David Plaut: Off the Cuff

Test Development: Why Some Tests Fly and Others Flop

David Plaut — Mon, 09 Nov 2009 19:59:00 GMT

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)

Reference Range Headaches

David Plaut — Mon, 26 Oct 2009 17:23:00 GMT

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)

Case Studies: What's Your Dx?

David Plaut — Mon, 19 Oct 2009 16:25:00 GMT

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)

Warfarin and Dabigatran

David Plaut — Mon, 28 Sep 2009 16:52:00 GMT

Coumadin (Warfarin) has long been used to treat patients with atrial fibrillation. There is no doubt that Coumadin reduces the risk of stroke in the patients. However, the risk of hemorrhage and systemic embolism is increased. In addition to the risk...(read more)

PSA Progress

David Plaut — Mon, 21 Sep 2009 16:21:00 GMT

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)

Multitasking: Myth or Manageable?

David Plaut — Thu, 10 Sep 2009 16:10:00 GMT

The concept of multitasking demands our attention. Is it really possible? If so, in what situations? What is known about multitasking? To begin, quite simply, there are times when multitasking clearly works--most people can walk and chew gum or carry...(read more)

AMI Case Study

David Plaut — Fri, 14 Aug 2009 13:29:00 GMT

With this blog I would like to try something new by presenting an interesting case for you to ponder. Please study that data and the diagnosis and contemplate the situation before reading my comments. A 32 year old homeless male presents to the Emergency...(read more)

Losing Weight--And Not Finding It Again, Part II

David Plaut — Mon, 03 Aug 2009 16:35:00 GMT

Obesity is recognized as a serious chronic disease, but there is pessimism about how successful treatment can be. One pessimistic view is that almost no one succeeds in long-term maintenance of weight loss. For this blog, I will define success as "individuals...(read more)

Serum Biochemical Markers of Acute Pancreatitis

David Plaut — Thu, 30 Jul 2009 16:59:00 GMT

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)

An Immunotherapy Success Story: BCG and Bladder Cancer

David Plaut — Mon, 13 Jul 2009 15:23:00 GMT

Bacillus Calmette-Guerin (BCG) therapy of bladder cancer is the most successful immunotherapy used against any established human neoplasm. Although how BCG works in the bladder is still being defined, it is clear that BCG orchestrates a vigorous immune...(read more)

Losing Weight--And Not Finding It Again

David Plaut — Wed, 17 Jun 2009 18:28:00 GMT

The February 26, 2009 issue of the New England Journal of Medicine published an article comparing four diets: 1) 20 percent fat, 15 percent protein and 65 percent carbohydrates (low-fat, average-protein); 2) 20 percent fat, 25 percent protein and 55 percent...(read more)

Utility of Lp-PLA2

David Plaut — Mon, 08 Jun 2009 15:33:00 GMT

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)

Cystic Fibrosis: An Update

David Plaut — Mon, 01 Jun 2009 16:26:00 GMT

The most common fatal genetic (inborn) disease in North American among Caucasians is cystic fibrosis (CF). Approximately 30,000 American suffer from CF and another 10 million persons are silent carriers of the defective gene. The gene that should produce...(read more)

Blood Substitutes

David Plaut — Wed, 27 May 2009 18:59:00 GMT

Blood substitutes have been studied for at least 70 years; the search continues. All of the first and second generations of these replacements for human blood have been discontinued. Some of the third generation products have also been discontinued. There...(read more)

Screening for Ovarian Cancer With Biomarkers: Are We There Yet?

David Plaut — Wed, 29 Apr 2009 21:04:00 GMT

CA-125 is used mainly to monitor patients with ovarian cancer (OC), in part due to the low level of sensitivity when CA-125 is used alone. In an effort to improve the early detection of OC while keeping the number of false positives low (higher specificity),...(read more)