Annals of clinical biochemistry
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The use of herbal products in the UK is increasing, and over-the-counter herbal supplements are perceived by the public as 'safe' and 'harmless'. Although the majority of them are safe, some herbal medicines carry risks. ⋯ Other herbs are hepato- or nephrotoxic and some interact with prescription medicines. Doctors should be made aware of the need to take a herbal as well as a drug history, and the clinical laboratory has a role in helping understanding of how herbal products may affect laboratory tests and in suggesting relevant lines of investigation in patients whose symptoms may be linked to the use of herbal products.
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Ann. Clin. Biochem. · Sep 2003
National guidelines for analysis of cerebrospinal fluid for bilirubin in suspected subarachnoid haemorrhage.
It is crucially important to detect subarachnoid haemorrhage (SAH) in all patients in whom it has occurred in order to select patients for angiography and preventative surgery. A computed tomography (CT) scan is positive in up to 98% of patients with SAH presenting within 12h but is positive in only 50% of patients presenting within 1 week. Cerebrospinal fluid (CSF) bilirubin spectrophotometry can be used to determine the need for angiography in those few CT-negative patients in whom clinical suspicion of a SAH remains high; it may remain positive for up to 2 weeks after the event. ⋯ Oxyhaemoglobin occurring on its own is difficult to interpret and may be increased as a result of in vitro haemolysis of red cells introduced into the CSF during lumbar puncture. This process is exacerbated by vacuum tube transport systems. Results should be interpreted in the light of other investigations (e.g. if scan shows bilirubin then measure serum bilirubin and CSF oxyhaemoglobin and protein) and other confounding variables such as the time elapsed from presentation to LP.