Abstract:
AIM:To determine the reliability of international normalised ratio (INR) measurement in primary care by practice nurses using near patient testing (NPT), in comparison with results obtained within hospital laboratories by varied methods. METHODS:As part of an MRC funded study into primary care oral anticoagulation management, INR measurements obtained in general practice were validated against values on the same samples obtained in hospital laboratories. A prospective comparative trial was undertaken between three hospital laboratories and nine general practices. All patients attending general practice based anticoagulant clinics had parallel INR estimations performed in general practice and in a hospital laboratory. RESULTS:405 tests were performed. Comparison between results obtained in the practices and those in the reference hospital laboratory (gold standard), which used the same method of testing for INR, showed a correlation coefficient of 0.96. Correlation coefficients comparing the results with the various standard laboratory techniques ranged from 0.86 to 0.92. It was estimated that up to 53% of tests would have resulted in clinically significant differences (change in warfarin dose) depending upon the site and method of testing. The practice derived results showed a positive bias ranging from 0.28 to 1.55, depending upon the site and method of testing. CONCLUSIONS:No technical problems associated with INR testing within primary care were uncovered. Discrepant INR results are as problematic in hospital settings as they are in primary care. These data highlight the failings of the INR to standardise when different techniques and reagents are used, an issue which needs to be resolved. For primary care to become more involved in therapeutic oral anticoagulation monitoring, close links are needed between hospital laboratories and practices, particularly with regard to training and quality assurance.
journal_name
J Clin Patholjournal_title
Journal of clinical pathologyauthors
Hobbs FD,Fitzmaurice DA,Murray ET,Holder R,Rose PE,Roper JLdoi
10.1136/jcp.52.7.494keywords:
subject
Has Abstractpub_date
1999-07-01 00:00:00pages
494-7issue
7eissn
0021-9746issn
1472-4146journal_volume
52pub_type
杂志文章abstract::Only four cases of tracheopathia osteoplastica have been reported in Britain in the past 110 years. Ten further cases are now reported; in two the diagnosis was made at bronchoscopy. It is suggested that the reputed rarity of the condition in Britain is not the whole picture. ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.20.6.814
更新日期:1967-11-01 00:00:00
abstract::Tumour tissue from 29 patients with primary brain lymphoma was reviewed to determine if there was an aetiological association between Epstein-Barr virus and polyclonal and monoclonal lymphoproliferations. The morphology and immunophenotype in 24 patients for whom paraffin wax embedded tissue was available were studied...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.43.3.220
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND:An increased level of serum C-reactive protein (CRP) is a known prognostic factor for acute coronary events and sudden cardiac death, and it is associated with coronary calcification. CRP is expressed in coronary arteries, but its role in the development of coronary plaques is unclear. AIM:To investigate CR...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2006.038729
更新日期:2007-05-01 00:00:00
abstract::An antibody was raised against a protein isolated from the cytoplasm of mesothelioma cells. It was subsequently used in an immunoperoxidase procedure on formalin fixed, paraffin embedded tissue sections. A representative sample of benign and malignant tumours from all the systems of the human body was examined. All th...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.39.9.961
更新日期:1986-09-01 00:00:00
abstract::Assessment of ERBB2 (HER2) status in breast carcinomas has become critical in determining response to the humanised monoclonal antibody trastuzumab. The current joint College of American Pathologists and the American Society of Clinical Oncology guidelines for the evaluation of HER2 status in breast carcinoma involve ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1136/jcp.2009.062760
更新日期:2010-03-01 00:00:00
abstract::In studies using indirect immunofluorescence IgG antibodies to Clostridium perfringens were found in sera from healthy adults. Sera from 236 healthy children were examined. The normally occurring IgG antibodies to C perfringens were found to have an age related variation. Preliminary data suggest that they are not cor...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.40.3.282
更新日期:1987-03-01 00:00:00
abstract::The usefulness of placental alkaline phosphatase (PLAP) as a diagnostic marker of malignancy was assessed in pleural fluid from 60 patients with effusions. Pleural fluid PLAP activities were measured by an enzyme linked immunoassay (ELISA) using the two monoclonal antibodies H17E2 and H317. Similar values were found i...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.45.12.1114
更新日期:1992-12-01 00:00:00
abstract::Pathological findings are described in four cases of a new aminoaciduria in which homocystine is excreted in the urine. All the patients were mentally retarded children. Three of them presented diagnostic features of Marfan's syndrome. Necropsy on one case and biopsy findings in the others are described. Fatty change ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.17.4.427
更新日期:1964-07-01 00:00:00
abstract::The PAS and acid phosphatase reactions showed a different pattern of positivity in the cells of lymphoproliferative disorders according to their B or T cell nature. In B-cell leukaemias (chronic lymphocytic and prolymphocytic) a low proportion of lymphocytes gave a positive result with the acid phosphatase reaction, w...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.27.10.767
更新日期:1974-10-01 00:00:00
abstract::Histological assessment of melanocytic naevi constitutes a substantial proportion of a dermatopathologist's daily workload. Although they may be excised for cosmetic reasons, most lesions encountered are clinically atypical and are biopsied or excised to exclude melanoma. Although dysplastic naevi are most often encou...
journal_title:Journal of clinical pathology
pub_type: 杂志文章,评审
doi:10.1136/jcp.2003.008516
更新日期:2004-11-01 00:00:00
abstract::The immunofluorescent examination of nasopharyngeal secretions has been compared with conventional cell culture for the diagnosis of respiratory syncytial (RS) virus infection in children under the age of 2 years in Newcastle upon Tyne and Manchester. Two hundred and sixty-eight identifications of RS virus were made b...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.24.4.308
更新日期:1971-05-01 00:00:00
abstract::An outbreak of rotavirus infection in elderly patients in a long-stay ward of a geriatric hospital is described. Virus was detected in 7/15 (47%) symptomatic individuals. Four members of staff were among those affected. The findings emphasise the need for electron microscopy to be used in the initial investigation of ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.33.3.306
更新日期:1980-03-01 00:00:00
abstract:BACKGROUND:For breast and prostate cancer, a gene expression signature of the tumour is associated with the development of distant metastases. Regarding head and neck squamous cell carcinoma (HNSCC), the only known risk factor is the presence of > or =3 tumour-positive lymph nodes. AIM:To evaluate whether a HNSCC gene...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2005.035451
更新日期:2006-12-01 00:00:00
abstract::Two newborn babies with an intact atrial septum are described. In one, the two components of the atrial septum appeared to have become fused after relatively normal initial development; the left side of this heart was hypoplastic. In the other baby the formation of the atrial septum appeared to have been completely an...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.19.6.549
更新日期:1966-11-01 00:00:00
abstract:AIMS:To assess the frequency and cause of incidental (non-metastatic) lymph node pathology discovered before or at radical prostatectomy. METHODS:Eight hundred and fifty four consecutive lymphadenectomies received between 1988 and 2001 were reviewed. All had been processed and stained routinely. Additional techniques,...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.55.8.623
更新日期:2002-08-01 00:00:00
abstract::The urinary excretion of the renal proximal tubular enzyme, gamma-glutamyltransferase (gamma-GT), has been studied in 41 patients receiving tobramycin, gentamicin or streptomycin for a variety of infections. All patients receiving tobramycin or gentamicin have shown increased excretion of gamma-GT in the urine. Only 4...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.30.5.432
更新日期:1977-05-01 00:00:00
abstract::Staphylococcus aureus isolated between 1967 and 1975 from the nose and skin lesions of patients in dermatology wards and from the burns of patients in a burns unit in Birmingham showed a high incidence of multiple antibiotic-resistant strains in both environments. Over 20% of the strains isolated from patients on admi...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.30.1.40
更新日期:1977-01-01 00:00:00
abstract::The mean areas of lymphoid follicles have been determined in 20 specimens of malignant follicular (centrocytic-centroblastic) lymphoma, 15 specimens of reactive follicular hyperplasia and 10 palatine tonsils. In all of the benign specimens and whenever possible for those showing malignancy, the areas of both the whole...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.36.9.1055
更新日期:1983-09-01 00:00:00
abstract::The arrangement of the T cell receptor and immunoglobulin genes was analysed in lymphoid tissue biopsy specimens from 25 cases of angioimmunoblastic lymphadenopathy. Nineteen cases showed a rearrangement of the gene coding for the beta chain of the T cell receptor, and in one case a clonal rearrangement of immunoglobu...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.39.11.1229
更新日期:1986-11-01 00:00:00
abstract:AIMS:To develop a specific radioimmunoassay for the routine determination of serum vitamin B12. METHODS:Antisera were raised in rabbits by immunisation with the monocarboxylic acid derivative of cyanocobalamin coupled to human serum albumin. Antibody titres and affinities were determined and the antiserum giving the h...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.45.4.328
更新日期:1992-04-01 00:00:00
abstract::Two hundred and forty-seven strains of micro-organisms were isolated from the urinary tract of 121 patients with neurological complaints leading to paraplegia. The commonest infecting organism was E. coli and the commonest type of Proteus was P. mirabilis. Infections with more than one type of organism were present in...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.13.1.54
更新日期:1960-01-01 00:00:00
abstract:INTRODUCTION:Cellular blue naevi (CBN) measure 1-2 cm in diameter and affect the dermis, occasionally extending into the subcutaneous fat. The case of a 14-year-old boy with a giant CBN (GCBN) involving the right half of the face, the jugal mucosa and the lower eyelid with a tumour that had infiltrated the bone and the...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2005.029488
更新日期:2007-01-01 00:00:00
abstract::Human epidermal growth factor receptor 2 (HER2) testing is required for newly diagnosed breast cancer and advised for recurrent and metastatic breast cancer, to determine treatment planning using HER2-directed therapy in the neoadjuvant, adjuvant and advanced disease settings. Wide variation, nationally, in the turnar...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jclinpath-2013-201819
更新日期:2014-02-01 00:00:00
abstract::Microsatellite instability (MSI) testing is tricky in gynaecological cancers (GC). Thus, we aimed to describe the instability patterns to improve MSI test interpretation in sporadic and hereditary GCs. Ninety-five cases, including uterine and ovarian cancers, with known genetic and immunohistochemical (IHC) features, ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jclinpath-2017-204348
更新日期:2017-09-01 00:00:00
abstract::Incomplete expression of human haemoglobin beta-chains at birth may lead to difficulty in the early demonstration of an inherited beta-chain variant. In this case, the rare unstable variant, Hb Tacoma beta30 (B12) arg leads to ser, although not present in cord blood in sufficient amounts to be easily detected by routi...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.31.9.883
更新日期:1978-09-01 00:00:00
abstract:AIM:To assess the reliability of local international normalised ratios (INR) using a set of three international reference preparation (IRP) certified freeze dried plasmas. METHODS:55 centres in the United Kingdom and the Republic of Ireland participated; 36 centres employed coagulometers and 19 a manual prothrombin ti...
journal_title:Journal of clinical pathology
pub_type: 杂志文章,多中心研究
doi:10.1136/jcp.51.5.356
更新日期:1998-05-01 00:00:00
abstract::A study has been made of 523 strains of staphylococci on the basis of biological properties, phage typing, and serology. The value of serology in the identification of pathogenic staphylococci has been assessed. ...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.23.4.370
更新日期:1970-05-01 00:00:00
abstract:BACKGROUND:Parathyroid hormone (PTH) is important in the evaluation of patients with calcium metabolism disorders and/or chronic renal disease. AIMS:To assess the differences between serum and plasma PTH measurements using the Advia Centaur. METHODS:Twenty six paired serum and edetate samples from patients with chron...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2004.022186
更新日期:2005-09-01 00:00:00
abstract::The effect of temperature, time of storage, and presence of air bubbles in specimens for blood gas analysis was studied. The results show that air bubbles in a 10% proportion are undesirable because of significant elevation in the PO2, and the storage of anaerobic blood samples at room temperature (25 degrees C) is ac...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.33.9.864
更新日期:1980-09-01 00:00:00
abstract:AIMS:To determine the sensitivity and specificity of a multiplex PCR assay for the contemporary identification of major species involved in oral candidiasis, without extraction and purification of DNA from the samples under investigation; and evaluation of this method in comparison with routine phenotypic culture ident...
journal_title:Journal of clinical pathology
pub_type: 杂志文章
doi:10.1136/jcp.2006.040782
更新日期:2007-09-01 00:00:00