Salivary cortisol (SC) is a measure of free cortisol and follows diurnal rhythm of serum or plasma cortisol, so it is convenient for collection noninvasively on an outpatient basis. The Endocrine Society recommends measuring MiSC concentrations as a first-line test in screening for Cushing's syndrome. To define its utility as a diagnostic test, it is important to know whether assay techniques or thresholds affect the rate of false-positive results. Revision of literature showed that there are marked differences in sensitivity and specificity, and cutoff values of SC assays. The aim of this study was to compare MiSC results obtained by available immunoassays with different analytical sensitivity (AS) in an Argentinian population, and compare by pairs of methods their Diagnostic Concordance (DC) using individual reported cutoffs (RCO). Material and methods: Salivary samples obtained at 11 PM, from 133 adults subjects (18-74 years), with no corticoid therapy (last 6 months), psychiatric medication, depression, thyroid diseases, statins administration, or smoking. MiSC (nmol/L) were measured by ECLIA Cobas Roche (RCO: 4.9; AS: 1.5); RIA Beckman Coulter (RCO: 0.8; AS: 0.8), CLIA Liaison DiaSorin (RCO: 8.0; AS: 4.4), CLIA Access Beckman Coulter (RCO: 8.3; AS: 0.3) and CLIA Immulite 1000 Siemens (modified methodic) (RCO: 5.0 own data not reported; AS: 1.0). Bland & Altman biases were calculated between methods. Results: Calculated median, range and p95 (nmoL/L) for each method were: ECLIA Cobas (n=131): 1.6 (1.5-14.5) 6.4; RIA (n=90): 1.33 (0.8-7.7) 3.6, CLIA Liaison (n=126): 4.4 (8.4-22.1) 8.2, CLIA Access (n= 125): 4.1 (0.3-28) 15.6, and CLIA Immulite1000 (n: 99): 2.5 (1.4-20) 7.6. Calculated p95 was higher than RCO in all methods, being RIA the highest. ANOVA analysis for paired samples measured by all methods showed significant (p<0.005) differences except for Access and Liaison (p=1,000). Biases (nmol/L) obtained were: Cobas vs Immulite = -1; Access vs Cobas = 3.2; Cobas vs Liaison = -2.8; Cobas vs RIA = 0.9; Access vs Immulite = 2.4; Immulite vs Liaison = -1.8; Access vs Liaison = 0.3; Access vs RIA = 4.1; Liaison vs RIA = 3.6; Immulite vs RIA = 1.9. Lowest bias found was between Access and Liaison, result coincident with ANOVA. %DC between pairs of methods using RCOs was: Cobas vs Immulite = 87%; Access vs Cobas= 84%; Cobas vs Liaison = 95%; Cobas vs RIA = 64%; Access vs Immulite = 85%; Immulite vs Liaison = 90%; Access vs Liaison = 84%; Access vs RIA= 72%; Liaison vs RIA = 63%; Immulite vs RIA = 70%. Lowest %DC was found when RIA was involved in the comparison, which could be due to its low AS and RCO that are the same. Conclusions: Differences in %DC observed could be due to not only differences between methods but differences in composition of the population studied. Validating MiSC cutoff values in individual laboratories is important for good clinical use of results in the diagnosis and follow-up of Cushing’s syndrome. Unless otherwise noted, all abstracts...
R e s u m o :A resposta da frequência cardíaca é considerada o melhor parâmetro para monitorar a intensidade do trabalho do coração, tornando-se ferramenta indispensável na prescrição individualizada do exercício físico e para a clínica, com intuito de elucidar as causas e os riscos de morbimortalidade desencadeados por sua oscilação caracterizada por arritmias fatais. O teste de exercício máximo ou teste ergométrico é utilizado para avaliar possíveis alterações cardiovasculares e identificar vários marcadores metabólicos. Este teste associado a um ergoespirômetro permite coletar e analisar os gases inspirados e expirados e obter importantes marcadores metabólicos como o limiar anaeróbio e o ponto de compensação v e n t i l a t ó r i a . E s t e s l i m i a r e s p o d e m s e r identificadostambém por meio da análise da resposta da frequência cardíaca durante o exercício físico, tornandose um método mais prático e menos dispendioso comparativamente a ergoespirometria. Este trabalho apresenta como objetivos identificar mudanças na curva de resposta da frequência cardíaca de adultos, durante teste cardiopulmonar e identificar o limiar anaeróbio e o ponto de compensação ventilatória, empregando ferramenta estatística. Os dados para análise foram obtidos por meio da aplicação do teste cardiopulmonar, realizado em dois homens, na faixa etária entre 40 e 60 anos. Primeiramente estes voluntários foram submetidos a uma avaliação e anamnese, para estimar a função cognitiva, risco para queda, capacidade física e funcional, os níveis de atividade física e grau de dependência. Os dados resultantes da aplicação dos testesserão compilados e analisados utilizando modelagem estatística, para a verificação de curva de frequência cardíaca em adultos durante teste cardiopulmonar. Palavras-chave: Exercício Físico, Frequência Cardíaca, Limiar Anaeróbio, Teste de esforço.Abstract:The heart rate response is considered the best parameter to monitor the intensity of work of heart, becoming indispensable tool in individualized prescription of physical exercise and the clinic, in order to elucidate the causes and risks of morbidity and mortality triggered by its oscillation characterized in fatal arrhythmias. The maximal exercise test or treadmill test is used to evaluate cardiovascular abnormalities and identify various metabolic markers. This test associated with aergospirometer lets you collect and analyze the inspired and expired gases and obtain important metabolic markers such as anaerobic threshold and the respiratory compensation point. These thresholds may also be identified through the analysis of heart rate response during exercise, making it a more practical and less expensive method compared to spirometry. This work has the objective to identify changes in the response curve of heart rate in adults during cardiopulmonary exercise testing and identify the anaerobic threshold and the respiratory compensation point, using statistical tool. The data for analysis were obtained through the application of cardiopulmonary exercise te...
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