Clinica chimica acta; international journal of clinical chemistry
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Comparative Study
Prognostic value of combining high sensitive troponin T and N-terminal pro B-type natriuretic peptide in chest pain patients with no persistent ST-elevation.
The aim was to examine whether high sensitive troponin T (Hs-TnT) is better than conventional troponins to risk stratify chest pain patients, in particular when applying early serial measurements or combining with natriuretic peptides. Samples were obtained on admission and after 2 h in 231 chest pain patients who were followed for a median time of 22 months. Troponin levels were determined by Hs-TnT, conventional TnT (Roche Diagnostics) and troponin I (Beckman Coulter) assays. ⋯ In those with negative TnI, Hs-TnT identified 26 patients of whom 23% had subsequent events. After adjusting for differences in baseline characteristics, both Hs-TnT and NT-proBNP were independently associated with short-term (3 months) risk of combined endpoint and long-term risk of death or MI. By combining Hs-TnT and NT-proBNP patients could be divided into low-, intermediate- and high-risk groups.
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Sepsis, a common deadly systemic infection caused by a variety of pathogens, has some clinical symptoms similar to the systemic inflammatory response syndrome (SIRS), a whole-body non-infectious inflammatory reaction to severe insults, such as burn, trauma, hypotensive shock and so on. Treatment of sepsis depends mainly on anti-microbial, while remedy for SIRS might require steroids that could possibly enhance the spread of microbes. Unfortunately, it is very difficult to distinguish these two completely different serious conditions without blood culture, which takes days to grow and identify causative pathogens. We examined a biomarker, serum decoy receptor 3 (DcR3), was evaluated for its utility in the differential diagnosis between sepsis and SIRS. ⋯ The serum DcR3 has a potential to serve as a new biomarker for sepsis with its high specificity and sensitivity.
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The objective of this study was to determine maternal and placental concentrations of follistatin-like 3 (FSTL3), and, maternal concentrations of myostatin in gestational diabetes mellitus (GDM). ⋯ Maternal and placental FSTL3 concentrations were reduced in GDM women compared with normally pregnant women, suggesting FSTL3 may play an important role in the pathogenesis of gestational diabetes.
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The need for reducing unnecessary antibiotic treatment is being emphasized in the management of urinary tract infections (UTI), a disease frequent in childhood. An ideal test should provide early diagnosis without the waiting times of urine culture, but even a simple test of exclusion could significantly improve patient management. ⋯ This routine method could improve the management of UTI in children by early identifying patients with low probability of infection, for whom antibiotic treatment can be withheld until the results of urine culture become available.
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Leukocyte recruitment and inflammatory response play an important role in the pathophysiology after aneurysmal subarachnoid hemorrhage (SAH). We determined whether leukocyte adhesion molecules after aneurysmal SAH can predict the presence of delayed cerebral infarction (DCI). ⋯ Higher expressions of neutrophil PSGL-1 on admission may imply a danger of DCI in patients with aneurysmal SAH.