genders was only 1.7 U/L (0.03 μkat/L), allowing a single RI of 11-34 U/L (0.18-0.57 μkat/L) to be defined. Interregional differences were not statistically significant for ALT, but partitioning was required due to significant gender differences. RIs for ALT were 8-41 U/L (0.13-0.68 μkat/L) for females and 9-59 U/L (0.15-0.99 μkat/L) for males, respectively. The upper reference limits for GGT from the Nordic Country population were higher than those from the other three regions and results from this group were excluded from final calculations. The GGT RIs were 6-40 U/L (0.11-0.66 μkat/L) for females and 12-68 U/L (0.20- 1.13 μkat/L) for males, respectively. For AST and ALT, the implementation of common RIs appears to be possible, because no differences between regions were observed. However, a common RI for GGT that is

  9. Radiographic measurements of hip dysplasia at skeletal maturity - new reference intervals based on 2,038 19-year-old Norwegians

    International Nuclear Information System (INIS)

    Laborie, Lene Bjerke; Rosendahl, Karen; Engesaeter, Ingvild Oevsteboe; Lehmann, Trude Gundersen; Engesaeter, Lars Birger; Sera, Francesco; Dezateux, Carol

    2013-01-01

    Normative references for radiographic measurements commonly used in the diagnosis of developmental dysplasia of the hip at skeletal maturity are incomplete. The present study therefore aimed to establish new gender-specific standards for measurements reflecting the acetabular morphology, namely Sharp's angle, the acetabular roof angle of Toennis (AA) and the acetabular depth-width ratio (ADR), and measurements reflecting the position of the femoral head related to the acetabulum, namely the center-edge (CE) angle of Wiberg, the refined CE angle of Ogata, and the femoral head extrusion index (FHEI). The joint space width (JSW) is also reported. The population-based 1989 Bergen Birth Cohort (n = 3,935) was invited at age 19 years to a follow-up during 2007-09, of which 2,038 (52 %) attended. A standardized antero-posterior radiograph was assessed. The normative references are presented as mean ± standard deviation (SD) and 2.5-97.5 percentiles with 95 % confidence intervals. A total of 2,011 (841 males, 1,170 females, mean age 18.6 (SD 0.6)) radiographs were analyzed. Sharp's angle was 38.8 ± 3.5 in males and 40.7 ± 3.5 in females, with 97.5 percentiles of 46 and 47 , respectively. The CE angle was 32.1 ± 6.1 in males and 31.0 ± 6.1 in females, with 2.5 percentiles of 21 and 20 , respectively. The FHEI was 86.0 % ± 6.3 % in males and 85.6 % ± 6.6 % in females, with 2.5 percentiles of 74 and 73 , respectively. Updated gender-specific reference ranges for radiographic measurements commonly used for hip dysplasia at skeletal maturity are reported, similar to or slightly wider than those described in the literature. Statistically significant gender differences have been confirmed for most of the measurements. (orig.)

  10. Mathematical Modeling of the Pituitary-Thyroid Feedback Loop: Role of a TSH-T3-Shunt and Sensitivity Analysis.

    Science.gov (United States)

    Berberich, Julian; Dietrich, Johannes W; Hoermann, Rudolf; Müller, Matthias A

    2018-01-01

    Despite significant progress in assay technology, diagnosis of functional thyroid disorders may still be a challenge, as illustrated by the vague upper limit of the reference range for serum thyrotropin ( TSH ). Diagnostical problems also apply to subjects affected by syndrome T, i.e., those 10% of hypothyroid patients who continue to suffer from poor quality of life despite normal TSH concentrations under substitution therapy with levothyroxine ( L - T 4 ). In this paper, we extend a mathematical model of the pituitary-thyroid feedback loop in order to improve the understanding of thyroid hormone homeostasis. In particular, we incorporate a TSH - T 3 -shunt inside the thyroid, whose existence has recently been demonstrated in several clinical studies. The resulting extended model shows good accordance with various clinical observations, such as a circadian rhythm in free peripheral triiodothyronine ( FT 3 ). Furthermore, we perform a sensitivity analysis of the derived model, revealing the dependence of TSH and hormone concentrations on different system parameters. The results have implications for clinical interpretation of thyroid tests, e.g., in the differential diagnosis of subclinical hypothyroidism.

  11. Can neonatal TSH screening reflect trends in population iodine intake?

    LENUS (Irish Health Repository)

    Burns, Robert

    2008-08-01

    The distribution of neonatal blood thyroid-stimulating hormone (TSH) concentrations has been used as an index reflecting population dietary iodine intake, with higher concentrations being indicative of lower iodine intake. We examined this distribution in neonates born in Ireland, where the pregnant population has shown a recent decline in urinary iodine (UI) excretion. Our objectives were to determine if any alteration was observed in the percentage of values > 5.0 mIU\\/L and whether a trend in neonatal blood TSH was apparent.

  12. TSH-induced cyclic AMP production in an ovine thyroid cell line: OVNIS 5H.

    Science.gov (United States)

    Fayet, G; Aouani, A; Hovsépian, S

    1986-01-06

    The TSH-induced cyclic AMP response was studied using a 3-year-old ovine thyroid cell line TSH-independent for growth: OVNIS 5H. The kinetics of cyclic AMP production was followed both in cell layers and in cell culture media, with or without phosphodiesterase inhibitor. It is noteworthy that following the first wave in cyclic AMP obtained within minutes, we observed later a sustained exponential increase in cyclic AMP during the 5 days following TSH stimulation. A bioassay of TSH was derived allowing measurement of 1 microU/ml TSH from a crude bTSH preparation.

  13. Development of Australian reference ranges for the left fetal modified myocardial performance index and the influence of caliper location on time interval measurement.

    Science.gov (United States)

    Meriki, N; Welsh, A W

    2012-01-01

    To construct gestational age-adjusted reference ranges of the left fetal modified myocardial performance index (Mod-MPI) in the Australian population and assess the influence of valve click caliper position on constituent time intervals and the Mod-MPI. This is a prospective longitudinal study of 117 normal singleton fetuses undergoing 318 ultrasound scans at 4-6 weekly intervals between 18 and 38 weeks of gestation. The isovolumetric contraction time (ICT), isovolumetric relaxation time (IRT), and ejection time (ET) were measured at 3 different caliper positions in each fetus: beginning of the original valve clicks ('original'), beginning of the reflected valve clicks ('reflected'), and peak of valve clicks ('peak'). The Mod-MPI was calculated as (ICT + IRT)/ET. The Mod-MPI increased throughout gestation with means ± SD of 0.42 ± 0.05 'reflected' and 'peak' versus 0.49 ± 0.03 'original' at 19 weeks, and means of 0.46 ± 0.05 'reflected and peak' versus 0.51 ± 0.08 'original' at 36 weeks. Throughout gestation, ICT remained fairly constant and IRT increased, while ET decreased with 'original' click and remained constant for 'reflected' and 'peak' clicks. A modest increase in Mod-MPI was seen with increasing fetal heart rate. Analysis of repeatability for the 3 methods showed the following ICCs: 'original', 0.797 (95% CI 0.762-0.829); 'reflected', 0.809 (95% CI 0.775-0.839), and 'peak', 0.799 (95% CI 0.764-0.831). Detailed exploration of the morphology of mitral and aortic valve closure and opening clicks shows how selection of different phases of these clicks may significantly influence the Mod-MPI. We recommend that the peak of the valve clicks be standardized between research groups. Copyright © 2012 S. Karger AG, Basel.

  14. A nationwide multicentre study in Turkey for establishing reference intervals of haematological parameters with novel use of a panel of whole blood

    Science.gov (United States)

    Ozarda, Yesim; Ichihara, Kiyoshi; Bakan, Ebubekir; Polat, Harun; Ozturk, Nurinnisa; Baygutalp, Nurcan K.; Taneli, Fatma; Guvenc, Yesim; Ormen, Murat; Erbayraktar, Zubeyde; Aksoy, Nurten; Sezen, Hatice; Demir, Meltem; Eskandari, Gulcin; Polat, Gurbuz; Mete, Nuriye; Yuksel, Hatice; Vatansev, Husamettin; Gun, Fatma; Akin, Okhan; Ceylan, Ozlem; Noyan, Tevfik; Gozlukaya, Ozgul; Aliyazicioglu, Yuksel; Kahraman, Sevim; Dirican, Melahat; Tuncer, Gul Ozlem; Kimura, Shogo; Eker, Pinar

    2017-01-01

    Introduction A nationwide multicentre study was conducted to establish well-defined reference intervals (RIs) of haematological parameters for the Turkish population in consideration of sources of variation in reference values (RVs). Materials and methods K2-EDTA whole blood samples (total of 3363) were collected from 12 laboratories. Sera were also collected for measurements of iron, UIBC, TIBC, and ferritin for use in the latent abnormal values exclusion (LAVE) method. The blood samples were analysed within 2 hours in each laboratory using Cell Dyn and Ruby (Abbott), LH780 (Beckman Coulter), or XT-2000i (Sysmex). A panel of freshly prepared blood from 40 healthy volunteers was measured in common to assess any analyser-dependent bias in the measurements. The SD ratio (SDR) based on ANOVA was used to judge the need for partitioning RVs. RIs were computed by the parametric method with/without applying the LAVE method. Results Analyser-dependent bias was found for basophils (Bas), MCHC, RDW and MPV from the panel test results and thus those RIs were derived for each manufacturer. RIs were determined from all volunteers’ results for WBC, neutrophils, lymphocytes, monocytes, eosinophils, MCV, MCH and platelets. Gender-specific RIs were required for RBC, haemoglobin, haematocrit, iron, UIBC and ferritin. Region-specific RIs were required for RBC, haemoglobin, haematocrit, UIBC, and TIBC. Conclusions With the novel use of a freshly prepared blood panel, manufacturer-specific RIs’ were derived for Bas, Bas%, MCHC, RDW and MPV. Regional differences in RIs were observed among the 7 regions of Turkey, which may be attributed to nutritional or environmental factors, including altitude. PMID:28694726

  15. Reference Intervals for Urinary Cotinine Levels and the Influence of Sampling Time and Other Predictors on Its Excretion Among Italian Schoolchildren

    Directory of Open Access Journals (Sweden)

    Carmela Protano

    2018-04-01

    Full Text Available (1 Background: Environmental Tobacco Smoke (ETS exposure remains a public health problem worldwide. The aims are to establish urinary (u- cotinine reference values for healthy Italian children, to evaluate the role of the sampling time and of other factors on children’s u-cotinine excretion. (2 Methods: A cross-sectional study was performed on 330 children. Information on participants was gathered by a questionnaire and u-cotinine was determined in two samples for each child, collected during the evening and the next morning. (3 Results: Reference intervals (as the 2.5th and 97.5th percentiles of the distribution in evening and morning samples were respectively equal to 0.98–4.29 and 0.91–4.50 µg L−1 (ETS unexposed and 1.39–16.34 and 1.49–20.95 µg L−1 (ETS exposed. No statistical differences were recovered between median values found in evening and morning samples, both in ETS unexposed and exposed. Significant predictors of u-cotinine excretions were ponderal status according to body mass index of children (β = 0.202; p-value = 0.041 for evening samples; β = 0.169; p-value = 0.039 for morning samples and paternal educational level (β = −0.258; p-value = 0.010; for evening samples; β = −0.013; p-value = 0.003 for morning samples. (4 Conclusions: The results evidenced the need of further studies for assessing the role of confounding factors on ETS exposure, and the necessity of educational interventions on smokers for rising their awareness about ETS.

  16. Multiple metals predict prolactin and thyrotropin (TSH) levels in men

    Energy Technology Data Exchange (ETDEWEB)

    Meeker, John D., E-mail: meekerj@umich.edu [Department of Environmental Health Sciences, University of Michigan School of Public Health, 6635 SPH Tower, 109 S. Observatory St., Ann Arbor, MI 48109 (United States); Rossano, Mary G. [Department of Animal and Food Sciences, University of Kentucky, Lexington, KY (United States); Protas, Bridget [Department of Epidemiology, Michigan State University, East Lansing, MI (United States); Diamond, Michael P.; Puscheck, Elizabeth [Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI (United States); Daly, Douglas [Grand Rapids Fertility and IVF, Grand Rapids, MI (United States); Paneth, Nigel [Department of Obstetrics and Gynecology, Michigan State University, East Lansing, MI (United States); Wirth, Julia J. [Department of Epidemiology, Michigan State University, East Lansing, MI (United States); Department of Obstetrics and Gynecology, Michigan State University, East Lansing, MI (United States)

    2009-10-15

    Exposure to a number of metals can affect neuroendocrine and thyroid signaling, which can result in adverse effects on development, behavior, metabolism, reproduction, and other functions. The present study assessed the relationship between metal concentrations in blood and serum prolactin (PRL) and thyrotropin (TSH) levels, markers of dopaminergic, and thyroid function, respectively, among men participating in a study of environmental influences on male reproductive health. Blood samples from 219 men were analyzed for concentrations of 11 metals and serum levels of PRL and TSH. In multiple linear regression models adjusted for age, BMI and smoking, PRL was inversely associated with arsenic, cadmium, copper, lead, manganese, molybdenum, and zinc, but positively associated with chromium. Several of these associations (Cd, Pb, Mo) are consistent with limited studies in humans or animals, and a number of the relationships (Cr, Cu, Pb, Mo) remained when additionally considering multiple metals in the model. Lead and copper were associated with non-monotonic decrease in TSH, while arsenic was associated with a dose-dependent increase in TSH. For arsenic these findings were consistent with recent experimental studies where arsenic inhibited enzymes involved in thyroid hormone synthesis and signaling. More research is needed for a better understanding of the role of metals in neuroendocrine and thyroid function and related health implications.

  17. Hyperthyroidism caused by TSH-producing adenoma | Brunova ...

    African Journals Online (AJOL)

    Objectives. To present a new case of central hyperthyroidism caused by thyrotropin (TSH)-producing adenoma. Design. Case report. Setting. Departments of Internal Medicine, Diagnostic Radiology and Biochemistry, University of the Orange"Free State, Bloemfontein. Subject and outcome measures. A 36-year-old woman ...

  18. An Evaluation by TSH Radioimmunoassay on Familial Thyroid Disorders

    International Nuclear Information System (INIS)

    Kim, Ji Yeul

    1989-01-01

    The occurrence of thyroid disorders is connected with iodine deficiency, defective synthesis or releasing of thyroid hormone and endemicity. Genetic factors are known as a single gene defects, interaction of multiple genes with environmental factors, as well as chromosomal aberrations. Diofnosis thyroid disorders is enforced by 13I uptake test, thyroid scanning with 131 I or 99m Tc and serum radioimmunoassays of T3, T4, free T4 and TSH. They were largely classified as hypothyroidism, hyperthyroidism, simple goiter and normal. The pedigree of 58 families was drawn by propositus, and then the correlation between thyroid disorders and TSH levels was analyzed. The results are as follows: 1) The offsprings and their mothers of 15 families were hypothyroidism, THS level was 5 folds for offsprings and 4 folds for mothers in comparison with control group. 2) 13 families were hyperthyroidism in siblings but their mothers were normal in thyroid function, TSH level of the siblings was lower than control group. 3) Though the offsprings and their mothers of 10 families were similar to TSH level of control group, they are all simple goiter, familial thyroid disorders, in other thyroid function test. The familial thyroid disorders suggested that these transmitted from mothers to offsprings with X-linked dominant or autosomal dominant inheritance.

  19. Cálcio ionizado no soro: estimativa do intervalo de referência e condições de coleta Serum ionized calcium: reference interval estimation and blood collection condictions

    Directory of Open Access Journals (Sweden)

    Adagmar Andriolo

    2004-04-01

    methodology with favorable cost/benefice ratio. The use of this methodology implies in reference interval estimation. OBJECTIVE: To estimate the reference interval for serum ionized calcium, and to evaluate interferences in tourniquet time application, and interferences in sample refrigeration before analysis. MATERIAL AND METHOD: to estimate the reference interval we included the results of 11,320 consecutive calcium ionized determinations accomplished from January 2000 to November 2002; in order to evaluate the effect of sample refrigeration, 16 samples were collected in duplicate, so that one tube was placed in ice bath and the other was maintained in room temperature. To evaluate the effect of tourniquet application time, we collected blood samples from one arm of 6 normal subjects, immediately after, and from the other arm, after 3 minutes of the tourniquet application. The blood was collected in evacuated tubes with gel separator and centrifuged up to 30 minutes after collection. All determinations were performed up to 4 hours after the centrifugation by ion-selective electrode. RESULTS: regarding to the central 95% data distribution, the inferior and superior limits were, respectively, 1.11 (confidence interval of 90%: 1.1 to 1.11 and 1.4mmol/l (confidence interval of 90%: 1.39 to 1.41. No significant differences were detected between results with and without refrigeration and between samples with less than 1 and after 3 minutes of tourniquet application.

  20. Highly sensitive determination of TSH in the follow-up of TSH-suppressive therapy of patients with differentiated thyroid cancer

    Energy Technology Data Exchange (ETDEWEB)

    Mann, K.; Saller, B.; Mehl, U.; Hoermann, R.; Moser, E.

    1988-02-01

    Basal and TRH-stimulated TSH levels were determined in 72 patients with differentiated thyroid cancer on hormonal treatment, using a highly sensitive immunoradiometric assay (IRMAclon, Henning). 43 patients were under treatment with levothyroxine (T/sub 4/), 29 patients with triiodothyronine (T/sub 3/). In 33/43 patients (77%) under T/sub 4/- and in 18/29 patients (62%) under T/sub 3/-treatment basal TSH levels were below 0.1 mU/l. 3 patients showed a significant response (to above 0.5 mU/l) in the TRH test despite basal values of less than 0.1 mU/l. In 2 patients with elevated basal TSH levels (0.23 and 0.60 mU/l, resp.) in the IRMAclon, total suppression of TSH secretion was suggested by a failure of TSH to rise after TRH. By retesting these samples in an own TSH IRMA, basal and stimulated TSH values were below 0.1 mU/l. In conclusion, basal and TRH-stimulated TSH levels are well correlated in most patients with thyroid cancer under hormonal treatment. However, in some cases (5/72) determination of basal TSH could not clearly define the degree of thyrotropic suppression. Thus, TRH testing is still necessary to establish definitely complete TSH suppression in patients with thyroid carcinoma under suppressive treatment.

  1. Determination of reference intervals and comparison of venous blood gas parameters using a standard and nonstandard collection method in 51 dogs.

    Science.gov (United States)

    Bachmann, K; Kutter, A; Jud Schefer, R S; Sigrist, N

    2018-03-01

    The aim of this study was to determine reference intervals (RI) for venous blood parameters determined with the RAPIDPoint 500 (RP500) blood gas analyzer using blood gas syringes (BGS) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGS. The null hypothesis was that canine venous blood samples collected in BGS and in LH tubes are comparable. Jugular blood was collected from 51 healthy dogs into a BGS and a LH tube. The BGS was immediately analyzed followed by the LH tube. The RI were calculated from BGS results. The BGS and LH tubes results were compared using paired t-test or Wilcoxon matched-pairs signed-rank test and Bland-Altman analysis. To assess clinical relevance, the bias between BGS and LH tubes was compared with the allowable total error (TEa). Values derived from LH tubes showed no significant difference for standard bicarbonate (HCO3std), whole blood base excess (BE B), Na, K, Cl, glucose and hemoglobin (tHb). The pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionized Ca, anion gap and lactate were significantly (p.

  2. Reference intervals of cadmium, lead, and mercury in blood, urine, hair, and nails among residents in Mansoura city, Nile Delta, Egypt

    International Nuclear Information System (INIS)

    Mortada, Waelin I.; Sobh, Mohamed A.; El-Defrawy, Mohamed M.; Farahat, Sami E.

    2002-01-01

    A random sample of 68 males and 25 females who reside in Mansoura city, Egypt, was examined for concentrations of cadmium, lead, and mercury in blood, urine, hair, and nails. The effect of gender and smoking on such levels was studied. The influence of dental amalgam on the levels of mercury in these biological samples were also examined. The results obtained show that only blood lead, which increased among males, was affected by gender. Blood levels of cadmium and lead as well as hair lead appeared to increase with smoking habit. Mercury levels in blood and urine were related to the presence of dental amalgam fillings. International comparisons between our results and the corresponding levels in other localities in the world showed that there ere environmentally related variations in terms of cadmium levels in hair, lead levels in blood, urine, hair, and nails, and mercury levels in blood, air, and nails. In conclusion, reference intervals of cadmium, lead, and mercury in the biological samples are environmentally related parameters. Some factors, such as gender, smoking habit, and the presence of dental amalgam fillings, may affect such levels and therefore should be considered

  3. Biological Reference Interval for Hematological Profile of Umbilical Cord Blood: A Study Conducted at A Tertiary Care Centre in South India

    Science.gov (United States)

    Raj, Reddy S. Sudheer; Priyathersini, N.; Rajendran, Rithika; Rajendran, Rashmika; Ramadoss, Umalakshmi

    2015-01-01

    Introduction Umbilical cord blood (UCB) a source of hematopoietic stem cells, is also an acceptable sample to assess neonatal sepsis. Though reports are available for stem cell counts very minimal literature is available regarding hematologic parameters, which may vary on ethnicity. Aim To establish biological reference interval for hematological parameters of umbilical cord blood to guide neonatologists, hematopoietic stem cell transplant specialists and future analysis. Materials and Methods Prospective longitudinal study was done from January 2014 to April 2014 after ethics committee approval. UCB from 120 full term new borns of normal birth weight born out of uneventful pregnancy to mothers aged between 21 to 45 years with hemoglobin above 10g/dL were processed in Beckman Coulter LH780 analyzer for complete blood count and counter checked by peripheral smear. Results tabulated in Microsoft excel are analyzed using IBM SPSS statistics 16 software. Results Male to female ratio is 1:1.05. There is no difference in the values between males and females. When compared with few studies available, though many values are comparable a few values are not comparable. Conclusion This study can be a useful guide to neonatologists, hematopoietic stem cells transplant hematologists and future analysis. PMID:26557584

  4. TSH Isoforms: About a Case of Hypothyroidism in a Down's Syndrome Young Adult

    Directory of Open Access Journals (Sweden)

    Anne-Sophie Gauchez

    2010-01-01

    Full Text Available Background. For unknown reasons, the prevalence of thyroid autoimmune disorders is higher in patients with Down's syndrome than in the general population. The present case strongly supports a recent evaluation of propagating screening for thyroid disease in this group of patients to assure early diagnosis of hypothyroidism. Methods. In a 25-year-old man diagnosed with Down's syndrome, clinical manifestations of hypothyroidism were lacking, but profound biochemical abnormalities were found with particularly high levels of thyroid stimulating hormone (TSH. Antigenic properties of TSH were characterized using a panel of anti-TSH antibodies. Results. Technical problems not infrequently associated with TSH measurements are convincingly ruled out. Antigenic characterization of the patient's circulating TSH revealed circulating forms of TSH different from pituitary TSH which closely resembled TSH recombinant human hormone. Conclusions. It appears counterintuitive that the bioactivity of TSH decreases in the hypothyroid state as higher bioactivity of TSH is anticipated in hypothyroidism promoted by an increased hypothalamic TRH drive. In contrast, diminished negative thyroid hormone feedback will enhance posttranslational glycosylation of TSH subunits and increase sialylation of the carbohydrate side chains. Both exert a negative effect on TSH bioactivity, only compensated by the very high levels of the hormone as in the present case.

  5. Application of smoothed continuous labile haemoglobin A1c reference intervals for identification of potentially spurious HbA1c results.

    Science.gov (United States)

    Loh, Tze Ping; Peng, Weng Kung; Chen, Lan; Sethi, Sunil Kumar

    2014-08-01

    We aim to develop smoothed continuous 2.5th and 97.5th percentile values for labile glycated haemoglobin A1c to glycated haemoglobin A1c (LHbA1c:HbA1c) ratio against HbA1c, and apply them on our patient population for identification of potentially spurious HbA1c measurements. The LHbA1c and HbA1c were measured using Bio-rad Variant II high-performance liquid chromatography system. We recorded the LHbA1c and HbA1c values of 1555 patients who had normal chromatograms. Using these results, the 2.5th and 97.5th percentile reference limits of the LHbA1c:HbA1c ratio were described by LHbA1c:HbA1c=-0.0072×HbA1c +0.2925 and LHbA1c:HbA1c=-0.0132×HbA1c +0.5327, respectively. When the reference intervals were applied on a separate 1000 patients, 34 and 29 of them had abnormally high and low LHbA1c:HbA1c ratios, respectively. Most of the observed high ratios were associated concurrently with elevated plasma glucose, anaemia, chronic liver and kidney diseases. A suppressed ratio was mostly associated with haemoglobin variants. Patients with heterozygous HbE or HbS variants tend to have lower LHbA1c:HbA1c ratios while the converse is true for heterozygous HbJ. The continuous LHbA1c:HbA1c ratio may be used to detect confounding factors or spurious HbA1c results, but its performance is confounded and reduced by the ambient plasma glucose. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  6. Determination of reference intervals and comparison of venous blood gas parameters using standard and non-standard collection methods in 24 cats.

    Science.gov (United States)

    Bachmann, Karin; Kutter, Annette Pn; Schefer, Rahel Jud; Marly-Voquer, Charlotte; Sigrist, Nadja

    2017-08-01

    Objectives The aim of this study was to determine in-house reference intervals (RIs) for venous blood analysis with the RAPIDPoint 500 blood gas analyser using blood gas syringes (BGSs) and to determine whether immediate analysis of venous blood collected into lithium heparin (LH) tubes can replace anaerobic blood sampling into BGSs. Methods Venous blood was collected from 24 healthy cats and directly transferred into a BGS and an LH tube. The BGS was immediately analysed on the RAPIDPoint 500 followed by the LH tube. The BGSs and LH tubes were compared using paired t-test or Wilcoxon matched-pairs signed-rank test, Bland-Altman and Passing-Bablok analysis. To assess clinical relevance, bias or percentage bias between BGSs and LH tubes was compared with the allowable total error (TEa) recommended for the respective parameter. Results Based on the values obtained from the BGSs, RIs were calculated for the evaluated parameters, including blood gases, electrolytes, glucose and lactate. Values derived from LH tubes showed no significant difference for standard bicarbonate, whole blood base excess, haematocrit, total haemoglobin, sodium, potassium, chloride, glucose and lactate, while pH, partial pressure of carbon dioxide and oxygen, actual bicarbonate, extracellular base excess, ionised calcium and anion gap were significantly different to the samples collected in BGSs ( P glucose and lactate can be made based on blood collected in LH tubes and analysed within 5 mins. For pH, partial pressure of carbon dioxide and oxygen, extracellular base excess, anion gap and ionised calcium the clinically relevant alterations have to be considered if analysed in LH tubes.

  7. Association of TSH With Cardiovascular Disease Risk in Overweight and Obese Children During Lifestyle Intervention.

    Science.gov (United States)

    Rijks, Jesse M; Plat, Jogchum; Dorenbos, Elke; Penders, Bas; Gerver, Willem-Jan M; Vreugdenhil, Anita C E

    2017-06-01

    Overweight and obese children have an increased risk to develop cardiovascular diseases (CVDs) in which thyroid-stimulating hormone (TSH) has been suggested as an intermediary factor. However, results of cross-sectional studies are inconclusive, and intervention studies investigating changes in TSH concentrations in association with changes in cardiovascular risk parameters in overweight and obese children are scarce. To gain insight in associations of circulating TSH concentrations and cardiovascular risk parameters in overweight and obese children. Nonrandomized lifestyle intervention. Centre for Overweight Adolescent and Children's Healthcare. Three hundred thirty euthyroid overweight and obese children. Long-term lifestyle intervention. TSH concentrations, pituitary TSH release in response to thyrotropin-releasing hormone (TRH), and cardiovascular risk parameters. At baseline, serum total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TAG), and monocyte chemotactic protein 1 concentrations were significantly associated with serum TSH concentrations. TSH release by the pituitary in response to exogenous TRH was not associated with cardiovascular risk parameters. During lifestyle intervention, several cardiovascular risk parameters significantly improved. In children whose body mass index z score improved, changes in TSH concentrations were significantly associated with changes in TC, LDL-C, and TAG concentrations. In euthyroid overweight and obese children, circulating TSH concentrations are positively associated with markers representing increased CVD risk. Changes in TSH concentrations are also associated with changes in lipid concentrations in children with successful weight loss, which is consistent with TSH being an intermediary factor in modulating lipid and lipoprotein metabolism. Copyright © 2017 Endocrine Society

  8. Reference intervals for biochemical and haematological analytes of juvenile captive-bred long-tailed macaques (Macaca fascicularis) from Mauritius with examination of the effects of individual characteristics using principal component analysis.

    Science.gov (United States)

    Naiken, Sandiren; Griffiths, Mary-Ann; Hurdial, Jaymahalaxmi R; Narainapoulle, Sam; Honess, Paul

    2016-12-01

    The Mauritian cynomolgus macaque (Macaca fascicularis) is widely used in biomedical research. Determining reference intervals for biochemical and haematological analytes provides an important tool for clinical diagnosis and pre-clinical research. Blood samples from 736 Mauritian long-tailed macaques were analysed to determine reference intervals of 13 biochemical and 10 haematological analytes. The need for partitioning the reference interval between males and females was determined. To examine the variation associated with age, body weight and sex on the analytes, our correlating, multivariate data set was first reduced using principal component analysis, and then the effect of these characteristics on factor scores was examined using GLM analysis. Partitioning of reference intervals, based on sex, was recommended for albumin, alkaline phosphatase and mean corpuscular haemoglobin. Sex significantly influenced the concentration of lymphocytes, granulocytes and white blood cells. These findings provide useful reference data for research involving Mauritian long-tailed macaques. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  9. Recombinant TSH stimulated remnant ablation therapy in thyroid cancer: the success rate depends on the definition of ablation success--an observational study.

    Directory of Open Access Journals (Sweden)

    Anouk N A van der Horst-Schrivers

    Full Text Available Patients with differentiated thyroid cancer (DTC are treated with (near-total thyroidectomy followed by remnant ablation. Optimal radioiodine-131 (131I uptake is achieved by withholding thyroid hormone (THW, pretreatment with recombinant human Thyrotropin Stimulating Hormone (rhTSH is an alternative. Six randomized trials have been published comparing THW and rhTSH, however comparison is difficult because an uniform definition of ablation success is lacking. Using a strict definition, we performed an observational study aiming to determine the efficacy of rhTSH as preparation for remnant ablation.Adult DTC patients with, tumor stage T1b to T3, Nx, N0 and N1, M0 were included in a prospective multicenter observational study with a fully sequential design, using a stopping rule. All patients received remnant ablation with 131I using rhTSH. Ablation success was defined as no visible uptake in the original thyroid bed on a rhTSH stimulated 150 MBq 131I whole body scan (WBS 9 months after remnant ablation, or no visible uptake in the original thyroid bed on a post therapeutic WBS when a second high dose was necessary.After interim analysis of the first 8 patients, the failure rate was estimated to be 69% (90% confidence interval (CI 20-86% and the inclusion of new patients had to be stopped. Final analysis resulted in an ablation success in 11 out of 17 patients (65%, 95% CI 38-86%.According to this study, the efficacy of rhTSH in the preparation of 131I ablation therapy is inferior, when using a strict definition of ablation success. The current lack of agreement as to the definition of successful remnant ablation, makes comparison between different ablation strategies difficult. Our results point to the need for an international consensus on the definition of ablation success, not only in routine patient's care but also for scientific reasons.Dutch Trial Registration NTR2395.

  10. Development of a high-resolution melting genotyping assay for the angiotensin I converting enzyme insertion/deletion polymorphism and establishment of genotype-specific reference intervals in a Danish population.

    Science.gov (United States)

    Nissen, Peter H; Campbell, Nina Buntzen; Højskov, Carsten S; Fløe, Andreas; Hoffmann, Hans Jürgen; Hilberg, Ole; Ladefoged, Søren A; Møller, Holger J

    2015-01-01

    The serum-angiotensin I converting enzyme (s-ACE) activity is influenced by a genetic insertion/deletion (I/D) polymorphism in the ACE gene, and the resulting large interindividual variation in s-ACE limits the use of normal reference intervals in the evaluation of sarcoidosis. In this study, we developed a new method for genotyping the I/D polymorphism in ACE and established genotype-specific reference intervals in order to improve the diagnostic accuracy and the value for treatment of sarcoidosis. The new genotyping assay is based on high-resolution melting (HRM) using LCGreen + and was used to genotype 400 healthy Danish individuals. The assay was compared to a real-time polymerase chain reaction (RT-PCR) assay in a validation set of 86 samples. Enzyme activity in serum was measured using the Infinity™ ACE Liquid Stable Reagent from Thermo adapted for the ABX Pentra analyzer. There was full concordance between genotyping assays. The three genotypes II, ID and DD were present with a frequency of 0.23, 0.51 and 0.26. The distribution of s-ACE values in the total population was non-Gaussian (non-parametric 95% reference interval 12.0-60.0 U/L). The median activities of the genotypes differed significantly (Preference intervals for the subpopulations were determined to 6.3-38.5, 14.0-56.0 and 23.3-71.2 U/L for II, ID and DD, respectively. We have developed a simple and robust method for ACE genotyping and determined genotype-specific reference intervals for s-ACE concentrations in the Danish population. The new reference intervals may increase the value of s-ACE measurements. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  11. Recombinant TSH in follow-up and therapy of differentiated thyroid carcinoma; Rekombinantes TSH in der Nachsorge und Therapie des differenzierten Schilddruesenkarzinoms

    Energy Technology Data Exchange (ETDEWEB)

    Luster, M.; Reiners, C. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2000-03-01

    I-131-scintigraphy and serum thyroglobulin testing - if possible under stimulation of thyrotropin - are besides physical examination and ultrasonography crucial for the optimal follow-up of patients with well-differentiated thyroid carcinoma. This required physicians to withdraw patients from thyroid hormone suppression therapy (THST) for several weeks in order to raise endogenous TSH-levels. Clinical hypothyroidism often results in substantial patient discomfort, with sometimes major psychic alterations; the subsequent disability to work is occasionally an unpleasant consequence from an economical point of view. The temporary use of bovine, and for a short period of time human TSH is obsolete today because of a high risk of allergic reactions or the potential transmission of the Creutzfeldt-Jakob disease, respectively. Lately recombinant human TSH (rhTSH, Thyrogen {sup trademark}), a hormone that was developed with the help of genetic engineering techniques, is available; its pharmacological safety has been demonstrated in previous phase-I/II-studies. The results of a phase-III-study showed in the majority of patients a marked rise in thyroglobulin levels after rhTSH. In all cases an adequate TSH level (>100 mU/l) was achieved after i.m. injection of recombinant TSH. Wholebody-scans showed a high level of accordance (>90%) in addition to a substantially lower background-activity. A tumour-background-ratio corresponding to conventional imaging could be demonstrated. (orig.) [German] Neben der klinischen Untersuchung und der Sonographie stellen die I-131-Szintigraphie sowie der Tumormarker Thyreoglobulin (Tg) - die Bestimmung von Tg moeglichst unter Stimulationsbedingungen - die Saeulen des Nachsorgekonzeptes beim differenzierten Schilddruesenkarzinom dar. Zur Induktion der endogenen TSH-Stimulation war es bislang erforderlich, eine mehrwoechige Phase des Absetzens der suppressiven Schilddruesenhormongabe mit konsekutiver Hypothyreose herbeizufuehren. Die

  12. Dose-dependent acute effects of recombinant human TSH (rhTSH) on thyroid size and function. Comparison of 0.1, 0.3 and 0.9 mg of rhTSH

    DEFF Research Database (Denmark)

    Fast, Søren; Nielsen, Viveque Egsgaard; Bonnema, Steen Joop

    2009-01-01

    Context: Recombinant human TSH (rhTSH) is used to augment the effect of radioiodine therapy for nontoxic multinodular goitre. Reports of acute thyroid swelling and hyperthyroidism warrant safety studies evaluating whether these side-effects are dose-dependent. Objective: To determine the effects...... on thyroid size and function of various doses of rhTSH. Design: In nine healthy male volunteers the effect of placebo, 0.1, 0.3 and 0.9 mg of rhTSH was examined in a paired design including four consecutive study rounds. Main outcome measures: Were evaluated at baseline, 24h, 48h, 96h, 7 days and 28 days...... after rhTSH and included: Thyroid volume (TV) estimation by planimetric ultrasound, and thyroid function by serum TSH, freeT3, freeT4 and Tg levels. Results: Following placebo or 0.1 mg rhTSH the TV did not change significantly from baseline at any time. At 24 and 48 hours after administration of 0.3 mg...

  13. HUBUNGAN ANTARA STATUS TSH IBU HAMIL DENGAN RIWAYAT KEHAMILAN DAN KELAHIRAN DI DAERAH ENDEMIK GAKI

    Directory of Open Access Journals (Sweden)

    Yusi Dwi Nurcahyani

    2013-02-01

    Full Text Available Background: Excess of iodine during pregnancy can give a special problem. Diagnosis of hyperthyroidism during pregnancy can cause first-trimester spontaneous abortions, high rates ofstill births and neonatal deaths, two- to threefold increases in the frequency of low birth weight infants, preterm delivery, fetal or neonatal hyperthyroidism, and intrauterine growth retardation. Odjective: These studies examine the relationship between TSH levels in pregnant women with a history of pregnancy and birth mothers in1DD endemic areas. Method: This study is a non-intervention with cross sectional comparative design. ln previous research carried out screening for pregnant women who live in areas of endemic iodine deficiency disorder. From the results of screening found 67 pregnant women, where 32 pregnant women have a lower TSH «0.3 ulll/ml and 35 pregnant women had normal TSH levels (0.3-3.611'1U/ml. After giving birth mothers checked TSH level again and recorded the history o[his birth. Result: ln this study there was no difference for complaints during pregnancy that leads to the signs ofhyperthvroidism between group of pregnant women with low TSH and group of pregnant women with normal TSH. There was no significant difference between postpartum maternal TSH and TSH babies group ofpregnant women with low TSH and group ofpregnant women with normal TSH. There was a significant differencefor TSH mother before and after deli velJl. Conclusions: Low serum TSH value has no effect on the clinical state ofpregnant women and infants born allegedly under the influence of the increase olhCG in the .first trimester of pregnancy, is not because of the circumstances leading to hyperthyroid mothers. But in this study hCG levels pregnant women are not were measured. Key words: low TSH, pregnant women, birth mothet.

  14. Interval Training

    Science.gov (United States)

    Healthy Lifestyle Fitness Interval training can help you get the most out of your workout. By Mayo Clinic Staff Are you ready to shake up ... more time at the gym? Consider aerobic interval training. Once the domain of elite athletes, interval training ...

  15. TSH Receptor Signaling Abrogation by a Novel Small Molecule.

    Science.gov (United States)

    Latif, Rauf; Realubit, Ronald B; Karan, Charles; Mezei, Mihaly; Davies, Terry F

    2016-01-01

    Pathological activation of the thyroid-stimulating hormone receptor (TSHR) is caused by thyroid-stimulating antibodies in patients with Graves' disease (GD) or by somatic and rare genomic mutations that enhance constitutive activation of the receptor influencing both G protein and non-G protein signaling. Potential selective small molecule antagonists represent novel therapeutic compounds for abrogation of such abnormal TSHR signaling. In this study, we describe the identification and in vitro characterization of a novel small molecule antagonist by high-throughput screening (HTS). The identification of the TSHR antagonist was performed using a transcription-based TSH-inhibition bioassay. TSHR-expressing CHO cells, which also expressed a luciferase-tagged CRE response element, were optimized using bovine TSH as the activator, in a 384 well plate format, which had a Z score of 0.3-0.6. Using this HTS assay, we screened a diverse library of ~80,000 compounds at a final concentration of 16.7 μM. The selection criteria for a positive hit were based on a mean signal threshold of ≥50% inhibition of control TSH stimulation. The screening resulted in 450 positive hits giving a hit ratio of 0.56%. A secondary confirmation screen against TSH and forskolin - a post receptor activator of adenylyl cyclase - confirmed one TSHR-specific candidate antagonist molecule (named VA-K-14). This lead molecule had an IC 50 of 12.3 μM and a unique chemical structure. A parallel analysis for cell viability indicated that the lead inhibitor was non-cytotoxic at its effective concentrations. In silico docking studies performed using a TSHR transmembrane model showed the hydrophobic contact locations and the possible mode of inhibition of TSHR signaling. Furthermore, this molecule was capable of inhibiting TSHR stimulation by GD patient sera and monoclonal-stimulating TSHR antibodies. In conclusion, we report the identification of a novel small molecule TSHR inhibitor, which has the

  16. Relationship between serum TSH and the responsiveness of toxic solitary autonomous thyroid nodules to radioiodine therapy

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, U; Kirkegaard, B C

    1998-01-01

    OBJECTIVE: To investigate if serum TSH at the time of 131I therapy influences the outcome. DESIGN: A retrospective analysis of data on 39 consecutive patients with toxic solitary autonomous thyroid nodules treated with 131I during a 4 year period. METHODS: Serum TSH was determined by an ultrasens......OBJECTIVE: To investigate if serum TSH at the time of 131I therapy influences the outcome. DESIGN: A retrospective analysis of data on 39 consecutive patients with toxic solitary autonomous thyroid nodules treated with 131I during a 4 year period. METHODS: Serum TSH was determined...... hypothyroidism both had detectable serum TSH at the time of 131I treatment. No other clinical parameter seemed to influence the outcome. CONCLUSION: There is no clinically significant effect of circulating TSH on the response of toxic solitary autonomous thyroid nodules to 131I therapy. However, keeping...

  17. Effect of Sulpirid on blood serum prolactin- and TSH-levels

    International Nuclear Information System (INIS)

    Foldes, J.; Gyertyanfi, G.; Borvendeg, J.

    1979-01-01

    Euthyreoid and hyperthyreoid women were subjected to examinations investigating the effect of a dopamine-antagonist (Sulpirid) on serum TSH and prolactin (LTH)-levels. For measurements of serum concentrations the following kits were used: prolactine: CIS; TSH: Ria-mat-TSH (Byk-Mallinkrodt); thyroxine: Tiopac T 4 (Amersham); triiodothyronine: Ria-mat-T 3 (Byk-Mallinkrodt). Sulpirid increased both the LTH and the TSH-levels. In case of hyperthyreosis the effect of Sulpirid on LTH-levels was less pronounced and it had no effect on serum-TSH at all. Pre-treatment with a dopamine-agonist (Bromocryptin) impeded the effect of Sulpirid. It is concluded that dopamine-receptors do have a role in the regulation of TSH-secretion in the hypophysis. (L.E.)

  18. School based screening for hypothyroidism in Down's syndrome by dried blood spot TSH measurement

    OpenAIRE

    Noble, S; Leyland, K; Findlay, C; Clark, C; Redfern, J; Mackenzie, J; Girdwood, R; Donaldson, M

    2000-01-01

    OBJECTIVE—To determine the feasibility of annual hypothyroid screening of children with Down's syndrome by measuring thyroid stimulating hormone (TSH) on dried blood spots at school, and to describe the outcome in positive children.
DESIGN—Establishment of a register of school children with Down's syndrome, and procedures for obtaining permission from parents, annual capillary blood samples, TSH measurement, and clinical assessment of children with TSH values > 10 mU/litr...

  19. Serum TSH levels are associated with cardiovascular risk factors in overweight and obese adolescents.

    Science.gov (United States)

    Souza, Luciana Lopes de; Guedes, Erika Paniago; Teixeira, Patrícia Fátima Dos Santos; Moreira, Rodrigo Oliveira; Godoy-Matos, Amelio Fernando; Vaisman, Mario

    2016-01-01

    To investigate the relationship between serum thyrotropin (TSH), insulin resistance (IR), and cardiovascular risk factors (CRF) in a sample of overweight and obese Brazilian adolescents. A retrospective, longitudinal analysis of 199 overweight and obese pubescent adolescents was performed. The TSH and free T4 (fT4) levels, anthropometric measurements, and laboratory test results of these patients were analyzed. 27 individuals (13.56%) presented with TSH levels above the normal level (subclinical hypothyroidism [SCH]). Their waist circumference (WC) was significantly higher than those of euthyroid individuals. Serum TSH was positively correlated with the homeostasis model assessment of insulin resistance (HOMA-IR) index, triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). Using TSH and BMI as independent variables, TSH levels were shown to be independently related to HOMA-IR (p=0.001) and TG (p=0.007). Among euthyroid subjects, individuals with TSH values <2.5mIU/mL exhibited statistically significant decreases in waist-to-hip ratio, HDL-C levels, and HOMA-IR scores and a tendency toward lower WC values. SCH in overweight and obese adolescents appears to be associated with excess weight, especially visceral weight. In euthyroid adolescents, there appears to be a direct relationship between TSH and some CRF. In conclusion, in the present sample of overweight and obese adolescents, TSH levels appear to be associated with IR and CRF. Copyright © 2016 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  20. Functional Evaluation of TSH Secretory Reserve Capacity in Hypothalamo pituitary Disorders

    International Nuclear Information System (INIS)

    Kim, Sun Yong; Choi, Kyoo Ok; Park, Chang Yun; Huh, Kab Bum; Ryu, Kyung Ja

    1979-01-01

    The TRH stimulation test was known as a highly diagnostic method in hypothalamo pituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were 25 follows: 1) In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2) All 2 acromegaly patients showed normal TSH response. 3) In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4) In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5) Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6) In diabetes inspidus, TSH response were all absent. 7) In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

  1. Functional Evaluation of TSH Secretory Reserve Capacity in Hypothalamo pituitary Disorders

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Sun Yong; Choi, Kyoo Ok; Park, Chang Yun; Huh, Kab Bum; Ryu, Kyung Ja [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-03-15

    The TRH stimulation test was known as a highly diagnostic method in hypothalamo pituitary disorders. To evaluate the location and the extension of the lesion, we estimated TSH response to TRH test in 27 patients. Correlation between volume of sella and TSH response was also studied. The results obtained were 25 follows: 1) In Sheehan's syndrome, TSH response after TRH test were not observed in all of 12 patients. 2) All 2 acromegaly patients showed normal TSH response. 3) In 4 cases of chromophobe adenoma, 2 cases showed no TSH response. In 2 responded cases, one patient whose tumor mass extended to suprasella region was hypothyroid state. 4) In craniopharyingioma 3 cases, the tumor which extended to intrasella showed hypothyroid and no TSH response. 5) Correlation between volume of sella and TSH response were valuable in 2 cases, but no diagnostic significance. 6) In diabetes inspidus, TSH response were all absent. 7) In primary amenorrhea, TSH response observed in 1 case, which conformed with isolated FSH deficiency.

  2. El referéndum europeo: la decisiva intervención de los soberanos nacionales en el proceso de integración

    Directory of Open Access Journals (Sweden)

    Victor Manuel Cuesta López

    2017-12-01

    Full Text Available Resumen: En los últimos meses hemos asistido a la proliferación de referéndums en los Estados miembros de la Unión Europea que vienen a cuestionar importantes avances en la integración o, incluso, la propia pertenencia a la Unión.  En este contexto, el presente artículo se propone delimitar el concepto de referéndum europeo para, a continuación, presentar la evolución de sus convocatorias a lo largo de las distintas fases del proceso de integración. También propondremos la sistematización de las consultas celebradas en función de su naturaleza jurídico-constitucional (referéndum obligatorio o facultativo y las presentaremos atendiendo al objeto de las mismas: referéndums de pertenencia (adhesión, ampliación de terceros o permanencia, referéndums de ratificación de los tratados constitutivos y sus sucesivas reformas y referéndums sobre políticas europeas específicas. A pesar de que cada referéndum europeo responde a contextos jurídicos y políticos nacionales muy particulares, trataremos de determinar si existe alguna relación entre el tipo de consulta convocada y su resultado favorable o contrario a una mayor integración. Palabras clave: referéndum, Unión Europea, soberanía, democracia directa. Abstract: The referendums held during the last months in several Member States of the European Union have openly questioned essential aspects of the integration process or even the membership. In this context, this article aims to define the concept of European referendum, to present its evolution throughout the integration process, and to propose its categorization according to their legal nature (compulsory or facultative referendum and their subject matter (enlargement, ratification of the Treaties or specific European policies. Although each European referendum responds to very specific legal and political contexts, this article tries to determine whether there is any relationship between the type of consultation and

  3. Recombinant human TSH in differentiated thyroid cancer: a nuclear medicine perspective

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P. [CEA, DSV, I2BM, SHFJ, LMNRB, Orsay (France); Rubello, D. [Osped S Maria Misericordia, IRCCS, IOV, Dept Nucl Med, PET Ctr, I-45100 Rovigo (Italy); Hindie, E. [Hop St Louis, Dept Nucl Med, Paris (France)

    2008-07-01

    The use of recombinant human thyroid-stimulating hormone (rhTSH) in differentiated thyroid cancer (DTC) is widely discussed in the literature with regard to the diagnostic and therapeutic aspects of the management of DTC patients. However, some controversy about the appropriate indications, advantages and potential disadvantages of the use of rhTSH may still exist within the community of nuclear medicine physicians. In our opinion, the clinical benefits of rhTSH in avoiding hypothyroidism outweigh its somewhat lesser diagnostic accuracy. However, we disagree on designating rhTSH as the 'golden standard' to obtain TSH stimulation, as suggested by some authors. Thus, the first follow-up examination after ablation, which is determinant for patients' prognostic classification, can be either done under rhTSH stimulation or after hormone withdrawal. In our practice, and for higher risk patients, we still favour performing the initial follow-up after thyroid hormone withdrawal. rhTSH also shows the ability to enhance radioiodine concentration into thyroid cells. This characteristic is obviously of great interest among the nuclear medicine community. In clinical practice, it seems preferable to perform {sup 131}I treatment for metastatic disease during hypothyroidism. rhTSH may find its utility for the treatment of specific populations of patients, i.e. those in whom hormone withdrawal is medically contraindicated or in whom adequate endogenous TSH levels cannot be obtained due to reduced pituitary reserve or continued thyroxine production by metastatic tissue. In conclusion, rhTSH has demonstrated to be a reliable alternative to hypothyroidism for the stimulation of Tg in the follow-up of thyroid cancer patients. However, its use must be more carefully chosen in the therapeutic setting. Our feeling is that rhTSH should no tbe used for remnant ablation in high-risk patients and for the treatment of metastatic disease, except for specific populations of

  4. Interval Training.

    Science.gov (United States)

    President's Council on Physical Fitness and Sports, Washington, DC.

    Regardless of the type of physical activity used, interval training is simply repeated periods of physical stress interspersed with recovery periods during which activity of a reduced intensity is performed. During the recovery periods, the individual usually keeps moving and does not completely recover before the next exercise interval (e.g.,…

  5. Reference Intervals for Plasma l-Arginine and the l-Arginine:Asymmetric Dimethylarginine Ratio in the Framingham Offspring Cohort123

    OpenAIRE

    Lüneburg, Nicole; Xanthakis, Vanessa; Schwedhelm, Edzard; Sullivan, Lisa M.; Maas, Renke; Anderssohn, Maike; Riederer, Ulrich; Glazer, Nicole L.; Vasan, Ramachandran S.; Böger, Rainer H.

    2011-01-01

    l-Arginine, as a precursor of NO synthesis, has attracted much scientific attention in recent years. Experimental mouse models suggest that l-arginine supplementation can retard, halt, or even reverse atherogenesis. In human studies, supplementation with l-arginine improved endothelium-dependent vasodilation. However, l-arginine levels are best interpreted in the context of levels of asymmetric dimethylarginine (ADMA), a competitive inhibitor of NO synthase. Thus, reference limits for circula...

  6. Reference Intervals for Plasma l-Arginine and the l-Arginine:Asymmetric Dimethylarginine Ratio in the Framingham Offspring Cohort123

    Science.gov (United States)

    Lüneburg, Nicole; Xanthakis, Vanessa; Schwedhelm, Edzard; Sullivan, Lisa M.; Maas, Renke; Anderssohn, Maike; Riederer, Ulrich; Glazer, Nicole L.; Vasan, Ramachandran S.; Böger, Rainer H.

    2011-01-01

    l-Arginine, as a precursor of NO synthesis, has attracted much scientific attention in recent years. Experimental mouse models suggest that l-arginine supplementation can retard, halt, or even reverse atherogenesis. In human studies, supplementation with l-arginine improved endothelium-dependent vasodilation. However, l-arginine levels are best interpreted in the context of levels of asymmetric dimethylarginine (ADMA), a competitive inhibitor of NO synthase. Thus, reference limits for circulating l-arginine and the l-arginine:ADMA ratio may help to determine the nutritional state of individuals at high cardiovascular risk in light of increased ADMA levels. We defined reference limits for plasma l-arginine in 1141 people and for the l-arginine:ADMA ratio in 1138 relatively healthy individuals from the Framingham Offspring Cohort. Plasma l-arginine and ADMA concentrations were determined by using a stable isotope-based LC-MS/MS method. The reference limits (2.5th and 97.5th percentiles) for plasma l-arginine were 41.0 μmol/L (95% CI = 39.5–42.5 μmol/L) and 114 μmol/L (95% CI = 112–115 μmol/L), whereas corresponding reference limits (2.5th and 97.5th percentiles) for the l-arginine:ADMA ratio were 74.3 μmol/L (95% CI = 71.1–77.3 μmol/L) and 225 μmol/L (95% CI = 222–228 μmol/L). Plasma l-arginine was positively associated with the estimated glomerular filtration rate (eGFR) and blood glucose levels, whereas the l-arginine:ADMA ratio was positively associated with eGFR and diastolic blood pressure but inversely associated with homocysteine and (log)C-reactive protein. We report reference levels for plasma l-arginine and for the l-arginine:ADMA ratio that may be helpful for evaluation of the effects of l-arginine supplementation in participants with an impaired l-arginine/NO pathway. PMID:22031661

  7. Radioiodine therapy of benign non-toxic goitre. Potential role of recombinant human TSH

    DEFF Research Database (Denmark)

    Fast, S; Bonnema, S J; Hegedüs, L

    2011-01-01

    This review provides an update on recombinant human TSH (rh-TSH) augmented radioiodine (¹³¹I) therapy and outlines its potential role in the treatment of symptomatic benign multinodular non-toxic goitre. In some countries, ¹³¹I has been used for three decades to reduce the size of nodular goitres...

  8. Does the use of recombinant TSH in preparation for I-131 scintigraphy scan affect hearing function?

    Directory of Open Access Journals (Sweden)

    Mehtap Doğan

    2018-03-01

    Conclusion: Sensorineural hearing loss was detected, especially at low frequencies, in patients with DTC after surgical treatment whose hormone replacement therapy was withdrawn but not in those receiving rhTSH. It is therefore preferred to use rhTSH when preparing for I-131 scintigraphy scan in patients at risk for hearing loss.

  9. Biological impact of the TSH-beta splice variant in health and disease

    Directory of Open Access Journals (Sweden)

    John R. Klein

    2014-04-01

    Full Text Available Thyroid stimulating hormone (TSH, a glycoprotein hormone composed of alpha and beta chains, is produced by thryrotrope cells of the anterior pituitary. Within the conventional endocrine loop, pituitary-derived TSH binds to receptors in the thyroid, resulting in the release of the thyroid hormones thyroxine (T4 and triiodothyronine (T3. T4 and T3 in turn regulate nearly every aspect of mammalian physiology, including basal metabolism, growth and development, and mood and cognition. Although TSH-beta has been known for years to be produced by cells of the immune system, the significance of that has remained largely unclear. Recently, a splice variant of TSH-beta (TSH-beta-v, which consists of a truncated but biologically functional portion of the native form of TSH-beta, was shown to be produced by bone marrow cells and peripheral blood leukocytes, particularly cells of the myeloid/monocyte lineage. In contrast, full-length native TSH-beta is minimally produced by cells of the immune system. The present article will describe the discovery of the TSH-beta-v and will discuss its potential role in immunity and autoimmunity, inflammation, and bone remodeling.

  10. Radioimmunoassay of human thyrotropin (TSH): an improvement on microtiter plate method

    International Nuclear Information System (INIS)

    Romaldini, J.H.; Rodrigues, H.F.; Tanaka, L.M.; Teixeira, V.L.; Reis, L.C.F.

    1980-01-01

    A methodological improvement is presented of solid phase (microtiter 'U' plates) radioimmunoassay of human TSH. The high concentration (1:1 x 10 4 ) of anti-TSH serum was adsorbed by microtiter cups. The bound and free 125 I-TSH was separated by simple washng with distilled water. The assay was completed within 48 hours. Minimal labeled TSH damage was achieved by a) repurification of 125 I-TSH by a high Sephadex G-100 (1.5 x 70 cm) column on the day ofssay; b) satisfactory low specific activity (67+- 27.5 uCi/ug); c) stoage with 0.2% BSA-PBS (1:5 dilution) at-80 0 C up to 4 weeks. Maximal binding was 59 +- 13%. The minimum detectable amount of TSH in this assay was 0.13 uU/cup. The microtiter plate radioimmunoassay for TSH was reproducible and precise (interassay variability 11.6 to 18.8%, interassay variability 12 to 22.6%). The recovery of standard TSH was 101+- 16% (r=0,939). Results obtained from the clinical application of the method are related. (Author) [pt

  11. Higher TSH Levels Within the Normal Range Are Associated With Unexplained Infertility.

    Science.gov (United States)

    Orouji Jokar, Tahereh; Fourman, Lindsay T; Lee, Hang; Mentzinger, Katherine; Fazeli, Pouneh K

    2018-02-01

    Unexplained infertility (UI), defined as the inability to conceive after 12 months of unprotected intercourse with no diagnosed cause, affects 10% to 30% of infertile couples. An improved understanding of the mechanisms underlying UI could lead to less invasive and less costly treatment strategies. Abnormalities in thyroid function and hyperprolactinemia are well-known causes of infertility, but whether thyrotropin (TSH) and prolactin levels within the normal range are associated with UI is unknown. To compare TSH and prolactin levels in women with UI and women with a normal fertility evaluation except for an azoospermic or severely oligospermic male partner. Cross-sectional study including women evaluated at a large academic health system between 1 January 2000 and 31 December 2012 with normal TSH (levels within the normal range of the assay and ≤5 mIU/L) and normal prolactin levels (≤20 ng/mL) and either UI (n = 187) or no other cause of infertility other than an azoospermic or severely oligospermic partner (n = 52). TSH and prolactin. Women with UI had significantly higher TSH levels than controls [UI: TSH 1.95 mIU/L, interquartile range: (1.54, 2.61); severe male factor: TSH 1.66 mIU/L, interquartile range: (1.25, 2.17); P = 0.003]. This finding remained significant after we controlled for age, body mass index, and smoking status. Nearly twice as many women with UI (26.9%) had a TSH ≥2.5 mIU/L compared with controls (13.5%; P < 0.05). Prolactin levels did not differ between the groups. Women with UI have higher TSH levels compared with a control population. More studies are necessary to determine whether treatment of high-normal TSH levels decreases time to conception in couples with UI. Copyright © 2017 Endocrine Society

  12. Hematology and serum chemistry in stranded and wild-caught harbor seals in central California: reference intervals, predictors of survival, and parameters affecting blood variables.

    Science.gov (United States)

    Greig, Denise J; Gulland, Frances M D; Rios, Carlos A; Hall, Ailsa J

    2010-10-01

    Blood was collected from stranded harbor seal (Phoca vitulina) pups at admission (n=64) and release (n=45) from rehabilitation in 2007 and 2008 and from wild-caught harbor seal pups, subadults, and adults (n=110) in 2004, 2007, and 2008. Blood values measured at the time of admission were not predictive of survival during rehabilitation. Mass was associated with survival until release, and all pups that died weighed less than 10 kg at the time of admission. Döhle bodies were observed in leukocytes from 15% to 22% of the pups in rehabilitation, but not in the wild pups. Thresholds (95% confidence intervals) among wild pups were less than those in the released pups for leukocytes, neutrophils, total cholesterol, alanine aminotransferase (ALT), glucose, phosphorus, sodium, potassium, total protein, albumin, and globulin; thresholds were greater in wild pups than in released pups for hemoglobin (HGB), hematocrit (HCT), and glucose. Thresholds among released pups were less than those in wild pups for HGB, HCT, mean cell volume, chloride, and creatine kinase; thresholds among released pups were greater than those in wild pups for neutrophils, platelets, total cholesterol, triglycerides, ALT, aspartate aminotransferase, sorbitol dehydrogenase, bilirubin, phosphorus, potassium, total protein, and albumin. Age, girth, and geographic location affected the blood variables from wild-caught pups; age class, geographic location, sex, and body condition affected the blood variables of wild-caught, subadult and adult harbor seals.

  13. Intestinal TSH production is localized in crypt enterocytes and in villus 'hotblocks' and is coupled to IL-7 production: evidence for involvement of TSH during acute enteric virus infection.

    Science.gov (United States)

    Scofield, Virginia L; Montufar-Solis, Dina; Cheng, Elly; Estes, Mary K; Klein, John R

    2005-06-15

    The immune and neuroendocrine systems have been shown to work conjointly in a number of ways. One aspect of this has to do with a potential role for thyroid stimulating hormone (TSH) in the regulation of the mucosal immune system, although the mechanisms by which this occurs remain vague. To more thoroughly understand how TSH participates in intestinal intraepithelial lymphocyte (IEL) development and immunity, experiments have been conducted to define local sites of intestinal TSH production, and to characterize changes that occur in the synthesis of TSH during acute enteric virus infection. Here, we demonstrate that TSH in the small intestine is specifically localized to regions below villus crypts as seen by immunocytochemical staining, which revealed high-level TSH staining in lower crypts in the absence of IL-7 staining, and TSH and IL-7 co-staining in upper crypt regions. Additionally, prominent TSH staining was evident in TSH 'hotblocks' sparsely dispersed throughout the epithelial layer. In rotavirus-infected mice, the TSH staining pattern differed significantly from that of non-infected animals. Notably, at 2 and 3 days post-infection, TSH expression was high in and near apical villi where virus infection was greatest. These findings lend credence to the notion that TSH plays a role both in the development of intestinal T cells, and in the process of local immunity during enteric virus infection.

  14. Modified-Release Recombinant Human TSH (MRrhTSH) Augments the Effect of 131I Therapy in Benign Multinodular Goiter: Results from a Multicenter International, Randomized, Placebo-Controlled Study

    DEFF Research Database (Denmark)

    Graf, H; Fast, S; Pacini, F

    2011-01-01

    Background: Recombinant human TSH (rhTSH) can be used to enhance (131)I therapy for shrinkage of multinodular goiter (MG). Objective, Design, and Setting: The objective of the study was to compare the efficacy and safety of 0.01 and 0.03 mg modified-release (MR) rhTSH as an adjuvant to (131)I...

  15. Assessment of Serum Tri-Iodothyronine (T3, Thyroxin (T4 and Thyroid-Stimulating Hormone (TSH Levels Among Patients With Major Depressive Disorder (MDD in Hamedan, Northwestern Iran

    Directory of Open Access Journals (Sweden)

    Kassaee

    2016-04-01

    Full Text Available Background Depression is one of the most common psychiatric disorders. Over the last few years, the relationship between the hypothalamic-pituitary-thyroid (HPT axis and depression has been the focus of increasing attention. Objectives In this study, the serum levels of T3, T4, and TSH in patients with major depressive disorder have been compared to the healthy adults in Hamedan, northwestern Iran. Patients and Methods In this case-control study, serum levels of T3, T4, and TSH were measured in 32 patients with major depression, diagnosed according to the beck depression inventory (BDI, who were referred to the Hamedan psychiatric hospital and were age- and sex-matched normal adults. Sampling was conducted through convenience sampling in a completely randomized design. Data were analyzed using an independent t-test and a one-way analysis of variance (ANOVA test. A logistic regression model was used for depression occurrence probability prediction. Results Serum T4 and TSH levels were significantly higher in depressive patients than in the control group (P = 0.01, whereas there was no significant difference in T3 serum levels between the two groups (P = 0.08. The serum TSH level was significantly higher in depressive patients compared to non-depressive patients (P = 0.001. According to logistic regression analysis, a one unit increase in serum T4 or TSH levels may enhance non-clinical depression probability by 1.3 or 1.7 times and clinical depression probability by 1.2 or 2.9 times, respectively. Conclusions Serum T4 and TSH levels in depressive patients were found to be significantly higher than those of the control group, indicating the association between serum T4 and TSH levels and depression in the subjects in 2010 - 2011 in Hamedan, northwestern Iran.

  16. Reference intervals for hematological parameters of animals bred and kept at the vivarium of the Faculty of Medicine of the State University of São Paulo

    Directory of Open Access Journals (Sweden)

    Marilda Osti Spinelli

    2014-03-01

    Full Text Available Knowledge of specific hematological parameters of laboratory animals used in experiments is highly relevant to evaluate functional alterations of their vital organs. Hematological reference rates for rats, mice, rabbits and hamsters, bred in conventional healthy conditions and derived from the Vivarium of the FMUSP’s Vivarium Center are established. One hundred and twenty mice of the strains BALB/c, C57BL / 6 and Swiss, 80 Wistar rats, 80 Golden hamsters and 80 New Zealand rabbits, males and females, apparently normal and healthy, over 10-weeks-old, were employed in current experiment. The analysis was determined by flow cytometry process (CELM CC510 involving the separation of erythrocytes and leukocytes, and cell identification by the suspension method and quantification. Hematological derivatives such as hematometric indexes (application of equations and morphological quantification of leukocytes and erythrocytes were determined by scanning/differential (Panótico-commercial, whereas hemoglobin dosage was determined by spectrophotometry (CELM E210D. Results are given as means and standard deviants of hematological profiles in the blood of the animals grouped by species, strain and sex. Data are an important asset for researchers in their analysis of experimental results. CEAU Certificate n.° 251/11 HCFMUSP.

  17. Cloning and functional characterization of a testicular TSH receptor cDNA from the African catfish (Clarias gariepinus)

    NARCIS (Netherlands)

    Vischer, H F; Bogerd, J.

    A cDNA encoding a putative thyroid-stimulating hormone receptor (cfTSH-R) was cloned from the testis of the African catfish (Clarias gariepinus). The cfTSH-R showed the highest amino acid sequence identity with the TSH-Rs of other fish species. In addition, an insertion of approximately 50 amino

  18. Urine reference intervals for human chorionic gonadotropin (hCG) isoforms by immunoextraction-tandem mass spectrometry to detect hCG use.

    Science.gov (United States)

    Butch, Anthony W; Ahrens, Brian D; Avliyakulov, Nuraly K

    2017-11-03

    Human chorionic gonadotropin (hCG) stimulates testosterone production by the testicles and can normalize suppressed testosterone concentrations in males following prolonged anabolic steroid use. Because of the potential for abuse by males, hCG is on the World Anti-Doping Agency (WADA) list of prohibited substances. The majority of WADA-accredited laboratories measure urinary hCG using an automated immunoassay. Only immunoassays that recognize the intact alpha and beta heterodimer of hCG (intact hCG) should be used to measure urinary hCG for doping control purposes since intact hCG is the only biologically active molecule. WADA further requires that confirmation testing is performed using an intact hCG immunoassay that is different from the one used in the initial testing procedure or by liquid chromatography-tandem mass spectrometry (LC-MS/MS). In this study we measured the concentration of intact hCG, free β-subunit (hCGβ) and β-subunit core fragment (hCGβcf) in 570, 275, and 256 male urine samples, respectively, by an immunoextraction LC-MS/MS method. Mean concentrations of intact hCG, hCGβ and hCGβcf were 0.04 IU/L, 0.47 pmol/L and 0.16 pmol/L, respectively. The upper reference limits (97.5 th percentile) for intact hCG, hCGβ and hCGβcf were 0.21 IU/L, 0.40 pmol/L, and 1.86 pmol/L, respectively. Based on these data, we recommend a threshold of 1.0 IU/L for intact hCG (false positive rate of hCG. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Blood analytes of oceanic-juvenile loggerhead sea turtles (Caretta caretta) from Azorean waters: reference intervals, size-relevant correlations and comparisons to neritic loggerheads from western Atlantic coastal waters

    Science.gov (United States)

    Bjorndal, Karen A; Perrault, Justin R; Martins, Helen R; Bolten, Alan B

    2018-01-01

    Abstract Blood analyte reference intervals are scarce for immature life stages of the loggerhead sea turtle (Caretta caretta). The objectives of this study were to (1) document reference intervals of packed cell volume (PCV) and 20 plasma chemistry analytes from wild oceanic-juvenile stage loggerhead turtles from Azorean waters, (2) investigate correlations with body size (minimum straight carapace length: SCLmin) and (3) compare plasma chemistry data to those from older, larger neritic juveniles (turtles with SCLmin of 17.6–60.0 cm (mean 34.9 ± 12.1 cm) were captured, sampled and immediately released. Reference intervals are reported. There were several biologically relevant correlations of blood analytes with SCLmin: positive correlations of PCV, proteins and triglycerides with SCLmin indicated somatic growth, increasing diving activity and/or diet; negative correlations of tissue enzymes with SCLmin suggested faster growth at smaller turtle size, while negative correlations of electrolytes with SCLmin indicated differences in diet, environmental conditions and/or osmoregulation unique to the geographic location. Comparisons of loggerhead turtles from the Azores (i.e. oceanic) and Cape Canaveral (i.e. neritic) identified significant differences regarding diet, somatic growth, and/or environment: in Azorean turtles, albumin, triglycerides and bilirubin increased with SCLmin, while alkaline phosphatase, lactate dehydrogenase and sodium decreased. In larger neritic Cape Canaveral turtles, aspartate aminotransferase increased with SCLmin, while the albumin:globulin ratio, phosphorus and cholesterol decreased. These differences suggest unique physiological disparities between life stage development and migration, reflecting biological and habitat differences between the two populations. This information presents biologically important data that is applicable to stranded individual turtles and to the population level, a tool for the development of conservation

  20. Recombinant TSH in follow-up and therapy of differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Luster, M.; Reiners, C.

    2000-01-01

    I-131-scintigraphy and serum thyroglobulin testing - if possible under stimulation of thyrotropin - are besides physical examination and ultrasonography crucial for the optimal follow-up of patients with well-differentiated thyroid carcinoma. This required physicians to withdraw patients from thyroid hormone suppression therapy (THST) for several weeks in order to raise endogenous TSH-levels. Clinical hypothyroidism often results in substantial patient discomfort, with sometimes major psychic alterations; the subsequent disability to work is occasionally an unpleasant consequence from an economical point of view. The temporary use of bovine, and for a short period of time human TSH is obsolete today because of a high risk of allergic reactions or the potential transmission of the Creutzfeldt-Jakob disease, respectively. Lately recombinant human TSH (rhTSH, Thyrogen trademark ), a hormone that was developed with the help of genetic engineering techniques, is available; its pharmacological safety has been demonstrated in previous phase-I/II-studies. The results of a phase-III-study showed in the majority of patients a marked rise in thyroglobulin levels after rhTSH. In all cases an adequate TSH level (>100 mU/l) was achieved after i.m. injection of recombinant TSH. Wholebody-scans showed a high level of accordance (>90%) in addition to a substantially lower background-activity. A tumour-background-ratio corresponding to conventional imaging could be demonstrated. (orig.) [de

  1. Lesion dose in differentiated thyroid carcinoma metastases after rhTSH or thyroid hormone withdrawal: {sup 124}I PET/CT dosimetric comparisons

    Energy Technology Data Exchange (ETDEWEB)

    Freudenberg, Lutz Stefan; Jentzen, Walter; Brandau, Wolfgang; Bockisch, Andreas [University of Duisburg/Essen, Department of Nuclear Medicine, Essen (Germany); Petrich, Thorsten; Knapp, Wolfram H. [Hanover University School of Medicine, Department of Nuclear Medicine, Hanover (Germany); Froemke, Cornelia [Hanover University School of Medicine, Institute of Biometry, Hanover (Germany); Marlowe, Robert J. [Spencer-Fontayne Corporation, Jersey City, NJ (United States); Heusner, Till [University of Duisburg/Essen, Department of Diagnostic and Interventional Radiology and Neuroradiology, Essen (Germany)

    2010-12-15

    Renal radioiodine excretion is {proportional_to}50% faster during euthyroidism versus hypothyroidism. We therefore sought to assess lesion dose/GBq of administered {sup 131}I activity (LDpA) in iodine-avid metastases (IAM) of differentiated thyroid carcinoma (DTC) in athyreotic patients after recombinant human thyroid-stimulating hormone (rhTSH) versus after thyroid hormone withdrawal (THW). We retrospectively compared mean LDpA between groups of consecutive patients (N = 63) receiving {sup 124}I positron emission tomography/computed tomography ({sup 124}I PET/CT) aided by rhTSH (n = 27) or THW (n = 36); we prospectively compared LDpA after these stimulation methods within another individual. Data derived from serial PET scans and one CT scan performed 2-96 h post-{sup 124}I ingestion. A mixed model analysis of covariance (ANCOVA) calculated the treatment groups' mean LDpAs adjusting for statistically significant baseline intergroup differences: non-IAM were more prevalent, median IAM count/patient lower in cervical lymph nodes and higher in distant sites, median stimulated thyroglobulin higher, mean cumulative radioiodine activity greater and prior diagnostic scintigraphy more frequent in the rhTSH patients. Mean LDpAs were: rhTSH group (n = 71 IAM), 30.6 Gy/GBq; THW group (n = 66 IAM), 51.8 Gy/GBq. The difference in group means (rhTSH less THW), -21.2 Gy/GBq, was statistically non-significant (p = 0.1667). However, the 95% confidence interval of that difference (-51.4 to + 9 Gy/GBq) suggested a trend favouring THW. The within-patient comparison found 2.9- to 10-fold higher LDpAs under THW. We found some suggestions, but no statistically significant evidence, that rhTSH administration results in a lower radiation dose to DTC metastases than does THW. A large, well-controlled, prospective within-patient study should resolve this issue. (orig.)

  2. Time to reconsider nonsurgical therapy of benign nontoxic multinodular goitre. Focus on recombinant human TSH (rhTSH) augmented radioiodine therapy

    DEFF Research Database (Denmark)

    Fast, Søren; Nielsen, Viveque; Bonnema, Steen

    2009-01-01

    alternatives are needed. Until recently, levothyroxine therapy was the preferred non-surgical alternative, but due to low efficacy and potential side-effects, it is not recommended for routine use in recent international guidelines. Conventional radioiodine (131I)-therapy has been used for two decades......, which makes 131I-therapy less feasible. Another challenge is the negative correlation between initial goitre size and goitre volume reduction (GVR). With its ability to more than double the thyroid 131I-uptake, recombinant human TSH (rhTSH) increases the absorbed radiation dose and thus enhances the GVR...... efficacy. Thus, although in its infancy, and still experimental, rhTSH-augmented 131I-therapy may profoundly alter the nonsurgical treatment of benign non-toxic MNG....

  3. Radioiodine therapy in non-toxic multinodular goitre. The possibility of effect-amplification with recombinant human TSH (rhTSH)

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, Steen J.; Nielsen, Viveque E.; Hegedues, Laszlo [Odense Univ. Hospital (Denmark). Dept. of Endocrinology and Metabolism

    2006-12-15

    There is no consensus regarding the optimum treatment of benign non-toxic goitre. L-thyroxine suppressive therapy is widely used, but there is poor evidence of its efficacy, and it may have serious adverse effects on health. Surgery is first choice in large goitres or if malignancy is suspected. {sup 131}I therapy results in a one-year goitre reduction of around 40% in multinodular goitres, usually with a high degree of patient satisfaction and improvement of the inspiratory capacity. The effect is attenuated with increasing goitre size. The risk of hypothyroidism is 22-58% within 5-8 years. A sufficient thyroid {sup 131}I uptake is mandatory for {sup 131}I therapy to be feasible and pre-stimulation with recombinant human TSH (rhTSH) increases this considerably. This leads to an increased absorbed thyroid dose by approx.75%, mainly in those patients with the lowest thyroid {sup 131}I uptake, and a more homogeneous intrathyroidal isotope distribution. Pre-stimulation with even a small dose of rhTSH seems to allow a reduction of the {sup 131}I activity while still achieving a mean goitre reduction of approximately 40% within a year. A significantly lower extrathyroidal radiation is achieved by this approach. With an unchanged {sup 131}I activity, rhTSH pre-stimulation improves the goitre reduction by 30-50%. However, this is at the expense of a higher rate of hypothyroidism, cervical pain and transient thyrotoxicosis. Of particular concern is the observation made in healthy persons, that rhTSH results in a transient average thyroid volume increase of 35%. A similar goitre swelling may cause problems in susceptible patients during rhTSH-augmented {sup 131}I therapy. Thus, this concept still needs a closer evaluation before routine use.

  4. Intervalos de referência para elementos menores e traço em cabelo humano para a população da cidade do Rio de Janeiro - Brasil Reference intervals for minor and trace elements in human hair for the population of Rio de Janeiro city, Brazil

    Directory of Open Access Journals (Sweden)

    Maria Tereza W.D. Carneiro

    2002-02-01

    Full Text Available Inductively coupled plasma mass spectrometry (ICP-MS has been used for the determination of twenty minor and trace elements in hair samples from an urban population group (N = 1775, aiming at the establishment of reliable hair reference intervals. Statistical evaluation of the data with respect to age, sex and anatomic region was performed by multivariant analysis and according to recommendations of the International Federation of Clinical Chemistry (IFCC. The results show that mainly age and anatomic region (scalp or pubis influence significantly the concentration of several elements. Comparison of the here calculated reference intervals with those previously published and used by clinical laboratories for this population showed larger discrepancies and the need for an urgent revision of these data.

  5. Protocol for thyroid remnant ablation after recombinant TSH in thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, F.; Salvai, M.E.; Niepomniszcze, H.; Tamer, E. El

    2009-01-01

    In some countries, in order to perform rhTSH-aided thyroid remnant ablation (TRA) after surgery, it is generally necessary to confirm that thyroidectomy has been almost complete. Otherwise, the nuclear medicine specialist will not administer a high radioiodine dose because it might be hazardous due to the possibility of thyroid remnant actinic thyroiditis. Considering this, it would be necessary to use two rhTSH kits (one for diagnostic purposes and the other one to administer the 131 I dose). In this study, we used an alternative protocol for TRA with the use of one kit of rhTSH in twenty patients diagnosed with low risk papillary thyroid carcinoma. All patients had negative titers of anti-thyroglobulin antibodies. Successful thyroid remnant ablation was confirmed with an undetectable rhTSH stimulated thyroglobulin level ( [es

  6. Iodine excretion during stimulation with rhTSH in differentiated thyroid carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Loeffler, M.; Weckesser, M.; Franzius, C.; Kies, P.; Schober, O. [Muenster Univ. (Germany). Dept. of Nuclear Medicine

    2003-12-01

    Aim: Elevated iodine intake is a serious problem in the diagnostic and therapeutic application of {sup 131}iodine in patients with differentiated thyroid cancer. Therefore, iodine avoidance is necessary 3 months in advance. Additionally, endogenous stimulation requires withdrawal of thyroid hormone substitution for 4 weeks. Exogenous stimulation using recombinant human TSH (rhTSH) enables the continuous substitution of levothyroxine, which contains 65.4% of its molecular weight in iodine. Thus, a substantial source of iodine intake is maintained during exogenous stimulation. Although this amount of stable iodine is comparable to the iodine intake in regions of normal iodine supply, it may reduce the accumulation of radioiodine in thyroid carcinoma tissue. The aim of this study was to assess the iodine excretion depending on different ways of stimulation. Methods: Iodine excretion was measured in 146 patients in the long term follow up after differentiated thyroid carcinoma. Patients were separated into 2 groups, those on hormone withdrawal (G I) and rhTSH-stimulated patients on hormone substitution (G II). Results: Iodine excretion was significantly lower in hypothyroid patients (G I, median 50 {mu}g/l, range: 25-600 {mu}g/l) than in those under levothyroxine medication (G II, median 75 {mu}g/l, 25-600 {mu}g/l, p<0.027). TSH in G I (median 57.0 {mu}U/ml, range: 14.4-183 {mu}U/ml) was significantly lower (p<0.001) than in G II (117 {mu}U/ml, 32.2-281 {mu}U/ml). Conclusion: Iodine excretion was higher in patients under rhTSH-stimulation than after hormone withdrawal. This may indicate an increased iodine pool in rhTSH-stimulated patients (deiodination of levothyroxine), thus limiting the sensitivity of radioiodine scanning to the level of endogenous stimulation despite significantly higher TSH levels during rhTSH-stimulation. (orig.) [German] Ziel: Eine erhoehte Iodzufuhr ist ein erhebliches Problem in der diagnostischen und therapeutischen Anwendung von {sup 131}Iod

  7. Usefulness of recombinant human TSH aided radioiodine doses administered in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Pitoia, Fabian; El Tamer, Elias; Schere, Daniel B.; Passerieu, Mariano; Bruno, Oscar D.; Niepominiszcze, Hugo

    2006-01-01

    The published studies confirming the safety and efficacy of rh TSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI) dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC). In order to establish the efficacy of RI therapy after rh TSH, we have reviewed 39 rh TSH-aided radioiodine treatments in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17), with previous thyroid bed uptake and undetectable thyroglobulin (Tg) levels under levothyroxine treatment and GII (n=11), with proven metastatic local or distant disease. Median follow-up after the first rh TSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months). Sixteen patients (94%) in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rh TSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer) and five out of the remaining patients have persistent disease. In conclusion, rh TSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94%) patients (GI). rh TSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rh TSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels. (author) [es

  8. The Changes of Serum TSH in Various States of Thyroid Function

    International Nuclear Information System (INIS)

    Ro, Heung Kyu

    1975-01-01

    The serum concentrations of thyrotropin (TSH) were measured by means of radioimmunoassay, in 98 cases of normal controls, 51 cases of hyperthyroidism, 80 cases of primary hypothyroidism and 4 cases of secondary hypothyroidism to evaluate the diagnostic significance in various functional states of the thyroid. The obtained data were analyzed in correlation with other thyroid function test values in various phases of the functional thyroid diseases. The results were as follows: 1) The serum TSH concentration in normal control group was (1.3-8.0 μU/ml). 2) The measurement of serum TSH was more significant in diagnostic accuracy compared with that of serum T 4 (75.0±12.2%). Free T-4 Index (64.2±15.2%), serum T 3 (41.0±21.0%) or T 3 resin uptake (41.1±15.8%) in evaluation of primary hypothyroidism. 3) In case of overt hypothyroidism, the serum TSH and T 4 were both abnormal, compatible with the clinical diagnosis, while in case of preclinical or mild hypothyroidism, the serum T 4 (41.2±23.8% or 50.0±25.0%) was much less reliable than serum TSH. 4) In the treatment of primary hypothyroidism with desiccated thyroid, the administration of 1 grain of the hormone per day was sufficient to suppress the serum concentration of TSH to normal range. It showed that the measurement of serum TSH concentration was a significant criteria in evaluating the efficiency of the treatment of hypothyroidism. 5) The measurement of serum TSH concentration is a very significant method in the early detection of hypothyroidism induced during or after the treatment of the hyperthyroidism with antithyroid drugs or radioactive Iodine ( 131 I).

  9. Changing reference intervals for haemoglobin in Denmark

    DEFF Research Database (Denmark)

    Ryberg-Nørholt, Judith; Frederiksen, Henrik; Nybo, Mads

    2017-01-01

    ,973 males, aged 18 - 105 years) from general practitioners and community specialists of Funen, Denmark, were extracted from the laboratory information system. The prevalence of anaemia according to the new and the old RI were investigated, and additional costs were calculated based on estimated additional...... approach for establishing new RI, here particularly for Hb, should be thoroughly considered. In general, physicians should use RI with caution....

  10. interval functions

    Directory of Open Access Journals (Sweden)

    J. A. Chatfield

    1978-01-01

    Full Text Available Suppose N is a Banach space of norm |•| and R is the set of real numbers. All integrals used are of the subdivision-refinement type. The main theorem [Theorem 3] gives a representation of TH where H is a function from R×R to N such that H(p+,p+, H(p,p+, H(p−,p−, and H(p−,p each exist for each p and T is a bounded linear operator on the space of all such functions H. In particular we show that TH=(I∫abfHdα+∑i=1∞[H(xi−1,xi−1+−H(xi−1+,xi−1+]β(xi−1+∑i=1∞[H(xi−,xi−H(xi−,xi−]Θ(xi−1,xiwhere each of α, β, and Θ depend only on T, α is of bounded variation, β and Θ are 0 except at a countable number of points, fH is a function from R to N depending on H and {xi}i=1∞ denotes the points P in [a,b]. for which [H(p,p+−H(p+,p+]≠0 or [H(p−,p−H(p−,p−]≠0. We also define an interior interval function integral and give a relationship between it and the standard interval function integral.

  11. Establishing biological reference intervals for novel platelet parameters (immature platelet fraction, high immature platelet fraction, platelet distribution width, platelet large cell ratio, platelet-X, plateletcrit, and platelet distribution width and their correlations among each other

    Directory of Open Access Journals (Sweden)

    Ritesh Sachdev

    2014-01-01

    Full Text Available Aims: This study aims to establish biological reference interval for novel platelet parameters. Settings and Design: A total of 945 healthy individuals, age ranges from 18 to 64 years (881 males and 64 females coming for voluntary blood donation from June to August 2012 (3 months were enrolled after exclusion of rejection criteria. Materials and Methods: The samples were assayed by running in complete blood count + reticulocyte mode on the Sysmex XE-2100 hematology analyzer and the reference interval for the population was calculated using Clinical and Laboratory Standards Institute guidelines. Statistical analysis used: Tests were performed using SPSS (Statistical Product and Service Solutions , developed by IBM corporation, version 13. Student t test and pearsons correlation analysis were also used. Results: The normal range for various parameters was platelet count: 150-520 × 10 3 /cu mm, immature platelet fraction (IPF: 0.3-8.7%, platelet distribution width (PDW: 8.3-25.0 fL, mean platelet volume (MPV: 8.6-15.5 fL, plateletcrit (PCT: 0.15-0.62%, high immature platelet fraction (H-IPF: 0.1-2.7%, platelet large cell ratio (P-LCR: 11.9-66.9% and platelet-X (PLT-X (ch: 11.0-22.0. Negative correlation was observed between platelet count (r = −0.468 to r = −0.531; P < 0.001 and PCT (r = −0.080 to r = −0.235; P < 0.05 to P < 0.001 with IPF, PDW, MPV, H-IPF, P-LCR, and platelet-X. IPF/H-IPF showed a positive correlation among them and also with PDW, MPV, P-LCR, platelet-X (r = +0.662 to r = +0.925; P < 0.001. Conclusions: These novel platelet parameters offer newer avenues in research and clinical use. Establishing biological reference interval for different platelet parameters would help determine true high and low values and help guide treatment decisions.

  12. Androgen-mediated development of irradiation-induced thyroid tumors in rats: dependence on animal age during interval of androgen replacement in castrated males

    International Nuclear Information System (INIS)

    Hofmann, C.; Oslapas, R.; Nayyar, R.; Paloyan, E.

    1986-01-01

    When male Long-Evans rats at age 8 weeks were radiation treated (40 microCi Na131I), thyroid follicular adenomas and carcinomas were observed at age 24 months with a high incidence of 94%. Castration of males prior to irradiation significantly reduced this tumor incidence to 60%. When testosterone (T) was replaced in castrated, irradiated male rats, differentially increased incidences of thyroid tumors occurred. Immediate (age 2-6 mo) or early (age 6-12 mo) T replacement at approximate physiologic levels led to thyroid follicular tumor incidences of 100 and 82%, respectively, whereas intermediate (12-18 mo) or late (18-24 mo) T treatment led to only 70 and 73% incidences, respectively. Continuous T replacement (2-24 mo) in castrated irradiated male rats raised thyroid tumor incidence to 100%. Since elevated thyroid-stimulating hormone (TSH) is a reported requisite for development of radiation-associated thyroid tumors, the effects of T on serum TSH levels were examined. Mean serum TSH values in all irradiated animal groups were significantly elevated above age-matched nonirradiated animals at 6, 12, 18, and 24 months. Serum TSH levels were higher in continuous T-replaced irradiated castrates than in intact, irradiated males, whereas such intact male TSH levels were greater than those for irradiated castrates without T treatment. Interval T replacement in castrated male rats was associated with increased serum TSH levels during the treatment interval and with lowered TSH levels after discontinuation of T treatment, particularly in irradiated rats. However, when irradiated, castrated males received late T replacement (age 18-24 mo), there was no elevation of TSH at the end of the treatment interval. An indirect effect of T via early stimulation of TSH may be partly responsible for the high incidence of irradiation-induced thyroid tumors in rats

  13. Effects of thyroxine (T4) and triiodothyronine (T3) on the thyrotropin (TSH) response to TSH-releasing hormone (TRH) in the rat

    International Nuclear Information System (INIS)

    Boado, R.J.; Ulloa, E.R.; Zaninovich, A.A.

    1982-01-01

    Wistar rats were treated with 7.8 or 260 nmols T4/100 g BW, 1.5 or 260 nmols T3/100 g BW, or saline as control. Twenty minutes later 1 μg TRH/100 g BW was injected iv. Heparinized blood samples were drawn at times 0 and 30 minutes (10 min post-TRH) for determination of plasma TSH, T4 and T3 by RIA. Other group of rats were administered with 150 μCi of 3',5'- 125 I-T4 prepared by iodination of 3,5-diiodothyronine. Thirty minutes later the hypophyses were removed, and chromatographed. Other group of animals were treated with 5 mg of iopanoic acid (IOP)/100 g BW. Thereafter, rats were injected iv with 260 nmols T4 or T3/100 g BW and the TRH-test performed as described above. In the control group there was a 11-fold increase in plasma TSH at 10 minutes post-TRH. In rats treated with 260 nmols T4 the post-TRH increment in plasma TSH was 5+-1-fold (p 125 I-T3 in the hypophyses 30 minutes after 125 I-T4 administration. The present data indicate that T4 is capable of depressing the release of TSH in response to TRH stimulation in normal rats. (M.E.L.) [es

  14. The effect of a physical stress on the serum levels of the thyroid hormones and TSH; Wplyw wysilku fizycznego na stezenie TSH i hormonow tarczycy we krwi

    Energy Technology Data Exchange (ETDEWEB)

    Jankowska, H.; Kijek, J.; Szymanek, B.; Tarkowska, A. [Akademia Medyczna, Lublin (Poland)

    1993-12-31

    The aim of the study was to evaluate how and in what way the serum values of the thyroid hormones and TSH are changing a physical stress. The study was performed in a group of 78 patients aged 22-67 years, accepted for the stress examination for cardiological indications. The exercise using the bicycle ergometer was started from at the level of 25 Watts and was increased after every 3 minutes by next 25 Watts. The blood samples were taken before the stress, at the maximum exercise and at 30, 60, 90 and 120 minutes after the end of the stress test. The serum concentrations of TT{sub 4}, FT{sub 4}, TT{sub 3}, FT{sub 3}, r-T{sub 3} and TSH were measured using the RIA and FIA methods. The value of hematocrit was also evaluated in all blood samples. In all the patients under observation strenuous physical stress provides significant changes in TT{sub 4}, FT{sub 4}, TT{sub 3}, FT{sub 3}, r-T{sub 3} and TSH concentrations in the serum. The maximum changes revealed TSH. The observed changes in the hormone concentration did not correlate significantly with the degree of the exercise and with the heart function. (author). 32 refs, 2 figs, 4 tabs.

  15. Stable expression of human thyrotropin (hTSH) in mammalian cells (CHO) expressing α2,6 sialyltransferase

    International Nuclear Information System (INIS)

    Damiani, Renata

    2009-01-01

    A CHO cell line, previously genetically modified by the introduction of rat α2,6-sialyltransferase cDNA, generated for the first time a human-like sialylated recombinant hTSH (hlsr-hTSH) more similar to the native hormone, with 61% of α2,3- and 39% of α2,6-linked sialic acid residues. The best clone, when submitted to gene amplification with up to 8 μM methotrexate, presented a secretion level of ∼2 μg hTSH/10 6 cells/day, useful for product purification and characterization. The relative molecular masses (M r ) of the heterodimer and of the α- and β-subunits of purified hlsr-hTSH, determined by MALDI-TOF mass spectrometry, and the relative hydrophobicities, determined by RP-HPLC, were not remarkably different from those presented by two r-hTSH preparations secreted by normal CHO cells. Some differences were observed, though, in N-glycan composition, with more tri- and much more tetra-sialylated structures in hlsr-hTSH. When analyzed via an in vivo bioassay based on hTSH-induced T 4 release in mice, hlsr-hTSH was shown to be equipotent (p > 0.05) with the commercial preparation of r-hTSH (Thyrogen), and 1.5-fold more potent than native hTSH (p < 0.001). (author)

  16. Inhibition of thyrotropin response to TSH-releasing hormone by thyroxine in hypothyroid rats

    Energy Technology Data Exchange (ETDEWEB)

    Boado, R.J.; Zaninovich, A.A.; Ulloa, E.R.; Fernandez Pol, J.A.

    1985-05-01

    Pharmacological amounts of throxine (T4) can inhibit the thyrotropin (TSH) response to TSH-releasing hormone (TRH) before its conversion to triiodothyronine (T3) in the hypophysis of euthyroid rate. The present work tested physiological doses of T4 in hypothyroid rats. Rats were treated with iopanoic acid (IOP) 5 mg/100 g BW 24, 12 and 1.5 hours preceding the study, to prevent intrapituitary conversion of T4 to T3. Nonradioactive T4 was injected iv at time 0. At 20 min a 1 ..mu..g/100 g BW dose of TRH was injected iv. Blood samples were drawn at times 0, 20, and 30 min for determination by radioimmunoassay of plasma T4, T3, and TSH. In untreated rats basal TSH was 1450 +- 200 (SEM) ..mu..U/ml. At 20 min it was 105 +- 12% the basal value and at 30 min (10 min post-TRH) plasma TSH rose to 165 +- 14%. In T4-treated rats, those injected with IOP or with the vehicle alone both had the TSH response suppressed. IOP reduced intrapitutiary T3 from 4.6 +- 2.4 to 0.5 +- 0.2 fmol/min/gland. Thirty min. following the iv injection of 150 ..mu..Ci of double-labeled /sup 125/I-T4, the in vitro cytoplasmic radioactivity in control rats was 1.3 +- 0.13 x 10-/sup 2/% of the injected dose (75% T4, 17% T3), while in nuclei it was 4.2 +- 3.6 x 10-/sup 3/% (5l% T4, 28% T3). The injection of 25 ..mu..g of nonradioactive T4 decreased /sup 125/I-T4 in cytoplasm with no changes in nuclei. These findings suggest an intrinsic capacity of T4 to control TRH stimulation of TSH through binding to cytoplasmic receptors.

  17. Diagnostic and Prognostic Value of TSH Levels in Differentiated Thyroid Cancers

    Directory of Open Access Journals (Sweden)

    Mazhar Müslüm Tuna

    2014-03-01

    Full Text Available Purpose: The frequency of thyroid surgery for suspected malignancy but with a benign result in pathological examination is increasing in recent years. For this reason, additional preoperative markers are needed for increasing the sensitivity for evaluating the preoperative malignancy risk of thyroid nodules. In this study, we aimed to evaluate the diagnostic value of serum TSH levels for determining the differentiated thyroid cancers (DTC and to identify a proper cut-off value if relevant association is present. Material and Method: Our study included 380 patients who underwent thyroidectomy due to nodular goiter in our hospital between 01.01.2012 and 01.06.2013 retrospectively. 201 patients who were diagnosed with DTC constituted the study group, and 179 consecutive patients with a benign pathology result were included as controls. Patients who had overt hyperthyroidism or hypothyroidism and was taken medicines that affect TSH level were excluded. Results: There were no significant differences between the two groups in terms of age, sex, and family history of thyroid disease. Preoperative TSH levels were 1.66 mIU/lt and 1.59 mIU/lt in patients with DTC and controls, respectively (p=0.641. There was no correlation between TSH and tumor size, and no relationship between TSH and capsular invasion, vascular invasion, extrathyroidal invasion and lymph node metastasis. Discussion: In our study, no relationship was found between preoperative TSH level and DTC. In addition, there was no relationship between TSH and bad prognostic parameters. Turk Jem 2014; 1: 1-4

  18. Childhood Thyroid Function Reference Ranges and Determinants: A Literature Overview and a Prospective Cohort Study.

    Science.gov (United States)

    Önsesveren, Ibrahim; Barjaktarovic, Mirjana; Chaker, Layal; de Rijke, Yolanda B; Jaddoe, Vincent W V; van Santen, Hanneke M; Visser, Theo J; Peeters, Robin P; Korevaar, Tim I M

    2017-11-01

    Reported cutoffs for childhood thyrotropin (TSH) and free thyroxine (fT4) reference ranges vary widely, and knowledge on the determinants of childhood thyroid function is sparse. This study aimed to summarize the existing studies on thyroid function reference ranges in children. Furthermore, the objective was to investigate the determinants of childhood TSH and fT4 concentration in a population based-prospective cohort. First, to identify studies on childhood thyroid reference ranges, The National Library of Medicine's PubMed, Embase, Ovid Medline, Web of Science, and Google Scholar databases were systematically searched. Second, in a non-selected sample of 4273 children (median age 6.0 years, range 4.9-9.1 years) from the cohort, the associations of age, sex, anthropometric characteristics, ethnicity, maternal education, and time and season at venipuncture were studied with TSH and fT4 concentrations. The study also investigated to what extent between-individual variations in the determinants of TSH and fT4 could influence the calculation of reference ranges. Published reference ranges for TSH and fT4 differ per age range and within age ranges (cutoffs low TSH: 0.13 to >1 mIU/L; high TSH: 2.36 to >10 mIU/L; low fT4: 7.0 to >10 pmol/L; high fT4: 15.5 to >30 pmol/L). In the present cohort, weight, sex, and ethnicity were determinants of TSH (p ≤ 0.03) and fT4 concentrations (p ≤ 0.01), and height and time at venipuncture were determinants of TSH only (p childhood TSH and fT4 across and within age ranges and assays. The present cohort shows only a minimal association between TSH and fT4, suggesting that the hypothalamus-pituitary-thyroid axis remains unaffected by thyroid interfering factors. Various determinants of TSH and fT4 in children were identified, which accounted for a considerable variation of reference range cutoffs.

  19. Thirty six treatments with radiodine after the administration of TSH recombinant in 26 patients with carcinoma differentiated from thyroid gland

    International Nuclear Information System (INIS)

    Pitoia, F.; Passerieu, M.; Bruno, O.D.; Niepomniszcze, H.

    2004-01-01

    The released studies that confirm the safety and efficacy the TSH recombinant (rhTSH) led to an increase in the interest for the use in the patients' preparation with thyroid remanents normal or differenced thyroid carcinoma persistent/recurrent, before the administration of therapeutic radioiodine doses in some situations, when it is impossible the suspension of the hormonal therapy thyroid. The objective is to evaluate the effectiveness of the administration of therapeutic doses of radioiodine after the administration of rhTSH

  20. Preoperative TSH level and risk of thyroid cancer in patients with nodular thyroid disease: nodule size contribution.

    Science.gov (United States)

    Zafón, Carles; Obiols, Gabriel; Mesa, Jordi

    2015-01-01

    Many reports have supported the relationship between high preoperative TSH levels and risk of thyroid cancer in nodular thyroid disease (NTD). We investigated whether TSH levels are related to the risk of differentiated thyroid carcinoma (DTC) in patients who have undergone total thyroidectomy for NTD. The relationship between TSH and size of malignant nodule was investigated. Finally, we assessed whether TSH levels are related to DTC and presence of additional benign nodules. A retrospective study of 980 patients was conducted. Variables included age at diagnosis, TSH level, nodule size, gender, final histology (benign versus DTC), and type of malignancy. Malignancy was present in 261 (26.6%) patients. These patients had higher median TSH levels as compared to those with no malignancy (1.61 mU/L (0.9-2.5) versus 0.9 mU/L (0.3-1.6); p-value<0.001). TSH was higher in patients with DTC in whom the largest nodule was malignant than in patients in whom the largest nodule was benign (1.80 mU/L (1.1-2.6) versus 1.38 mU/L (0.7-2.1) respectively; p-value=0.025). A significant correlation was seen between malignant nodule size and TSH level, but not between TSH levels and size of the largest benign nodule. Our study supported an association between preoperative TSH levels and risk of DTC in patients with NTD. There was also a direct relationship between malignant nodule size and TSH levels. By contrast, no relationship was found between the size of benign nodules and TSH levels. Copyright © 2014 SEEN. Published by Elsevier Espana. All rights reserved.

  1. Radioimmunoassay of serum T3, T4 and TSH during anesthesia and operation

    International Nuclear Information System (INIS)

    Gosheva-Antonova, Ts.; Zakharieva, B.; Kurtev, I.

    1987-01-01

    The serum concentrations of thyroxine (T 3 ), triiodothyronine (T 4 ) and thyroid-stimulating hormone (TSH) were determined in 31 partients before and during urologic operations on the 30th and 60th minute since the onset of the operation, performed under endotracheal halotane or neuroleptanesthesia (NLA) in assisted breathing and intravenous drip anesthesia with ketalar-diazepam in spontaneous breathing. There was statistically significant rise in T 4 level, decrease in T 3 and negligible changes in TSH level, in patients operated under halotane anesthesia. In those operated under NLA, T 4 tended initially to be elevated, with subseguent fall to starting level, with a tendency toward rise in TSH and stable unchanged T 3 level. Ketalar-diazepam anesthesia was applied only to patients subjected to transurethral resections. T 4 in them tended to be decreased, while T 3 and TSH showed negligible changes. Since the operations of patients anesthesized with halotane and NLA had similar localizations and severity, the differences in the thyroid hormone reactions could be associated with the type of anesthesia. The negligible changes in TSH are highly suggestive that this hormone is not influenced by the operation stress and anesthetics, and does hot exert regulating effect upon the thyroid status under these conditions. The milder reactions in patients operated under ketalar-diazepam anestesia may largely be associated with the milder operation stress in transurethal resection

  2. Elaboração e validação de intervalos de referência longitudinais de peso fetal com uma amostra da população brasileira Elaboration and validation of longitudinal reference intervals of fetal weight with a sample of the Brazilian population

    Directory of Open Access Journals (Sweden)

    Érica Luciana de Paula Furlan

    2012-10-01

    Full Text Available OBJETIVOS: Elaborar modelos de predição de peso fetal e de percentis longitudinais de peso fetal estimado (PFE com uma amostra da população brasileira. MÉTODOS: Estudo observacional prospectivo. Dois grupos de gestantes foram recrutados: Grupo EPF (estimativa de peso fetal: pacientes para elaboração (EPF-El e validação (EPF-Val de um modelo de predição de peso fetal; Grupo IRL (intervalos de referência longitudinais: gestantes para elaboração (IRL-El e validação (IRL-Val de intervalos de referência longitudinais de PFE. Regressão polinomial foi utilizada com os dados do subgrupo EPF-El para gerar o modelo de predição de peso fetal. O desempenho deste modelo foi comparado com os de outros disponíveis na literatura. Modelos lineares mistos foram usados para elaboração de intervalos longitudinais de PFE com os dados do subgrupo IRL-El. Os dados do subgrupo IRL-Val foram usados para validação destes intervalos. RESULTADOS: Quatrocentos e cinqüenta e oito pacientes compuseram o Grupo EPF (EPF-El: 367; EPF-Val: 91 e 315 o Grupo IRL (IRL-El: 265; IRL-Val: 50. A fórmula para cálculo do PFE foi: PFE=-8,277+2,146xDBPxCAxCF-2,449xCFxDBP². Os desempenhos de outras fórmulas para estimativa de peso fetal em nossa amostra foram significativamente piores do que os do modelo gerado neste estudo. Equações para predição de percentis condicionais de PFE foram derivadas das avaliações longitudinais do subgrupo IRL-El e validadas com os dados do subgrupo IRL-Val. CONCLUSÕES: descrevemos um método para adaptação de intervalos de referência longitudinais de PFE, sendo este obtido por meio de fórmulas geradas em uma amostra da população brasileira.PURPOSES: To elaborate models for the estimation of fetal weight and longitudinal reference intervals of estimated fetal weight (EFW using a sample of the Brazilian population. METHODS: Prospective observational study. Two groups of patients were evaluated: Group EFW (estimation of

  3. Recombinant human TSH (rhTSH) as adjuvant in the treatment of multi nodular goiters with radioiodine: results on goiter reduction after 18 months

    International Nuclear Information System (INIS)

    Albino, Claudio C.; Gaviolli, Aroldo; Mesa, Cleo; Graf, Hans

    2005-01-01

    Full text: Introduction: Multi nodular goiter (MNG) is defined as a benign increase of the thyroid gland, happening in euthyroid individuals and areas without significant lack of iodine (1). The natural history of this entity is characterized by slow evolution, progressive increase of size, nodularity and glandular autonomy (2). Obstructive symptoms are frequent and the hyperthyroidism happens in about 10% of the cases, after 12 years of evolution. We demonstrated in our paper that rh TSH is a safe and efficient therapeutic tool in the treatment of MNG allowing the use of outpatient therapeutic 131 I doses (3) .Our goal in this study was to evaluate goiter reduction up to 18 months after a fixed, small 131 I dose with the aid of 0,1 mg rh TSH and compare with data obtained on 6 months. Patients and Methods: From September 2002 through May 2004, 14 MNG patients were evaluated. Diagnosis of MNG was done clinically and through ultrasound. They either had contraindications for surgery, or refused a surgical approach. The subjects' mean age was 68 years (range 45 to 82 years), and everyone was female. The thyroid volume was measured through helical CT (AUKELET -Toshiba). A 0.9 mg vial of rh TSH was diluted in 9 ml of sterile water for injection, and 1 ml (0,1 mg) of rh TSH was administered intramuscularly on day 1. On day 2, 24 hours after the rh TSH injection, a therapeutic dose of 30 mCi (1.11 GBq) of 131 I was administered to all patients. Results: The basal thyroid volume by CT scan was 121.1 +/- 45.4 and decreased to 66,7 +/- 47 ml 6 months after therapy, an average reduction of 45 +/-19% (p = 0.0004). After 18 months of therapy the thyroid volume was 57,6 ± 42 ml, an average reduction of 52 ± 15 %. Conclusion: rh TSH is an efficient and fast therapeutic tool in the treatment of MNG allowing the use of outpatient therapeutic 131 I doses. There was a little gain on reduction of goiter volume after 6 months. (author)

  4. Clinical evaluation of thyrotropin-releasing hormone (TRH) test with a sensitive immunoradiometric thyrotropin (TSH) assay kit

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Saeko; Demura, Reiko; Yamanaka, Yukako; Ishiwatari, Naoko; Jibiki, Kazuko; Odagiri, Emi; Demura, Hiroshi

    1987-10-01

    Thyrotropin-releasing hormone (TRH) test was performed using a commercially available immunoradiometric thyrotropin (TSH) assay kit (RIA-gnost hTSH) in patients with endocrine diseases. The basal serum concentration of TSH ranged from 0.2 to 2.9 ..mu..U/ml in healthy subjects. The values for endocrine diseases, except for Graves' disease, were almost within the normal range. A significant increase in TSH values caused by TRH test was observed in females compared with males (4.4 - 24.7 ..mu..U/ml vs 4.1 - 12.3 ..mu..U/ml). In cases of Graves' disease, there was a good correlation between the basal TSH value and the response of TSH to TRH. However, in the other endocrine diseases, including acromegaly, prolactinoma, anorexia nervosa, Cushing syndrome, and hypopituitarism, the response of TSH to TRH did not necessarily correlated with the basal TSH value. TRH test would be of value in elucidating pathophysiologic features, as well as in accurately diagnosing secretion reserve of TSH. (Namekawa, K.).

  5. Clinical evaluation of thyrotropin-releasing hormone (TRH) test with a sensitive immunoradiometric thyrotropin (TSH) assay kit

    International Nuclear Information System (INIS)

    Nakamura, Saeko; Demura, Reiko; Yamanaka, Yukako; Ishiwatari, Naoko; Jibiki, Kazuko; Odagiri, Emi; Demura, Hiroshi

    1987-01-01

    Thyrotropin-releasing hormone (TRH) test was performed using a commercially available immunoradiometric thyrotropin (TSH) assay kit (RIA-gnost hTSH) in patients with endocrine diseases. The basal serum concentration of TSH ranged from 0.2 to 2.9 μU/ml in healthy subjects. The values for endocrine diseases, except for Graves' disease, were almost within the normal range. A significant increase in TSH values caused by TRH test was observed in females compared with males (4.4 - 24.7 μU/ml vs 4.1 - 12.3 μU/ml). In cases of Graves' disease, there was a good correlation between the basal TSH value and the response of TSH to TRH. However, in the other endocrine diseases, including acromegaly, prolactinoma, anorexia nervosa, Cushing syndrome, and hypopituitarism, the response of TSH to TRH did not necessarily correlated with the basal TSH value. TRH test would be of value in elucidating pathophysiologic features, as well as in accurately diagnosing secretion reserve of TSH. (Namekawa, K.)

  6. An automated immunoradiometric assay of thyrotrophin (TSH) in dried blood filter paper spots

    International Nuclear Information System (INIS)

    John, R.; Woodhead, J.S.

    1982-01-01

    An immunoradiometric two-site assay for thyrotrophin (TSH) in dried blood filter paper spots is described. The assay is automated by means of the Kemtek 3000 automated immunoassay system. The technique uses a 6.0 mm disc punched from the dried blood samples collected as part of the screening programme for phenylketonuria. The method is sensitive and precise, and results correlate well with those obtained in TSH assays of serum samples. The procedure is rapid, results being available within 24 h of receipt of samples. Of 25204 specimens so far screened by this assay, 99.9% have TSH levels less than 15 mU/l. One false positive result has been obtained and six confirmed cases of neonatal hypothyroidism detected, giving a prevalence of 1 in 4200. (Auth.)

  7. Automated immunoradiometric assay of thyrotrophin (TSH) in dried blood filter paper spots

    Energy Technology Data Exchange (ETDEWEB)

    John, R.; Woodhead, J.S. (Welsh National School of Medicine, Cardiff (UK))

    1982-11-10

    An immunoradiometric two-site assay for thyrotrophin (TSH) in dried blood filter paper spots is described. The assay is automated by means of the Kemtek 3000 automated immunoassay system. The technique uses a 6.0 mm disc punched from the dried blood samples collected as part of the screening programme for phenylketonuria. The method is sensitive and precise, and results correlate well with those obtained in TSH assays of serum samples. The procedure is rapid, results being available within 24 h of receipt of samples. Of 25204 specimens so far screened by this assay, 99.9% have TSH levels less than 15 mU/l. One false positive result has been obtained and six confirmed cases of neonatal hypothyroidism detected, giving a prevalence of 1 in 4200.

  8. Ghrelin-mediated inhibition of the TSH-stimulated function of differentiated human thyrocytes ex vivo.

    Science.gov (United States)

    Barington, Maria; Brorson, Marianne Møller; Hofman-Bang, Jacob; Rasmussen, Åse Krogh; Holst, Birgitte; Feldt-Rasmussen, Ulla

    2017-01-01

    Ghrelin is a peptide hormone produced mainly in the gastrointestinal tract known to regulate several physiological functions including gut motility, adipose tissue accumulation and hunger sensation leading to increased bodyweight. Studies have found a correlation between the plasma levels of thyroid hormones and ghrelin, but an effect of ghrelin on the human thyroid has never been investigated even though ghrelin receptors are present in the thyroid. The present study shows a ghrelin-induced decrease in the thyroid-stimulating hormone (TSH)-induced production of thyroglobulin and mRNA expression of thyroperoxidase in a primary culture of human thyroid cells obtained from paranodular tissue. Accordingly, a trend was noted for an inhibition of TSH-stimulated expression of the sodium-iodine symporter and the TSH-receptor. Thus, this study suggests an effect of ghrelin on human thyrocytes and thereby emphasizes the relevance of examining whether ghrelin also influences the metabolic homeostasis through altered thyroid hormone production.

  9. Total protein measurement in canine cerebrospinal fluid: agreement between a turbidimetric assay and 2 dye-binding methods and determination of reference intervals using an indirect a posteriori method.

    Science.gov (United States)

    Riond, B; Steffen, F; Schmied, O; Hofmann-Lehmann, R; Lutz, H

    2014-03-01

    In veterinary clinical laboratories, qualitative tests for total protein measurement in canine cerebrospinal fluid (CSF) have been replaced by quantitative methods, which can be divided into dye-binding assays and turbidimetric methods. There is a lack of validation data and reference intervals (RIs) for these assays. The aim of the present study was to assess agreement between the turbidimetric benzethonium chloride method and 2 dye-binding methods (Pyrogallol Red-Molybdate method [PRM], Coomassie Brilliant Blue [CBB] technique) for measurement of total protein concentration in canine CSF. Furthermore, RIs were determined for all 3 methods using an indirect a posteriori method. For assay comparison, a total of 118 canine CSF specimens were analyzed. For RIs calculation, clinical records of 401 canine patients with normal CSF analysis were studied and classified according to their final diagnosis in pathologic and nonpathologic values. The turbidimetric assay showed excellent agreement with the PRM assay (mean bias 0.003 g/L [-0.26-0.27]). The CBB method generally showed higher total protein values than the turbidimetric assay and the PRM assay (mean bias -0.14 g/L for turbidimetric and PRM assay). From 90 of 401 canine patients, nonparametric reference intervals (2.5%, 97.5% quantile) were calculated (turbidimetric assay and PRM method: 0.08-0.35 g/L (90% CI: 0.07-0.08/0.33-0.39); CBB method: 0.17-0.55 g/L (90% CI: 0.16-0.18/0.52-0.61). Total protein concentration in canine CSF specimens remained stable for up to 6 months of storage at -80°C. Due to variations among methods, RIs for total protein concentration in canine CSF have to be calculated for each method. The a posteriori method of RIs calculation described here should encourage other veterinary laboratories to establish RIs that are laboratory-specific. ©2014 American Society for Veterinary Clinical Pathology and European Society for Veterinary Clinical Pathology.

  10. Neonatal hypothyroidism: detection by estimation of TSH in dried blood eluate

    International Nuclear Information System (INIS)

    Daver, A.; Chassevent, A.; Larra, F.; Guittet, J.; Berthelot, J.; Larget Piet, L.

    1978-01-01

    The micromethod for the estimation of TSH was used in a group of 3173 newborn. At the same time, TSH curves during the first six days were established. One case of hypothyroidism was detected and treated during the neonatal period and then regularly followed-up using the micromethod. The existence of a recall level of 5 per cent in the statistics is discussed. Technical modifications are envisaged with the aim of reducing the percentage of specimens in which it is impossible to perform an estimation [fr

  11. Correlation between the estimated molecular weight and the immunological properties of 125I-TSH

    International Nuclear Information System (INIS)

    Quiroga, S.E.; Ciscato, V.A.; Barmasch, M.; Kurcbart, H.; Veira de Giacomini, S.; Altschuler, N.; Caro, R.A.

    1976-09-01

    Thyrotropic Stimulating Hormone (TSH) was radioiodinated by the Chloramine T method in order to be used in radioimmu-noassay procedures. It was purified by gel filtration and each fraction of the eluate was analyzed in order to determine which one had the most suitable behaviour for that use. The molecular weight of each fraction was estimated, as well as its immunological reactivity and its non-specific binding. The 125 I-TSH fraction with better properties was the closest to the molecular weight of the native hormone, which is found at the posterior shoulder of the main proteic peak of the elution pattern. (author) [es

  12. FSH and TSH in the Regulation of Bone Mass: The Pituitary/Immune/Bone Axis

    Directory of Open Access Journals (Sweden)

    Graziana Colaianni

    2013-01-01

    Full Text Available Recent evidences have highlighted that the pituitary hormones have profound effects on bone, so that the pituitary-bone axis is now becoming an important issue in the skeletal biology. Here, we discuss the topical evidence about the dysfunction of the pituitary-bone axis that leads to osteoporotic bone loss. We will explore the context of FSH and TSH hormones arguing their direct or indirect role in bone loss. In addition, we will focus on the knowledge that both FSH and TSH have influence on proinflammatory and proosteoclastogenic cytokine expression, such as TNFα and IL-1, underlining the correlation of pituitary-bone axis to the immune system.

  13. TSH-receptor-autoantibody-titers in untreated toxic diffuse goitres - an early indicator of relapse

    International Nuclear Information System (INIS)

    Becker, W.; Reiners, C.; Boerner, W.

    1984-01-01

    TSH-receptor-auto antibodies were determined in follow-up of 30 patients with relapse of toxic diffuse goitres, i.e. patients with Graves' disease and toxic disseminated autonomy, and in 13 patients with spontaneous remission after antithyroid drug therapy by use of a commercially available TSH-radioreceptorassay (TRAK-assay). All the patients with very high receptor-autoantibody-titers in untreated thyrotoxicosis (F > 20%) had one or more periods of hyperthyroidism or a very severe course of disease. None of these patients showed a spontaneous remission of disease. They all could be identified as Graves' patients. Patients with TRAK-titers 3% [de

  14. The value of recombinant human TSH-aided 131I treatment in differentiated thyroid carcinoma patients

    International Nuclear Information System (INIS)

    Ding Yong; Long Yahong; Tian Jiahe; Xu Baixuan; Xing Jialiu; Fang Yi; Wei Lijing; Zong Zhaoyi

    2013-01-01

    Objective: To evaluate the efficacy and safety of recombinant human TSH(rhTSH)-aided 131 I treatment for DTC. Methods: A total of 144 patients with DTC who underwent total or near total thyroidectomy were retrospectively analyzed. The rhTSH-aided 131 I treatment of 3.7 GBq was performed in 72 cases (Group Ⅰ: euthyroid). Another 72 cases received radioiodine ablation treatment of 3.7 GBq after 4 to 6 weeks of thyroxine withdrawal (Group Ⅱ: hypothyroidism). Serum endogenous TSH, FT 3 , FT 4 and Tg were measured. The life qualities of both groups were observed, such as intolerance to cold, weight gain, constipation, motor retardation, skin dryness, periorbital edema and bone pain. Absence of visible uptake or uptake rate less than 1% was taken as complete ablation. The efficacy of 131 I treatment was evaluated. The life quality of both groups was evaluated by χ 2 test, and the effect of 131 I treatment was analyzed by t test. Results: Serum TSH was effectively improved in both groups before 131 I treatment. In group Ⅰ, TSH was higher than that of group Ⅱ ((141.26 ± 27.30) mU/L vs (70.57 ± 51.13) mU/L; t=2.435, P<0.05), and FT 3 , FT 4 were not significantly different before or after the injection of rhTSH. Tg was well stimulated in both groups with no statistical difference. Group Ⅱ exhibited more side effects, which included intolerance to cold 80.56% (58/72), weight gain 86.11% (62/72), constipation 15.28% (11/72), motor retardation 22.22% (16/72), skin dryness 56.94% (41/72), bone pain 2.78% (2/72), and no periorbital edema was found. Group Ⅰ had a higher quality of life than group Ⅱ, only few side effects were observed including dizziness and nausea 2.78% (2/72), bone pain 2.78% (2/72), and transient tachycardia 1.39% (1/72). The effect of 131 I treatment was evaluated by whole body scans with a diagnostic dose of 131 I. The complete ablation rate was 70.83% (51/72) in group Ⅰ and 66.67% (48/72) in group Ⅱ (χ 2 =0.58, P>0.05). Conclusion: The

  15. T3 Regulates a Human Macrophage-Derived TSH-β Splice Variant: Implications for Human Bone Biology.

    Science.gov (United States)

    Baliram, R; Latif, R; Morshed, S A; Zaidi, M; Davies, T F

    2016-09-01

    TSH and thyroid hormones (T3 and T4) are intimately involved in bone biology. We have previously reported the presence of a murine TSH-β splice variant (TSH-βv) expressed specifically in bone marrow-derived macrophages and that exerted an osteoprotective effect by inducing osteoblastogenesis. To extend this observation and its relevance to human bone biology, we set out to identify and characterize a TSH-β variant in human macrophages. Real-time PCR analyses using human TSH-β-specific primers identified a 364-bp product in macrophages, bone marrow, and peripheral blood mononuclear cells that was sequence verified and was homologous to a human TSH-βv previously reported. We then examined TSH-βv regulation using the THP-1 human monocyte cell line matured into macrophages. After 4 days, 46.1% of the THP-1 cells expressed the macrophage markers CD-14 and macrophage colony-stimulating factor and exhibited typical morphological characteristics of macrophages. Real-time PCR analyses of these cells treated in a dose-dependent manner with T3 showed a 14-fold induction of human TSH-βv mRNA and variant protein. Furthermore, these human TSH-βv-positive cells, induced by T3 exposure, had categorized into both M1 and M2 macrophage phenotypes as evidenced by the expression of macrophage colony-stimulating factor for M1 and CCL-22 for M2. These data indicate that in hyperthyroidism, bone marrow resident macrophages have the potential to exert enhanced osteoprotective effects by oversecreting human TSH-βv, which may exert its local osteoprotective role via osteoblast and osteoclast TSH receptors.

  16. Termitarium-inhabiting Bacillus endophyticus TSH42 and Bacillus cereus TSH77 colonizing Curcuma longa L.: isolation, characterization, and evaluation of their biocontrol and plant-growth-promoting activities.

    Science.gov (United States)

    Chauhan, Ankit Kumar; Maheshwari, Dinesh Kumar; Kim, Kangmin; Bajpai, Vivek K

    2016-10-01

    Bacillus strains were isolated from termitarium soil and screened for their antifungal activity through the production of diffusible and volatile metabolites. Further, the bacterial strains that showed antifungal activity were evaluated for their biocontrol potential on the basis of their plant-growth-promoting attributes. Termitarium-inhabiting Bacillus strains TSH42 and TSH77 significantly reduced the growth of pathogenic fungus Fusarium solani, controlled the symptoms of rhizome rot in turmeric (Curcuma longa L.), and demonstrated various plant-growth-promoting traits in different in vitro assays. On the basis of morphological, physiological, biochemical, and 16S rDNA characteristics, isolates TSH42 and TSH77 were identified as Bacillus endophyticus (KT379993) and Bacillus cereus (KT379994), respectively. Through liquid chromatography - mass spectrometry analysis, acidified cell-free culture filtrate (CFCF) of B. cereus TSH77 was shown to contain surfactin and fengycin, while CFCF of B. endophyticus TSH42 contained iturin in addition to surfactin and fengycin. Treatment of the turmeric (C. longa L.) plants with TSH42 and TSH77 significantly reduced the percentage incidence of rhizome rot disease caused by F. solani. The same treatment also increased the fresh rhizome biomass and plant growth in greenhouse conditions.

  17. Hypothyroidism in adults. Levothyroxine if warranted by clinical and laboratory findings, not for simple TSH elevation.

    Science.gov (United States)

    2015-10-01

    Hypothyroidism is a common disorder due to inadequate thyroid hormone secretion. When a patient has signs and symptoms suggestive of hypothyroidism, how is it determined whether thyroid hormone replacement therapy will have a favourable harm-benefit balance? How should treatment be managed? To answer these questions, we conducted a review of the literature using the standard Prescrire methodology. The symptoms of hypothyroidism are due to slow metabolism (constipation, fatigue, sensitivity to cold, weight gain, etc.) and to polysaccharide accumulation in certain tissues, leading to hoarseness, eyelid swelling, etc. A blood TSH concentration of less than 4 or 5 mlU/L rules out peripheral hypothyroidism. TSH levels increase with age. Between 30% and 60% of high TSH levels are not confirmed on a second blood test. In overt hypothyroidism, the TSH level is high and the free T4 (thyroxine) level is low. Most of these patients are symptomatic. So-called subclinical hypothyroidism, which is rarely symptomatic, is characterised by high blood TSH levels and normal free T4 levels. The natural history of hypothyroidism depends on its cause. In chronic autoimmune thyroiditis, the most common form seen in rich countries, hypothyroidism generally worsens over time. However, other situations can lead to transient hypothyroidism that may last several weeks or months. Subclinical hypothyroidism, as the name implies, is usually asymptomatic. The risk of progression to overt hypothyroidism is about 3% to 4% per year overall but increases with the initial TSH level. Treatment guidelines are mainly based on physiological and pharmacological considerations and generally recommend levothyroxine therapy. The adverse effects of levothyroxine are signs of thyrotoxicosis in case of overdose (tachycardia, tremor, sweating, etc.). Even a slight overdose carries a risk of osteoporotic fractures and atrial fibrillation, especially in the elderly. In young adults, levothyroxine is usually started

  18. A TSHβ Variant with Impaired Immunoreactivity but Intact Biological Activity and Its Clinical Implications

    DEFF Research Database (Denmark)

    Pappa, Theodora; Johannesen, Jesper; Scherberg, Neal

    2015-01-01

    BACKGROUND: Thyrotropin (TSH) deficiency caused by TSHβ gene mutations is a rare form of congenital central hypothyroidism. Nine different TSHβ gene mutations have been reported, all with clinical manifestations. The aim was to identify the genetic cause of undetectable TSH levels in two siblings...

  19. Lower-normal TSH is associated with better metabolic risk factors: a cross-sectional study on spanish men

    Science.gov (United States)

    Background and aims: Subclinical thyroid conditions, defined by normal thyroxin (T4) but abnormal thyroid-stimulating hormone (TSH) levels, may be associated with cardiovascular and metabolic risk. More recently, TSH levels within the normal range have been suggested to be associated with metabolic ...

  20. Risk-benefit ratio for TSH- suppressive Levothyroxine therapy in differentiated thyroid cancer.

    Science.gov (United States)

    Do Cao, C; Wémeau, J-L

    2015-02-01

    In the setting of differentiated thyroid cancer (DTC) management, levothyroxine dose should be carefully adjusted with respect to underlying individual health status, dynamically reassessed risk of relapse and medical monitoring. Future guidelines should give priority to a tailored approach to TSH suppression therapy in DTC patients. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  1. Targeting the thyroid gland with thyroid-stimulating hormone (TSH)-nanoliposomes.

    Science.gov (United States)

    Paolino, Donatella; Cosco, Donato; Gaspari, Marco; Celano, Marilena; Wolfram, Joy; Voce, Pasquale; Puxeddu, Efisio; Filetti, Sebastiano; Celia, Christian; Ferrari, Mauro; Russo, Diego; Fresta, Massimo

    2014-08-01

    Various tissue-specific antibodies have been attached to nanoparticles to obtain targeted delivery. In particular, nanodelivery systems with selectivity for breast, prostate and cancer tissue have been developed. Here, we have developed a nanodelivery system that targets the thyroid gland. Nanoliposomes have been conjugated to the thyroid-stimulating hormone (TSH), which binds to the TSH receptor (TSHr) on the surface of thyrocytes. The results indicate that the intracellular uptake of TSH-nanoliposomes is increased in cells expressing the TSHr. The accumulation of targeted nanoliposomes in the thyroid gland following intravenous injection was 3.5-fold higher in comparison to untargeted nanoliposomes. Furthermore, TSH-nanoliposomes encapsulated with gemcitabine showed improved anticancer efficacy in vitro and in a tumor model of follicular thyroid carcinoma. This drug delivery system could be used for the treatment of a broad spectrum of thyroid diseases to reduce side effects and improve therapeutic efficacy. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Enraizamento e crescimento de estacas herbáceas do cacaueiro (clones Cepec 42, tsh 516 e tsh 1188 em função da aplicação do ácido indolbutírico (AIB

    Directory of Open Access Journals (Sweden)

    Faria José Cláudio

    2003-01-01

    Full Text Available Estacas apicais herbáceas de ramos plagiotrópicos do cacaueiro (clones CEPEC 42, TSH 516 e TSH 1188 foram tratadas com 0 e 6.000 mg.kg-1 do ácido indolbutírico (AIB e estaqueadas em tubetes de 288 cm³ contendo como substrato uma mistura de Plantmax® e fibra de coco triturada (1:1, enriquecido com Osmocote® (19-06-20 e PG mix® (14-16-18. Os tubetes foram acondicionados em bandejas e estas foram mantidas em câmaras de nebulização. Na avaliação, realizada aos 78 dias após o estaqueamento, verificou-se que, independentemente da aplicação de AIB, as estacas dos clones avaliados apresentaram índices de enraizamento superiores a 87%, mas o tratamento das estacas com AIB aumentou os índices de sobrevivência e de estacas enraizadas de todos os clones, número de raízes (clones TSH 516 e TSH 1188, matéria seca de raízes (Clones CEPEC 42 e TSH 516 e matéria seca da parte aérea (Clones TSH 566 e TSH 1188.

  3. Rapid iterative stimulation (IS) of endogenous TSH (En-TSH) utilizing thyrotropin releasing hormone (TRH) in patients with differentiated thyroid carcinoma (DTC)

    International Nuclear Information System (INIS)

    Degrossi, Osvaldo J.; Degrossi, Elina B.; Barmasch, Martha; Lopart, Iris; Mignogna, A.; Garcia del Rio, H.; Alvarez, Liliana; Pena, Marta

    2007-01-01

    In the follow up (F) of patients with DTC it is necessary to obtain high figures of serum TSH for determination of serum Tg and 131 I scan (WBS). For this object, the method, for a long time, was to withdrawal thyroid hormone therapy (generally l-T4) that produced hypothyroidism with the inconvenient for the patients, dramatics in certain cases. Our objective was to increase TSH by IS to shortening time of L-T4 withdrawal for F, ablation (A) or treatment (T) with 131 I. In 37 patients with DTC (G-1), aged 19-78 years, 34 with papillary DTC and 3 with follicular forms, 25 females, 12 males, 43 studies were carried out; 6 p carried 2 studies. The group was divided in 2 sub-groups: G-1A, 7 patients derived for A; G-1 B 36 patients for F or T with 131 I. Six patients carried out 2 studies; 4 of them for A and for F and 2 realizes 2 times F. All patients treated with I-T4 replaced this hormone for T3 during 3 weeks that was withdrawal the day before IS. In G-1A, between 8/10 days after surgery they begin IS. IS: At days 1, 3, 5 and 6, the patients were injected i.v. with 200 mcg of TRH; at 30 minutes of the 3rd injection blood TSH determination; immediately 370 MBq of 99m T was administered and at 30 minutes a WBS was carried out. At 30 minutes of the 4th injection blood figures of TSH, Tg and Tg-ab were determined; immediately the activity of 131 I indicated for each group was given to the patients; in G-1A, at 8 days and in G1-B, at 48 hours WBS were carried out. As a control group (G-2) 41 studies in 35 DTC patients that withdrawal-T4 for 4/5 weeks, were studied, aged 18-81 years, 31 females and 4 males; 32 with papillary and 3 follicular form; 18 for A (G-2A) and 23 for F (G-2B); 6 p carried out 2 studies. One for A and the second as the first control. In G-1, TSH values obtained were 26-360 UI/L (83 ± 54. In G-1A : 137 ± 109 and in G-1B 7, 62 ± 52). The 2 tracers 131 I and 99m Tc-Tc, produces show similar figures. In G-1A all p present thyroid remnants and

  4. The TSH dynamics in upperand low-normal range in patients with primary hypothyroidism: clinical presentation, well-being and quality of life

    Directory of Open Access Journals (Sweden)

    A V Podzolkov

    2010-12-01

    Full Text Available In our study we try to determine whether small changes in thyroxine treatment is effective in patients with symptoms of hypothyroidism but with thyroid function tests within the reference range, and to investigate the effect of thyroxine treatment on psychological and physical wellbeing in healthy participants. Sixty ambulatory patients with primary hypothyroidism receiving levothyroxine (L-T4 participated in the study. Patients were divided into 2 groups according to their TSH level. The first group was in TSH low-normal range (0.4–2.0 mU/l, the second in upper-normal (2.1–4.0 mU/l range. We analyzed the results of several tests: “12 classical hypothyroidism symp- toms”, SF36, HARS, HDRS, Zung scale at baseline and in 3 months. With a small-dose changes we cross the groups to compare the results. Results: At baseline analyze there was a small differ-ence between two groups. Women with in the upper-normal TSH range had more expressed symptoms of hypothyroidism. After small changes in thyroxine treatment we could not say that the clinical picture of a hypothyroidism has changed cardinally, however, it is necessary to notice that there was dynamics of separate symptoms. The same picture was noticed with the depression and anxiety levels. The meanings were rather close and small dose changes in L-T4 treatment were more expressed in group with upper-normal range. The positive dynamics of well-being after dose changing were registered in both groups. Conclusion: Small changes in T4 dosage do not produce measurable changes in hypothyroid symptoms, well-being, or quality of life.

  5. Genome-wide association study identifies a novel susceptibility gene for serum TSH levels in Chinese populations.

    Science.gov (United States)

    Zhan, Ming; Chen, Gang; Pan, Chun-Ming; Gu, Zhao-Hui; Zhao, Shuang-Xia; Liu, Wei; Wang, Hai-Ning; Ye, Xiao-Ping; Xie, Hui-Jun; Yu, Sha-Sha; Liang, Jun; Gao, Guan-Qi; Yuan, Guo-Yue; Zhang, Xiao-Mei; Zuo, Chun-Lin; Su, Bin; Huang, Wei; Ning, Guang; Chen, Sai-Juan; Chen, Jia-Lun; Song, Huai-Dong

    2014-10-15

    Thyroid-stimulating hormone (TSH) is a sensitive indicator of thyroid function. High and low TSH levels reflect hypothyroidism and hyperthyroidism, respectively. Even within the normal range, small differences in TSH levels, on the order of 0.5-1.0 mU/l, are associated with significant differences in blood pressure, BMI, dyslipidemia, risk of atrial fibrillation and atherosclerosis. Most of the variance in TSH levels is thought to be genetically influenced. We conducted a genome-wide association study of TSH levels in 1346 Chinese Han individuals. In the replication study, we genotyped four candidate SNPs with the top association signals in an independent isolated Chinese She cohort (n = 3235). We identified a novel serum TSH susceptibility locus within XKR4 at 8q12.1 (rs2622590, Pcombined = 2.21 × 10(-10)), and we confirmed two previously reported TSH susceptibility loci near FOXE1 at 9q22.33 and near CAPZB at 1p36.13, respectively. The rs2622590_T allele at XKR4 and the rs925489_C allele near FOXE1 were correlated with low TSH levels and were found to be nominally associated to patients with papillary thyroid carcinoma (PTC) (OR = 1.41, P= 0.014 for rs2622590_T, and OR = 1.61, P= 0.030 for rs925489_C). The rs2622590 and rs925489 genotypes were also correlated with the expression levels of FOXE1 and XKR4, respectively, in PTC tissues (P = 2.41 × 10(-4) and P= 0.02). Our findings suggest that the SNPs in XKR4 and near FOXE1 are involved in the regulation of TSH levels. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Indirect Basal Metabolism Estimation in Tailoring Recombinant Human TSH Administration in Patients Affected by Differentiated Thyroid Cancer: A Hypothesis-Generating Study

    Directory of Open Access Journals (Sweden)

    Agnese Barnabei

    2018-02-01

    Full Text Available PurposeRecombinant human TSH (rhTSH is currently used in follow-up of patients affected by differentiated thyroid cancer (DTC. Age, sex, weight, body mass index, body surface area (BSA and renal function are known factors affecting serum TSH peak levels, but the proper rhTSH dose to deliver to single patient remains elusive. In this study, the correlations of basal metabolic rates with serum TSH peak following rhTSH administration were investigated.MethodsWe evaluated 221 patients affected by thyroid cancer that received a standard dose rhTSH. Blood samples were collected at pre-established time points. Data on body weight, height, and BSA were collected. The Mifflin-St Jeor and Fleisch equations were used to assess basal metabolism.ResultsThe median value (range of serum TSH peaks was 142 ± 53 μU/ml. Serum TSH peaks were significantly lower in males than in females (p = 0.04. TSH values also increased with age. Data showed a significant decrease of TSH peak levels at day 3 from the administration of rhTSH when basal metabolic rates increased (p = 0.002 and p = 0.009, respectively. Similar findings were observed at day 5 (p = 0.004 and p = 0.04, respectively. A multivariate analysis of several factors revealed that patients’ basal metabolism (obtained using the Mifflin-St Jeor but not Fleisch equation predicts serum TSH level peak at day 3 (p < 0.001. These results were used to generate a new formula based on Mifflin-StJeor equation which reveals as a promising tool in tailoring rhTSH dose.ConclusionBasal metabolism appears an improving factor in tailoring diagnostic rhTSH dose in patients affected by DTC.

  7. The impact of a TSH receptor gene polymorphism on thyroid-related phenotypes in a healthy Danish twin population

    DEFF Research Database (Denmark)

    Hansen, P.S.; Deure, W.M. van der; Peeters, R.P.

    2007-01-01

    OBJECTIVES: The Asp727Glu polymorphism in the TSH receptor (TSHR) gene is associated with serum TSH levels. However, the proportion of genetic variation accounted for by this polymorphism is unknown. In this study, we (1) examined the association of the Asp727Glu polymorphism with thyroid size.......8%. The polymorphism was not significantly associated with thyroid size, thyroid hormones or thyroid antibody levels. CONCLUSIONS: The TSHR-727Glu allele was associated with decreasing TSH levels; however, the contribution to the genetic variance was very small. No association was found with other thyroid...

  8. Suplementasi Besi Mampu Memperbaiki Kadar Hormon TSH Anak Sekolah di Daerah Endemik GAKI

    Directory of Open Access Journals (Sweden)

    Yusi Dwi Nurcahyani

    2015-01-01

    Full Text Available ABSTRACT Multiple nutritional and environmental influences contribute to the prevalence and severity of IDDs in iodine deficient areas, including iron. In many developing countries, children are at high risk of both goiter and iron deficiency anemia. Iron deficiency adversely affects thyroid metabolism and may reduce the efficacy of iodized salt. The aim of this study was to investigate whether iron supplementation can improve thyrothrophin hormone in school children in iodine deficient areas. A trial of iron supplementation was carried out in an area of endemic goiter in Kertek Wonosobo (n = 35, another group given placebo (n = 35. At baseline, anthropometri, TSH, ferritin, urinary iodine excretion and level of iodized salt were measured. After 13 weeks supplementation, the same data collecting was conducted. Supplement’s compliance during the study reached 100%. Two subject were excluded from from the analysis because they have extreme bio chemical data than the overall average. Statistical test showed no differences in age and gender proportion between groups. There were no significant difference in nutritional status, level of EIU, and level of iodine in salt between groups after the intervention, but there was a significant increase in ferritin level in the iron group (31.0 vs 44.8 μg/l, p<0.05. There were a significant difference in protein and iron intake, but no significant different in energy intake.These two group did not differ in TSH level change. After taking into account the modification variable effect of adequate protein > 70% RDA, the effect of iron supplementation was proved to be effective in changing TSH level (p <0.05. Our result indicate that increase in iron status can improve TSH hormone after considering adequate protein intake (RDA. Keywords : IDD, iron supplementation, thyroid function.   ABSTRAK Di daerah yang kekurangan iodium, pengaruh gizi dan lingkungan berkontribusi pada prevalensi dan tingkat keparahan GAKI

  9. Associations between brominated flame retardants in human milk and thyroid-stimulating hormone (TSH) in neonates.

    Science.gov (United States)

    Eggesbø, Merete; Thomsen, Cathrine; Jørgensen, Jens V; Becher, Georg; Odland, Jon Øyvind; Longnecker, Matthew P

    2011-08-01

    Brominated flame retardants (BFRs) have been in widespread use in a vast array of consumer products since the 1970s. The metabolites of some BFRs show a structural similarity to thyroid hormones and experimental animal studies have confirmed that they may interfere with thyroid hormone homeostasis. A major concern has been whether intrauterine exposure to BFRs may disturb thyroid homeostasis since the fetal brain is particularly susceptible to alterations in thyroid hormones. However, few reports on newborns have been published to date. To evaluate the association between BFRs and neonatal thyroid-stimulating hormone (TSH). We studied six polybrominated diphenyl ethers (PBDEs) measured in milk samples from 239 women who were part of the "Norwegian Human Milk Study" (HUMIS), 2003-2006. Hexabromocyclododecane (HBCD) and BDE-209 were measured in a subset of the women (193 and 46 milk samples, respectively). The milk was sampled at a median of 33 days after delivery. TSH was measured in babies three days after delivery as part of the routine national screening program for early detection of congenital hypothyroidism. Additional information was obtained through the Medical Birth Registry and questionnaires to the mothers. The PBDE concentrations in human milk in Norway were comparable to concentrations reported from other European countries and Asia, but not the US and Canada where levels are approximately one order of higher magnitude. We observed no statistically significant associations between BDE-47, 99, 153, 154, 209 and HBCD in human milk and TSH in models adjusted for possible confounders and other environmental toxicants including polychlorinated biphenyls (PCBs). We did not observe an association between TSH and exposure to HBCD and PBDEs within the exposure levels observed. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. Decrease in TSH levels after lactose restriction in Hashimoto's thyroiditis patients with lactose intolerance.

    Science.gov (United States)

    Asik, Mehmet; Gunes, Fahri; Binnetoglu, Emine; Eroglu, Mustafa; Bozkurt, Neslihan; Sen, Hacer; Akbal, Erdem; Bakar, Coskum; Beyazit, Yavuz; Ukinc, Kubilay

    2014-06-01

    We aimed to evaluate the prevalence of lactose intolerance (LI) in patients with Hashimoto's thyroiditis(HT) and the effects of lactose restriction on thyroid function in these patients. Eighty-three HT patients taking L-thyroxine (LT4) were enrolled, and lactose tolerance tests were performed on all patients. Lactose intolerance was diagnosed in 75.9 % of the patients with HT. Thirty-eight patients with LI were started on a lactose-restricted diet for 8 weeks. Thirty-eight patients with LI (30 euthyroid and 8 with subclinical hypothyroidism), and 12 patients without LI were included in the final analysis. The level of TSH significantly decreased in the euthyroid and subclinical hypothyroid patients with LI [from 2.06 ± 1.02 to 1.51 ±1.1 IU/mL and from 5.45 ± 0.74 to 2.25 ± 1.88 IU/mL,respectively (both P0.05). Lactose intolerance occurs at a high frequency in HT patients. Lactose restriction leads to decreased levels of TSH, and LI should be considered in hypothyroid patients who require increasing LT4 doses,have irregular TSH levels and are resistant to LT4 treatment.

  11. Multichannel interval timer

    International Nuclear Information System (INIS)

    Turko, B.T.

    1983-10-01

    A CAMAC based modular multichannel interval timer is described. The timer comprises twelve high resolution time digitizers with a common start enabling twelve independent stop inputs. Ten time ranges from 2.5 μs to 1.3 μs can be preset. Time can be read out in twelve 24-bit words either via CAMAC Crate Controller or an external FIFO register. LSB time calibration is 78.125 ps. An additional word reads out the operational status of twelve stop channels. The system consists of two modules. The analog module contains a reference clock and 13 analog time stretchers. The digital module contains counters, logic and interface circuits. The timer has an excellent differential linearity, thermal stability and crosstalk free performance

  12. Is suppressed thyroid-stimulating hormone (TSH) associated with subclinical depression in the Danish General Suburban Population Study?

    DEFF Research Database (Denmark)

    Kvetny, Jan; Ellervik, Christina; Bech, Per

    2015-01-01

    BACKGROUND: The first phase of the Danish General Suburban Population Study (GESUS) including 8214 individuals was an attempt to evaluate the association between subclinical hypothyroidism without or with elevated peroxidase antibodies and depression. No such association was found. In the second...... phase, including 14,787 individuals, we have focused on suppressed TSH (thyroid-stimulating hormone) and depression. AIMS: To evaluate to what extent suppressed TSH is associated with subclinical depression. METHODS: The total scores of the Major Depression Inventory (MDI) were used to evaluate...... subclinical depression, both by its total score and by an algorithm of the subthreshold depressed by presence of at least three of the 10 ICD-10 depression symptoms. Serum levels of TSH were used to classify the individuals into suppressed (TSH

  13. Indirect Basal Metabolism Estimation in Tailoring Recombinant Human TSH Administration in Patients Affected by Differentiated Thyroid Cancer: A Hypothesis-Generating Study.

    Science.gov (United States)

    Barnabei, Agnese; Strigari, Lidia; Persichetti, Agnese; Baldelli, Roberto; Rizza, Laura; Annoscia, Claudia; Lauretta, Rosa; Cigliana, Giovanni; Barba, Maddalena; De Leo, Aurora; Appetecchia, Marialuisa; Torino, Francesco

    2018-01-01

    Recombinant human TSH (rhTSH) is currently used in follow-up of patients affected by differentiated thyroid cancer (DTC). Age, sex, weight, body mass index, body surface area (BSA) and renal function are known factors affecting serum TSH peak levels, but the proper rhTSH dose to deliver to single patient remains elusive. In this study, the correlations of basal metabolic rates with serum TSH peak following rhTSH administration were investigated. We evaluated 221 patients affected by thyroid cancer that received a standard dose rhTSH. Blood samples were collected at pre-established time points. Data on body weight, height, and BSA were collected. The Mifflin-St Jeor and Fleisch equations were used to assess basal metabolism. The median value (range) of serum TSH peaks was 142 ± 53 μU/ml. Serum TSH peaks were significantly lower in males than in females ( p  = 0.04). TSH values also increased with age. Data showed a significant decrease of TSH peak levels at day 3 from the administration of rhTSH when basal metabolic rates increased ( p  = 0.002 and p  = 0.009, respectively). Similar findings were observed at day 5 ( p  = 0.004 and p  = 0.04, respectively). A multivariate analysis of several factors revealed that patients' basal metabolism (obtained using the Mifflin-St Jeor but not Fleisch equation) predicts serum TSH level peak at day 3 ( p  Basal metabolism appears an improving factor in tailoring diagnostic rhTSH dose in patients affected by DTC.

  14. Evolution to permanent or transient conditions in children with positive neonatal TSH screening tests in Sergipe, Brazil.

    Science.gov (United States)

    Matos, Diana M; Ramalho, Roberto J R; Carvalho, Bruno M; Almeida, Maria Augusta C T; Passos, Luciana F D; Vasconcelos, Talmay T S; Melo, Enaldo V; Oliveira, Carla R P; Santos, Elenilde G; Resende, Karla F; Aguiar-Oliveira, Manuel H

    2016-10-01

    To assess the evolution to permanent or transient conditions in children with positive neonatal TSH tests in Sergipe, Brazil, from 2004 to 2010. Out of 193,794 screened newborns, 713 presented a neonatal TSH level higher than the local cutoff (5.2 µU/mL). From the confirmatory serum TSH values, the children were diagnosed with initial congenital hypothyroidism (CH) or suspect CH. From the evolution, they were classified as permanent CH, hyperthyrotropinemia, or transient TSH elevation. The mean incidence of each final condition was calculated for the total period of time. The initial diagnosis included 37 CH (18.1%) and 167 suspect CH (81.9%) cases. The final diagnosis included 46 cases of permanent CH (22.5%), 56 of hyperthyrotropinemia (27.5%), and 102 of transient TSH elevation (50.0%). Out of the 37 cases of initial CH, 23 (62.2%) had permanent CH, nine (24.3%) had hyperthyrotropinemia, and five (13.5%) had transient TSH elevation. Out of the 167 suspect CH cases, 23 (13.8%) had permanent CH, 47 (28.1%) had hyperthyrotropinemia and 97 (58.1%) had transient TSH elevation. The mean incidence after the follow up was 1:4,166 for permanent CH, 1:3,448 for hyperthyrotropinemia, and 1:1,887 for transient TSH elevation. Eighty-six percent of the children with an initial diagnosis of CH and 41.9% with suspect CH had a permanent condition (CH or hyperthyrotropinemia). The follow-up of children with an initial diagnosis of CH or suspect CH is necessary to determine whether the disorder is permanent because predicting the evolution of the condition is difficult.

  15. Usefulness of recombinant human TSH-aided radioiodine doses administered in patients with differentiated thyroid carcinoma Administración de dosis terapéuticas de radioyodo luego de TSH recombinante en pacientes con carcinoma diferenciado de tiroides

    Directory of Open Access Journals (Sweden)

    Fabián Pitoia

    2006-04-01

    Full Text Available The published studies confirming the safety and efficacy of rhTSH for diagnostic purposes have led to an increased interest in its use for preparation for radioiodine (RI dose administration in patients with recurrent or persistent differentiated thyroid carcinoma (DTC. In order to establish the efficacy of RI therapy after rhTSH, we have reviewed 39 rhTSH-aided radioiodine treatment in a series of 28 DTC patients. Patients were divided into two groups: GI (n=17, with previous thyroid bed uptake and undetectable thyroglobulin (Tg levels under levothyroxine treatment and GII (n=11, with proven metastatic local or distant disease. Median follow-up after the first rhTSH-aided radioiodine treatment was 32 ± 13 months (range 8 to 54 months. Sixteen patients (94% in GI were rendered disease free and one patient was shown to have persistent disease. In GII, the post therapy whole body scan showed pathological uptakes in all cases: in four patients in lungs, in four in mediastinum and in three in lateral neck. In two patients with mediastinum uptake, Tg levels were undetectable after rhTSH. In the follow-up, two patients with lateral neck uptake were rendered disease free, four patients died (three due to thyroid cancer and five out of the remaining patients have persistent disease. In conclusion, rhTSH aided therapy was helpful to eliminate normal thyroid bed remnants in 16/17 (94% patients (GI. rhTSH stimulated Tg was undetectable in two patients with mediastinal metastasis. We believe that rhTSH is a good alternative to levothyroxine withdrawal for the treatment of DTC with radioactive iodine, increasing the quality of life in these patients. Caution should be recommended in the follow-up of unselected DTC patients only with stimulated Tg levels.Los estudios publicados que confirman la seguridad y eficacia de la TSH recombinante (rhTSH llevaron a un incremento en el interés para su uso como adyuvante terapéutico en el CDT (ablación o tratamiento

  16. Comparison between thyroid hormone withdrawal and recombinant human TSH administration before radioiodine treatment for advanced thyroid cancer

    International Nuclear Information System (INIS)

    Coelho, Sabrina M.; Corbo, Rossana; Buescu, Alexandru; Carvalho, Denise P.; Vaisman, Mario

    2005-01-01

    Full text: Radioiodine treatment is traditionally performed after thyroid hormone withdrawal. However, induction of hypothyroidism is associated with physical and psychological symptoms and a possible induction of tumor growth. This is particularly harmful in patients with advanced thyroid cancer (ATC). The objective of this study was to compare the thyroxine withdrawal and the recombinant human TSH (rh TSH) administration in patients with non-radioiodine responsive ATC after retinoic acid (RA) therapy for induction of iodine uptake. Patients were treated with isotretinoin (1.0 to 1.5 mg/kg/d) for 5 weeks, then, thyroxine (LT 4 ) was discontinued 4 weeks before therapeutic dose (150 mCi). Based on the presence of a satisfactory response to RA (increased iodine uptake, reduction of serum thyroglobulin and tumor regression), another cycle of RA was offered, then rh TSH was used (0.9 mg in two consecutive days). A total of 8 patients (1 follicular, 1 poorly differentiated and 6 papillary carcinomas) were treated. In a patient with pituitary adenoma the endogenous TSH did not rise after T 4 withdrawal, and rh TSH was administered before radioiodine therapy. Although an increase in iodine uptake was observed after RA therapy in the patient with poorly differentiated cancer, the tumor continued to progress and patient died of respiratory insufficiency. Four out of 7 patients had at least a partial response and were selected for re-treatment. Post-therapeutic whole body scan was similar using both protocols, but patients had fewer side effects with rh TSH. One patient who had no compressive symptoms during LT 4 withdrawal did present dysphagia and dysphonia secondary to tumor swelling, 6 hours after the last rh TSH injection. Glucocorticoid was administered and symptoms were reversed after 10 days. Conclusion: Radioiodine uptake using rh TSH was comparable to T 4 withdrawal and is particularly useful when endogenous TSH cannot rise. However, the possibility of compressive

  17. Convex Interval Games

    NARCIS (Netherlands)

    Alparslan-Gok, S.Z.; Brânzei, R.; Tijs, S.H.

    2008-01-01

    In this paper, convex interval games are introduced and some characterizations are given. Some economic situations leading to convex interval games are discussed. The Weber set and the Shapley value are defined for a suitable class of interval games and their relations with the interval core for

  18. Cooperative interval games

    OpenAIRE

    Bok, Jan

    2014-01-01

    In this thesis, we study cooperative interval games, a generalized model of cooperative games in which worth of every coalition corresponds with a closed interval representing all possible outcomes of their cooperation. We give a brief introduction into classical cooperative games, interval analysis and finally introduction to cooperative interval games with focus on selections, that is on all possible outcomes of interval game with no additional uncertainty. We introduce new selection-based ...

  19. TSH Receptor Function Is Required for Normal Thyroid Differentiation in Zebrafish

    Science.gov (United States)

    Opitz, Robert; Maquet, Emilie; Zoenen, Maxime; Dadhich, Rajesh

    2011-01-01

    TSH is the primary physiological regulator of thyroid gland function. The effects of TSH on thyroid cells are mediated via activation of its membrane receptor [TSH receptor (TSHR)]. In this study, we examined functional thyroid differentiation in zebrafish and characterized the role of TSHR signaling during thyroid organogenesis. Cloning of a cDNA encoding zebrafish Tshr showed conservation of primary structure and functional properties between zebrafish and mammalian TSHR. In situ hybridization confirmed that the thyroid is the major site of tshr expression during zebrafish development. In addition, we identified tpo, iyd, duox, and duoxa as novel thyroid differentiation markers in zebrafish. Temporal analyses of differentiation marker expression demonstrated the induction of an early thyroid differentiation program along with thyroid budding, followed by a delayed onset of duox and duoxa expression coincident with thyroid hormone synthesis. Furthermore, comparative analyses in mouse and zebrafish revealed for the first time a thyroid-enriched expression of cell death regulators of the B-cell lymphoma 2 family during early thyroid morphogenesis. Knockdown of tshr function by morpholino microinjection into embryos did not affect early thyroid morphogenesis but caused defects in later functional differentiation. The thyroid phenotype observed in tshr morphants at later stages comprised a reduction in number and size of functional follicles, down-regulation of differentiation markers, as well as reduced thyroid transcription factor expression. A comparison of our results with phenotypes observed in mouse models of defective TSHR and cAMP signaling highlights the value of zebrafish as a model to enhance the understanding of functional differentiation in the vertebrate thyroid. PMID:21737742

  20. An Enantiomer of an Oral Small Molecule TSH Receptor Agonist Exhibits Improved Pharmacologic Properties

    Directory of Open Access Journals (Sweden)

    Susanne Neumann

    2016-07-01

    Full Text Available We are developing an orally available small molecule, allosteric TSH receptor (TSHR agonist for follow up diagnostics of patients with thyroid cancer. The agonist C2 (NCGC00161870 that we have studied so far is a racemic mixture containing equal amounts of two enantiomers, E1 and E2. As enantiomers of many drugs exhibit different pharmacologic properties, we assessed the properties of E1 and E2. We separated the two enantiomers by chiral chromatography and determined E2 as the (S-(+ isomer via crystal structure analysis. E1 and E2 were shown to bind differently to a homology model of the transmembrane domain of TSHR in which E2 was calculated to exhibit lower binding energy than E1 and was therefore predicted to be more potent than E1. In HEK293 cells expressing human TSHRs, C2, E1, and E2 were equally efficacious in stimulating cAMP production, but their potencies were different. E2 was more potent (EC50 = 18 nM than C2 (EC50 = 46 nM which was more potent than E1 (EC50 = 217 nM. In primary cultures of human thyrocytes, C2, E1, and E2 stimulated increases in thyroperoxidase mRNA of 92-, 55-, and 137-fold and in sodium-iodide symporter mRNA of 20-fold, 4-fold and 121-fold above basal levels, respectively. In mice, C2 stimulated an increase in radioactive iodine uptake of 1.5-fold and E2 of 2.8-fold above basal level, whereas E1 did not have an effect. C2 stimulated an increase in serum T4 of 2.4-fold, E1 of 1.9-fold, and E2 of 5.6-fold above basal levels, and a 5 day oral dosing regimen of E2 increased serum T4 levels comparable to recombinant human TSH (rhTSH, Thyrogen®. Thus, E2 is more effective than either C2 or E1 in stimulating thyroid function and as efficacious as rhTSH in vivo. E2 represents the next step toward developing an oral drug for patients with thyroid cancer.

  1. Preparation of quality control samples in radioimmunoassay for thyroid stimulating hormone (TSH)

    International Nuclear Information System (INIS)

    Ali, O.M.

    2006-03-01

    To days, the radioimmunoassay is becomes the best technique to analysis different concentrations of substance, especially in medical and research laboratories. Although the specificity of RIA techniques, the quality controls must takes place to give good results as possible. In this dissertation i prepared quality control samples of thyroid stimulating hormone (TSH), to use it in RIA techniques and to control the reliability results of those laboratories which used these methods. We used China production kits of RIA method to determine the level of hormone (low-normal-high) concentration. Statistical parameters were used to drown the control chart of the mean to these data.(Author)

  2. Structural studies of the O-specific polysaccharide from detergent degrading bacteria Pseudomonas putida TSh-18.

    Science.gov (United States)

    Sigida, Elena N; Fedonenko, Yuliya P; Shashkov, Alexander S; Zdorovenko, Evelina L; Ignatov, Vladimir V; Knirel, Yuriy A

    2017-08-07

    An O-specific polysaccharide was obtained by mild acid degradation of the lipopolysaccharide of bacteria Pseudomonas putida TSh-18, capable of degrading non-ionogenic technical detergents. The polysaccharide was found to contain a rarely occurring sugar derivative 4,6-dideoxy-4-[(R)-3-hydroxybutanoylamino]-d-galactose [d-Fucp4N(RHb)]. Sugar and methylation analyses, Smith degradation, solvolysis with CF 3 CO 2 H, and 1 H and 13 C NMR spectroscopy enabled elucidation of the following structure of the branched trisaccharide repeating units of the polysaccharide. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Electrocardiographic PR Interval Duration and Cardiovascular Risk

    DEFF Research Database (Denmark)

    Rasmussen, Peter Vibe; Nielsen, Jonas Bille; Skov, Morten Wagner

    2017-01-01

    Background Because of ambiguous reports in the literature, we aimed to investigate the association between PR interval and the risk of all-cause and cardiovascular death, heart failure, and pacemaker implantation, allowing for a nonlinear relationship. MethodsWe included 293,111 individuals...... into 7 groups based on the population PR interval distribution. Cox models were used, with reference to a PR interval between 152 and 161 ms (40th to ..., and 1805 pacemaker implantations. A short PR interval ( PR interval ( > 200 ms; HR, 1.23; 95% CI, 1.14-1.32; P

  4. TSH, thyroid hormones and nuclear-binding of T3 in mononuclear blood cells from obese and non-obese women

    DEFF Research Database (Denmark)

    Matzen, L E; Kvetny, J; Pedersen, K K

    1989-01-01

    The specific nuclear-binding of T3 (NBT3) in mononuclear blood cells, and the concentrations of TSH, thyroid hormones, and binding proteins were measured after overnight fasting in 12 obese and in 14 non-obese women, none of the subjects were taking any medicine. The concentrations of TSH and fre...... concentration and was not caused by a primary tissue resistance. The higher TSH and TT3 in the obese women could be caused by a greater caloric intake....

  5. Iterative stimulation of endogenous TSH for ablation. Followup and/or treatment with I-131 in patients with differentiated thyroid carcinoma

    International Nuclear Information System (INIS)

    Degrossi, Osvaldo J.; Garcia del Rio, Hernan; Alvarez, L.; Pena, M.; Faure, E.

    2006-01-01

    In patients with differentiated thyroid carcinoma it is indispensable to raise the values of TSH to determine thyroglobulin and to effect the total tracking with radioiodine. Traditionally to raise the endogenous TSH it is necessary to suspend the opotherapy during a prolonged time with the consistent hypothyroidism. The objective of this work is to increase the endogenous TSH, shortening the time of abstinence of opotherapy [es

  6. Thyroid-Stimulating Hormone (TSH) Concentration at Birth in Belgian Neonates and Cognitive Development at Preschool Age.

    Science.gov (United States)

    Trumpff, Caroline; De Schepper, Jean; Vanderfaeillie, Johan; Vercruysse, Nathalie; Van Oyen, Herman; Moreno-Reyes, Rodrigo; Tafforeau, Jean; Vanderpas, Jean; Vandevijvere, Stefanie

    2015-11-02

    The main objective of the study was to investigate the effect of MID during late pregnancy, assessed by the thyroid-stimulating hormone (TSH) concentration at neonatal screening, on cognitive development of preschool children. A retrospective cohort study including 311 Belgian preschool children of 4-6 years old was conducted. Children were selected at random from the total list of neonates screened in 2008, 2009, and 2010 by the Brussels new-born screening center. Infants with congenital hypothyroidism, low birth weight, and/or prematurity were excluded from the selection. The selected children were stratified by gender and TSH-range (0.45-15 mIU/L). Cognitive abilities were assessed using Wechsler Preschool and Primary Scale of Intelligence-third edition. In addition, several socioeconomic, parental, and child confounding factors were assessed. Neonatal TSH concentration-a surrogate marker for MID-was not associated with Full Scale and Performance IQ scores in children. Lower Verbal IQ scores were found in children with neonatal TSH values comprised between 10-15 mIU/L compared to lower TSH levels in univariate analysis but these results did not hold when adjusting for confounding factors. Current levels of iodine deficiency among pregnant Belgian women may not be severe enough to affect the neurodevelopment of preschool children.

  7. Thyroid-Stimulating Hormone (TSH Concentration at Birth in Belgian Neonates and Cognitive Development at Preschool Age

    Directory of Open Access Journals (Sweden)

    Caroline Trumpff

    2015-11-01

    Full Text Available The main objective of the study was to investigate the effect of MID during late pregnancy, assessed by the thyroid-stimulating hormone (TSH concentration at neonatal screening, on cognitive development of preschool children. A retrospective cohort study including 311 Belgian preschool children of 4–6 years old was conducted. Children were selected at random from the total list of neonates screened in 2008, 2009, and 2010 by the Brussels new-born screening center. Infants with congenital hypothyroidism, low birth weight, and/or prematurity were excluded from the selection. The selected children were stratified by gender and TSH-range (0.45–15 mIU/L. Cognitive abilities were assessed using Wechsler Preschool and Primary Scale of Intelligence—third edition. In addition, several socioeconomic, parental, and child confounding factors were assessed. Neonatal TSH concentration—a surrogate marker for MID—was not associated with Full Scale and Performance IQ scores in children. Lower Verbal IQ scores were found in children with neonatal TSH values comprised between 10–15 mIU/L compared to lower TSH levels in univariate analysis but these results did not hold when adjusting for confounding factors. Current levels of iodine deficiency among pregnant Belgian women may not be severe enough to affect the neurodevelopment of preschool children.

  8. [Development of a simple oral short test with the TSH releasing hormone (TRH) and its use in thyroid diagnosis].

    Science.gov (United States)

    Staub, J J; Girard, J; Gemsenjäger, E

    1976-12-11

    A simple test with 40 mg of oral TRH after overnight fasting was developed and can be characterized as follows: This short oral TRH test has been found to be a most valuable thyroid function test for detection of hyper- and hypothyroidism. It is as reliable as the intravenous TRH test. Oral TRH produces much stronger and more prolonged TSH stimulation similar to that of a depot preparation. Therefore, the incidence of euthyroid controls with absent or subnormal TSH response to TRH is definitely lower than after intravenous TRH. In patients with low TSH response after i.v. TRH the oral TRH test is of particular diagnostic value in distinguishing euthyroid function from TSH suppression or pituitary failure. 40 mg or oral TRH produces reliable stimulation of T3 in most euthyroid subjects. In patients with hyper- and hypothyroidism no increase of T3 is obserable. Oral TRH allows simultaneous assessment of pituitary TSH and thyroid reserve in a single test. The practical advantages (side effects in only 2% [for i.v. TRH 60%], only 1 or 2 blood samples, fewer sampling errors and no i.v. injection) outweigh the disadvantages (longer duration of the test, dependence on food intake and gastrointestinal absorption).

  9. Incidence of radiation-induced Graves' disease in patients treated with radioiodine for thyroid autonomy before and after introduction of a high-sensitivity TSH receptor antibody assay

    International Nuclear Information System (INIS)

    Dunkelmann, Simone; Wolf, Ricarda; Koch, Annedore; Kittner, Christian; Groth, Peter; Schuemichen, Carl

    2004-01-01

    Autoimmune hyperthyroidism may occur several months after radioiodine therapy (RIT) for functional thyroid autonomy. Exacerbation of pre-existing subclinical Graves' disease (GD) has been held responsible for this phenomenon. Determination of TSH receptor antibody using solubilised porcine epithelial cell membranes is insensitive and may have failed to diagnose GD in these patients before RIT. Following the introduction of a more sensitive assay, using the human TSH receptor as an antigen, it has been expected that the incidence of radiation-induced GD after RIT for functional thyroid autonomy will be reduced. In a first group of 1,428 patients treated between November 1993 and March 1997 (group I) we used the porcine TRAb assay to exclude GD, while in a second group comprising 1,408 patients treated between January 2000 and December 2001 (group II), GD was excluded using the human TRAb assay. A matched control group of 231 patients was derived from group II. In group I a total of 15 (1.05%) patients developed obvious or suspected radiation-induced GD, while in group II 17 (1.2%) did so; the interval until development of GD was 8.4 and 8.8 months, respectively, after RIT. Serum anti-thyroid peroxidase levels before RIT were elevated in 36.4% of group I patients and 47.1% of group II patients, but in only 5.6% of the control group. Other non-specific signs of mild immunopathy of the thyroid were seen retrospectively in 73.3%, 64.7% and 16.0% of the patients in these three groups, respectively. In conclusion, the introduction of a high-sensitivity TRAb assay did not reduce the incidence of autoimmune hyperthyroidism occurring late after RIT for functional thyroid autonomy, but mild immunopathy of the thyroid is seen more frequently in these patients and seems to be a predisposing factor in the development of radiation-induced GD. (orig.)

  10. A reference dosimetric system for dose interval of radiotherapy based on alanine/RPE; Um sistema dosimetrico de referencia para o intervalo de doses da radioterapia baseado na alanina/RPE

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigues Junior, Orlando; Galante, Ocimar L.; Campos, Leticia L. [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)]. E-mail: rodrijr@net.ipen.br

    2001-07-01

    This work describes the development of a reference dosimetric system based on alanine/EPR for radiotherapy dose levels. Currently the IPEN is concluding a similar system for the dose range used for irradiation of products, 10-10{sup 5} Gy. The objective of this work is to present the efforts towards to improve the measure accuracy for doses in the range between 1-10 Gy. This system could be used as reference by radiotherapy services, as much in the quality control of the equipment, as for routine accompaniment of more complex handling where the total doses can reach some grays. The system uses alanine as detector and electronic paramagnetic resonance - EPR as measure technique. To reach accuracy better than 5% mathematical studies on the best optimization of the EPR spectrometer parameters and methods for the handling of the EPR sign are discussed. (author)

  11. [Human anti-murine immunoglobulin antibodies as disturbing factors in TSH determination].

    Science.gov (United States)

    Horneff, G; Becker, W; Wolf, F; Kalden, J R; Burmester, G R

    1991-03-18

    Monoclonal murine antibodies are increasingly used for immunotherapy and in vivo diagnostic procedures such as immunoscintigraphy. The therapeutic or diagnostic reagent however, is a foreign antigen, which may induce host reactivity. This may interfere with the therapeutic or diagnostic reagent in vivo, resulting in a loss of efficacy or the necessity to increase dosages. In addition, there is an important interference to in vitro immunoassays detecting specific antigens utilizing murine monoclonal antibodies. In the present study, sera of patients who had undergone a therapeutic trial using 140 mg of an anti-CD4 antibody, were investigated. Human anti-murine-immunoglobulin-antibodies (HAMA) were detected 2-3 weeks after treatment was started and reached maximal amounts of 0.8 micrograms/ml after a single and 2 micrograms/ml after a repeated treatment course. Parallely raised values of TSH were found in sera containing HAMAs of more than 0.3 micrograms/ml. Elevations of TSH levels up to 13 microU/ml were most pronounced after a repeated trial of the murine antibody and were detectable up to 20 weeks.

  12. Clinical value of determination of TSH-binding inhibiting immunoglobulins (TBII) by a radioreceptor assay

    International Nuclear Information System (INIS)

    Heberling, H.J.; Bierwolf, B.; Lohmann, D.

    1986-01-01

    The clinical value of a commercial kit for determination of TBII was evaluated. 50 patients with untreated Graves' disease, 21 patients with Graves' disease before and during medical therapy, 18 patients after finishing medical therapy and 10 patients after surgical treatment were examined. Besides these, 41 patients with other thyroid diseases and 36 patients without any thyroid disorder were included. In 47 (94%) of 50 patients with untreated Graves' disease TBII were detectable in serum using a TSH standard curve. Binding activities exceeding 10 U/l TSH equivalents were regarded as positive. In other thyroid diseases TBII were negative with the exception of 3 of 22 patient with autonomously functioning thyroid nodules. After 12 months of antithyroid drug treatment of 19 patients the incidence of positive antibody findings was 26%. During follow-up after medical therapy (1-9 years) 7 of 18 patients had increased TBII in correlation with clinical and functional findings. The determination of TBII by TRAK assay proved to be a sensitive and specific method. The assay can be used to differentiate between hyperthyroidism of autoimmune or non-immunogenic origin. Thus the method seems to be helpful for the follow-up under medical treatment of patients with Graves' disease. (author)

  13. Evidence for cooperative signal triggering at the extracellular loops of the TSH receptor.

    Science.gov (United States)

    Kleinau, Gunnar; Jaeschke, Holger; Mueller, Sandra; Raaka, Bruce M; Neumann, Susanne; Paschke, Ralf; Krause, Gerd

    2008-08-01

    The mechanisms governing transition of the thyroid stimulating hormone (TSH) receptor (TSHR) from basal to active conformations are poorly understood. Considering that constitutively activating mutations (CAMs) and inactivating mutations in each of the extracellular loops (ECLs) trigger only partial TSHR activation or inactivation, respectively, we hypothesized that full signaling occurs via multiple extracellular signal propagation events. Therefore, individual CAMs in the extracellular region were combined to create double and triple mutants. In support of our hypothesis, combinations of mutants in the ECLs are in some cases additive, while in others they are even synergistic, with triple mutant I486A/I568V/V656F exhibiting a 70-fold increase in TSH-independent signaling. The proximity but likely different spatial orientation of the residues of activating and inactivating mutations in each ECL supports a dual functionality to facilitate signal induction and conduction, respectively. This is the first report for G-protein coupled receptors, suggesting that multiple and cooperative signal propagating events at all three ECLs are required for full receptor activation. Our findings provide new insights concerning molecular signal transmission from extracellular domains toward the transmembrane helix bundle of the glycoprotein hormone receptors.

  14. Protocol for thyroid remnant ablation after recombinant TSH in thyroid carcinoma Protocolo para ablación de remanentes tiroideos luego de TSH recombinante en el cáncer diferenciado de tiroides

    Directory of Open Access Journals (Sweden)

    Fabián Pitoia

    2009-02-01

    Full Text Available In some countries, in order to perform rhTSH-aided thyroid remnant ablation (TRA after surgery, it is generally necessary to confirm that thyroidectomy has been almost complete. Otherwise, the nuclear medicine specialist will not administer a high radioiodine dose because it might be hazardous due to the possibility of thyroid remnant actinic thyroiditis. Considering this, it would be necessary to use two rhTSH kits (one for diagnostic purposes and the other one to administer the 131I dose. In this study, we used an alternative protocol for TRA with the use of one kit of rhTSH in twenty patients diagnosed with low risk papillary thyroid carcinoma. All patients had negative titers of anti-thyroglobulin antibodies. Successful thyroid remnant ablation was confirmed with an undetectable rhTSH stimulated thyroglobulin level (En algunos países, para realizar la ablación de los remanentes tiroideos con radioyodo después de la cirugía, generalmente se requiere confirmar que la tiroidectomía fue casi completa, ya que de otra manera el especialista en medicina nuclear no administrará una dosis elevada de radioyodo, considerando que esto puede ser dañino para el paciente debido a la posibilidad de generar una tiroiditis actínica. De acuerdo con esto, sería necesario administrar 2 kits de rhTSH (uno para diagnóstico y otro para la dosis de radioyodo. En este estudio, empleamos un protocolo alternativo para la ablación luego de la administración de un único kit (2 ampollas de rhTSH en 20 pacientes con antecedentes de un carcinoma papilar de bajo riesgo. Todos los pacientes presentaban títulos negativos de anticuerpos anti-tiroglobulina. La ablación exitosa de remanente tiroideo se confirmó con un nivel no detectable de tiroglobulina (<1 ng/ml al estímulo por rhTSH en los 20 pacientes, entre 8 a 12 meses luego de la ablación. El uso de este protocolo que combina la posibilidad de realizar un centellograma diagnóstico y la ablación luego

  15. Recombinant human TSH-aided radioiodine treatment of advanced differentiated thyroid carcinoma: a single-centre study of 54 patients

    International Nuclear Information System (INIS)

    Jarzab, Barbara; Handkiewicz-Junak, Daria; Roskosz, Jozef; Puch, Zbigniew; Wygoda, Zbigniew; Kukulska, Aleksandra; Jurecka-Lubieniecka, Beata; Hasse-Lazar, Kornelia; Turska, Maria; Zajusz, Aleksander

    2003-01-01

    In 54 consecutive patients who had retained bulky metastatic and/or locoregional lesions of DTC despite the exhaustion of other therapeutic options, we gave one to four courses of two consecutive daily intramuscular injections of rhTSH, 0.9 mg, followed by a therapeutic activity of 131 I per os on day 3. Fifty patients had received prior radioiodine treatment aided by l-thyroxine (T 4 ) withdrawal. We included in the study 23 patients who had received a trial of isotretinoin therapy for re-differentiation of confirmed de-differentiated metastases. In a blinded, within-patient comparison of post-therapy whole-body scans after the first rhTSH-aided and latest withdrawal-aided treatments in patients with functional metastases at baseline, 18 of 27 (67%) scan pairs were concordant, four (15%) were discordant in favour of the rhTSH-aided scan and five (19%) were discordant in favour of the withdrawal-aided scan. In total, 37 (74%) of 50 paired scans were concordant, eight (16%) favoured rhTSH and five (10%) favoured withdrawal. All differences appeared to be attributable to clinical causes, not to any difference between endogenous and exogenous TSH stimulation. Reflecting the biochemical activity of rhTSH and the release of thyroglobulin (Tg) due to tumour destruction, median serum Tg concentration rose approximately fourfold between baseline and day 6 of the rhTSH-aided treatment course. rhTSH was well tolerated, with mostly minor, transient toxicity, except for neck oedema in three patients with neck infiltrates and pathological spine fracture in one patient with a large vertebral metastasis. At 6 months, complete response occurred in one (2%), partial response in 12 (26%) and disease stabilisation in 19 (40%) of 47 evaluable patients. The rate of complete + partial response was 41% and that of disease stabilisation, 30%, in the 27 evaluable patients with functional metastases at baseline; the corresponding rates were 10% and 55% in the 20 evaluable patients with non