Annals of clinical biochemistry
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Ann. Clin. Biochem. · Jul 2003
Case ReportsMajor ketogenesis and the absence of an osmolar gap in an atypical case of alcoholic ketoacidosis.
A new case of alcoholic ketoacidosis (AKA) is presented because of unusual clinical and biochemical features. Although it shares some similarities with typical cases of AKA, it appears as unique because of predominantly neurological, rather than abdominal symptoms, major ketogenesis with normal ketone body ratio, the presence of large amounts of propanediol and the absence of an osmolar gap.
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Nephrotoxicity from non-steroidal anti-inflammatory drugs (NSAID) is well recognized. We report a case of severe hypokalaemia and weakness due to renal tubular acidosis in a young woman who was taking 40-60 tablets per day of Nurofen Plus (ibuprofen 200 mg and codeine phosphate 12.8 mg). Proprietary brands of ibuprofen are freely available to the public and those containing codeine may be potentially subject to abuse. This case highlights the need to be aware of this potential and of the life-threatening electrolyte and acid-base disturbances that might be encountered with the widespread availability of these types of NSAID.
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Ann. Clin. Biochem. · Nov 2002
Comparative StudyInfluence of glucuronosyl bilirubin and (EZ)-cyclobilirubin on determination of serum unbound bilirubin by UB-analyser.
In the enzyme reaction for the determination of the unbound (free) bilirubin concentration by glucose oxidase and peroxidase, materials with low affinity for serum protein are reactive. The influence of these materials on the determination of serum unbound bilirubin was investigated. METHODS Serum samples from patients with neonatal hyperbilirubinaemia were analysed by high-performance liquid chromatography for total glucuronosyl bilirubin concentration (TGC) and (EZ)-cyclobilirubin concentration [(EZ)-C]. Based on these measurements, the samples were classified into three groups: group I [13 samples, TGC <2 micromol/L and (EZ)-C < 2.5 micromol/L]; group II [four samples, TGC < 2 micromol/L and (EZ)-C > or = 2.5 micromol/L]; and group III (five samples, TGC > or = 2 micromol/L). The concentrations of total bilirubin and unbound bilirubin were measured in these same samples with a UB-analyser. When the absorbance at 460nm was monitored, the decrease in absorbance was non-linear (concave curve). The degree of concavity was estimated (D15 value) as the deviation from linearity at 15s. ⋯ These results indicated that determination of serum unbound bilirubin concentration using the UB-analyser could be positively skewed by high concentrations of TGC and (EZ)-C.
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Ann. Clin. Biochem. · Sep 2002
Comparative StudyNear-patient testing of blood glucose using the Bayer Rapidlab 860 analyser in a regional neonatal unit.
We evaluated the use of the glucose biosensor on the Bayer Rapidlab 860 (BR 860) blood gas analyser for neonates and compared it with two laboratory-based methods for measuring blood glucose using the Yellow Springs Instruments 2300 STAT PLUS (YSI) analyser and the Vitros 750 XRC (Vitros) analyser. ⋯ The BR 860 analyser provides neonatal blood glucose measurements in the clinical setting of a neonatal unit that compare well with results obtained using laboratory-based methods.
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Ann. Clin. Biochem. · Sep 2002
Comparative StudyPoint-of-care testing of blood glucose in the neonatal unit using the AVL Omni 9 analyser.
Blood glucose measurements in newborns at risk of hypoglycaemia are an essential part of their medical management. Blood glucose measurements obtained by point-of-care testing using an AVL Omni 9 blood gas and metabolite analyser were compared with those obtained in the central laboratory using a Dade Dimension RXL analyser. ⋯ Point-of-care testing of blood glucose using the AVL Omni 9 blood gas and metabolite analyser is a reliable means of measuring blood glucose and has the advantage of providing a fast result using small volumes of blood.