Dynamics of brain natriuretic peptide in critically ill patients with severe sepsis and septic shock.

Purpose: Changes of B-type natriuretic peptide (BNP) in sepsis and its utility in predicting intensive care unit outcomes remains a conflicting issue. To investigate the changes in plasma levels of BNP in patients with severe sepsis/septic shock and to study the association of BNP levels with the severity of the disease and prognosis of those patients.

Methods: Thirty patients with severe sepsis or septic shock were enrolled in our study.

Gestational diabetes in a tertiary care hospital: implications of applying the IADPSG criteria.

Background: The American Diabetes Association has endorsed the International Association of Diabetes and Pregnancy Groups (IADPSG) recommendation that every pregnant woman should undergo the 75 g oral glucose tolerance test (OGTT) to screen for gestational diabetes mellitus (GDM).

Purpose: To find the cost and workload implications of switching from the current two-step screening of GDM to the one-step IADPSG approach.

Methods: The cost (US $) and laboratory workload units (WLU) were calculated for three possible strategies: (1) 50 g glucose screen, if positive, followed by the 100 g OGTT; (2) universal 75 g OGTT; and (3) screening with the initial fasting plasma glucose of the OGTT.

Performance of the Roche Accu-Chek active glucose meter to screen for gestational diabetes mellitus using fasting capillary blood.

Background: Point-of-care (POC) blood glucose measurement using glucose meters is used by diabetes patients to mange their disease. POC glucose testing also is also used in tight glycemic control protocols and as a screening tool for diabetes. We report the performance and effectiveness of the Accu-Chek® Active (Roche Diagnostics GmbH, Mannheim, Germany) glucose meter to screen for gestational diabetes mellitus (GDM) using blood fasting capillary glucose (FCG).

Gestational diabetes: an evaluation of serum fructosamine as a screening test in a high-risk population.

Aim: To evaluate the value of serum fructosamine as a screening test for gestational diabetes mellitus (GDM).

Methods: 849 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) for universal screening of GDM. The fasting serum fructosamine (cFruc) was assessed using the area under the receiver operating characteristic curve (AUC).

Gestational diabetes mellitus: simplifying the international association of diabetes and pregnancy diagnostic algorithm using fasting plasma glucose.

Objective: To determine the impact of the International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria on 1) gestational diabetes mellitus (GDM) diagnosis compared with the American Diabetes Association (ADA) criteria and 2) the fasting plasma glucose (FPG) to predict GDM.

Research Design And Methods: In 10,283 pregnant women undergoing a 75-g oral glucose tolerance test (OGTT) for universal screening of GDM, two FPG thresholds (of the OGTT) were used to rule in and to rule out GDM.

Results: The IADPSG and ADA criteria identified GDM in 3,875 (37.

Gestational diabetes: using a portable glucometer to simplify the approach to screening.

Background: In populations at a high-risk for gestational diabetes (GDM), the recommendation of screening every pregnant woman with the oral glucose tolerance test (OGTT) is very demanding.

Aim: To assess the usefulness of the portable, plasma optimized glucometer in simplifying the approach to screening of GDM.

Methods: 1,662 pregnant women underwent the one-step 75 g OGTT for routine screening of GDM, as defined by the criteria of the American Diabetes Association.

Gestational diabetes: fasting and postprandial glucose as first prenatal screening tests in a high-risk population.

Objective: To evaluate the value of fasting (FPG) and 2-hour postprandial (PPG) plasma glucose as screening tests for gestational diabetes mellitus (GDM) in a high-risk population during early pregnancy.

Study Design: At their first prenatal visit, 708 women underwent FPG and PPG for universal screening for GDM, with the diagnosis confirmed by the 75-g oral glucose tolerance test (World Health Organization criteria). The area under the receiver operating characteristic curve (AUC) was used to analyze the performance of the 2 screening tests.

Implementing the Stockholm Conference hierarchy of objective quality criteria in a routine laboratory.

Background: Analytical performance of clinical laboratory testing should be evaluated against objective quality specifications. The Stockholm Conference consensus recommendation states that from a hierarchy of quality models, the highest-ranking model should be used. This study reports the performance of a routine clinical laboratory using these quality recommendations.

Gestational diabetes: relevance of diagnostic criteria and preventive strategies for Type 2 diabetes mellitus.

Objective: Women with gestational diabetes mellitus (GDM) are at risk to develop Type 2 diabetes mellitus (DM(2)). The aim of this study was to compare the effect of three international diagnostic criteria on the prevalence of GDM with its implications for prevention of DM(2 )in the population.

Materials And Methods: One thousand one hundred and seventy-two pregnant women, who underwent the 75-g oral glucose tolerance test for routine, antenatal GDM screening, were classified using the criteria of the American Diabetes Association (ADA), the World Health Organization (WHO) and Australasian Diabetes in Pregnancy Society (ADIPS).

Fasting plasma glucose as a screening test for gestational diabetes mellitus.

Although debated, most preeminent expert panels recommend routine screening for gestational diabetes mellitus (GDM). Among the many tests that have been used and evaluated for the screening of GDM, the fasting plasma glucose (FPG) remains very appealing. It is easy to administer, well tolerated, inexpensive, reproducible and patient friendly.

Thyroid function abnormalities and antithyroid antibody prevalence in pregnant women at high risk for gestational diabetes mellitus.

Both gestational diabetes mellitus (GDM) and thyroid dysfunction in pregnancy compromise maternal and fetal health. The aim of the present study was to determine the prevalence of abnormal thyroid function and antithyroid antibodies during early pregnancy in a population at high risk for GDM. Serum free triiodothyronine (FT3), free thyroxine (FT4) and thyroid-stimulating hormone (TSH) were measured in 301 pregnant women who underwent routine 'universal screening' for GDM.

Thyrotrophin and free thyroxine trimester-specific reference intervals in a mixed ethnic pregnant population in the United Arab Emirates.

Background: Physiological alterations in the homeostatic control of thyroid hormones cause changes in thyroid function tests in pregnant women. A lack of method, trimester and population-specific reference intervals for free thyroxine (FT4) and thyrotrophin (TSH) makes interpretation of FT4 and TSH levels in pregnancy difficult. We established trimester-specific reference intervals for TSH and FT4 in a mixed ethnic population of pregnant women attending two antenatal clinics in the United Arab Emirates.

Gestational diabetes: a reappraisal of HBA1c as a screening test.

Background: Recent technological advances have made HBA1c a more standardized and user-friendly test with wide availability. This study evaluated HBA1c as a screening test for gestational diabetes mellitus (GDM) in a high-risk population.

Methods: A total of 442 pregnant women were assessed by HBA1c.

Thyroid hormone reference intervals in an ambulatory Arab population on the Abbott Architect i2000 immunoassay analyzer.

Background: Considerable differences in reference intervals for FT4 and TSH have been reported between countries. Method related differences in the distribution of free thyroxine (FT4) have also been reported. The aim of this study was to establish reference intervals for thyrotrophin (TSH) and FT4 in an ambulatory adult (16-75 y) Arab population attending a general practice clinic using the Abbott Architect i2000 immunoassay analyzer.

HbA1c: a comparison of NGSP with IFCC transformed values.

Background: An approved IFCC reference method for measuring HbA1c, with a firm and reproducible correlation with NGSP values, is now available. We established (i) the degree of agreement of HbA1c results between the NGSP-certified and the IFCC-calibrated (converted to NGSP values) immunochemical method and (ii) the difference in the classification of control of diabetes mellitus (DM) in individual patients between the methods.

Methods: HbA1c was measured on the same hemolysate from each patient by both methods (n=92).

Gestational diabetes in a high-risk population: using the fasting plasma glucose to simplify the diagnostic algorithm.

Objective: To evaluate the value of fasting plasma glucose (FPG) in screening a high-risk population for gestational diabetes mellitus (GDM).

Study Design: During an 8-month period, 1685 pregnant women underwent the one-step 75 g oral glucose tolerance test (OGTT) as a part of a universal screening program. The receiver operating characteristic (ROC) curve was used to analyze the performance of the FPG.

Gestational diabetes: implications of variation in post-partum follow-up criteria.

Objective: To compare the recommendations of the American Diabetes Association (ADA) with the World Health Organization (WHO) for evaluating women with gestational diabetes (GDM) after delivery.

Study Design: During a 5-year period, 549 patients underwent the 2h, 75 g oral glucose tolerance test (OGTT), 4-8 weeks after delivery. They were classified by the criteria of WHO (1985), the ADA [1997, fasting glucose (FPG)] and the revised WHO (1999).

Evaluation of HbA1C results in an external quality assessment scheme in South Africa.

Background: Measuring HbA1c blood levels allows us to assess average glycaemia in individuals during the preceding 6-8 weeks. There is a clear association between increasing risk of complications with higher HbA1c values and a significant risk reduction of the complications with lower HbA1c values.

Methods: The performance of South African laboratories in an External Quality Assurance scheme for HbA1c is reported.

Biological variation in sweat sodium chloride conductivity.

Background: Sweat conductivity, which is equivalent to sweat NaCl concentration, is used as a screening test to identify possible cystic fibrosis (CF) patients. No data exist on the biological variation of this variable and the influence it may have on the interpretation of sweat testing. The aim of this study was to determine the components of biological variation for sweat sodium chloride conductivity and to apply biological variation parameters in the interpretation of sweat conductivity.