Clinical biochemistry
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Clinical biochemistry · Aug 2013
Low vacuum and discard tubes reduce hemolysis in samples drawn from intravenous catheters.
In-vitro hemolysis is a great challenge to emergency departments where blood is drawn from intravenous catheters (IVCs). Although high quality samples can be obtained by straight needle venipuncture, IVCs are preferred for various reasons. The aim of this study was to identify blood collection practices that reduce hemolysis while using IVC. ⋯ In summary, both discard and low vacuum tubes reduce hemolysis while drawing blood from IVC. Of these practices the use of a low vacuum tube is preferred considering the less volume of blood and the amount of tubes drawn.
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Clinical biochemistry · Aug 2013
Improved sensitivity of point of care troponin I values using reporting to below the 99 th percentile of normals.
Troponin point of care tests have been found to have inferior sensitivity to laboratory based tests, when either the 10% CV or the 99 th percentile of a healthy population is used as the cut-off. In a prospective study we evaluated a decreased cut-off in the detection of cardiac injury. ⋯ We believe that we have described in this study a way to improve the sensitivity of point of care assays for troponin that allows us to identify additional patients without losing the specificity required to identify appropriate patients for discharge from the emergency department.
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Clinical biochemistry · Aug 2013
Simultaneous detection of 19 drugs of abuse on dried urine spot by liquid chromatography-tandem mass spectrometry.
The lack of specificity of immunoassays for drugs of abuse testing (DAT), and concerns over its cost in conjunction with reflex confirmatory tests prompted us to investigate the combinatorial use of dried urine spot (DUS) and LC-MS/MS as an alternative. ⋯ We established and validated a DUS-LC-MS/MS method for DAT that conforms to the guidelines dictated by FDA, CLSI, and SAMHSA. While our method with high sensitivity and specificity provides an alternative diagnostic utility to EMIT immunoassays, it also offers superior solutions in specimen transportation, preservation, and storage. The benefits of our method are apparent in reducing turnaround time and test costs that result in better patient care.
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Clinical biochemistry · Aug 2013
New insights in the pathophysiology of acute myocardial infarction detectable by a contemporary troponin assay.
ST-elevation and non-ST-elevation myocardial infarction (STEMI, NSTEMI) are considered two distinct pathophysiologic entities. We evaluated cardiac troponin I (cTnI) release in STEMI and NSTEMI using a "contemporary" (CV>10 to 20% at the 99th percentile concentration) cTnI assay for patients undergoing early percutaneous coronary intervention (PCI). ⋯ STEMI and NSTEMI patients have different patterns and dynamics of cTnI release influenced by the interaction with time from symptoms, by aging and history of CAD.
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Clinical biochemistry · Jul 2013
ReviewCirculating miRNAs as sensitive and specific biomarkers for the diagnosis and monitoring of human diseases: promises and challenges.
The regulation and modulation of gene expression has been a central focus of modern biomedical research ever since the first molecular elucidation of DNA. The cellular mechanisms by which genes are expressed and repressed hold valuable insight for maintaining tissue homeostasis or conversely provide mechanistic understanding of disease progression. Hence, the discovery of the first miRNA in humans roughly a decade ago profoundly shook the previously established dogmas of gene regulation. ⋯ We discuss the practicality of miRNAs in the screening, diagnosis and prognosis of a range of pathologies. Characteristics and pitfalls of miRNA detection in blood are also discussed. The topics covered here are pertinent in the design of future miRNA-based detection strategies for use in clinical biochemistry laboratory settings.