Determination of serum albumin, analytical challenges: a French multicenter study.

Among the biological markers of morbidity and mortality, albumin holds a key place in the range of criteria used by the High Authority for Health (HAS) for the assessment of malnutrition and the coding of information system medicalization program (PMSI). If the principle of quantification methods have not changed in recent years, the dispersion of external evaluations of the quality (EEQ) data shows that the standardization using the certified reference material (CRM) 470 is not optimal. The aim of this multicenter study involving 7 sites, conducted by a working group of the French Society of Clinical Biology (SFBC), was to assess whether the albuminemia values depend on the analytical system used.

[Utility of soluble transferrin receptor measurement for early diagnostic of iron deficiency in elderly hospitalized patients].

Diagnosis of iron deficiency is not easily performed in inflammatory situation as usually encountered in elderly hospitalized patients (>70 years old). At first, we determined serum soluble receptor transferrin (RsTf), RsTf/serum ferritin ratio (RsTf-F index) and biochemical and haematological values used to evaluate iron status, in iron-depleted subjects (ferritinemia≤50 μg/L) (group 2) (n=22, 82±7 years) or not (group 1, reference group) (n=18, 82±6 years), without inflammatory diseases. Relevance of the biological parameters to diagnose iron deficiency was evaluated (ROC curve) and a cut-off value of RsTf-F (>1.

Diagnostic and prognostic value of brain natriuretic peptide (BNP) concentrations in very elderly heart disease patients: specific geriatric cut-off and impacts of age, gender, renal dysfunction, and nutritional status.

Confirming the presence of heart failure (HF) in geriatric patients is made difficult by the overlapping symptoms with other diseases and by limited access to investigative techniques such as echography, and the clinical signs are either non-constant or difficult to interpret. In this context, BNP measurement could prove highly useful. We determined a cut-off value of BNP for diagnosing HF in geriatric patients and gauged its predictive power in terms of cardiovascular events, dependence and death within a 6-month timeframe.

A new formula for correction of total calcium level into ionized serum calcium values in very elderly hospitalized patients.

Ionized calcium (Ca(2+)) seems to be the best measure of active serum calcium but, in France, numerous laboratories do not have Ca(2+) analyzers so that numerous clinicians use Payne's formula to obtain adjusted calcium (Ca(Ad)) values. In frail very elderly patients with protein/energetic malnutrition and very low concentrations of albumin, "correction" with Payne's formula usually gives false hypercalcemic results, so that hypocalcemia may be seriously underdiagnosed. Two hundred and ninety-four patients of 80 years and older with serum albumin level < 35 g/l were included in four French hospitals for elderly people.

Is biolectrical impedance analysis a tool at bedside, during heat waves to assist geriatricians with discriminative diagnosis of hypertonic dehydration?

Objectives: To assess BIA data given by Analycor 3 and some bio-impedance equations to assist geriatricians with discriminative diagnosis of hypertonic dehydration, during heat waves.

Design: Prospective study: a dehydrated patients group has been compared with a randomised control group.

Setting: The study was carried out in a French geriatric department, in the Emile Roux geriatric hospital.