Whole blood glucose: what are we actually measuring?
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Biomedical subjects
Publications and source records attributed to K Wiener.
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The HemoCue blood glucose analyser was investigated with particular respect to its susceptibility to influence by the haematocrit of the blood specimen. The red cells and plasma of fresh blood samples were separated and then recombined in proportions to give a range of haematocrit values and the resulting specimens assayed for glucose. The HemoCue exhibited no appreciable influence of haematocrit. The instrument was easy to use, stable and had good precision (CV 1.8%). However, results tended to be a little higher than those produced by a conventional laboratory analyser on whole blood and it is understood that the factory calibration of newer HemoCue instruments has been modified to correct for this.
Four studies examined the federally mandated warning on alcohol containers, which is required by law to be "located in a conspicuous and prominent place." In all four studies few of the drinkers could recall the main parts of the warnings, even though the warning had been required on all alcohol containers for over two years. In Study 1, 44 adults looked at the warning on various beer containers and 77% thought that the warning was not conspicuous but could be made conspicuous through various changes, such as by printing the warning horizontally (parallel to the brand name) rather than vertically. In Study 2, 50 adults looked at the warning placed horizontally on one beer can and vertically on a similar can and rated the horizontal warning significantly more conspicuous. In Study 3, 44 adults spent several minutes in a simulated drinking atmosphere. Half the subjects had beer cans with a horizontal warning and half had a vertical warning. The subjects with the horizontal warning later showed significantly better awareness/recall of the warning. In Study 4, with 75 adult subjects in a bar, the half of the subjects prompted to notice the alcohol warning drank less thereafter in the bar than the other subjects. The findings of the series of studies suggest that the conspicuousness of health warnings on alcohol containers tends to influence their possible effectiveness.
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By means of a questionnaire, an attempt was made to assess the quality of performance and interpretation of the oral glucose tolerance test by laboratories participating in the UK External Quality Assessment Scheme for Clinical Chemistry. The results showed a general awareness of current recommendations in terms of both protocol for the test and criteria for interpretation of results, but some deficiencies were observed in both these areas and in some case deviations in protocol may have been sufficient to invalidate comparison of results with currently recommended criteria for interpretation of the test.
The Glynn and Kendal technique for plasma paracetamol assay was investigated in an attempt to eliminate its susceptibility to interference from salicylate. Modification of the nitrating reaction so as to produce milder conditions by omission of hydrochloric acid, reduction of nitrite concentration, and limiting the time of reaction to 2 minutes resulted in far less interference. A further improvement was achieved by reading at 450 nm. The proposed modification reduces the interference from a salicylate concentration of 100 mg/dl to the equivalent paracetamol concentration of 12 mg/l, compared with about 70 mg/l in the unmodified method.
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The organisation of a regional quality control scheme for salicylate and paracetamol estimations in plasma is described. The results show considerable variation in both bias and precision between laboratories, with some overall improvement in performance during the second year of the scheme. No method can be singled out as producing better results than the others. The major factor seems to be the care with which the analyses are performed.
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Differences in alkaline phosphatase activity of some commerical control sera were observed when comparing manual with AutoAnalyzer versions of the Kind and King procedure. This phenomenon was found to be associated with sera boosted with exogenous alkaline phosphatase and to be owing mainly to inadequate provision of buffer in some automated methods. It is suggested that a modification to the SMA procedure may lessen the problem, but the constraints of the system necessitate a compromise. There was better precision after the modification had been introduced. Awareness of this phenomenon is of paramount importance if commerical sera are to be used in any way in the calibration of automated systems for alkaline phosphatase assay.
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