Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:Q0Z944 (hemoglobin)
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A study undertaken in Michigan from August 1968 to April 1970 showed that the county of residence was the most significant factor for determining pesticide residue levels in humans. Occupation, sex, and location of residence were also determined to be associated with blood residue levels. Residues of sigmaDDT and dieldrin were greater in persons 45 years or older. No relationships were detected between blood hemoglobin and blood residue values. In general, as the blood levels for glucose, cholesterol, uric acid, and creatinine increased, so did the levels of pesticide residues. However, when all variables were used, no equation could be developed which would reliably predict a blood residue level given these demographic characteristics.
Pestic Monit J 1977 Dec
PMID:A study of pesticide residues in Michigan's general population, 1968-70. 60 9

Current forms of brain monitoring, such as electroencephalography (EEG), have had limited clinical utility. The EEG records spontaneous cerebrocortical activity and thus is an indirect indicator of metabolic demand and, to a lesser extent, an indicator of mismatch of supply versus demand. Ischemia modulates EEG activity in ways that can usually be detected, but EEG patterns can be similarly modulated by many other factors, including temperature and pharmacologic manipulation. This in vivo study in physiologically monitored animals evaluated the use of correlated optical spectroscopy, performed with an instrument having a fiberoptic light-guide bundle in contact with the cerebral cortex, for the simultaneous monitoring of cerebrovascular oxygen availability and intracellular oxygen delivery. A highly specific monitor of cerebral intracellular oxygen supply, the cerebrocortical intramitochondrial NADH redox state, was monitored in vivo with a fluorescence technique. Absorption spectroscopy was used concurrently to monitor hemoglobin content (blood volume) and oxygen saturation in the microcirculation. Correlated changes in optical signals from cerebrocortical NADH and hemoglobin were studied in a swine model (n = 7) of nitrogen hypoxia. Measurements were made at four wavelengths with a time-division, multiplexed fluorometer/reflectometer. Because the NADH fluorescence signal at 450 nm is affected by local changes in blood volume, a "corrected" fluorescence signal is usually calculated. In previous studies, where only two wave lengths have been measured, attempts at correction were based on reflectance at the excitation wavelength (366 nm). We compared estimators of changes in microcirculatory blood volume using reflection at two wavelengths: 366 nm and 585 nm, the wavelengths for maximum and isobestic absorption. The results of the studies were as follows: (1) during transient hypoxia, NADH and local hemoglobin saturation signals changed in concert with arterial pulse oximetry, with changes in NADH lagging behind changes in saturation by an average of 5.3 seconds; (2) after hypocapnic ventilation to a mean PaCO2 of 20.2 +/- 0.8 mm Hg, NADH increased by 11.5 +/- 8.7% (as compared with maximal change during anoxia), local hemoglobin saturation decreased by 7.7 +/- 6.4%, and local blood volume decreased by 12.5 +/- 13%, while arterial SpO2 was unchanged; (3) our two measures of local blood volume were closely correlated during carbon dioxide perturbations, but poorly correlated during hypoxic perturbation; and (4) NADH fluorescence provided a more rapid, sensitive indicator of oxygen deprivation than did the EEG. During transient hypoxia, EEG changes occurred 57.4 +/- 10.4 seconds after the onset of decline in local hemoglobin saturation, after NADH had completed 50% of its maximal increase.
J Clin Monit 1992 Jul
PMID:Correlated, simultaneous, multiple-wavelength optical monitoring in vivo of localized cerebrocortical NADH and brain microvessel hemoglobin oxygen saturation. 149 28

Mixed venous oxygen saturation (SvO2) monitoring has been advocated for some critically ill patients. Patients with end-stage hepatic failure have oxygen consumption rates that are lower than normal. Using the Fick equation, oxygen consumption may be calculated if mixed venous and arterial oxygen tensions (and saturations), hemoglobin, and cardiac output are determined simultaneously. This report describes a unique pattern of changes in SvO2 and oxygen consumption in 7 patients undergoing liver transplantation. A previous study correlated plasma carbohydrate (glucose) levels with early hepatic graft survival. After induction, the 7 patients reported here had low oxygen consumption and high SvO2 values. The oxygen consumption rates decreased to the lowest point during the anhepatic phase and rose above baseline by the end of the case. The SvO2 and oxygen consumption data reported here follow the presence of presumed hepatic metabolic activity (increased CO2 and ionized calcium). Further research must be completed to determine whether these measurements indicate early hepatic nonfunction.
J Clin Monit 1992 Jan
PMID:Oxygen consumption and mixed venous oxygen saturation monitoring during orthotopic liver transplantation. 153 56

A heterogeneous enzyme-labeled immunometric assay for quantifying digoxin in serum or plasma was developed. The sample's drug reacts with an excess of an antidigoxin Fab'-beta-galactosidase monoconjugate and then the free monoconjugate is removed by polyacrylamide digitoxigenin-coupled beads; the beta-galactosidase activity of the supernatant measured photometrically at 634 nm is directly proportional to the digoxin concentration in the sample. The assay shares the basic reagents for the immunological reaction with the Seralyzer dry-strip immunometric assay; the reagents for the indicator enzyme reaction were instead formulated in liquid form for use with common clinical analyzers. The test requires a two-point calibration (a 3.0 micrograms/L digoxin calibrator and a reagent blank). One sample can be assayed in approximately 20 min; the assay range is from 0.3 to 5.0 micrograms/L. Dilution tests showed an average found/expected ratio of 100.6%. Mean analytical recovery was 99.2%. Overall coefficients of variation (CVs) (three replicates for 12 runs over 15 days; daily calibration) ranged from 4.9 to 10.0% (Technicon RA-50) and from 2.5 to 10.0% (Cobas Fara) for samples with digoxin concentrations of 4.7 to 0.5 micrograms/L. No interference was found by high levels of common analytes (bilirubin, triglycerides, hemoglobin, total protein, uric acid) or anticoagulants. Cross-reactivity by digoxin metabolites and structurally-related compounds was investigated. Good correlations were found with radiommunoassay (RIA) (r = 0.986) and enzyme immunoassay (EIA) (r = 0.994). Thus, the assay is a specific, reliable, and convenient method for measuring digoxin in both small and large laboratories.
Ther Drug Monit 1992 Feb
PMID:An enzyme-labeled immunometric assay for quantitation of digoxin in serum or plasma. 154 93

The records of 32 neonates in an intensive care unit were examined retrospectively to determine if fetal hemoglobin concentrations could be predicted on the basis of gestational or postnatal age, or on the volume of red blood cell transfusions. In nontransfused neonates, the correlation between measured concentrations of fetal hemoglobin and post-natal age was r = 0.53 with a 17.2 standard error of prediction. In these same neonates, the correlation between measured fetal hemoglobin divided by birth weight and gestational age was r = 0.70, with a 9.6 standard error of prediction. A three-variable regression equation (the latter two variables plus calculated fetal hemoglobin) was found to have a high correlation with data for measured fetal hemoglobin (r = 0.97) and a relatively low 8.4 standard error of prediction. In transfused neonates, however, measured hemoglobin concentrations divided by birth weight correlated poorly with gestational age (r = 0.30 and a 12.4 standard error of prediction). In addition, the transfused neonates had low correlations when fetal hemoglobin concentrations alone were compared with the total volume of red blood cell transfusions (r = 0.35) and with postnatal age (r = 0.18) and the standard errors of prediction were all approximately 17. The correlations found between concentrations of fetal hemoglobin and age in transfused neonates were poorer than those reported in earlier nontransfused infant studies. Previous studies have also shown that neonatal blood containing fetal hemoglobin interferes with the spectrophotometric measurements of carboxyhemoglobin and oxyhemoglobin. Because of the imprecision in the predictions of fetal hemoglobin using age, weight, or the volume of transfusion, we conclude that fetal hemoglobin should be measured if accurate spectrophotometric determinations of carboxyhemoglobin and oxyhemoglobin are desired.
J Clin Monit 1991 Apr
PMID:Fetal hemoglobin of transfused neonates and spectrophotometric measurements of oxyhemoglobin and carboxyhemoglobin. 171 33

This study describes the results from a series of human experiments demonstrating the ability to measure arterial hemoglobin oxygen saturation (SaO2) from the forearm and calf using a reflectance pulse oximeter sensor. A special optical reflectance sensor that includes a heating element was interfaced to a temperature controller and a commercial Data-scope ACCUSAT pulse oximeter that was adapted for this study to perform as a reflectance pulse oximeter. The reflectance pulse oximeter sensor was evaluated in a group of 10 healthy adult volunteers during steady-state hypoxia. Hypoxia was induced by gradually lowering the inspired fraction of oxygen in the breathing gas mixture from 100 to 12%. Simultaneous SaO2 measurements obtained from the forearm and calf with two identical reflectance pulse oximeters were compared with SaO2 values measured by a finger sensor that was interfaced to a standard Datascope ACCUSAT transmittance pulse oximeter. The equations for the best-fitted linear regression lines between the percent reflectance, SpO2(r), and transmittance, SpO2(t), values in the range between 73 and 100% were SpO2(r) = -7.06 + 1.09 SpO2(t) for the forearm (n = 91, r = 0.95) and SpO2(r) = 7.78 + 0.93 SpO2(t) for the calf (n = 93, r = 0.88). The regression analysis of the forearm data revealed a mean +/- SD error of 2.47 +/- 1.66% (SaO2 = 90-100%), 2.35 +/- 2.45% (SaO2 = 80-89%), and 2.42 +/- 1.20% (SaO2 = 70-79%). The corresponding regression analysis of the calf data revealed a mean +/- SD error of 3.36 +/- 3.06% (SaO2 = 90-100%), 3.45 +/- 4.12% (SaO2 = 80-89%), and 2.97 +/- 2.75% (SaO2 = 70-79%).(ABSTRACT TRUNCATED AT 250 WORDS)
J Clin Monit 1991 Jan
PMID:Skin reflectance pulse oximetry: in vivo measurements from the forearm and calf. 199 2

A 6-week multicenter, double-blind, controlled study comparing the therapeutic efficacy of two antidepressant drugs, trazodone and fluoxetine, was conducted. The hematocrit, hemoglobin, red blood cell count, serum cholesterol, serum calcium, and serum albumin levels were all significantly decreased after six weeks of trazodone treatment. Similar findings were not obvious for the fluoxetine treatment group. Trazodone caused the development of a pseudoanemia in 36% of the trazodone treatment patients compared with 20% of the fluoxetine treatment patients. The anemia was not regarded as clinically significant. Of the decreases in the patients' chemistries, only the decrease in cholesterol could not be reconciled.
Ther Drug Monit 1990 Nov
PMID:A report of trazodone-associated laboratory abnormalities. 227 96

We evaluated the Ames Seralyzer III with a new reagent and drystrip test for assay of digoxin. Assay precision was acceptable in the therapeutic range. Within-run imprecision (coefficient of variation, n = 20) was 7% at 0.9 ng/ml (1.2 nM) and 3.5% at 1.9 ng/ml (2.4 nM); run-to-run imprecision was 7.6% at 0.8 ng/ml (1.0 nM) and 5.7% at 2.1 ng/ml (2.7 nM). The method is very reproducible and is linear between 0.5 and 4.3 ng/ml (0.6-5.5 nM). The assay performed well with patient samples, with Abbott TDx used as the reference procedure. Bilirubin up to 16 mg/dl (273 microM) and hemoglobin up to 11 g/l do not cause interference. Digoxin-like immunoreactive factors cause minimal interference. Some digoxin metabolites such as monodigitoxoside, bis-digitoxoside, and digoxigenin cross-react with the digoxin antibody. Patients on spironolactone have falsely increased digoxin values. The new digoxin assay is easy to perform and uses 30 microliters serum; the result can be reported in 15-20 min.
Ther Drug Monit 1990 Mar
PMID:A dry-strip immunometric assay for digoxin on the Ames Seralyzer. 231 78

A computer-based system was developed for monitoring cardiac output using the Fick principle during general anesthesia. The variables of the oxygen-consumption Fick equation were measured using the following system: oxygen uptake by an originally developed respiratory gas monitoring system, arteriovenous oxygen saturation difference by pulse and fiberoptic oximetry, and hemoglobin concentration by an in vitro oximeter. Fick cardiac output and systemic vascular resistance were calculated every 30 seconds. Fick cardiac output was compared with thermodilution cardiac output in 11 anesthetized patients. A total of 208 corresponding cardiac output measurements showed a range of 2 to 9 L.min-1. The correlation coefficient between the thermodilution and Fick cardiac outputs was 0.961, with a regression equation of Fick cardiac output = 1.058 thermodilution cardiac output - 0.359. The difference between the thermodilution and Fick cardiac outputs was 0.103 +/- 0.395. The Fick cardiac output was significantly lower than the thermodilution cardiac output, especially in the low flow range. We demonstrated that this new monitoring system was clinically feasible and sufficiently accurate, under the limited circumstances of our study. The integration of routinely used equipment has made possible a frequently repeatable method for estimating cardiac output in patients.
J Clin Monit 1990 Apr
PMID:Frequently repeated Fick cardiac output measurements during anesthesia. 235 98

A retrospective evaluation of simultaneous tests of oximeters of various manufacturers in volunteer subjects disclosed greater errors at low saturations in subjects with low hemoglobin (Hb) concentrations. Forty-three pulse oximeters of 12 manufacturers studied over a period of 10 months showed that, at a mean arterial oxygen saturation (SaO2) level of 54.5%, as Hb concentration fell, average pulse oximeter (SpO2) bias increased approximately linearly from 0 at Hb greater than 14 g/dl to about -14% at 8 less than Hb less than 9 g/dl. At SaO2 = 53.6%, the mean bias (SaO2--SpO2) of 13 oximeters of 5 manufacturers averaged -15.0% (n = 43) in a subject with Hb = 8 g/dl, but -6.4% (n = 390) in nonanemic subjects. The additional bias in the anemic subject increased with desaturation. It was 0.13% at SaO2 = 98.5% (n = 13), -1.31% at 87.5% (n = 38), -2.71% at 75.1% (n = 38), -5.18% at 61.3% (n = 26), and -9.95% at 53.6% (n = 41); n is the product of the number of oximeters and number of tests in each saturation range. The instruments that showed the greatest errors at low saturations in nonanemic subjects also showed the greatest additional errors associated with anemia (the range between manufacturers of anemic incremental error at about 53% being from -3.2 to -14.5%) and conformed well to the relationship bias (anemic) = 1.35 x bias (normal) -8.18% (r = 0.94; Sy.x = 3.3%). The error due to anemia was zero at 97% SaO2 and became evident when SaO2 fell below 75%.
J Clin Monit 1990 Apr
PMID:Effect of anemia on pulse oximeter accuracy at low saturation. 235 7


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