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Biomedical subjects

A Stott

Publications and source records attributed to A Stott.

12 recordsLinked to original sources
PubMed2001

Glycated haemoglobin assays. Approaches to standardization of results.

AIMS: To compare different approaches to DCCT standardization of glycated haemoglobin (HbA(1c)) results. METHODS: In the first part of the study seven laboratories in the Mersey area participated, using a variety of methods of measurement. The approaches used were the Standardization Initiative for Glycated Haemoglobin Scheme (SIGH) using fresh blood samples and the Wales External Quality Assurance Scheme (WEQAS) using both fresh and lyophilized blood samples. Additional studies performed in the Royal Liverpool University Hospital (RLUH) laboratory involved: (i) re-calibration of the HPLC analyser using lyophilized blood samples supplied by the manufacturer and (ii) the use of fresh blood samples from the UK National External Quality Assurance Scheme (UKNEQAS). RESULTS: Inter-laboratory analytical coefficients of variation following DCCT alignment showed little change. The effect on percentage bias was more marked and was independent of the level of HbA(1c). Comparing DCCT-aligned HbA(1c) results from 3902 diabetic patients attending the RLUH, indicated that there was a statistically significant difference (P < 0.0001) between the corrected results produced by the five schemes. The effect of DCCT alignment on reported HbA(1c) values using the different approaches was variable resulting in an apparent increase in the number of diabetic patients with poor glycaemic control (HbA(1c) values > 7.0%) in all cases. CONCLUSION: The method of HbA1c standardization used determines the degree of correction required and a consensus approach is recommended. Implementation will assist extrapolation from research-based evidence to local practice. Associated changes to patient management must come under the jurisdiction of the physicians responsible for the diabetic service.

Biomarkers↗
PubMed2001

Troponin T as a first-line test: the Royal Liverpool and Broadgreen University Hospital experience.

Many hospital laboratories are unable to offer a cardiac troponin service because of the cost of providing this assay in addition to existing cardiac enzyme profiles: we circumvented this problem by withdrawing the conventional cardiac enzyme service and substituting cardiac troponin T. By ensuring that only one specimen for cTnT is analysed per episode of chest pain. substantial financial savings have been achieved.

Chemistry, Clinical↗
PubMed1989

Hyperthyrotrophinaemia during thyroxine replacement therapy.

During the follow-up of 224 cases of treated hypothyroidism, 14 clinically euthyroid patients were found to have elevated serum thyrotrophin and normal total thyroxine concentrations. Closer observation of these patients during the following 27 months resulted in the serum thyrotrophin levels returning to normal spontaneously in 8 patients (Group 1) whilst remaining elevated in 6 (Group 2), despite no significant differences in thyroid hormone levels between the two groups. Serum thyrotrophin in Group 2 patients remained high until an additional 50 micrograms/day thyroxine was prescribed although only 2 patients noted any benefit. Non-compliance or inadequate dosage of thyroxine are the probable causes of this sub-clinical hypothyroidism. Thyroid hormone estimations fail to differentiate the two conditions and we recommend a period of closer observation before making any thyroxine dosage adjustments in order to detect non-compliance.

Adult↗
PubMed1987

Purple urine bag syndrome.

Purple pigment extracted from the urinary catheters and collecting bags of two elderly female patients was analysed by a variety of chemical techniques, including mass spectroscopy and nuclear magnetic resonance. Although previous studies identified the pigment as indigo, we failed to confirm this. Our analysis also demonstrated that indicanuria is not a requirement for the production of the pigment and furthermore indicates that the molecular structure of the pigment is either a steroidal or bile acid conjugate.

Aged↗
PubMed1982

Lipid analysis in non-fasting diabetics.

Serum cholesterol and triglyceride concentrations were measured in diabetic and non-diabetic inpatients in the fasting state and at 1, 2, 2 1/2 and 3 hours after breakfast. No significant changes in these parameters were observed during this period. It is suggested that the use of non-fasting samples for lipid analysis in cardiovascular disease studies is feasible.

Adult↗
PubMed1981

Ionized calcium in acute pancreatitis and its relationships with total calcium and serum lipase.

Serial measurements of serum amylase, lipase and ionized calcium were made in a prospective study of 17 patients with acute pancreatitis. The mean serum ionized calcium was significantly below the normal range for the first 24 h and had returned to normal after 48 h. There was no correlation between serum ionized calcium and paired calcium corrected for albumin during the first 36 h of the study, but they were correlated for the remainder of the investigation. Serum lipase and ionized calcium levels were just significantly correlated over the first 3 days (r = -0.44; t = 2.3; P less than 0.05; d.f. 22), but failed to reach correlation over the whole period of study (r = -0.34; t = 2.0; d.f. 31). These data establish a significant drop in directly measured ionized calcium early in an attack of pancreatitis, which is not seen in the paired corrected calcium values. Furthermore, the drop is correlated with serum lipase, although this is weak and other factors must be involved in the hypocalcaemia.

Acute Disease↗
PubMed1981

Impaired bacteriological responses in babies after maternal iron dextran infusion.

The effect of a total dose infusion of iron dextran in pregnancy on 15 mothers and their babies was compared with 19 controls. The bacteriostatic effect and opsonising ability of the sera, of babies born to the treated mothers, were considerably impaired. This was associated with a significantly lower transferrin concentration in these mothers. Although these in vitro tests were not associated with an increase in overt infection during the perinatal period, they suggest the need for caution in the use of total dose infusions in pregnancy.

Blood Bactericidal Activity↗