Abstract:
:The NHS 'Choose Wisely' campaign places greater emphasis on the clinician-patient dialogue. Patients are often in receipt of their laboratory data and want to know whether they are normal. But what is meant by normal? Comparator data, to a measured value, are colloquially known as the 'normal range'. It is often assumed that a result outside this limit signals disease and a result within health. However, this range is correctly termed the 'reference interval'. The clinical risk from a measured value is continuous, not binary. The reference interval provides a point of reference against which to interpret an individual's results-rather than defining normality itself. This article discusses the theory of normality-and describes that it is relative and situational. The concept of normality being not an absolute state influenced the development of the reference interval. We conclude with suggestions to optimise the use and interpretation of the reference interval, thereby facilitating greater patient understanding.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Whyte MB,Kelly Pdoi
10.1136/postgradmedj-2018-135983subject
Has Abstractpub_date
2018-11-01 00:00:00pages
613-616issue
1117eissn
0032-5473issn
1469-0756pii
postgradmedj-2018-135983journal_volume
94pub_type
杂志文章abstract::Common bile duct perforation causing biliary peritonitis is an unusual entity and a pancreatic calculus causing this perforation is all the more rare, and to our knowledge has not been reported previously. Such an unusual presentation of chronic calcific pancreatitis is herein reported. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.804.837
更新日期:1992-10-01 00:00:00
abstract::Oral administration of 1 g of acetazolamide to 8 normal subjects studied at sea level and in normoxia caused an acute increase in cerebral blood flow (CBF). During the subsequent prolonged oral treatment with 1 g of acetazolamide daily, CBF returned to normal within 2 days. The alveolar CO2 tension decreased gradually...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.737.185
更新日期:1987-03-01 00:00:00
abstract::Six Arabs subjects (three postpubertal, two prepubertal and one pubertal) from three interrelated Omani families with male pseudohermaphroditism due to 5 alpha-reductase-2 deficiency were evaluated. These subjects had been raised as girls since birth as they were born with a clitoral-like phallus and ambiguous externa...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.866.802
更新日期:1997-12-01 00:00:00
abstract:OBJECTIVE:To assess parent preferences for utilisation of a parent-focused, telephone-based coaching service, or 'FITLINE,' to prevent or manage childhood obesity. METHODS:A cross-sectional survey of parents of children aged 2-12 years was conducted at a paediatric practice in Greater Boston, Massachusetts, USA, betwe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132928
更新日期:2015-04-01 00:00:00
abstract::During the course of an obscure illness in a teenage girl it was eventually realized that the diagnosis was 'epidemic neuromyasthenia'. The illness which occurred between February and September 1976 was characterized by fatigue, pallor, headache, nuchal pain, alterations in mentation, dizziness, nausea and vomiting, p...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.54.637.731
更新日期:1978-11-01 00:00:00
abstract::Twenty-four hour intragastric acidity was measured in nine volunteer subjects in a single-blind placebo-controlled cross-over study comparing the effects of famotidine with ranitidine. The volunteer subjects received famotidine (40 mg at night), famotidine (20 mg at night), ranitidine (300 mg at night) or placebo in a...
journal_title:Postgraduate medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1986-01-01 00:00:00
abstract::In a retrospective review of patients admitted to a coronary care unit, 809 patients had a definite myocardial infarction and plasma potassium was measured within 48 hr. The mean (+/- s.d.) plasma potassium was 4.04 (+/- 0.56) mmol/litre. A potassium concentration of less than 4.0 mmol/litre was found in 383 patients,...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.692.354
更新日期:1983-06-01 00:00:00
abstract::A study has been made in rodents of the interactions between a range of psychotropic drugs, narcotic agonist and partial agonist analgesics, and pain. In rodents, tricyclic antidepressants do not alone reduce pain responses but, in combination with morphine or pentazocine, clomipramine enhances analgesic activity afte...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:
更新日期:1980-01-01 00:00:00
abstract::A case of Peutz-Jeghers syndrome with polyps in the gall bladder is presented. No previous description of this finding has been reported. The literature regarding known sites of polyposis in this condition is reviewed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.56.655.373
更新日期:1980-05-01 00:00:00
abstract::Perforation of the gastrointestinal tract by ingested foreign bodies is rare; the diagnosis of pyogenic liver abscess resulting from such perforations is usually made at post-mortem. We present a case of perforation of the gut, due to an ingested dental plate, with a resultant pyogenic liver abscess, which presented a...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.59.693.455
更新日期:1983-07-01 00:00:00
abstract::Digital clubbing has been a well recognised feature of several distinct clinical conditions, including respiratory, cardiac, and gastrointestinal diseases since the Hippocratic era. However, clubbing associated with Behçet's disease has not been reported before. We describe a case of clubbing in a young man with Behçe...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.863.575
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Obesity has been declared a 21st century pandemic by WHO. Yet surveys reveal physicians-in-training are uncomfortable managing obesity. One major barrier is the lack of residency education on obesity management. This study incorporates an obesity-specific didactic curriculum into an internal medic...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2014-132821
更新日期:2014-11-01 00:00:00
abstract::A female patient demonstrating a previously not reported constellation of polyglandular autoimmune syndrome type III (including autoimmune thyroiditis, Graves' ophthalmopathy, insulin-dependent diabetes mellitus and vitiligo), coeliac disease and sarcoidosis is described. This may be a random association but might als...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.69.807.72
更新日期:1993-01-01 00:00:00
abstract::Coronary heart disease, especially when it affects younger individuals, tends to cluster in families. Known risk factors occur in 50-75% of patients with myocardial infarction. Yet commonly occurring risk factors are not strongly inherited, and the familial aggregation of coronary heart diseas may not be attributable ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.52.610.477
更新日期:1976-08-01 00:00:00
abstract::The healthcare industry has seen an increase in the adoption of team training, such as crew resource management (CRM), to improve teamwork and coordination within acute care medical teams. A meta-analysis was carried out in order to quantify the effects of CRM training on reactions, learning, behaviour and clinical ca...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,meta分析
doi:10.1136/postgradmedj-2014-132800
更新日期:2014-12-01 00:00:00
abstract::Renal disease in Churg-Strauss syndrome is generally thought to be benign in nature, thereby distinguishing this rare condition from other necrotizing vasculitides. We report a case in which acute renal failure developed during the aggressive vasculitic phase of the illness requiring dialysis therapy. After one week o...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.64.755.713
更新日期:1988-09-01 00:00:00
abstract::A high proportion (40%) of patients with definite myocardial ischaemia who were questioned on admission to a Cardiac Monitoring Unit had experienced preceding chest pain which had been misinterpreted by both the patients themselves and doctors as 'indigestion' and which had often been inappropriately treated. 'Indiges...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.60.703.338
更新日期:1984-05-01 00:00:00
abstract::Healthcare workers have a high risk of occupational exposure, more so in developing countries, with high incidence of blood borne diseases and prevalence of unsafe practices. Among the various blood borne diseases, the most common and important ones are HIV infection, hepatitis B, and hepatitis C. Most of the occupati...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pmj.79.932.324
更新日期:2003-06-01 00:00:00
abstract::A patient suffering from typhoid fever with severe pancytopenia is presented. Bone marrow examination revealed extensive haemophagocytosis which possibly contributed to the pancytopenia. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.73.855.41
更新日期:1997-01-01 00:00:00
abstract::The clinical features, treatment and survival of 36 patients with microscopic polyarteritis diagnosed between 1957-1988 have been reviewed. All had a focal segmental necrotizing glomerulonephritis on renal biopsy with evidence of a small vessel vasculitis. Most had a prodromal illness of less than 1 month. Severity of...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.65.766.515
更新日期:1989-08-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.63.736.135
更新日期:1987-02-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pmj.78.923.559
更新日期:2002-09-01 00:00:00
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journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/postgradmedj-2015-133805
更新日期:2016-11-01 00:00:00
abstract::Relatively simple and rapid procedures have been developed for evaluating the local efficacy of vaginal antifungal agents in vivo in a vaginal candidiasis model in ovariectomized rats. The results of this investigation indicate that the model and methods described are quite suitable for screening potential antifungal ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.55.647.648
更新日期:1979-09-01 00:00:00
abstract::Greater trochanteric pain syndrome (GTPS) is a commonly diagnosed regional pain syndrome with a wide spectrum of aetiologies, reflecting the anatomy of the structures outside the hip joint capsule. There are five muscle tendons that insert on to the greater trochanter and three bursae in the region of the greater troc...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/postgradmedj-2013-131828
更新日期:2014-10-01 00:00:00
abstract::Despite the remarkable advances in cardiovascular therapeutics over the past four decades, little impact has been made on either the incidence or mortality rate of congestive heart failure and it remains a major clinical and public health problem. Recent practice audits have suggested that proven efficacious therapies...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.73.858.194
更新日期:1997-04-01 00:00:00
abstract::Prognostication of newly diagnosed colorectal cancer (CRC) predominantly relies on stage as defined by the UICC-TNM and American Joint Committee on Cancer classifications. Tumour extent, lymph node status, tumour grade and the assessment of lymphatic and venous invasion are still the most important morphological progn...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/jcp.2007.054858
更新日期:2008-08-01 00:00:00
abstract::We report a case of adult pyloric obstruction caused by the delayed presentation of a congenital gastric diverticulum. The derivation, classification and treatment of these abnormalities are discussed. ...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.68.798.296
更新日期:1992-04-01 00:00:00
abstract::Although many of the fundamental biological features of toxoplasmosis are today well appreciated, the practical problem of prevention of its most serious consequence--disabling congenital disease, remains unsolved. The reasons vary in different communities, but are concerned with detection of the chief mode of spread,...
journal_title:Postgraduate medical journal
pub_type: 杂志文章
doi:10.1136/pgmj.53.624.614
更新日期:1977-10-01 00:00:00
abstract::Stroke is the third most common cause of death in developed countries. In England and Wales, 1000 people under the age of 30 have a stroke each year. Cocaine is the most commonly used class A drug, and the first report of cocaine-induced stroke was in 1977. Since the development of alkaloidal "crack" cocaine in the 19...
journal_title:Postgraduate medical journal
pub_type: 杂志文章,评审
doi:10.1136/pgmj.2006.055970
更新日期:2007-06-01 00:00:00