Point-of-care testing (POCT): Current techniques and future perspectives.

Point-of-care testing (POCT) is a laboratory-medicine discipline that is evolving rapidly in analytical scope and clinical application. In this review, we first describe the state of the art of medical-laboratory tests that can be performed near the patient. At present, POCT ranges from basic blood-glucose measurement to complex viscoelastic coagulation assays.

Point-of-care testing in hospitals and primary care.

Background: Many medical laboratory tests can now be done near the patient (point-of-care testing, POCT), ranging from basic blood glucose measurement to complex coagulation testing. Switching from conventional laboratory testing to POCT shortens the time to decision-making about further testing or treatment, as delays are no longer caused by specimen transport and preparation, and the test results are rapidly available at the point of care. Better medical outcomes and lower costs may ensue.

Point-of-care determination of neonatal bilirubin with the blood gas analyzer RapidLab 1265.

Background: The aim of the study was to evaluate the comparability of the new neonatal bilirubin method on the RapidLab 1265 blood gas analyzer. This point-of-care testing (POCT) device has the option for the determination of neonatal bilirubin, making it potentially valuable for use in neonate intensive care units or in outpatient ambulances.

Methods: We paired 240 patient samples for intermethod comparisons between the new POCT method and the routine laboratory method (Vitros 350 chemistry system with BuBc slide).

[The analgesic effect of exercise during labor].

Objective: The aim of this study was to test for an analgesic effect of exercise during labor.

Patients And Methods: 50 women in labor exercised continuously with moderate intensity on a bicycle ergometer for 20 minutes. During rest and exercise, they rated their pain on a visual analogue scale (VAS).

Vaccination of patients with advanced ovarian carcinoma with the anti-idiotype ACA125: immunological response and survival (phase Ib/II).

Purpose: A Phase I/IIb multicenter study was conducted to evaluate the safety and immunogenicity of the anti-idiotypic antibody vaccine ACA125 that functionally imitates the tumor antigen CA125 in 119 patients with advanced ovarian carcinoma. A preliminary report on the initial 42 patients demonstrated safety and immunogenicity.

Experimental Design: Using the complete intention-to-treat population (n = 119) who received a mean of 9.

Short-term calcium supplementation has no effect on biochemical markers of bone remodeling in early postmenopausal women.

Introduction: This study was designed to assess changes in biochemical markers of bone remodeling in early postmenopausal women receiving calcium supplementation.

Materials And Methods: In a randomized cross-over study of eighteen weeks duration, the effect of a 6-week calcium supplementation (1000 mg calcium carbonate) on biochemical markers of bone resorption (collagen type I cross-linked C- and N-telopeptides) and bone formation (osteocalcin, total and bone-specific alkaline phosphatase), and total serum calcium was assessed in 27 early postmenopausal women.

Results: While total serum calcium levels increased significantly due to calcium supplementation (p<0.

Bone remodeling and bone mineral density during pregnancy.

Introduction: The effect of pregnancy upon the maternal skeleton is not fully understood. The information that has been gathered by recent studies is conflicting with regard to overall loss or gain of bone during pregnancy. The aim of the present longitudinal, controlled study, therefore, was to investigate the effect of pregnancy on lumbar spine, wrist, and hip bone mineral density, and to describe bone remodeling during pregnancy as indicated by biochemical markers of both bone resorption and formation.

Adhesion molecules, activin and inhibin--candidates for the biochemical prediction of hypertensive diseases in pregnancy?

Background: The aim of the prospective study was to compare standard parameters as Doppler ultrasound and 24-h blood pressure measurement with possible maternal serological markers regarding their prognostic value in predicting hypertensive diseases in pregnancy.

Materials: Twenty-four-hour blood pressure measurement was performed before and after 32+0 gestational week in 57 pregnant women with either chronic hypertension ( n=13), preeclampsia ( n=21), pregnancy-induced hypertension (PIH; n=12) or normotension ( n=11). Blood samples were taken and the concentrations of soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), activin A and inhibin A were determined as well as serum uric acid, creatinine, total serum protein and serum albumin.

Interleukin-6 fused to an anti-idiotype antibody in a vaccine increases the specific humoral immune response against CA125+ (MUC-16) ovarian cancer.

Anti-idiotypic (Id) monoclonal antibodies can serve as surrogate for tumor-associated antigens in vaccination strategies. The murine anti-Id monoclonal antibody ACA125 that mimics the CA125 carbohydrate antigen expressed on ovarian cancer cells induces an anti-anti-Id antibody (Ab3) response that is associated with prolonged survival of ovarian cancer patients. To increase the Ab3 antibody response, we evaluated two strategies in a mouse model: (a) coinjection of human interleukin (IL)-6 together with the fusion protein chACA125, which consists of the anti-Id ACA125 single-chain Fv antibody joined to the human IgG1 CH2/CH3 domain; and (b) injection of the fusion protein chACA125-IL-6, which consists of the ACA125 single-chain Fv fused to human IL-6 via the IgG1 CH2/CH3 domain.

A double-blind, placebo-controlled study of vitamin A and zinc supplementation in persons with tuberculosis in Indonesia: effects on clinical response and nutritional status.

Background: The results of cross-sectional studies indicate that micronutrient deficiencies are common in patients with tuberculosis. No published data exist on the effect of vitamin A and zinc supplementation on antituberculosis treatment.

Objective: Our goal was to investigate whether vitamin A and zinc supplementation increases the efficacy of antituberculosis treatment with respect to clinical response and nutritional status.

Vaccination with autologous tumour antigen-pulsed dendritic cells in advanced gynaecological malignancies: clinical and immunological evaluation of a phase I trial.

Dendritic cell (DC)-based therapy has proven to be effective in patients with malignant lymphoma, melanoma, and renal and prostate carcinoma. In this phase I clinical trial, we have shown that patients with advanced gynaecological malignancies can be effectively vaccinated with DC pulsed with keyhole limpet haemocyanin (KLH) and autologous tumour antigens. Two patients with uterine sarcoma and six subjects with ovarian carcinoma received three to 23 intracutaneous injections of antigen-pulsed DC at 10-day or 4-week intervals.

Analytical performance of a portable critical care blood gas analyzer.

The portable blood gas analyzer OPTI Critical Care Analyzer was evaluated in comparison to routine laboratory assays using heparinized blood samples of adults and newborns. Within-run imprecision studies were performed with native blood using tonometry to adjust blood gas concentrations. The results obtained show a very close agreement between the OPTI system and the comparison methods for all parameters tested: hemoglobin (y=1.

Immunological consolidation of ovarian carcinoma recurrences with monoclonal anti-idiotype antibody ACA125: immune responses and survival in palliative treatment. See The biology behind: K. A. Foon and M. Bhattacharya-Chatterjee, Are solid tumor anti-idiotype vaccines ready for prime time? Clin. Cancer Res., 7:1112-1115, 2001.

The aim of the present study was to assess whether the induction of specific immune responses by vaccination with the murine monoclonal anti-idiotypic antibody ACA125, which imitates the tumor-associated antigen CA125, has a positive influence on the survival of patients with recurrent ovarian carcinoma. Forty-two patients with platinum-pretreated recurrences were included in a clinical Phase I/II trial of consolidation in third-line therapy. Patients initially received four immunizations with 2 mg of alum-precipitated anti-idiotype ACA125 every 2 weeks and then monthly applications.

Cross-linked type I collagen C- and N-telopeptides in women with bone metastases from breast cancer.

This study documents values of biochemical markers of bone remodeling in 106 patients with breast cancer. Based on scintigraphic and radiological findings, patients were divided into 3 groups: 19 patients with bone metastases, 65 patients without bone metastases and normal bone scintigrams, and 22 patients with pathological, non-malignant findings on scintigraphy without proof of bone metastases. Urinary cross-linked type I collagen N-telopeptides (NTx) and serum cross-linked type I collagen C-telopeptides (ICTP) were assessed as markers of bone resorption.

Digoxin, flecainide, and amiodarone transfer across the placenta and the effects of an elevated umbilical venous pressure on the transfer rate.

Clinical observations suggest that flecainide might pass the placenta more easily than digoxin, and that its transfer is less disturbed in case of hydrops fetalis than that of digoxin. The purpose of the study was to compare the materno-fetal transplacental transfer of digoxin, flecainide, and amiodarone, another antiarrhythmic agent used in the treatment of fetal tachyarrhythmia, and to assess the effect of an elevated umbilical venous pressure (UVP) on the transfer rate. Isolated lobules of 16 human placentas were dually perfused after spontaneous delivery or caesarean section.

Immunological properties of a single-chain fragment of the anti-idiotypic antibody ACA125.

Vaccination with anti-idiotypic antibodies has been described as a promising concept for treatment of several malignant diseases. The murine monoclonal anti-idiotypic antibody ACA125 imitates a specific epitope of the tumor-associated antigen CA125 expressed by 80% of ovarian carcinomas. In the first clinical trial it could be shown that mAb ACA125 is able to elicit anti-anti-idiotypic antibodies (Ab3) with anti-CA125 specificity in patients with advanced ovarian cancer.

Influence of NH(4)CI on polarized release of endogenous protein degradation products and on morphology in LLC-PK(1) cells.

Increased renal ammoniagenesis is thought to be a causative factor for renal hypertrophy which occurs in several disorders accompanied by metabolic acidosis. We studied the influence of ammonia on the polarized release of degradation products of endogenous proteins in LLC-PK(1) cells. Release of acid-soluble radioactivity to the extracellular space decreased under the influence of NH(4)Cl with a remarkable transient reduction of basolateral release.

Recommendations of the German Working Group on medical laboratory testing (AML) on the introduction and quality assurance of procedures for Point-of-Care Testing (POCT) in hospitals.

The following recommendations were drawn up by the Working Group "Point-of-Care Testing" of the DGKC and DGLM which was set up in 1997. This first document from the Working Group sets out the principles which should be observed when introducing point-of-care testing. These general recommendations are to be followed by further specific recommendations on individual procedures or groups of procedures, e.

Serum oxytocin concentration during embryo transfer procedure.

Objective: To determine the effect of the embryo transfer (ET) procedure on serum concentration of oxytocin.

Study Design: Prospective clinical study of 10 women undergoing in vitro fertilization (IVF) treatment with ET in the Section of Reproductive Medicine and Endocrinology at the Department of Obstetrics and Gynecology, University of Bonn, Germany. Serial blood samples were collected in time intervals of 20 s during embryo transfer procedure and serum oxytocin concentration was measured.

[Monoclonal anti-idiotype antibodies in immunotherapy of ovarian carcinoma (MAb ACA125) and breast carcinoma (MAb ACA14C5)].

Anti-idiotypic antibodies, which imitate a tumor-associated antigen by their variable region, offer an elegant method for the induction of a specific immune response, when used as a surrogate antigen for immunization. We generated anti-idiotypic antibodies imitating 2 different tumor-associated antigens. I.

Evaluation of immunological responses in patients with ovarian cancer treated with the anti-idiotype vaccine ACA125 by determination of intracellular cytokines--a preliminary report.

In a first clinical trial, 45 patients with advanced ovarian carcinoma and recurrences were treated with the murine monoclonal anti-idiotypic antibody (Ab2) designated ACA125 for active immunotherapy. The monoclonal antibody (MAb) ACA125 mimics a specific epitope of the tumor-associated antigen CA125 expressed by most malignant ovarian tumors. Patients with CA125-positive tumors are immunologically tolerant to CA125, which could be overcome by the use of an anti-idiotypic antibody as a surrogate for the tumor antigen CA125.

Shifts in the TH1/TH2 balance during human pregnancy correlate with apoptotic changes.

An important prerequisite for a successful pregnancy is that the maternal immune system does not reject the fetus. Down-regulation of the T helper 1 (TH1) associated cellular immune response could therefore be essential. With flow cytometric techniques, we show on a single cell level that both CD4+ and CD8+ T cells from peripheral blood produce less TH1 cytokines (i.

Blood glucose determinations in newborns: four instruments compared.

Four portable analyzers, HemoCue B-Glucose (I), Accu-Check III (II), One-touch II (III), and Glucometer Elite (IV), with different measuring principles were tested for their suitability for measuring blood glucose in neonates. Precision of all instruments is satisfactory. In the analysis of capillary blood from newborns, two instruments show an excellent accuracy; however, the scatter of the results for instrument (II) is about 1.