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Biomedical subjects

J H Keffer

Publications and source records attributed to J H Keffer.

31 records · Page 2Linked to original sources
PubMed1995

False-positive serum prostate-specific antigen values in a patient with non-Hodgkin lymphoma of the kidney.

Prostate-specific antigen (PSA) is the clinically most useful tumor marker for prostate cancer. Although false-positive elevations have been reported due to disease processes outside the prostate gland with the use of the polyclonal assay, such false-positive test results have been exceedingly rare with the use of the monoclonal assay. We report the case of a patient diagnosed with a B-cell lymphoma of the kidney and a significant elevation of serum PSA levels by monoclonal assay in the absence of either inflammatory or malignant prostate disease. PSA returned to normal during lymphoma-specific chemotherapy with a cyclophosphamide, mechlorethamine, vincristine, procarbazine, prednisone regimen. Possible explanations and clinical implications are discussed.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1995

Effects of cocaine on cortisol secretion in humans.

The effects of acute cocaine administration on the pituitary adrenal axis in humans without a history of drug abuse are unknown. The authors studied 12 male volunteers twice in a double-blinded, placebo-controlled, randomized fashion. After intranasal administration of 2 mg/kg cocaine, cortisol levels were significantly higher than after placebo administration. The authors concluded that acute administration of cocaine to humans increases cortisol secretion.

Administration, Intranasal↗
PubMed1995

Economic considerations of point-of-care testing.

Point-of-care testing is a rapidly expanding trend. This review discusses some of the issues driving the development of this new approach to laboratory testing, assesses the factors appropriate in introducing and managing point-of-care testing, and directs attention to realistically assessing the potential for cost-effectiveness analysis. Although considered optimal, formal cost-effective analysis is limited. A commentary on the published literature of the field is presented. Observations are offered on the inadequacies of published studies that purport to describe this application. As an alternative, a more general assessment of the economic effect of point-of-care testing in the general context of the laboratory mission is recommended. Suggested guidelines are included.

Cost-Benefit Analysis↗
PubMed1986

Quality assurance in home laboratory testing.

In review, one is compelled to the notion that a variety of the aforementioned thoughts become pre-eminent in assuring quality. The selection of the tests available for home testing is crucial. They should be divided into categories of single encounter tests and multiple use tests. The single encounter implies a test that has an extremely high degree of reliability and is likely to achieve an answer to the question asked. This should relate to a disease or process for which potential favorable treatment can be achieved or which may have a major favorable impact on public health. In this category one thinks in terms of the worldwide prevalence of hepatitis B and other infectious diseases that are particularly common in third world countries. Yet, these are not "markets" likely to be able to afford this testing. Similarly, these societies are not currently sophisticated in terms of application of preventive measures. On the other hand, major benefits could be projected from the other category of testing, namely, therapeutic monitoring in the hands of individuals who will repetitively test for the same substance in the same manner. This includes not only diabetes but other conditions that are monitored for drug therapy, including seizure disorders and bronchospasm. Inherent in this aspect is the requirement for meaningful and ongoing instruction in proper testing methodology and recording of results. The incorporation of some type of memory device to enforce this aspect of testing appears extremely desirable, if not mandatory. Finally, we must consider the potential for misuse of the single test type of device. One suspects that it would be highly desirable that any test made available for self-testing should also be mandated as accessible through certified laboratories at the request of an individual, which would at least provide reliable performance of the test with a quality result. The development of the concept of quality assurance in home testing is in its infancy and will require continuing evolution.

Aged↗
PubMed1983

Selecting equipment and reagents: a personal experience and process.

The selection of laboratory equipment and reagents, whatever the section of the laboratory, is not a momentary decision. In this article the author shares his personal experience which emphasizes an ongoing process involving collaboration with the entire staff. Emphasis is placed on assessing the medical needs of the institution and the unique characteristics of the laboratory personnel, space, and financial resources. The author asserts that the process must be personalized to make a satisfactory selection of instrumentation and reagent systems.

Decision Making↗
PubMed1979

Thyroid replacement therapy: a rational approach to laboratory monitoring.

A brief summary of the diagnostic laboratory criteria for primary hypothyroidism and the practical aspects of the pharmacology of thyroid hormone therapy are presented. A minimal testing protocol for the adequacy of replacement therapy is advocated based on classic studies of restored thyroid function.

Humans↗