BACKGROUND: Hospitals in countries with public health systems have recently adopted organizational changes to improve efficiency and resource allocation, and reducing inappropriate hospitalizations has been established as an important goal, as well as avoiding or buffering overcrowding in Emergency Departments. AIMS: ...

Calcium is an essential mineral required for numerous biological functions. In circulation, calcium is found in three different fractions, anion-bound, protein-bound and free or ”ionized”. The amount of calcium in each of these fractions is dependent on the concentration of hydrogen ions, anions and plasma proteins....

Diagnosing heart failure (HF) in patients presenting in primary care is difficult. Clinical assessment of symptoms and signs has limited sensitivity and specificity. NT-proBNP determination has been proven to be useful and accurate for ruling out the diagnosis of systolic HF, and some have even proposed different...

Metabolic acidosis is a common metabolic disturbance among the acutely/critically ill that has many possible causes. The condition is diagnosed by arterial blood gas analysis which reveals primary reduction in pH and bicarbonate, followed by secondary (compensatory) reduction in pCO₂.  Abnormal accumulation of...

In health, plasma potassium concentration is maintained within the approximate range of 3.5-5.0 mmol/L. Hypokalemia, a very common electrolyte disturbance – present in up to 20 % of hospitalized patients – is diagnosed if plasma potassium is less than 3.5 mmol/L.  Although mild hypokalemia is often asymptomatic, a...

Blood gas analysis is unique among blood tests in its requirement for arterial blood; all others are performed on venous, or more rarely, capillary blood samples. Sampling arterial blood is a technically difficult procedure to perform, and painful for the patient: significantly more painful than sampling either venous ...

The preanalytical phase of laboratory testing has long been recognized as a stage for potential error, and blood gas analysis is a test that is well-recognized as being particularly vulnerable in this regard. Much research has been directed at devising procedures that minimize variability of measured blood gas...

Compared with other plasma electrolytes, such as sodium, potassium and bicarbonate, chloride usually gets very limited coverage in medical texts. Now in a wide-ranging review article chloride gets the exclusive billing that its physio-pathological significance deserves.  The article begins with consideration of the...

Chris Price and Andrew St John have followed their book Point-of-Care Testing for Managers and Policymakers with another look at the subject from strategic vision to change management and implementation in Point-of-Care Testing: Making Innovation Work for Patient-Centered Care. In their latest book the authors give...

Clinical biomarker studies seldom follow recommendations for the evaluation of new biomarkers. Therefore it is important to assess any published clinical value of a biomarker or comparison of two or more biomarkers and see whether or not the published study applies to your situation. If the published study does not...