Annals of clinical and laboratory science
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Ann. Clin. Lab. Sci. · Sep 2018
Kidney Function, Nutritional Status, and the Left Ventricle Dysfunction Are Associated with Serum Uric Acid Levels in Patients with Heart Failure with Reduced Ejection Fraction.
The aim of this study was to assess the role of potential factors explaining variability of serum uric acid (SUA) levels in patients with chronic heart failure with reduced ejection fraction (HFrEF) not receiving xanthine oxidase inhibitors and acetylsalicylic acid, with multivariate adaptive regression splines and fuzzy c-regression models. ⋯ Kidney function, nutritional status, the use of thiazide diuretics and the severity of left ventricle dysfunction reflected by serum NT-proBNP levels explain the serum uric acid levels variability in patients with HFrEF.
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Ann. Clin. Lab. Sci. · Sep 2019
Sensitivity and Specificity of the Neutrophil-lymphocyte Ratio in the Diagnosis of Acute Appendicitis.
Acute appendicitis is a common surgical emergency; however, its misdiagnosis resulting in negative appendicectomy is not uncommon. Novel diagnostic methods will help reduce the rate of negative appendicectomy. We hypothesise that the neutrophil-lymphocyte ratio (NLR) will increase upon peritoneal involvement by inflammation, as it does in severe disease. ⋯ Inflammatory markers are useful adjuncts to history, examination, and radiological investigations in making the diagnosis of appendicitis. However, due to low sensitivity and specificity, they cannot be used alone. Calculation of the NLR has no additional benefit over the neutrophil count in diagnosis, or in distinguishing moderate and severe disease.
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Ann. Clin. Lab. Sci. · Dec 2016
Providing Hemostatic and Blood Conservation Options for Jehovah's Witness Patients in a Large Medical System.
People of the Jehovah's Witness faith believe that they shall "abstain from blood." Because of this belief, we encounter the challenges from Jehovah's Witness patients who actively seek medical care for themselves and their children, but refuse the transfusion of blood products, which may result in increased morbidity and mortality in this patient population. With the development/availability of new hemostatic/coagulation products and the advances in medical technology, we, in collaboration with our clinical colleagues and our local Jehovah's Witness leadership, have developed a clinical guideline comprising medical protocol and surgical strategy for patients refusing blood products. ⋯ Together, we have entered the medical protocol into the entire Memorial Hermann Hospital's electronic system. We report the detailed development and implementation process in order to share our experience and encourage others to develop their own management plan for this patient population.
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Ovarian cancer remains a leading cause of death from gynecological malignancy. Early diagnosis is the most important determinant of survival. ⋯ Numerous proteomics-based molecular biomarkers/panels have been identified and hold great potential for diagnostic applications, but they need further development and validation. This article reviews recently published data on the diagnosis of ovarian cancer with proteomics, including the major proteomics technologies and promising strategies for biomarker discovery and development.
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Granulocytic fragments have been described in the peripheral blood of patients with sepsis and the systemic inflammatory response syndrome (SIRS). Although initially proposed as a morphologic clue for distinguishing the leukoerythroblastosis of sepsis from that of myelophthisis or marrow replacement by tumor, granulocyte-derived fragments may be part of a spectrum of cellular fragmentation associated with pathological inflammation and thrombosis, and thus play an important role in the pathophysiology of sepsis and SIRS. Pathologists, hematologists, and medical technologists should be aware of their existence, the morphologic features that distinguish them from macrothombocytes and schistocytes, and their potential significance.