Ustav Klinicke Biochemie A Diagnostiky LF UK A FN

Hradec Králové, Czech Republic

Ustav Klinicke Biochemie A Diagnostiky LF UK A FN

Hradec Králové, Czech Republic
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Friedecky B.,Ustav Klinicke Biochemie a Diagnostiky LF UK a FN | Friedecky B.,R.Ø.S.A. | Tichy M.,Ustav Klinicke Biochemie a Diagnostiky LF UK a FN | Kratochvila J.,R.Ø.S.A. | And 4 more authors.
Klinicka Biochemie a Metabolismus | Year: 2010

Introduction: Cardiac troponins represent a dominant biochemical marker in the diagnosis of acute coronary syndrome. Recently or at the present time their determination undergoes another phase. It concerns a significant improvement of analytical sensitivity of the determination. It results in decreasing values of decisive limits accompanied by some problems of clinical interpretation. We found themselves in the phase of "Ultrasensitive diagnostics" and new knowledge for the needs of their routine use must be continually summarized. Method: This review is based on data from literature published in the past two years with special reference of data from 2010. Data from literature are combined with results of external quality control in Czech and Slovak clinical laboratories in 2009 and 2010 focused on the values of used decision limits. Results: The authors briefly deal with the history of cardiac markers with special reference no troponins. New methods of increased analytical sensitivity introduced to market and to the routine practice under the headings of "ultrasensitive" or "highly sensitive" are outlined in greater detail. The association between detection, required precision value, and the determination of decision-oriented limit are discussed. It has been shown that the main problem in using troponins in routine practice is a difficulty in reaching required precision of the measurement and subsequent problems in the creation of decision processes, which may seriously influence clinical specificity and sensitivity in diagnostic decision-making. The so far published limits values of biological variability are presented. The evaluation of decision-oriented limits provided by clinical laboratories to clinicians, constitute an important part of the communication. Conclusions: Increasing analytical sensitivity in determination of cardiac troponins is a clearly establishing trend in determination of troponins. This is associated with problems in values of the decision-oriented limits and with subsequent interpretation of laboratory results in conditions, when the number of results is definitely exceeding the diagnostic decision-making limit of acute coronary syndrome.


Pudil R.,I. interni kardioangilogicka klinika LF UK a FN | Praus R.,I. interni kardioangilogicka klinika LF UK a FN | Hulek P.,II. interni gastroenterologicka klinika LF UK a FN | Safka V.,I. interni kardioangilogicka klinika LF UK a FN | And 3 more authors.
Intervencni a Akutni Kardiologie | Year: 2013

Purpose: Liver cirrhosis is associated with hyperdynamic circulation which can result in heart failure. Transjugular intrahepatic portosystemic shunt (TIPS) due to increase of cardiac output is a stressful stimulus for cardiovascular system. Therefore, new methods for early detection of heart failure are needed. The aim of the study was to analyze the effect of TIPS procedure on hemodynamic. Material and Methods: 55 patients (38 men and 17 women, 55.6 ± 8.9 years) with liver cirrhosis treated with TIPS were enrolled in the study. Echocardiography was performed before, 24 hours, 7, 30 and 180 days after the procedure. Results: Left ventricular end-diastolic diameter (LVEDD) was increasing [before: median 47 (interquartile range: 44.7-51.2) mm, day 7: 50 (46.5-51.3) mm, p < 0.05; day 30: 49.5 (46.7-55.2) mm, p < 0.01; day 180: 52.5 (48.3-55.2) mm, p < 0.01)]. We noticed increase in vena cava inferior (VCI) diameter [before: 17 (15.5-19) mm, 24 h: 17 (15.5-19), p ns; day 7: 18 (16.3-19.4), p ns; day 30: 18.7 (16.5-19.8) mm, p < 0.05; day 180: 19 (18.2-20.5), p < 0.05]. Right ventricular (RV) diameter was increasing [before: 27 (25-29) mm, 24 h: 28 (26-30) mm, p ns; day 7: 29 (27.5-30) mm, p < 0.05; day 30: 30 (27-31) mm, p < 0.05; day 180: 30 (27.5-31.2), p < 0.05]. Transmitral E wave significantly was increasing [before: 75,5 (60.5-87.3) cm/s, 24 h: 88 (74.3-109.7), p < 0.01; day 7: 89 (81.5-105) p < 0.01; 1 month: 94 (82.7-108.5) p < 0.01; 6 months: 91 (80.1-120.2) p < 0.01]. The E/A ratio was increasing during the follow up (baseline: 0.88, 24 h after: 0.89, 1 week: 1.0, 30 days: 1.13, 6 month: 1.06 p < 0.01). Conclusion: Hemodynamic changes following TIPS procedure can be monitored using echocardiography. Transmitral flow analysis can serve as a useful tool for evaluating of diastolic function in these patients. Copyright 2009 © Solen s.r.o.


Plisek S.,Klinika Infekcnich Nemoci LF UK a FN | Pliskova L.,Ustav Klinicke Biochemie a Diagnostiky LF UK a FN | Bolehovska R.,Ustav Klinicke Biochemie a Diagnostiky LF UK a FN | Kapla J.,Klinika Infekcnich Nemoci LF UK a FN | Stepanova V.,Ustav Klinicke Mikrobiologie LF UK a FN
Klinicka Biochemie a Metabolismus | Year: 2010

Our work analyzes the group of 93 patients with chronic hepatitis C under treatment some of these patients have passed the antiviral therapy repeatedly, with the view of the possibility to determine the prediction of the therapy success. Using the statistical data processing, especially ROC analysis, we tried to define the predictive factors that may help the physician prior to antiviral therapy introduction or already during the ongoing therapy to predict the probability to reach the sustained viral response (SVR) in the patient. According to our findings we conclude that the crucial for SVR prediction is the monitoring of HCV viremia level 7 days and 3 months after the introduction of antiviral therapy. The monitoring of ALT activity, especially ALT/AST ratio prior to therapy introduction, after 4 weeks of ongoing therapy and the decrease of ALT activity after 4 weeks of ongoing therapy enables the satisfactory ratio of prediction. HCV viremia level determination prior to therapy introduction and detection of the decrease of its level after 7 days and 3 months of ongoing therapy belong to factors (parameters), which may satisfactory predict SVR. The monitoring of leucocytes count decrease after 4 weeks of therapy and the neutrophiles count prior to therapy introduction and its decrease after 4 weeks of therapy belong to well-founded factors in SVR prediction as well. High hematotoxicity reflects better interferon therapy efficacy. On the other hand BMI, albumin and bilirubin levels are factors that did not show evidence of any prediction value of SVR in our patients.


Pudil R.,1. Interni Klinika LF UK a FN | Tichy M.,Ustav Klinicke Biochemie a Diagnostiky LF UK a FN
Klinicka Biochemie a Metabolismus | Year: 2010

Natriuretic peptides play an important role in heart failure. The review focuses on biology of natriuretic peptides, their role in pathophysiology of heart failure. The authors comment their use in diagnosis both systolic and diastolic heart failure, and their role in monitoring of the therapy. Furthermore, the authors discuss the significance of natriuretic peptide assessment in pulmonary embolism. The therapeutic experiments using natriuretic peptides and their analogues in patients with heart failure are discussed.


Pitelinova J.,Oddeleni Klinicke Biochemie | Solcova L.,Oddeleni Klinicke Biochemie | Tichy M.,Ustav Klinicke Biochemie A Diagnostiky LF UK A FN
Klinicka Biochemie a Metabolismus | Year: 2011

There is significant recurrent discrepance between elevated fasting plasma glukose and glycohemoglobin in a patient with diabetes mellitus type 1. The fall in glycohemoglobin results is due to short life span of erythrocytes as a product of dapson-induced hemolysis. Fructosamine concentrations is more appropriate to control diabetes mellitus in this case, because is not affected by hemolysis.


Friedecky B.,Ustav Klinicke Biochemie a Diagnostiky LF UK a FN
Klinicka Biochemie a Metabolismus | Year: 2010

The objective of this review are data of current state in frequency, detection and evaluation of errors in clinical laboratories obtained by studying the recent literature. There are introduced data from all phases of laboratory examinations - preanalytical, analytical and postanalytical. Their possible negative effects on the level of health care and on the risk for patients are analysed. Also connections between numbers and kinds of errors with patient's health care are described. Accreditation standards, personal responsibilities and creation of quality indicators systems are another part of this review.

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