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[Clinical reference values for laboratory hematology tests calculated using the iterative truncation method with correction: Part 2, Reference values for white blood cell (WBC) count, WBC differential including segmented neutrophil, band neutrophil, lymphocyte, monocyte, eosinophil, basophil, platelet count and mean platelet volume].

Age and sex dependent differences in the clinical reference values for white blood cell(WBC) count, WBC differential including segmented neutrophils(SEG), band neutrophils(BAND), lymphocytes (LYMPH), monocytes(MONO), eosinophils(EOSINO), basophils(BASO), platelet count(PLT) and mean platelet volume(MPV) were calculated by the iterative truncation method with correction(Usui's method) using the result from tests on 6,300 patient specimens obtained at Kyoto University Hospital. WBC counts exhibited log-normal distribution in all age either in male and female. PLT counts and MPV showed normal or log-normal distribution. WBC differential (SEG, BAND, LYMPH, MONO, EOSINO, BASO) usually showed log-normal distribution. As to the reference value for WBC, high limit values gradually decreased in the age range of 5-14 year old in males and females. After 15 year old, it gradually increased and reached adult's level. Low limit values for WBC gradually decreased with age both in males and females. The reference value for SEG showed similar change to WBC. The reference value for LYMPH gradually decreased age both in males and females. The reference values for BAND, MONO, EOSINO, BASO were generated by the percentile method instead of the iterative truncation method because of the strong deviation in the distribution pattern. BAND, MONO and BASO values were very stable for all ages in males and females. High limit values for EOSINO in the age range of 5-10 year old in males and females remained constant, and gradually decreased in 10-20 year old, and were stable at ages above 20 year old. PLT counts gradually decreased with age, and the MPV remained constant in all age populations both in male and female.

Adolescent↗

Serum chemical values of gestating and lactating swine: reference values.

Reference values of 18 serum constituents were determined in gestating (n = 33) and lactating (n = 13) swine. Serum concentrations of calcium, glucose, urea nitrogen, cholesterol, total protein, and globulin were lower (P less than 0.10) during gestation than during lactation. Concentrations of creatinine, triglycerides, and creatine phosphokinase were higher (P less than 0.10) during gestation than during lactation. Creatinine concentration increased (P less than 0.05) from lactation days 14 to 26.

Animals↗

[Clinical reference values for laboratory hematology tests calculated using the iterative truncation method with correction: Part 1. Reference values for erythrocyte count, hemoglobin quantity, hematocrit and other erythrocyte parameters including MCV, MCH, MCHC and RDW].

Age and sex dependent differences in the clinical reference values for erythrocyte count (RBC), hemoglobin quantity (Hb), hematocrit (Ht) and other erythrocyte parameters including MCV (mean corpuscular volume), MCH (mean corpuscular hemoglobin), MCHC (mean corpuscular hemoglobin concentration) and RDW (red cell distribution width), were calculated by the iterative truncation method with correction (Usui's method) using the results from tests on 6,300 patients' specimens obtained at Kyoto University Hospital. For RBC, Hb and Ht, the data obtained from the individuals below 13 years old showed the normal or sometimes log-normal distribution, but adjustment by the Xn-type variable transformation was often necessary to obtain the normal distribution for the data taken from the populations containing individuals over the age of 14. For the clinical reference values of RBC, Hb and Ht, no sex difference was observed below the age of 12. The values for males were significantly higher than those of females in the age range 13-79, and the values showed no significant sex-dependent difference at ages above 80. In females, age-dependent change of values for RBC, Hb and Ht was less prominent than in males; especially the upper limit values for females were very stable for all ages. MCV and MCH gradually increased with age both in males and females, and the MCHC remained constant in all age populations of male and female. The reference value for RDW was generated by the percentile method instead of the iterative truncation method because of the strong deviation in the distribution pattern, and the RDW values showed a gradual increase with age in both males and females.

Age Factors↗

Trace element reference values in tissues from inhabitants of the European Community. V. Review of trace elements in blood, serum and urine and critical evaluation of reference values for the Danish population.

The availability of accurate trace element reference values in human tissues represents an important indicator to the health status of the general population and occupational groups exposed to trace elements. The EURO TERVIHT project (Trace Element Reference Values In Human Tissues) aims to establish and compare trace element reference values in tissues from inhabitants of the European Community as baseline values for clinical/toxicological assessment studies (Sabbioni et al., 1992, Sci. Total Environ., 120: 39-62). In this context, one of the first steps considered is the critical evaluation (state of the art) of existing literature on trace element reference values in blood, serum and urine in the general population of each EC country. This paper reviews the Danish situation.

Adolescent↗

Doppler ultrasonography of the fetoplacental circulation--normal reference values.

Normal reference values for the resistance index, A/B ratio and pulsatility index of the umbilical artery obtained by Doppler ultrasonography are presented. The resistance index and A/B ratio values are very similar to those previously published, indicating no need to formulate normal values for different populations. The pulsatility index differed from other published values, probably reflecting different calculation methods built into the spectrum analysers rather than differences in waveforms. The resistance index had the lowest coefficient of variation and showed least inter-observer variation. For routine use the resistance index is preferable to other indices.

Adult↗

Trace element reference values in tissues from inhabitants of the European Community. VII. Review of trace elements in blood, serum and urine of the Belgian population and critical evaluation of their possible use as reference values.

The availability of accurate trace element reference values in human tissues represents an important indicator to the health status of the general population and occupational groups exposed to trace elements. The EURO TERVIHT project (Trace Element Reference Values In Human Tissues) aims to establish and compare trace element reference values in tissues from inhabitants of the European Community as baseline values for clinical/toxicological assessment studies (Sabbioni et al., 1992a,b). In this context one of the first steps considered is the critical evaluation (state of the art) of existing literature on trace element reference values in blood, serum and urine in the general population of each EC country. This paper reviews the Belgian situation.

Adolescent↗

Establishing reference values from adults: recommendation on procedures for the preparation of individuals, collection of blood, and handling and storage of specimens. Committee on Reference Values of the Scandinavian Society for Clinical Chemistry.

The concentrations of blood components are influenced by a number of preanalytical factors, the importance of which varies [1]. Therefore it is necessary to standardize the specimen collection, as was done by the Committee on Reference Values of the Scandinavian Society for Clinical Chemistry and Clinical Physiology, which in 1975 published its recommendation on the production of reference values in clinical chemistry [2]. It was the very first recommendation of its kind. Since then, new information has accumulated, and it has become necessary to revise the part concerning the preparation of subjects for blood collection, the collection procedure itself, and the subsequent handling of the specimen. Also, The International Federation of Clinical Chemistry (Expert Panel on Theory of Reference Values) has produced its own recommendation [3]. The recommendation described below replaces pp. 39-44 of the former Scandinavian recommendation [2]. The procedure described below is designed for the collection of specimens for the measurement of the majority of components in blood and specimen collection from the cubital vein is described. It can be easily adapted for the collection of blood from other vessels [4]. Certain laboratory investigations require a special protocol. In that case, the preparation of the subject prior to and during specimen collection as well as the procedure itself should be described in sufficient detail to permit reproduction by adequately trained personnel. In any project designed to produce reference values the same protocol for the preparation of individuals and specimen collection should be used throughout the project. The protocol should be described in detail. Thus, it is not satisfactory to state only that the present recommendation was followed. Each section of the recommendation is followed by a check list for points which should be taken into account.

Adult↗

Element reference values in tissues from inhabitants of the European Community. VI. Review of elements in blood, plasma and urine and a critical evaluation of reference values for the United Kingdom population.

Reference values for the concentration of elements in whole blood for the UK population are presented together with estimates for concentrations in plasma and urine. The blood data, when compared with other values obtained for Belgium, Denmark and Italy, obtained through the EURO-Terviht programme of the European Union, together with data from other countries, indicate similar concentrations. The data provide a basis for identifying the expected levels for the non-occupational exposed population against which differences attributable to various states of well-being, morbidity and mortality can be evaluated. However, it is also apparent that significant differences do exist which are related to geography and diet. In order to consider these differences, further improvements in the determination of elements in human tissues and fluids are required. Particular attention should be paid to that proportion of an element in the environment which is bioavailable together with its toxicity.

Autopsy↗

Hippuric acid in urine: reference values.

OBJECTIVE: To establish reference values for hippuric acid (HA) excreted in the urine, and to evaluate the impact of age, gender, alcohol, and tobacco, on these levels in a population nonexposed to toluene. METHODS: Reference values for hippuric acid in urine were determined in 115 toluene nonexposed healthy volunteers, from Alfenas city, Southeastern Brazil. A questionnaire was applied to each volunteer and data on occupational and personal habits were collected. Biochemical and hematological analyses were used to confirm the volunteers' good health condition. Reference values were expressed in g HA/g urine creatinine, as mean +/- standard deviation (x +/- SD), median, 95% confidence interval (95%CI), 95th percentile, and upper reference value (URV, mean +2 SD). RESULTS: Reference values of hippuric acid in urine were: mean +/- standard deviation =0.18+/-0.10; median =0.15; 95% confidence interval =0.16+/-0.20; 95th percentile = 0.36 and upper reference value (URV, mean +2 SD) =0.38. Statistically significant differences in urinary HA (Wilcoxon - Mann/Whitney, p<0.05) were observed for different genders and age groups. Alcohol ingestion and smoking habit did not significantly affect the results. CONCLUSIONS: The reference values of hippuric acid in urine can be used in biomonitoring programs of workers occupationally exposed to toluene, especially in the southern region of the state of Minas Gerais. Age and gender may affect the HA reference values.

Adolescent↗

Reference values for multifrequency bioimpedance analysis in dialysis patients.

BACKGROUND: The role of multifrequency bioimpedance(MF-BIA) in the assessment of fluid status in dialysis patients is still not fully elucidated. Especially, the predictive value of reference values for extracellular water (ECW) has not yet been addressed. Aim of the present study was to validate cut-off values for MF-BIA in the diagnosis of hypervolemia in dialysis patients, using strict clinical criteria and echocardiography as reference techniques. METHODS: 90 patients [42 on hemodialysis; 48 on peritoneal dialysis] were divided into the following groups: clinically normovolemic (mean 24- or 48-hour systolic blood pressure below 133 mm Hg without use of antihypertensive agents; n = 12), 'hypervolemic' (mean systolic blood pressure above 133 mm Hg with 2 or more antihypertensive agents; n = 34) or undetermined (n = 44). The 80th percentile for normalized ECW in the clinically normovolemic patients was used as reference value. 20 healthy age-matched controls were included for comparison. RESULTS: The 80th percentiles for ECW:body weight (BW) and ECW:height in 'normovolemic' subjects were, respectively, 0.245 liters/kg and 10.96 liters/m in males, and 0.232 liters/kg and 9.13 liters/m in females. ECW:BW and ECW:height were above these values in, respectively, 26 (sensitivity 76%) and 29 (sensitivity 86%) of the 34 'hypervolemic' patients. In the undetermined group, left ventricular end-diastolic diameter was significantly different between patients with normalized ECW below and above these cut-off values (49.0 +/- 5.1 vs. 52.4 +/- 5.7 mm; p < 0.05). Use of the ECW:TBW ratio resulted yielded low sensitivity (45%). ECW:height was lower in the 'normovolemic' dialysis patients compared to healthy controls (9.7 +/- 1.3 l/m versus 12.2 +/- 1.9 l/m). CONCLUSION: In our study population, ECW by MF-BIA, normalized for height was able to predict hypervolemia, based on strict clinical criteria, with a sensitivity of 86% and a specificity of 80%. The normalization procedure for ECW may influence the classification of hydration status. Strictly normotensive dialysis patients had lower normalized ECW than healthy control subjects.

Adult↗