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Biomedical subjects

A C Halstead

Publications and source records attributed to A C Halstead.

12 recordsLinked to original sources

Spurious rise in total carbon dioxide and chloride with negative anion gap after cystogram.

We report a case of spurious hyperchloraemia, elevated total carbon dioxide and negative anion gap 9 days following a voiding cystourethrogram (VCU) in a patient with bladder exstrophy and obstructive uropathy. We believe that the spurious laboratory results were due to analytical interference of the absorbed iodine with the method of bicarbonate and chloride measurement. The absorbed iodine was retained in the circulation for an extended period because of associated renal impairment. Our patient was also on piperacillin which might have interfered with iodine clearance. Physicians and laboratory pathologists should be aware of this effect when interpreting laboratory results of patients who have undergone a VCU in association with obstructive uropathy and impaired renal function.

Acid-Base Equilibrium

Influence of maternal factors on cord and neonatal plasma micronutrient levels.

The influence of gestational length, maternal prenatal supplement and maternal levels on umbilical cord and neonatal plasma selenium, alpha-tocopherol, and retinol were studied and appropriate reference intervals for ongoing studies of gestational and perinatal micronutrient requirements were derived. We measured retinol, alpha-tocopherol (total and alpha-tocopherol:cholesterol ratio), selenium, and glutathione peroxidase in 160 umbilical cord samples and 58 paired maternal and neonatal samples collected on the third postpartum day. Selenium and glutathione peroxidase were also measured in 25 paired umbilical artery and vein samples. The strongest correlation with gestational age and birthweight was found for the cord blood variables, whereas levels in maternal blood were not related to either gestation or weight. Neonatal values were significantly lower than maternal for selenium (0.96 [0.25] compared with 1.56 [0.27] mumol/liter), retinol (0.54 [0.19] and 1.26 [0.45] mumol/liter), alpha-tocopherol (11.5 [3.63] and 32.4 [9.20] mumol/liter), and glutathione peroxidase (446 [174] and 873 [176] U/liter) but not for the ratio of alpha-tocopherol:cholesterol (5.0 compared with 6.0). Maternal use of tocopherol and retinol supplements did not significantly affect blood concentrations. Maternal plasma selenium levels at term were about 60% of nonpregnant adult females. Selenium concentration and glutathione peroxidase activity did not differ between paired umbilical cord arterial and venous samples. Selenium, retinol, and glutathione peroxidase differed between infants born before or after 37 weeks' gestation.

Birth Weight

Tolerance of weanling pigs for dietary vitamin A and D.

Weanling cross-bred pigs (36 or 48) were caged individually and fed diets containing a supplement of vitamin A (Expt 1) or vitamin D3 (Expt 2) at levels representing 1, 5, 10, 25, 50 and 100 times the NRC (1988) estimated requirements, for 4 weeks. Growth rate, feed intake and feed/gain ratio were not influenced significantly. In Expt 1 the plasma retinol concentrations were at 4 weeks, respectively, 31.7, 39.4, 43.2, 42.9, 44.4, and 46.3 micrograms/dl (P less than 0.05). In Expt 2, the plasma 25(OH)D3 concentrations were at 2 weeks, respectively, 22.5, 29.5, 35.7, 46.2, 79.9, 135.3 ng/ml (P less than 0.001). Histological examination of lung, stomach, kidney, liver and heart indicated no abnormalities, but focal microscopic lesions consistent with osteochondrosis were found in pigs receiving vitamin A at levels over 10 times the requirement. The incidence of osteochondrosis at 2 weeks was, respectively, 0/8, 0/8, 0/8, 0/8, 0/8, and 1/8, and at 4 weeks was, respectively, 0/8, 0/8, 0/8, 2/8, 2/8 and 2/8. The NRC (1988) estimate of the requirement for vitamin D may be somewhat low since the concentration of plasma 25(OH)D was lower with 200 or 1,000 IU vitamin D/kg diet than at the start.

Animal Nutritional Physiological Phenomena

Timing of specimen collection is crucial in urine screening of drug dependent mothers and newborns.

We compared results of urine drug analysis with clinical data and history to test the usefulness of peripartum drug screening and to establish guidelines for optimal testing. Urine from 28 mothers and 52 babies was analysed. Drugs not suspected by history were found in 10 mothers and six babies. Results assisted in the management of neonatal withdrawal in three babies. Drugs suspected by history were not found in 11/22 mothers and 23/35 babies. About half of these results were associated with delayed urine collection. In 12/28 mothers, drugs administered in hospital could have confused interpretation of screen results. We conclude that urine drug screening without strict protocols for specimen collection is of limited usefulness for management of drug abuse in pregnancy and neonatal drug withdrawal. We favour testing of maternal urine obtained before drugs are administered in hospital. Neonatal urine, if used, should be collected in the first day of life.

Drug Evaluation, Preclinical

Age- and sex-specific pediatric reference intervals: study design and methods illustrated by measurement of serum proteins with the Behring LN Nephelometer.

We analyzed blood from 450 healthy children and adolescents, ages one to 19 y, as well as term and preterm infants, to define age- and sex-specific reference intervals for numerous blood constituents. Reference intervals were derived by using nonparametric methods to determine the 0.025 and 0.975 fractiles. Ten serum proteins were measured with the Behring LN Nephelometer. Girls over 10 years of age had higher concentrations of ceruloplasmin and alpha 1-antitrypsin than other children had. There was no sex-related difference in reference intervals for the other proteins tested. Reference intervals are presented for immunoglobulins G, A, and M, complement fractions C3c and C4, ceruloplasmin, transferrin, alpha 1-antitrypsin, retinol-binding protein, and prealbumin (transthyretin).

Adolescent

Age- and sex-specific pediatric reference intervals for biochemistry analytes as measured with the Ektachem-700 analyzer.

Using the Ektachem-700 multilayer film analyzer, we defined age- and sex-specific reference intervals for 20 analytes in sera from a healthy population of neonates and children ages one to 19 years. Upper and lower normal reference intervals for each analyte were determined by nonparametric methods as the 0.975 and 0.025 fractiles, respectively. Newborns have lower concentrations of total protein and albumin, and higher concentrations of phosphate, bilirubin, and enzymes in serum than older children do. Concentrations of urea, glucose, calcium, phosphate, and bilirubin change rapidly postnatally. Outside the neonatal period, no significant age- or sex-related difference was found for plasma glucose, serum amylase, conjugated or unconjugated bilirubin, or lipase. There was no sex-related difference in reference intervals for albumin, total protein, calcium, phosphate, or urea. However, concentrations of uric acid and creatine kinase are much higher in postpubertal boys than in girls. Alkaline phosphatase values peak later in boys. Except for lactate dehydrogenase and gamma-glutamyltransferase, the reference intervals defined here do not differ strikingly from data derived with use of other analyzers. The age- and sex-related trends are independent of method. However, each laboratory should determine the degree to which these reference ranges can be directly applied to analyses performed with another analyzer.

Adolescent

Age- and sex-specific pediatric reference intervals and correlations for zinc, copper, selenium, iron, vitamins A and E, and related proteins.

Age- and sex-specific reference intervals based on the 0.025 and 0.975 fractiles of data derived from a healthy pediatric population are presented for zinc, copper, selenium, iron, ferritin, retinol, alpha-tocopherol, and related analytes in serum. Age was an important covariate for copper, selenium, retinol, and tocopherol, and ferritin in boys. Strong correlations were found between retinol and retinol-binding protein, prealbumin (transthyretin), alpha-tocopherol, and selenium. Tocopherol was highly correlated with both cholesterol and triglycerides. We found no relationship between serum zinc and either retinol or retinol-binding protein. Despite exclusion of children in whom anemia, microcytosis, or variant hemoglobins were found, the 0.025 fractile for iron in several age groups was even less than the concentration considered to indicate poor iron nutritional status.

Adolescent

Changes in serum anion gap and sodium level in monoclonal gammopathies.

In a group of patients with monoclonal gammopathies a decrease in the serum anion gap was seen with increasing serum concentrations of monoclonal IgG and IgM but not monoclonal IgA. This was probably related to the fact that IgG and IgM are cationic but IgA is a anionic at a physiologic pH. The serum sodium level decreased by 0.7 mmol/l for every increase of 1 g/dl in the serum level of the monoclonal immunoglobulin, likely because of the volume displacement effect of the monoclonal protein.

Acid-Base Equilibrium