Clinical Biochemist Reviews最新文献_第3页

Revisiting the Biological Variability of Cardiac Troponin: Implications for Clinical Practice. 重新审视心肌肌钙蛋白的生物变异性：对临床实践的影响。

Clinical Biochemist Reviews Pub Date : 2019-11-01 DOI: 10.33176/AACB-19-00032

Nick S R Lan, Damon A Bell

{"title":"Revisiting the Biological Variability of Cardiac Troponin: Implications for Clinical Practice.","authors":"Nick S R Lan, Damon A Bell","doi":"10.33176/AACB-19-00032","DOIUrl":"10.33176/AACB-19-00032","url":null,"abstract":"The diagnosis of acute myocardial injury requires a rise and/or fall of cardiac troponin (cTn) on serial testing, with at least one concentration above the 99th percentile value of a normal reference population according to the recently published Fourth Universal Definition of Myocardial Infarction.1 However, the magnitude of change in cTn that constitutes a significant rise and/or fall was again not specified in detail. High-sensitivity cardiac troponin (hs-cTn) assays can measure ten-fold lower concentrations of cTn with more precision than older assays, and can accurately quantify cTn in more than 50% of healthy individuals with a coefficient of variation of less than 10% at the 99th percentile. These hs-cTn assays are also able to detect the normal variations in cTn results that are due to biological variability. Understanding and quantifying the normal variations in cTn is important as this would allow significant changes to be better defined. Numerous studies have sought to investigate the biological variability of cTn over the last ten years. Such studies are usually conducted in healthy individuals, however individuals with chronic cardiac disease or chronic renal failure have also been examined. These studies have yielded varying results in regards to significant change values for cTn. In light of the recent redefinition for myocardial infarction, the purpose of this mini-review is to revisit the biological variability of cTn. In particular, we outline concepts for determining a significant change value, review the results of previous studies on the biological variation of cTn and discuss potential considerations for clinical practice.","PeriodicalId":34924,"journal":{"name":"Clinical Biochemist Reviews","volume":"40 4","pages":"201-216"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892703/pdf/cbr-40-201.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37475015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Superwarfarin (Long-Acting Anticoagulant Rodenticides) Poisoning: from Pathophysiology to Laboratory-Guided Clinical Management. 超级华法林（长效抗凝灭鼠剂）中毒：从病理生理学到实验室指导下的临床治疗。

Clinical Biochemist Reviews Pub Date : 2019-11-01 DOI: 10.33176/AACB-19-00029

Yeow-Kuan Chong, Tony Wing-Lai Mak

{"title":"Superwarfarin (Long-Acting Anticoagulant Rodenticides) Poisoning: from Pathophysiology to Laboratory-Guided Clinical Management.","authors":"Yeow-Kuan Chong, Tony Wing-Lai Mak","doi":"10.33176/AACB-19-00029","DOIUrl":"10.33176/AACB-19-00029","url":null,"abstract":"Superwarfarins are long-acting anticoagulant rodenticides developed from warfarin. The mechanism of action is by inhibition of vitamin K epoxide reductase, resulting in the inability of the body to recycle vitamin K. Deficiency of vitamin K thereafter leads to inability for the body to synthesise vitamin K-dependent coagulation factors, factor II, VII, IX, and X, leading to prolonged prothrombin time. Due to the bulky aromatic sidechains, superwarfarins have a much longer half-life when compared to warfarin, and exposure to superwarfarins results in a prolonged period of anticoagulation which can result in clinical bleeding. Diagnosis is straightforward in patients with known history of superwarfarin exposure but has proved difficult for patients who did not report superwarfarin intake. Superwarfarin poisoning should therefore be suspected in all patients with unexplained prolongation of prothrombin time, and can be confirmed by their detection in serum. Treatment for superwarfarin poisoning includes rapid correction of factor deficiencies with either 4-factor prothrombin complex concentrate or fresh frozen plasma in patients with active bleeding, and high dose vitamin K therapy given multiple times per day for a prolonged period of weeks to months.","PeriodicalId":34924,"journal":{"name":"Clinical Biochemist Reviews","volume":"40 4","pages":"175-185"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6892705/pdf/cbr-40-175.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37475081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indirect Reference Intervals: Harnessing the Power of Stored Laboratory Data. 间接参考间隔:利用存储的实验室数据的力量。

Clinical Biochemist Reviews Pub Date : 2019-05-01 DOI: 10.33176/AACB-19-00022

Christopher-John L Farrell, Lan Nguyen

{"title":"Indirect Reference Intervals: Harnessing the Power of Stored Laboratory Data.","authors":"Christopher-John L Farrell, Lan Nguyen","doi":"10.33176/AACB-19-00022","DOIUrl":"https://doi.org/10.33176/AACB-19-00022","url":null,"abstract":"Reference intervals are relied upon by clinicians when interpreting their patients' test results. Therefore, laboratorians directly contribute to patient care when they report accurate reference intervals. The traditional approach to establishing reference intervals is to perform a study on healthy volunteers. However, the practical aspects of the staff time and cost required to perform these studies make this approach difficult for clinical laboratories to routinely use. Indirect methods for deriving reference intervals, which utilise patient results stored in the laboratory's database, provide an alternative approach that is quick and inexpensive to perform. Additionally, because large amounts of patient data can be used, the approach can provide more detailed reference interval information when multiple partitions are required, such as with different age-groups. However, if the indirect approach is to be used to derive accurate reference intervals, several considerations need to be addressed. The laboratorian must assess whether the assay and patient population were stable over the study period, whether data 'clean-up' steps should be used prior to data analysis and, often, how the distribution of values from healthy individuals should be modelled. The assumptions and potential pitfalls of the particular indirect technique chosen for data analysis also need to be considered. A comprehensive understanding of all aspects of the indirect approach to establishing reference intervals allows the laboratorian to harness the power of the data stored in their laboratory database and ensure the reference intervals they report are accurate.","PeriodicalId":34924,"journal":{"name":"Clinical Biochemist Reviews","volume":"40 2","pages":"99-111"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6544248/pdf/cbr-40-99.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 32

Kidney Injury Biomarkers in an Academic Hospital Setting: Where Are We Now? 学术医院环境中的肾损伤生物标志物:我们现在在哪里?

Clinical Biochemist Reviews Pub Date : 2019-05-01 DOI: 10.33176/AACB-18-00017

Tirsa T van Duijl, L Renee Ruhaak, Johan W de Fijter, Christa M Cobbaert

{"title":"Kidney Injury Biomarkers in an Academic Hospital Setting: Where Are We Now?","authors":"Tirsa T van Duijl, L Renee Ruhaak, Johan W de Fijter, Christa M Cobbaert","doi":"10.33176/AACB-18-00017","DOIUrl":"https://doi.org/10.33176/AACB-18-00017","url":null,"abstract":"Acute kidney injury (AKI) is a frequent complication in hospitalised patients and is diagnosed by urinary output and serum creatinine. Serum creatinine is an indirect marker for renal glomerular filtration, but lacks specificity for damage to kidney tissue and the relatively late response to injury precludes early recognition of AKI. Timely diagnosis of kidney injury using biomarkers that provide information about the aetiology of kidney injury is an unmet clinical need. To overcome the suboptimal performance of serum creatinine, injury biomarkers have been proposed that predict AKI in diverse clinical settings. The clinical performance of these markers is considered moderate due to the lack of specificity for kidney tissue or the underlying injury mechanisms, poor test specificity and confounding by interventions or comorbidities. Hence, it is not unequivocally beneficial to implement current kidney injury biomarkers in the clinical laboratory for diagnostic purposes. In this article we review biomarkers that might fulfil AKI-related unmet clinical needs in the academic hospital setting.","PeriodicalId":34924,"journal":{"name":"Clinical Biochemist Reviews","volume":"40 2","pages":"79-97"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.33176/AACB-18-00017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 18

Biochemical Markers for the Diagnosis and Monitoring of Wilson Disease. 肝豆状核变性诊断和监测的生化标志物。

Clinical Biochemist Reviews Pub Date : 2019-05-01 DOI: 10.33176/AACB-18-00014

Isabelle Mohr, Karl Heinz Weiss

{"title":"Biochemical Markers for the Diagnosis and Monitoring of Wilson Disease.","authors":"Isabelle Mohr, Karl Heinz Weiss","doi":"10.33176/AACB-18-00014","DOIUrl":"https://doi.org/10.33176/AACB-18-00014","url":null,"abstract":"Wilson disease (WD) is an autosomal recessively-inherited disorder of copper metabolism and characterised by a pathological accumulation of copper. The ATP7B gene encodes for a transmembrane copper transporter essential for biliary copper excretion. Depending on time of diagnosis, severity of disease can vary widely. Almost all patients show evidence of progressive liver disease. Neurological impairments or psychiatric symptoms are common in WD patients not diagnosed during adolescence. WD is a treatable disorder, and early treatment can prevent the development of symptoms in patients diagnosed while still asymptomatic. This is why the early diagnosis of WD is crucial. The diagnosis is based on clinical symptoms, abnormal measures of copper metabolism and DNA analysis. Available treatment includes chelators and zinc salts which increase copper excretion and reduce copper uptake. In severe cases, liver transplantation is indicated and accomplishes a phenotypic correction of the hepatic gene defect. Recently, clinical development of the new copper modulating agent tetrathiomolybdate has started and direct genetic therapies are being tested in animal models. The following review focuses especially on biochemical markers and how they can be utilised in diagnosis and drug monitoring.","PeriodicalId":34924,"journal":{"name":"Clinical Biochemist Reviews","volume":"40 2","pages":"59-77"},"PeriodicalIF":0.0,"publicationDate":"2019-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.33176/AACB-18-00014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37334060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 34

Proposed Addendum to 2012 Recommendations for Standardised Reporting of Protein Electrophoresis in Australia and New Zealand. 2012年澳大利亚和新西兰蛋白质电泳标准化报告建议的拟议附录。

Clinical Biochemist Reviews Pub Date : 2019-02-01

Jillian R Tate, Joel D Smith, Nilika Wijeratne, Peter Mollee

引用次数: 0

The Paraprotein - an Enduring Biomarker. 副蛋白-持久的生物标志物。

Clinical Biochemist Reviews Pub Date : 2019-02-01

Jillian R Tate

引用次数: 0

Report of the Survey Conducted by RCPAQAP on Current Practice for Paraprotein and Serum Free Light Chain Measurement and Reporting: a Need for Harmonisation. RCPAQAP进行的关于副蛋白和无血清轻链测量和报告的当前实践的调查报告：需要协调。

Clinical Biochemist Reviews Pub Date : 2019-02-01

Nilika Wijeratne, Jillian R Tate, Louise Wienholt, Peter Mollee

引用次数: 0

Paraprotein Sample Exchange in Australia and New Zealand - 2018. 澳大利亚和新西兰的副蛋白样品交换-2018。

Clinical Biochemist Reviews Pub Date : 2019-02-01

Nilika Wijeratne, Jillian R Tate, Stephen Du Toit, Joel D Smith, Andrew Soepnel, Kay Weng Choy, Helen Martin, Robyn Henry, Kaye Glegg, Elizabeth Byrnes, Louise Wienholt, Peter Mollee

引用次数: 0

Proceedings of the Australasian Association of Clinical Biochemists’ 57th Annual Scientific Conference 澳大利亚临床生物化学家协会第57届年度科学会议论文集

Clinical Biochemist Reviews Pub Date : 2019-01-01 DOI: 10.33176/2019abstracts

引用次数: 0