Clin Chem Lab Med
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Neutrophil gelatinase-associated lipocalin (NGAL), an iron-transporting protein rapidly accumulating in the kidney tubules and urine after nephrotoxic and ischemic insults, has been put forward as an early, sensitive, non-invasive biomarker for acute kidney injury (AKI). The aim of this study was to evaluate urinary NGAL levels as a predictor of early AKI (first 5 days after injury) in multi-trauma patients. ⋯ Urinary NGAL can be used from the 1st day of injury as a reliable predictor of early AKI in multi-trauma patients.
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The differential diagnosis between bacterial and viral meningitis is not easy in some cases. Cerebrospinal fluid (CSF) analysis is essential for establishing this diagnosis. The objectives were to quantitate lactic acid (LA) concentrations in bacterial and viral meningitis, and other central nervous system (CNS) diseases in order to evaluate the diagnostic utility of CSF LA for discriminating bacterial from viral meningitis. ⋯ CSF LA is a powerful test to discriminate bacterial from viral meningitis with high sensitivity, specificity and predictive values. CSF LA can help in the cases with diagnostic uncertainty.
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Total error (TE) in analytical measurement is calculated as systematic error (SE) plus z-times random error (RE). The z-multiplier is typically chosen at the 95% probability level, being 1.96 in the absence of SE is of considerable magnitude (one-sided 95% probability). Up to now, no SE/RE ratio dependent z-values have been considered. Here, we present z-values for SE/RE ratios ranging from 0 to 1. ⋯ The results show that at SE/RE ratios > 0.75 the one-sided 95% probability level is practically reached. The results allow a refined calculation of TE at specified SE/RE ratios and a general understanding of the relevance of two- and one-sided probabilities at different SE/RE ratios.
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Comparative Study
Comparative study of calculated and measured total carbon dioxide.
Total carbon dioxide content (TCO2) can be calculated from measured values of pH and pCO2 according to a simplified and standardized form of the Henderson-Hasselbalch equation, or measured directly. ⋯ Calculated TCO2 determined using blood gas analysis agreed with measured TCO2 and may be used to assess acid-base imbalance. However, clinicians should be cautious if using this calculated value in the critically ill patient.
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Acutely dyspneic patients are challenging, because their symptoms can be due to cardiac, pulmonary or other diseases. B-type natriuretic peptide testing offers higher diagnostic accuracy (85%-90%) than clinical assessments for identifying heart failure as the cause of dyspnea. ⋯ It has been shown that systematic natriuretic peptide testing reduces the economic expenses associated with clinical management of acutely dyspneic patients. Finally, whether these biomarkers could be used to guide heart failure therapy in the acute setting remains to be elucidated.