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Drachten, Netherlands

Kruit A.,Medical laboratory | Zanen P.,University Utrecht
Clinical Biochemistry | Year: 2015

Objective: A direct, inverse correlation between 25-hydroxy vitamin D (25(OH) vitamin D) levels and C-reactive protein (CRP), a sensitive biomarker for inflammation, was found in some, but not all, studies. These effects were seen in healthy subjects as well as in some inflammatory diseases. Design and methods: CRP and 25(OH) vitamin D data (2011-2013) from 923 in- and outpatients (males/females 340/583; median age: 76. years (95% confidence interval (CI): 75-77) were analyzed. A standardized diagnosis according to the Dutch diagnosis coding standard for each patient was obtained. Each diagnosis was categorized as either inflammatory or non-inflammatory disease. Analysis of variance was performed with age, gender, inflammatory status (inflammatory disease/non-inflammatory disease), and season as corrective factors. Results: The correlation between (log) ln-25(OH) vitamin D and ln-CRP was highly significant (p<0.001) with a regression coefficient of -0.879. In the inflammatory disease group, the R2 value was 0.726 and in the non-inflammatory disease group it was 0.502. It was shown that increasing 25(OH) vitamin D levels are associated with decreasing CRP levels, with a stronger effect in the inflammatory disease group compared to the non-inflammatory disease group. Conclusions: Our study shows an inverse correlation between 25(OH) vitamin D and CRP in a large patient cohort but more importantly shows that this effect is more pronounced in patients with inflammatory diseases compared to patients with non-inflammatory diseases. © 2016 The Canadian Society of Clinical Chemists.

Krone B.,University of Gottingen | Krone B.,Medical laboratory | Grange J.M.,The London Clinic
BMC Neurology | Year: 2013

Background: Multiple sclerosis (MS) has undergone a significant increase in incidence in the industrialised nations over the last 130 years. Changing environmental factors, possibly infections or a lack of or altered timing of them, determine the prevalence of the disease. Although a plethora of aetiological factors, clearly evident in a group of children with MS, appear relevant, there may nevertheless be a single factor essential for the aetiopathogenesis and clinical manifestation of MS.Description and discussion: This hitherto unknown factor is postulated to be a 'melanoma-like neuromelanin' (MLN) dependent on the activation of a gene for syncytin-1. An involvement of MLN could explain the diverse findings in the epidemiology, immunology and pathology of MS, requiring a consideration of a complex infectious background, the human leucocyte antigens, as well as cosmic radiation causing geomagnetic disturbances, vitamin D deficiency, smoking, and lower levels of uric acid.Summary: In principle, the MLN-based concept is a unifying one, capable of explaining a number of characteristics of the disease. To date, MLN has not been addressed in studies on MS and future work will need to be done on human patients, as there is little or no neuromelanin (the precursor of MLN) in the animals used as experimental models in the study of MS. © 2013 Krone and Grange; licensee BioMed Central Ltd.

Zhang H.,Nanjing Medical University | Jin G.,Nanjing Medical University | Li H.,Nanjing Medical University | Ren C.,Medical laboratory | And 7 more authors.
Carcinogenesis | Year: 2011

Two recent genome-wide association studies reported significant associations of genetic variants at 1q22, 10q23 and 20p13 with gastric cancer (GC) risk in Chinese populations. However, these findings have not been confirmed in other independent studies. Here, we performed an independent case-control study in a Chinese population by genotyping three loci (rs4072037A>G at 1q22, rs2274223A>G at 10q23 and rs13042395C>T at 20p13) in 1681 GC cases and 1858 controls. We found that rs4072037 at 1q22 and rs2274223 at 10q23 were significantly associated with risk of GC with per allele odds ratio (OR) of 0.72 [95% confidence interval (CI): 0.63-0.81; P 5 2.98 3 1027] and 1.42 (95% CI: 1.27-1.58;P 5 9.68 3 10210), respectively. The association was more prominent for rs2274223 in female (OR 5 1.86, 95% CI: 1.49-2.32) and gastric cardia adenocarcinoma (GCA) (OR 5 1.71, 95% CI: 1.49-1.95). Furthermore, we combined the two single-nucleotide polymorphisms to evaluate the joint effect and found that the GC risk significantly increased with the number of risk allele increasing with a trend P value of 6.66 3 10-16, and individuals with four risk alleles had a 3.28-fold (95% CI: 1.75-6.13) risk of GC compared with those having no risk alleles. However, no significant association was detected between rs13042395 at 20p13 and GC risk (OR 5 1.04, 95% CI: 0.94-1.15; P 5 0.452). In conclusion, our results indicate that genetic variants at 1q22 and 10q23 but not 20p13 may serve as candidate markers for GC susceptibility in the Chinese population. © The Author 2011. Published by Oxford University Press.

Baroke E.,Hannover Medical School | Schmidt J.J.,Hannover Medical School | Strunk A.-K.,Hannover Medical School | Wiesner O.,Hannover Medical School | And 2 more authors.
Clinical Nephrology | Year: 2015

Hemodialysis is the extracorporeal treatment of choice for various life-threatening intoxications, with the exception of highly protein-bound substances, which are preferably removed by charcoal hemoperfusion. This technique, however, is limited by its availability and its significant side effects. We present a potentially life-threatening diphenhydramine (DPH) overdose in a stuporous female patient in which high cut-off hemodialysis was used. Timely detoxification resulted in rapid gain of consciousness, allowing the patient to state the existence and location of another poison victim. © 2015 Dustri-Verlag Dr. K. Feistle.

Kitagawa M.,Medical laboratory
Rinsho byori. The Japanese journal of clinical pathology | Year: 2010

In Japan, an ISO15189 accreditation system was started in 2005. To date, 47 hospitals have been accredited. In this session, I will present the merits of acquiring accreditation regarding ISO15189 based on our experience. Our hospital has 263 beds. The Clinical Examination Section consists of 12 staff (including 5 part-time workers): 7 in change of sample examination and 5 in charge of physiological examination. The annual number of samples is approximately 150,000. Samples collected on health checkups account for 90%. To improve the quality and service, assessment by third persons has been positively utilized in our hospital. Accreditation regarding ISO9001, ISO14001, ISO27001, privacy mark, hospital function assessment, the functional assessment of "ningen-dock"/health checkup hospitals, labor/hygiene service function assessment, and ISO15189 has been acquired. Patients may not recognize ISO. So, it must be utilized, considering that the acquisition of accreditation is not a goal but a starting point. Furthermore, cost-performance should be improved to achieve utilization-related merits. It is important to not only acquire accreditation but also help clinical staff and patients become aware of some changes/merits. Patients may consult a hospital for the following reasons: confidence in the hospital, and the staffs kind/polite attitudes. Long-term management strategies should be established without pursuing only short-term profits. I will introduce several merits of acquiring accreditation regarding ISO15189. Initially, incidental conditions for bids and appeal points include accreditation regarding ISO15189. Our corporation has participated in some competitive bids regarding health checkup business. In some companies, the bid conditions included ISO acquisition. In our hospital, clinical trials have been positively carried out. For participation in trials, hospitals must pass an institutional examination. However, ISO acquisition facilitates the preparation of documents, leading to successful results. The staffs consciousness has also change. I feel that they try to manage samples from blood collection until reporting laboratory data and interpret laboratory findings strictly. With ISO9001 and ISO14001 activities in our corporation, improvements in consciousness and service have increased the number of patients. Although items other than ISO also improved, ISO played an important role. We could participate in an international collaborative study, "Regional Difference in Laboratory Data and Establishment of Common Reference Ranges", which was mainly designed by Prof. Ichihara, Medical Research Department, Yamaguchi University Graduate School. This also resulted from ISO15189 acquisition. Furthermore, the Japanese Society of "Ningen-Dock" selected Dr. Yoshida, the chairman of the board of directors in our corporation, as a chairman of a meeting that will be held by this society in Asahikawa in 2010 as a result of ISO15189 acquisition by the Clinical Examination Section of our hospital, that is, high-level consciousness. It may be the first case for a middle-/small-scale general hospital to lead a meeting held by such a prestigious society. Thus, I have introduced the merits of ISO15189 acquisition. I hope that our experience will contribute to future ISO activities.

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