scholarly journals Szignifikáns inverz kapcsolat a pajzsmirigy-stimuláló hormon (TSH) és a prosztataspecifikus antigén (PSA) vérszintjei között 40–75 éves korú férfiakban

2019 ◽  
Vol 160 (35) ◽  
pp. 1376-1379
Author(s):  
Zoltán Tóth ◽  
Béla Gyarmati ◽  
Tamás Szabó ◽  
Barna Vásárhelyi
Keyword(s):  
Information System ◽  
Regression Analysis ◽  
Reference Range ◽  
Specific Antigen ◽  
Clinical Decision ◽  
Reference Ranges ◽  
Laboratory Information System ◽  
Thyroid Status ◽  
Male Patients ◽  
Clinical Decision Limits

Abstract: Introduction: Recent experiments and clinical studies indicate the contribution of thyroid hormones to prostate pathology. Aim: In our retrospective analyzis of university patient population, we evaluated the association between thyroid stimulatory hormone (TSH) and prostate specific antigen (PSA). Method: From the Laboratory Information System we retrieved the data of male patients between 40 and 75 years of age who had been subjected to simultaneous TSH and PSA measurements during the last 12 years (n = 7279). The association between logTSH and logPSA levels was tested with multiple regression analysis and adjusted for age. Results: Significant associations between logPSA and logTSH and age (r = 0.297 and 0.472, respectively) were detected. PSA levels were higher in patients with TSH below (n = 405) than in those with TSH within reference range (TSH 0,35–4,95 mU/ml) (n = 6698) (PSA level: 1.118 [0.639–2.338] vs. 0.920 [0.508–1.826] ng/ml, p<0.016). Based on estimates, a 10% decrease in TSH is associated with a 0.42% increase in PSA levels in our population. This corresponds to a 42% increase in PSA levels in the same patient if he would present with 0.2 mU/ml instead of 2.0 mU/ml TSH. Conclusion: The finding that hyperthyreosis might be associated with higher PSA levels indicates that PSA reference ranges would differ in hyperthyreotic and in euthyreotic patients. Probably the PSA clinical decision limits is also recommended to be modified according to the patient’s thyroid status. Orv Hetil. 2019; 160(35): 1376–1379.

Inaccuracy of Sodium Measurement in Patients with Severe Hypernatremia

2020 ◽  
Author(s):  
Amir Karin ◽  
Davor Brinc ◽  
Felix Leung ◽  
Benjamin P Jung
Keyword(s):  
Information System ◽  
Whole Blood ◽  
Healthy Donor ◽  
Reference Range ◽  
Blood Analysis ◽  
Plasma Sodium ◽  
Laboratory Information System ◽  
Positive Bias ◽  
Blood Gas ◽  
Whole Blood Analysis

Abstract Introduction We observed discordant sodium results from a patient with severe hypernatremia such that whole-blood analysis produced results up to 9.6 mmol/L higher than plasma sodium obtained on the same collection. We investigated this bias by comparing other patients’ sodium results and performing comparisons of 3 blood gas and 2 chemistry analyzers. Methods First, the laboratory information system was queried for whole-blood sodium results &gt;160 mmol/L, which were used for comparison against plasma results from the same collection. Second, whole blood was collected from a healthy donor, a portion of which was spiked with sodium chloride to generate 8 samples with target concentrations of 140 to 185 mmol/L. Whole-blood sodium was measured in duplicate on the ABL90, RAPIDPoint 500, and GEM 4000. Plasma sodium was then measured in duplicate on the Architect c8000 and Cobas c702. Finally, plasma was injected on the blood gas analyzers to measure sodium in singleton. Results Overall, 53 paired results from patients showed a significant positive bias on the ABL90 relative to Vitros when sodium was &gt;160 mmol/L. The magnitude of difference was insignificant within the reference range but increased proportionately with concentration. The magnitude and pattern of positive bias in ABL90 sodium results were consistent with the observation in patient results. Conclusion In severe hypernatremia, sodium results produced by blood gas and plasma analyzers can differ significantly.

Use of laboratory information system data for indirect estimation of reference interval for vitamin B12

2015 ◽  
Vol 39 (6) ◽  
Author(s):  
Mufide Oncel ◽  
Emel Sahin ◽  
Aysel Kiyici ◽  
Bahattin Adam
Keyword(s):  
Information System ◽  
Vitamin B12 ◽  
Clinical Laboratory ◽  
Reference Interval ◽  
Serum Levels ◽  
Reference Intervals ◽  
National Committee ◽  
Reference Ranges ◽  
Laboratory Information System ◽  
The One

AbstractIn common, clinical laboratories use reference intervals recommended by the manufacturers. Various factors affect laboratory tests such as age, sex, diet and genetics. So, it is recommended for each laboratory to determine its own reference ranges for each test used. We aimed to establish our reference interval for vitamin B12.The data archive of laboratory information system was searched for a 1-year period between January and December, 2013. Among 2526 subjects searched for vitamin B12, 2368 remained (1–70 years old, 512 male and 1856 female) when we excluded the outliers for estimation of reference range for vitamin B12 with nonparametric method according to National Committee for Clinical Laboratory Standards (NCCLS) C28-A3 guidelines. Serum levels of vitamin B12 were determined with electrochemiluminescent technique.New reference interval for vitamin B12 derived from our results was 101–702 pg/mL, and was not affected by gender.New reference interval was different from the one recommended by the manufacturer. We suggest that established reference interval reflects our population better than the values recommended by the manufacturer.

scholarly journals Ratio of Thyroxine to Thyroxine-Binding Globulin

1981 ◽  
Vol 18 (2) ◽  
pp. 93-96 ◽  
Author(s):  
C F Cusick
Keyword(s):  
Reference Range ◽  
False Positives ◽  
Patient Data ◽  
Reference Ranges ◽  
Thyroid Status ◽  
False Negatives ◽  
Thyroxine Binding Globulin ◽  
Serum Thyroxine ◽  
Protein Levels ◽  
Serum T4

The thyroxine:thyroxine-binding globulin ratio in serum (T4:TBG) has been proposed as a measure of thyroid status unaffected by altered binding protein levels. Here 320 apparently euthyroid patients are used to derive euthyroid ranges for serum thyroxine concentrations at specific TBG levels. These ranges are compared with those predicted by a T4:TBG reference range derived from the same patient data. The comparison suggests that the ratio would give false positives for hyperthyroidism at low TBG levels and false negatives at high TBG levels. To overcome this the use of graphical reporting of results or the relation of patient results to empirical reference ranges appropriate to the TBG level is suggested.

scholarly journals Gestational age-specific reference ranges from different laboratories misclassify pregnant women's thyroid status: comparison of two longitudinal prospective cohort studies

2014 ◽  
Vol 170 (2) ◽  
pp. 329-339 ◽  
Author(s):  
Sofie Bliddal ◽  
Ulla Feldt-Rasmussen ◽  
Malene Boas ◽  
Jens Faber ◽  
Anders Juul ◽  
...  
Keyword(s):  
Thyroid Hormone ◽  
Pregnant Women ◽  
Gestational Age ◽  
Reference Range ◽  
The Other ◽  
Specific Reference ◽  
Reference Ranges ◽  
Thyroid Status ◽  
Prospective Cohort Studies ◽  
Tsh Levels

ObjectivesCorrect interpretation of thyroid status during pregnancy is vital to secure fetal development. Pregnancy-related changes in maternal thyroid status necessitate the use of gestational age-specific reference ranges. In this study, we investigated between-laboratory reproducibility of thyroid reference ranges in pregnant women.DesignComparison of two longitudinal prospective cohort studies including 255 (cohort 1) and 101 (cohort 2) healthy antibody-negative Danish pregnant women attending prenatal care at Copenhagen University Hospital.MethodsDifferent immunoassays were used to measure thyroid hormone levels in the two cohorts. Thyroid hormone reference ranges were established for every 5 weeks of gestation. Differences between cohorts were explored through mixed-model repeated measures regression analyses. By applying reference ranges from one cohort to the other, the proportion of women who would be misclassified by doing so was investigated.ResultsTSH increased and free thyroxine (FT4) decreased as pregnancy progressed. Results indicated highly significant differences between cohorts in free triiodothyronine (F=21.3, P<0.001) and FT4 (F=941, P<0.001). TSH levels were comparable (P=0.09). Up to 90.3% of the women had FT4 levels outside their laboratory's nonpregnant reference range, and up to 100% outside the other cohort's gestational-age-specific reference ranges. Z-score-based reference ranges markedly improved comparison between cohorts.ConclusionEven in the same region, the use of gestational-age-specific reference ranges from different laboratories led to misclassification. Up to 100% of maternal FT4 levels fell outside the other cohort's reference range despite similar TSH levels. In clinical practice, thyroid testing of pregnant women without adding method specificity to gestational age-dependent reference ranges will compromise patient safety.

Effects of Age and Health on the Euthyroid Reference Ranges for Serum Free Thyroxine and Free Triiodothyronine

1985 ◽  
Vol 24 (02) ◽  
pp. 57-65 ◽  
Author(s):  
J. E. M. Midgley ◽  
K. R. Gruner
Keyword(s):  
Lower Limit ◽  
Healthy Subjects ◽  
Thyroid Dysfunction ◽  
Reference Range ◽  
Free Thyroxine ◽  
Reference Ranges ◽  
Free Triiodothyronine ◽  
Serum Free ◽  
Young Subjects ◽  
Age Range

SummaryAge-related trends in serum free thyroxine (FT4) and free triiodothyronine (FT3) concentrations were measured in 7248 euthyroid subjects (age-range 3 months to 106 years). 5700 were patients referred to hospitals for investigation of suspected thyroid dysfunction, but who were diagnosed euthyroid. 1548 were healthy blood donors (age-range 18-63 years) with no indication of thyroid dysfunction. FT4 concentrations were little affected by the age, the sex or the state of health of the subjects in either group. Serum FT3 concentrations were significantly affected by both age and health factors. The upper limit of the euthyroid reference range for young subjects up to 15 years was about 20% higher (10.4 pmol/1) than for adult subjects older than 25 years (8.8 pmol/1). The change in the upper limits typical of young subjects to that typical of adults occurred steadily over the decade 15–25 years. After this age, little further change occurred, especially in healthy subjects. Additionally, the lower limit of the euthyroid range for FT3 was extended by the inclusion in the reference group of patients referred to hospitals. Compared with the lower limit of the FT3 range for healthy subjects (5 pmol/1), the corresponding limit for referred subjects (young or adult) was 3.5–3.8 pmol/1. Broadening of the FT3 reference range was probably brought about by a significant number of patients in the hospital-referred group with the “1OW-T3 syndrome” of mild non-thyroidal illness. Accordingly, FT3 was inferior to FT4 in the discrimination of hypothyroidism, as FT4 was unaffected by this phenomenon. Effects of age and non-thyroidal illness on serum FT3 concentrations require great care when selecting subjects for a laboratory euthyroid reference range typical of the routine workload. Constraints on the choice of subjects for FT4 reference ranges are less stringent.

Effectivness of Health Information System Applications: Clinical Information and Diagnosis-Treatment Systems in Turkey

2017 ◽  
Vol 5 (1) ◽  
pp. 122
Author(s):  
Assist. Prof. Dr. Demokaan DEMİREL
Keyword(s):  
Decision Making ◽  
Information System ◽  
Information Systems ◽  
Management Information System ◽  
Health Sector ◽  
Health Information System ◽  
Clinical Information ◽  
Clinical Decision ◽  
Clinical Information Systems ◽  
Management Information

The distinctive quality of the new social structure is that information becomes the only factor of production. In today's organizations, public administrators are directly responsible for applying information to administrative processes. In addition to his managerial responsibilities, a knowledge based organization requires every employee to take responsibility for achieving efficiency. This has increased the importance of information systems in the decision-making process. Information systems consist of computer and communication technology, data base management and model management and include activity processing system, management information system, decision support systems, senior management information system, expert systems and office automation systems. Information systems in the health sector aim at the management and provision of preventive and curative health services. The use of information systems in healthcare has the benefits of increasing service quality, shortening treatment processes, maximizing efficiency of the time, labour and medical devices. The use of information systems for clinical decision making and reducing medical errors in the healthcare industry dates back to the 1960s. Clinical information systems involve processing, storing and re-accessing information that supports patient care in a hospital. Clinical information systems are systems that are directly or indirectly related to patient care. These systems include electronic health/patient records, clinical decision support systems, nurse information systems, patient tracking systems, tele-medicine, case mix and smart card applications. Diagnosis-treatment systems are information-based systems used in the diagnosis and treatment of diseases. It consists of laboratory information systems, picture archiving and communication system, pharmacy information system, radiology information system, nuclear medicine information system. This study aims to evaluate the effectiveness of health information system applications in Turkey. The first part of the study focuses on the concept of information systems and the types of information systems in organization structures. In the second part, clinical information systems and applications for diagnosis-treatment systems in Turkey are examined. Finally, the study evaluates applications in the health sector qualitatively from the new organizational structure, which is formed by information systems.

Comparison of Time spent between an electronic and a paper-based laboratory information system by laboratorians at a polyclinic in Greater Accra, Ghana: A time-motion study

2020 ◽  
Author(s):  
Philip Boakye
Keyword(s):  
Information System ◽  
Negative Impact ◽  
Laboratory Information System ◽  
Time Motion ◽  
Accessible Information ◽  
Motion Study ◽  
Significant Difference ◽  
Significant Negative Impact ◽  
Key Issues ◽  
Motion Studies

The acceptance of electronic laboratory information system (LIS) is gradually increasing in developing countries. However, the issue of time effectiveness due to computerization is less clear as there is fewer accessible information. One of the key issues for laboratorians is their indecision with LISs’ would-be effect of time on their work. A polyclinic in Ghana was in the process of implementing electronic LIS. Several of the laboratorians did not have knowledge and skill in computing and there were disagreeing views on the time effectiveness of the LIS after implementation. The management of the polyclinic laboratory was concerned to assess time advantageousness of recording data when using the electronic LIS compared with paper-based LIS. <div><br></div><div>Five randomly selected laboratorians were provided two sheets of paper with tables to document the time they spent for both paper-based and electronic LIS. Data were collected for a total of 230 records,115 electronic LIS and 115 paper-based LIS. The t-test (mean-comparison test) was computed to compare the means of both electronic and paperbased LIS times. </div><div><br></div><div>There was a statistical significant difference in the time spent between electronic and paper-based LIS. The time spent between paper-based and electronic LIS was 0.41 minutes (95% CI 0.15 to 0.66) longer than in electronic LIS. </div><div><br></div><div>LIS can be adopted in polyclinics without having significant negative impact on time spent between electronic and paper-based LIS. More time–motion studies that include laboratorians are however necessary in order to get a more complete picture of time spent between electronic and paper-based LIS. </div>

Computerized method for validating laboratory reference ranges for triiodothyronine and thyroxin immunoassays

1991 ◽  
Vol 37 (3) ◽  
pp. 438-442 ◽  
Author(s):  
Brian Luttrell ◽  
Sall Watters
Keyword(s):  
Reference Range ◽  
Normal Values ◽  
Reference Group ◽  
Normal Population ◽  
Normal Subjects ◽  
Reference Ranges ◽  
Large Samples ◽  
Laboratory Reference ◽  
Euthyroid Status ◽  
Computer Based

Abstract We used a computer-based method to help validate the reference ranges of assays for triiodothyronine (T3) and thyroxin (T4). A retrospective search of a database of laboratory results for the previous six months identified all patients with apparent euthyroid status, as defined by methods independent of the immunoassay under review. A computer-generated reference group (CGR Group) of 2001 records had a gaussian distribution of T4 values and a reference range (mean +/- 2 SD) of 56-161 nmol/L, compared with the supplier's suggested range for euthyroid subjects (58-148 nmol/L) and an in-house range of 60-144 nmol/L for a group of 97 normal subjects. A similar CGR Group of 1902 records gave a reference range for T3 of 0.7-2.1 nmol/L (manufacturer's range 0.8-2.8; normal subjects 0.8-2.2). An attempt to devise a reference range for thyrotropin failed when we found that its concentration in the population of patients with normal values for thyroid hormones was distributed differently from that in the normal population. The method is intended to be used in addition to conventionally derived ranges based on results for healthy subjects. It allows the laboratory to conveniently verify the reference ranges for T3 and T4 assays at regular intervals by using very large samples with appropriate age, sex, and weight distribution, drawn from the population of patients' samples submitted for analysis.

scholarly journals Control of Graves’ hyperthyroidism with very long-term methimazole treatment: a clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fereidoun Azizi ◽  
Hengameh Abdi ◽  
Atieh Amouzegar
Keyword(s):  
Low Dose ◽  
Reference Range ◽  
Antithyroid Drug ◽  
Therapeutic Modality ◽  
Thyroid Status ◽  
Antithyroid Drug Therapy ◽  
Daily Dose ◽  
Prevention Of Relapse

Abstract Background Long-term antithyroid drug therapy has become one of the options for treatment of Graves’ hyperthyroidism. The aim of this study was to compare thyroid status in those who discontinued methimazole (MMI) treatment after 12.8 years with those who continued MMI as long as 24 years. Methods Fifty nine patients with Graves’ disease on long-term MMI for 14.2 ± 2.9 years were recruited; 32 patients (54%) decided to discontinue MMI and 27 (46%) preferred additional years of MMI treatment. All patients were followed for a mean of 6 additional years. Results Of 27 patients who continued MMI up to 24 years, suppressed serum thyrotropin (TSH) was not observed in any patient after the seventh year of treatment. Serum free thyroxine, triiodothyronine, TSH and TSH receptor antibody concentrations remained normal up to the length of the study. Mean daily dose of MMI to maintain TSH in the reference range decreased gradually and reached to 2.8 ± 1.7 mg by 24 years of MMI treatment. No adverse reaction related to MMI occured during additional years of therapy. In 32 patients who discontinued MMI, hyperthyroidism relapsed in 6 patients (19%), one left follow-up and 25 (78%) remained euthyroid during the study. Conclusions Long-term low dose MMI treatment may be a lifelong effective and safe therapeutic modality in patients with Graves’ hyperthyroidism for prevention of relapse, if studies from other centers confirm findings of this research. Trial registration IRCT201009224794N1, 2010-10-25. Retrospectively registered. https://www.irct.ir/trial/5143.

scholarly journals Predicting PM2.5 levels over the north of Iraq using regression analysis and geographical information system (GIS) techniques

2021 ◽  
Vol 12 (1) ◽  
pp. 1778-1796
Author(s):  
Hussein Habeeb Hamed ◽  
Huda Jamal Jumaah ◽  
Bahareh Kalantar ◽  
Naonori Ueda ◽  
Vahideh Saeidi ◽  
...  
Keyword(s):  
Information System ◽  
Regression Analysis ◽  
Geographical Information System ◽  
Geographical Information ◽  
Gis Techniques ◽  
The North
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