Clinica chimica acta; international journal of clinical chemistry
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Acute kidney injury (AKI) and chronic kidney disease (CKD) are conditions that substantially increase morbidity and mortality. Although novel biomarkers are being used in practice, the diagnosis of AKI and CKD is still made with surrogate markers of GFR, such as serum creatinine (SCr), urine output and creatinine based estimating equations. SCr is limited as a marker of kidney dysfunction in both settings and may be inaccurate in several situations, such as in patients with low muscle mass or with fluid overload. New biomarkers have the potential to identify earlier patients with AKI and CKD and in the future potentially intervene to modify outcomes. ⋯ Recent advances in molecular biology have resulted in promising biomarkers for AKI and CKD diagnoses; however more research is necessary to implement them successfully into clinical practice in order to facilitate early diagnosis, guide interventions and monitor disease progression. The following review describes the most important biomarkers studied in kidney disease and will discuss the use and the value of these biomarkers in different clinical settings.
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The availability of portable healthcare devices, which can acquire and transmit medical data to remote experts would dramatically affect healthcare in areas with poor infrastructure. Smartphones, which feature touchscreen computer capabilities and sophisticated cameras, have become widely available with over billion units shipped in 2013. ⋯ This review covers the use of smartphones to acquire, analyze, communicate, and liberate clinical laboratory data. Smartphones promise to dramatically improve the quality and quantity of healthcare offered in resource-limited areas.
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We really appreciate the comments from Drs. Reibnegger and Fuchs regarding our recent publication "Normalization of urinary pteridines by urine specific gravity for early cancer detection [Clin. Chim. ⋯ Their letter not only provides unique insights that are both relevant and helpful to many researchers engaging in similar studies, but also provides a wonderful opportunity for us to address these potential concerns that may also be shared by other readers. We addressed all of the comments by Drs. Reibnegger and Fuchs in this letter.
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Subjects with spinal cord injury (SCI) exhibit impaired left ventricular (LV) diastolic function, which has been reported to be attenuated by regular physical activity. This study investigated the relationship between circulating matrix metalloproteinases (MMPs) and tissue inhibitors of MMPs (TIMPs) and echocardiographic parameters in SCI subjects and the role of physical activity in this regard. Forty-two men with SCI [19 sedentary (S-SCI) and 23 physically-active (PA-SCI)] were evaluated by clinical, anthropometric, laboratory, and echocardiographic analysis. ⋯ Bivariate analysis showed that pro-MMP-2 correlated inversely with Em and directly with E/Em, while MMP-9 correlated directly with LV mass index and LV end-diastolic diameter in the whole sample. Following multiple regression analysis, pro-MMP-2, but not physical activity, remained associated with Em, while MMP-9 was associated with LV mass index in the whole sample. These findings suggest differing roles for MMPs in LV structure and function regulation and an interaction among pro-MMP-2, diastolic function and physical activity in SCI subjects.
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Thromboelastrography (TEG) is one of the most common whole-blood viscoelastic coagulation tests used in clinical laboratories and at the point of care. TEG provides information on coagulation defects that are often difficult to detect using routine laboratory tests such as activated partial prothrombin time or prothrombin time. ⋯ However, TEG and other viscoelastic coagulation tests are affected by unique pre-analytic and analytic variables that do not impact other common laboratory coagulation tests. In this review the underlying principles, clinical applications, and laboratory aspects of TEG testing are discussed.