A survey of precision diagnosis and management capacity of pulmonary embolism in 90 hospitals of China.

OBJECTIVE: To conduct a survey of diagnostic facility and therapeutic capability of Pulmonary thromboembolism (PE) in 90 hospitals throughout China. METHOD: It was a cross-sectional study among the participating hospitals of the National Key Research & Development Program of China-the Precision Research of Standardized Management and Application of Pulmonary Thromboembolism to obtain the equipment and application of radiological facility to diagnose PE, laboratory tests for thrombophilia, coagulation function and the availability of anticoagulants and thrombolysis agents. RESULTS: CT pulmonary arteriography is capable in all 90 hospitals, 71.11% of the hospitals could perform ventilation/perfusion scintigraphy, 24.44% of the hospitals do not routinely perform right heart evaluation by echocardiography. Protein C and protein S activity can be detected in half of the hospitals and warfarin pharmacogenomics tests can be conducted in 40 hospitals. Immune turbidimetry was used as the detection method of D-dimer in 72.37% hospitals. About 81.11% of participating hospitals were equipped with new novel oral anticoagulants, all of which were equipped with Rivaroxaban. CONCLUSION: The hospitals are capable for standardized diagnosis and management PE, while the capability of precise stratification, coagulation function tests, thrombophilia screening and pharmacogenomics requires further improvement.

Interpretation and Validation of Maximum Absorbance Data Obtained from Turbidimetry Analysis of Plasma Clots.

Turbidimetry is used to characterize fibrin clot properties. In purified systems, maximum absorbance (MA) directly relates to fibrin fiber cross-sectional area. However, in plasma samples there are discrepancies in the relationships between MA and fibrinogen concentration, fiber diameter, other clot properties, and cardiovascular disease outcomes, which complicate data interpretation. This study aims to advance understanding of MA of plasma clots through testing how well it relates to fundamental dependence on fibrinogen concentration and fiber diameter as predicted by light scattering theory, other clot properties and lifestyle, and biochemical variables. Plasma samples from 30 apparently healthy individuals with a fibrinogen concentration from 2.4 to 6.4 g/L were included. We performed turbidimetry, permeability, scanning electron microscopy, and rheometry on in vitro formed plasma clots. MA correlated more strongly with fibrinogen concentration (r = 0.65; p < 0.001) than with fiber diameter (r = 0.47; p = 0.01), which combined explained only 46% of the MA variance. Of additional variables measured, only low-density lipoprotein cholesterol correlated with MA (r = 0.46; p = 0.01) and clot lysis (r = 0.62; p < 0.0001) but not with fiber diameter or fibrinogen concentration. MA correlated with clot lysis time (r = 0.59; p = 0.001), storage modulus (r = 0.61; p = 0.001), and loss modulus (r = 0.59; p = 0.001), and negatively with clot permeability (r = -0.60; p = 0.001) also after adjustment for fibrinogen concentration and fiber diameter. Increased MA is indicative of a prothrombotic clot phenotype irrespective of fibrinogen concentration. MA is more indicative of overall clot density than of fiber diameter. Other plasma components can alter internal fiber density without altering fiber diameter and should be considered when interpreting MA of plasma samples.

Diagnostic accuracy of serum cystatin C in chronic kidney disease: a meta-analysis.

BACKGROUND: Chronic kidney disease (CKD) is a major health problem worldwide with dramatically increasing incidence and prevalence. Serum cystatin C (sCysC) has been clarified by many studies as a relatively accurate marker to evaluate renal function. STUDY DESIGN: Meta-analysis of diagnostic test studies. SETTING AND POPULATION: Various clinical settings of CKD, including adult patients with diabetes, renal transplant patients, and so on. SELECTION CRITERIA: A computerized search of PubMed, Cochrane clinical trial database, and Current Contents (from inception until June 16, 2014) was performed to identify potentially relevant articles. INDEX TESTS: Increased sCysC concentration. REFERENCE TESTS: The measured glomerular filtration rate measured by nuclear medicine techniques such as 99Tc-diethylene triamine pentacaetic acid (99Tc-DTPA) or 51Cr-ethylenediamine tetra-acetic acid (51Cr-EDTA), or calculated by Cockcroft-Gault (CG) or Modification of Diet in Renal Disease (MDRD) formula or 24 hours creatinine clearance rate. RESULTS: In total 19 studies were included in this study. Across all settings, the diagnostic odds ratio (DOR) of sCysC in predicting CKD was 40 (95% CI, 26 - 61) when sensitivity and specificity was 0.85 (95% CI, 0.81 - 0.89) and 0.87 (95% CI, 0.84 - 0.90), respectively. The area under the curve for the receiver-operating characteristic (AUROC) of sCysC to predict CKD was 0.92 (95% CI, 0.90 - 0.94). For the diagnostic value of sCysC in diabetics with CKD, the DOR was 51 (95% CI, 22 - 122), with sensitivity and specificity of 0.89 and 0.87, respectively. Subgroup analysis showed that sCysC was of better diagnostic value in the West than in Asia, and the diagnostic value of sCysC assayed by particle-enhanced nephelometric immunoassay (PENIA) was higher than sCysC assayed by particle-enhanced turbidimetric immunoassay (PETIA). CONCLUSION: SCysC appears to be a good biomarker in the definition of CKD. However, its performance is different in subgroups restricted by clinical settings, race, and sCysC assay.

Turbidity of mouthrinsed water as a screening index for oral malodor.

OBJECTIVES: The objectives of this research were to examine the relationship between turbidity of mouthrinsed water and oral malodor, and to evaluate whether the turbidity could be used to screen oral malodor. STUDY DESIGN: The subjects were 165 oral malodor patients. Gas chromatography and organoleptic test (OT) were used for oral malodor measurement. Oral examination along with collection of saliva and quantification of bacteria was conducted. Turbidity of mouthrinsed water was measured with turbidimeter. Logistic regression with oral malodor status by OT as the dependent variable and receiver operating characteristic (ROC) analysis were performed. RESULTS: Turbidity had a significant association with oral malodor status. In addition, ROC analysis showed that the turbidity had an ability to screen for presence or absence of oral malodor. CONCLUSION: Turbidity could reflect or represent other influential variables of oral malodor and may be useful as a screening method for oral malodor.

What have we learnt about high-density lipoprotein cholesterol measurements during 32 years? Experiences in Finland 1980-2012.

BACKGROUND: High-density lipoprotein cholesterol (HDL-C) is important in risk assessment for cardiovascular disease or metabolic syndrome; however, different direct HDL-C assays may lead to erroneous risk estimates and potentially misclassify people. METHODS: Data for 30-year HDL-C trends in Finland were obtained from the national FINRISK surveys during 1982-2012 (n=45766) taking into account biases from three external quality assessment programs (EQA). We also compared two different direct HDL-C and turbidimetric apolipoprotein A-I methods using 413 fresh serum samples. RESULTS: HDL-C concentrations in the Finnish population were on average 1.33 (±0.04) mmol/l for men and 1.62 (±0.05) mmol/l for women after bias-correction. Positive HDL-C trends were observed for both sexes with original data, but trends disappeared after bias-correction. Comparison of two direct HDL-C methods demonstrated concentration-dependent difference. When HDL-C concentrations were <1.0 mmol/l, the mean bias was -12.0% (95% CI -13.5 to -10.0) whereas HDL-C concentrations >1.55 mmol/l showed mean bias of 9.0% (95% CI 7.0-10.5). CONCLUSIONS: Accurate reporting of HDL-C concentrations at the population level requires proper and regular attendance to reliable EQA programs. We found evidence for a concentration-dependent difference between some direct HDL-C methods, which may cause misclassification of people in cardiovascular risk assessment.

D-Dimer levels at different stages of pregnancy in Australian women: a single centre study using two different immunoturbidimetric assays.

BACKGROUND: To date there is minimal data available on D-Dimer levels at different stages of pregnancy. PATIENTS AND METHODS: We prospectively measured D-Dimer levels in 632 consecutive pregnant women from March 2007 to January 2009. The median age of the participants was 31 years (range; 18-42) with a median weight of 78 kilograms (range; 46-137). All subjects were investigated during each trimester with two different immunoturbidimetric assays; D-Dimer PLUS and INNOVANCE D-Dimer. D-Dimer levels were determined using a Sysmex® CA 1500 analyser. RESULTS: Our data demonstrate that D-Dimer levels in pregnancy show different patterns of rise within the first trimester, depending on the assay used; D-Dimer PLUS=0.88 (SD: mean ratio), INNOVANCE D-Dimer=0.72 (SD: mean ratio). Furthermore, the rise in mean results was greater for the INNOVANCE D-Dimer assay compared to the D-Dimer PLUS assay as shown by the ratio of third to first trimester results of 3.68 and 1.96 respectively. Both D-Dimer assays demonstrated moderate levels of intra-subject variability, with overall mean CVs of 16.5% (D-Dimer PLUS) and 16.9% (INNOVANCE D-Dimer). Furthermore, we studied the association between D-Dimer levels and occurrence of diseases of pregnancy. For both assays, there was no consistently interpretable evidence of an association between raised mean D-Dimer levels or rising D-Dimer levels and any of the diseases or conditions associated with pregnancy. CONCLUSION: Our data suggest that the INNOVANCE D-Dimer assay increases significantly with the advancement of pregnancy, and is more sensitive than D-Dimer PLUS assay in the pregnant population.

Hybrid diffusion-P3 equation in N-layered turbid media: steady-state domain.

This paper discusses light propagation in N-layered turbid media. The hybrid diffusion-P3 equation is solved for an N-layered finite or infinite turbid medium in the steady-state domain for one point source using the extrapolated boundary condition. The Fourier transform formalism is applied to derive the analytical solutions of the fluence rate in Fourier space. Two inverse Fourier transform methods are developed to calculate the fluence rate in real space. In addition, the solutions of the hybrid diffusion-P3 equation are compared to the solutions of the diffusion equation and the Monte Carlo simulation. For the case of small absorption coefficients, the solutions of the N-layered diffusion equation and hybrid diffusion-P3 equation are almost equivalent and are in agreement with the Monte Carlo simulation. For the case of large absorption coefficients, the model of the hybrid diffusion-P3 equation is more precise than that of the diffusion equation. In conclusion, the model of the hybrid diffusion-P3 equation can replace the diffusion equation for modeling light propagation in the N-layered turbid media for a wide range of absorption coefficients.

Influence of linear birefringence in the computation of scattering phase functions.

Birefringent media, like biological tissues, are usually assumed to be uniaxial. For biological tissues, the influence of linear birefringence on the scattering phase function is assumed to be neglectable. In order to examine this, a numerical study of the influence of linear birefringence on the scattering phase function and the resulting backscattering Mueller matrices was performed. It is assumed that the media consist of spherical scattering particles embedded in a nonabsorbing medium, which allows us to employ the Lorenz-Mie theory. In the Monte Carlo framework, the influence of linear birefringence on the components of the electric field vector is captured through the Jones N-matrix formalism. The Lorenz-Mie theory indicates that a given linear birefringence value Δn has a bigger impact on the scattering phase function for large particles. This conclusion is further supported by Monte Carlo simulations, where the phase function was calculated based on the refractive index once in the ordinary direction and once in the extraordinary one. For large particles, comparisons of the resulting backscattering Mueller matrices show significant differences even for small Δn values.

Estimation of carbamazepine and carbamazepine-10,11-epoxide concentrations in plasma using mathematical equations generated with two carbamazepine immunoassays.

Carbamazepine is metabolized to an active metabolite known as carbamazepine-10,11-epoxide, or simply the "epoxide" metabolite. The presence of this metabolite can have clinically significant implications in therapeutic drug monitoring of carbamazepine, but accurate quantification of the epoxide metabolite is currently limited to chromatographic techniques. In this study, mathematical equations are proposed for the estimation of carbamazepine and epoxide metabolite concentrations based on values generated by common carbamazepine immunoassays. Three immunoassays were studied: particle-enhanced turbidimetric inhibition immunoassay (PETINIA, Siemens Healthcare Diagnostics, Deerfield, IL), ADVIA Centaur (Siemens Healthcare Diagnostics), and a cloned enzyme donor immunoassay (CEDIA; Roche, Indianapolis, IN). Equations were based on observed cross-reactivity of epoxide with the PETINIA (average, 96.2%; range, 86.6%-105.7%) and epoxide cross-reactivity with the ADVIA Centaur assay (average, 6.5%; range, 5.3%-7.7%). In addition, equations were developed using average cross-reactivity of epoxide with the PETINIA and with the CEDIA. Values determined by calculation correlated well with carbamazepine and epoxide concentrations in supplemented and patient samples, for which values of carbamazepine (2.2-12.0 microg/mL [9-51 micromol/L]) and the epoxide metabolite (0.6-2.4 microg/mL) were also verified by liquid chromatography-tandem mass spectrometry.

Doseamento microbiológico de apramicina - desenvolvimento e validação de método empregando leitura cinética em microplacas / Apramycin microbiological assay - method development and validation using kinetic microplate reading

O princípio do ensaio turbidimétrico é simples: a solução-teste é adicionada a suspensão do microrganismo-teste em meio de cultura, a mistura é incubada em condições adequadas e o crescimento microbiano é medido através da leitura fotométrica. O emprego de método de microplacas com leitura cínética para a dosagem de antibióticos é de interesse considerável, uma vez que possibilita reduzir quantidade de material e tempo de análise necessários e permite o ensaio de grande número de amostras simultaneamente, com leitura e cálculo automatizados. O objetivo deste trabalho é determinar as condições experimentais ideais para o desenvolvimento de metodologia para a dosagem microbiológica de apramicina empregando microplacas e modo de leitura cinético, e validar o método desenvolvido, através da avaliação dos parâmetros de especificidade e seletividade, linearidade, faixa ou intervalo linear, limite de detecção e quantificação, exatidão e precisão. As condições estabelecidas abrangem curva-padrão de apramicina com concentrações entre 5 e 35 μg/ml, e emprego de meio de cultura caldo de triptona-soja inoculado com Escherichia coli (ATCC 8739) na proporção de 5%. Foram obtidos resultados satisfatórios após 2 horas de incubação. O método desenvolvido apresentou especificidade e seletividade adequadas, linearidade na faixa de 5 a 35 1.19/ml, limite de deteção e quantificação de 0,1 e 0,4 μg/ml, respectivamente, exatidão (recuperação = 98,5%) e precisao (DPR = 6,0%) satisfatórias. O ensaio em microplaca agrega características dos ensaios microbiológicos (avaliação da atividade do antibiótico frente a microrganismo-teste sensível) e físico-químicos (facilidade operacional e major rapidez na obtenção dos resultdos).

The turbidimetric assay principle is simple: the test-solution is added to a suspension of test-microorganism in culture media, the mixture is incubated in appropriate conditions and the microbial growth is measured by photometric reading. Microplate with kinetic reading mode employed in antibiotic assay is considerable interesting, once it allows reduction of material and analysis time and it permits that a great numbers of samples could be analyzed simultaneously, with automated reading and calculating. The aim of this work is to determinate best experimental conditions to development of methodology for microbiological assay of apramycin employing microplate and kinetic reading mode, and to validate the developed method, through evaluation of parameters of specificity and selectivity, linearity, linear range, limit of detection and quantification, accuracy and precision. Established conditions considered standard-curve of apramycin in concentrations from 5 to 35 μg/ml, and tryptic soy broth inoculated with 5% of Escherichia coli (ATCC 8739) suspension. Satisfactory results were obtained with 2 hours incubation. The developed method showed appropriate specificity and selectivity, linearity in the range from 5 to 35 μg/ml, limit of detection and quantification of 0,1 and 0,4 μg/ml, respectively, satisfactory accuracy (recuperation = 98,5%) and precision (RSD = 6,0%). Microplate assay considered characteristics of microbiological assay (evaluation of antibiotic activity against sensible test-microorganism) and physical-chemistry (operational facility and quicker results).

Sediment concentration and turbidity changes during culvert removals.

The concentrations of sediment and turbidity in stream water were monitored during culvert removals to determine the short term effects of road obliteration. Sediment concentration was measured at 11 stream crossings among two locations in Idaho and one in Washington. Sediment concentration immediately below the culvert outlet exceeded levels above the culvert outlet by at least three orders of magnitude at all stream crossings. Sediment yields ranged from 170 to less than 1kg in the 24-h period following culvert removal. Turbidity exceeded the regulatory limits during culvert removal at all locations monitored in this study and remained above the limits beyond the monitoring periods of 24h at four of the locations. Sediment concentrations 100m downstream of the culvert outlet were reduced by an order of magnitude, but did not change the turbidity values sufficiently to meet regulatory limits. Sediment concentrations an average of 810m downstream of the culvert outlet were similar to sediment concentrations above the culvert for the entire excavation period and turbidity regulations were met. Mitigation consisting of two straw bales placed in the stream caused a significant reduction in sediment yield from an average of 67kg to an average of 1.6kg.

Applications of turbidity monitoring to forest management in California.

Many California streams have been adversely affected by sedimentation caused by historic and current land uses, including timber harvesting. The impacts of timber harvesting and logging transportation systems on erosion and sediment delivery can be directly measured, modeled, or inferred from water quality measurements. California regulatory agencies, researchers, and land owners have adopted turbidity monitoring to determine effects of forest management practices on suspended sediment loads and water quality at watershed, project, and site scales. Watershed-scale trends in sediment discharge and responses to current forest practices may be estimated from data collected at automated sampling stations that measure turbidity, stream flow, suspended sediment concentrations, and other water quality parameters. Future results from these studies will provide a basis for assessing the effectiveness of modern forest practice regulations in protecting water quality. At the project scale, manual sampling of water column turbidity during high stream flow events within and downstream from active timber harvest plans can identify emerging sediment sources. Remedial actions can then be taken by managers to prevent or mitigate water quality impacts. At the site scale, manual turbidity sampling during storms or high stream flow events at sites located upstream and downstream from new, upgraded, or decommissioned stream crossings has proven to be a valuable way to determine whether measures taken to prevent post-construction erosion and sediment production are effective. Turbidity monitoring at the project and site scales is therefore an important tool for adaptive management. Uncertainty regarding the effects of current forest practices must be resolved through watershed-scale experiments. In the short term, this uncertainty will stimulate increased use of project and site-scale monitoring.

Determination of the optical properties of turbid media using relative interstitial radiance measurements: Monte Carlo study, experimental validation, and sensitivity analysis.

Interstitial quantification of the optical properties of tissue is important in biomedicine for both treatment planning of minimally invasive laser therapies and optical spectroscopic characterization of tissues, for example, prostate cancer. In a previous study, we analyzed a method first demonstrated by Dickey et al., [Phys. Med. Biol. 46, 2359 (2001)] to utilize relative interstitial steady-state radiance measurements for recovering the optical properties of turbid media. The uniqueness of point radiance measurements were demonstrated in a forward sense, and strategies were suggested for improving performance under noisy experimental conditions. In this work, we test our previous conclusions by fitting the P3 approximation for radiance to Monte Carlo predictions and experimental data in tissue-simulating phantoms. Fits are performed at: 1. a single sensor position (0.5 or 1 cm), 2. two sensor positions (0.5 and 1 cm), and 3. a single sensor position (0.5 or 1 cm) with input knowledge of the sample's effective attenuation coefficient. The results demonstrate that single sensor radiance measurements can be used to retrieve optical properties to within approximately 20%, provided the transport albedo is greater than approximately 0.9. Furthermore, compared to the single sensor fits, employing radiance data at two sensor positions did not significantly improve the accuracy of recovered optical properties. However, with knowledge of the effective attenuation coefficient of the medium, optical properties can be retrieved experimentally to within approximately 10% for an albedo greater or equal to 0.5.

Different accuracies of rapid enzyme-linked immunosorbent, turbidimetric, and agglutination D-dimer assays for thrombosis exclusion: impact on diagnostic work-ups of outpatients with suspected deep vein thrombosis and pulmonary embolism.

The requirement for a safe diagnostic strategy should be based on an overall posttest incidence of venous thromboembolism (VTE) of less than 1%, with a negative predictive value of more than 99 to 100% during 3-month follow-up. Compression ultrasonography (CUS) and spiral computed tomography (CT) currently are the methods of choice to confirm or rule out deep venous thrombosis (DVT) and pulmonary embolism (PE), respectively. CUS has a negative predictive value (NPV) of 97 to 98%, indicating the need to improve the diagnostic work-up of patients with suspected DVT by clinical score assessment and D-dimer testing. Spiral CT as a stand-alone method detects all clinically relevant PEs and a large number of alternative diagnoses. It rules out PE with a NPV of 98 to 99%. Spiral CT is expensive, emphasizing the need to improve the diagnostic work-up of patients with suspected PE by the use of clinical score assessment and D-dimer testing. Clinical score assessment for DVT and PE has not safely ruled out VTE in multicenter studies and in routine daily practices. Modification of the Wells clinical score assessment for DVT by elimination of the "minus 2 points" for alternative diagnosis will improve the reproducibility of the clinical score assessment. The combination of a first negative CUS and a negative SimpliRed or an enzyme-linked immunosorbent assay (ELISA) VIDAS D-dimer of < 1,000 ng/mL safely exclude DVT (NPV > 99%) irrespective of clinical score assessment and without the need to repeat CUS in approximately 60 to 70% of patients. The rapid quantitative and qualitative agglutination D-dimer assays for the exclusion of VTE are not sensitive enough as stand-alone tests and should be used in combination with clinical score assessment. A normal rapid ELISA VIDAS D-dimer test as a stand-alone test safely excludes DVT and PE, with a NPV of 99 to 100%, irrespective of clinical score, without the need of CUS or spiral CT. The combined strategy of a rapid ELISA VIDAS D-dimer followed by objective testing with CUS for DVT and by spiral CT for PE will reduce the need for noninvasive imaging techniques by 40 to 50%.

Detection of kappa and lambda light chain monoclonal proteins in human serum: automated immunoassay versus immunofixation electrophoresis.

Recently, turbidimetric immunoassays for detecting and quantifying kappa and lambda free light chains (FLC) have become available and are promoted as being more sensitive than immunofixation electrophoresis (IFE) in detecting FLC monoclonal proteins. In this study, we assessed the ability of these turbidimetric assays to detect serum monoclonal proteins involving both free and heavy-chain-bound kappa and lambda light chains compared to standard immunofixation electrophoresis. Sera demonstrating a restricted band of protein migration (other than a definite M spike) by serum protein electrophoresis (SPE), which may represent early monoclonal proteins, were also examined. When compared to IFE, percent agreement, sensitivity, and specificity for the kappa-FLC and lambda-FLC were 94.6, 72.9, and 99.5% and 98.5, 91.4, and 99.7%, respectively, in detecting monoclonal proteins involving free and heavy-chain-bound light chains. The majority of sera (73.7%) demonstrating a restricted band of protein migration on SPE demonstrated abnormal IFE patterns suggestive of multiple myeloma or monoclonal gammopathy of unknown significance, but gave normal kappa/lambda FLC ratios using the turbidimetric immunoassays. In conclusion, the kappa and lambda FLC assays are significantly less sensitive (72.9 to 91.4%) than IFE, but specific in detecting serum monoclonal proteins. Moreover, the kappa/lambda ratio has little value in routine screening since the majority of sera with abnormal IFE patterns had normal kappa/lambda FLC ratios.

Phase I of the Kissimmee River restoration project, Florida, USA: impacts of construction on water quality.

Phase I of the Kissimmee River restoration project included backfilling of 12 km of canal and restoring flow through 24 km of continuous river channel. We quantified the effects of construction activities on four water quality parameters (turbidity, total phosphorus flow-weighted concentration, total phosphorus load and dissolved oxygen concentration). Data were collected at stations upstream and downstream of the construction and at four stations within the construction zone to determine if canal backfilling and construction of 2.4 km of new river channel would negatively impact local and downstream water quality. Turbidity levels at the downstream station were elevated for approximately 2 weeks during the one and a half year construction period, but never exceeded the Florida Department of Environmental Protection construction permit criteria. Turbidity levels at stations within the construction zone were high at certain times. Flow-weighted concentration of total phosphorus at the downstream station was slightly higher than the upstream station during construction, but low discharge limited downstream transport of phosphorus. Total phosphorus loads at the upstream and downstream stations were similar and loading to Lake Okeechobee was not significantly affected by construction. Mean water column dissolved oxygen concentrations at all sampling stations were similar during construction.

Methodology evaluation of a new immunoturbidimetric method for measuring serum soluble transferrin receptor.

The value of soluble transferrin receptor (sTfR) detected in serum is closely related to erythroid TfR turnover rate. An increased erythropoietic activity causes an increase in the sTfR level. Therefore, it is a useful test for monitoring the erythropoiesis. In this study, a new immunoturbidimetric method for automated measurement of sTfR was evaluated for its performance characteristics. Imprecision studies on patients' sera with 1.01 mg/l and 2.94 mg/l concentrations yielded within-run CVs of 1.16% and 1.27%. Accuracy analysis of the test by using the low and high control kit sera with 1.45 mg/l and 5.41 mg/l concentrations were 89.06% and 95.41%, respectively. The evaluation was also performed in 60 individual pediatric subjects, 30 beta-thalassemia/HbE and 30 control pediatric subjects. There is a statistically significant difference of sTfR between both groups (p < 0.0005, 95% Cl = 9.457-14.124). Ninety-five percent of matched pediatric subjects had sTfR level < or = 2.670 mg/l and 93.33% of patients diagnosed beta-thalassemia/HbE had values > 2.670 mg/l. In conclusion, this immunoturbidimeteric test yields good laboratory performance characteristics in terms of precision and accuracy.

A fast and simple turbidimetric method for the determination of sulfate in sulfate-reducing bacterial cultures.

A standard turbidimetric assay for the determination of sulfate in water was modified with the objective of achieving a quick and simple method for monitoring the decrease of sulfate in cultures of sulfate-reducing bacteria. The effects of sulfate concentration, mixing time and the ratio of sample to conditioning reagent were optimized using a central composite face-centered response surface model design. The results suggested that a mixing time of 30 s resulted in smaller absorbance variance, the variance in absorbance measurements tended to increase with concentration of sulfate and that the ratio between the amount of conditioning reagent and sample had no significant influence on the absorbance variance. The modified assay thus developed is simple and quick, and covers a comparatively large sulfate concentration range (0-5 mM) compared to the standard turbidimetric assay.