Clin Lab
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Comparative Study
Clinical usefulness of the semiquantitative procalcitonin test in the diagnosis of bacterial infections in a third level children's hospital.
The differential diagnosis between viral and bacterial infections can be challenging in children. Procalcitonin (PCT) has been investigated as an early marker for bacterial infections. The aim of this study was to assess the usefulness of procalcitonin (PCT) compared to C-reactive protein (CRP), white cell blood count (WBC), and absolute neutrophil count (ANC) for differentiating bacterial from viral infections in a third level pediatric hospital. ⋯ The PCT semiquantitative test is not sufficiently sensitive to be used alone as a marker of bacterial infection.
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Rapid and reliable exclusion of acute myocardial infarction during emergency department triage is an important clinical need. The purpose of this study was to evaluate the potential role of copeptin, a marker of acute endogenous stress, together with high sensitive troponin-I for a rapid and early rule-out of acute myocardial infarction. ⋯ Copeptin concentrations are more sensitive than myoglobin as an early marker of myocardial damage. Although copeptin provides significant incremental value on top of high sensitivity troponin-I, myoglobin does not.
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Transfusion-related acute lung injury (TRALI) is the leading cause of transfusion related morbidity and mortality. TRALI is suggested to be a "two hit" event. The "first hit" is the underlying condition of the patient which results in sequestration and priming of neutrophils in the pulmonary compartment. ⋯ Although it could be speculated that all of these factors may be involved in the onset of TRALI, only one pre-clinical study shows an association between the aged erythrocyte and the onset of TRALI. The suggested mechanism is a decrease in the chemokine scavenging function of the erythrocyte by reduction of the Duffy antigen expression resulting in an increase in lung injury. Further research is needed to elucidate possible mechanisms of onset of TRALI by aged blood products.
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Procalcitonin (PCT) and C-reactive protein (CRP) measurements in pleural fluid and plasma have been proposed to facilitate differential diagnosis of pleural effusion (PE). The primary aim of this study was to evaluate the usefulness of these measurements when differentiating between benign (BPE) and malignant pleural effusion (MPE). ⋯ CRP levels in the pleural fluid and plasma were higher in patients with BPE, particulary infectious PE. However, the measurement of CRP and PCT is not a useful parameter for discriminating between BPE and MPE and does not provide useful information in clinical practice.
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The enigma of Traumatic Brain Injury (TBI), reflected in recent scientific literature, is its uncertain consequences, variability of the final prognosis with apparently similar TBI, necessity for peripheral biomarkers, and more specific predictive models. ⋯ Significantly higher S100B levels are observed on exitus, with excellent TBI prognosis and evolution performance. Hospital stay in the NICU produces significant increases in S100B compared to healthy subjects, without invalidating it as a biomarker. Polytraumatism associated to TBI does not significantly alter S100B levels. S100B at 24 hours > or = 0.90 microg/L appears to predict unfavourable TBI evolution with a NPV: 94.2% and PPV: 54.9%. We propose a predictive model when we associate S100B at 24 hours with amnesia duration over 30 minutes with a NPV of 85.5% and a PPV of 83.3%.