Journal of clinical laboratory analysis
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J. Clin. Lab. Anal. · Jan 2010
Is procalcitonin better than C-reactive protein for early diagnosis of bacterial pneumonia in children?
Early diagnosis of bacterial pneumonia plays a pivotal role in the management. We evaluated the diagnostic accuracy of procalcitonin (PCT) as compared with C-reactive protein (CRP) for the early diagnosis of bacterial pneumonia in children. In total, 92 children consisting of 46 patients of bacterial pneumonia were admitted in the Military hospital, Rawalpindi, Pakistan and equal number of controls were included. ⋯ The area under receiver characteristic curves for PCT and CRP were 0.89 (95% CI=0.83-0.96) and 0.79 (95% CI=0.70-0.88), respectively. In total, 38 patients were diagnosed to have bacterial pneumonia with PCT (sensitivity 83% at cutoff > or = 1 ng/ml) and 26 children with CRP (sensitivity 57% at cutoff > or = 6 mg/L). PCT has better diagnostic accuracy than CRP and can be utilized for early diagnosis of bacterial pneumonia in children.
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J. Clin. Lab. Anal. · Jan 2007
Chemiluminescent determination of leukocyte alkaline phosphatase: an advantageous alternative to the cytochemical assay.
The determination of leukocyte alkaline phosphatase (LAP) is used as an aid to diagnose many diseases in the laboratory. For example, it can be used to distinguish chronic myeloid leukemia (CML) from other myeloproliferative disorders (particularly myelofibrosis and polycythemia) and leukemoid reactions (LR). Traditionally, this test is performed with the use of subjective cytochemical assays that assign a score to the level of LAP. ⋯ A high linear correlation was found between the chemiluminescent result (slope) and the cytochemical score. The slope for healthy individuals ranged between 0.61 and 8.49 (10(-5) mV.s/cell), with a median of 2.04 (10(-5) mV.s/cell). These results were statistically different from those of CML patients (range=0.07-1.75, median=0.79) and LR patients (range= 3.84-47.24, median=9.58; P<0.05).
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J. Clin. Lab. Anal. · Jan 2007
Comparative StudyDiagnostic value of Elecsys S100 as a marker of acute brain injury in the emergency department.
The aim of this study was to evaluate the screening and diagnostic validity of the initial serum S100 levels by Elecsys S100 immunoassay in an emergency department. We measured serum S100 in 101 acute brain injury (ABI) patients, in 40 healthy subjects, and in 41 chronic brain injury (CBI) patients (the control group). The ABI patients were divided in several groups according to the Glasgow Coma Scale (GCS), injury type and findings of brain imaging. ⋯ At a cutoff of 0.105 microg/L, the sensitivity was 84.8% and the specificity 74.3% for all of the ABI patients, and the sensitivity was increased to 96.9% for the traumatic ABI patients for detecting image-positive ABI. There was no significant difference of S100 levels among the groups on the CCT or MRI pathological findings (P=0.478). In conclusion, serum S100 levels can be used in the emergency department as an additional screening tool to identify CCT- or MRI-positive ABI.
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J. Clin. Lab. Anal. · Jan 2006
Comparative StudyComparison of BNP and NT-proBNP assays in the approach to the emergency diagnosis of acute dyspnea.
N-terminal pro-brain natriuretic peptide (NT-proBNP) and BNP measurement could have a significant role in differentiating dyspnea between cardiac or pulmonary origin in the emergency room. The development of new and different commercial assays for these B-type natriuretic peptides offers the possibility of improving and simplifying their measurements but this could be defaulted due to the differences in methodology and the lack of assay standardization. We compared four available methods of measuring NT-proBNP and BNP and evaluated their usefulness in diagnosing the causes of breathlessness in the emergency room. ⋯ The area under the receiver-operating characteristic curve (ROC) for BNP or NT-proBNP for detecting any cardiac dysfunction was higher than 0.96 (95% CI). A BNP value of 116 pg/mL measurement with the Access BNP assay (Beckman Coulter Inc., Fullerton, CA), a BNP value of 79 pg/mL with Advia Centaur BNP assay (Bayer Diagnostics, Tarrytown, NY), and an NT-proBNP level of 817 pg/mL in Elecsys NT-proBNP assay (Roche Diagnostic, Mannheim, Germany), showed both high sensitivity (>92%) and high specificity (>93%). We have found that NT-proBNP and BNP present similar diagnostic accuracies for the differential diagnosis of dyspnea.
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J. Clin. Lab. Anal. · Jan 2006
Comparative StudyUse of sodium concentration and anion gap to improve correlation between serum chloride and bicarbonate concentrations.
Although most acid-base disorders cause opposite and equal changes in serum chloride and bicarbonate concentrations, this inverse relationship can be distorted by changes in the anion gap and/or water balance. Therefore, we examined the relationship between chloride and bicarbonate before and after adjusting for anion gap and serum sodium concentration. Patients with abnormal electrolytes were grouped by chloride and bicarbonate concentrations (low, normal, and high). ⋯ After adjustments, chloride and bicarbonate were discordant in 40 patients (31 low/high, 9 high/low) and concordant in none. The correlation between serum chloride and bicarbonate improved from -0.459 to -0.998 after adjustments for sodium and anion gap. A very close inverse relationship between serum chloride and bicarbonate concentrations is commonly distorted by concomitant water disturbances and anion gap acidoses in internal medicine patients admitted with electrolyte disorders.