Clinics in laboratory medicine
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Prenatal testing for infectious diseases is performed frequently and for a variety of indications. The purpose of this article is to review the maternal and fetal infections that pose diagnostic concerns. Recent advances in diagnostic testing (such as avidity testing) is included. Testing issues focus on the diagnosis of maternal and fetal infection.
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Review
Advances in pretransfusion infectious disease testing: ensuring the safety of transfusion therapy.
The public expects a zero-tolerance policy for the transmission of infectious agents by blood transfusion. Although unrealistic, the efforts to reach this goal have produced an extremely safe albeit costly blood supply [82]. ⋯ As new, exotic, potentially blood transmittable infectious agents evolve [83], new barriers will be erected to [figure: see text] interdict these agents. In the interim, the US blood supply is the safest in the world.
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Regulatory guidelines concerning point-of-care testing have had a major impact on the development and evolution of these technologies. Beginning with mandates under CLIA '88, hospital accreditation organizations have developed guidelines for the management of point-of-care testing to ensure quality testing. Over the past decade, most hospitals have learned to manage these new technologies as part of the laboratory quality assurance program. Issues concerning regulatory compliance continue to influence the development and use of point-of-care technologies providing opportunity for continuous quality improvement and improved patient care.
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Antiresorptive pharmacologic interventions for the prevention and treatment of osteoporosis are discussed. These interventions include estrogen; calcitonin; biphosphonates; and selective estrogen receptor modulators and their use in postmenopausal osteoporosis, steroid-induced osteoporosis, and osteoporosis in men. The effects of antiresorptive therapy on bone mineral density, biomarkers of bone turnover, and fracture risk are discussed.
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Review
Utility of cardiac troponins in patients with suspected cardiac trauma or after cardiac surgery.
Detection of cardiac injury after blunt chest wall trauma or cardiac surgery is problematic. Previously available biomarkers have been hindered largely by limitations of specifity for myocardial damage. Both cardiac troponin I and T have been evaluated in these patient subgroups. While many questions remain unanswered, it appears that measurement of troponin proteins will facilitate patient care in these difficult situations.