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R B Payne

Publications and source records attributed to R B Payne.

At least 19 recordsLinked to original sources
PubMed1991

Mnemonic coding system for clinical data entry into laboratory computers: its effect on quality and efficiency.

A simplified coding method for entering the clinical details found on pathology request cards was developed. The method uses a basic four letter code, derived from the initial character of the first four words in a clinical detail, being expanded to four characters with letters from the final word if the number of words is less than four. Rules were devised to cope with common medical terminology. In excess of 90% of clinical details on request cards are readily input by clerical staff using our coding system, and 8% of clinical details are used intelligently by the computer in scheduling further tests or automatically commenting on results. A carefully designed coding system such as the one outlined above could greatly facilitate input of clinical detail without the penalty of reduced throughput.

Clinical Laboratory Information Systems↗
PubMed1991

Protein interference with ion-selective electrode measurement depends on reference electrode composition and design.

There is controversy about whether protein interferes with ion measurements using ion-selective electrodes. We have investigated the effects of changes in the salt-bridge composition of five commercially available analysers with open, membrane-restricted or porous frit-restricted reference electrode junctions on measurements of an albumin solution prepared by gel filtration. When the manufacturers' salt bridges were used, instruments with open or membrane-restricted junctions showed apparent increases in the activity of ionized calcium, sodium and potassium in the presence of protein. When the hypertonic bridge solutions were replaced with 150 mmol/L potassium chloride this increase disappeared. The instrument with a porous frit-restricted junction showed no protein effect, but its response to changes in sample sodium chloride concentration in protein-free solution suggested that its junction was functionally equivalent to that formed with an isotonic sodium chloride bridge. Our results emphasize that liquid junction design and composition affect ion measurements in protein-containing solutions and suggest that the use of hypertonic bridge solutions for biological samples needs to be re-examined.

Calcium Chloride↗
PubMed1991

Effects of ionic strength on ionized calcium measured using reference electrode liquid junctions of varying design and composition.

Five commercial analysers were used to measure ionized calcium in aqueous and protein solutions which contained the same amount of calcium but had sodium chloride concentrations ranging from 100 to 150 mmol/L. In aqueous solutions measured activity fell significantly with increasing ionic strength while in protein solutions it increased. When isotonic sodium chloride was substituted for the hypertonic potassium chloride reference electrode liquid junction of an analyser with an open junction, there was a marked positive change in the effect of ionic strength in both aqueous and protein solutions. In contrast, when either isotonic sodium chloride or potassium chloride was substituted for the hypertonic potassium chloride of an instrument with a membrane-restricted junction, there was no effect on the change of measured values with ionic strength. Increasing the protein concentration by ultrafiltration did not change ionized calcium values when isotonic reference solutions were used with either open or membrane-restricted junctions. Because membrane-restricted isotonic junctions respond like hypertonic junctions to changes in sample ionic strength but do not exhibit protein interference, they may prove to have advantages over both open isotonic junctions and all configurations of hypertonic junction for measurements in patients.

Calcium↗
PubMed1990

Hyperlactatemia and increasing metabolic acidosis in hepatorenal failure treated by hemofiltration.

We report a case of increasing hyperlactatemia in the course of repeated treatment by machine hemofiltration (MHF) using a lactate-buffered replacement solution. The hyperlactatemia was associated with a reduction in mean arterial pressure, and in the majority of treatments a metabolic acidosis developed. Hyperlactatemia due to exogenous lactate may not be as benign as previously discussed.

Acidosis, Lactic↗
PubMed1990

Albumin-adjusted calcium concentration in serum increases during normal pregnancy.

Concentrations of total calcium and albumin were measured in serum specimens from 41 women at intervals before, during, and after 42 pregnancies. The albumin concentration decreased but the calcium decreased more slowly, so that the albumin-adjusted calcium concentration increased from conception to term. These findings, taken in conjunction with published observations of hypercalciuria, increased concentrations of 1,25-dihydroxycholecalciferol and calcitonin in serum, and decreased concentrations of intact parathyrin in serum, strongly suggest that maternal ionized calcium increases throughout normal pregnancy.

Adult↗
PubMed1979

Serum-calcium.

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Calcium↗
PubMed1979

Interpretation of serum total calcium: effects of adjustment for albumin concentration on frequency of abnormal values and on detection of change in the individual.

Serum total calcium was measured in 1693 patients during a four-month period. We examined the effects of adjustment for albumin concentration on the interpretation of single measurements of serum total calcium and on the variation of series of measurements in individual patients. Markedly abnormal total calcium concentrations--2.75 mmol/l (11.0 mg/100 ml) or more, or 2.00 mmol/l (8.0 mg/100 ml) or less--were found in 115 patients, but only 24 (21%) remained markedly abnormal after adjustment for albumin. Three patients, two with malignant disease and one with primary hyperparathyroidism, had significant hypercalcaemia which was masked by hypoalbuminaemia. The serum total calcium measured on a subsequent occasion had changed 0.15 mmol/l (0.6 mg/100 ml) or more in 60 patients, but after adjustment for albumin this number was reduced to 27 (45%). The within-person standard deviation for serum total calcium was calculated in 26 patients with normal mean adjusted calcium concentrations who had had six or more sequential measurements. The mean standard deviation was 0.148 mmol/1 (0.59 mg/100 ml) and, after adjustment for albumin, this was reduced to 0.100 mmol/1 (0.40 mg/100 ml). We conclude that adjustment of serum total calcium concentration for albumin is essential to detect abnormal values and to assess changes in a value.

Blood Protein Disorders↗
PubMed1979

Adjusted calcium conflict resolved? Differing effects on plasma total calcium of changes in plasma albumin after venous stasis or myocardial infarction.

Others have challenged the concept of adjusting total plasma calcium for albumin concentration on the grounds that after the application of a tourniquet the increase in calcium for a given increase in albumin differs significantly between normal individuals. We have confirmed this finding. In contrast, we have found that after myocardial infarction the fall in calcium for a given fall in albumin does not differ significantly between patients. Thus the adjustment of calcium for albumin using a single equation remains valid in patients with changes in albumin due to disease. We recommend that for consistent results blood should be taken with the minimum of venous stasis even though the patient's calcium is to be adjusted for albumin.

Blood Flow Velocity↗
PubMed1979

Re-examination of effect of paracetamol on serum uric acid measured by phosphotungstic acid reduction.

The drug paracetamol (N-acetyl-p-aminophenol; acetaminophen) caused a spurious increase in serum uric acid measured by phosphotungstic acid reduction methods. However, the increase was less than 0.12 mmol/1 at plasma levels of paracetamol found in overdosage (40 mg/100 ml) and was small at therapeutic concentrations (less than 4 mg/100 ml). It is concluded that few patients with joint pain who have taken paracetamol paracetamol as an analgesic will have clinically misleading values for serum uric acid.

Acetaminophen↗
PubMed1978

Effect of myo-inositol on peripheral-nerve function in diabetes.

myo-Inositol, 500 mg twice a day, given to seven diabetic patients for two weeks, increased the amplitude of the evoked action potentials of the median, sural, and popliteal nerves by an average of 76%, 160%, and 40%, respectively. There was no significant change in the conduction velocities of these nerves, myo-Inositol may be valuable in the treatment of diabetic neuropathy.

Aged↗