scholarly journals Biomarkers of Diseases: Their Role in Emergency Medicine

2021 ◽  
Author(s):  
Anoop T. Chakrapani
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Renal Failure ◽  
Calcium Binding ◽  
Clinical Decision Making ◽  
Care Delivery ◽  
Binding Protein ◽  
Cns Injury ◽  
Necrosis Factor Alpha ◽  
Neutrophil Gelatinase Associated Lipocalin

Biomarkers have been playing an increasingly significant role in clinical decision making processes worldwide. Numerous studies are being undertaken across the globe in the elusive search for the ideal biomarker for each clinical condition. In the emergency department, where rapid diagnosis of various diseases like acute coronary syndromes, pulmonary embolism, heart failure, sepsis, acute renal failure etc. is of utmost importance, specific biomarkers can expedite the time to diagnosis and treatment. To enumerate, the following biomarkers have proved their worth within the setting of emergency departments across the world. The role of cardiac troponins and CK-MB has been well established in the clinical algorithms to detect myocardial infarction. Newer markers like Heart Fatty Acid Binding Protein (H-FABP), BNP, Pro BNP as well as Ischemia modified albumin (IMA) are coming into the fray in the detection of cardiovascular emergencies, especially in the detection of heart failure. Novel biomarkers like Mid-region Proadrenomedullin (MR-proADM) are found to be useful in sepsis along with Tumour necrosis factor-alpha (TNF-alpha), Interleukins and Presepsin in burns patients. Human neutrophil gelatinase-associated lipocalin (NGAL) levels can detect renal failure much earlier than conventional methods. S100 calcium binding protein B (S100B) has been found to be useful in detection of CNS injury and hence can be used to avoid unnecessary radiation to patients in the form of CT scans. Point of care testing of many of these biomarkers in the Emergency department itself paves way for a revolutionary step in faster emergency care delivery and better patient outcomes.

scholarly journals Time Trends, Predictors, and Outcome of Emergency Department Use for Gout: A Nationwide US Study

2016 ◽  
Vol 43 (8) ◽  
pp. 1581-1588 ◽  
Author(s):  
Jasvinder A. Singh ◽  
Shaohua Yu
Keyword(s):  
Heart Failure ◽  
Emergency Department ◽  
Renal Failure ◽  
Heart Disease ◽  
Time Trends ◽  
Primary Diagnosis ◽  
Older Age ◽  
Discharge Disposition ◽  
Ed Visits ◽  
Income Quartile

Objective.To assess gout-related emergency department (ED) use/charges and discharge disposition.Methods.We used the US National ED Sample (NEDS) data to examine the time trends in total ED visits and charges and ED-related hospitalizations with gout as the primary diagnosis. We assessed multivariable-adjusted predictors of ED charges and hospitalization for gout-related visits using the 2012 NEDS data.Results.There were 180,789, 201,044, and 205,152 ED visits in 2009, 2010, and 2012 with gout as the primary diagnosis, with total ED charges of $195 million, $239 million, and $287 million, respectively; these accounted for 0.14%–0.16% of all ED visits. Mean/median 2012 ED charges/visit were $1398/$956. Of all gout-related ED visits, 7.7% were admitted to the hospital in 2012. Mean/median length of hospital stay was 3.9/2.6 days and mean/median inpatient charge/admission with gout as the primary diagnosis was $22,066/$15,912 in 2012. In multivariable-adjusted analyses, these factors were associated with higher ED charges: older age, female sex, highest income quartile, being uninsured, metropolitan residence, Western United States hospital location, heart disease, renal failure, heart failure, hypertension (HTN), diabetes, osteoarthritis (OA), and chronic obstructive pulmonary disease (COPD). These factors were associated with higher odds of hospitalization: older age, Northeast location, metropolitan teaching hospital, higher income quartile, heart disease, renal failure, heart failure, hyperlipidemia, HTN, diabetes, COPD, and OA, whereas self-pay insurance status was associated with lower odds of hospitalization, following an ED visit for gout.Conclusion.Absolute ED use and charges for gout increased over time, but relative use remained stable. Modifiable comorbidity factors associated with higher gout-related use should be targeted to reduce morbidity and healthcare use.

Regulation of myocardial function by histidine-rich, calcium-binding protein

2004 ◽  
Vol 287 (4) ◽  
pp. H1705-H1711 ◽  
Author(s):  
Guo-Chang Fan ◽  
Kimberly N. Gregory ◽  
Wen Zhao ◽  
Woo Jin Park ◽  
Evangelia G. Kranias
Keyword(s):  
Heart Failure ◽  
Ryanodine Receptor ◽  
Calcium Binding ◽  
Recombinant Adenovirus ◽  
Contractile Function ◽  
Binding Protein ◽  
Human Heart Failure ◽  
Rat Cardiomyocytes ◽  
Adult Rat ◽  
Protein Levels

Impaired sarcoplasmic reticulum (SR) Ca release has been suggested to contribute to the depressed cardiac function in heart failure. The release of Ca from the SR may be regulated by the ryanodine receptor, triadin, junctin, calsequestrin, and a histidine-rich, Ca-binding protein (HRC). We observed that the levels of HRC were reduced in animal models and human heart failure. To gain insight into the physiological function of HRC, we infected adult rat cardiac myocytes with a recombinant adenovirus that contains the full-length mouse HRC cDNA. Overexpression (1.7-fold) of HRC in adult rat cardiomyocytes was associated with increased SR Ca load (28%) but decreased SR Ca-induced Ca release (37%), resulting in impaired Ca cycling and depressed fractional shortening (36%) as well as depressed rates of shortening (38%) and relengthening (33%). Furthermore, the depressed basal contractile and Ca kinetic parameters in the HRC-infected myocytes remained significantly depressed even after maximal isoproterenol stimulation. Interestingly, HRC overexpresssion was accompanied by increased protein levels of junctin (1.4-fold) and triadin (1.8-fold), whereas the protein levels of ryanodine receptor, calsequestrin, phospholamban, and sarco(endo)plasmic reticulum Ca-ATPase remained unaltered. Collectively, these data indicate that alterations in expression levels of HRC are associated with impaired cardiac SR Ca homeostasis and contractile function.

RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASES AND ANATOMOSIS OF ARTERIOVENOUS FISTULAR IN PATIENTS WITH REGULARLY HEMODIALYSIS

2017 ◽  
pp. 88-92
Author(s):  
Van Hien Pham ◽  
Huu Vu Quang Nguyen ◽  
Tam Vo
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Renal Failure ◽  
Chronic Renal Failure ◽  
Cardiovascular Diseases ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Negative Correlation ◽  
Mean Value ◽  
The Mean

Background: Cardiovascular diseases are the leading cause of death in patients with chronic renal failure. When a patient undergoes dialysis, making AVF or AVG causes cardiovascular events. Understanding the relationship between complications: hypertension, heart failure, AVF or AVG (formation time, position, diameter) helps us monitor, detect, prevent and treatment of complications to limit the risk of death in patients with dialysis. Objective: Relationship between cardiovascular diseases and anatomosis of arteriovenous fistular in patients with regularly hemodialysis at Cho Ray Hospital. Methods: A cross-sectional study was conducted at Cho Ray Hospital from 2015 to 2016. The survey some cardiovascular diseases are done by clinical examination, tests for diagnostic imaging such as X-ray, electrocardiogram and echocardiogram: heart and diameter of anastomosis AVF, AVG. Results: The study population included 303 patients with chronic renal failure who were dialysis. Of which, patients aged 25-45 accounted for the highest proportion (43.9%). The proportion of male and female patients was similar (48.5% and 51.5% respectively). The mean value of systolic blood pressure on patients made AVF, AVG less than 12 months is higher than patients made AVF, AVG over 12 months, and there is negative correlation (r = -0.43) between AVF, AVG and systolic blood pressure (p <0.05). The mean value of diastolic blood pressure on patients made AVF, AVG less than 12 months is lower than patients made AVF, AVG over 12 months, and and there is positive correlation (r = -0.43) between AVF, AVG and diastolic blood pressure (p <0.05) (p <0.05). The prevalence of patients with heart failure made AVF, AVG over 12 months is higher than that of the under 12 months group, there is a negative correlation (r = - 0.43) between AVF, AVG diameter and EF index (p <0.05). Conclusion: It is important to note the diameter of anastomosis AVF, AVG in patients with chronic renal failure dialysis to limit cardiovascular complications, especially heart failure. Key words: Chronic kidney disease, hemodialysis.

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