Discrepancies between thyrotropin (TSH) measurement by four sensitive immunometric assays

A comparison of four different commercial immunometric thyrotropin (TSH) assays (Amerlite R TSH-30 Ultrasensitive assay from Kodak, BeriLux R hTSH from Behring Werke, Delfia R hTSH Ultra from Wallac and IMX R Ultrasensitive hTSH from Abbott) was made by measuring serum TSH in 81 consecutive patients referred to hospital for various reasons with a serum TSH less than 0.8 mlU/l in the IMX assay. The analytical and functional assay sensitivities of each of the assays were analysed. Even though three of the methods had a sensitivity corresponding to third generation assays, we could only demonstrate an overall agreement of serum TSH when comparing two of the kits. The measurements in Delfia Ultra and Berilux showed good agreement (P = 0.7, paired t-test and bias = 0.003 mIU/l), while the comparisons between the other assays showed different measurements (P < 0.00001, paired t-test and bias more than 0.07 mIU/l). Differences in the calibrators used in the assays might explain some of the discrepancy, although all methods were calibrated according to the same international standard. Also, differences in the specificity of the TSH monoclonal antibodies used in the assays might be an evident explanation and further studies of the specificity of the monoclonal antibodies are needed. An international collaborative study to clarify reasons for the differences between the TSH assays and to standardize the measurements is recommended.     

A general and flexible method of problem definition in structural optimization systems

This paper describes the implementation of a general and flexible method of formulating problems of mathematical programming in structural optimization systems. The method enables the formulation and solution of problems involving scalar, integral, min/max, max/min and possibly non-differentiable user defined functions in any conceivable mix. The mathematical formulation is based on the bound formulation, and the implementation specific details involve a parser capable of interpreting and performing symbolic differentiation of the user defined functions.     

Fertilization in vitro. A review over the medical indications and suggestion to unified guidelines for public fertility clinics in Denmark

Medical indications for in vitro fertilization and embryo transfer (IVF-ET) internationally and in Denmark are reviewed. Reports from large international centres document that tubal infertility, unexplained infertility, endometriosis and male infertility are equally good indications for IVF. Traditionally, tubal infertility has been the only medical indication qualifying for IVF treatment within the National Health Service in Denmark. Thus, in this country, couples with unexplained and male infertility and with endometriosis have to pay up to 25,000 D.Kr. per IVF-ET treatment in private fertility clinics. Since there is no scientific basis for this discrimination, it is urged that the present rules are changed, so that couples with unexplained and male infertility and endometriosis are also allowed IVF treatment free of charge in the public fertility clinics.     

Study of inaccuracy in semi-analytical sensitivity analysis — a model problem

The semi-analytical method of sensitivity analysis (Zienkiewicz and Campbell 1973; Esping 1983; Cheng and Liu 1987) of finite element discretized structures is attractive due to the balance between computational cost and ease of implementation (Cheng and Liu 1987; Haftka and Adelman 1989), but unfortunately the method may exhibit serious inaccuracies when applied in shape optimization of structures modelled by beam, plate, shell and Hermite elements (Cheng and Liu 1987; Haftka and Adelman 1989; Barthelemyet al. 1988; Barthelemy and Haftka 1988; Choi and Twu 1991, Pedersenet al. 1989; Chenget al. 1989).In the present paper, we perform an exact analysis of the error of sensitivity for a simple model problem which has earlier been considered by Barthelemyet al. (1988), Barthelemy and Haftka (1988), Pedersenet al. (1989). The analysis gives a deep insight into the nature of the general inaccuracy problem and enables us to devise methods by which the severe error of the sensitivity can be substantially reduced or removed for the model problem. The results of the paper are illustrated via an example.A method of error elimination for an extended class of semianalytical analysis problems is developed and presented in a companion paper (Olhoff and Rasmussen 1991).     

Psychological impact of colorectal cancer screening.

This article examines the psychological impact of participating in sigmoidoscopy screening for colorectal cancer prevention. The 1st study examined psychological well-being at 3 months, in relation to screening outcome, in 4,153 individuals. The 2nd study used longitudinal data to examine changes in psychological functioning from before to after screening in relation both to screening outcome and baseline indicators of vulnerability. There were few psychological differences between those who had received negative results or had polyps detected. These findings were confirmed in the longitudinal study, which also found no evidence for vulnerability to adverse effects among those who were initially most anxious or who perceived their risk of cancer to be higher. The longitudinal data suggested that screening might produce transient positive effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Long-term prognosis for women with chronic pelvic pain without laparoscopically demonstrable cause

With the object of assessing the long-term prognosis and the frequencies of recurrence and remission in women chronic low abdominal pain without laparoscopically visible cause, questionnaire were sent in 1985 and 1991 to 55 women who had been submitted to laparoscopy in 1982-1984 for this reason. These women had been told that there was no demonstrable explanation of the pain experienced and were then discharged. 65% and 55% respectively had experienced and unfavourable course with considerable and continued symptoms. Only 22% stated in both investigations that they had experienced a favourable course and that they were, by and large, free from pain. 36% changed from an unfavourable to a favourable course or the reverse. The assessment made by the women was confirmed by a series of subordinate questions and this demonstrated a marked difference between the favourable and unfavourable courses of the condition. It is concluded that laparoscopy with exclusion of significant pathology is not, in itself, satisfactory as treatment of this patient group and that no improvement occurs in the course of time. The condition varies greatly with many recurrences and remissions and, for this reason, uncontrolled reports of the therapeutic effects are of no significance. When compared with the literature, it is suggested that this patient group should be referred early in the course of the condition to a therapist with specialist psychological/sexological insight and/or to a physiotherapist with interest in this patient group.