Scandinavian journal of clinical and laboratory investigation
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Scand. J. Clin. Lab. Invest. · Dec 2000
Time-dependent diagnostic performance of a rapid troponin T version 2 bedside test in patients with acute coronary syndromes.
In a prospective trial, the diagnostic performance of the second version of the troponin T rapid assay (Trop T; cutoff 0.2 microg/L) was compared with the quantitative cardiac-specific troponin T assay (cTnT ELISA; cutoff 0.1 microg/L) and other established cardiac markers such as CK, CK-MB activity, CK-MB mass and myoglobin. Additionally, a 30-day follow-up was performed to determine the suitability of the Trop T assay and the reference markers for short-term risk stratification. Two-hundred-and-eighty-six consecutive patients with chest pain and suspected acute myocardial infarction (AMI) were enrolled in two CCU departments. ⋯ The admission Trop T and cTnT ELISA were the only significant biochemical predictors of major cardiac events. In conclusion, these data show that Trop T has similar diagnostic sensitivity as cTnT ELISA and is a useful tool to confirm acute or subacute myocardial infarction. Trop T is an excellent marker in detecting minor myocardial damage in UAP patients and is suitable for short-term risk stratification.
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Scand. J. Clin. Lab. Invest. · May 1999
Determination of the effect of pH and foetal haemoglobin fraction on haemoglobin oxygen saturation readings by the OSM3 hemoximeter.
The visible absorption spectrum of oxyhaemoglobin depends on its content of foetal haemoglobin and on the pH of the blood. These variables are known to affect oxygen saturation readings measured by the OSM3 Hemoximeter. As the hemoximeter estimates foetal haemoglobin content from the absorption spectrum of oxyhaemoglobin, this estimation is affected by pH. ⋯ The effect of pH on readings of saturation and fractional foetal haemoglobin was confirmed and a correction factor was calculated. The value of KHbF, the coefficient used in the OSM3 Hemoximeter to estimate the amount of fractional foetal haemoglobin present in a sample, was determined to be 18.3, which slightly but significantly differed (p = 0.04) from the 18.6 used by the OSM3 Hemoximeter. An equation was derived to correct the errors made by pH on the saturation measurement of oxygenated blood.
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Scand. J. Clin. Lab. Invest. · Nov 1998
Thrombin-antithrombin III and D-dimer plasma levels in patients with benign or malignant ovarian tumours.
In 50 patients with benign ovarian tumours, 39 malignant ovarian carcinoma patients and 39 age-matched healthy women, plasma levels of thrombin-antithrombin III complex and D-dimer were determined as well as CA 125. The coagulation activation marker thrombin-antithrombin III complex and D-dimer levels were elevated in the malignant group compared to the benign and control groups. The results suggest that coagulation and fibrinolysis must play a prominent role in ovarian cancer. Moreover, D-dimer and thrombin-antithrombin III were equally useful as CA 125 for the discrimination of patients with benign or malignant ovarian tumours as evidenced by receiver operating and likelihood ratio calculations.
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Scand. J. Clin. Lab. Invest. · Jul 1997
Randomized Controlled Trial Comparative Study Clinical TrialEffect of bolus injection versus continuous infusion of furosemide on diuresis and neurohormonal activation in patients with severe congestive heart failure.
Previous studies have demonstrated that continuous infusion of furosemide results in increased diuresis and natriuresis compared with bolus administration of the drug in patients with severe heart failure. We reasoned that continuous infusion of furosemide caused less activation of neurohumoral mechanisms, since other studies have shown that bolus administration of furosemide may activate this system. We therefore tested the hypothesis that continuous administration of furosemide would increase water and sodium excretion due to less activation of neurohormones. ⋯ Neither regimens of furosemide caused any further significant changes in neurohumoral response except that pro-ANF decreased more during the first 8 h after bolus administration compared to continuous infusion. This study has demonstrated that bolus administration of furosemide in conventional doses is equally effective as continuous intravenous infusion in patients with severe heart failure. This may be due to maximal neurohormonal activation in severe heart failure (NYHA III-IV) which could not be further activated by bolus administration.
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Scand. J. Clin. Lab. Invest. · Dec 1996
Cardiac markers in the early hours of acute myocardial infarction: clinical performance of creatine kinase, creatine kinase MB isoenzyme (activity and mass concentration), creatine kinase MM and MB subform ratios, myoglobin and cardiac troponin T.
We compared early markers of acute myocardial infarction (AMI) in the first 6 h from the onset of symptoms in 133 non-traumatized patients arriving at the emergency department with chest pain suggestive of AMI. Clinical performance parameters were calculated on the basis of 45 patients with AMI and 88 patients with a non-AMI diagnosis. At admission and in the first 0-3 h after the onset of chest pain the creatine kinase-MB (CK-MB) subform ratio was the most sensitive test at a comparable specificity level of 0.95. ⋯ Cardiac troponin T (cTnT) demonstrated an ROC area equal to the CK-MB isoform ratio and myoglobin at 6 h. However, the likelihood ratio for ruling out AMI was lower, mostly due to the elevated cTnT in unstable coronary disease not defined as AMI. We conclude that the CK-MB subform ratio, CK-MB mass concentration and myoglobin do not demonstrate any significant differences in clinical performance for ruling in or ruling out acute myocardial infarction at 6 h after the onset of chest pain.