Reference ranges and diagnostic thresholds of laboratory markers of cardiac damage and dysfunction in a population of apparently healthy black Africans.

Background: Due to the increasing migration flows mostly concerning Western countries, the problem of reference ranges and cut-off values is a living matter. In particular, the influence of ethnic origin on traditional and novel biochemical markers of cardiac damage, including cardiac troponin T (cTnT), ischemia modified albumin (IMA) and N-terminal prohormone brain natriuretic peptide (NT-proBNP), has not been investigated, to the best of our knowledge.

Methods: CTnT, NT-proBNP and IMA were assayed by a Modular System in 34 apparently healthy black Africans originating mainly from Central Africa and in 34 apparently healthy white, non-immigrant Italians, matched for age and sex.

Dark chocolate: consumption for pleasure or therapy?

Traditional chocolate is derived from the cocoa bean, which is one of the most concentrated sources of flavanols, a subgroup of the natural antioxidant plant compounds called flavonoids. Accumulating evidence from the past 10 years demonstrates that moderate consumption of chocolate, especially dark chocolate, may exert protective effects against the development of cardiovascular disease. Several mechanisms have been proposed to explain this positive influence, including metabolic, antihypertensive, anti-inflammatory, and anti-thrombotic effects, as well as effects on insulin sensitivity and vascular endothelial function.

No correlation between lipoprotein(a) and biochemical markers of renal function in the general population.

Context: Lipoprotein(a) (Lp(a)) is receiving major emphasis as an independent risk factor for cardiovascular disease. Results of studies on Lp(a) in patients with impaired renal function are contradictory, and no information is available on the association between Lp(a) and estimated glomerular filtration rate and cystatin C.

Objective: To evaluate the potential relationships among the biochemical markers creatinine, estimated glomerular filtration rate, and cystatin C and their association with Lp(a) in patients with impaired renal function.

Hyperthyroidism is associated with shortened APTT and increased fibrinogen values in a general population of unselected outpatients.

Although clinical evidence supports a plausible association between thyroid disorders and venous thrombosis, reliable evidence is so far lacking on the potential biological mechanisms and neither temporary nor permanent thromboembolic risk factors were constantly identified. We performed a 2-years retrospective analysis to retrieve combined results of activated partial thromboplastin time (APTT), prothrombin time (PT), fibrinogen, and thyroid stimulating hormone (TSH), performed on outpatients over 15 years of age and referred by general practitioners for routine blood testing. Cumulative results were retrieved for 1,329 such outpatients.

Relationship between hypomagnesemia and glucose homeostasis.

Background: Controversial data are available on the relationship between magnesium metabolism and glucose homeostasis.

Methods: We performed a retrospective analysis to retrieve results of serum magnesium and fasting plasma glucose (FPG) tests (7,659 outpatients >35 years old).

Results: Subjects with FPG value > 7.

Non-homogeneous separation of triglycerides, gamma-glutamyltransferase, C-reactive protein and lactate dehydrogenase after centrifugation of lithium-heparin tubes.

Background: Clinical chemistry testing is influenced by a variety of preanalytical variables, including sample preparation. The presence of a diluted plasma layer at the top of primary tubes containing plasma citrate has recently been reported. However, no indication is available so far on the potential non-homogeneous distribution of clinical chemistry analytes during centrifugation of primary tubes containing lithium-heparin as an additive.

Antithrombotic prophylaxis in patients with von Willebrand disease undergoing major surgery: when is it necessary?

Most patients with congenital von Willebrand disease (VWD) undergoing major surgical procedures require prophylactic replacement therapy with von Willebrand factor (VWF)/factor VIII (FVIII) concentrates. Venous thromboembolism has been reported in such patients, as a result of a combination of various treatments (i.e.

Determinants of kidney function in Swedish families: role of heritable factors.

The aim of this study was to evaluate the determinants of kidney function and the role of heritable factors in a sample of 249 siblings free from known cardiovascular disease and without antihypertensive drugs belonging to 110 families. Four different measures and estimates of kidney function were considered. Blood pressure was recorded during 24 h by ambulatory blood pressure monitoring.

Immune tolerance with rituximab in congenital haemophilia with inhibitors: a systematic literature review based on individual patients' analysis.

Rituximab, a monoclonal antibody against the pan B-cell antigen CD20, has been successfully used in both adults and children for the management of malignant and non-malignant immune-mediated disorders including acquired haemophilia. On the basis of this positive experience, a number of investigators have recently used this agent in patients with congenital haemophilia and inhibitors refractory to first-line treatments. After a careful electronic and hand search, we have collected 29 studies that included 49 cases.

Sudden cardiac death in young athletes.

Although regular aerobic physical activity increases exercise capacity and plays a role in both primary and secondary prevention of a variety of chronic disorders, competitive physical exercise is associated with a significant increase of risk of sudden death in athletes, especially adolescents and young adults. Several pathogenetic mechanisms have been speculated, including silent cardiovascular conditions, mostly cardiomyopathy, premature coronary artery disease and congenital coronary anomalies. Uneventful events, especially commotio cordis, and abuse of unfair and dangerous performance-enhancing drugs, are also claimed as potential causes.

Influence of acute physical exercise on emerging muscular biomarkers.

Background: Although there is comprehensive information on traditional biomarkers of muscle and cardiac damage following exercise, less is known on the kinetics of innovative markers, including ischemia modified albumin (IMA), glycogen phosphorylase isoenzyme BB (GPBB), carbonic anhydrase III (CAIII) and heart-type fatty acid-binding protein (H-FABP) in athletes performing a sub-maximal exercise.

Methods: A total of 10 healthy trained Caucasian males performed a 21-km run. Blood samples were collected before the run, immediately after (post), 3, 6 and 24 h thereafter.

Prevalence of folic Acid and vitamin B12 deficiencies in patients with thyroid disorders.

Although macrocytosis might occur with frequency in patients with thyroid disorders, there is controversial information on the metabolic relationship between thyroid stimulating hormone (TSH), folic acid and B12 in the general population. We performed a retrospective analysis to retrieve results of serum folic acid, B12, and TSH performed on consecutive outpatients referred by general practitioners for routine blood testing over the last 2 years. A positive, significant trend towards increased values of folic acid, but not of B12, could be observed across the spectrum of TSH values suggestive for hypo- and hyperthyroidism.

Relationship between red blood cell distribution width and kidney function tests in a large cohort of unselected outpatients.

Objective: A strong, independent, association has recently been shown between higher red blood cell distribution width (RDW) and the risk of all-cause death and cardiovascular events. However, the mechanism(s) underlying this association remains unclear. Since impaired kidney function is a well-known risk factor for cardiovascular disease, we assessed whether RDW is associated with decreased kidney function.

Eosinophilia and first-line coagulation testing.

Although eosinophilia (eosinophil count >0.60 x 10(9)/l), is a prothrombotic condition, little is known on the association between eosinophil count in blood and first-line coagulations tests, including fibrinogen, activated partial thromboplastin time (APTT), prothrombin time (PT) and platelet count. Cumulative results of APTT, PT, fibrinogen, platelet and eosinophil counts were retrieved from 6,944 outpatients >15 years old referred to our laboratory for routine blood testing over the previous 3 years.

Acute variation of biochemical markers of muscle damage following a 21-km, half-marathon run.

Objective: Although there is information on biochemical markers of muscle and cardiac damage following strenuous exercise, little is known about the kinetics of these markers in athletes performing sub-maximal exercise.

Material And Methods: Fifteen healthy, trained, Caucasian males took part in a 21-km run. Blood samples were collected before the run, immediately after (post), and 3 h, 6 h and 24 h thereafter.