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1.
Hemophagocytic lymphohistiocytosis (HLH) is an inflammatory condition that may run a rapid fatal course and calls for prompt diagnosis. Early intervention with steroids and other immunosuppressive drugs can contain the disease process and favours positive outcome. Ferritin ≥500 ng/ml is a HLH diagnostic criterion. We evaluated the diagnostic potential of admission ferritin, in children with HLH. Pediatric patients of a referral teaching hospital from Feb 2010–Oct 2013 having been investigated for ferritin on admission were included. HLH was confirmed when patients had clinical features and met 5/8 diagnostic criteria of the revised 2004 HLH guidelines. Ferritin was estimated on Cobas e411 by electrochemiluminiscence, with a measuring range of 0.5–2000 ng/ml. Dilutions were made when linearity exceeded and absolute values were reported. 905 on-admission ferritin investigations were reviewed out of which 346 values ≥500 ng/ml. Hyperferritinemia was seen in HLH/MAS (macrophage activation syndrome) [HLH group, median age 4 year 4 month, 59% male] and in systemic lupus erythematosus, sepsis, juvenile idiopathic arthritis, impending HLH, haemolytic anemias and malignancy [non-HLH group, median age 4 year 6 month, 60% male]. Of 346, 72 cases of hyperferritinemia were diagnosed with secondary HLH while one patient had primary HLH. 13/73 patients expired. The median ferritin level of the HLH group was significantly higher [6556 (2402–11,734) ng/ml] compared to non-HLH group [median 1175 (943–2000) ng/ml] (p < 0.0001). Receiver operator characteristics curve analysis revealed optimal admission ferritin of 3120 ng/ml as the cut-off with sensitivity of 70% and specificity of 88.9% for HLH diagnosis, exceeding the currently prescribed cut-off of 500 ng/ml. Hyperferritinemia below 3120 ng/ml has higher negative predictive value to rule out secondary HLH on admission in the study population of children predominantly diagnosed with infection associated HLH than the prescribed cut-off as per the 2004 guidelines. This may prove to be beneficial to alert physicians for prompt intervention which considerably decreases mortality in this often fatal condition.  相似文献   

2.
Recent acquisitions on the early detection and monitoring of the progression of diabetic complications (nephropathy) using the techniques of enzymology (lysosomal enzymes) are reviewed. it appears that the kidney is the principal source of urinary lysosomal enzymes. Urinary samples for lysosomal enzyme determination can be either 24-hour or spot-collection. The use of synthetic substrates (4-methylumbelliferyl substrates) provides an easy, inexpensive, sensitive and highly reproducible method of lysosomal enzyme assay. It is recommended that more than one enzyme be assayed in the process. The use of fractional enzyme excretion (FEE) ratios is further recommended. The urinary lysosomal glycosidases investigated and found to be of particular diagnostic value in the early detection of diabetic nephropathy include N-acetyl-β-D-glucosaminidase (β-hexosaminidase, NAG), β-glucuronidase and β-galactosidase, with NAG being the most useful indicator. Urinary NAG can be used in monitoring the progression of diabetic nephropathy. The fluorimetric assay of lysosomal glycosidases is particuarly recommended in developing countries since it is simple, sensitive and inexpensive.  相似文献   

3.
Apart from the biochemical parameters routinely used like Vanillyl Mandellic Acid for the patients with neuroblastoma the parameters like neuron specific enolase, ferritin, lactate dehydrogenase, gamma glutamyl transferase were also studied to assess the utility in diagnosing the patients with neuroblastoma. The study involved 40 healthy ambulatory subjects and 30 untreated cases of histologically proved neuroblastoma referred to the Tata Memorial Hospital for further management and treatment. The urinary Vanillyl Mandellic Acid levels and the serum levels of neuron specific enolase, ferritin, lactate dehydrogenase had increased significantly, p<0.001 whereas the gamma glutamyl transferase had decreased significantly p<0.001, as compared to the normal. Serum neuron specific enolase, ferritin, lactate dehydrogenase alongwith urinary Vanillyl Mandellic Acid could be of help in diagnosing the patients with neuroblastoma.  相似文献   

4.
HIV infects cluster of differentiation 4 (CD4) T-lymphocytes, monocytes and macrophages resulting in decreased number and function of CD4 cells, changes that affect both cell mediated and humoral immunity. Hematological abnormalities are a common complication of human immune virus (HIV) infection and these abnormalities increase as the disease advances. Anemia is the most common haematological abnormality in HIV seropositive patients and its incidence is strongly associated with the progression of the disease. The aim of present study was to assess the haematological profile of HIV seropositive women and compare them with CD4 count. Two hundred seropositive females (age 18–25 years) attending antiretroviral therapy clinic were selected. Routine gynaecological and haematological investigations were carried out, study samples were drawn and serum iron, folate and ferritin were analysed by chemiluminiscence and CD4 count was determined by using flow-cytometry. Anemia was prevalent in seropositive women especially in those with low CD4 levels. Serum folate and ferritin levels were significantly lower in females with lower CD4 levels. Serum iron levels were higher at low CD4 levels. The mean CD4 count in HIV seropositive anaemic women were lower as compared to non anaemics suggesting that anaemia improves with higher CD4 cell counts. Plasma folate and ferritin levels are sensitive predictor of anaemia in early HIV infections and these patients should have a regular monitoring of their folate and ferritin levels especially with lower CD4 levels.  相似文献   

5.
High ferritin levels have been found to be associated with non infectious as well as infectious causes including tuberculosis. This is one case report of 41 year old male who presented with cough with expectoration. The patient had Multi drug resistant tuberculosis (MDRTB) and type 2 diabetes mellitus. The laboratory findings showed Iron 280 μg/dl, Total iron binding capacity (TIBC) 61 μg/dl, and ferritin 92,945 ng/ml which indicates that iron is an essential nutrient for the survival of the pathogen Mycobacterium tuberculosis.  相似文献   

6.
Free iron in serum has been found in several disease conditions including diabetes. In the present work, we studied the relationship between free iron, fasting blood glucose (FBG) and glycated haemoglobin (HbA1c). Study was carried out on 50 type 2 diabetes cases under poor glycemic control associated with complications, 53 type 2 diabetes cases under good glycemic control and 40 healthy controls. We estimated free iron, both ferrous (Fe+2) and ferric (Fe+3) form, protein thiols, lipid hydroperoxides, FBG, HbA1c and serum ferritin levels in serum. There was a significant increase in free iron in Fe+3 state (p <0.01), HbA1c (p<0.01), serum ferritin (p<0.01), lipid hydroperoxides (p<0.01) and significant decrease in protein thiols (<0.01) in diabetes cases under poor glycemic control compared to diabetes cases under good glycemic control and healthy controls. Free iron correlated positively with HbA1c (p<0.01). Poor glycemic control and increase in glycation of haemoglobin is contributing to the increase in free iron pool which is known to increase oxidant generation.  相似文献   

7.
Appropriate therapeutic measures can improve the life expectancy of patients with ovarian malignancy. There has been a pressing need for serodiagnostic assays to enable, the close patient monitoring. Cancer Antigen 125 (CA125) has been described as a useful marker in patient monitoring for ovarian malignancy. Keeping this in view, the present study was planned. 40 consecutive female patients of ovarian carcinoma (mean age 52.4±10.7 years) were selected for serum CA125 analysis during the period of year 1995–2001. The tumour marker concentration was compared with histologic types of ovarian tumour and the FIGO staging of the disease. 25 healthy females (mean age 35.2–10.4 years) served as control. Mean serum CA125 concentrations in patients with papillary serous adenocarcinoma(Mean±%CV 1571±121.5 U/ml) was much higher than patients with mucinous adenocarcinoma(775±78U/ml). Mean serum CA125 concentration in endometrioid carcinoma was very high(2853±136 U/ml). The patient with clear cell carcinoma however had shown moderate increase(60 U/ml). No correlation was found between serum CA125 concentration and the FIGO staging of disease. Quantitation of CA125 was most helpful in monitoring the response of treatment and followup of the patients after completion of their treatment. Posttherapeutically its concentration showed more than 50% reduction in almost all (91.4%) patients (P<0.001). Importantly these patients had also shown significant regression of the disease clinically and radiologically. 8.6% of patients had shown static or increase in serum CA125 concentration which was associated with either clinically static or progressive disease. Recurrence of the disease was noted in patients who had shown increase in serum CA125 concentration (biochemical recurrence) in the followup However, in our test population biochemical recurrence(increase in serum marker concentration) preceded the clinical or radiological recurrence by an average of 6.5 months. Kaplan meier survival analysis for evaluation of overall survival in our test subjects showed an overall survival of 32% at one year and median survival of 9 months with confidence interval of 6.34 to 11.66. We conclude that serum CA125 is a useful marker for monitoring the treatment and predicting an early recurrence of the disease in ovarian carcinoma patients. A study in larger number of patients is needed to define its exact role in the management of the carcinoma ovary.  相似文献   

8.

Introduction

Preanalytical control and monitoring continue to be an important issue for clinical laboratory professionals. The aim of the study was to evaluate a monitoring system of preanalytical errors regarding not suitable samples for analysis, based on different indicators; to compare such indicators in different phlebotomy centres; and finally to evaluate a single synthetic preanalytical indicator that may be included in the balanced scorecard management system (BSC).

Materials and methods

We collected individual and global preanalytical errors in haematology, coagulation, chemistry, and urine samples analysis. We also analyzed a synthetic indicator that represents the sum of all types of preanalytical errors, expressed in a sigma level. We studied the evolution of those indicators over time and compared indicator results by way of the comparison of proportions and Chi-square.

Results

There was a decrease in the number of errors along the years (P < 0.001). This pattern was confirmed in primary care patients, inpatients and outpatients. In blood samples, fewer errors occurred in outpatients, followed by inpatients.

Conclusion

We present a practical and effective methodology to monitor unsuitable sample preanalytical errors. The synthetic indicator results summarize overall preanalytical sample errors, and can be used as part of BSC management system.Key words: Preanalytical phase, errors in laboratory medicine, balanced scorecard, patient safety  相似文献   

9.
刘儒渊  曾家琳 《资源科学》2006,28(3):120-127
本研究应用由植群覆盖度减少率(CR)、植相变异度(FD)及植株高度降低率(HR)等三项植群冲击介量所合成之植群冲击指数(IVI),与步道截面土壤冲蚀量之变化,自1991至2004年间,定期就游客践踏对塔塔加步道所造成之游憩冲击效应进行长期的调查监测,探讨其变迁与可能的影响因子。本文汇整14年来所完成之重要调查监测与研究成果,并提出若干建议事项供为游憩生态学之相关研究,与经营管理单位在制定或修正其步道冲击防治与管理策略时之参考。  相似文献   

10.
Open-content communities that focus on co-creation without requirements for entry have to face the issue of institutional trust in contributors. This research investigates the various ways in which these communities manage this issue. It is shown that communities of open-source software—continue to—rely mainly on hierarchy (reserving write-access for higher echelons), which substitutes (the need for) trust. Encyclopedic communities, though, largely avoid this solution. In the particular case of Wikipedia, which is confronted with persistent vandalism, another arrangement has been pioneered instead. Trust (i.e. full write-access) is ‘backgrounded’ by means of a permanent mobilization of Wikipedians to monitor incoming edits. Computational approaches have been developed for the purpose, yielding both sophisticated monitoring tools that are used by human patrollers, and bots that operate autonomously. Measures of reputation are also under investigation within Wikipedia; their incorporation in monitoring efforts, as an indicator of the trustworthiness of editors, is envisaged. These collective monitoring efforts are interpreted as focusing on avoiding possible damage being inflicted on Wikipedian spaces, thereby being allowed to keep the discretionary powers of editing intact for all users. Further, the essential differences between backgrounding and substituting trust are elaborated. Finally it is argued that the Wikipedian monitoring of new edits, especially by its heavy reliance on computational tools, raises a number of moral questions that need to be answered urgently.  相似文献   

11.
从知识管理的角度出发,构建网络舆情知识复杂度指标体系。指标体系的设计充分顾及了网络舆情的知识复杂性,在对网络舆情知识复杂度影响因素进行全面分析的基础上,通过指标量化方法和复杂度映射函数建立网络舆情知识复杂度评价指标体系。最后,利用灰色相似度思想和偏差分析方法对所提指标体系进行了有效性验证,结果表明,所提指标体系具有较高的有效性指数,能够作为政府应用知识管理理论和方法应对网络舆情的决策参考。  相似文献   

12.
The stethoscope is widely used for listening to heart sounds (cardiology), lung sounds (chest medicine) and digestive, bowel sounds, etc. An obvious development from this is to seek to automate the process by which a physician listens to and interprets the sounds. In parallel with signal processing developments, medical usage of diagnostic instrumentation is changing. The study described in this paper aimed to prove the feasibility of an automatic stethoscope for particular screening and monitoring algorithms, for which we envisage genuine clinical applicability. The first algorithm is to enable non-specialists to screen for pulmonary fibrosis. The algorithm was found to distinguish effectively between signals representing patients with chronic obstructive pulmonary disease (COPD), those with pulmonary fibrosis and normal individuals. A clear demarcation was observed between signals from patients in different diagnostic categories, with orders of magnitude differences between the groups. The second application is the monitoring of asthmatic patients. The proportion of wheeze within a given time recording is an objective indicator of the patient's condition, which can be used to monitor the person's progress during treatment. The proposed usage of each algorithm is demonstrated through a conceptual device, in which the ability to objectively quantify the patient's condition represents a powerful opportunity to improve clinical outcomes.  相似文献   

13.
基于主成分分析的广东省区域水资源紧缺风险评价   总被引：2，自引：0，他引：2  
凌子燕  刘锐 《资源科学》2010,32(12):2324-2328
在调查和分析广东省水资源现状的基础上,选择水资源压力、社会状态和防旱响应3个准则层共18个指标构建水资源紧缺风险评价体系。运用主成分分析法确定评价指标权重后采用综合指数模型计算风险指数,应用GIS的空间分析技术,建立一套区域水资源紧缺风险评价指标体系和评价模型,为广东省水资源紧缺风险的研究和决策提供依据。评价广东省6个地区水资源紧缺风险的结果表明,农作物播种面积、工业废水排放达标率和万元GDP用水量3个指标对这些地区的水资源紧缺总风险指数的影响较大;各地区资源风险指数、使用风险指数和管理风险指数的差异体现出不同地区不同的缺水特征,参评地区中湛江已经进入了水资源紧缺高风险区域。  相似文献   

14.
权重的确定是多指标综合评价中的一个重要步骤。本文针对传统层次分析法(AHP)在实践中无法摆脱评估过程中的随机性及专家的主观随意性等原因使得确定的权重与实际相悖的不足，提出将群决策的思想融入AHP法。通过将专家意见做为对各个指标赋权的主要依据，并根据指标之间的相关逻辑来逐步调整各指标的权重占比，保持动态赋权，从而改进传统AHP法。然后根据建立的指标层次结构模型运用改进的AHP法求得主观权重，将其应用于供水绩效评估指标权重确定方法中，获得满意的效果。改进AHP法可以用于制定合理、公正的绩效评估体系，也可以应用于其他的评价指标体系权重确定。  相似文献   

15.
We present an immunoaggregation assay chip for multiplexed biomarkers detection. This chip is based on immunoaggregation of antibody functionalized microparticles (Ab-MPs) to quantify concentrations of multiple biomarkers simultaneously. A mixture of multiple types of Ab-MPs probes with different sizes and magnetic properties, which were functionalized by different antibodies, was used for the multiplexed assay. The interactions between biomarkers and their specific Ab-MPs probes caused the immunoaggregation of Ab-MPs. A two-stage micro resistive pulse sensor was used to differentiate and count the Ab-MP aggregates triggered by different biomarkers via size and magnetic property for multiplexed detection. The volume fraction of each type of Ab-MP aggregates indicates the concentration of the corresponding target biomarker. In our study, we demonstrated multiplexed detection of two model biomarkers (human ferritin and mouse anti-rabbit IgG) in 10% fetal bovine serum, using anti-ferritin Ab and anti-mouse IgG Ab functionalized MPs. We found that the volume fraction of Ab-MP aggregates increased with the increased biomarker concentrations. The detection ranges from 5.2 ng/ml to 208 ng/ml and 3.1 ng/ml to 5.12 × 104 ng/ml were achieved for human ferritin and mouse anti-rabbit IgG. This bioassay chip is able to quantitatively detect multiple biomarkers in a single test without fluorescence or enzymatic labeling process and hence is promising to serve as a useful tool for rapid detection of multiple biomarkers in biomedical research and clinical applications.  相似文献   

16.
The levels of norepinephrine (NE), dopamine (DA) serotonin (5-HT) and its metabolite 5-hydroxyindole acetic acid (5-HIAA) have been determined in the cerebrospinal fluid (CSF) of normal (n=25) and suicidal attempt cases (n=30). A significant decrease in the level of NE (p<0.01), 5-HT(p<0.001) and 5-HIAA (p<0.001) in the CSF of suicide attempt cases were observed as compared to normal controls. It is concluded that CSF 5-HIAA level which is drastically depleted may be used as an early biochemical indicator of suicidal attempt so that it may be treated by the drugs which can enhance the suppressed neurotransmitter activity.  相似文献   

17.
Leucine amino peptidase (LAP) activity was studied in serum and urine samples of 25 healthy ambulant subjects, 20 patients with localised and 41 patients with malignant disseminated disease. Serum levels of the enzyme were elevated but not significantly in both localised and disseminated disease whereas the urinary activity of the enzyme was markedly elevated in disseminated disease (p<0.001) as compared to localised disease. This quantitative method used for determination is reliable, accurate, simple, rapid and cost effective and therefore has better application as an indicator of disseminated disease in a clincal setting.  相似文献   

18.
The wound-healing assay is an easy and economical way to quantify cell migration under diverse stimuli. Traditional assays such as scratch assays and barrier assays are widely and commonly used, but neither of them can represent the complicated condition when a wound occurs. It has been suggested that wound-healing is related to electric fields, which were found to regulate wound re-epithelialization. As a wound occurs, the disruption of epithelial barrier short-circuits the trans-epithelial potential and then a lateral endogenous electric field is created. This field has been proved invitro as an important cue for guiding the migration of fibroblasts, macrophages, and keratinocytes, a phenomenon termed electrotaxis or galvanotaxis. In this paper, we report a microfluidic electrical-stimulated wound-healing chip (ESWHC) integrating electric field with a modified barrier assay. This chip was used to study the migration of fibroblasts under different conditions such as serum, electric field, and wound-healing-promoting drugs. We successfully demonstrate the feasibility of ESWHC to effectively and quantitatively study cell migration during wound-healing process, and therefore this chip could be useful in drug discovery and drug safety tests.  相似文献   

19.
Osteoporosis encompasses a wide spectrum of conditions associated with imbalance of osteoclastic and osteoblastic activities. The increased activity of osteoclasts leads to increased free radical formation and hence lipid peroxidation. Present study probes into the role of antioxidants as a palliative treatment for osteoporosis. It involved 50 healthy controls and 75 clinically diagnosed osteoporosis patients. Both the groups underwent baseline assessment of biochemical markers viz. osteoblastic markers: serum Alkaline phosphatase. Free or ionic calcium and Inorganic phosphorus, osteoclastic markers: serum Tartarate resistant acid phosphatase and Malondialdehyde and the antioxidant status: serum Superoxide dismutase and Erythrocyte reduced glutathione. The osteoporotic group was then divided into groups A (Vitamin E-Evinal 400 mg), B (Vitamin C-Celin 500 mg), C (Vitamin E+C-Evinal+Celin) for antioxidant supplementation for a period of 90 days. The results reveal that there is significant fall in concentration of serum MDA (p<0.001), TrACP (p<0.01). Improvement in antioxidant status is reflected by significant rise in concentration of serum SOD (p<0.001) and erythrocyte GSH (p<0.001) after 90 days of antioxidant supplementation in osteoporosis. The findings indicate that on the whole bone status improved with prolonged antioxidant vitamin supplementation, which can be used as a palliative treatment for osteoporosis. The efficacy is not affected whether the vitamins are administered singly or conjointly.  相似文献   

20.
陈洪海  王慧  隋新 《科研管理》2020,41(8):240-247
针对现有因子分析及相关分析两种方法在指标筛选与赋权方面有待完善之处,提出一种基于信息贡献率的评价指标筛选与赋权方法。该方法首先利用因子方差贡献率和因子载荷构建评价指标的信息贡献率,以此反映该指标解释原始指标集全部信息的比例,然后在现有相关分析法中引入病态指数测度指标集的信息重叠水平,进而实现评价指标的系统筛选与赋权。本研究认为评价指标的信息贡献率越大,其解释原始指标集信息的比例越大,因此该指标越应予以保留,其权重亦应越大。此外,研究亦发现因子分析法易误删信息解释能力强的指标,相关分析法筛选指标易不充分,而本文方法解决了这些问题。  相似文献   

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