Clinical chemistry
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Editorial Comment
Step by Step Toward Biomarker-Based Precision Medicine in Heart Failure.
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Meta Analysis
Completeness of Reporting of Systematic Reviews of Diagnostic Test Accuracy Based on the PRISMA-DTA Reporting Guideline.
We evaluated the completeness of reporting of diagnostic test accuracy (DTA) systematic reviews using the recently developed Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA)-DTA guidelines. ⋯ Recently published reports of DTA systematic reviews are not fully informative when evaluated against the PRISMA-DTA guidelines. These results should guide knowledge translation strategies, including journal level (e.g., PRISMA-DTA adoption, increased abstract word count, and use of supplementary material) and author level (PRISMA-DTA citation awareness) strategies.
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Randomized Controlled Trial Multicenter Study
Circulating Proenkephalin, Acute Kidney Injury, and Its Improvement in Patients with Severe Sepsis or Shock.
Acute kidney injury (AKI) occurs in many critically ill patients and is associated with high mortality. We examined whether proenkephalin could predict incident AKI and its improvement in septic patients. ⋯ Early measurement and the trajectory of penKid predict incident AKI, improvement of renal function, and the need for RRT in the acute phase after intensive care unit admission during sepsis or septic shock. PenKid measurement may be a valuable tool to test early therapies aimed at preventing the risk of AKI in sepsis.
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Observational Study
Detectable High-Sensitivity Cardiac Troponin within the Population Reference Interval Conveys High 5-Year Cardiovascular Risk: An Observational Study.
Increased cardiac troponin I or T detected by high-sensitivity assays (hs-cTnI or hs-cTnT) confers an increased risk of adverse prognosis. We determined whether patients presenting with putatively normal, detectable cTn concentrations [> limit of detection and < upper reference limit (URL)] have increased risk of major adverse cardiovascular events (MACE) or all-cause mortality. ⋯ Many patients with ACS ruled out and putatively normal but detectable hs-cTnI concentrations are at similar long-term risk as those with MACE. hs-cTnT concentrations are more strongly associated with 5-year mortality than hs-cTnI.
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The emergence of novel psychoactive substances (NPS), particularly synthetic cannabinoid receptor agonists (SCRA), has involved hundreds of potentially harmful chemicals in a highly dynamic international market challenging users', clinicians', and regulators' understanding of what circulating substances are causing harm. We describe a toxicovigilance system for NPS that predicted the UK emergence and identified the clinical toxicity caused by novel indole and indazole carboxylate SCRA. ⋯ This toxicovigilance system predicted the emergence of misuse of indole and indazole carboxylate SCRA, documented associated clinical harms, and notified relevant agencies. Toxicity appears consistent with other SCRA, including mental state disturbances and reduced consciousness.