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Biomedical subjects

Donald C McMillan

Publications and source records attributed to Donald C McMillan.

At least 19 recordsLinked to original sources
PubMed2007

Evaluation of an inflammation-based prognostic score in patients with metastatic renal cancer.

BACKGROUND: Recently, it was shown that an inflammation-based prognostic score, the Glasgow Prognostic Score (GPS), provides additional prognostic information in patients with advanced cancer. The objective of the current study was to examine the value of the GPS compared with established scoring systems in predicting cancer-specific survival in patients with metastatic renal cancer. METHODS: One hundred nineteen patients who underwent immunotherapy for metastatic renal cancer were recruited. The Memorial Sloan-Kettering Cancer Center (MSKCC) score and the Metastatic Renal Carcinoma Comprehensive Prognostic System (MRCCPS) score were calculated as described previously. Patients who had both an elevated C-reactive protein level (>10 mg/L) and hypoalbuminemia (<35 g/L) were allocated a GPS of 2. Patients who had only 1 of those 2 biochemical abnormalities were allocated a GPS of 1. Patients who had neither abnormality were allocated a GPS of 0. RESULTS: On multivariate analysis of significant individual factors, only calcium (hazard ratio [HR], 3.21; 95% confidence interval [95% CI], 1.51-6.83; P = .002), white cell count (HR, 1.66; 95% CI, 1.17-2.35; P = .004), albumin (HR, 2.63; 95% CI, 1.38-5.03; P = .003), and C-reactive protein (HR, 2.85; 95% CI; 1.49-5.45; P = .002) were associated independently with cancer-specific survival. On multivariate analysis of the different scoring systems, the MSKCC (HR, 1.88; 95% CI, 1.22-2.88; P = .004), the MRCCPS (HR, 1.42; 95% CI, 0.97-2.09; P = .071), and the GPS (HR, 2.35; 95% CI, 1.51-3.67; P < .001) were associated independently with cancer-specific survival. CONCLUSIONS: An inflammation-based prognostic score (GPS) predicted survival independent of established scoring systems in patients with metastatic renal cancer.

C-Reactive Protein↗
PubMed2006

Evaluation of an inflammation-based prognostic score in patients with inoperable pancreatic cancer.

BACKGROUND/AIMS: Patients with pancreatic cancer have one of the poorest survival rates and selection of patients for active treatment remains problematical. The present study assesses the value of an inflammation-based score (Glasgow Prognostic Score, GPS) in patients with inoperable pancreatic cancer. METHODS: The GPS was constructed as follows: patients with both an elevated C-reactive protein (>10 mg/l) and hypoalbuminaemia (<35 g/l) were allocated a score of 2. Patients in whom only 1 or none of these biochemical abnormalities was present were allocated a score of 1 or 0, respectively. RESULTS: One hundred and eighty-seven patients were studied and 49 (26%) underwent an operative palliative bypass procedure. At the end of follow-up, 181 (97%) patients died, 17% of patients were alive at 12 months. On univariate analysis, age (p < 0.01), TNM stage (p < 0.001) and the GPS (p < 0.001) were significant predictors of survival. On multivariate survival analysis, stratified for bypass procedure, age (hazard ratio 1.53, 95%CI 1.12-2.10, p = 0.008), TNM stage (hazard ratio 1.70, 95%CI 1.33-2.18, p < 0.001) and the GPS (hazard ratio 1.72, 95%CI 1.40-2.11, p < 0.001) remained independent significant predictors of survival. CONCLUSION: At diagnosis, the presence of a systemic inflammatory response (as measured by the GPS) appears to be a useful indicator of poor outcome, independent of TNM stage, in patients with inoperable pancreatic cancer.

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PubMed2006

Vitamin antioxidants, lipid peroxidation and the systemic inflammatory response in patients with prostate cancer.

The relationship between lipid soluble antioxidant vitamins, lipid peroxidation, disease stage and the systemic inflammatory response were examined in healthy subjects (n = 14), patients with benign prostate hyperplasia BPH (n = 20), localized (n = 40) and metastatic (n = 38) prostate cancer. Prostate cancer patients had higher concentrations of malondialdehyde (p < 0.05) and lower circulating concentrations of lutein (p < 0.05), lycopene (p < 0.001) and beta-carotene (p < 0.05). Patients with metastatic prostate cancer, when compared with patients having localized disease, had a higher Gleason score (p < 0.01) and had more hormonal treatment, but lower concentrations of PSA (p < 0.05), alpha-tocopherol (p < or = 0.05), retinol (p < 0.01), lutein (p < 0.05) and lycopene (p < 0.01). In the prostate cancer patients, PSA was correlated with the concentrations of the lipid peroxidation product, malondialdehyde (rs= 0.353, p = 0.002). C-reactive protein was not correlated with the vitamin antioxidants nor malondialdehyde. In contrast, there was a negative correlation between malondialdehyde concentrations and both lutein (rs= -0.263, p = 0.020) and lycopene (rs= -0.269, p = 0.017). These results indicate that lower concentrations of carotenoids, in particular, lycopene reflect disease progression rather than the systemic inflammatory response in patients with prostate cancer.

Aged↗
PubMed2006

Systemic inflammatory response, prostate-specific antigen and survival in patients with metastatic prostate cancer.

BACKGROUND: It is increasingly recognised that, in cancer patients, disease progression is dependent on a complex interaction of the tumour and the host inflammatory response and that the systemic inflammatory response, as evidenced by an elevated C-reactive protein (CRP) concentration, may be a useful prognostic factor. MATERIALS AND METHODS: The prognostic value of CRP compared with prostate-specific antigen (PSA) was examined in 62 patients with metastatic prostate cancer receiving androgen-deprivation therapy. RESULTS: In all, 41 (66%) of patients died, 38 (61%) of their disease. On univariate survival analysis, PSA (p < 0.05) and CRP (p < 0.05) were significant predictors of cancer-specific survival. On multivariate analysis, both PSA (HR 1.96, 95% CI 1.00-3.83, p = 0.049) and CR (HR 1.97, 95% CI 0.99-3.92, p = 0.052) were independent predictors of cancer-specific survival. PSA concentrations were significantly correlated with those of CRP (r(s) = 0.46, p < 0.001). CONCLUSION: The results of the present study suggest that, in patients with metastatic prostate cancer, the presence of an elevated CRP concentration predicts poor outcome, independent of PSA.

Aged↗
PubMed2005

Biological variation of vitamins in blood of healthy individuals.

BACKGROUND: Components of biological variation can be used to define objective quality specifications (imprecision, bias, and total error), to assess the usefulness of reference values [index of individuality (II)], and to evaluate significance of changes in serial results from an individual [reference change value (RCV)]. However, biological variation data on vitamins in blood are limited. The aims of the present study were to determine the intra- and interindividual biological variation of vitamins A, E, B(1), B(2), B(6), C, and K and carotenoids in plasma, whole blood, or erythrocytes from apparently healthy persons and to define quality specifications for vitamin measurements based on their biology. METHODS: Fasting plasma, whole blood, and erythrocytes were collected from 14 healthy volunteers at regular weekly intervals over 22 weeks. Vitamins were measured by HPLC. From the data generated, the intra- (CV(I)) and interindividual (CV(G)) biological CVs were estimated for each vitamin. Derived quality specifications, II, and RCV were calculated from CV(I) and CV(G). RESULTS: CV(I) was 4.8%-38% and CV(G) was 10%-65% for the vitamins measured. The CV(I)s for vitamins A, E, B(1), and B(2) were lower (4.8%-7.6%) than for the other vitamins in blood. For all vitamins, CV(G) was higher than CV(I), with II <1.0 (range, 0.36-0.95). The RCVs for vitamins were high (15.8%-108%). Apart from vitamins A, B(1), and erythrocyte B(2), the imprecision of our methods for measurement of vitamins in blood was within the desirable goal. CONCLUSIONS: For most vitamin measurements in plasma, whole blood, or erythrocytes, the desirable imprecision goals based on biological variation are obtainable by current methodologies. Population reference intervals for vitamins are of limited value in demonstrating deficiency or excess.

Adult↗
PubMed2005

The relationship between plasma and red cell B-vitamin concentrations in critically-ill patients.

BACKGROUND AND AIMS: Low vitamin B-complex status has been associated with poorer outcome in critically-ill patients. However, these findings have been based on indirect methods. Using direct methods for assessing vitamin status, we examined the effect of B-complex vitamin supplementation by measuring plasma and red blood cell B1, B2 and B6-vitamin concentrations in critically-ill patients. METHODS: Thiamine diphosphate (TDP), flavin adenine dinucleotide (FAD) and pyridoxal phosphate (PLP) concentrations were measured in plasma and red cells of normal subjects (n=49) and ITU patients (n=41). RESULTS: Compared with the normal subjects, critically-ill patients had higher C-reactive protein and lower albumin concentrations (P<0.001). Also, plasma FAD and PLP were lower (P<0.001) and red cell concentrations of both were higher (P<0.01) in critically-ill patients. Critically-ill patients were grouped according to whether (n=23) or not (n=18) they had been supplemented with B-complex vitamins. Compared with non-supplemented group, the supplemented group had significantly higher red cell TDP and PLP concentrations (P<0.01). Plasma FAD and PLP concentrations did not differ significantly between the groups. CONCLUSIONS: The results of the present study suggest that direct measurements of red cell FAD and PLP are more responsive to supplementation than plasma measurements in the critically-ill patient.

Adult↗
PubMed2005

The relationship between the acute changes in the systemic inflammatory response, lipid soluble antioxidant vitamins and lipid peroxidation following elective knee arthroplasty.

BACKGROUND AND AIMS: The aim of the present study was to examine the time course of the change in the concentrations of plasma retinol, alpha-tocopherol, lutein, lycopene, alpha-carotene, beta-carotene (antioxidant vitamins) and malondialdehyde (lipid peroxidation) in patients following elective knee arthroplasty. METHODS: Patients (n=20) who underwent an elective knee arthroplasty, had venous blood samples withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h after the start of surgery for the analysis of circulating concentrations of C-reactive protein, albumin, cholesterol, triglycerides and malondialdehyde and also the lipid soluble antioxidants vitamins. RESULTS: Over the study period of 0-168 h there was a significant increase in circulating C-reactive protein concentrations (peak 48 h, P<0.001) and a significant fall in albumin, cholesterol and triglyceride concentrations (trough 48 h, P<0.001). Malondialdehyde concentrations fell by approximately 35% (P<0.001) during the study period. However, they did not alter significantly over the study period when adjusted for triglyceride (P=0.309). The plasma concentrations of retinol, alpha-tocopherol, lutein, lycopene, alpha-carotene and beta-carotene all fell (P0.001). When adjusted for cholesterol, the reductions in plasma concentrations of alpha-tocopherol, lutein, lycopene, and beta-carotene in the post-operative period were no longer statistically significant. CONCLUSIONS: The results of the present study indicate that, in apparently healthy subjects undergoing an acute inflammatory insult, circulating lipid soluble vitamin antioxidants are transiently reduced. However, when corrected for lipids the concentrations were similar to those of baseline. In the absence of an increase in lipid peroxidation such falls in plasma concentrations of lipid soluble vitamins are unlikely to be a reliable measure of status.

Aged↗
PubMed2005

The correlation between fatigue, physical function, the systemic inflammatory response, and psychological distress in patients with advanced lung cancer.

BACKGROUND: Functional disability is reported frequently in fatigued cancer patients, but little is known about the correlation between fatigue and objective physical function. In addition, from previous work, the systemic inflammatory response and psychological distress appear to be related to fatigue. METHODS: Thirty-eight patients with metastatic or locally advanced lung carcinoma and 15 age-matched and gender-matched, healthy controls completed the Functional Assessment of Chronic Illness Therapy-Fatigue scale, a visual analogue weakness score, and the Hospital Anxiety and Depression (HAD) scale. Hemoglobin concentrations, C-reactive protein (CRP) concentrations, creatine kinase concentrations, white blood cell count, body composition, Karnofsky performance status (KPS), grip strength, and chair-rise time also were measured in both groups. The cancer patients were then grouped into tertiles on the basis of fatigue scores. RESULTS: The cancer patients had greater fatigue compared with the control group (P < 0.001). They also weighed less, had lower hemoglobin and creatine kinase levels and higher CRP levels, and had lower KPS, poorer grip strength, longer chair-rise times, and increased HAD scale scores (all P < 0.01). KPS and chair-rise time were correlated strongly (r(2) = 0.565; P < 0.001). With increasing fatigue, KPS was lower, and chair-rise time and HAD scale scores were greater (P < 0.01). On multiple regression analysis, only KPS, weakness, and HAD scale scores were correlated independently with fatigue (r(2) = 0.570; P < 0.001). CONCLUSIONS: Objective physical function (as measured by chair-rise time) in patients with advanced lung cancer was poorer with increasing fatigue. Results of the current study suggest that fatigue is not a result primarily of weight loss or anemia but is related to KPS and psychological distress.

Adult↗
PubMed2005

The effect of gender on postoperative mortality after emergency abdominal surgery.

BACKGROUND: The factors contributing to the high mortality after emergency abdominal surgery are unclear. Recent studies have revealed gender differences in immune function after trauma and in the presence of sepsis. OBJECTIVE: This study tested the hypothesis that factors determining survival after emergency abdominal surgery differ in males and females. METHODS: Consecutive patients, aged > or =50 years, who underwent emergency abdominal surgery between July 1998 and June 2000 at the Royal and Western Infirmaries in Glasgow, Scotland, were identified for study. Data collected retrospectively included sex, age, severity of surgery, seniority of surgeon and anesthetist, extent of deprivation, and 30-day postoperative mortality. RESULTS: A total of 633 patients were identified for study; 49 (8%) were excluded from analysis because 30-day mortality or surgery details were unavailable. Of the remaining 584 patients, 256 were male and 328 were female. The overall 30-day mortality was 26%, with 74 (29%) males and 79 (24%) females dying within this period. The mortality rates were 25% in males and 10% in females (P = 0.043) after minor surgery, 26% in males and 23% in females (P = NS) after intermediate surgery, and 44% in males and 39% in females (P = NS) after major surgery. On univariate logistic regression analysis in males, increasing age (P < 0.001), severity of surgery (P = 0.04), and seniority of anesthetist (P < 0.001) were associated with mortality. In females, severity of surgery (P < 0.001) was associated with mortality. CONCLUSIONS: These results show that in females, 30-day mortality was determined by severity of surgery, whereas in males increasing age and seniority of anesthetist also influenced 30-day mortality.

Abdomen↗
PubMed2005

Is portal hypertension associated with protein-losing enteropathy?

BACKGROUND AND AIM: Hypoalbuminemia in patients with decompensated cirrhosis has traditionally been assumed to be a result of to impaired liver synthesis; however, protein-losing enteropathy (PLE) may also contribute. The aim of this study was to assess whether hypoalbuminemic cirrhotic patients with portal hypertension had evidence of PLE. METHODS: Sixteen patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension underwent whole gut lavage with polyethylene glycol solution. The effluent obtained was analyzed for albumin, immunoglobulin (Ig)G and alpha1-antitrypsin (alpha1-AT). Serum C-reactive protein (CRP) was also measured to assess the systemic inflammatory response. RESULTS: Twelve of the 16 enrolled patients had a persistently low albumin concentration at the time of lavage. Only one patient (who was subsequently found to have celiac disease) had elevated concentrations of lavage albumin, alpha1-AT and IgG levels. There was a significant correlation between lavage albumin and alpha1-AT (r = 0.671, P = 0.024), and between lavage albumin and IgG (r = 0.614, P = 0.045). There was no correlation between serum albumin and lavage proteins. Six patients had elevated serum CRP levels, but serum albumin or lavage protein concentrations did not correlate with serum CRP. CONCLUSION: There is no evidence of a significant PLE in patients with alcoholic cirrhosis, hypoalbuminemia and portal hypertension.

Adult↗
PubMed2005

The systemic inflammatory response predicts overall and cancer specific survival in patients with malignant lymphoma.

BACKGROUND: The value of C-reactive protein concentrations in the assessment of prognosis in patients with advanced lymphoma has not been clearly defined. MATERIAL/METHODS: Patients with a diagnosis of non-Hodgkin's lymphoma (n = 108) and Hodgkin's lymphoma, (n = 39) and who had measurements of C-reactive protein were studied retrospectively and the data was reviewed over 8 years. RESULTS: Median survival, from the time of sampling, was 7.4 months. On univariate analysis there was a significant relationship between the duration of cancer specific survival and tumour type (p < 0.05), circulating concentrations of albumin (p < 0.001) and C-reactive protein (p < 0.001). In contrast, only C-reactive protein concentration was a predictor of death from intercurrent disease (p < 0.05). On multivariate analysis, C-reactive protein concentration remained a strong independent predictor of both death from cancer and intercurrent disease (p < 0.001). The hazard ratio associated with a unit increase in stratified C-reactive protein concentration was 8.18 (95% CI 4.80 - 13.95) for cancer specific death and 2.11 (95% CI 1.22 - 3.64) for intercurrent death. CONCLUSIONS: The results of the present study demonstrate that patients with advanced lymphoma have evidence of a systemic inflammatory response and the magnitude of the C-reactive protein response predicts the duration of overall and cancer specific survival.

C-Reactive Protein↗
PubMed2004

The relationship between leptin concentrations, the systemic inflammatory response and illness severity in surgical patients admitted to ITU.

BACKGROUND & AIMS: The relationship between circulation leptin concentrations, mediators of the systemic inflammatory response and illness severity in critically ill patients remains unclear. The aim of the present study was to examine these relationships in critically ill surgical patients admitted to the intensive therapy unit (ITU). PATIENTS AND METHODS: Patients (n = 38) who had undergone surgery and subsequently admitted to ITU were prospectively entered into a cross-sectional study. Circulating concentrations of leptin, cortisol, growth hormone, interleukin-6, C-reactive protein and albumin were measured. Sex and age matched controls (n = 14) were also studied. RESULTS: On day 1, the critically ill group had lower BMI and leptin concentrations and a pronounced systemic inflammatory response compared with controls. There was a weak positive correlation between leptin concentrations and BMI in the critically ill patients (r = 0.42, P<0.10). In contrast, leptin was inversely correlated with C-reactive protein (r = -0.59, P<0.05) but not with cortisol, growth hormone, interleukin-6, APACHE II or predicted mortality. Leptin concentrations did not alter with the day of admission to ITU. CONCLUSIONS: On ITU admission, leptin concentrations appeared to be low for BMI, related to the magnitude of the systemic inflammatory response but did not appear to be regulated by proposed mediators in critically ill surgical patients.

Adult↗
PubMed2004

The relationship between plasma and red cell concentrations of vitamins thiamine diphosphate, flavin adenine dinucleotide and pyridoxal 5-phosphate following elective knee arthroplasty.

BACKGROUND & AIMS: Water soluble vitamins B1, B2 and B6 are essential precursors for a wide variety of coenzymes involved in intermediary metabolism and their status is usually assessed from blood samples. The aim of the study was to examine the relationship between plasma and intra-cellular B-vitamins following the systemic inflammatory response of surgery. METHODS: Patients (n = 10) who underwent an elective knee arthroplasty, had venous blood samples withdrawn pre-operatively and at 12, 24, 48, 72 and 168 h after the start of surgery for the analysis of circulating concentrations of C-reactive protein and albumin and also plasma and/ or red cell thiamine diphosphate (TDP), flavin adenine dinucleotide (FAD), pyridoxal 5-phosphate (PLP) as indicators of vitamins B1, B2, and B6 status respectively. RESULTS: Pre-operative, baseline vitamin assessments were all within population reference ranges. Over the study period of 0-168 h there was a significant increase in circulating C-reactive protein concentrations (peak 48 h, P < 0.001) and a significant fall in albumin concentrations (trough 48 h, P < 0.001). Plasma FAD and PLP concentrations fell transiently (P < 0.001) by approximately 40% reaching their nadir at approximately 48 h. CONCLUSIONS: The results of the present study indicate that plasma concentrations of FAD and PLP are transiently reduced following an inflammatory insult and therefore unlikely to be a reliable measure of status in the presence of a systemic inflammatory response. It may be that during such a response red cell concentrations provide a more reliable measure.

Aged↗
PubMed2004

Modulation of the liver export protein synthetic response to feeding by an n-3 fatty-acid-enriched nutritional supplement is associated with anabolism in cachectic cancer patients.

The acute-phase protein response is associated with accelerated weight loss and shortened survival in cancer. This may be due to hepatic protein synthesis increasing demand for amino acids. An n -3 fatty-acid-enriched nutritional supplement will moderate aspects of cachexia in cancer patients. The present study examined the effect of such a supplement on hepatic synthesis of albumin and fibrinogen. Albumin and fibrinogen synthesis were measured in the fed and fasting state in eight weight-losing patients with pancreatic cancer by an intravenous flooding dose technique. Tracer incorporation into proteins was measured by GC/MS. Patients were restudied after 3 weeks of oral supplement enriched with fish oil (providing 2510 kJ/day and 2 g of eicosapentaenoic acid/day). At baseline, all patients were losing weight (median, 2.4 kg/month). After 3 weeks of consumption of the fish-oil-enriched nutritional supplement, patients' weight stabilized (median change, +1 kg; P = 0.01). At baseline, albumin and fibrinogen synthesis rates were stimulated in the fed compared with the fasting state [14.2 compared with 11.3 g/day (29% rise; P = 0.01) and 4.5 compared with 3.3 g/day (38% rise; P = 0.01) respectively]. After 3 weeks of the supplement, this stimulation in the fed state was no longer observed for albumin and was reduced for fibrinogen [11.2 compared with 10.5 g/day (3% rise; P = 0.21) and 3.7 compared with 2.9 g/day (17% rise; P = 0.01) respectively]. After 3 weeks, the combined albumin plus fibrinogen synthetic rate tended to fall in the fasting state (14.7 compared with 12.3 g/day; P = 0.09) and was significantly reduced in the fed state (18.7 compared with 14.6 g/day; P = 0.01). Modulation of hepatic export protein synthesis with feeding may have contributed to the net whole-body anabolism observed with administration of the n -3 fatty-acid-enriched oral supplement.

Aged↗
PubMed2004

Score based on hypoalbuminemia and elevated C-reactive protein predicts survival in patients with advanced gastrointestinal cancer.

The presence of a systemic inflammatory response (as evidenced by elevated C-reactive protein concentrations) has been shown to be associated with loss of lean body mass and poor survival in cancer patients. The aim of this study is to assess the value of the combination of hypoalbuminemia and an elevated circulating concentration of C-reactive protein as a prognostic score in patients with advanced gastrointestinal cancer. Patients with advanced colorectal (n = 99) and gastric (n = 66) cancer and who had measurements of albumin and C-reactive protein were identified. Hypoalbuminemia (< 35 g/l/ > or = 35 g/l) and an elevated C-reactive protein (< or = 10 mg/l/ > 10 mg/l) were combined to form a prognostic score (0, 1, and 2). In patients with colorectal cancer, median survival was 12.1, 6.1, and 1.7 m (P < 0.001) for scores of 0, 1, and 2, respectively. In patients with gastric cancer the corresponding median survival was 6.1, 3.1, and 1.6 m, respectively (P < 0.01). The results of the present study suggest that, in patients with advanced gastrointestinal cancer, a cumulative score based on hypoalbuminemia and an elevated C-reactive protein may be useful. It has the advantage that it is based on routinely available well-standardized measurements and is simple to use.

Aged↗
PubMed2003

Optimisation and validation of a sensitive high-performance liquid chromatography assay for routine measurement of pyridoxal 5-phosphate in human plasma and red cells using pre-column semicarbazide derivatisation.

There are few studies in which direct measurement of vitamin B6 status in both plasma and red cells has been assessed. The aims of the present study were to evaluate the use of a simple, robust HPLC method of direct pyridoxal 5'-phosphate (PLP) measurement in plasma and red cells and to assess its use in establishing reference ranges in a healthy population. A reverse phase HPLC method with pre-column derivatisation using semicarbazide for the simultaneous measurement of PLP, its degradation product, 4-pyridoxic acid (PA) and pyridoxal (PL) in plasma and red cells was developed. Pre-column derivatisation, reverse phase chromatography and detection procedures were optimised. The recovery, precision, linearity and sensitivity of the assay for plasma and red cell PLP, PA and PL was established. The recovery of PLP was greater than 95% for both plasma and red cell samples. The Intra and Inter batch imprecision for PLP was less than 6% and 7%, respectively. The method for PLP was linear up to at least 1000 nmol/l and the detection limit was 2.1 nmol/l (limit of quantification; 5.8 nmol/l). Accuracy of PLP measurements in plasma were acceptable, showing a mean bias of 4.5% from the mean value of laboratories (N=34) participating in an external quality assurance scheme. Geometric mean (95% reference intervals) for plasma and red cell PLP in the healthy subjects (N=126) were 56 (21-138) nmol/l and 410 (250-680) pmol/g Hb, respectively. There was a strong positive correlation (r(2)=0.81) between plasma and red cell PLP levels in the reference population. The HPLC method described was found to be suitable for the routine measurement of PLP in both plasma and red cells.

Calibration↗
PubMed2003

A prospective study of the impact of weight loss and the systemic inflammatory response on quality of life in patients with inoperable non-small cell lung cancer.

The relationship between weight loss, the systemic inflammatory response and quality of life in patients with inoperable non-small cell lung cancer (NSCLC) was studied. The extent of weight loss, the systemic inflammatory response (C-reactive protein) and quality of life (EORTC-QLQ-C30) was measured in 106 patients with inoperable NSCLC (stage III and IV). Approximately 40% had more than 5% weight loss and almost 80% had elevated circulating C-reactive protein concentrations (>10 mg/l). The functional scale scores of the EORTC-QLQ-C30 were poor (50 or less) and the fatigue symptom score was also poor (50 or more). When patients were grouped according to whether or not they had experienced more than 5% weight loss, Karnofsky performance status and global quality of life were lower (P<0.05) and symptom scores fatigue (P<0.05) and pain (P<0.01) were greater in the weight-losing group. When the weight-stable cancer patients were grouped according to whether or not they had evidence of a systemic inflammatory response, the symptom fatigue was higher in the inflammatory group (P<0.05). In the weight-stable cancer patients C-reactive protein concentration was correlated with fatigue r=0.31 (P<0.05). The results of the present study indicate that both weight loss and the systemic inflammatory response impact on different aspects of quality of life. In particular, fatigue is associated with the presence of a systemic inflammatory response independent of weight loss.

Adult↗