Comparative analysis of high CRP-levels in human blood using point-of-care and laboratory-based methods.

OBJECTIVES: The use of point-of-care (POC) methods and the measurements of C-reactive protein (CRP) as a diagnostic marker have both increased over the past years. This has led to an increase in POC-methods analysing CRP. High CRP levels are often seen as an indication for the subscription of antibiotics. The quality of POC-systems compared to routine diagnostic measurements for the analysis of CRP is thereby of main importance, since many small practises will use POC-methods. This study compared high-level CRP concentrations (above 100 mg/L) using an i-CHROMATM with 2 routinely used laboratory-based systems (Architect and ABX). DESIGN: and Methods: A total of 199 patient samples with a CRP concentration above 100 mg/L were analysed with the i-CHROMATM POC system and the turbidimetric routine methods using the Architect and ABX equipment. RESULTS: The results of the i-CHROMATM device showed a significant decrease in the CRP levels compared to those obtained with the Architect and the ABX (i-CHROMATM vs. Architect: y â€‹= â€‹0.6792x + 94.701; R2 = 0.4980, i-CHROMATM vs. ABX: y â€‹= â€‹0.3674x + 118.05; R2 â€‹= â€‹0.3964, Architect vs. ABX: y â€‹= â€‹0.7657x + 36.337; R2 = 0.9311). Furthermore, data analysis showed a partition of the i-CHROMATM measurements in two defined clouds, which could not be explained with any of the available sample information. CONCLUSIONS: This analysis showed the limitations of the i-CHROMATM CRP analyser. In addition, it illustrates the need for strict regulations on the information and output provided by companies regarding the boundaries of novel and existing diagnostic methods.

Evaluation of reference intervals of haematological and biochemical markers in an Austrian adolescent study cohort.

Background Reference intervals are a prerequisite for the interpretation of laboratory data related to diagnostic issues and treatment strategies. In adolescents, biomarker concentrations change with age, necessitating a continuous age-related definition of the reference intervals. The purpose of this pilot study was to evaluate the reference intervals for a healthy population of adolescents in Salzburg and compare these, when possible, with age- and gender-matched published data. Methods Anthropometrical parameters and blood samples were collected from adolescents (male and female; 14-17 years) in a school setting. Haematological samples were measured using Sysmex XS-1000i, lipid and carbohydrate metabolism markers as well as enzymes and hormones were determined by Cobas c311, Vitros ECiQ® or ELISA. The reference intervals were calculated according to the CLSI guidelines C28-A3c. Results Samples of 102 participants were included. Compared to age- and gender-matched reference intervals, the BMI levels were in the lower normal rage. Most haematological parameters and biomedical makers reveal similar ranges to values published in other studies. Conclusions This data analysis allowed for a partial comparison of reference values with published data and enabled a new determination of paediatric reference intervals for an Austrian cohort.

Qualitative study of patients' decision-making when accepting second-line treatment after failure of first-line chemotherapy.

OBJECTIVE: Treatment failures in advanced lung cancer are frequent events affecting patients during or after first-line chemotherapy. International guidelines recommend second-line chemotherapy. However, around one half of patients who experience disease progression enter a systemic second-line therapy. In the herein qualitative study, we investigated patients' thoughts and attitudes determining the decision to undergo a second-line chemotherapy. METHODS: Thirty-three purposively selected patients who recently accepted second-line or palliative chemotherapy were invited to participate in this survey consisting of semi-structured in-depth interviews. Grounded theory was applied to investigate participants' perceptions of the context that have surrounded their decision to undergo palliative chemotherapy. RESULTS: For most patients, tumor burden and reduced quality of life in relation with lung cancer itself were major drivers of the decision-making process. There was a balance between two different attitudes: making a decision to undergo a new line of chemotherapy or starting a psychological process in order to accept end of life. Choosing between these two attitudes allowed the patient to keep the matter of palliative care at a distance. Even in case of low chance of success, many patients who worried about their life partner's future would accept a new chemotherapy line. Some patients experienced ambivalent thoughts regarding social network, particularly about their family as daily function impairment required an increased need for relative's support. The initial "Worrying about others" thoughts left place to in an increasing self-need of care as those provided by relatives; this phenomenon might increase patients' self- perception of being a burden for others. Confidence previously established with formal caregiver support was another major decision driver: some patients with sustained confidence in their medical staff may have privileged this formal support rather than family support when the latter was perceived as weak, insufficient or intrusive. CONCLUSION: This study identified three domains involved into a complex interplay for lung cancer patients' decision regarding second-line palliative chemotherapy: (i) perception of the definitive loss of health, (ii) interactions between idiosyncrasy (hope, disease burden) and environment (healthcare and social network support), and (iii) patient's subjective evaluation of chemotherapy benefit-risk.

How Preconceptions About Lung Cancer Treatment Interact With Medical Discourse for Patients Who Accept Chemotherapy?

OBJECTIVE: Chemotherapy is widely prescribed for lung cancer with palliation as primary end point. This study aimed at determining how preconceptions about lung cancer and its treatment interact with medical discourse into acceptance of chemotherapy. METHODS: Twenty-three purposively selected patients who recently accepted chemotherapy were invited to participate in this survey consisting of semi-structured in-depth interviews. Grounded theory was applied to investigate participants' perceptions of the context that have surrounded their decision to undergo chemotherapy. RESULTS: Major drivers of social representation of illness were linked with stigma. Participants also evoked the disease itself as a stereotype representation of incurable disease. Significant others' experiences were major components of participants' knowledge of chemotherapy. Searching for information regarding lung cancer actively confronted participants with the disease and its prognosis. However, the searching process was self-limited because of the poor prognosis of the disease, insofar as complete information would have precluded from any hope. We therefore identified 3 domains that provide insights into the participant's views and attitude toward chemotherapy: (i) synthesizing preconceptions of disease and chemotherapy with personal medical case; (ii) slowly constructing complex knowledge of cancer and treatment; and (iii) accepting chemotherapy as a surrogate for acknowledging incurable disease. CONCLUSION: Patients have preconceptions about chemotherapy that result from complex features involving social perception, stigma, and significant others' experiences. In this context, developing a personal knowledge about lung cancer and its treatment is a slow construction. This process needs time to be explained and reformulated, so that patients might give their informed consent.

The C. elegans rab family: identification, classification and toolkit construction.

Rab monomeric GTPases regulate specific aspects of vesicle transport in eukaryotes including coat recruitment, uncoating, fission, motility, target selection and fusion. Moreover, individual Rab proteins function at specific sites within the cell, for example the ER, golgi and early endosome. Importantly, the localization and function of individual Rab subfamily members are often conserved underscoring the significant contributions that model organisms such as Caenorhabditis elegans can make towards a better understanding of human disease caused by Rab and vesicle trafficking malfunction. With this in mind, a bioinformatics approach was first taken to identify and classify the complete C. elegans Rab family placing individual Rabs into specific subfamilies based on molecular phylogenetics. For genes that were difficult to classify by sequence similarity alone, we did a comparative analysis of intron position among specific subfamilies from yeast to humans. This two-pronged approach allowed the classification of 30 out of 31 C. elegans Rab proteins identified here including Rab31/Rab50, a likely member of the last eukaryotic common ancestor (LECA). Second, a molecular toolset was created to facilitate research on biological processes that involve Rab proteins. Specifically, we used Gateway-compatible C. elegans ORFeome clones as starting material to create 44 full-length, sequence-verified, dominant-negative (DN) and constitutive active (CA) rab open reading frames (ORFs). Development of this toolset provided independent research projects for students enrolled in a research-based molecular techniques course at California State University, East Bay (CSUEB).