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Biomedical subjects

A Kallner

Publications and source records attributed to A Kallner.

At least 55 records · Page 3Linked to original sources
PubMed1993

A quality manual for the clinical laboratory including the elements of a quality system. Proposed guidelines.

Development of quality manuals is a means for the promotion of quality in clinical laboratories by describing the total quality system. It also provides opportunity of checking whether the quality system is implemented in reality and demonstrates to the hospital administration and the clinicians that the laboratory is committed to quality. The intention of these guidelines is to describe the elements of the quality system for a large clinical laboratory, and to present such a system in the form of a quality manual. The proposed guidelines comply, where relevant, with ISO/IEC guide 25 'General requirements for the technical competence of testing laboratories' and EN 45001 'General criteria for the operation of testing laboratories'. The document may be used as an aid for laboratories wishing to be accredited according to EN 45001, or intending to apply for formal certification of their quality systems, according to ISO 9001 'Quality systems--Model for quality assurance in design/development, production, installation, and servicing' utilizing ISO 9004 'Quality management and quality system elements--guidelines; Part 2 Guidelines for service'. However, information about the minimum requirements for official recognition should be obtained from the particular accreditation or certification body concerned.

Chemistry, Clinical↗
PubMed1992

Influence of triglycerides and urate on methods for determination of fructosamine.

The original fructosamine assay, based on reduction of NBT, has been modified and marketed as a kit. The development includes addition of detergents, uricase, change of the buffer and NBT concentrations, and use of a new calibrator. We report the effects of these changes on the measured values of fructosamine in lipemic and uricemic sera. A secondary calibrator produced from pooled serum and stabilized by removal of glucose was used to calibrate the original fructosamine assay and enhance transferability of results. There was no correlation between the difference between the results obtained by the two procedures and the concentration of urate or triglycerides. The development of colour was faster with the original method. It is suggested that measurements of fructosamine by either method are practically equivalent. However, the use of polylysine as a calibrator is advantageous. It is suggested that the generic term S-Glycated proteins is used for the measurand rather than S-Fructosamine which in effect has become a commercial term.

Fructosamine↗
PubMed1992

Psychosocial work environment in relation to changes in selected biochemical parameters in district nurses.

Sixty-four female district nurses between the ages of 25 and 60 in the greater Stockholm area were subjects in a longitudinal study of psychosocial work environment and biochemical serum parameters. Each participant filled out questionnaires and had blood drawn on four different occasions at three-month intervals during one year. The rating on the fourth occasion showed psychosocial work environment to have deteriorated--social climate and authority over decisions were significantly inferior to those on previous occasions. These changes were accompanied by small but significant elevations of serum cholesterol, calcium and triglycerides. Another pattern was also observed which was probably due to increased health habit awareness--a progressive decrease in glycated haemoglobin and gamma glutamyl transferase. No significant interactions were observed with age or smoking habits--old and young subjects did not differ in their change patterns over time, nor did smokers in respect to non-smokers.

Adult↗
PubMed1992

Techno-stress. A psychophysiological study of employees with VDU-associated skin complaints.

Little is known about the causes of health complaints associated with work with video display units (VDUs). The symptoms are to a large degree similar to those of "multiple chemical sensitivity." We observed 47 white-collar employees with and without VDU-associated skin complaints during a regular workday and a day of leisure. VDU workers with skin symptoms had higher levels of the stress-sensitive hormones thyroxin and prolactin compared with employees without symptoms. They also had lower levels of the anabolic hormone testosterone during work. VDU workers with skin complaints also reported more occupational mental strain. A model is proposed in which physiological signals act as unconditioned stimuli and the VDU environment as the conditioned stimuli.

Arousal↗
PubMed1991

On the temporal development of erythrocyte sedimentation rate using sealed vacuum tubes.

The temporal development of the erythrocyte sedimentation rate (ESR) was studied in wide, short vacuum tubes. It was found that in about 3% of the specimens arriving in the laboratory the ESR developed in three different phases during 60 min, whereas the other showed only two. The specimens with three phases behaved similarly in the Westergren method. It was shown that the Westergren ESR can be estimated with an acceptable accuracy already from measurements obtained after 30 min. Reproducibility and precision were improved by using a special instrument. Several advantages by this procedure were recognized, e.g., quicker results, identification of several otherwise missed rapid ESR. Accurate timing of the readings further improves accuracy and precision, and permits estimation of ESR (Westergren) up to 100 mm. In view of the obvious phases in the development of the ESR, it is proposed that this abbreviation is interpreted as erythrocyte sedimentation reaction and that the kind of quantity that is length is expressed in mm.

Blood Sedimentation↗
PubMed1991

Evaluation of the adenosine triphosphate test in the diagnosis of urinary tract infection.

Determination by bioluminescence of the bacterial adenosine triphosphate (ATP) level in urine was evaluated as a method for detection of bacteriuria in 1126 women with symptoms of UTI and 530 attending for follow-up. Conventional urine culture was used as reference method. The criterion for bacteriuria was growth of greater than or equal to 10(5) cfu/ml, giving a prevalence of 0.60. ATP levels of less than 10 nmol/l and greater than 50 mmol/l indicated abacteriuria and bacteruiria, respectively, whereas intermediate concentrations required culture if the nitrite test was negative. With this diagnostic strategy the sensitivity and specificity was 0.96 and 0.90 at the first visit and 0.90 and 0.98 at follow-up. With some methodological improvement the ATP test could be useful in medium-sized and small laboratories.

Adenosine Triphosphate↗
PubMed1991

Glomerular filtration rate: a comparison between Cr-EDTA clearance and a single sample technique with a non-ionic contrast agent.

An algorithm for the calculation of the glomerular filtration rate (GFR) from a single-point determination of the serum concentration of the non-ionic contrast medium iohexol has been evaluated. The algorithm is based upon the assumption that the distribution volumes of iohexol and 51Cr-EDTA are similar. It includes correction factors for non-immediate mixing and irregular extracellular distribution during the elimination phase. The calculated GFR from single-point determinations of iohexol obtained at 180, 200, 220 and 240 min after injection of 5 mL of this compound (300 g iodine/L) were compared with the results from simultaneously performed 51Cr-EDTA clearance in 98 patients. The single-point iohexol clearance values calculated from the different sampling times showed a coefficient of correlation of more than 0.95 to 51Cr-EDTA clearance.

Adult↗
PubMed1991

Effect of heavy drinking and alcohol withdrawal on markers of carbohydrate metabolism.

A number of biochemical markers were monitored in 38 male alcoholic patients at admittance and one week later. In patients with a drinking period of greater than 3 weeks the median fasting B-glucose decreased significantly as well as S-fructosamine concentrations. The ability of S-fructosamine to identify patients with a diabetic glucose tolerance test, expressed in terms of sensitivity and specificity, was 12 and 47%, respectively; that of HbA1c was still lower.

Adult↗
PubMed1991

Dynamics of creatine kinase shuttle enzymes in the human heart.

Myocardial cytoplasmic creatine kinase subunits M and B, mitochondrial CK (CKMIT), and citrate synthase (CS) were determined in 10 locations of the normal human heart (n = 8) and in papillary muscles of patients operated on for mitral regurgitation (n = 6). Compared to atrial biopsies, septal and left ventricular biopsies showed higher activities for CS (P less than 0.0001), total CK (P less than 0.05) and CKMIT (P less than 0.0001). CKM was evenly distributed. CKB activity in the right septum and left ventricular locations were 0.5-1% of total CK and 4-5 times lower than those of the atria and the right ventricular free wall. Activities of CS, CKB and CKMIT in right septal biopsies did not differ from those in left ventricular locations. The activities of CS, total CK, and CKM in papillary muscle from patients operated on for mitral regurgitation did not differ from that of healthy papillary muscle. CKMIT was about 40% lower (P less than 0.02), whereas CKB was 15-20 times higher (P less than 0.0001) than in the healthy heart. In conclusion, adaptations within the creatine kinase system occur in the human heart in health and disease. Small amounts of CKB in the normal left ventricle, as opposed to the right ventricular free wall, might be related to differences in myocardial perfusion during the cardiac cycle. In disease, a decreased CKMIT and dramatically increased CKB may indicate a stressed intracellular energy transfer. CK enzyme activities in right septal biopsy specimens may be used as an indication of metabolic stress on the myocardium of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Neuroendocrine and immunologic effects of unemployment and job insecurity.

We prospectively followed a cohort of 354 blue-collar men and women, some of whom lost their jobs. Results show marked effects during the anticipatory and early unemployment phase on mental well-being, serum cortisol, prolactin, total cholesterol, HDL cholesterol, and phytohemagglutinin reactivity of lymphocytes. Most of these changes appear to be of short-term duration. However, changes in cardiovascular risk factors are observed at least 2 years following the loss of one's job. Coping style appears to be a major determinant whether or not and how people will react to unemployment.

Adaptation, Psychological↗
PubMed1991

Endocrine and dermatological concomitants of mental stress.

The role of psychosocial stress in the etiology and clinical course of psoriasis and atopic dermatitis still remains to be elucidated. In this study, we assessed neuroendocrine, dermatological, and cognitive responses in healthy subjects and in subjects suffering from psoriasis and atopic dermatitis, respectively. Perceived stress increased the most in psoriatics during the stressor exposure but tended to return faster to baseline in this group than was found for atopics and healthy controls. Growth hormone secretion was attenuated during stress in patients with skin disorders. Overall, neuroendocrine reactivity was similar in the three groups. Dermal flare reactivity was enhanced in healthy controls but perceived itch enhanced in atopics in response to stress. Stress per se was not an important discriminator between groups. Coping style and other cognitive factors turned out to be of significant importance to predict skin reactivity rather than a specific skin disease. The study suggests that psychosocial stress affects the skin reactivity and that cognitive factors modulate such effects. However, a specific skin condition explains only a fraction of the overall variance in skin reactivity to specific stressors.

Dermatitis, Atopic↗
PubMed1990

Elimination of 14C-glycated albumin from serum of rabbit.

Glycated albumin was prepared by incubation of serum from rabbits with randomly labelled 14C-glucose. The isolated glycated albumin fraction was reinfused to the same animal. 14C-labelled glucose was given to alloxan-treated rabbits. The disappearance of the radioactivity showed a rapid initial phase and a slow elimination phase, which could be acceptably described by first-order kinetics. The estimated half-life of glycated albumin was about 6 days, which is about 70% of that generally stated for albumin in the rabbit. If these findings were transferred to human conditions, the half-life of fructosamine would be in the range of 13-14 days.

Animals↗
PubMed1990

Efficacy of single-dose versus seven-day trimethoprim treatment of cystitis in women: a randomized double-blind study.

Single-dose trimethoprim treatment of cystitis was compared with 7-day treatment in a randomized double-blind study in primary health care. Consecutive female patients (613) with symptoms of lower urinary tract infection (UTI) and positive bacteriuria screening tests were enrolled. In 502 cases UTI was confirmed by urine culture. Follow-up was performed twice, after 2-3 and 5-6 weeks. Short-term efficacy could be evaluated in 425 cases and accumulated efficacy in 344. Short-term efficacy was 82% for single-dose and 94% for 7-day treatment (P less than .001). Accumulated efficacy was 71% for single-dose and 87% for 7-day therapy (P less than .001). Fewer adverse reactions were noted with single-dose therapy (not significant). The cure rate for UTI caused by P-fimbriated Escherichia coli was not different from that of other E. coli infections. Infections with Staphylococcus saprophyticus showed a lower cure rate than E. coli infections with the single-dose regimen (P less than .05 for short-term efficacy).

Adolescent↗
PubMed1990

Tumor markers in human prostatic carcinoma. An optimation of reference values.

Serum concentrations of prostatic acid phosphatase, prostate-specific antigen, neopterin, osteocalcin, tissue polypeptide antigen, and CA-50 were measured before onset of treatment in 86 patients suffering from prostatic carcinoma. In an attempt to identify patients with a poor prognosis, the data were related to patient survival after 3 years. When the standard reference values, which are based on studies on healthy subjects, were used in the study on the deceased, the diagnostic sensitivity was acceptable, whereas the diagnostic specificity was low. A better relation to prognosis was obtained if higher discrimination values were employed. The increased specificity could be obtained with little loss of sensitivity. It is suggested that the discrimination value should be chosen after careful consideration of the expected performance of the test in differentiating between defined groups of patients. To indicate short-term prognosis in prostatic cancer, a higher than normally recommended discrimination value for the marker should be selected.

Aged↗