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Biomedical subjects

A H Free

Publications and source records attributed to A H Free.

13 recordsLinked to original sources

Urinalysis: its proper role in the physician's office.

Urine study is an important aspect of physician's office laboratories. The contributions that urine study can make are important for both the patient and the physician. State-of-the-art technology makes it possible to have urine test results available at the time the patient is being examined without inconvenience to the patient, the physician, or the laboratory. The cost-containment contributions of urine study are significant for both the patient and the physician. The analytes currently studied provide a broad spectrum of information that relates to many of the problems presented by the typical patient in the typical physician's office.

Amylases↗

Dry chemistry: its expanded role in doctor's office testing.

The physician's office laboratory is an important adjunct to quality patient care. Dry chemistry reagents and the instrumentation used with them provide an ideal mechanism to give the patient a timely, relatively inexpensive work-up. An office laboratory can save the physician and his or her staff many frustrations. But unless the physician's office laboratory director makes use of the assistance of laboratorians and manufacturers in setting up good quality assurance systems along with the choice of dry chemistry system, the director may merely replace his or her frustrations with new ones. The limitations of an office laboratory are far outweighed by the benefits in quality patient care.

Blood Chemical Analysis↗

The efficacy of quantitative and qualitative chloride titrators in the estimation of human salt intake.

We evaluated the utility of chloride titrator sticks for facilitating the assessment of dietary salt intake, in a systematic series of clinical trials. These inexpensive devices were applied daily to 24-h or nocturnal urine specimens, thereby avoiding the inter- and intra-subject variability in salt excretion which confounds the use of occasional 24-h urine collections. Chloride and sodium concentrations in urine were highly correlated (r greater than 0.92) in either nocturnal, diurnal, or 24-h collections. The quantitative chloride titrator estimates and measured chloride concentrations were highly correlated as well (r greater than 0.99). The qualitative chloride titrator was graded on a simple scale, and was successfully employed by outpatients attempting to limit their salt intake. Commonly used antihypertensive medications did not interfere with the determinations. Additional chloride intake, such as supplemental potassium chloride, interfered with estimates of salt ingestion, but if the daily amount of potassium chloride supplement was constant, adjustments in interpretation could be made. Renal insufficiency introduced a systematic over-estimation of salt intake by the qualitative chloride tirator, but only at high salt intakes. Relative estimates of salt intake in subjects with renal failure were still possible. We conclude that chloride titrators can facilitate the management of patients who require a prescribed salt intake.

Adult↗

Self testing, an emerging component of clinical chemistry.

Self testing as a phase of health delivery has been utilized for approximately 70 years, but within the last two decades there has been an increasing interest in and use of self testing. The practice of self testing has a sound basis, which involves medical relevancy, cost containment, and convenience. It is reasonable to anticipate that self testing will increase in the future as medical needs and available procedures are established. The clinical chemist, the physician, and the industrial producer of test systems all have important roles in self testing. The clinical chemist, whether in a hospital laboratory or in an industrial setting, has the responsibility to create new self-testing procedures that represent expansion and improvement over those currently available. The clinical chemist also has a critical role in the evaluation of new self-testing procedures and in validating their capability of providing high-quality information. The provision of quality-assurance programs and proficiency programs for the user can most effectively be carried out by clinical chemists. The clinical chemist can also play an important role as a consultant, teacher/educator, and trouble shooter in recognizing and helping solve problems that may appear in various areas of self testing. The classic role of the physician has been to diagnose disorders of the patients and provide therapy for effective care. The role of the physician in self testing is quite comparable to his usual role, since the ultimate diagnosis of disease will be carried out by the physician and he will continue to be the source for definition of therapy. A major portion of self testing will be carried out with the recommendation of a physician, and he will maintain a role in the interpretation of results. The physician needs to be familiar with self-testing practices and procedures and be prepared to provide interpretation of self-testing results. Industry supplies an increasing proportion of reagent systems and instruments for the clinical laboratory. The supplying of reagent systems and small instruments for self testing is almost completely a role of industry. The creation and funding of new products for self testing will be provided by industry to a large extent. A critical function of industry is to provide high-quality products and efficient customer service to the self-testing component of health delivery. We have each played a role in self testing over a period of approximately 40 years. During this period self testing has become an important phase of clinical laboratory practice.(ABSTRACT TRUNCATED AT 400 WORDS)

Blood Glucose↗

The utility of overnight urine collections in assessing compliance with a low sodium intake diet.

To develop methods of estimating sodium intake in free-living persons, we gave normal volunteers mean sodium intakes of 65, 110, and 200 mEq/day. The intake was randomly varied about each mean by an SD of 12.5% daily. Twenty-four-hour and night urinary sodium excretion were measured. Night urinary sodium excretion was also estimated by means of inexpensive quantitative and qualitative chloride titrator strips. The latter required no timed urine collection. A total of three 24-hour urine collections were necessary to differentiate the regimens with 95% accuracy. Three night urinary sodium excretory estimates by the quantitative chloride titrator provided 79% accuracy in identifying the level of dietary sodium intake. By applying the qualitative chloride titrator every other day, the dietary regimens could be differentiated with 95% accuracy. These techniques were not only useful in estimating sodium intake, but also provided a simple means of documenting compliance to sodium restriction. Patients should have no difficulty in applying these methods themselves in a home setting.

Adult↗

Urine glucose tests for diabetic patients with impaired vision.

A colorimetric test procedure called Mega-Diastix is described for detection and measurement of glucose in urine. The test is designed for use by diabetic patients with imparied vision. Data establishing the performance capabilities of this rapid, convenient test are presented. As an internal standard, the recommended procedure utilizes effervescent control tablets for preparation of simulated urine. Also described is a touch fermentation test for detection of urinary glucose by totally blind patients. Data are given that demonstrate the accuracy and ease of performance of this test, which entails a rapid yeast fermentation. An internal standard is also incorporated into the procedure for this test.

Blindness↗

Analytical applications of immobilized enzymes.

Several clinical laboratory methods using enzymes as reagents now may utilize immobilized enzymes. These are enzymes attached to solid surfaces by adsorption, covalent binding, cross linking or similar means. Immobilized enzymes are widely used presently in convenient tests for urine glucose and galactose or blood glucose and urea, and in serum glucose or urea determinations by automated methods. Advantages include enhanced stability, enzyme conservation, reuse and economy. Limitations in clinical analysis include the requirement for proper handling of both the immobilized enzyme and the specimen with which it is used. Immobilized enzymes of the future should aid in the new discoveries regarding sequential enzyme-catalyzed reactions in living cells and expand the utility of enzymes as reagents in analytical laboratory science.

Blood Glucose↗