Clinica chimica acta; international journal of clinical chemistry
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Metabolic acidosis, especially when induced by multiple drug poisoning, often makes rapid and accurate differential diagnosis of the condition challenging. ⋯ Delayed high anion gap metabolic acidosis may occur in the ED. Frequent monitoring of anion and osmolal gaps is a feasible method to perform a rapid differential diagnosis, particularly in response to drug poisoning.
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Heart-type fatty acid binding protein (H-FABP) is a tissue-specific protein which is rapidly released into the circulation when cardiomyocyte injury occurs. The aim of the study is to investigate the prognostic relevance of H-FABP for out-of-hospital cardiac arrest (OHCA) patients in the early post-cardiac arrest period. ⋯ The plasma level of H-FABP at 24h after the event may be an early and independent factor associated with survival to discharge in OHCA patients.
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The aim of this study was to test the prognostic performance of rising and falling kinetic changes of high-sensitivity cardiac troponin T (hs-cTnT) and the GRACE score. ⋯ Neither rising nor falling hs-cTnT changes improve the prognostic performance of elevated hs-cTnT admission values or the GRACE score. However, rising values are more likely associated with the decision for earlier invasive strategy.
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Contrast-induced acute kidney injury (AKI) is diagnosed by estimating serum creatinine at 48-72h after diagnostic or interventional coronary angiography. It is too late for an early intervention. Neutrophil gelatinase associated lipocalin (NGAL) and cystatin C are novel markers of AKI. We determined the optimum cut-off level of NGAL and cystatin C in early diagnosis and prediction of AKI in patients undergoing coronary angiography followed by angioplasty. ⋯ Serum NGAL and cystatin C may act as early markers of contrast-induced AKI in patients undergoing percutaneous coronary intervention. Patients with hypertension are susceptible to develop contrast-induced AKI.
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Errors associated with laboratory testing can cause significant patient harm. Sendout testing refers to tests sent by a primary lab to a reference lab when testing is unavailable at the primary lab. Sendout testing is particularly high risk for patient harm, due to many factors including increased hand-offs, manual processes, and complexity associated with rare, low-volume tests. No published prospective tools exist for sendout risk assessment. ⋯ This tool could be used by other laboratories to identify the areas of highest risk to patients, which in turn may guide them in focusing their quality improvement efforts and resources.