Clinica chimica acta; international journal of clinical chemistry
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In the modern health service, it is no longer acceptable for any clinician or other professional to abstain from continuing education after qualification. This is particularly true in the field of laboratory medicine because of the dramatic changes that have occurred in the organization, number and types of tests, and role of medical laboratories. In Italy, a program for continuing education in medicine (Educazione Continua in Medicina (ECM)) has recently been promoted by the National Government. ⋯ The activation of a national program for continuing education in medicine (ECM) in Italy provides a great opportunity for all professionals of the healthcare sector and for laboratorians, in particular. This educational project offers an unrivalled opportunity for the Italian Scientific Societies of Laboratory Medicine to weave quality improvement into their relationships with associates, thus reappraising their missions and goals.
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There is evidence that septic shock results from breakdown in the balance between vasodilators such as prostacyclin, prostaglandin E(2), and nitric oxide, and the vasoconstrictors thromboxane A(2), serotonin, and endothelin. Increased plasma endothelin (ET) concentrations during septic shock were found. Inducing phospholipase A(2), ET causes release of arachidonic acid and production of prostaglandins. Ibuprofen is nonsteroidal anti-inflammatory drug inhibiting prostaglandin synthesis. There are no any information about the effects of ibuprofen on ET production in endotoxemia. In the present study we aimed to determine the effects of ibuprofen on plasma ET concentrations in an animal model of endotoxin shock. ⋯ Ibuprofen administration during endotoxin shock seems to decrease the elevated ET concentrations, and increase the blood pressure.
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Laboratory services for the support of heart and lung transplantation in Australia have adapted to the special needs of the clinicians looking after the heart and lung transplantation patients. ⋯ Diagnostic pathology testing to support heart and lung transplantation is a combination of routine testing and specialized testing. Depending on the time-critical nature of the tests, this testing has to be done on site or in more centralized testing facilities. Further developments in the laboratory support of heart and lung transplantation will hopefully continue to improve both the short- and long-term outcomes of thoracic organ transplant recipients.
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Calcitonin (CT) is the most sensitive marker available for medullary thyroid carcinoma, but it lacks specificity. Procalcitonin is the precursor protein of calcitonin. Infections are known to be associated with elevations of procalcitonin. The aim of this study was to evaluate a new sensitive calcitonin assay in a large population and to study the assay specificity in two particular populations: patients with renal failure and patients hospitalized in intensive care units with a high procalcitonin level. ⋯ The new sensitive calcitonin assay tested is very efficient especially for the low concentrations. The cross-reaction for high procalcitonin levels exists and is variable according to the kits used. The procalcitonin evaluation can help the interpretation of ambiguous calcitonin levels.
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Brain natriuretic peptide (BNP), NT-proBNP and NT-pro-atrial natriuretic peptide (NT-proANP) were measured in blood samples from 57 patients using immunoassays and immunoradiometric assays to evaluate the usefulness as diagnostic markers for the detection of heart failure. For the detection of impaired left ventricular ejection fraction (LVEF), receiver operating characteristic curves showed that BNP had the best diagnostic performance with an area under curve (AUC) of 0.75+/-0.06. However, NT-proBNP (AUC: 0.67+/-0.07) and NT-proANP (AUC: 0.69+/-0.08) showed no significant difference to BNP. ⋯ Additionally, BNP and NT-proBNP correlated negatively with the resting LVEF (BNP: -0.472, p<0.001; NT-proBNP: -0.306, p=0.026), whereas NT-proANP showed no significant correlation. In summary, BNP was the best marker to detect patients with impaired LVEF compared to NT-proBNP and NT-proANP. However, NT-proBNP showed no significant differences to BNP and it is therefore a new promising alternative marker for the detection of left ventricular dysfunction.