The use of serum methotrexate level as an assessment of biochemical drug adherence in psoriasis.

Psoriasis is a common inflammatory skin condition affecting approximately 2–3% of people worldwide. Methotrexate (MTX) is a cheap and effective drug that is often recommended as the first-choice systemic agent for psoriasis. Around 40–50% of patients achieve a good response; however, mechanisms of nonresponse are poorly understood.

A sensitive LC-MS/MS methotrexate assay capable of assessing adherence to methotrexate therapy in rheumatoid arthritis.

Objectives: To develop a sensitive liquid chromatography-tandem mass spectrometry method capable of measuring serum methotrexate in patients with rheumatoid arthritis to assess adherence to drug treatment.

Methods: Isotopically labelled internal standard and deionised water were added to sample prior to solid phase extraction using a Waters Oasis Max ion-exchange 96-well plate. Following extraction, samples were analysed by LC-MS/MS on a TQS-micro mass spectrometer.

A rapid LC-MS/MS assay for the measurement of serum methotrexate in patients who have received high doses for chemotherapy.

Background: Methotrexate is used in high doses to treat a number of cancers, particularly certain haematological malignancies. Monitoring of serum methotrexate concentration is important due to the potential toxicity of methotrexate and the variation in methotrexate pharmacokinetics in different patients on the same treatment regimen.

Objective: To develop a rapid liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for monitoring serum methotrexate in patients on high-dose chemotherapy.

Diagnostic accuracy of point-of-care tests for detecting albuminuria: a systematic review and meta-analysis.

Background: Experts recommend screening for albuminuria in patients at risk for kidney disease.

Purpose: To systematically review evidence about the diagnostic accuracy of point-of-care (POC) tests for detecting albuminuria in individuals for whom guidelines recommend such detection.

Data Sources: Cochrane Library, EMBASE, Medion database, MEDLINE, and Science Citation Index from 1963 through 5 December 2013; hand searches of other relevant journals; and reference lists.

Replacing urine protein electrophoresis with serum free light chain analysis as a first-line test for detecting plasma cell disorders offers increased diagnostic accuracy and potential health benefit to patients.

Objectives: To determine the most clinically effective diagnostic testing strategy for plasma cell disorders in the clinical laboratory.

Methods: Serum and urine samples from 2,799 patients with suspected plasma cell dyscrasias were tested by alternative diagnostic testing strategies consisting of serum protein electrophoresis (SPE) with either urine protein electrophoresis (UPE) or serum free light chain (sFLC) analysis.

Results: The combination of sFLC analysis and SPE had the greatest sensitivity (100%), detecting abnormalities in all 124 patients diagnosed with plasma cell disorders.

Investigation of apparent non-albuminuric proteinuria in a primary care population.

Background: There is debate as to whether using the urinary albumin- or protein-to-creatinine ratio (ACR or PCR) should be the primary test for proteinuria. Whilst albuminuria (increased ACR) in the absence of proteinuria (increased PCR) may be expected in some patients, the converse (i.e.

The diagnostic accuracy of a urine albumin-creatinine ratio point-of-care test for detection of albuminuria in primary care.

Background: Albuminuria is an important sign of chronic kidney disease and is detected routinely by measurement of urinary albumin-creatinine ratio (ACR). A Siemens CLINITEK test designed for use at the point of care is available that can semiquantitatively measure ACR.

Study Design: Diagnostic accuracy study evaluating a urinary ACR point-of-care test.

Identification of a macro-alkaline phosphatase complex in a patient with inflammatory bowel disease.

We report the rare finding of a macro-alkaline phosphatase (macroALP) complex in a patient with a previously unexplained raised alkaline phosphatase activity. The clinical symptoms were persistent, daily diarrhoea for two months with blood in the stool. The patient was subsequently diagnosed with inflammatory bowel disease, specifically ulcerative colitis, following a rectal biopsy and colonoscopy.