Clinical biochemistry
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Clinical biochemistry · Aug 2005
Comparative StudyEvaluation of plasma ammonia levels in patients with acute liver failure and chronic liver disease and its correlation with the severity of hepatic encephalopathy and clinical features of raised intracranial tension.
The present study was designed to (a) evaluate and compare plasma ammonia levels (PAL) in patients with acute liver failure (ALF) and chronic liver disease (CLD) with or without hepatic encephalopathy (HE); (b) correlate the severity of HE with PAL; and (c) correlate PAL with clinical features of raised intracranial tension in ALF. ⋯ Raised PAL appears to be an important laboratory abnormality seen in patients with ALF, and there seems to be a significant correlation between the severity of encephalopathy and PAL in these patients. However, among patients with CLD, the proportion of patients with PAL more than the upper limit of normal range is not significantly different between those with or without HE. Our study also suggests that high PAL in ALF patients appears to correlate with clinical features of cerebral edema and raised intracranial tension.
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Clinical biochemistry · Jun 2005
Osmolality revisited--deriving and validating the best formula for calculated osmolality.
To derive a formula that can be used (i) to calculate osmolality in normal patients as well as those that are hyperglycemic and intoxicated, and (ii) to predict the presence of unexplained compounds with the osmol gap calculation in the presence and absence of ethanol. DESIGN AND EXPERIMENTS: We performed in vitro experiments to determine the relationship of serum osmolality with sodium, potassium, urea, glucose, ethanol, methanol, and ethylene glycol. Several formulas were then tested for their validity in predicting osmolality in normal individuals. Finally, we assessed whether these formulas would allow us to calculate the osmolality gap (OG) that may be indicative of the presence of other osmotically active compounds. The OG calculation was done both in the presence and absence of ethanol. In this way, the OG should be able to detect compounds like methanol and ethylene glycol even in the presence of ethanol which is easily measured and is very often present in the above-named poisonings. ⋯ This study shows that factors of 1.20 and 1.15 have to be applied to ethanol and glucose to allow for accurate calculation of osmolality and osmolality gap. There were insufficient patient data to verify the factors for methanol and ethylene glycol.
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Clinical biochemistry · Jun 2005
Comparative StudyComparison of three strategies for myocardial protection during coronary artery bypass graft surgery based on markers of cardiac damage.
To evaluate myocardial damage during coronary artery bypass grafting using three different intermittent cardioplegia and then measuring cTnI and CKMBm release. ⋯ A strategy of normothermic cardioplegia seems to preserve myocardium better than hypothermic cardioplegia.
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Clinical biochemistry · Apr 2005
ReviewMulti-analyte procedures for screening for and quantification of drugs in blood, plasma, or serum by liquid chromatography-single stage or tandem mass spectrometry (LC-MS or LC-MS/MS) relevant to clinical and forensic toxicology.
This paper reviews multi-analyte procedures for screening and quantification of drugs in blood, plasma, or serum using liquid chromatography coupled with a single stage or tandem mass spectrometer (LC-MS, LC-MS/MS). These procedures are relevant tools in clinical and forensic toxicology, and cover analysis of amphetamines, cocaine, hallucinogens, opioids, anesthetics, hypnotics, benzodiazepines, antidepressants, neuroleptics, antihistamines, sulfonylurea-type antidiabetics, beta-blockers, and other cardiac drugs. Basic information on the procedures is given in two tables and multi-analyte screening, identification, and quantification are illustrated in three figures. A critical discussion on the pros and cons of such LC-MS procedures is also included.