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Biomedical subjects

G Palomaki

Publications and source records attributed to G Palomaki.

7 recordsLinked to original sources
PubMed2005

The prevention of neonatal group B streptococcal disease: a report by a working group of the Medical Screening Society.

Streptococcus agalactiae, or Lancefield group B streptococcus (GBS), is the most frequent cause of serious bacterial sepsis, including neonatal meningitis, in UK neonates. Early-onset neonatal GBS infection, but not late-onset, can be prevented by screening to identify high-risk pregnancies and administering penicillin during delivery. A vaccine has been developed as an alternative means of prevention but it is awaiting a randomized trial before being available for general use. In this review we examine the published literature to assess the morbidity and mortality attributable to neonatal GBS infection, quantify the screening performance of the two alternative modes of screening (microbiological and risk factor based), review the evidence on the efficacy of the vaccine, and estimate the numbers of deaths and cases of serious disability that each strategy in turn might prevent in the UK, in order to assess the most effective means of prevention for the UK.

Antibiotic Prophylaxis↗
PubMed2001

Sources of variability: a College of American Pathologists Therapeutic Drug Monitoring study.

OBJECTIVE: To determine the magnitudes and sources of analytic variation in testing for therapeutic drugs. Specifically, among laboratories using the same analytic method, to compare the within-laboratory variation (including both short- and long-term variation) with the between-laboratory variation. DESIGN: Four identical challenges were prepared from a lyophilized pool of spiked sera and were sent in pairs 4 months apart to laboratories participating in a nationwide proficiency-testing program. For each of 25 drugs, the variability in reported results from laboratories using the same method was investigated using nested analysis of variance. SETTING: The first 2 mailings of the College of American Pathologists Therapeutic Drug Monitoring Survey, 1996, sets Z and ZM. MAIN OUTCOME MEASURES: For each drug, total variance was partitioned into within- and between-laboratory components for common methods. The within-laboratory component was further partitioned into short- and long-term components. PARTICIPANTS: The approximately 5000 laboratories enrolled in the survey. RESULTS: For the 25 drugs, the average percentages of the total variance due to short-term, within-laboratory variance; long-term, within-laboratory variance; between-laboratory variance; and total laboratory variance were 25.0% (range, 8.8--50.6%), 57.8% (35.3--73.7%), 17.3% (5.0--35.4%), and 82.7% (64.6--95.0%), respectively. CONCLUSION: For all drugs tested, the within-laboratory component of variance was greater than the between-laboratory component of variance. Within laboratories, the magnitude of the long-term component was generally greater than the magnitude of the short-term component. This information will be helpful in determining the clinical utility of various drug assays and in evaluating the appropriateness of regulations involving therapeutic drug testing.

Analysis of Variance↗
PubMed1998

Correlation of maternal triple screen values with fetal liver length.

Objective: To determine if a relationship exists between fetal liver length and any of the three serum markers (AFP, uE3, and hCG) that constitute the maternal triple marker screen.Methods: From March to November of 1996, 124 randomly selected women between 17.0 and 20.3 weeks gestation underwent serum triple screen testing on the same day that an anatomy sonogram was performed by a single sonographer. Fetal liver size was measured between the right hemidiaphragm and the tip of the right hepatic lobe. All triple marker screen results were obtained from the same commercial lab. Utilizing linear regression analysis, liver length adjusted for gestational age was plotted versus AFP, uE3, and hCG measurements (expressed as multiples of the median).Results: Of the 124 subjects, 17 (14%) were white and 97 (78%) were black; the remaining 10 (8%) were unknown or other. Neither hCG nor AFP measurements had a statistically significant association with liver length after taking into account gestational age (linear regression: R = -0.018, P =.848 and R = 0.100, P =.269 for hCG and AFP, respectively). Interestingly, a statistically significant correlation was identified between uE3 levels and fetal liver length (R = 0.205, P =.023).Conclusions: No statistical significance was identified between either maternal serum hCG or AFP and fetal liver size. A statistically significant correlation between maternal serum uE3 and liver size was observed. Although preliminary, sonographic evaluation of fetal liver size has little role in elucidating the etiology of abnormal hCG or AFP levels, but may be relevant in the interpretation of abnormal uE3 values.

Journal Article↗
PubMed1985

Screening for hypothermia in the ambulatory elderly. The Maine experience.

This study investigated the prevalence of low body temperatures in 97 elderly and 20 nonelderly subjects. To the best of our knowledge, no earlier survey has been conducted with a North American population. To ensure comparability with the British National Survey performed in 1973, urine temperatures were collected as a proxy measure of core temperatures. The urine-collecting funnel was modified to minimize cooling artifact introduced by the device. Study subjects were selected from an internal medicine clinic that serves the poor, a federally subsidized housing project, and a subsidized housing project in northernmost Maine. A youthful population (mean age, 32.3 years) was chosen to provide a comparative population to elderly participants (mean age, 73.9 years). Based on the British National Survey, the expected prevalence of low body temperatures (less than 35.5 degrees C) was 10%. The present study detected no low body temperatures, and the average urine and mouth temperatures were 0.3 and 0.19 degree C warmer, respectively, than those in the British National Survey. Youthful subjects were not significantly different from elderly participants. There appears to be no evidence from this study that low early-morning basal body temperature (less than 35.5 degrees C) is a common geriatric occurrence in ambient room temperature.

Adult↗
PubMed1984

Does smoking influence serum alpha-fetoprotein levels in mid-trimester pregnancies?

The effect of cigarette smoking during pregnancy on serum alpha-fetoprotein (AFP) levels was studied in 1925 consecutive women at 16-18 weeks gestation who subsequently had liveborn singleton infants. Cotinine and AFP were measured in sera in all the women and answers to a smoking questionnaire were analysed in 894. Cotinine, a metabolic derivative of nicotine, serves as an objective measure of the average daily absorption of smoking products because of its relatively long half-life. Infants born to women who smoked were, on average, 198 g lighter than those born to non-smokers, even though maternal weights were comparable. Whether analysed by self-reporting or by serum cotinine, cigarette smoking had no measurable effect on serum AFP levels.

Birth Weight↗