Upper Limit Of Reference Value Research Articles

Respiratory Health Associated with Systemic Metal Exposure in Post 9/11 Veterans in the Department of Veterans Affairs Toxic Embedded Fragment Registry.

Adverse respiratory outcomes in post-9/11 Veterans with elevated urinary metal measures and enrolled in the VA's Toxic Embedded Fragment registry were compared to those without elevated urinary metals. Veterans completed questionnaires, pulmonary physiology tests (pulmonary function and oscillometry) and provided urine samples for analysis of 13 metals. Respiratory symptoms, diagnoses and physiology measures were compared in Veterans with ≥1 urine metal elevation to those without metal elevations, adjusted for covariates, including smoking. Among 402 study participants, 24% had elevated urine metals, often just exceeding upper limits of reference values. Compared to Veterans without elevated metals, those with elevated metals had had higher FEV1 values but similar frequencies of respiratory symptoms and diagnoses and abnormalities on pulmonary physiology tests. Mild systemic metal elevations in post 9/11 Veterans are not associated with adverse respiratory health outcomes.

Биохимические и гематологические характеристики крови коров красной степной породы Павлодарской области Казахстана

To predict the breeding and productive characteristics of cattle, along with molecular genetic markers, biochemical and hematological indicators are used. The purpose of the study is to conduct a hemato-biochemical analysis of the blood serum of red steppe cows in the Pavlodar region of Kazakhstan. Deviations of protein level from the norm indicates metabolic disorders in the body, ration of animals. The total protein in the blood serum of cows is in the upper limit of reference values and makes 81,07±4,28 g/L. Determination of bilirubin content in blood allows to find out the ability of the liver to secrete bile. Total bilirubin amounted to 1,58±0,26 umol/L, which does not exceed the specified values. Urea is the end product of protein metabolism. Its content in blood increases with delayed excretion by kidneys. In the blood serum of cows the concentration of urea is 4,91±0,22 mmol/L. In biochemical analysis, alanine aminotransferase and aspartate aminotransferase are an indicator of cell damage in internal organs. Aspartateaminotransferase was 105,9±8,46 U/L, is within the reference values, indicating the absence of disorders in nitrogen metabolism. The concentration of alanine aminotransferase enzyme was 47,3±4,07 U/L, also indicating the absence of damage in the liver. Cholesterol as an important structural element of cell membrane participates in the formation of complexes with proteins of the inner mitochondrial membrane. Total cholesterol content – 4,72±0,32 mmol/L. Decrease in blood sugar level is a symptom of serious disturbance of carbohydrate metabolism and lack of glycogen reserves in liver and muscles. Decrease of sugar content in blood of cows can be considered as a result of mismatch of energy intake with feed and its expenditure on metabolic processes and milk formation. Glucose concentration was 2,00±0,31 mmol/L. Insignificant deviation from the reference values of amylase enzyme, which hydrolyzes starch and glycogen, was detected. The level of these blood proteins is characterized by great stability and is subject to small fluctuations under normal conditions. The concentration of the enzyme totaled 73,7±6,37 U/L.

Biochemical parameters of blood in cats with cardiogenic arterial thromboembolism and acute heart failure

Investigating the impact of vascular blockage on blood biochemical parameters, particularly in the context of acute heart failure, is crucial for understanding the underlying mechanisms of arterial thromboembolism in animals. The purpose of the study is to investigate the effect of vascular occlusion on the biochemical parameters of blood in cats with cardiogenic arterial thromboembolism. The study involved 12 cats and formed two groups: the first – animals with acute heart failure and the second – animals with arterial thromboembolism. Anamnesis data were collected for experimental animals, clinical examination, echocardiography, and biochemical examination of blood samples were performed. The activity of alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transpeptidase, the concentration of glucose, creatinine, urea, potassium, calcium, total and inorganic phosphorus were determined spectrophotometrically in blood serum. It was found that in cats with acute heart failure, the average value of serum aspartate aminotransferase activity increased by 2.8 times, and the creatinine concentration by 1.9 times compared to the upper limit of reference values. This indicates functional changes in the myocardium and kidneys in this pathology. In cats affected by arterial thromboembolism, the blood serum shows a significant elevation in various biochemical parameters compared to the upper limit of the corresponding reference intervals. Specifically, there is a 4.4-fold increase in alanine aminotransferase activity, a 4.3-fold increase in aspartate aminotransferase activity, a 1.4- fold increase in glucose concentration, a 1.8-fold increase in creatinine levels, a 2.0-fold increase in urea levels, and a 1.3-fold increase in inorganic phosphorus levels. The changes in biochemical parameters for feline thromboembolism may be a consequence of functional renal failure, ischemia, and muscle necrosis. Moreover, it was established that in most cats with acute heart failure, the urinary system is primarily affected, and with arterial thromboembolism, changes in muscle tissue also occur. The results obtained are of practical value for veterinary doctors when choosing a therapeutic strategy and prescribing additional diagnostic examinations

Дослідження маркерів пуринового та білкового обміну сироватки крові у хворих на генералізований пародонтит, асоційований з подагрою

The purpose of the study was to establish pathogenetic mechanisms, in particular, disorders of purine and protein metabolism of blood serum, which can cause increased susceptibility of gout patients to periodontal diseases, contribute to their progression and mutually burden the course of both diseases, which is a necessary prerequisite for effective prevention and treatment of these patients. Materials and methods. A biochemical study of venous blood was carried out in 60 men with gout, aged 30 to 59 years, who were undergoing inpatient treatment in the rheumatology department of Lviv Regional Clinical Hospital. All the examined were men, which is related to the gender-age characteristics of the prevalence of gout. 2 observation groups were formed: the main group consisted of 30 patients with generalized periodontitis on the background of gout; the comparison group included 30 people with generalized periodontitis, not burdened by rheumatological pathology. The results were compared with the indicators of 20 conditionally healthy individuals (control group). The research was carried out in the period between attacks of gouty arthritis, two weeks after therapy with non-steroidal anti-inflammatory drugs. In order for the test results to be objective, 24 hours before blood sampling, patients were recommended to exclude fruit and vegetable juices, caffeine, and alcoholic beverages from their diet, as well as to limit physical and mental exertion. Results and discussion. The results of the research presented the following: the patients of the main group had the highest level of the main marker of purine metabolism – uric acid in blood serum; it was 0.62 ± 0.18 mmol/l with a normal reference range of 0.20 - 0.42 mmol/l. In the comparison group, the laboratory indicator of uric acid content in blood serum was 0.38 ± 0.09 mmol/l and was at the upper limit of reference values, but it was by 1.6 times lower than in the main group, p < 0.05. In the control group, the lowest level of uric acid was observed with a digital value of 0.26 ± 0.06 mmol/l, which was by 1.5 times less than in the control group and by 2.4 times less compared to the data of the main group, p < 0.01. The level of urea, a marker of protein metabolism, in patients with generalized periodontitis on the background of gout was 9.21 ± 2.24 mmol/l and was by 1.3 times higher than the similar indicator of persons not burdened by rheumatological pathology (6.89 ± 1.53 mmol/l, p < 0.01) and by 1.9 times higher than in healthy individuals (4.72 ± 1.08 mmol/l, p < 0.01). Conclusion. According to the results of a biochemical study of the blood serum of patients with generalized periodontitis associated with gout, a significant increase in the concentration of uric acid was established, which indicated a violation of purine metabolism in these patients. Also, in patients with periodontal pathology on the background of gout, violations of protein homeostasis were observed, which was indicated by a high level of urea in the blood serum. Such a situation may indicate the presence, both at the systemic level in general and in periodontal tissues, in particular, of deep destructive processes that affect nuclear structures rich in nucleic acids, and the existence of a correlation between hyperuricemia and the destructive-inflammatory process in periodontics. Violations of purine and protein homeostasis contribute to the progression and mutually burden the course of both diseases

Abstract 15698: Logistic and Machine Learning Approaches to Identify Predictors of Venous Thromboembolism in Covid-19 Patients

Introduction: Venous thromboembolism (VTE) has a significantly higher incidence in COVID-19 patients when compared to other acute viral infections. The evidence on the risk factors of VTE in COVID-19 inhospital patients is still inconsistent. The information is of utmost importance, as a path to promote prevention, early diagnosis and treatment. Hypothesis: VTE predictors may be identified through logistic regression (LR) and machine learning (ML) approaches. Methods: This multicenter cohort study included consecutive COVID-19 adult patients from 16 hospitals, admitted between March and September, 2020. Deep venous thrombosis and pulmonary embolism were confirmed by objective imaging. LR analysis, tree-based boosting and bagging were used to investigate the association of variables upon hospital presentation with VTE. Results: Among 4,120 patients (median age 61 [interquartile range 48-72] years-old, 55.5% men, 39.3% admitted to intensive care unit), VTE was confirmed in 6.7%. In multivariate LR analysis, obesity (OR 1.50, 95%CI 1.11-2.02); being an ex-smoker (OR 1.44, 95%CI 1.03-2.01); surgery ≤ 90 days (OR 2.20, 95%CI 1.14-4.23); axillary temperature (OR 1.41, 95%CI 1.22-1.63); D-dimer ≥ 4 times above the upper limit of reference value (OR 2.16, 95%CI 1.26-3.67), lactate (OR 1.10, 95%CI 1.02-1.19), C-reactive protein levels (CRP, OR 1.09, 95% CI 1.01-1.18); and neutrophil count (OR 1.04, 95%CI 1.005-1.075) were independent predictors of VTE. Temperature at hospital presentation, SF ratio, neutrophil count, D-dimer, CRP and lactate levels were also identified as predictors by ML methods. Conclusions: By using ML and LR analysis, we showed that D-dimer, axillary temperature, neutrophil count, CPR and lactate levels are risk factors for VTE in COVID-19 patients. ML approaches were able to identify additional predictors. We suggest that patients presenting those risk factors at hospital admission should be more closely monitored for VTE development.

Laboratory features of cardiovascular injury in COVID-19 and other acute respiratory viral infections

The article presents data from a study of specific cardiac markers in patients with acute respiratory viral infection (ARVI) or coronavirus disease 2019 (COVID-19). COVID-19 caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) is characterized by cardiovascular injury. However, with other ARVIs, the prevalence of heart involvement is also high and, according to the literature data, is about 20%. At the same time, laboratory characteristics of these lesions have significant differences in ARVI and COVID-19, which necessitates different approaches to therapy.Aim. To determine the most significant markers for the diagnosis of cardiovascular involvement in patients with COVID-19.Material and methods. A total of 60 patients were included in the study: main group (n=30), COVID-19 was laboratory confirmed; comparison group (n=30), other ARVI pathogens were verified. The groups were completely comparable in sex, age and severity of disease course. The average values of troponin, creatine kinase MB, N-terminal pro-brain natriuretic peptide (NT-proBNP) and D-dimer were compared in patients of both groups in the acute disease phase, corresponding from 1 to 8 days from the symptoms’ onset. Data analysis was performed using a two-sided independent samples t-test using SPSS Statistics version 23.Results. The higher levels of troponin-I and D-dimer were significantly more common in the main group. The mean value of creatine kinase MB did not exceed the upper limits of reference values. There were no significant differences in NTproBnP levels between the groups. At the same time, in both groups, its level significantly exceeded the age reference values.Conclusion. The most effective markers of cardiovascular complications in COVID-19 patients should be considered troponin-I, D-dimer and NT-proBNP. Early diagnosis and laboratory monitoring in dynamics is important for the timely detection of cardiac pathology and alteration of therapy regimen.

Effect of MAGE-C1 Gene Expression on Prognosis and Effectiveness of Bortezomib-Containing Courses in Multiple Myeloma

Introduction. The group of genes, encoding cancer-testis antigens is actively studied as a new markers of refractory in some diseases, including multiple myeloma (MM). It is suggested that the MAGE-C1 gene in MM may be considered as an additional marker predicting the effectiveness of therapy.Purpose. Determine of MAGE-C1 gene expression by quantitative real-time polymerase chain reaction (qRT-PCR) in MM patients and assess the correlation of expression with some laboratory parameters and response on bortezomib-containing therapy.Patients and methods. A prospective study from February 2019 to July 2021 included 76 MM patients (43 men and 33 women) aged 35 to 82 years (median 58). The level of MAGE-C1 gene expression by qPCR-PCR in bone marrow samples, enriched with CD138+ cells, was determined for all patients. Quantity of MAGE-C1 expression was calculated with 2ΔCt method relative to housekeeping gene expression. Plasma cell content ranged from 1 to 89% (median 26%), monoclonal paraprotein secretion vary from 2.1 to 82.1 g/l, Bence-Jones protein in urine (from trace values to 12.54 g/day) was determined in 50 patients. High - risk cytogenetic [t(4; 14)(p16; q32), del17p] was documented in 22 patients, bone plasmocytomas - in 36 patients, myeloma nephropathy - in 17. All patients recieved induction with bortezomib - containing courses. Median follow-up duration: 14 months (1-22 months). As a control, similar bone marrow cells of 7 healthy donors were investigated.Results. The average value of MAGE-C1 expression in donors was 0.01 ± 0.007, a range of values vary from 0.0003 to 0.06. Gene expression MAGE-C1 index > 0.06 is accepted as increased expression. High serum lactate dehydrogenase (LDH) level (higher than the upper limit of reference values) was observed in patients with high MAGE-C1 gene expression [median - 0.35], normal LDH-level (≤ 260 U/L) was observed in patients with lower MAGE-C1 gene expression [median - 0.04]; p < 0.0001 (Figure 1). Negative correlation was found between the content of hemoglobin (Hb) and level of MAGE-C1 expression: Hb ≥ 12.0 g/dl was observed in patients with increased MAGE-C1 expression [median - 0.27], and Hb 5.5-11.8 g/dl - in patients with lower expression indices [median 0.1]; p=0,034.Antitumor response was evaluated after induction therapy in 51 patients. In 100% of patients with MAGE-C1 expression of ≤ 0.06 ≥ partial response (PR) was achieved, while in patients with MAGE-C1 expression of 0.07-1.0 ≥ PR was achieved in 84.6% of cases, and in patients with MAGE-C1 expression of > 1.0 - in 58%; p > 0.05. Besides, patients with ≥ PR had a level of MAGE-C1 expression lower than patients with a refractory to bortezomib [median 0.17 vs 1.14]; p = 0.04 (Figure 2).Conclusions. High MAGE-C1 gene expression in MM patients is associated with an increase in LDH, which corresponds to stage III by R-ISS. Probability of achievement of the antitumor response ≥ PR on the bortezomib-containing induction is reliable above at patients with low MAGE-C1 expression while the hyperexpression of this gene is followed by a refractory to a bortezomib therapy. Further study of MAGE-C1 gene expression may promote a personalized approach in the choice of antitumor therapy. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Acute Kidney Injury in Patients with the New Coronavirus Infection

Estimations of the frequency of acute kidney injury in SARS-CoV-2 (COVID-19) coronavirus disease are very diverse. The literature data is highly inconsistent and shows AKI ranging from 0.5 to 80%.The objective: to analyze the incidence of renal dysfunction in COVID-19 patients and assess the significance of systemic inflammation for its development.Subjects and methods: The analysis was performed basing on data of 3,806 patients with COVID-19 treated at the Pavlov State Medical University, 395 of them were admitted to the intensive care units (ICU). The criterion for establishing renal dysfunction (RD) is the increase in blood creatinine level above the upper limit of reference values (0.115 mmol/l). Patients with end-stage chronic kidney disease who needed to continue routine long-term dialysis were not included in the study. We analyzed the incidence of renal dysfunction, changes in blood levels of creatinine, urea, and electrolytes during 8 days. In addition, glomerular filtration rate, diuresis volume, levels of hematocrit, hemoglobin, LDH, CRP, ferritin, and procalcitonin were evaluated.Results. The frequency of RD among all patients was 19.0%, among patients in the ICU – 41.0%. In 79% and 81%, respectively, it was detected on the first day of hospitalization. The increase in the number of patients with RD and the aggravation of the existing dysfunction occurred after 6 days. At the initial stage of the disease, the manifestations of RD in most cases were not expressed even in those with an unfavorable course of the disease but the level of creatinine showed a weak but significant (p &lt; 0.5) correlation with changes in CRP (r = 0.110), ferritin (r = 0.137), and procalcitonin (PCT, r = 0.418). The difference in the level of creatinine in patients with PСT level above and below 0.5 ng/ml was observed on the first day only; the value of this parameter returned to normal faster in the subgroup of patients whose procalcitonin level did not exceed 0.5 ng/ml.Conclusion. In case of the signs indicative of RD, it is advisable to distinguish between primary and secondary injury. In the first case, it is primarily due to systemic inflammation, in the second case it is caused by additional impact of other aggressive factors. This will make it possible to clarify the renal and non-renal indications for renal replacement therapy (RRT) in patients with COVID-19, and to evaluate the results adequately since the effectiveness of RRT at different stages of the disease cannot be the same.

Blood Pressure Response to Treadmill Cardiopulmonary Exercise Test in Children with Normal Cardiac Anatomy and Function

To describe blood pressure (BP) responses during cardiopulmonary exercise testing (CPET) and propose criteria for abnormal BP responses in children with normal hearts. Treadmill CPET data of children <18years with normal hearts were retrospectively analyzed to evaluate BP responses to exercise at the Children's Hospital of Michigan over an 8-year period (2011-2018). Our cohort included 1085 children (boys, 59%) aged 7-17years. Analysis of variance for systolic BP at peak exercise (peak SBP) and SBP change (Δ) showed significant age and sex effects and age-sex interaction effects (P<.01). In the multiple linear regression model (P<.001, R square 0.298, standard error of the estimate 17.15), peak SBP (mm Hg) was predicted as 132.27+1.37×age (years)+(3.31×age (years) - 31.88)×sex [boys 1, girls 0]. The following criteria for abnormal BP responses in children were proposed: hypertensive BP response was defined by peak SBP with a 90% CI upper limit of reference values based on age and sex, and blunted BP response as ΔSBP <10mm Hg for aged 7-11years, <20mm Hg for boys aged 12-17years, and ΔSBP <10mm Hg in girls. BP responses to treadmill CPET depend on age and sex in children with normal hearts. The proposed criteria for abnormal BP responses in children during CPET will need to be verified in a large pediatric cohort.

State of lipid metabolism in patients receiving androgen replacement therapy

Objective. To assess the state of lipid metabolism indicators and predict cardiovascular risk in patients with secondary (acquired) hypogonadism on the background of androgen replacement therapy. Testosterone replacement therapy is often used in modern medicine for diagnosed androgen deficiency in patients of any age group. There are quite a lot of publications devoted to diagnosis and treatment, but the effectiveness and safety of any therapy is determined by several factors, of which two were considered in the presented study dose-dependent effect and compliance.&#x0D; Material and methods. Sixty two patients aged 30 to 52 years with androgen deficiency and a low risk of developing cardiovascular diseases were examined according to the Princeton Consensus criteria. Patients were divided into groups depending on the severity of androgen deficiency and the duration of therapy. Complaints, objective status, muscle strength, daily blood pressure and heart rate monitoring data, lipidogram and sex hormone indicators were evaluated.&#x0D; Results. The obtained data suggest that androgen replacement therapy in doses that lead to an increase in the level of testosterone in the blood above the upper limit of reference values had a negative impact on the lipid spectrum and increased cardiovascular risk for this group of patients.&#x0D; Conclusions. The analyzed approach to therapy of androgen deficiency should provide an individual adjustment of dosage on the background of determining the target blood testosterone level.

Abstract 13065: Blood Pressure Response to Treadmill Cardiopulmonary Exercise Testing in Children With Normal Hearts

Background: Blood pressure (BP) response to the treadmill cardiopulmonary exercise test (CPET) has yet been studied with no standard criteria for abnormal BP responses in children. Our hypothesis was that the reference values of BP responses to the treadmill CPET should be defined by gender and age in children. Objectives: The objective of our study was to describe the BP responses to the treadmill CPET and propose the criteria for abnormal BP responses in children. Methods: The treadmill CPET data were retrospectively analyzed to evaluate the BP responses to exercise during the period of 8 years (2011-2018). Children aged &lt;18 years with normal hearts were included for the analysis. Results: Our cohort consisted of 1,085 children (males 59%) aged 7-17 years. The analysis of variance for Systolic BP at peak exercise (peak SBP) and change (Δ) of SBP showed significant age and gender effects and age-gender interaction effect ( p &lt;0.01). In the multiple linear regression model ( p &lt;0.001), peak SBP (mmHg) was predicted as 100.39 + 4.68 x age (years) for males; 132.27 + 1.37 x age (years) for females. The following criteria for abnormal BP responses in children were proposed. Hypertensive BP response were defined by peak SBP &gt;90% confidence interval upper limit of reference values based on age and gender. Blunted BP response was defined by 1) ΔSBP &lt;10 mmHg for age 7-11 years and &lt;20 mmHg for age 12-17 years in males; and ΔSBP &lt;10 mmHg in females. Conclusion: Blood Pressure response to the treadmill CPET was dependent on age and gender in children with normal hearts. The proposed criteria for abnormal BP responses in children should prove useful in interpreting BP responses in children during the CPET.

Application and optimization of reference change values for Delta Checks in clinical laboratory.

BackgroundDelta check is a patient‐based QC tool for detecting errors by comparing current and previous test results of patient. Reference change value (RCV) is adopted in guidelines as method for delta check, but the performance is not verified. We applied RCV‐based delta check method to patients' data and modified for application.Materials and methodsReference change value were calculated using results of internal QC materials and biological variation data. Test results of 17 analytes in inpatients, outpatients, and health examination recipients were collected. The detection rates of currently used delta check method and those of RCV‐based method were compared, and the methods were modified.ResultsReference change value‐based method had higher detection rates compared to conventional method. Applied modifications reduced detection rates. Removing the pairs of results within reference interval reduced detection rates (0.42% ~ 10.92%). When RCV was divided by time interval, the detection rates were similar to prior rates in outpatients (0.19% ~ 1.34%). Using RCV multiplied by twice the upper limit of reference value as cutoff reduced the detection rate (0.07% ~ 1.58%).ConclusionsReference change value is a robust criterion for delta check and included in clinical laboratory practice guideline. However, RCV‐based method generates high detection rates which increase workload. It needs modification for use in clinical laboratories.

PSYCHOPHYSIOLOGICAL STATUS IN OVERWEIGHT INDIVIDUALS

Aim. The article deals with establishing psychophysiological features in overweight women to develop a set of measures for weight decrease and psychocorrection. Materials and methods. We studied two groups of women who were willing to participate in the study: the first group – mean age 54.2 ± 3.0; the second group – mean age 25.0 ± 1.7. The average BMI of the first group corresponded with obesity values (32.3 ± 1.6), while an average BMI of the second group was within the upper limit of reference values (23.7 ± 0.9). However, according to body composition data, there was a risk of BMI increase. As far as the percentage of adipose tissue exceeded the recommended values, recommended weight loss was 18.2 ± 2.6 kg for the older group and 5.6 ± 1.4 kg for the young group. Two groups of women of the same age with normal weight were examined as control groups. Results of the study revealed both age-related and psychophysiological features in women of different weight. EEG analysis showed that alpha rhythm amplitude in women from the first group was higher on average and frequency was lower compared to the second group. In the experimental group, we also revealed a higher level of delta activity in the frontal region at rest. The study of a psychoemotional status revealed that all participants hardly coped with stress. However, young participants overcame stress more easily compared to the older group. Anxiety assessment showed increased values of anxiety. In all participants, personal anxiety was almost at the same level within 48 points. Situational anxiety was higher in young women (51.2 ± 1.3 and 49.6 ± 2.1 points, respectively). Conclusion. The most psychophysiological indicators identified functional stress, particularly in overweight older women. To preserve the optimal psychophysiological status of persons participating in weight correction programs, it is also necessary to correct a psychophysical status in accordance with age-related features.

Celiac antibodies in children with type 1 diabetes – A diagnostic validation study

Introduction: Autoimmune diseases, such as celiac disease (CD) and diabetes mellitus type 1, tend to co-occur within the same patient. The prevalence of CD in diabetic children is higher than in the general population, and is estimated to be 0.6–16.4%. The diagnosis of CD is based on histopathological examination and serological testing, however, these methods are still imperfect and new diagnostic algorithms should be considered.Aim: The aim of the study was to assess the diagnostic value of serological tests detecting antibodies against deamidated gliadin peptide, endomysium, tissue transglutaminase, neo-epitope tissue transglutaminase and to identify HLA-related genetic predisposition to CD in patients with type 1 diabetes mellitus (DM1).Methods: Autoantibodies were measured in the sera of 392 children suffering from DM1 aged 1–19 years old (mean 11.76 ± 4.14 years old). Additionally, PCR-based assessment of HLA DQ2/DQ8 genotyping was performed.Results: A positive result of at least one serological test was obtained from 81 children (20.66%). The sensitivity and specificity were 76.47% and 91.67% for anti-DGP IgA, 70.59% and 58.33% for IgG anti-DGP, respectively. A positive predictive value was 100% for the anti-TG IgA at cutoff levels of 5 and 10 times higher than upper limit of reference values. HLA DQ2 and/or DQ8 were found in 97.6% of examined children.Conclusions: Tests based on anti-TG IgA are more accurate for detecting CD in children with type 1 diabetes than anti-DGP IgA. A high percentage of diabetic children carry HLA alleles predisposing to CD, which indicates that genetic screening in this group of patients is not obligated.

Serum bone alkaline phosphatase is a useful marker to evaluate lumbar bone mineral density in Japanese postmenopausal osteoporotic women during denosumab treatment.

A worldwide health concern, osteoporosis (OP), increases the risk of bone fracture and results in morbidity. This study examined whether the representative bone absorption marker serum tartrate-resistant acid phosphatase 5b (TRACP-5b) or bone formation marker bone alkaline phosphatase (BAP) could estimate primary OP status and denosumab efficacy in a real-world setting. We retrospectively enrolled 114 female postmenopausal primary OP patients in Japan. Values and percent changes in TRACP-5b, BAP, lumbar 1–4 bone mineral density (L-BMD), and total hip BMD (H-BMD) were assessed before treatment and at 4, 8, and 12 months of therapy to identify the correlations between the percent changes in bone metabolic markers and BMD. We also established two sets of subgroups based on the upper limits of reference values in Japan for serum: TRACP-5b (<420 mU/dL) and (≥420 mU/dL) and BAP (<14.5 µg/L) and (≥14.5 µg/L). Negative correlations were observed for the percent changes of TRACP-5b and H-BMD at 4 months (r=−0.3476) and 8 months (r=−0.3880), for the percent changes of BAP and H-BMD at 8 months (r=−0.3354), and for the percent changes of BAP and L-BMD at 12 months (r=−0.3186). We observed a significant difference between the subgroups for the percent changes of L-BMD at 8 months (p=0.013) and 12 months (p=0.004) in BAP values. These results suggest that TRACP-5b and BAP had negative correlations with BMD, and that BAP represented a useful serum marker to evaluate L-BMD during denosumab therapy for OP.

Conventional Tumor Markers in Cerebralspinal Fluid in Patients with Elevated Serum Tumor Markers and without Central Nervous System Malignant Diseases.

Objective To explore the diffusion pattern of tumor markers (TM) from serum to cerebrospinal fluid (CSF) via the blood-brain barrier in patients with elevated serum tumor markers (TM).Methods Inpatients receiving lumbar puncture during hospitalization in our center from January 1, 2013 to December 31, 2015 were divided into study group (n=181) and control group (n=251). The study group consisted of patients with elevated serum TMs but without malignant central nervous system diseases. The control group consisted of patients with normal serum TM levels and without malignant diseases. TMs measured in the study group included elevated serum alpha-fetoprotein (AFP) (n=0), carcinoembryonic antigen (CEA) (n=26), carcinomic antigen(CA)125 (n=39), CA15- 3 (n=3),CA19- 9 (n=19), CA724 (n=47), CYFRA21- 1 (n=49), and SCC (n=17).Levels of TMs in the CSF of study group was compared with that of control group.Results Median CEA (U=0.00,P=0.00),CA19- 9 (U=0.00,P=0.00),CA15- 3 (U=0.00,P=0.04),SCC (U=0.00,P=0.00),CA125 (U=0.00,P=0.00),CA72- 4 (U=3.00,P=0.00)),and CYFRA21- 1 (U=0.00,P=0.00) in CSF were significantly lower than the corresponding serum TM levels in the study group.There was no significant difference between study group and control group for the CSF level of CEA (U=3091.00,P=0.18),CA19- 9 (U=1897.00,P=0.14), CA15- 3 (U=373.50,P=0.91)and SCC (U=1925.50,P=0.76). CSF CA125 (U=2188.00,P=0.00) and CA724 (U=1279.00,P=0.00) levels in the study group were lower than those in control group. CSF level of CYFRA21- 1 (U=1826.50,P=0.00) in study group was higher than that in control group;however, it was still lower than the upper limit of reference value. Conclusion In patients with elevated serum CEA, CA19- 9, CA15- 3, SCC, CA125, and CA72- 4 levels, transblood-brain-barrier diffusion of TMs from serum to CSF is highly unlikely.

Reference value for micronucleus frequency of peripheral blood lymphocytes in general Chinese population: a method of Monte Carlo simulation

To estimate the reference value for micronucleus frequency of peripheral blood lymphocytes in general Chinese population, and to guide the genotoxicity evaluation and risk analysis for populations exposed to environmental or occupational chemicals. A fulltext search was performed in CNKI with the key words of "micronucleus" and "human", and PubMed was searched with "cytokinesis-block micronucleus","CBMN","humans", and "adults", to obtain the articles published at home and abroad from 2001 to 2014 in which cytokinesis-block micronucleus (CBMN)assay was applied for micronucleus detection and populations not exposed to genotoxins were established as a control. Monte Carlo simulation was performed based on the micronucleus frequency, standard deviation, and sample size provided in these articles to calculate the micronucleus frequency for general population and to analyze the influence of sex, smoking, and drinking on micronucleus frequency. A total of 23 articles were included in the final analysis. The minimum mean micronucleus frequency was 0.39‰, and the maximum mean micronucleus frequency was 25.3‰. There were 1623 subjects in the control group in total (range 22~178, mean 70.6). Monte Carlo simulation was performed 100 times, and the mode of micronucleus frequency was 0 or 1‰; the values of P0, P25, P50 , P75, and P95 were 0‰, 1‰, 2‰~3‰, 5‰~6‰, and 14‰~19‰, respectively; the mean value was 4.36‰(range 4.22‰~4.57‰). With the application of one-sided 95% range(x±1.64 s), the upper limit of the range of reference value was calculated to be 13.46‰~14.75‰. The micronucleus frequency of peripheral blood lymphocytes in general Chinese population is 4.36‰, the interquartile range is 1‰~5‰ or 1‰~6‰, and the upper limit of reference value is 14.17‰. The factors of living area, sex, smoking, and drinking may influence micronucleus frequency.

Active Dry Yeast Culture Supplementation Effect on the Blood Biochemical Indicators of Dairy Goats

The aim of study was to assess the feeding level on a commercial farm and to evaluate the effect of active dry yeast culture supplementation on blood indicators of dairy goats. Eighteen goats were divided into control and experimental groups. Beginning one week before expected kidding does in experimental group were supplemented 10 g/day/goat of yeast until 100d post-partum, after which the dose was increased to 20 g/day/goat. Blood samples were taken on days 7, 30, 80, 120 and 180 of lactation. There were differences in AST and ALT activity, and ALB, total protein, and creatinine contents between groups on the 180th day of lactation. The parameters of lipid and bone profiles changed concurrently/in parallel in both groups and differences between the groups were found only in calcium and total protein contents at the end of the experiment. The level of creatinine kinase was higher than the upper limit of reference value in both groups. In the experimental group there were no differences in macroelement contents during lactation. In the control group the contents of most macroelements were lowest on 180th day of lactation. Some biochemical indicators had values below references (glucose, AST, ALT GGT LDH, calcium, total protein), which means that the diet of the animals was not properly balanced or may be because of a malnutrition problem. However, the values in the experimental group underwent much lower fluctuations, and thus the yeast supplementation could have had a positive influence on the homeostasis and could have improved the intestinal absorption of minerals.

Evaluation of the correlations between magnesium concentration and selected serum lipid components in women and men of different age with chronic kidney failure

In literature of the recent years, more and more attention has been paid to the correlations between magnesium and blood lipids. Lipid balance disorders induced by hypomagnesaemia bring about changes in the liquidity of cellular membranes. Increased migration of lipids, in particular of VLDL and LDL, across arterial walls has been observed in hypomagnesaemia, with their consequential deposition in the internal membrane. Kidneys, apart from urine production and elimination, fulfil many other important functions in organism. They determine normal functioning of the whole organism, while disorders in their function lead to serious changes in homeostasis. Lipid balance disorders are a serious risk factor in the development of atherosclerotic lesions in patients with chronic kidney failure. The aim of this study was to examine the correlations between magnesium concentration and total cholesterol and HDLand LDL-cholesterol contents in women and men with chronic kidney failure under and over 50 years of age. Subjects were divided into four groups: K1 – 14 women 34-50 years old, K2 – 14 women over 50 years old, M1 – 17 men 30-50 years old, and M2 – 13 men over 50 years old. Tests were made using a COBAS INTEGRA analyser. High concentration of Mg, exceeding the upper limit of reference values, was observed both in two women and men groups (K1 – 1.26 mmol(+) kg –1; K2 – 1.25 mmol(+) kg–1; M1 – 1.13 mmol(+) kg –1; M2 – 1.16 mmol(+) kg –1). Also the levels of total and HDL-cholesterol in all subjects were within physiological limits (respectively: K1 – 4.61 and 1.23 mmol(+) kg–1; K2 – 4.69 and 1.29 mmol(+) kg –1; M1 –3.94 and 1.20 mmol(+) kg–1; M2 – 3.98 and 1.16 mmol(+) kg –1). Only the LDL-cholesterol concentration in the group of younger men was below normal limit (1.93 mmol(+) kg–1). Small positive correlations were obtained between Mg content and that of total and LDL-cholesterol in older

Physical Performance and Quality of Life After Extended Abdominoperineal Excision of Rectum and Reconstruction of the Pelvic Floor With Gluteus Maximus Flap

This study aimed to evaluate the physical performance and quality of life after an extended abdominoperineal excision of the rectum and the reconstruction with a right-sided unilateral gluteus myocutaneus rotation flap in patients with rectal and anal cancer. Nineteen patients with primary or recurrent rectal or anal cancer were investigated a mean of 26 months (range, 10-39 mo) after the operation. All patients received preoperative radiation therapy. Physical performance, hip movability, balance, and ability to sit were measured according to a prospective protocol, and the patients' perception of pain and quality of life were investigated with questionnaires. Postoperative complications and oncological results were registered retrospectively from patient records of 36 patients who had undergone operations. The timed-stands test showed that 12 of 19 patients performed worse than the upper limit of reference values adjusted for age and gender. The Berg balance scale showed a mean score of 52.8 that is close to the maximum score (56) of the test. The mean calculated EQ-5D (EuroQol Group, Rotterdam, The Netherlands) quality-of-life index was 0.71 based on the 5 questions in the instrument. The ability to sit 10 minutes was reduced in 4 patients, and 8 patients used a cushion or ring. Mean pain score was 20 (visual analog scale from 0 to 100) while sitting, and only 9 of 19 patients were pain free. The hip mobility was normal, but 6 patients had reduced flexion strength on the right side compared with the left side. Twenty-eight of 36 patients (78%) had some kind of early or late complication after surgery. Local recurrence was found in 4 of 36 patients (11%). The oncological outcome of the operation was acceptable, but functional drawbacks must be considered preoperatively in counseling the patient. More research is needed to find ways to preserve better function and well-being.