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C G Fraser

Publications and source records attributed to C G Fraser.

157 records · Page 9Linked to original sources

Comparison of three kits for the enzymatic determination of urea.

A comparative evaluation of Beckman (A), Boehringer (B), and Calbiochem (C) kits for the enzymatic end-point determination of urea has been carried out. Acceptable within-day and day-to-day precision was obtained with all kits. The recoveries obtained fulfilled the criteria of Logan (CRC Critical Reviews in Clinical Laboratory Sciences, 1972, 3, 271-289). Correlation between the results obtained by all kit methods and the diacetyl monoxime continuous-flow method, the reference method in this study, was excellent, but all methods evidenced a net negative bias at urea levels up to at least 20 mmol/1. We recommend kit A as the most satisfactory for routine use, consider kit B to be in the main acceptable, and suggest that kit C has disadvantages regarding both the accuracy attainable with quality control materials and the lack of information on blank correction for interfering compounds.

Hemolysis↗

Evaluation of a radiometric method for determination of total and unsaturated iron-binding capacities and serum iron.

We describe an evaluation of the "RES-OMAT FE-59" radiometric kit (Mallinckrodt Australia Pty. Ltd.) for determination of total iron-binding capacity and unsaturated iron-binding capacity; serum iron may be calculated from total iron-binding capacity and unsaturated iron-binding capacity. Values obtained on patients' sera were compared with those obtained by continuous-flow analysis; correlation coefficients were 0.92, 0.93, and 0.88 for total iron-binding capacity, unsaturated iron-binding capacity, and iron, respectively. Precision between-run and within-run was almost identical and compares very favorably with that reported by Dixon [Ann. Clin. Biochem. 10, 127 (1973)] and that achieved in inter-laboratory surveys. Analytical recovery averaged only 83.5%, but results of analyses of sera with assigned or consensus values showed good accuracy. Satisfactory performance cannot be achieved with lyophilzed bovine quality-control materials. The kit has significant technical advantages over colorimetric methods and good short- and long-term analytical performance.

Blood Proteins↗

Manual and centrifugal analyzer determination of cholesterol and triglycerides with single-vial enzymatic reagents.

We have assessed Calbiochem single-vial enzymatic reagent systems for the analysis for cholesterol and triglycerides, using manual and centrifugal analyzer techniques. Analysis for cholesterol by both techniques had acceptable performance by the short-term criteria of the Center for Disease Control (CDC) during this study carried out under optimal conditions of variance. Analysis for triglycerides by the manual technique did not meet CDC criteria, and we do not recommend use of this method. Analysis for triglycerides by the centrifugal analyzer technique had acceptable short-term precision but had unacceptable accuracy at high concentrations of triglycerides; this method may be considered to have acceptable performance for routine laboratory use.

Centrifugation↗

Effectiveness of an outpatient urine screening program.

We evaluated the effectiveness of a routine outpatient urinalysis screening program on a sample population of 2600 patients. The 189 abnormal urine results found in 182 patients were followed up by study of any new clinical and laboratory investigations or therapeutic modifications initiated on the basis of any abnormal test result. The urinalysis screening program appeared to have significant bearing on diagnosis or treatment in only 13 patients. Abnormalities found in 150 of the 182 patients were either not noted or no further positive action was taken. Thus we concluded that under the conditions of this study the urine screening program added to hospital costs without significant benefit to the patient.

Bilirubin↗

Urinalysis by use of multi-test reagent strips: two dipsticks compared.

We compared Ames' "N-Multistix" with Boehringer's "Combur-8" ("Chemstrip-8") multi-test urine reagent strips by analysis of contrived urine specimens, testing accuracy, precision, specificity, and limits of detection of both products. Relative cost and ease of use were also examined. Each brand of urinary dipstick had specific advantages but it is unlikely that patient care would be adversely affected by preferential use of either product.

Acetoacetates↗

Age-related changes in laboratory test results. Clinical implications.

Many quantities assayed in clinical laboratories demonstrate age-related changes. Particularly important periods are early life, adolescence, old age, and after the menopause in females. The changes that occur until adulthood are well documented. Fewer data are available on elderly people even though they consume a large component of healthcare resources. In diagnosis, and prior to initiation of drug therapy, when no previous results are available, reference values must be available to aid interpretation. Reference intervals generated from elderly people are sometimes wider than in younger adults. It is suggested that conventional adult reference values should be used in general for the very elderly since, at least in part, the wider intervals are probably due to inclusion of individuals who are unhealthy in the reference sample group. Most quantities have marked individuality, and serial values for an individual span only a part of the reference interval. Individuals can have values which are very unusual for them but still lie within the reference limits; this implies that clinical laboratory tests will be less than ideal in the detection of latent or early disease. The average within-subject variation in healthy elderly people and younger adults is similar. Therefore, the large database on biological variation can be used, with analytical imprecision, to calculate critical differences for serial results in an elderly individual which must be exceeded before significance can be claimed. These critical differences are of value in monitoring the effects of drug therapy.

Aged↗

Serum tumor markers in monitoring patients: interpretation of results using analytical and biological variation.

During cancer monitoring, data on biological and analytical variation are required in order to define the critical difference which provides an objective means to interpret serial values. We evaluated four tumor markers on serial samples collected from healthy subjects and patients. Analytical coefficients of variation (CV(A)), were obtained from "precision profiles" based on the differences between duplicates cumulated from assay runs in the laboratory. We defined the mean intrasubject biological variation (CV(I)) for CA 19-9 and TPA, separately for healthy people and patients; since the differences between the two groups were not statistically significant, we pooled the results and re-evaluated CV(I) in the combined groups (CA 19-9: CV(I) = 15.9%; TPA: CV(I) = 25.7%). In addition, we evaluated CV(I) for CEA (10.9%) and for TPS (25.9%) in patients. We then evaluated the inter-subject biological variations (CV(G)); the calculated indices of individuality for the four markers were less than 0.6 which shows conventional reference values to be of little utility for interpretation. We finally evaluated the critical differences (p < 0.05) for CA 19-9 (CD = 44.7%), for TPA (CD = 72.5%), CEA (CD = 32.7%) and TPS (CD = 72.5%); these are generally applicable since there was no heterogeneity in intra-subject biological variability.

Adult↗