Abstract:
BACKGROUND:To investigate the reasons why general practitioners (GPs) request rheumatoid factor (RF) assays, we studied 200 consecutive requests for RF from general practice in 1995. METHOD:By means of an audit questionnaire, we studied 100 negative, 50 positive and 50 borderline RF results and compared these with the presenting symptoms that prompted the request, the GPs' understanding of the significance of the result, the referral intention and behaviour of the GP, and finally, the patient outcome after 5 years. RESULTS:There was an 80% response rate. The presenting symptoms closely matched the American Rheumatism Association revised criteria for the classification of rheumatoid arthritis, indicating that the requests were made on valid clinical grounds, with polyarthralgia, morning stiffness and joint pain being the most common. Most GPs considered a negative or positive result to be meaningful, in that a positive RF meant that a referral was more likely than with a negative or borderline result, even in the presence of appropriate symptoms in all three groups. Seventeen to thirty per cent felt that the test excluded or confirmed RA. The result appeared to influence this decision to a greater extent than it should. A 5-year follow-up on these patients showed that 26/40 patients with positive RF were referred, and that 25 of them developed a rheumatic disease of some kind, with 17 patients eventually being diagnosed with RA. Only 17/80 patients with negative RF were referred, the remainder having no autoimmune problem evident after 5 years, 11 of them developing a rheumatic disease, and only three being diagnosed with RA. CONCLUSIONS:Although this is a locally based study, we believe the conclusions would be applicable to all laboratories and GPs undertaking these tests. RF requests are made on valid clinical grounds by GPs, but there may be an over-reliance on the results as regards referral behaviour. If patients were referred on clinical grounds, this would significantly lengthen consultants' waiting lists.
journal_name
Ann Clin Biochemjournal_title
Annals of clinical biochemistryauthors
Sinclair D,Hull RGdoi
10.1258/000456303763046049subject
Has Abstractpub_date
2003-03-01 00:00:00pages
131-7issue
Pt 2eissn
0004-5632issn
1758-1001journal_volume
40pub_type
杂志文章abstract::γ-glutamyltransferase plays a key role in the synthesis and metabolism of extracellular glutathione, a major antioxidant in several defence mechanisms in the body. γ-glutamyltransferase is affected by environmental and genetic factors, and is raised when there is depletion of glutathione. Hence, it is a marker of oxid...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
doi:10.1177/0004563215597010
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:LC-MS/MS is rapidly becoming the technology of choice for measuring steroid hormones. We have developed a rapid LC-MS/MS assay for the routine analysis of serum cortisol. We have used this assay to investigate the effects of gender and exogenous steroid interference on the immunoassay measurement of serum co...
journal_title:Annals of clinical biochemistry
pub_type: 临床试验,杂志文章
doi:10.1177/0004563212473448
更新日期:2013-07-01 00:00:00
abstract:BACKGROUND AND METHODS:We report a case of insulinoma in which the diagnosis was very challenging as some of the biochemical data were consistently equivocal. In order to assess the relative reliability of the analytical tests, retrospective biochemical data on 45 other cases of histologically confirmed insulinoma were...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/000456303770367315
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abstract::An automated assay for serum amylase is described. Using the AutoAnalyzer II the method employs, as substrate, a solution of dyed amylopectin which is commercially available (DyAmyl-L). After incubation of serum and substrate at 55 degrees C, 1.0 mol/lKOH is introduced and the coloured products of enzymic hydrolysis a...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/000456327701400190
更新日期:1977-11-01 00:00:00
abstract::The diagnostic usefulness of fasting total serum bile acids (SBA/F) in the detection of liver diseases and assessment of different aspects of hepatic function alteration was evaluated in 61 healthy subjects and 186 patients with liver disease. The value of SBA/F was compared with other routine tests. In 49 healthy sub...
journal_title:Annals of clinical biochemistry
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abstract:BACKGROUND:Urinary excretion of the low molecular weight protein cystatin C is a marker of renal disorders and a good predictor of the severity of acute tubular necrosis. We evaluated the measurement of urinary cystatin C and determined its reference range. METHODS:Measurement of urinary cystatin C by particle-enhance...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/000456304322879980
更新日期:2004-03-01 00:00:00
abstract:BACKGROUND:Pregnancy represents a major risk factor for deep vein thrombosis (DVT). Most coagulation/fibrinolysis markers currently utilized change during pregnancy, and therefore they cannot accurately evaluate thrombotic events in pregnancy because the rate of false positive results is high. Fibrin monomer complex (F...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/000456307781646076
更新日期:2007-09-01 00:00:00
abstract::Iron status is influenced by inflammation when the normal control of iron metabolism is reorganized by the primary mediators of the acute phase response, tumour necrosis factor-alpha and interleukin-1. The objective of this review is to show how indices of iron status, particularly haemoglobin, serum ferritin and solu...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
doi:10.1258/acb.2007.007167
更新日期:2008-01-01 00:00:00
abstract:BACKGROUND:We evaluated the diagnostic discrimination of a new micro-flow cell device (Nanoduct) which measures sweat conductivity in situ at a regional referral centre for cystic fibrosis (CF). METHODS:The device was evaluated in comparison to the measurement of sweat chloride with the established quantitative piloca...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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abstract:BACKGROUND:Serum ornithine carbamoyltransferase is a diagnostic marker of hepatic disorders due to its localization in periportal mitochondria. METHODS:We have developed a new method for the determination of serum ornithine carbamoyltransferase. It is based on the reverse reaction of ornithine carbamoyltransferase, us...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:2003-05-01 00:00:00
abstract::It is crucially important to detect subarachnoid haemorrhage (SAH) in all patients in whom it has occurred to select patients for angiography and preventative surgery. A computerized tomography (CT) scan is positive in up to 98% of patients with SAH presenting within 12 h, but is positive in only 50% of those presenti...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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abstract::In the last few years, the use of enzyme labels in immunoassays has been investigated. The aim of this review is to evaluate critically the role of such labels in clinical biochemistry. Special attention has been given to the problems involved in preparing enzyme labels and the ways in which such labels can be used in...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
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更新日期:1979-09-01 00:00:00
abstract:BACKGROUND:The stability of parathyroid hormone (PTH) in whole blood has not been well characterized. Previous studies show EDTA plasma samples to be more stable than serum samples. METHODS:Blood from 17 haemodialysis patients and five healthy volunteers was collected into serum separator tubes (SSTs) and potassium ED...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/000456307780480927
更新日期:2007-05-01 00:00:00
abstract::We report the case of a 78-year-old patient with late diagnosis of hyperoxaluria type III (PH3). He developed renal failure after nephrectomy for clear cell papillary renal carcinoma and complained of recurrent urolithiasis for some 30 years, whose aetiology was never identified. Biochemical laboratory investigations ...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Oxidative stress may play an aetiological role in the development and progression of cardiovascular disease (CVD). However, evidence on its biochemical markers has been controversial. This article aimed to assess the role of F2-isoprostanes, a marker for measuring in vivo lipid oxidation, as a biomarker for ...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
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abstract:BACKGROUND:Serum triglyceride concentrations are measured as total glycerides content in many Western countries. In Japan, glycerol-blanked triglycerides (TG-GB) are measured to identify postprandial hypertriglyceridaemia and to minimize the influence of glycerol formulation on serum triglyceride values. However, TG-GB...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1177/0004563215617782
更新日期:2016-09-01 00:00:00
abstract::The ischaemic lactate-ammonia test is widely used for investigating patients with muscle pain and fatigue. It involves measuring plasma lactate and ammonia produced as a result of forearm exercise under ischaemic conditions in a fasted subject. Its clinical use is to screen patients with muscle complaints for disorder...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
doi:10.1258/0004563011900786
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journal_title:Annals of clinical biochemistry
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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abstract::Gestational diabetes is a common pregnancy disorder which is generally managed with diet, exercise, metformin or insulin treatment and which usually resolves after delivery of the infant. Identifying and treating gestational diabetes improves maternal and fetal outcomes and allows for health promotion to reduce the mo...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
doi:10.1177/0004563216674743
更新日期:2017-01-01 00:00:00
abstract::A real time data processing system for a group of three clinical chemistry laboratories (one base and two satellite) has been developed as a successor to one used previously. This paper describes both the inadequacies of the previous worksheet-based system and the advantages of the new system, including flexibility, f...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:1979-01-01 00:00:00
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,meta分析
doi:10.1258/acb.2008.008168
更新日期:2009-01-01 00:00:00
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章,评审
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更新日期:2013-07-01 00:00:00
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:2010-09-01 00:00:00
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journal_title:Annals of clinical biochemistry
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journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
doi:10.1258/acb.2012.011279
更新日期:2012-11-01 00:00:00
abstract::In a group of 121 adult patients with end-stage chronic renal failure who had been undergoing maintenance haemodialysis for up to 10 years a number of biochemical variables have been measured and related to a set of objective radiological changes in the same patients. The changes in plasma calcium, magnesium, phosphat...
journal_title:Annals of clinical biochemistry
pub_type: 杂志文章
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更新日期:1975-05-01 00:00:00