Annals of clinical and laboratory science
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Ann. Clin. Lab. Sci. · Jan 2013
Comparative StudySerum methylmalonic acid and holotranscobalamin-II as markers for vitamin B12 deficiency in end-stage renal disease patients.
Vitamin replacement, particularly B vitamins, remains an important concern in end-stage renal disease (ESRD) patients undergoing chronic hemodialysis. Serum markers such as methylmalonic acid (MMA) and holoTranscobalamin (holoTC) used to detect vitamin B12 deficiency are affected by impaired renal function which makes the interpretation of these biomarkers difficult in ESRD patients. We investigated the role renal failure has on MMA and holoTC concentrations and evaluated using MMA and/or holoTC to identify B12 deficient patients. ⋯ MMA is viable marker of B12 deficiency in ESRD patients. Holo TC has potential as a supplementary marker with MMA to predict the response of vitamin B12 supplementation. Future studies on MMA and B12 should be done to confirm these findings in larger cohorts and to identify individuals who may benefit from vitamin B12 supplementation.
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Ann. Clin. Lab. Sci. · Jan 2013
Evaluation of heparin-induced thrombocytopenia (HIT) laboratory testing and the 4Ts scoring system in the intensive care unit.
Over-diagnosis of heparin-induced thrombocytopenia (HIT) results in costly and unnecessary laboratory screening and treatment with direct thrombin inhibitors. Our aim was to evaluate the utility of the 4Ts scoring system to predict HIT in multiple ICU settings and to characterize our treatment of these cases. ⋯ Our modified 4Ts scoring system appears to be an effective tool for predicting HIT in the ICU and could avoid significant drug and laboratory expenditures if implemented prospectively. The clinical management of patients suspected of HIT is highly variable at our institution. Clinical protocols and education encouraging the proper identification and treatment of suspected HIT need to be established.
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Ann. Clin. Lab. Sci. · Jan 2013
Case ReportsLymphomatoid granulomatosis: a case report with unique clinical and histopathologic features.
Lymphomatoid granulomatosis is a rare lymphoproliferative disorder composed of rare-to-abundant atypical Epstein Barr virus infected B-cells admixed with numerous reactive T-cells. We report a case of a 42 year-old man presenting with fevers of unknown origin and acute renal failure. ⋯ The patient responded to chemotherapy, but later underwent relapse and transformation to diffuse large B-cell lymphoma. The clinical and histological features of lymphomatoid granulomatosis and differential diagnoses as related to this case are discussed.
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Ann. Clin. Lab. Sci. · Jan 2013
The optimal time window of ischemic preconditioning (IPC) on the reperfusion injury in moderate to severe hepatocirrhosis in rats.
To evaluate the effects of different-time ischemic preconditioning (IPC) schemes on the ischemia-reperfusion (I/R) injury in moderate to severe hepatocirrhosis in rats and to identify the optimal time window of IPC. ⋯ The 5-10 min through 8-10 min-IPC achieves the highest protective effect on the I/R injury of moderate to severe hepatocirrhosis. With the aggravation of liver cirrhosis, the pre-implementation time has been shortened. Thus, IPC of 5-10min may be effective for severe liver cirrhosis.