The growing role of cardiac markers has been elucidated in patients with acute coronary syndrome, heart failure and other cardiovascular diseases. The markers can be cytosolic like heart-type fatty-acid-binding protein (H-FABP) and creatine kinase MB (CKMB), myofibrillary like troponin T (TnT) and cardio-endocrine...

Some of the frequently asked questions are: Should we use BE (base excess) or SID (strong ion difference) as a measure of a metabolic acid-base disturbance?  Is there any difference between BB (buffer base) and SID? Should we use SBE (standard base excess), i.e. BE referring to the expanded extracellular fluid or...

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...

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....

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...

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...

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.   ...

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)...

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...

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...