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David Plaut: Off the Cuff

Another Blood Glucose Marker?
March 20, 2014 3:24 PM by David Plaut
It is well known that both HbA1c is an excellent marker to assess 2-3 month blood glucose levels and that measuring the blood glucose is good for the past few hours. This is certainly true for most people. But ... there are situations where another marker Read More...
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Atherogenic Dyslipidemia
October 29, 2013 12:18 PM by David Plaut
Recently in an online issue of the British Medical Journal, an interventional cardiology specialist registrar at Croydon University Hospital, London, says government obsession with reducing total cholesterol has led to millions of people being overmedicated Read More...
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The Framingham Study
July 3, 2013 3:52 PM by David Plaut
The "Framingham study" has been going on for more than 50 years. It began to study cholesterol in an entire community in Massachusetts. Today, children of the original cohort are included in much more than just cholesterol. Recently over 12 000 persons Read More...
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Myocardial Infarction Protocol
May 23, 2013 11:33 AM by David Plaut
One of my pet concerns is the best rule out myocardial infarction protocol. Best includes rapid, high sensitive and high specificity tests with as few markers as possible. Recently, two articles from Australia and New Zealand added significant data to Read More...
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A1c: Good, but Not Perfect
April 14, 2011 11:44 AM by David Plaut
A1c is good--but it's not perfect. A friend recently sent me a case study: These data come from a pregnant woman whom the doctor is concerned about gestational diabetes. Hemoglobin A1c …..6.4 (Jan 2011), then repeated in March and measured that A1c 5.8% Read More...
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When Two Tests Are Better Than One
May 10, 2010 3:34 PM by David Plaut
I have written several times, in different places, that there is significant pitfall in running more than one diagnostic test in screening. For example, if four tests are performed on an apparently healthy person and the tests are independent there is Read More...
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Monitoring A1c Changes
March 1, 2010 11:33 AM by David Plaut
Recently, I have found myself thinking more about the reported data that a lowering of one's A1C, especially if the initial value is about 7, will reduce the risk of a cardiac event (e.g., an AMI) by some 10%. Thus, a change of 8% A1c to 7% would lower Read More...
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Putting a Finger on the Problem
February 1, 2010 10:11 AM by David Plaut
Recently I was asked to help troubleshoot a problem concerning low T4 values on some patients in a clinic setting. A patient had T4 values on the latest sample of 3.4 ug/dL while the two previous samples some six months apart were 8.9 and 9.3 ug/dL. This Read More...
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Anemia in the Elderly
December 8, 2009 9:35 AM by David Plaut
Iron deficiency anemia (IDA) and anemia of chronic disease (ACD) have both been associated with older age; approximately 1 in 5 elderly patients have IDA. Vitamin B12 deficiency, folate deficiency, gastrointestinal bleeding and myelodysplastic syndrome Read More...
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Test Development: Why Some Tests Fly and Others Flop
November 9, 2009 2:59 PM by David Plaut
Why do some diagnostic tests that seem useful to clinicians in their infancy never fully develop into stars? A number of reasons should be kept in mind when working with a new test in your laboratory or just reading an article or listening to a vendor. Read More...
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Reference Range Headaches
October 26, 2009 1:23 PM by David Plaut
I was recently asked to give a lecture on establishing a reference range. For me, this is an easy task on paper but a difficult task to carry out. By reference range I mean that range from a low value to a high value within which most “normal” people Read More...
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Case Studies: What's Your Dx?
October 19, 2009 12:25 PM by David Plaut
What's the diagnosis? Answer: diabetic ketoacidosis Another one: Answer: Non-thyroidal illness. Normal cortisol suggests no issue of the hypothalamus-pituitary-thyroid axis. Read More...
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PSA Progress
September 21, 2009 12:21 PM by David Plaut
Prostate cancer (PCa) remains the second leading cause of cancer deaths in the U.S. as in most Western societies. Most men with PCa will not die from the disease but with it. Since the mid-1980s, screening with the prostate-specific antigen (PSA) blood Read More...
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Serum Biochemical Markers of Acute Pancreatitis
July 30, 2009 12:59 PM by David Plaut
Acute pancreatitis usually occurs as a result of alcohol abuse or bile duct obstruction. A careful review of the patient's history and appropriate laboratory studies can help the physician identify the etiology of the condition and guide management. Prompt Read More...
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Utility of Lp-PLA2
June 8, 2009 11:33 AM by David Plaut
A number of recent studies have demonstrated a major role for inflammation in atherogenesis, the pathophysiology of vulnerable plaque and, consequently, of cardiovascular events. Circulating markers of inflammation (e.g., CRP as measured by an hs-method Read More...
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