Annals of clinical and laboratory science
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Ann. Clin. Lab. Sci. · Jul 1996
Comparative StudyComparison of myoglobin, creatine kinase-MB, and cardiac troponin I for diagnosis of acute myocardial infarction.
Serial plasma concentrations of myoglobin, creatine kinase MB (CK-MB) isoenzyme, and cardiac troponin I (cTnI) were measured in 25 patients with a confirmed diagnosis of acute myocardial infarction (AMI), and 74 patients who were suspected of AMI but were subsequently ruled out for this diagnosis. The cutoff concentration for the cTnI assay was optimally determined to be 2.5 ng/mL. Of the three markers, myoglobin had the highest clinical sensitivity (50 percent) when blood was collected between 0 to 6 h after the onset of chest pain. ⋯ The clinical efficiency of cTnI for all samples was better than either CK-MB or myoglobin, owing mainly to the wider diagnostic window. The specificity of cTnI for 59 patients with chronic renal failure, skeletal muscle trauma and disease was better than all of these markers including cardiac troponin T (cTnT). Results of this study show that cTnI is an effective marker for the retrospective diagnosis of AMI, and consideration should be given to its use in place of CK-MB.
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Ann. Clin. Lab. Sci. · Jan 2008
Case ReportsUse of bivalirudin to prevent thrombosis following orthotopic liver transplantation in a patient with Budd-Chiari syndrome and a history of heparin-induced thrombocytopenia.
Type II heparin-induced thrombocytopenia (HIT) is an immune-mediated syndrome that may arise in a time-dependent manner following heparin therapy, placing patients at significant risk for thromboembolic events. Therapy includes anticoagulation with a direct thrombin inhibitor and avoidance of heparin. ⋯ During the post-transplant graft function improvement, we observed a significant dose-effect alteration manifested by an increased bivalirudin dose requirement as factor V activity increased. This observation is an important consideration in the attempt to maintain an optimal balance between effective anticoagulation and a reduced risk of postoperative bleeding.
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Ann. Clin. Lab. Sci. · Jan 2012
Procalcitonin levels within 48 hours after burn injury as a prognostic factor.
This study was performed to evaluate the clinical significance of procalcitonin in burn patients and to investigate whether procalcitonin levels at admission can be a prognostic indicator for sepsis and mortality. ⋯ Procalcitonin concentrations determined within the first 48 hours after burn injury can be a useful prognostic indicator for sepsis and mortality in burn patients.
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Ann. Clin. Lab. Sci. · Jan 2015
Diagnostic Accuracy of a New Urinalysis System, DongJiu, for Diagnosis of Urinary Tract Infection.
The microscopic and chemical analysis of urine is essential for the diagnosis of patients with urinary tract infections (UTI). Quantitative urine culture is the 'gold standard' method for the diagnosis of UTI, but it is labour-intensive and time consuming. The DongJiu 8602 is a new automated urinalysis system with dipstick and microscopy testing. The aim of this study was to evaluate the analytical and diagnostic performance of DongJiu 8602 in comparison to urine culture as the reference method. ⋯ According to our data, performances of microscopic and dipstick parameters of DongJiu 8602 were not satisfactory. Although, analytical sensitivity was improved slightly with combined assessment of microscopic and dipstick results for the lack of UTI, it did not achieve expected levels.
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Ann. Clin. Lab. Sci. · Jan 2008
Delta neutrophil index in automated immature granulocyte counts for assessing disease severity of patients with sepsis.
This study investigated the relationship between calculated immature granulocyte (IG) counts and the severity of sepsis. Coagulation parameters, fibrinolytic indices, bacterial isolation rates in blood cultures, and mortality were observed in 237 patients with suspected sepsis. The difference in leukocyte subfractions (delta neutrophil index; DN) identified by a cytochemical myeloperoxidase reaction and by a nuclear lobularity assay was determined with a blood cell analyzer (ADVIA 120, Siemens, Inc.). ⋯ Positive blood culture rate averaged 3.5-fold higher in patients with DN >40% vs the subgroup with low DN of 5-10%. The mortality rate of patients with DN >40% markedly exceeded the mortality rate of patients with DN of 5-10% (79% vs 15%, p <0.05). Thus, DN has implications for the severity of sepsis and may be valuable to assess the prognosis of patients with suspected sepsis.