Clinica chimica acta; international journal of clinical chemistry
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We recently introduced an optical sensor, termed photothermal spectral-domain optical coherence reflectometer (PT SD-OCR), capable of direct measurement of hemoglobin concentration ([Hb]) without chemicals and pre-processing of blood. PT SD-OCR measures [Hb] by quantifying refractive index changes of blood samples due to photothermal effect under the irradiation of 532-nm light. We evaluated diagnostic accuracy and precision of PT SD-OCR in anemic patients. ⋯ Simple and chemical-free operation of PT SD-OCR enabled rapid and accurate measurement of [Hb] in anemic patients. The sensor is expected to facilitate clinical procedures related to blood-related disorders in patient care.
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Acute kidney injury (AKI) and chronic kidney disease (CKD) are conditions that substantially increase morbidity and mortality. Although novel biomarkers are being used in practice, the diagnosis of AKI and CKD is still made with surrogate markers of GFR, such as serum creatinine (SCr), urine output and creatinine based estimating equations. SCr is limited as a marker of kidney dysfunction in both settings and may be inaccurate in several situations, such as in patients with low muscle mass or with fluid overload. New biomarkers have the potential to identify earlier patients with AKI and CKD and in the future potentially intervene to modify outcomes. ⋯ Recent advances in molecular biology have resulted in promising biomarkers for AKI and CKD diagnoses; however more research is necessary to implement them successfully into clinical practice in order to facilitate early diagnosis, guide interventions and monitor disease progression. The following review describes the most important biomarkers studied in kidney disease and will discuss the use and the value of these biomarkers in different clinical settings.
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The availability of portable healthcare devices, which can acquire and transmit medical data to remote experts would dramatically affect healthcare in areas with poor infrastructure. Smartphones, which feature touchscreen computer capabilities and sophisticated cameras, have become widely available with over billion units shipped in 2013. ⋯ This review covers the use of smartphones to acquire, analyze, communicate, and liberate clinical laboratory data. Smartphones promise to dramatically improve the quality and quantity of healthcare offered in resource-limited areas.
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Cell apoptosis in critically ill patients plays a pivotal role in the pathogenesis of sepsis. This study aimed to determine the prognostic value of leukocyte apoptosis in patients with severe sepsis. ⋯ Leukocyte apoptosis is significantly higher in patients with severe sepsis. The percentages of late lymphocyte and monocyte apoptosis may be predictive of outcome in such patients. Aside from serum lactate, APO2.7 level in lymphocyte apoptosis is also a useful predictor of outcome on admission to the emergency department.
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Beta-ketothiolase deficiency is a rare inborn errors of metabolism (IEM) affecting the catabolism of isoleucine, characterized by severe ketoacidosis in children of 6 to 24months old. A prompt diagnosis is of paramount importance as the metabolic decompensation can be effectively reverted by glucose infusion and health outcomes are improved on a protein-restricted diet. Currently, majority of the laboratory diagnosis were made based on mass-spectrometry and molecular genetics while little is mentioned on the advancement of nuclear magnetic resonance (NMR) spectroscopy for the diagnosis of this condition. ⋯ This case illustrated that NMR-based urinalysis is complementary to organic acid analysis for diagnosis of beta-ketothiolase deficiency. The operation of NMR is simple and fast; sample preparation is a two-step procedure while the NMR acquisition is automatic and usually takes <15min. We envisage that NMR analysis will become more available in clinical laboratories and will play an important role in acute pediatric care.