Annals of clinical and laboratory science
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During a down-sizing of residency programs at a State University Medical School, hospital based residents' positions were eliminated. It was determined to find out the characteristics of the residents who graduated from the Laboratory Medicine Program, to compare women graduates with men graduates, and to compare IMGs with United States Graduates. ⋯ Of 100 graduates, there were 57 directors, 52 certified, and 41 with academic appointments. Twenty-two graduates (11 women and 11 men) attained all three.
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Ann. Clin. Lab. Sci. · Nov 1997
ReviewHemostatic abnormalities associated with cancer and its therapy.
Hemostatic abnormalities associated with malignancy have been described since the middle of the 19th century. Abnormalities associated with hypercoagulability and hemorrhage are reported in various percentages of patients depending upon the underlying neoplasm and the type of therapy. Changes in the quantitative and qualitative aspects of protein coagulation factors, anticoagulant proteins, circulating anticoagulants, platelets, and vascular responses have been noted. ⋯ Chemotherapy has been reported to be associated with venous and arterial thromboses, cerebrovascular events, and coagulopathies. Radiation therapy decreases platelet production, particularly if the active bone marrow has been included in the field. Laboratory evaluation of HAAC requires consideration of the type of malignant disorder, the history and physical condition of the patient and any therapy.
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This study reports the predictive value, in septic patients, of septic shock at presentation (SS factor) alone and in combination with multiple markers, using survival of the sepsis episode as the outcome measure. The SS factor correctly predicted the outcome in 53/68 (78%) of patients in this study. ⋯ The four-input algorithm (APII, IL-6, IL-6sR, SS factor) correctly classified 16/18 (89%, Group A) and 14/18 (78%, Group B) of patients in the test subset. The corresponding four-input neural network model (10 iterations) correctly classified 61 to 89% of the 18 patients in the 10 test subsets.
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Positive pressure ventilation with hyperdistention of the lungs (PPVHDL) causes microscopic lung injury in rats and in mice. This study compared lung lavage and serum levels of lactate dehydrogenase (LDH), aspartate aminotransferase (AST), creatinine phosphokinase (CPK), lung lavage and plasma endothelin-1 (ET-1) concentration, lung tissue ET-1 mRNA expression, angiotensin converting enzyme (ACE) activity of lung homogenates, and histology of the lung structure in control and PPVHDL rats. Rats were anesthetized with pentobarbital. ⋯ No significant difference was found in lung tissue ET-1 mRNA expression and lung protein concentration between the two groups. Lung ACE activity, in contrast, was significantly lower in PPVHDL rats. This study demonstrated that moderate alveolar hyperdistention caused significant structural lung damage accompanied by decreased ACE activity after seven hours of mechanical ventilation and that elevated lung lavage and serum LDH and AST levels in lung lavage and in serum might be early markers of ventilator-induced lung injury in this rat model.
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Ann. Clin. Lab. Sci. · Jul 1996
Comparative StudyComparison of myoglobin, creatine kinase-MB, and cardiac troponin I for diagnosis of acute myocardial infarction.
Serial plasma concentrations of myoglobin, creatine kinase MB (CK-MB) isoenzyme, and cardiac troponin I (cTnI) were measured in 25 patients with a confirmed diagnosis of acute myocardial infarction (AMI), and 74 patients who were suspected of AMI but were subsequently ruled out for this diagnosis. The cutoff concentration for the cTnI assay was optimally determined to be 2.5 ng/mL. Of the three markers, myoglobin had the highest clinical sensitivity (50 percent) when blood was collected between 0 to 6 h after the onset of chest pain. ⋯ The clinical efficiency of cTnI for all samples was better than either CK-MB or myoglobin, owing mainly to the wider diagnostic window. The specificity of cTnI for 59 patients with chronic renal failure, skeletal muscle trauma and disease was better than all of these markers including cardiac troponin T (cTnT). Results of this study show that cTnI is an effective marker for the retrospective diagnosis of AMI, and consideration should be given to its use in place of CK-MB.