Scandinavian journal of clinical and laboratory investigation. Supplementum
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Scand J Clin Lab Invest Suppl · Jan 2016
ReviewSerum-free light-chain analysis in diagnosis and management of multiple myeloma and related conditions.
The introduction of the serum-free light-chain (S-FLC) assay has been a breakthrough in the diagnosis and management of plasma cell dyscrasias, particularly monoclonal light-chain diseases. The first method, proposed in 2001, quantifies serum-free light-chains using polyclonal antibodies. More recently, assays based on monoclonal antibodies have entered into clinical practice. ⋯ It is also useful for risk stratification in solitary plasmacytoma and AL amyloidosis. The S-FLC measurement is part of the new diagnostic criteria for multiple myeloma, and provides a marker to follow changes in clonal substructure over time. Finally, the evaluation of S-FLC is fundamental for assessing the response to treatment in monoclonal light chain diseases.
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The burden of disease and public health issues affecting girls and women throughout their lives is significantly greater in resource-poor settings. These women and girls suffer from high rates of maternal mortality, obstetric fistulas, female genital cutting, HIV/AIDS, malaria in pregnancy, and cervical cancer. ⋯ A life-course approach that includes improvements in earlier-life factors such as diet and exercise is necessary to improve women's long-term health outcomes. Innovative diagnostic tools and treatment strategies along with cost-effective health service delivery systems are needed to make a significant impact on women's and girls' health worldwide.
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Vitamin D (cholecalciferol) is important for normal development and maintenance of the skeleton. The metabolites 25(OH)D and 1,25(OH)(2)D are not only important for treating rickets and osteomalacia but also for all types and clinical stages of osteoporosis. Patients with low calcium intake and a low vitamin D status are at risk to develop secondary hyperparathyroidism, increased bone resorbtion, osteopenia and fractures. ⋯ Studies and meta-analyses during the last two decades on the effect of vitamin D and calcium supplements have not resolved the controversy on the risk of falls and fractures in healthy or osteopenic elderly populations. A thorough analysis of these trials supports our clinical experience that the efficacy of vitamin D-calcium supplementation depends on factors related to patient selection, medical intervention and study design, e.g. age, mobility, preventing falls and fractures, co-morbidity, initial vitamin D status and renal function. We conclude that plain vitamin D (cholecalciferol) with sufficient calcium intake is able to reduce the risk of falls and fractures only when adopting optimal selection criteria for patients and study conditions.
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Scand J Clin Lab Invest Suppl · Jan 1996
ReviewElevations in blood lactate: overview of use in critical care.
Blood lactate measurements are being used clinically as an indicator of circulatory impairment and the overall state of oxygenation of patients in critical care. This report briefly covers the areas of usage of lactate testing, lactate biochemistry, appropriate sample handling, and clinical interpretation of lactate measurements in critical care monitoring including pediatric cardiac surgery and extracorporeal membrane oxygenation (ECMO).
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Scand J Clin Lab Invest Suppl · Jan 1990
Simultaneous measurements of blood pH, pCO2, pO2 and concentrations of hemoglobin and its derivates--a multicenter study.
During the last few years a need for simultaneous measurements of pH, pCO2, pO2, total hemoglobin concentration, oxygen saturation, carboxyhemoglobin, and methemoglobin has been emphasized. Besides the direct use of such measured quantities a series of algorithms has been developed, especially to describe series of oxygen parameters of the blood. A multicenter study involving 20 hospital centers in Denmark and Sweden was conducted. ⋯ Based on the DPG results, an internal quality procedure has been suggested. Oxygen saturation was calculated based on actual values of pH and pO2 and the standard oxyhemoglobin dissociation curve, and then compared to the measured oxygen saturation. The discrepancy between the calculated and measured values for the different types of blood samples showed that calculation of oxygen saturation should be used with great care for pO2 values below 10 kPa and especially for capillary and umbilical blood samples.