scholarly journals Cardiac Troponins Metabolism: From Biochemical Mechanisms to Clinical Practice (Literature Review)

2021 ◽  
Vol 22 (20) ◽  
pp. 10928
Author(s):  
Aleksey M. Chaulin
Keyword(s):  
Clinical Practice ◽  
Oral Fluid ◽  
Biological Fluids ◽  
Laboratory Diagnostics ◽  
Biochemical Mechanisms ◽  
Exogenous Compounds ◽  
Laboratory Biomarkers ◽  
Practice Literature ◽  
Daily Changes ◽  
Cardiac Troponins

The metabolic processes of endo- and exogenous compounds play an important role in diagnosing and treating patients since many metabolites are laboratory biomarkers and/or targets for therapeutic agents. Cardiac troponins are one of the most critical biomarkers to diagnose cardiovascular diseases, including acute myocardial infarction. The study of troponin metabolism is of great interest as it opens up new possibilities for optimizing laboratory diagnostics. This article discusses in detail the key stages of the cardiac troponins metabolism, in particular the mechanisms of release from a healthy myocardium, mechanisms of circulation in the bloodstream, possible mechanisms of troponin penetration into other biological fluids (oral fluid, cerebrospinal fluid, pericardial and amniotic fluids), mechanisms of elimination of cardiac troponins from the blood, and daily changes in the levels of troponins in the blood. Considering these aspects of cardiac troponin metabolism, attention is focused on the potential value for clinical practice.

scholarly journals Period prevalence and identification challenges of viral haemorrhagic fever suspect cases in a tertiary referral hospital in Guinea: a cross-sectional, retrospective study of triage and emergency room patient profiles

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Manuel Raab ◽  
Lisa M. Pfadenhauer ◽  
Vinh-Kim Nguyen ◽  
Dansira Doumbouya ◽  
Michael Hoelscher ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Emergency Room ◽  
Retrospective Chart Review ◽  
Laboratory Diagnostics ◽  
Haemorrhagic Fever ◽  
Case Definitions ◽  
Tertiary Referral Hospital ◽  
Cross Sectional ◽  
Viral Haemorrhagic Fever ◽  
Suspect Case

Abstract Background A functioning Viral Haemorrhagic Fever (VHF) surveillance system in countries at risk for outbreaks can reduce early transmission in case of an outbreak. Surveillance performance depends on the application of suspect case definitions in daily clinical practice. Recommended suspect case criteria during outbreaks are designed for high sensitivity and include general symptoms, pyrexia, haemorrhage, epidemiological link and unexplained death in patients. Non-outbreak criteria are narrower, relying on the persistence of fever and the presence of haemorrhagic signs. Methods This study ascertains VHF suspect case prevalence based on outbreak and non-outbreak criteria in a Guinean regional hospital for a period of three months. The study further describes clinical trajectories of patients who meet non-outbreak VHF suspect case criteria in order to discuss challenges in their identification. We used cross-sectional data collection at triage and emergency room to record demographic and clinical data of all admitted patients during the study period. For the follow-up study with description of diagnostic trajectories of VHF suspect cases, we used retrospective chart review. Results The most common symptoms of all patients upon admission were fever, tiredness/weakness and abdominal pain. 686 patients met EVD outbreak criteria, ten adult patients and two paediatric patients met study-specific non-outbreak VHF suspect case criteria. None of the suspect cases was treated as VHF suspect case and none tested positive for malaria upon admission. Their most frequent discharge diagnosis was unspecific gastrointestinal infection. The most common diagnostic measures were haemoglobin level and glycaemia for both adults and for children; of the requested examinations for hospitalized suspect cases, 36% were not executed or obtained. Half of those patients self-discharged against medical advice. Conclusions Our study shows that the number of VHF suspect cases may vary greatly depending on which suspect case criteria are applied. Identification of VHF suspect cases seems challenging in clinical practice. We suggest that this may be due to the low use of laboratory diagnostics to support certain diagnoses and the non-application of VHF suspect case definitions in clinical practice. Future VHF suspect case management should aim to tackle such challenges in comparable hospital settings.

scholarly journals Attitudes and beliefs of emergency physicians on lab tests utilization in clinical practice. A multicenter survey

2019 ◽  
Vol 15 (3) ◽  
Author(s):  
Carlotta Saccenti ◽  
Marco Lunian ◽  
Martina Montagnana ◽  
Andrea Balloni ◽  
Giulia Maria Azin ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Pathways ◽  
Medical Knowledge ◽  
Nationwide Survey ◽  
Laboratory Diagnostics ◽  
Attitudes And Beliefs ◽  
Emergency Physicians ◽  
Digital Format ◽  
Multicenter Survey ◽  
Real Scenario

It is commonly perceived that the main obstacle for an effective partnership between Emergency Medicine (EM) and Laboratory Medicine (LM) is the lack of reciprocal knowledge and understanding. A further aspect is a partial comprehension of clinical significance and implications of some tests. The real scenario of attitudes and beliefs of Emergency Physicians (EPs) on lab tests utilization in clinical practice remains largely unclear. Therefore, this original study was designed to explore this field of medical knowledge, by using a survey on attitudes and beliefs in laboratory diagnostics which was disseminated among many Italian EPs. A questionnaire containing 20 different items/statements was designed and then disseminated either directly, or in a digital format. Overall, 183 questionnaires were compiled and collected. The results of this nationwide survey seem to confirm the existence of a suboptimal knowledge of both clinical and economic impact of urgent laboratory tests by Italian EPs. An unsatisfactory relationship between EPs and laboratory professionals seems also to emerge. Several EPs attribute this to Shortage of time to think (18.6%), followed by Fair of medical-legal litigation (13.6%). On the other hand, interestingly, it also emerged that some Italian hospitals still include obsolete o redundant tests in panels of urgent laboratory analyses, potentially misleading for the diagnostic reasoning in the Emergency Department (ED). In conclusion, the virtuous circle between EM and LM should be further reinforced for optimizing clinical pathways in Italian EDs, improving clinical outcomes and reducing unnecessary expenditures. A major agreement between laboratory and emergency professionals

scholarly journals Advanced Techniques in Clinical Practice: Use of Lab-on-a-Chip Electrophoresis and Other Methods in Protein Profiling

2009 ◽  
Vol 28 (4) ◽  
pp. 274-278 ◽  
Author(s):  
Olgica Trenčevska ◽  
Vasko Aleksovski ◽  
Kiro Stojanoski
Keyword(s):  
Mass Spectrometry ◽  
Clinical Practice ◽  
Cystatin C ◽  
Biological Fluids ◽  
Neurological Diseases ◽  
Protein Profile ◽  
Lab On A Chip ◽  
Protein Profiling ◽  
Complete Analysis ◽  
Potential Biomarker

Advanced Techniques in Clinical Practice: Use of Lab-on-a-Chip Electrophoresis and Other Methods in Protein ProfilingProteins in clinical practice are analyzed as important parameters in the determination and treatment of different diseases. The scopes of the analyses are mainly concentrated in two levels - analyses of the complete protein profile, or determination of an isolated protein. In this work, despite of the use of conventional methods, mainly electrophoresis, new techniques have been implemented in protein analyses. Lab-on-a-chip is an electrophoretic technique that, when optimized, provides analyses of the total protein profile. When normal samples are compared to samples obtained from patients with different neurological diseases, characteristic patterns can be noted. Also, correlation and comparison can be made between the newly developed microchip electrophoresis method and the results obtained using the conventional techniques. When an analysis of a specific protein is necessary, mass spectrometry has proven to give best results, in both the se lectivity and specificity of analyses. It is believed that cystatin C is a potential biomarker in neurological diseases; therefore, the mass spectrometry method has been developed in order to obtain qualitative and quantitative analyses of biological fluids. Using the developed method of mass spectrometry immunoassay (MSIA), cystatin C was easily isolated and analyzed, obtaining complete analysis within minutes. The resulting mass spectra revealed various levels of cystatin C isoforms in serum and CSF samples.

scholarly journals S32 * RECENT ADVANCES IN LABORATORY DIAGNOSTICS OF ALCOHOL AND DRUG USE AND DEPENDENCE. APPLICATION OF NEW BIOMARKERS INTO CLINICAL PRACTICE

2013 ◽  
Vol 48 (suppl 1) ◽  
pp. i32-i33
Author(s):  
A. Grzywacz ◽  
A. Jasiewicz ◽  
I. Malecka ◽  
A. Suchanecka ◽  
J. Samochowiec ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Drug Use ◽  
Laboratory Diagnostics ◽  
Alcohol And Drug Use ◽  
Recent Advances ◽  
New Biomarkers

Clinical and Diagnostic Value of Cardiac Markers in Human Biological Fluids

Kardiologiia ◽  
2019 ◽  
Vol 59 (11) ◽  
pp. 66-75 ◽  
Author(s):  
A. M. Chaulin ◽  
L. S. Karslyan ◽  
E. V. Bazyuk ◽  
D. A. Nurbaltaeva ◽  
D. V. Duplyakov
Keyword(s):  
Blood Serum ◽  
Oral Fluid ◽  
Biological Fluids ◽  
High Sensitivity ◽  
Diagnostic Value ◽  
Cardiac Markers ◽  
Methods Of Analysis ◽  
Clinical Diagnostic

The article is devoted to problems of clinical-diagnostic value of determination of cardio-specific troponins in human biological fluids. Improvement of laboratory instrumentation and emergence of high sensitivity methods of analysis have allowed to identify troponins in urine, dialysate, and oral fluid. In the review we present actual information related to measurement of troponins in blood serum, data on testing of cardio-specific troponins in urine, dialysate, and oral fluid. Special attention is paid to determination of some cardiomarkers in oral fluid with thorough analysis of diagnostic value and effectiveness of the conducted studies.

OPPORTUNITIES OF MODERN LABORATORY DIAGNOSTICS OF INFECTIOUS COMPLICATIONS OF ACUTE PANCREATITIS (LITERATURE REVIEW)

2019 ◽  
Vol 64 (3) ◽  
pp. 145-152
Author(s):  
S. Ya. Ivanusa ◽  
A. M. Ivanov ◽  
M. V. Lazutkin ◽  
A. V. Chebotar
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Practice ◽  
Systemic Infection ◽  
Infectious Complications ◽  
Cochrane Library ◽  
Laboratory Diagnostics ◽  
Blood Concentrations ◽  
Reactive Protein ◽  
Literary Sources ◽  
Instrumental Methods

A systematic search of literary sources in the abstract databases Scopus, Web of Science, MedLine, the Cochrane Library, CyberLeninka, RSCI for 2010-2018. The search queries were: acute pancreatitis and complications, acute pancreatitis and diagnosis, acute pancreatitis and diagnosis and complications, acute pancreatitis and complications, and sepsis. The results of search and analysis of selected literature sources are presented. It was revealed that the currently used set of laboratory and instrumental methods of diagnosis of infectious complications of acute pancreatitis does not fully meet the needs of clinical practice. The most common of them are the determination of blood concentrations Of C-reactive protein and procalcitonin. At the same time, a number of disadvantages of these methods are noted. In the last decade, many new markers of systemic infection have been introduced into clinical practice. Some of them are currently being investigated in order to diagnose systemic infection in General and infectious complications of acute pancreatitis in particular. The most promising are such as presepsin, MID-regional Pro-adrenomedullinum, CD64 neutrophil index and some others.

Monitoring nicotine intake from e-cigarettes: measurement of parent drug and metabolites in oral fluid and plasma

2017 ◽  
Vol 55 (3) ◽  
Author(s):  
Esther Papaseit ◽  
Magí Farré ◽  
Silvia Graziano ◽  
Roberta Pacifici ◽  
Clara Pérez-Mañá ◽  
...  
Keyword(s):  
Oral Fluid ◽  
Electronic Cigarettes ◽  
Biological Fluids ◽  
Parent Drug ◽  
Controlled Clinical Trial ◽  
Suitable Alternative ◽  
Tobacco Cigarette ◽  
Toxicological Studies ◽  
Liquid Chromatography Tandem Mass ◽  
Plasma Concentration Ratio

AbstractBackground:Electronic cigarettes (e-cig) known as electronic nicotine devices recently gained popularity among smokers. Despite many studies investigating their safety and toxicity, few examined the delivery of e-cig-derived nicotine and its metabolites in alternative biological fluids.Methods:We performed a randomized, crossover, and controlled clinical trial in nine healthy smokers. Nicotine (NIC), cotinine (COT), and trans-3′-hydroxycotinine (3-HCOT) were measured in plasma and oral fluid by liquid chromatography-tandem mass spectrometry after consumption of two consecutive e-cig administrations or two consecutive tobacco cigarettes.Results:NIC and its metabolites were detected both in oral fluid and plasma following both administration conditions. Concentrations in oral fluid resulted various orders of magnitude higher than those observed in plasma. Oral fluid concentration of tobacco cigarette and e-cig-derived NIC peaked at 15 min after each administration and ranged between 1.0 and 1396 μg/L and from 0.3 to 860 μg/L; those of COT between 52.8 and 110 μg/L and from 33.8 to 94.7 μg/L; and those of 3-HCOT between 12.4 and 23.5 μg/L and from 8.5 to 24.4 μg/L. The oral fluid to plasma concentration ratio of both e-cig- and tobacco cigarette-derived NIC peaked at 15 min after both administrations and correlated with oral fluid NIC concentration.Conclusions:The obtained results support the measurement of NIC and metabolites in oral fluid in the assessment of intake after e-cig use and appear to be a suitable alternative to plasma when monitoring nicotine delivery from e-cig for clinical and toxicological studies.

scholarly journals Cardiac troponins in hypertension: mechanisms of increase and diagnostic value

2021 ◽  
Vol 27 (4) ◽  
pp. 390-401
Author(s):  
A. M. Chaulin ◽  
D. V. Duplyakov
Keyword(s):  
Cardiac Troponin ◽  
Prognostic Value ◽  
Biological Fluids ◽  
Diagnostic Value ◽  
Healthy Individuals ◽  
Pathological Conditions ◽  
Highly Sensitive ◽  
Protein Molecules ◽  
Diagnostic And Prognostic Value ◽  
Cardiac Troponins

The understanding of the diagnostic and prognostic value of many biomarkers of cardiovascular diseases (CVD), including cardiac troponins (cTnT and cTnI), is changing significantly with the development of methods for their determination. New highly sensitive immunoassays can detect minimal concentrations of cardiac troponin protein molecules in biological fluids (several ng/L or less), allowing the detection of cTnT and cTnI in all healthy individuals. Along with this, there are opportunities to use cTnT and cTnI both to assess the risk of developing CVD in healthy people, and to identify and monitor many early pathological conditions that pose a risk to the cardiovascular system and the life of patients. These pathological conditions include hypertension (HTN), which is the direct cause leading to coronary heart disease, acute myocardial infarction, stroke, and other CVD. A number of recent studies reported the possibility of using highly sensitive cTnT and cTnI in the management of HTN patients. In this article, we consider in detail the diagnostic and prognostic value of cardiac troponins in HTN, we also discuss the main possible mechanisms underlying the increase in cTnT and cTnI in human body fluids.

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