Clin Lab
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Hereditary hemochromatosis is the most common autosomal recessive disease in populations of Northern European ancestry. Population studies demonstrated highly variable frequencies of the HFE Cys282Tyr allele in various regions throughout Europe and decreasing allele frequencies from north to south. However, most of the German prevalence studies covered the central and southern regions of the country. ⋯ The HFE Cys282Tyr allele frequency was 4.44%. Phenotypic markers of iron overload were elevated in one homozygote. We conclude that in contrast to previous hemochromatosis prevalence studies in Germany using blood donors or employees, the present study involving hospital patients estimated a HFE Cys282Tyr allele frequency of 4.44% and supports the emerging concept of an allele gradient decreasing from North to South within Germany.
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Multicenter Study Comparative Study Clinical Trial Controlled Clinical Trial
Quantitative bedside testing of troponin T: is it equal to laboratory testing? The Cardiac Reader Troponin T (CARE T) study.
The progressive evolution of cardiac marker testing in patients with acute coronary syndromes has extended their role into risk stratification and guidance of therapeutic regimen. To provide utilization of cardiac markers around the clock and facilitate the diagnostic work-up of patients with acute chest pain in the emergency room, a point-of-care system for quantitative troponin T and myoglobin testing in whole blood samples was developed. Aim of this multicenter study was to evaluate bedside quantitative determination of myoglobin and troponin T in chest pain patients in a clinical routine setting. ⋯ The results show that the cardiac reader system represents a promising alternative to central laboratory testing with an accuracy sufficiently for rapid decision making in the emergency room. Myoglobin results in this study did not add supplementary information to the cardiac reader troponin result. However, point-of-care testing of troponin T is advantageous whenever marker results could positively effect initial triage decisions and interventional management choices.
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Review Comparative Study
Comparison of cardiac troponin T and troponin I assays--implications of analytical and biochemical differences on clinical performance.
The usefulness of cardiac troponins for detection of myocardial cell necrosis and risk stratification has been established beyond doubt. Cardiac troponin testing is a key diagnostic element for the diagnosis and management of patients with acute coronary syndromes without ST segment elevation and is increasingly used in non-coronary diseases to indicate prognostically important cardiac damage. ⋯ In fact, recent studies in patients with end-stage renal disease under chronic hemodialysis have readdressed the issue whether cTnT and cTnI are really comparable. The present review will provide a state-of-the-art overview on the performance of cardiac troponins in acute coronary disease and other clinical conditions.
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Although it seems to be rather unlikely, it still remains unclear whether hepatitis G virus (HGV) is involved in post-transfusion hepatitis. Prevalence of HGV viremia and persistence in blood donors was determined. ALT and AST values of viremic and non-viremic donations of the donors were compared. 25,006 blood donations were tested for the presence of HGV RNA by reverse transcriptase polymerase chain reaction. ⋯ Patients have a significantly higher prevalence of HGV viremia compared to blood donors. In blood donors no liver affection by means of ALT or AST elevation can be seen. Long persistence of HGV viremia is common and the presence of anti-E2 does not exclude viremia.
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Comparative Study
Detection of procalcitonin (PCT) in healthy controls and patients with local infection by a sensitive ILMA.
Procalcitonin (PCT) is an established marker for severe systemic bacterial infection and sepsis. So far the relevance of PCT in healthy individuals or patients with local infections is unclear due to the lack of highly sensitive assays. The aim of our study was the characterization of a new sensitive PCT assay, the establishment of reference values and the assessment of diagnostic accuracy. ⋯ The new PCT assay is 30 times more sensitive than the established routine assay LUMItest PCT, thus allowing for the first time PCT detection in healthy individuals. First results indicate that the assay is suitable to differentiate local bacterial infections from other non-infectious diseases.