Thesis (M.S.)--West Virginia University, 2001. / Title from document title page. Document formatted into pages; contains vii, 78 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 63-69).

Thesis (Ph. D.)--Massachusetts Institute of Technology and Woods Hole Oceanographic Institution, 1983. / Bibliography: p. 166-168.

Cardiovascular disease, including hypertension, accounts for almost 50% of the deaths in patients with end stage renal disease (ESRD) on hemodialysis (HD) yet hypertension remains very poorly controlled in this population. The purpose of this study was to retrospectively compare control of hypertension in hemodialysis (HD) patients when extracellular volume (ECV) was assessed and managed by clinical parameters and physical assessment data alone with control of hypertension when data from blood volume monitoring (BVM) technology was also used to assess and manage ECV in a freestanding outpatient hemodialysis unit. The main cause of hypertension in the ESRD population has been identified as increased ECV most likely secondary to increased interdialytic weight gain and failure to attain and maintain patient’s dry weight. HD nurses often employ clinical parameters along with physical examination to determine a patient’s pre, intra, and post dialytic fluid status and this approach can have a high index of error. BVM technology is being used in many hemodialysis units to assist with assessment of ECV. A comparative retrospective chart review was used to collect data for this project. A descriptive, cross-sectional design was employed to answer the question:“Are hypertensive hemodialysis patients who dialyze in a freestanding dialysis unit, where BVM technology is utilized, more likely to be normotensive as defined by a pre dialysis blood pressure of less than 140/90 and post dialysis blood pressure less than 130/80”? A pilot study was conducted to determine if the patient population and data were available in existing patient records for extrapolation. Approval for the study was obtained from the University IRB. A convenience sample was obtained from the records of patients meeting the inclusion criteria. Variables were measured and analyzed using iv descriptive statistics such as sampled paired T-test to compare pre and post BVM systolic, diastolic blood pressures, intradialytic weight gain, serum Albumin and sodium levels, and hemoglobin. A p-value of 0.05 was assigned for statistical significance. Data analysis showed there were statisticaly significant differences in the pre dialysis systolic blood pressure, post BVM, and the serum sodium pre and post BVM when the two groups were compared These statistically significant findings support a correlation between reduction in the HD patient’s ECV and improved blood pressure control. The reduction of pre-dialysis SBP was significant because many patients on hemodialysis have systolic hypertension that may or may not coexist with diastolic hypertension. The findings of this study may be used to formulate a protocol to be used in the HD units where the BVM is available. The protocol would rely on accurate nursing assessment of clinical parameters, patient verbalizations of symptoms, and the routine use of the BVM in order to continuously assess the patient’s fluid status. Future research recommendations include conducting the study in a population closer to the national sample, a study where glucose readings and /or hemoglobin A1C levels are measured to assess the impact of glucose on ECV, and which antihypertensive class of medication works best with BVM technology to effectively manage hypertension in this population.

Thesis (Ph.D.)--Massachusetts Institute of Technology, Dept. of Mechanical Engineering ,1979. / MICROFICHE COPY AVAILABLE IN ARCHIVES AND ENGINEERING. / Vita. / Includes bibliographical references. / Ph.D.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / A adenosina desaminase (ADA â E.C.3.5.4.4.) à uma enzima fundamental no catabolismo das purinas. Ela catalisa a desaminaÃÃo da adenosina ou 2âdeoxi-adenosina produzindo amÃnia e inosina ou 2â-deoxi-inosina, respectivamente. Sua atividade à expressa por 2 isoenzimas presentes em 3 isoformas. A ADA1 (36kDa) ou ADA1 ligada ao CD26 (280kDa) sÃo amplamente distribuÃdas nos tecidos. Sua aÃÃo à particularmente importante porque altos nÃveis de 2âdeoxi-adenosina sÃo tÃxicos para as cÃlulas do sistema imunolÃgico. A ADA2 (100kDa) à normalmente encontrada no soro e sintetizada somente pelo sistema monocÃtico-macrofÃgico. A importÃncia biolÃgica da ADA2 ainda nÃo està totalmente estabelecida, principalmente devido as suas caracterÃsticas cinÃticas. O presente trabalho teve como objetivo discriminar as isoenzimas da adenosina desaminase humana atravÃs de eletroforese em gel de agarose e pelo modelo proposto por Vale e Almeida (1998), bem como realizar um estudo descritivo retrospectivo sobre o perfil dos exames de ADA no Estado do CearÃ. As amostras de lÃquido ascÃtico, pleural e pericÃrdico foram submetidas à eletroforese em agarose a 1% a 80 V por 7 horas. O gel foi fatiado e cada fatia foi incubada em adenosina (22 ou 0,55mM) por 20 horas para a detecÃÃo da amÃnia liberada pela reaÃÃo enzimÃtica. Os resultados encontrados a partir da eletroforese foram comparados com os resultados achados pelo modelo de Vale e Almeida (1998). O lÃquido pleural à o fluido que à mais frequentemente solicitado para a determinaÃÃo da ADA, seguido pelos lÃquidos ascÃtico, cefalorraquidiano, pericÃrdico e soro. Observamos que os valores de atividade enzimÃtica sÃo influenciados pelo tipo de lÃquido corporal onde a enzima se encontra, podendo estar relacionada Ãs barreiras corporais, tais como a barreira hematoencefÃlica. A partir dos resultados obtidos, podemos concluir que o modelo matemÃtico proposto pode ser usado em laboratÃrios clÃnicos para discriminar as isoenzimas da ADA. / Adenosine deaminase (ADA â E.C.3.5.4.4.) is a fundamental enzyme in the catabolism of the purines. It catalyzes the deamination of adenosine or 2âdeoxy-adenosine producing ammonium and inosine or 2â-deoxyinosine, respectively. Its activity is expressed by two isoenzymes presented in three isoforms. ADA1 (36 kDa) and ADA1 bound to CD26 (280kDa) are widely distributed in the body tissues. Their action is particularly important because high levels of 2âdeoxy-adenosine are toxic for the immune system cells. ADA2 (100kDa) is normally found in serum and is synthesized only in monocyte-macrophage system. The biological importance of ADA2 is not yet fully clear, especially for its kinetics characteristics. The objective of the present work was to discriminate the isoenzymes of human adenosine deaminase using agarose electrophoresis and by mathematical model proposed by Vale and Almeida (1998). In addition, we performed a study of the profile of ADA tests in State of Ceara (Brazil). Samples of of ascites, pleural and pericardial effusion were submitted to electrophoresis in 1% agarose at 80V for 7 hours. The gel was sliced and each slice was incubated in adenosine (22 or 0,55mM) for 20 hours to detect the ammonium released by enzymatic reaction. The results found from electrophoresis were compatible with the model proposed by Vale and Almeida (1998). The pleural fluid is the most frequently requested for the determination of ADA, followed by ascitic fluid, cerebrospinal fluid, pericardial fluid and serum. We observed that the value of enzymatic activity is influenced by corporal fluid type where the enzyme is localized. These data can be associated with the corporal barrier, like brain barrier. We concluded that the proposed mathematical model could be used in clinical laboratories to discriminate ADA isoenzymes to improve the diagnostic method.

Screening complex biological specimens such as exhaled air, tissue, blood and urine to identify biomarkers in different forms of cancer has become increasingly popular over the last decade, mainly due to new instruments and improved bioinformatics. However, despite some progress, the identification of biomarkers has shown to be a difficult task with few new biomarkers (excluding recent genetic markers) being considered for introduction to clinical analysis. This review describes recent advances in gas chromatographic methods for the identification of biomarkers in the detection, diagnosis and treatment of cancer. It presents a general overview of cancer metabolism, the current biomarkers used for cancer diagnosis and treatment, a background to metabolic changes in tumors, an overview of current GC methods, and collectively presents the scope and outlook of GC methods in oncology.

Thesis (doctoral)--University of Lund, 1981. / "From the Departments of Infectious Diseases and Clinical Bacteriology, University of Lund, General Hospital, Malmö, Sweden." "The English text revised by L. James Brown." Bibliography: p. 29-33.

No description available.

Introdução: A tuberculose (TB) é uma das infecções mais prevalentes na humanidade, sendo o comprometimento pulmonar a principal causa de morbimortalidade. A cultura é o padrão de referência para diagnóstico, porém apresenta baixa sensibilidade. Das formas extrapulmonares, a TB pleural é a mais comum e apresenta diagnóstico confirmatório difícil por ser paucibacilar e conter interferentes intrínsecos na amostra. A reação em cadeia da polimerase (PCR), por amplificar o DNA da micobactéria, apresenta-se como teste mais sensível que a cultura, sendo positivo em amostras que apresentam a partir de 102 UFC/mL (unidades formadoras de colônia por mL) de M. tuberculosis (MTB). Entretanto, quando utilizada em amostras de escarro, lavado broncoalveolar e/ou líquido pleural pode ter seu desempenho comprometido pela presença de inibidores intrínsecos da amostra (variáveis pré-analíticas) e pelas técnicas de amplificação e detecção (variáveis analíticas) utilizadas na reação. Objetivo: Avaliar a influência de variáveis pré-analíticas (concentração de células, hemácias e proteínas) na detecção do DNA do M. tuberculosis em amostras de escarro, lavado broncoalveolar (LBA) e líquido pleural (LP), utilizando combinações de métodos de extração/detecção. Métodos: Amostras de escarro, lavado broncoalveolar e líquido pleural de pacientes não infectados pelo M. tuberculosis foram obtidas através de indução à expectoração, broncoscopia respiratória e/ou toracocentese, respectivamente, em volumes suficientes para o estudo. Para testar o limiar de detecção do M. tuberculosis, as amostras foram preparadas \"in vitro\" de maneira a conter concentrações variadas dos interferentes pré-analíticos e de UFC/mL da micobactéria. Para a técnica de PCR, o DNA foi extraído pelo método de extração QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) e pelo AMPLICOR® Respiratory Specimen Preparation (Roche Molecular Systems, Inc., Branchburg, NJ, USA) e amplificado e detectado por três métodos: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) e 3) \"in-house\" ou caseiro. Desta maneira, foram testadas as seguintes combinações: Extração Roche/detecção Roche (R/R); Extração Roche/detecção Nanogen (R/N); Extração Roche/detecção \"in house\" (R/IH); Extração Qiagen/detecção Roche (Q/R); Extração Qiagen/detecção Nanogen (Q/N) e Extração Qiagen/detecção \"in house\" (Q/IH). Resultados: Em amostras de escarro, a quantidade de células e de hemácias não interferiu na detecção do M. tuberculosis, com exceção do método de extração/detecção Roche. Nas amostras de LBA, médias e altas concentrações de células e altas concentrações de hemácias contribuíram para menor detecção do MTB quando utilizado o método de detecção Roche, enquanto que no líquido pleural, a concentração de hemácias foi a variável que mais interferiu na detecção do agente. Em ambas as situações a menor detecção foi obtida com a combinação Q/N. Conclusão: A qualidade pré-analítica das amostras biológicas recebidas no laboratório clínico pode interferir no desempenho diagnóstico dos testes moleculares. A escolha dos métodos de extração e detecção é de fundamental importância na sensibilidade analítica do teste, para garantia de melhores resultados, especialmente quando trabalhamos com amostras paucibacilares que contém potenciais inibidores da reação / Introduction: Tuberculosis (TB) is one of the most prevalent infections in humanity, and pulmonary compromise is the leading cause of morbidity and mortality. Culture is the reference standard for diagnosis, but has low sensitivity. Of the extrapulmonary forms, pleural TB is the most common and presents difficult confirmatory diagnosis due to be paucibacillary and to contain intrinsic interfering in the sample. The polymerase chain reaction (PCR), for amplifying DNA of the mycobacterium, appears as more sensitive test than the culture, with positive results from 102 CFU/ml (colony forming units per ml) of M. tuberculosis (MTB). However, when used in sputum samples, bronchoalveolar lavage and/or pleural fluid, this test can also have its performance compromised by the presence of intrinsic sample inhibitors (pre-analytical variables) and by the amplification and detection techniques (analytical variables) used in the reaction. Objective: To evaluate the influence of pre-analytical variables (concentration of cells, red blood cells and proteins) in DNA detection of M. tuberculosis from sputum, bronchoalveolar lavage (BAL) and pleural fluid (PF) samples by using combinations of extraction/detection methods. Methods: Samples of sputum, bronchoalveolar lavage and pleural fluid of patients not infected with M. tuberculosis were obtained by inducing sputum, respiratory bronchoscopy and/or thoracentesis, respectively, in sufficient volumes for the study. To test the detection threshold of M. tuberculosis, samples were prepared \"in vitro\" to contain variable concentrations of pre-analytical interfering and CFU/mL of mycobacteria. For PCR, DNA was extracted by two methods: the QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) and Respiratory Specimen Preparation Amplicor (Roche Molecular Systems, Inc., Branchburg, NJ, USA) and amplified and detected by three methods: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) and 3) \"in-house\". Thus, the following combinations were tested: Roche extraction and detection (R/R); Roche extraction and Nanogen detection (R/N); Roche extraction and \"in house\" detection (R/IH); Qiagen extraction and Roche detection (Q/R); Qiagen extraction and Nanogen detection (Q/N) and Qiagen extraction and \"in house\" detection (Q/IH). Results: In sputum samples, the amount of cells and red blood cells did not interfere with M. tuberculosis detection, an exception for Roche extraction/detection method. In BAL samples, medium and high cell concentrations and high concentrations of red blood cells contributed to lower detection of MTB when using the Roche detection method, while in the pleural fluid, the concentration of red blood cells was the variable that most interfered with the MTB detection. In both situations, the smallest detection was obtained with the combination Q/N. Conclusion: The pre-analytical quality of biological samples received in the clinical laboratory can interfere with the performance of molecular diagnostic tests. The choice for the extraction/detection methods is of fundamental importance in the analytical sensitivity of PCR, in order to guarantee better results, especially when working with paucibacillary samples containing potential reaction inhibitors

Introdução: A tuberculose (TB) é uma das infecções mais prevalentes na humanidade, sendo o comprometimento pulmonar a principal causa de morbimortalidade. A cultura é o padrão de referência para diagnóstico, porém apresenta baixa sensibilidade. Das formas extrapulmonares, a TB pleural é a mais comum e apresenta diagnóstico confirmatório difícil por ser paucibacilar e conter interferentes intrínsecos na amostra. A reação em cadeia da polimerase (PCR), por amplificar o DNA da micobactéria, apresenta-se como teste mais sensível que a cultura, sendo positivo em amostras que apresentam a partir de 102 UFC/mL (unidades formadoras de colônia por mL) de M. tuberculosis (MTB). Entretanto, quando utilizada em amostras de escarro, lavado broncoalveolar e/ou líquido pleural pode ter seu desempenho comprometido pela presença de inibidores intrínsecos da amostra (variáveis pré-analíticas) e pelas técnicas de amplificação e detecção (variáveis analíticas) utilizadas na reação. Objetivo: Avaliar a influência de variáveis pré-analíticas (concentração de células, hemácias e proteínas) na detecção do DNA do M. tuberculosis em amostras de escarro, lavado broncoalveolar (LBA) e líquido pleural (LP), utilizando combinações de métodos de extração/detecção. Métodos: Amostras de escarro, lavado broncoalveolar e líquido pleural de pacientes não infectados pelo M. tuberculosis foram obtidas através de indução à expectoração, broncoscopia respiratória e/ou toracocentese, respectivamente, em volumes suficientes para o estudo. Para testar o limiar de detecção do M. tuberculosis, as amostras foram preparadas \"in vitro\" de maneira a conter concentrações variadas dos interferentes pré-analíticos e de UFC/mL da micobactéria. Para a técnica de PCR, o DNA foi extraído pelo método de extração QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) e pelo AMPLICOR® Respiratory Specimen Preparation (Roche Molecular Systems, Inc., Branchburg, NJ, USA) e amplificado e detectado por três métodos: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) e 3) \"in-house\" ou caseiro. Desta maneira, foram testadas as seguintes combinações: Extração Roche/detecção Roche (R/R); Extração Roche/detecção Nanogen (R/N); Extração Roche/detecção \"in house\" (R/IH); Extração Qiagen/detecção Roche (Q/R); Extração Qiagen/detecção Nanogen (Q/N) e Extração Qiagen/detecção \"in house\" (Q/IH). Resultados: Em amostras de escarro, a quantidade de células e de hemácias não interferiu na detecção do M. tuberculosis, com exceção do método de extração/detecção Roche. Nas amostras de LBA, médias e altas concentrações de células e altas concentrações de hemácias contribuíram para menor detecção do MTB quando utilizado o método de detecção Roche, enquanto que no líquido pleural, a concentração de hemácias foi a variável que mais interferiu na detecção do agente. Em ambas as situações a menor detecção foi obtida com a combinação Q/N. Conclusão: A qualidade pré-analítica das amostras biológicas recebidas no laboratório clínico pode interferir no desempenho diagnóstico dos testes moleculares. A escolha dos métodos de extração e detecção é de fundamental importância na sensibilidade analítica do teste, para garantia de melhores resultados, especialmente quando trabalhamos com amostras paucibacilares que contém potenciais inibidores da reação / Introduction: Tuberculosis (TB) is one of the most prevalent infections in humanity, and pulmonary compromise is the leading cause of morbidity and mortality. Culture is the reference standard for diagnosis, but has low sensitivity. Of the extrapulmonary forms, pleural TB is the most common and presents difficult confirmatory diagnosis due to be paucibacillary and to contain intrinsic interfering in the sample. The polymerase chain reaction (PCR), for amplifying DNA of the mycobacterium, appears as more sensitive test than the culture, with positive results from 102 CFU/ml (colony forming units per ml) of M. tuberculosis (MTB). However, when used in sputum samples, bronchoalveolar lavage and/or pleural fluid, this test can also have its performance compromised by the presence of intrinsic sample inhibitors (pre-analytical variables) and by the amplification and detection techniques (analytical variables) used in the reaction. Objective: To evaluate the influence of pre-analytical variables (concentration of cells, red blood cells and proteins) in DNA detection of M. tuberculosis from sputum, bronchoalveolar lavage (BAL) and pleural fluid (PF) samples by using combinations of extraction/detection methods. Methods: Samples of sputum, bronchoalveolar lavage and pleural fluid of patients not infected with M. tuberculosis were obtained by inducing sputum, respiratory bronchoscopy and/or thoracentesis, respectively, in sufficient volumes for the study. To test the detection threshold of M. tuberculosis, samples were prepared \"in vitro\" to contain variable concentrations of pre-analytical interfering and CFU/mL of mycobacteria. For PCR, DNA was extracted by two methods: the QIAamp® DNA Mini Kit (Qiagen, Hilden, Germany) and Respiratory Specimen Preparation Amplicor (Roche Molecular Systems, Inc., Branchburg, NJ, USA) and amplified and detected by three methods: 1) COBAS® TaqMan® MTB Test (Roche Molecular Systems, Inc., Branchburg, NJ, USA); 2) MTB Q - PCR Alert Kit (Nanogen Advanced Diagnosis, Trezzano, Italy) and 3) \"in-house\". Thus, the following combinations were tested: Roche extraction and detection (R/R); Roche extraction and Nanogen detection (R/N); Roche extraction and \"in house\" detection (R/IH); Qiagen extraction and Roche detection (Q/R); Qiagen extraction and Nanogen detection (Q/N) and Qiagen extraction and \"in house\" detection (Q/IH). Results: In sputum samples, the amount of cells and red blood cells did not interfere with M. tuberculosis detection, an exception for Roche extraction/detection method. In BAL samples, medium and high cell concentrations and high concentrations of red blood cells contributed to lower detection of MTB when using the Roche detection method, while in the pleural fluid, the concentration of red blood cells was the variable that most interfered with the MTB detection. In both situations, the smallest detection was obtained with the combination Q/N. Conclusion: The pre-analytical quality of biological samples received in the clinical laboratory can interfere with the performance of molecular diagnostic tests. The choice for the extraction/detection methods is of fundamental importance in the analytical sensitivity of PCR, in order to guarantee better results, especially when working with paucibacillary samples containing potential reaction inhibitors