Biomedical subjects

Robert S Galen

Publications and source records attributed to Robert S Galen.

4 recordsLinked to original sources

PubMed2005

Principles of screening.

Screening and diagnostic testing are sequentially-oriented procedures for progressively analyzing risk. Screening is broadly based and aimed at identifying those at high risk of a disease or condition. Diagnostic testing is designed to more definitively answer the question of whether or not a person has a disease or condition. Understanding the differences among four key measures of evaluation for tests (sensitivity, specificity, positive predictive value and negative predictive value) are necessary for proper utilization of screening tests.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Electrophoretic measurement of lipoprotein(a) cholesterol in plasma with and without ultracentrifugation: comparison with an immunoturbidimetric lipoprotein(a) method.

OBJECTIVES: Elevated plasma lipoprotein(a) [Lp(a)] is a significant risk factor for vascular disease. Standardization of Lp(a) mass measurement is complicated by the heterogeneity of apolipoprotein(a) [apo(a)]. We investigated whether Lp(a) cholesterol measurement, which is not influenced by apo(a) size, is a viable alternative to measuring Lp(a) mass. DESIGN AND METHODS: Plasma Lp(a) cholesterol was measured electrophoretically, with and without ultracentrifugation, and results were compared to each other and to immunoturbidimetrically measured Lp(a) mass in 470 subjects. RESULTS: Ultracentrifuged and whole plasma Lp(a) cholesterol levels demonstrated high correlation (R = 0.964). All samples with detectable (>/=2.0 mg/dl) Lp(a) cholesterol had Lp(a) mass >30 mg/dl (the clinically relevant cutpoint), while 59 samples with Lp(a) mass >30 mg/dl did not have detectable Lp(a) cholesterol. CONCLUSIONS: Lp(a) cholesterol can be measured in whole plasma without interference from VLDL lipoproteins. The relative clinical merits of measuring Lp(a) cholesterol vs. Lp(a) mass or both in combination deserves investigation.

Blotting, Western↗

PubMed2004

A rapid platelet function assay used to regulate platelet transfusion prophylaxis following cardiopulmonary bypass surgery.

Subsequent to cardiac surgery with cardiopulmonary bypass (CPB), patients are at risk of postoperative bleeding caused by acquired defects associated with the procedure. As such, many patients receive prophylactic blood product transfusion. The effectiveness of measuring platelet function using a near-patient platelet function analyzer for the purpose of regulating platelet transfusion and potentially modulating other blood products including fresh frozen plasma (FFP) and cryoprecipitate (CRYO) transfusion was evaluated prospectively in patients undergoing CPB. A 6-month prospective study was designed that encompassed all CPB patients at Aultman Hospital (Canton, OH) during 2001. Each patient was assessed postoperatively for platelet count and function using a point-of-care analyzer. Data were used to help determine whether a platelet transfusion would be administered. Transfusion of CRYO and FFP was also recorded. The data were then compared to the retrospective same 6-month period in the preceding year for the purpose of determining the value of this system in guiding transfusion triage. There were 1770 platelet packs transfused during the study period, representing a 34% reduction in platelet usage. Platelet transfusions were reduced by 51% (5.75 in 2001 vs. 11.75 in 2000) per patient. CRYO/FFP usage was also substantially reduced. During the study period, the patient caseload had increased by 72 (310 vs. 238). Monitoring platelet count and function as a result of CPB and administering an appropriate transfusion protocol can positively impact transfusion outcome.

Autoanalysis↗

PubMed2003

A wireless diabetes management and communication system.

Current diabetes management requires the collection of a large volume of data by the patient for analysis by his or her provider. There are numerous practical and technical barriers to doing this effectively and efficiently. In addition, the calculation of the correct insulin dose is complex because it requires considering anticipated carbohydrate consumption and exercise in addition to the current blood glucose level. A Diabetes Management and Communication System (DMCS) has been developed using a Compaq iPAQ Pocket PC with a Sprint PCS wireless AirCard. This system circumvents the problem of multiple proprietary programs for each brand of meter and permits the accurate determination of the proper insulin dose. Privacy is maintained by using only the iPAQ serial number as the patient identifier with access to the website protected by unique patient and provider passwords. The iPAQ was programmed with formulas that included: insulin sensitivity factor, current glucose level, amount of carbohydrates, appropriate carbohydrate:insulin ratio for that meal, and duration/intensity of exercise. Once the information is entered, an insulin dose is calculated, although an alternative dose can be selected. The data are downloaded to http://www.HealthSentry.net, where they are displayed in both tabular and graphic form. The patient may view the glucose data in both tabular and graphic form on the iPAQ. Thus a DMCS has been developed to assist patients and providers in improving glycemic control. A proof-of-concept study is underway to determine the effectiveness of the DMCS in patients with Type 1 diabetes mellitus who are currently using insulin pumps.

Automation↗