Search PubMedSearch

Biomedical subjects

J M Hicks

Publications and source records attributed to J M Hicks.

At least 19 recordsLinked to original sources

Alcohol and drug use in teenagers with diabetes mellitus.

Alcohol and drug use in adolescents with diabetes mellitus was assessed by an anonymous self-administered questionnaire with verification by urine drug screening. Approximately 50% of these adolescents report having tried alcohol and 25% report ongoing use. Almost 25% have tried drugs of abuse and 5% report ongoing use. One of 97 consecutive urine specimens was positive for marijuana. In general, the frequency of alcohol and drug use was less than expected based on other studies of different clinical groups of patients in the same age range. Patients with diabetes who reported drug use or who reported they live in an environment of substance abuse had poorer diabetes control than patients who did not.

Adolescent

A comparison of three desktop chemistry analyzers for the pediatric practice.

Three desktop chemistry analyzers most frequently utilized in physicians' offices are compared for performance and precision: the DT60 (Kodak), Vision (Abbott), and Reflotron (Boehringer-Mannheim). The manufacturers' instructions were followed for all the reagents, calibrators and controls provided with each analyzer used. Precision, stability, dynamic range, interferences, and comparison of analyses of 50-100 patient samples with standard laboratory instruments were evaluated. Within-run precision on all three instruments was acceptable, the coefficient of variation (% CV) ranging from 0.8-5.4% and run-to-run precision CV of 1.1-7.3%. Within-run precision for glucose, blood urea, nitrogen, cholesterol and sodium for an experienced technologist, a clerk without any laboratory experience and a physician with no recent laboratory training were compared: the total CV varied between 1.1 and 6.3%. There are differences in the way bilirubin and hemoglobin interfere with the chemistries on the analyzers. Instrument size, available analyses, reagent cost and ease of operation were also assessed. The data suggest that all three analyzers performed well and would be suitable for the pediatric office setting.

Bilirubin

A dry-strip immunometric assay for digoxin on the Ames Seralyzer.

We evaluated the Ames Seralyzer III with a new reagent and drystrip test for assay of digoxin. Assay precision was acceptable in the therapeutic range. Within-run imprecision (coefficient of variation, n = 20) was 7% at 0.9 ng/ml (1.2 nM) and 3.5% at 1.9 ng/ml (2.4 nM); run-to-run imprecision was 7.6% at 0.8 ng/ml (1.0 nM) and 5.7% at 2.1 ng/ml (2.7 nM). The method is very reproducible and is linear between 0.5 and 4.3 ng/ml (0.6-5.5 nM). The assay performed well with patient samples, with Abbott TDx used as the reference procedure. Bilirubin up to 16 mg/dl (273 microM) and hemoglobin up to 11 g/l do not cause interference. Digoxin-like immunoreactive factors cause minimal interference. Some digoxin metabolites such as monodigitoxoside, bis-digitoxoside, and digoxigenin cross-react with the digoxin antibody. Patients on spironolactone have falsely increased digoxin values. The new digoxin assay is easy to perform and uses 30 microliters serum; the result can be reported in 15-20 min.

Antibody Specificity

Evaluation of colorimetric dipstick test to detect alcohol in saliva: a pilot study.

The Alco Screen Saliva Dipstick is an inexpensive, easy-to-use, colorimetric test that gives a semiquantitative estimation of the blood alcohol value by measuring the relative concentration of salivary alcohol. To evaluate its accuracy, we compared the results from tests with the Alco dipstick with values from simultaneously measured blood alcohol tests in 53 patients who were suspected of having ingested alcohol. The correlation between Alco dipstick results and blood alcohol values was strong (r [Spearman's rho], + .91). When the blood alcohol concentration was 0.1 g/dL or more, the Alco dipstick test was 90.9% sensitive, 71.4% specific, and 92% efficient. At Alco dipstick values of 0.02 and 0.05 g/dL, however, semiquantitative concordance was unsatisfactory. Nevertheless, even at the 0.05-g/dL value of salivary alcohol, the test was still valuable as a screen of de facto alcohol ingestion. Definitive diagnosis of relative alcohol intoxication requires confirmatory breath or blood alcohol concentrations by standard methodologies.

Adolescent

High-dose caffeine suppresses postoperative apnea in former preterm infants.

Thirty-two former preterm infants (less than or equal to 44 weeks postconceptual age) undergoing inguinal hernia repair were prospectively studied. General inhalational anesthesia with neuromuscular blockade was used. No barbiturates or opioids were given. Infants were randomly divided into two groups. Group 1 received iv caffeine 10 mg/kg immediately after induction of anesthesia. Group 2 received iv saline. Respiratory pattern, heart rate, and SpO2 were monitored using an impedance pneumograph and a pulse oximeter, respectively, for at least 12 h postoperatively. Tracings were analyzed for evidence of apnea, periodic breathing, and/or bradycardia by a pulmonologist unaware of the drug given. None of the patients who received caffeine developed postoperative bradycardia, prolonged apnea, or periodic breathing, and none had postoperative SpO2 less than 90%. In the control group 13 (81%) developed prolonged apnea 4-6 h postoperatively. Fifty percent of the patients had SpO2 less than 90% at the time. This study shows that iv caffeine 10 mg/kg is effective in the control of apnea in otherwise healthy expremature infants between 37 and 44 weeks of postconceptual age. It is still recommended, however, that all infants at risk be monitored for at least 12 h for apnea and bradycardia following general anesthesia.

Anesthesia, General

Sweat tests.

Explore the source record for details and available documents.

Cystic Fibrosis

Limitations of immunochemical measurement of ceruloplasmin.

We describe a quantitative immunochemical method for the nephelometric measurement of ceruloplasmin. Results are compared with those from a radial immunodiffusion technique. We examine factors affecting the results, such as antiserum source and calibrators, and list reference limits for a pediatric population.

Age Factors

Evaluation of the Beckman creatinine analyzer.

We compared results obtained with the Beckman Creatinine Analyzer (Beckman Instruments, Inc.) to those with the GEMSAEC Centrifugal Analyzer (Electro-Nucleonics, Inc.) and with a manual method for determination of creatinine in serum and urine. Linearity, stability, recovery, and precision were evaluated. Interference from bilirubin, protein, lipemia, uric acid, and hemolysis is negligible, but acetone and acetoacetate can interfere.

Autoanalysis

Chemical and immunochemical measurement of total iron-binding capacity compared.

Radiometric, colorimetric, and two immunochemical methods for measuring total iron-binding capacity are compared. We evaluated the procedures on the basis of precision, applicability to a pediatric population, and accuracy as assessed by analytical recovery of purified transferrin. The immunoephelometric assay for transferrin provides significant advantages over the other methods examined.

Adolescent

Kinetic measurement of alpha-amylase with a centrifugal analyzer.

We compared results of an enzymic assay for alpha-amylase (EC 3.2 1.1), adapted to a centrifugal analyzer (GEMSAEC), with results by the manual dyed-starch (Phadebas) amylase assay. We assessed linearity and precision, and the stability of the reagent. The kinetic procedure is rapid, precise, requires only 25 microliter of serum, and thus is evidently suited for both pediatric and emergency use.

Amylases

Cerebrospinal fluid lactic acid levels in meningitis.

Measurement of cerebrospinal fluid lactic acid by gas liquid chromatography and by an enzymatic Monotest lactate test was evaluated for the early detection of bacterial meningitis in 396 patients. Spinal fluid specimens from 62/62 patients with a bacterial or mycoplasma etiology yielded lactate levels greater than the upper limits of normal, whereas specimens from 334 patients with no bacterial involvement gave values within the normal range. The duration of elevated CSF lactate values coincided with the clinical response to therapy. When considered along with the history and physical examination of the patient, determination of lactic acid proved to be a rapid and reliable diagnostic test for the early detection of untreated as well as partially treated pyogenic meningitis.

Adolescent

Evaluation of a new blood-collecting device ("microtainer") that is suited for pediatric use.

We evaluated the prototype of a "Microtainer" (800-mul) tube (Becton-Dickinson Co., Rutherford, N.J. 07070), In which a semi-solid silicone material is used to separate serum from erythrocytes on centrifugation. We compared results for 18 serum analytes with those obtained for specimens collected by the "dripping" method of capillary blood collection. The serum was examined microscopically for platelets and leukocytes from both normal and leukemic specimens. The cellular elements were all contained in the erythrocyte layer. Hemolysis was negligible. Means for paired samples did not differ significantly, except for Na+, for which the difference was not clinically significant. Values for potassium and lactate dehydrogenase were unchanged 24 h after collection, even though the serum was left in the collecting device.

Blood Chemical Analysis