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Clinical implementation of pharmacogenetics (PGx) into routine care will elevate the current paradigm of treatment decisions. However, while PGx tests are increasingly becoming reliable and affordable, several barriers have limited their widespread usage in Canada. Globally, over ninety successful PGx implementors can serve as models. The purpose of this paper is to outline the PGx implementation barriers documented in Quebec (Canada) to suggest efficient solutions based on existing PGx clinics and propose an adapted clinical implementation model. We conclude that the province of Quebec is ready to implement PGx.
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[Abstract] Objective To assess the clinical value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in diagnosis of ankylosing spondylitis. Methods Eighty patients with ankylosing spondylitis and 100 normal controls from Changhai Hospital, Naval Medical University (Second Militaray Medical University) were enrolled in our study. The fasting venous blood samples were collected in the morning for routine blood examination. The differences of NLR and PLR between the two groups were analyzed. The receiver operating characteristic (ROC) curve was used to evaluate the sensitivity and specificity of NLR and PLR, and combined diagnostic test was performed. Results The levels of NLR and PLR in ankylosing spondylitis patients were significantly higher than those in the control group (2.25 [1.66, 3.35] vs 1.50 [1.23, 2.09], P0.01; 147.94 [104.11, 188.80] vs 105.75 [89.55, 148.02], P0.01]. ROC curve analysis showed that the area under curve (AUC) of NLR in diagnosis of ankylosing spondylitis was 0.694 (95% confidence interval [CI]: 0.615-0.772, P0.01), and the sensitivity and specificity of NLR were 77.5% and 58.0%, respectively, when the cut-off value was 1.64. The AUC of PLR in diagnosis of ankylosing spondylitis was 0.662 (95% CI: 0.580-0.756), and the sensitivity and specificity of PLR were 66.2% and 63.0%, respectively, when the cut-off value was 120.91. The sensitivity and specificity of NLR and PLR parallel testing (NLR/PLR) were 83.8% and 50.0%, and the sensitivity and specificity of the NLR and PLR tandem testing (NLR+PLR) were 61.2% and 75.0%, respectively. Conclusion NLR and PLR both have clinical value for the diagnosis of ankylosing spondylitis, and the combination of the two can improve the diagnostic sensitivity and specificity.
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Objective To investigate the clinical impact of neutrophil to lymphocyte ratio (NLR) in the diagnosis of ulcerative colitis.Methods The study included 97 patients with ulcerative colitis (UC) and 95 patients with irritable bowel syndrome (IBS) from June 2009 to June 2016.The differences of NLR between the two groups were analyzed and the result of sensitivity and specificity were calculated.The differencesn of NLR were analyzed between the groups of different severity and in different lesionsseparately.Results NLR were significantly higher in ulcerative colitis than in irritable bowel syndrome (t=2.327,P<0.021).Sensitivity was 69.1 % and specificity was 75.8 %.There was statistic different in groups of different severity determination of newly diagnosed ulcerative colitis (F=8.221,P=0.001)and there was no statistic different between different lesions (F=0.737,P=0.483).Conclusion NLR is valuable in the diagnosis of UC and IBS can determine the degree of inflammation of ulcerative colitis.