Follow-up Blood Tests Research Articles

Outcomes of long-term testosterone replacement in older hypogonadal males: a retrospective analysis.

To determine the complications, toxicities, and compliance of long term testosterone replacement in hypogonadal males, we retrospectively assessed 45 elderly hypogonadal men receiving testosterone replacement therapy and 27 hypogonadal men taking testosterone. Hypogonadism was defined as a bioavailable testosterone serum concentration of 72 ng/dL or less. Both groups received baseline physical examinations and blood tests. The testosterone-treated group received 200 mg testosterone enanthate or cypionate im every 2 weeks, and follow-up examinations and blood samplings were performed every 3 months. The control group had a single follow-up blood test and physical examination. There was no significant difference in the initial blood tests in the two groups. At 2 yr follow-up, only the hematocrit showed a statistically significant increase in the testosterone-treated group compared to the control group (P < 0.001). A decrease in the urea nitrogen to creatinine ratio and an increase in the prostate-specific antigen concentration was not statistically significant. Eleven (24%) of the testosterone-treated subjects developed polycythemia sufficient to require phlebotomy or the temporary withholding of testosterone, one third of which occurred less than 1 yr after starting testosterone treatment. There was no significant difference in the incidence of new illness in the two groups during the 2-yr follow-up. Although self-assessment of libido was dramatically improved in the testosterone-treated group (P < 0.0001), approximately one third of the subjects discontinued therapy. In conclusion, testosterone replacement therapy appears to be well tolerated by over 84% of the subjects. Long term testosterone replacement to date appears to be a safe and effective means of treating hypogonadal elderly males, provided that frequent follow-up blood tests and examinations are performed.

Free-hand technique with ordinary antisepsis in abdominal US-guided fine-needle punctures: three-year experience.

To evaluate the adequacy of ordinary antisepsis in ultrasound (US)-guided free-hand fine-needle puncture. Diagnostic and therapeutic procedures (n = 573) were performed in 456 patients. No puncture attachments, sterile gloves, or drapes or covers were used. Before each procedure the transducer was cleaned with a solution of water and 70% alcohol. No needles were contaminated. Patients were monitored for 5 days to exclude sepsis. Subsequently, the patients underwent follow-up blood and laboratory testing, including testing for for hepatitis B and C markers and human immunodeficiency virus antibodies, every 3 months for 6 months. The operators underwent the same follow-up for the first 6 months and for an additional 6 months. No patient or operator presented with fever or sepsis or with negative viral or hepatitis markers that became positive during follow-up. Use of this free-hand US-guided technique with ordinary antisepsis is safe for patients and operators, and it allows savings in time and the cost of materials.

Primary care management of the liver transplant patient

The patient referred for liver transplantation typically has complications from a progressive, irreversible liver injury. Less traditional complications of end-stage liver disease, such as bone disease and some hepatobiliary malignancies, may also prompt referral. However, there are contraindications to liver transplantation, such as metastatic malignancy and persistent substance abuse. Each patient should be referred as early as possible. The evaluation process includes a complete physical examination and social and psychological evaluations. If transplantation is agreed upon, the patient is listed by clinical status and enters a waiting period for a donor liver. Following transplantation, the patient is maintained on a regimen of immunosuppressive drugs to prevent allograft rejection. Each patient is also maintained on prophylactic medications, to decrease the risk of opportunistic infection. Many of the postoperative problems in liver transplantation are a result of immunosuppression, either as side effects of the medications used to prevent and control rejection or from the intensity of resulting immunosuppression. These problems include headaches, systemic hypertension, acute and chronic allograft rejection, renal dysfunction, opportunistic infection with cytomegalovirus or Pneumocystis carinii, disease recurrence, and neoplasia. Routine, long-term care includes systematic clinical follow-up and repetitive blood tests. Communication among the transplant center, the patient, and the referring physician are essential to a successful outcome over the long term.

Lead Exposures During Shipboard Chipping and Grinding Paint-Removal Operations

Shipboard chipping and grinding paint-removal operations were evaluated to determine personnel exposures to airborne lead concentrations. Lead concentrations found in the bulk lead-paint samples ranged from 0.0037 to 11.5% by weight. Of the personnel conducting paint removal operations, 62% were exposed at or above the Occupational Safety and Health Administration (OSHA) Permissible Exposure Limit for lead of 50 µg/m3. Correlations of airborne lead concentrations and bulk lead-paint contents for chipping and grinding operations were statistically significant. Blood lead (Pb) levels were significantly higher in the follow-up blood tests when compared to the initial blood tests taken prior to paint removal. However, blood Pb levels were well below the OSHA allowable level of 40 µg/100 g.

Lead exposures during shipboard chipping and grinding paint-removal operations.

Shipboard chipping and grinding paint-removal operations were evaluated to determine personnel exposures to airborne lead concentrations. Lead concentrations found in the bulk lead-paint samples ranged from 0.0037 to 11.5% by weight. Of the personnel conducting paint removal operations, 62% were exposed at or above the Occupational Safety and Health Administration (OSHA) Permissible Exposure Limit for lead of 50 micrograms/m3. Correlations of airborne lead concentrations and bulk lead-paint contents for chipping and grinding operations were statistically significant. Blood lead (Pb) levels were significantly higher in the follow-up blood tests when compared to the initial blood tests taken prior to paint removal. However, blood Pb levels were well below the OSHA allowable level of 40 micrograms/100 g.

Mass Protection Program of Perinatal Hepatitis B Virus Infection in Japan and Impact of an Optional Booster Vaccination on Its Efficacy

We assessed the efficacy of a government-sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow-up procedures in such infants, including an evaluation of anti-HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti-HBs was higher in the standard group than in the follow-up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti-HBs response. In conclusion, we recommend that a follow-up blood test to confirm a response of anti-HBs to HBV vaccine should be performed at 4-8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infection in late infancy.

Abnormal liver enzyme levels

Chronic elevation of serum aminotransferase levels, even in the absence of symptoms, often reflects chronic hepatitis or other significant underlying liver disease. Patients with persistently abnormal alkaline phosphatase levels may have extrahepatic biliary tract disease or a chronic cholestatic disorder. Physicians can discover unsuspected liver disease without undue risk, expense, or inconvenience to the patient by means of the following: a carefully taken history and thorough physical examination, appropriate timing of follow-up blood tests, and timely referral for percutaneous liver biopsy or endoscopic retrograde cholangiopancreatography.

An evaluation of routine follow-up blood screening of infants for phenylketonuria.

ROUTINE follow-up blood testing has been advocated for newborn phenylketonuria screening programs.1 2 3 This advocacy derives from the fact that an occasional neonate with the disorder is undetected in routine screening programs that generally use a single blood specimen obtained during the first days of life4 and from the assumption that these infants would be detected if a second or follow-up blood specimen were obtained several weeks later. It is assumed that such affected neonates are not identified from the initial blood specimen because this specimen may be obtained before enough protein has been ingested to result in demonstrable hyperphenylalaninemia.1 These . . .

Breeding patterns in commercial beef herds. 3. Observations on dystocia in a Devon herd.

Summary A total of 16,111 cows in 18 beef herds in New South Wales were examined for pregnancy between June 1963 and February 1967. The mean pregnancy level was 86%. The pregnancy level for the lactating cows was 87% and for the non-lactating cows (excluding heifers) 85%. The pregnancy level for heifers was 84%. The herd pregnancy level ranged from 80% to 98%. Four herds had a significantly higher pregnancy level in the lactating cows, while three herds had a significantly higher pregnancy level in the non-lactating cows. Positive Br. abortus agglutination titres were recorded from three herds, none of which had been vaccinated with Strain 19. Br. abortus titres were negative in the remaining 15 herds. One of these herds had practised regular weaner vaccination with Strain 19 at 6–10 months of age. In one of the positive herds a typical abortion storm occurred with 33% of the pregnant cows failing to bring a calf to branding. A follow-up blood test of 65 of the WD cows at calf branding showed 74% with titres 1 in 40 or higher. The mean discrepancy between females pregnant at pregnancy diagnosis and calves branded from these females was 17% for heifers and 3.5% from the older cows. Dystocia was established as the main cause of calf loss in the heifer group.