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A Marchand

Publications and source records attributed to A Marchand.

At least 55 records · Page 3Linked to original sources
PubMed1983

The assessment of laboratory tests in the diagnosis of acute appendicitis.

A comparison of laboratory tests was undertaken in 106 patients admitted to the emergency room with the tentative diagnosis of acute appendicitis and who subsequently underwent appendectomy. The tests examined included the total white blood cell count, manual differential count, cytochemical differential count, and C-reactive protein. The sensitivity, specificity, efficiency, and predictive value of these tests in the diagnosis of acute appendicitis were calculated. The cytochemically determined neutrophil count, when greater than the upper limit of the reference interval of either 75% or 7.88 X 10(9)/L, and the total white blood count greater than the upper limit of the reference interval of 10.5 X 10(9)/L were the single best tests for the diagnosis of acute appendicitis with the highest sensitivities of all tests examined (81-84%). The manual differential count and C-reactive protein showed significantly lower sensitivities. Test combinations also were examined. The combinations consisted of two or more tests joined by an "or" rule, i.e., if any one of the individually linked tests of the combination is above the reference interval, the combination is considered as indicating acute appendicitis. When either of the following test combinations were utilized--(1) total white count greater than 10.5 X 10(9)/L or cytochemical neutrophils greater than either 75% or 7.88 X 10(9)/L or CRP greater than 1.2 mg/dL; (2) total white count greater than 10.5 X 10(9)/L or manual bands greater than either 11% or 1.15 X 10(9)/L or CRP greater than 1.2 mg/dL--the sensitivity of the combination in the diagnosis of acute appendicitis approached 100% with a specificity in the range of 50%. We suggest that these test combinations may be useful in deciding which patients need further observation and reexamination prior to surgery. We also suggest the need for further studies to assess the usefulness of these tests in other types of acute inflammation and infection.

Acute Disease↗
PubMed1981

Diagnosis of hemolytic disease by electrophoresis of erythrocyte lactate dehydrogenase isoenzymes on cellulose acetate or Agarose.

We determined the LD-1/LD-2 isoenzyme ratio in hemolysates of erythrocytes by electrophoresis on cellulose acetate and on agarose. A ratio exceeding 1.0 was found with the former but not the latter. Results were similar for in vitro models of hemolytic disorders. Using cellulose acetate electrophoresis, we determined the predictive value of data on total LD activity and of the LD-1/LD-2 ratio in diagnosis of hemolytic disease in 100 patients. The sensitivity of the "flipped" LD-1/LD-2 ratio was only 58%, the specificity was 93%, and the predictive value was 74% for diagnosis of hemolytic disease. A normal total LD activity is highly predictive (92%) for ruling at the presence of hemolytic disease.

Anemia↗
PubMed1980

The predictive value of serum haptoglobin in hemolytic disease.

Using a rapid, highly sensitive immunoprecipitin nephelometric technique, a retrospective study was undertaken to evaluate the clinical usefulness of determining serum haptoglobin in the diagnosis of hemolysis. Haptoglobin assays were performed shortly after admission in 100 patients with a variety of hematologic and nonhematologic conditions and the results correlated with the clinical diagnosis. An ad hoc boolean computer program allowed for the separation of hemolytic from nonhemolytic disorders with a haptoglobin limit of 25 mg/dL or less. The sensitivity and specificity of the test are high (83% and 96%, respectively), providing 87% probability of predicting hemolytic disease when the serum haptoglobin level falls below this limit. These data support the routine use of serum haptoglobin determinations in the diagnosis of hemolytic disease.

Adult↗
PubMed1979

Evaluation of a nephelometric assay for haptoglobin and its clinical usefulness.

Serum haptoglobin has been advocated as an indicator of intravascular hemolysis. We have evaluated a nephelometric determination of serum haptoglobin. The assay is sensitive and exhibits within-run precision in the range of 2.5-7.4% coefficient of variation (CV) and between-run precision of 7.0% (CV). In addition, when haptoglobin values determined with the nephelometric assay were compared with hemoglobin-binding capacity determined by electrophoresis, the correlation coefficient was 0.968. The assay is essentially independent of phenotype and free of significant interference by hemolysis. The clinical correlation of haptoglobin values obtained for 100 selected patients with the nephelometric technique correlated well, if less than 250 mg/L, with the presence of hemolytic disease.

Anemia, Hemolytic↗
PubMed1979

Anemia in the orthopedic patient: a diagnostic approach.

Anemia is the most common hematologic abnormality in the orthopedic patient. The diagnostic work-up is relatively simple if a systematic routine for ordering laboratory test is employed. The approach presented here includes a series of alogarithms incorporating pertinent laboratory tests that allow for a presumptive diagnosis and subsequent confirmation of a particular disease process. Whether all or none of the confirmatory tests is carried out depends on the severity of the anemia as well as the clinical setting. Failure to confirm a diagnosis means that other pathways should be followed or that additional diagnostic possibilities should be considered. There has been no attempt to cover all diagnostic possibilities should be considered. There has been no attempt to cover all diagnostic possibilities but rather to demonstrate a general approach to laboratory utilization.

Anemia↗
PubMed1975

Kinetics of a bacterial culture growth: validity of the affinity rule in biological systems.

The kinetic study of a process is usually performed by measuring a convenient intensive property, P, as a function of time. The "affinity rule" states that, when a given process takes place under different external constraints (e.g., different temperatures, pressures, pH values, etc.), the various P versus time curves are related by an affinity transformation parallel to the time axis: in other words the P versus log time curves are parallel and can be superimposed by translation. The validity of the rule has been extensively tested in chemical and physiochemical processes, but there is no evidence as yet that it extends to biological systems. The present paper shows that the rule is indeed valid for the kinetics of growth of an Escherichia coli culture at various temperatures and pH values. More extended experiments are necessary to prove or disprove the general validity of the rule in biological systems, but its practical interest is evident: whenever it is valid it will be possible, from a very small number of measurements, to predict the complete behavior of the system in a number of various external conditions

Aerobiosis↗
PubMed1975

Carcinoembryonic antigen in human ovarian neoplasms.

The presence and location of carcinoembryonic antigen (CEA) was examined in tissue sections of 14 mucinous and 13 serous cystadenomas and cystadenocarcinomas of the ovary. CEA was demonstrated in the mucinous tumors but was not present in the serous tumors. In the mucinous tumors, CEA was located in the glycocalyx and apical portions of the absorptive-type epithelium, with only trace quantities in goblet cells, a pattern identical to that seen in colonic neoplasms. Endocervical-type epithelium in the mucinous tumors contained little or no CEA.

Carcinoembryonic Antigen↗
PubMed1975

Studies on the mechanism of lithium action: preliminary report.

Preliminary observations in a small animal sample reveal that chronic lithium treatment in rats produced significant changes in the microvillous processes on the cell surface of the choroid plexus. These alterations may be associated with increased intracellular choroidal volume. The type of changes noted by SEM suggest an alteration in movement of water into the extracellular areas of the brain. This basic alteration produced by lithium in the secretory/absorptive capacity of the chorid plexus is probably reversible.

Animals↗
PubMed1974

A high-precision and large-capacity laser biophotometer.

A new type of biophotometer is described. Very precise and reproducible measurements of bacterial concentration can be performed at 3-s intervals for each of 32 simultaneously developing bacterial cultures. The large number of results is handled with modern data acquisition and computer-processing techniques.

Bacteria↗
PubMedDate not supplied

[Effect of different variables on the outcome of various cognitive-behavioral treatment modalities for panic disorder with agoraphobia].

The efficacy of cognitive-behavioral therapy (CBT) is clearly demonstrated in the treatment of panic-disorder with agoraphobia (PDA). Between 70% and 90% of people with PDA obtain an higher global functioning level after CBT, yet symptoms remain in 10 to 30% of participants after treatment termination. The goal of the present study is to find which variables have an effect on different CBT modalities (individual, group, self-help) for persons with moderate and high PDA. Eighty-four persons were randomly assigned to one of three treatment modalities. Evaluations were made before treatment, immediately after and one year later. Results show that sex, number of years with agoraphobia and anxiety level significantly predict outcome at post-test for the individual modality. However, only the number of years with agoraphobia is a strong predictor one year later for this treatment modality. For the self-help modality, no predictor is significant neither at post-test nor one year later. For the group modality, the agoraphobic avoidance predicts outcome at post-test whereas symptoms severity predicts outcome one year later.

Adolescent↗
PubMedDate not supplied

Comparing emergency department and psychiatric setting patients with panic disorder.

In a recent study, the authors reported that 25% (108/441) of consecutive emergency department (ED) chest pain patients had panic disorder (PD). As part of this study, the authors sought to answer the question: How do ED patients with PD compare with patients with PD who seek treatment in a psychiatric setting? PD patients from an ED (n = 108) and psychiatric clinic (n = 137) were compared with respect to comorbid Axis I diagnoses, self-report scores, and recent suicidal ideation. The group of psychiatric patients was younger (36.5 vs. 52.3 years) (P < 0.0001) and consisted of proportionally more women (63% vs. 39%) (P = 0.0001) than the ED patients. The psychiatric patients had significantly higher rates of comorbid agoraphobia (100% vs. 15%) (P < 0.0001), social phobia (23% vs. 3%) (P = 0.0001), specific phobia (12.3% vs. 4.6%) (P = 0.03), and posttraumatic stress disorder (16.9% vs. 5.6%) (P = 0.006), compared with the ED patients, and displayed significantly higher scores on all of the self-report panic measures. However, the patients in both groups had similar rates of comorbid generalized anxiety disorder (41.2% vs. 33.3%) (P = 0.17), major depression (8.8% vs. 11.1%) (P = 0.54), and obsessive-compulsive disorder (1.5% vs. 2.8%) (P = 0.7). Both groups also did not differ on the Beck Depression Inventory and in their rate of report of recent suicidal ideation (32% vs. 25%) (P = 0.23). Both psychiatric and ED patients with PD appear to be highly distressed patients who require treatment. Early intervention for ED patients may prevent both chronic patient distress and development of the significant phobic avoidance observed in psychiatric patients.

Adult↗