1,721,032 research outputs found
Hyponatremia and pseudohyponatremia: first, do no harm.
No full textHyponatremia and pseudohyponatremia: first, do no harm
A case of factitious hyponatremia and hypokalemia due to the presence of fibrin gel in serum.
No full textWe describe here the case of a 84-year-old woman under warfarin therapy for atrial fibrillation, who was admitted to the Emergency Department for severe gluteal hemorrhage. Blood samples were drawn after patient admission and transported within 20 min to the laboratory. Results of laboratory testing revealed a markedly increased value of international normalized ratio and extremely low values of serum sodium (60 mmol/L) and potassium (1.4 mmol/L). A second serum sample was collected approximately 2 h after the former, showing normal values of both sodium (145 mmol/L) and potassium (3.5 mmol/L). The analysis of the specimen collected upon patient admission revealed the presence of a small, transparent fibrin gel in the serum, which was partially aspirated by the sample probe of the instrument. This case underscores the importance that serum samples need to be allowed to clot completely prior to centrifugation and analysis, especially those collected from patients under anticoagulant treatment
p2PSA but not total and free PSA increases after myocardial infarction: results of a preliminary investigation.
No full textp2PSA but not total and free PSA increases after myocardial infarction: results of a preliminary investigation
Prostate-specific antigen (PSA) isoform p2PSA in prostate cancer screening: systematic review of current evidence and further perspectives.
No full textBackground. There is now evidence that the advantages of screening for prostate cancer based only on prostate specific antigen (PSA) are probably offset by the health and economic disadvantages arising from over-diagnosis and over-treatment. Among novel and promising biomarkers, attention has recently been focused on the PSA isoform p2PSA, alone or in combination with free PSA (as %p2PSA), and in combination with total and free PSA as the prostate health index (phi).
Methods. We performed an electronic search for original articles published in English, French, Spanish and Italian reporting studies that assessed the diagnostic performance of %p2PSA for prostate cancer screening in direct comparison with PSA, using the keywords “Prostate Cancer”, and “Measurement” or “Screening”, and “proPSA” or “p2PSA” or “[-2]proPSA”. Titles, abstracts and full texts were carefully read, and articles not matching the inclusion criteria were excluded. Heterogeneity was evaluated by the I-squared test. The pooled estimates of accuracy and the resulting area under the receiver operator characteristic curve (AUC) were calculated using a random effect model.
Results. On the basis of the electronic search, 11 articles and 12 studies, including a total of 5,139 subjects (2,338 with prostate cancer) and with modest heterogeneity (Isquared, 66%) were selected. The %p2PSA pooled estimates were always greater than those of PSA, and so was the cumulative pooled AUC (0.687 versus 0.538; p<0.001). The diagnostic odds ratio was more than double for %p2PSA than for total PSA (4.0 versus 1.7). With a sensitivity of 0.95, routine p2PSA testing may result in up to 10% fewer unnecessary biopsies than the use of PSA for screening. The AUC of phi was slightly but not significantly better than that of %p2PSA (0.736 versus 0.717; p=0.21).
Conclusions. These findings provide a rationale for planning further studies to assess whether %p2PSA testing may generate more favourable outcomes in terms of mortality and quality of life. Direct comparison does not permit the conclusion that the phi is globally superior to %p2PSA for detecting prostate cancer
Reduction of gross hemolysis in catheter-drawn blood using Greiner Holdex® tube holder
No full textIntroduction: Blood collection through intravenous lines frequently causes spurious hemolysis. Due to specific structure, the tube holder Holdex® (Greiner Bio-One GmbH, Kremsmuenster, Austria) is supposed to prevent erythrocyte injury in samples collected from catheters, so that we planned a specific study to support this hypothesis.
Materials and methods: Blood was collected from emergency department (ED) patients with 20-gauge catheter. In patients with odd order numbers, first and second tubes were collected with conventional holder (BD Vacutainer One Use Holder, Becton Dickinson, Milan, Italy) and the third with Holdex, whereas in even patients first and second tubes were drawn with Holdex and the third using BD Vacutainer One Use Holder. The first tube was discarded, whereas the second and third were centrifuged and serum was tested for potassium, lactate dehydrogenase (LD) and hemolysis index.
Results: The final study population consisted in 60 ED patients. Concentrations of potassium (4.25 vs. 4.16 mmol/L; P = 0.031), LD (498 vs. 459 U/L; P = 0.039) and cell-free hemoglobin (0.42 vs. 0.22 g/L; P = 0.042) were higher in samples collected with BD Vacutainer One Use Holder than with Holdex. The mean bias of cell-free hemoglobin was -0.4 g/L in samples collected with Holdex. Although the frequency of samples with cell-free hemoglobin > 0.5 g/L was identical (17/60 vs. 17/60; P = 1.00), the frequency of those with concentrations >3.0 g/L was higher using BD Vacutainer One Use Holder than Holdex (4/60 vs. 0/60; P = 0.042).
Conclusions: The use of Holdex for drawing blood from intravenous lines may be effective for reducing gross hemolysis
The concentration of high-sensitivity troponin I increases with ageing in patients admitted to the emergency department without acute coronary syndrome.
No full textThe concentration of high-sensitivity troponin I
increases with ageing in patients admitted to the
emergency department without acute coronary
syndrome
Development of a novel, hemolysis-resistant reagent for assessment of α-amylase in biological fluids.
No full textBackground: Although the assessment of α-amylase is an essential part of the diagnostic workout of several pancreatic and extra-pancreatic disorders, its enzymatic activity is significantly reduced in the presence of cell-free hemoglobin such as in samples with spurious hemolysis, due to chemical and spectrophotometric interference. We developed a new reagent that provides reliable results on hemolyzed biological specimens. Methods: All tests were performed on Beckman Coulter AU5822. Intra-assay imprecision was assessed on three serum samples with low, intermediate and high α-amylase concentration. Linearity was assessed by serially diluting two samples with low and high values of α-amylase. The comparison with commercial reagent was performed on 40 serum samples. Hemolysis studies were carried out by mechanically hemolysis of 20 lithium-heparin samples. Results: The intra-assay imprecision was comprised between 1.3% and 2.2%. The linearity was excellent (r=0.998), and highly significant agreement was observed with the commercial assay (r=1.00; mean bias -3.8%). Although a significant correlation between non-hemolyzed and hemolyzed specimens was found with both assays (p<0.001), a much greater agreement was observed with the experimental method (r=0.997 vs. 0.818). No measurement exceeded the total allowable error with the experimental assay, whereas the threshold was exceeded in 85% of samples using the commercial method. Conclusions: The clinical applications of the experimental reagent include α-amylase assessment in hemolyzed samples, in urine and other biological fluids contaminated with lysed erythrocytes, or in patients under frequent transfusions and hemoglobin-based blood substitutes therapy. The formulation of this reagent could be adapted for other clinical chemistry or immunochemistry assays
Blood sample contamination by glucose-containing solutions: effects and identification.
No full textBlood sample contamination by glucose-containing solutions: effects and identification
Highly-sensitive troponin I in patients admitted to the emergency room with acute infections.
No full textHighly-sensitive troponin I in patients admitted to the emergency room with acute infections
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