Clinica chimica acta; international journal of clinical chemistry
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Low levels of brain natriuretic peptides on admission identify low-risk patients with acute pulmonary embolism (APE) through their high NPV for mortality. However, increased natriuretic peptide values on admission are less helpful for identifying high-risk patients due to their low PPV. The aim of the study was to test whether the PPV for mortality can be improved by performing serial NT-proBNP measurements on admission, at 12 h, and at 24 h. ⋯ Persistent elevation of plasma NT-proBNP levels within 24 h after APE diagnosis indicates ongoing right ventricular dysfunction with a poor prognosis. These critically ill patients may be candidates for rapid aggressive intervention, including thrombolysis, catheter thrombectomy, or surgical embolectomy.
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Comparative Study Clinical Trial
Saliva collection method affects predictability of serum cortisol.
Measurement of cortisol is of particular importance for early diagnosis of adrenocorticotropic dysfunction and therapeutic monitoring. Saliva samples clearly present an easily manageable, non-invasive and anytime practicable assessment method of glucocorticoid production. The aims of the present study were to compare salivary cortisol collection method "Salivette" versus "passive drool", salivary cortisol concentrations with calculated free serum cortisol (FSC) and total serum cortisol (TSC) and the prediction of serum cortisol by salivary cortisol. ⋯ Our data indicate that salivary cortisol measurement with Salivettes is a reliable prediction method of total and calculated free serum cortisol levels. Moreover, it is a convenient method for saliva collection, handling and laboratory processing.
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In ST-elevation myocardial infarction (STEMI) B-type natriuretic peptide (BNP) holds promise for risk stratification. Aim of this study was to assess prognostic value of plasma BNP measurement and to compare with other powerful prognostic markers -- TIMI Risk Score (TRS) and C-reactive protein (CRP) in patients with first STEMI treated with primary PCI (pPCI). ⋯ Admission plasma BNP concentrations provide incremental prognostic information in patients with first STEMI treated with pPCI.