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Article
April 2010
NT-proBNP as a biomarker of cardioembolic stroke
In about 30-40 % of ischemic strokes, even after an extensive clinical investigation, it is not possible to determine any one etiology. It is possible that a fraction of these strokes, named cryptogenic, happen after an episode of paroxystic atrial fibrillation (AF) that was not registered. Strokes due to atrial...
Cardiac markers
Natriuretic peptide
Article
April 2010
Can lean save lives
PURPOSE – The purpose of this paper is to show how over the last 18 months Bolton Hospitals NHS Trust have been exploring whether or not lean methodologies, often known as the Toyota Production System, can indeed be applied to healthcare.
DESIGN/METHODOLOGY/APPROACH – This paper is a viewpoint.
FINDINGS – One’s...
Process optimization
Information management
Article
April 2010
Creatinine measurement in the radiology department 1
Clinical laboratory measurement of serum/plasma creatinine concentration has been used to assess patient kidney function for well over 50 years. With incorporation of creatinine analyses to blood gas and other point-of-care platforms the test is now available outside the laboratory, at the bedside and in the clinic.
...
Point-of-care testing
Creatinine/urea
Kidneys/fluids
Article
April 2010
Hyperglycemic control in the ICU
Tight glycemic control (TGC) in the intensive care unit is essential to comprehensive clinical management.
However, TGC that is too aggressive in the wrong patient populations (particularly non-diabetics) can result in hypoglycemia, which brings with it a set of sequelae that can increase morbidity and mortality....
Glucose
Point-of-care testing
Article
April 2010
Benefit of using a D-dimer assay with a high clinical specificity
CONTEXT: Sensitive D-dimer assays have been developed to exclude the diagnosis of deep vein thrombosis (DVT) and have exhibited great success when used in conjunction with a diagnostic algorithm, including pretest probability scoring and a compression ultrasound (CUS).
Improving specificity of D-dimer assays would...
Coagulation/fibrinolysis
D-dimer
Article
January 2010
Verification of methods and instruments
Analytical methods are often developed at one site and
transferred to other sites for routine use. Increasingly, the
method development is made by manufacturers of instruments and
reagents. Regulatory agencies have ruled that the
responsibility for the performance of IVDs in the laboratories
mainly should lie with...
Quality assurance
Creatinine/urea
Article
January 2010
Interpretation of laboratory results
Clinical laboratory test results are a very important parameter in diagnosis, monitoring and screening. 70-80 % of decisions in diagnosis are based on laboratory results and more and more laboratory analyses are requested. Thus a lot of data are provided and it is therefore imperative for patient care (and safety)...
Information management
Glucose
Creatinine/urea
D-dimer
CRP
Article
January 2010
Blood oxygenation and spurious hypoxemia
One of the principal utilities of arterial blood gas
(ABG) analysis is to help assess blood oxygenation status. The two
ABG parameters used for this assessment are
pO2(a) (partial pressure of oxygen in arterial
blood) and sO2(a) (% of total hemoglobin that is
saturated with oxygen).
In health pO2(a) is
maintained...
Blood gases/acid-base
Point-of-care testing
Glucose
Hemoglobins
Article
January 2010
Comparing D-dimer assays
When a new D-dimer method is to be implemented either as a substitute for a currently used D-dimer assay or as a supplement, maybe as a point-of-care assay, it is necessary to do a clinical comparison of the "old" assay versus the "new" assay. The major pitfalls in D-dimer comparisons are addressed in this paper.
...
Coagulation/fibrinolysis
D-dimer
Article
December 2009
Pediatric considerations in critical value assignment
Critical values are those associated with imminent danger unless acted upon promptly. Critical value menus often include results that do not fit this definition, leading to highly variable practice in adult and pediatric laboratories.
Existing menus may be subdivided into more uniform tiers of severity: the highly...
Neonatology
Bilirubin
Blood gases/acid-base
Electrolytes
Glucose
Creatinine/urea