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Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 50-57). Also available on the Internet.

Thesis (Ph. D.)--University of Missouri-Columbia, 1997. / Typescript. Vita. Includes bibliographical references (leaves 50-57). Also available on the Internet.

Thesis (Ph. D.)--Illinois State University, 1973. / Title from title page screen, viewed Oct. 14, 2004. Dissertation Committee: William L. Daniel (chair), Herman E. Brockman, David F. Weber, Arlan Richardson, Howard Hetzel. Includes bibliographical references (leaves 53-66) and abstract. Also available in print.

Class of 2015 Abstract / Objectives: The primary objective of the study was to evaluate for change in vitamin D levels and regimens in cystic fibrosis (CF) patients following implementation of the 2012 Cystic Fibrosis Foundation (CFF) vitamin D guidelines. Secondary endpoints included clinician adherence to guideline recommendations for treatment and management of vitamin D deficiency. Methods: This retrospective chart review included CF patients with 25-hydroxy vitamin D (25(OH)D) levels from University of Arizona Medical Center (UAMC) between April 1, 2011-March 31, 2012 and July 1, 2012-June 30, 2013. Total 25(OH)D levels and vitamin D regimens were collected along with data on respiratory cultures, pulmonary function, and hospitalizations. Data were analyzed by Student’s T-tests and chi square analyses. Results: A total of 62 patients were included in the study. Mean 25(OH)D levels did not significantly differ between the study periods (28.9±10.5 ng/mL pre-guideline and 27.0±9.1 ng/mL post-guideline, p=0.158). Cholecalciferol use increased post-guideline (57.1%) versus pre-guideline (75.8%, p=0.027). Post-guideline cholecalciferol doses increased to 2836.5±2669.4 international units [IU] daily compared to 1518.0±912.0 IU daily pre-guideline (p<0.001). Clinician adherence to dose titration recommendations resulted in significant 25(OH)D level elevations (28.3±8.9 ng/mL versus 24.7±9.0, p=0.047). Conclusions: The prescribing pattern of clinicians significantly changed to reflect vitamin D regimens suggested by CFF guidelines. This finding suggests that had sufficient time been allowed following guideline implementation, a significant difference in 25(OH)D levels would have resulted. Additional research is needed concerning the effect of the guidelines on vitamin D status, clinical outcomes, and comorbidities.

Following reports by Shapira et al. that α₂Macro-globulin (α₂M) is abnormal in cystic fibrosis (CF), the author set out to examine the properties of α₂M isolated from the plasma of children with CF and from the plasma of age/sex matched controls. To do so, a technique capable of isolating pure, physiologically "active" α₂M from small plasma samples had to be developed. By a two-step chromatographic technique, involving Cibacron Blue Sepharose chromatography and immuno-adsorption, the author was able to isolate "active" CF and control α₂M of at least 98 percent purity from 5 ml of plasma, regardless of plasma haptoglobin type. Having accomplished this, comparative studies of CF and control α₂M were undertaken. Four parameters were investigated: (1) the molar protease binding of α₂M (2) the interaction of α₂M -bovine cationic trypsin (BCT) complexes with the low molecular weight substrate BAEE, (3) the stability of formed α₂M-BCT complexes, and (4) the subunit structure of α₂M. Contrary to the reports of Shapira and his colleagues, this author found no differences between the subunit structure of CF and control α₂M nor between the abilities of CF and control α₂M to interact with BCT. Based upon these findings, the author believes that no firm evidence exists to implicate an α₂M defect in the pathogenesis of cystic fibrosis. / Medicine, Faculty of / Pathology and Laboratory Medicine, Department of / Graduate

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Background: Carcinoembryonic antigen (CEA) in the pancreatic cystic fluid is the most important biomarker for differentiating mucinous from non-mucinous pancreatic cystic lesions (PCLs). However, recent studies have shown that glucose levels in pancreatic cystic fluid can discriminate mucinous from non-mucinous cysts. Aims: To perform a meta-analysis to determine the utility of intracystic fluid glucose of pancreatic mucinous cysts compared with intracystic CEA. Methods: We conducted a systematic review of the literature in the PubMed, OVID Medline, and Cochrane databases. This meta-analysis considers studies published up to October 2020. Results: Six studies comprising 506 patients were selected; 61.2% of the population was female. Of the 480 PCLs, 287 (59.7%) were mucinous. Pooled sensitivity and specificity of cystic fluid glucose levels for mucinous PCLs were 91% and 85%, respectively. The positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 6.33 and 0.11, respectively. Pooled diagnostic odds ratio (DOR) was 60.94. The pooled area under the summary receiver operating characteristic (SROC) curve was 0.959. Pooled sensitivity and specificity of pancreatic cystic fluid CEA levels were 61% and 93%. The PLR and NLR were 8.51 and 0.40, respectively. Pooled DOR was 23.52, and the pooled area under the SROC curve was 0.861. Conclusion: Glucose has become a useful method and appears to be better than CEA for differentiating between mucinous PCLs and non-mucinous PCLs. We suggest that the analysis of glucose in PCLs be routinely performed for the differential diagnosis of these lesions. / Revisión por pares

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