scholarly journals Definition of the upper reference limit of glycated albumin in blood donors from Italy

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Chiara Bellia ◽  
Martina Zaninotto ◽  
Chiara Cosma ◽  
Luisa Agnello ◽  
Bruna Lo Sasso ◽  
...  
Keyword(s):  
Blood Donors ◽  
Glycated Albumin ◽  
Specific Reference ◽  
Reference Limit ◽  
Percentile Method ◽  
The Mean ◽  
Definition Of ◽  
Upper Reference Limit ◽  
Mean Glucose

AbstractBackground:Glycated Albumin (GA) has been proposed as a short-term indicator of glycemic homeostasis. The aim of this study is to describe the distribution of GA in a large sample of blood donors from Italy to evaluate whether demographic features, namely age and sex, could influence GA levels and define specific reference limits.Methods:The study included 1334 Italian blood donors. GA was measured using an enzymatic method (quantILab Glycated Albumin, IL Werfen, Germany). The upper reference limit (URL) was calculated using the non-parametric percentile method.Results:A modest, although significant, increase of GA was observed in relation to age (p<0.001), especially in males, where the differences were more pronounced (p<0.001 in males, p=0.003 in females). Slight differences were documented based on sex (12% [11.3–12.8] in males; 12.2% [11.4–13.1] in females; p=0.01). After excluding individuals with fasting plasma glucose ≥7 mmol/L, the calculated GA URL was 14.5% (95% CI: 14.3–14.7). Subjects with GA>14.5% presented a mean age of 48.4±12.2 years, 66.7% were males and the mean glucose was 6.88±2.5 mmol/L.Conclusions:GA in Caucasians shows a similar increasing trend at older ages documented in other ethnicities. The definition of the URL in this population could be useful for both clinical studies, which will clarify the role of GA for diagnosing and monitoring diabetes, and will encourage the introduction of GA in clinical practice.

scholarly journals Cerebrospinal Fluid Protein Concentration in Healthy Older Japanese Volunteers

2021 ◽  
Vol 18 (16) ◽  
pp. 8683
Author(s):  
Tatsuya Yoshihara ◽  
Masayoshi Zaitsu ◽  
Kazuya Ito ◽  
Ryuzo Hanada ◽  
Eunhee Chung ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Asian Population ◽  
Reference Interval ◽  
Reference Limit ◽  
Neurological Emergencies ◽  
Precise Diagnosis ◽  
The Mean ◽  
Upper Reference Limit ◽  
Age Range ◽  
Cerebrospinal Fluid Protein

The concentration of cerebrospinal fluid total protein (CSF-TP) is important for the diagnosis of neurological emergencies. Recently, some Western studies have shown that the current upper reference limit of CSF-TP is quite low for older patients. However, little is reported about the concentration of CSF-TP in the older Asian population. In this study, we retrospectively analyzed the CSF-TP concentrations in healthy older Japanese volunteers. CSF samples in 69 healthy Japanese volunteers (age range: 55–73 years) were collected by lumbar puncture, and the data of CSF were retrospectively analyzed. The mean (standard deviation) CSF-TP was 41.7 (12.3) mg/dL. The older group (≥65 years old) had higher CSF-TP concentration than the younger group (55–64 years old). The 2.5th percentile and 97.5th percentile of CSF-TP were estimated as 22.5 and 73.2 mg/dL, respectively, which were higher than the current reference range in Japan (10–40 mg/dL). Conclusions: The reference interval of CSF-TP in the older population should be reconsidered for the precise diagnosis of neurological emergencies.

Emergency department triage of patients with acute chest pain: definition of cardiac troponin I decisional value to manage patients without electrocardiographic evidence of ischemia

2004 ◽  
Vol 42 (5) ◽  
Author(s):  
Pascale Beyne ◽  
Erik Bouvier ◽  
Patrick Werner ◽  
Pierre Bourgoin ◽  
Damien Logeart ◽  
...  
Keyword(s):  
Chest Pain ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Acute Chest Pain ◽  
Final Diagnosis ◽  
Cardiac Troponin I ◽  
Reference Limit ◽  
Coronary Syndrome ◽  
Definition Of ◽  
Upper Reference Limit

AbstractThe aim of this study was to define the use of a new cardiac troponin I (cTnI) assay for emergency patients with chest pain and no specific electrocardiographic changes consistent with the presence of ischemia. Patients (n=106) admitted in Emergency/Cardiology Departments for chest pain and suspicion of acute coronary syndrome (ACS) were randomized into two diagnosis groups (ACS or non-ACS) by two independent cardiologists. cTnI measurements were performed at admission, and 6 hours and 12 hours later with a new generation assay (Access AccuTnI, Beckman Coulter). Using an upper reference limit of 0.04 μg/l, 27 patients had a cTnI elevation not related to the final diagnosis of ischemia; the positive predictive value (PPV) was 67% with specificity 48%. The decisional value was re-defined and set at 0.16 μg/l, a concentration corresponding to the 99th percentile of the non-ACS patient group. Precision (coefficient of variation) was 8% at this level, PPV 97% and specificity 98%. This new decisional value is now used in our institution and could be included in standard care guidelines to improve the management of patients presenting chest pain in emergency departments.

The universal definition of myocardial infarction

2015 ◽  
Author(s):  
Kristian Thygesen ◽  
Joseph S Alpert ◽  
Allan S Jaffe ◽  
Harvey D White
Keyword(s):  
Myocardial Infarction ◽  
Wall Motion ◽  
Regional Wall Motion ◽  
Cardiac Biomarkers ◽  
Regional Wall ◽  
Reference Limit ◽  
Electrocardiographic Changes ◽  
Universal Definition ◽  
Definition Of ◽  
Upper Reference Limit

Myocardial infarction is defined pathologically as myocyte necrosis due to prolonged ischaemia. These conditions are met when there is a detection of a rise and/or fall of cardiac biomarkers, preferably troponins, with at least one value above the 99th percentile of the upper reference limit, together with evidence of myocardial ischaemia, as recognized by at least one of the following: symptoms of ischaemia, electrocardiographic changes of new ischaemia, the development of pathological Q waves, imaging evidence of a new loss of viable myocardium or new regional wall motion abnormality, or the identification of an intracoronary thrombus by angiography or autopsy.

scholarly journals Cerebrospinal Fluid Protein Concentration in Japanese Healthy Older Volunteers

2021 ◽  
Author(s):  
Tatsuya Yoshihara ◽  
Masayoshi Zaitsu ◽  
Kazuya Ito ◽  
Ryuzo Hanada ◽  
Eunhee Chung ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Protein Concentration ◽  
Reference Range ◽  
Asian Population ◽  
Reference Limit ◽  
Older Volunteers ◽  
The Mean ◽  
Upper Reference Limit ◽  
Age Range ◽  
Cerebrospinal Fluid Protein

The concentration of cerebrospinal fluid total protein (CSF-TP) is important for the diagnosis of neurological emergencies. Recently, some Western studies have shown that the current upper reference limit of CSF-TP is quite low for older patients. However, little is reported about the concentration of CSF-TP in older Asian population. In this study, we retrospectively analyzed the CSF-TP concentrations in Japanese healthy older volunteers. CSF samples in 69 healthy Japanese volunteers (age range: 55–73 years) were collected by lumbar puncture, and the data of CSF were retrospectively analyzed. The mean (standard deviation) CSF-TP was 41.7 (12.3) mg/dL. The older group (≥ 65 years old) had higher CSF-TP concentration than the younger group (55–64 years old). The 2.5th percentile and 97.5th percentile of CSF-TP were estimated as 22.5 and 73.2 mg/dL, respectively, which were higher than the current reference range in Japan (10–40 mg/dL).

scholarly journals Evaluation of plasma N-terminal pro-B-type natriuretic peptide levels in healthy North American Salukis with normal echocardiographic measurements.

2021 ◽  
Author(s):  
Tamilselvam Gunasekaran ◽  
Christopher Brennan ◽  
Robert Sanders
Keyword(s):  
Body Weight ◽  
Heart Disease ◽  
Natriuretic Peptide ◽  
Plasma Concentrations ◽  
Clinical Use ◽  
Reference Limit ◽  
Cardiac Health ◽  
Percentile Method ◽  
Reference Limits ◽  
Upper Reference Limit

Measurement of N‐terminal pro‐B‐type natriuretic peptide (NT-proBNP) levels has been shown to have clinical significance for diagnosis and management of heart disease in dogs. Evaluation of current reference limits for specific breeds is necessary to ensure the test can accurately distinguish between healthy and diseased animals. The objective of this study is to evaluate the adequacy of currently established NT-proBNP reference limits for clinical use in healthy Salukis. Cardiac health of 33 clinically healthy Salukis was evaluated via echocardiography using available breed standards. Plasma concentrations of NT-proBNP were measured using a commercially available assay. A one-sided 97.5% upper reference limit for the NT-proBNP concentrations was calculated using non-parametric percentile method. The 97.5% upper reference limit was 769 pmol/L (90% CI, 547-1214 pmol/L) for the study dogs. This upper reference limit was within the currently established non-breed specific NT-proBNP upper reference limit of 900 pmol/L. No relationship between sex, age, or body weight on plasma levels of NT-proBNP was noted. Results of this study supports the use of currently available non-breed specific NT-proBNP cut-off values for clinical evaluation of healthy Salukis.

scholarly journals Effects of short-term bisoprolol on perioperative myocardial injury in patients undergoing non-cardiac surgery: a randomized control study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Wanwarang Wongcharoen ◽  
Thanyalak Chotayaporn ◽  
Kavint Chutikhongchalermroj ◽  
Apichat Tantraworasin ◽  
Somcharoen Saeteng ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Beta Blocker ◽  
Myocardial Injury ◽  
Troponin T ◽  
Protective Role ◽  
Reference Limit ◽  
Intraoperative Hypotension ◽  
Significant Difference ◽  
Upper Reference Limit

AbstractThe protective role of preoperative beta-blocker in patients undergoing non-cardiac surgery is unknown. We aimed to evaluate the effects of beta-blocker on perioperative myocardial injury in patients undergoing non-cardiac surgery. We consecutively enrolled 112 patients undergoing non-cardiac surgery. They were randomly allocated to receive bisoprolol or placebo given at least 2 days preoperatively and continued until 30 days after surgery. The primary outcome was incidence of perioperative myocardial injury defined by a rise of high-sensitive troponin-T (hs-TnT) more than 99th percentile of upper reference limit or a rise of hs-TnT more than 20% if baseline level is abnormal. Baseline characteristics were comparable between bisoprolol and placebo in randomized cohort Mean age was 62.5 ± 11.8 years and 76 (67.8%) of 112 patients were male. Among 112 patients, 49 (43.8%) underwent vascular surgery and 63 (56.2%) underwent thoracic surgery. The median duration of assigned treatment prior to surgery was 4 days (2–6 days). We did not demonstrate the significant difference in the incidence of perioperative myocardial injury [52.6% (30 of 57 patients) vs. 49.1% (27 of 55 patients), P = 0.706]. In addition, the incidence of intraoperative hypotension was higher in bisoprolol group than placebo group in patients undergoing non-cardiac surgery [70.2% (40 of 57 patients) vs. 47.3% (26 of 55 patients), P = 0.017]. We demonstrated that there was no statistically significant difference in perioperative myocardial injury observed between patients receiving bisoprolol and placebo who had undergone non-cardiac surgery.

User Requirements

2003 ◽  
pp. 280-304
Author(s):  
Len Asprey ◽  
Michael Middleton
Keyword(s):  
Information Systems ◽  
Business Process ◽  
Integrative Approach ◽  
Specific Reference ◽  
User Requirements ◽  
Business Systems ◽  
Systems Requirements ◽  
Definition Of ◽  
Process Level

In the last chapter, we discussed an integrative approach to developing requirements for information systems, applying Sommerville’s framework of user and systems requirements documentation. We now extend that discussion to consider an approach that might be useful when planning activities for analyzing user requirements for an IDCM endeavor. The information derived from the analysis of user requirements will be a key component of the requirements specification. Our objectives are as follows: • Discuss the role of the user requirements analysis in the context of IDCM; • Discuss the analysis and definition of strategic requirements for IDCM systems within the context of enterprise business planning; • Discuss the specification of tactical requirements for an IDCM solution at the site, workgroup, or business process level of an enterprise; • Consider the requirements for specifying interfaces to business systems; • Discuss the documentation of operational requirements with some specific reference to archiving and preservation concerns; and • Discuss extended requirements for IDCM solutions.

Determination of the upper reference limit of Human epididymis secretory protein 4 (HE4) in healthy male individuals and correlation with renal and fertility markers

2020 ◽  
Vol 20 ◽  
Author(s):  
Annalisa Schirinzi ◽  
Angela Pia Cazzolla ◽  
Elisa Mascolo ◽  
Giuseppe Palmieri ◽  
Francesco Pesce ◽  
...  
Keyword(s):  
Negative Correlation ◽  
Gynecologic Cancer ◽  
Secretory Protein ◽  
Large Cohort ◽  
Healthy Male ◽  
Reference Limit ◽  
Percentile Method ◽  
Human Epididymis ◽  
Bioavailable Testosterone ◽  
Upper Reference Limit

Background: Elevated human epididymis secretory protein 4 (HE4) serum levels have been widely investigated in patients with ovarian cancer. However, high levels of HE4 can be also found in other tumors and in renal fibrosis. To date, the HE4 assay manufacturer features the reference value only for the female pre- and post-menopausal population. The aim of this study was to determine the upper reference limit (URL) of HE4 in a well-defined and large cohort of healthy male individuals and investigate potential factors influencing HE4 levels in healthy subjects. Methods: The study included 307 Italian healthy male individuals. HE4 was measured using a chemiluminescent assay (Abbott Laboratories, Wiesbaden, Germany). The URL was calculated using the non-parametric percentile method. Differences in HE4 concentrations according to age, estimated glomerular filtration rate (eGFR), free and bioavailable testosterone were also evaluated. Results: The 97.5th percentile URL of serum HE4 in our study population was 57 pmol/L (90% CI). After stratifying subjects according to age, we found that the URL of HE4 was higher in older (> 50 years) than in younger subjects (18-30 years old), and overlapping with the URL in males from 31 to 50 years old (P=4.769e-16, r=0.44). A strong negative correlation between HE4 and eGFR was observed (P=8.412e-12, r=- 0.38). Moreover, a statistically significant negative correlation was also found between HE4 and free and bioavailable testosterone. Conclusion: In this study was determined the URL of HE4 in a large cohort of healthy male subjects. Our findings indicate that the HE4 age-dependent differences in males need to be taken into account. The definition of the HE4 URL in males and the correlation observed with eGFR and testosterone should foster the clinical use of HE4 beyond gynecologic cancer.

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