A rare case of persistent hyperkalaemia.

Hyperkalaemia is a common biochemical finding that can allude to preanalytical or truly pathological causes. Here, we present a case of a 41-year-old female patient who has regularly presented with incidences of isolated hyperkalaemia since 2012, with otherwise normal renal function and no other associated symptoms. Investigations into the patient's family history revealed similar biochemical findings in her brother and eldest son.

Derivation of a prediction model for emergency department acute kidney injury.

Background And Objective: Quality management of Acute Kidney Injury (AKI) is dependent on early detection, which is currently deemed to be suboptimal. The aim of this study was to identify combinations of variables associated with AKI and to derive a prediction tool for detecting patients attending the emergency department (ED) or hospital with AKI (ED-AKI).

Design, Setting, Participants And Measurements: This retrospective observational study was conducted in the ED of a tertiary university hospital in Wales.

Albumin and calcium reference interval using healthy individuals and a data-mining approach.

Background: Harmonization of reference intervals for analytes that have a sound calibration and metrological traceability is a widely recommended practice. The UK Pathology Harmony has recently harmonized reference intervals for calcium and albumin. In this study, we have determined the reference intervals for calcium and albumin on the UK's most commonly used analytical platforms.

The effect of different analytical platforms and methods on the performance of population-specific adjusted calcium equation.

Background: A recent attempt to improve the diagnostic value of adjusted calcium addressed a primary care-specific adjusted calcium equation, but validated the new equation for Roche Cobas, BCG and NM-BAPTA methods only. In this study, we aim to validate a population-specific equation for other methods and platforms.

Method: We collected retrospective patient data-sets from 15 hospital laboratories using a range of commercially available analytical platforms and methods for calcium and albumin measurements.

Clinical and laboratory characteristics of clozapine-treated patients with schizophrenia referred to a national immunodeficiency clinic reveals a B-cell signature resembling common variable immunodeficiency (CVID).

Aims: An association between antibody deficiency and clozapine use in individuals with schizophrenia has recently been reported. We hypothesised that if clozapine-associated hypogammaglobulinaemia was clinically relevant this would manifest in referral patterns.

Methods: Retrospective case note review of patients referred and assessed by Immunology Centre for Wales (ICW) between January 2005 and July 2018 with extraction of clinical and immunological features for individuals with diagnosis of schizophrenia-like illness.

Functional characterization of novel ABCB6 mutations and their clinical implications in familial pseudohyperkalemia.

Isolated familial pseudohyperkalemia is a dominant red cell trait characterized by cold-induced 'passive leak' of red cell potassium ions into plasma. The causative gene of this condition is ABCB6, which encodes an erythrocyte membrane ABC transporter protein bearing the Langereis blood group antigen system. In this study analyzing three new families, we report the first functional characterization of ABCB6 mutants, including the homozygous mutation V454A, heterozygous mutation R276W, and compound heterozygous mutations R276W and R723Q (in trans).

Does elective parathyroidectomy for primary hyperparathyroidism affect renal function? A prospective cohort study.

Introduction: Major surgery is associated with acute kidney injury (AKI). This study examines associations between elective parathyroid surgery and post-operative renal impairment.

Methods: Consecutive patients undergoing elective parathyroidectomy were evaluated, and demographic data and relevant blood parameters collected.

Severe hyperkalaemia: demographics and outcome.

Background: Few studies have evaluated the prevalence of severe hyperkalaemia in unselected patient populations. We identified all episodes of severe hyperkalaemia occurring in 1 year, and described patient demographics, clinical response and outcome. We also assessed junior doctor knowledge of its causes and significance.

Calculated globulin (CG) as a screening test for antibody deficiency.

Calculated globulin (total protein - albumin) is usually tested as part of a liver function test profile in both primary and secondary care and determines the serum globulin concentration, of which immunoglobulins are a major component. The main use hitherto of calculated globulin is to detect paraproteins when the level is high. This study investigated the potential to use low levels of calculated globulin to detect antibody deficiency.

A comparison of different methods of demand management on requesting activity in a teaching hospital intensive care unit.

Background: Laboratory services in the UK have witnessed an annual increase in requesting activity often with no associated increase in budget. This study evaluated the impact of different demand management strategies on biochemistry test requesting activity from a tertiary Intensive Care Unit (ICU) at a UK teaching hospital.

Method: We conducted an observational longitudinal study in which biochemistry requesting activity from the ICU was gathered over five separate six-month periods between 2009 and 2013.

Epidemiology and outcome of community-acquired acute kidney injury.

Aims: Very little data exist regarding community-acquired acute renal injury (CA-AKI). We have identified and characterized a patient cohort with CA-AKI, and documented its impact on renal function and patient mortality.

Methods: Using the database of the Medical Biochemistry Department of the Cardiff and Vale University Health Board we identified all patients with CA-AKI over a 1 month period in 2009.

Recurrent urolithiasis following parathyroidectomy for primary hyperparathyroidism.

Introduction: The effect of parathyroidectomy on the incidence of recurrent stone formation is uncertain. We aimed to compare the biochemistry and recurrence rate of urolithiasis in patients with primary hyperparathyroidism (pHPT) and stone formation (SF) and non-stone formation (NSF) with idiopathic stone formers (ISF).

Methods: Patients with pHPT and SF (Group 1) were identified from a prospective database.

The long-term impact of eGFR reporting on referral patterns.

Background: The prognostic significance of CKD has driven the widespread introduction of automated estimated glomerular filtration rate (eGFR) reporting, and the incorporation of CKD in the revised Quality Outcomes Framework (QOF) of the General Medical Services (GMS) contract in the U.K.

Aims: To assess the long-term impact of the introduction of these two initiatives, on patient referral numbers to a nephrology service.

The impact of local guidelines on the tumour marker requesting patterns of a General Surgery Department.

Background: The inappropriate use of tumour markers (TMs) is a common problem. The aim of this audit was to evaluate the impact of local guidelines on the TM requesting patterns of a General Surgery Department.

Methods: CA 125, CA 19-9, CA15-3, CEA, AFP and HCG requests from all hospital surgical locations were audited over two periods of eight months before and after the implementation of local requesting guidelines.

Acute hypoglycemia decreases myocardial blood flow reserve in patients with type 1 diabetes mellitus and in healthy humans.

Background: Hypoglycemia is associated with increased cardiovascular mortality, but the reason for this association is poorly understood. We tested the hypothesis that the myocardial blood flow reserve (MBFR) is decreased during hypoglycemia using myocardial contrast echocardiography in patients with type 1 diabetes mellitus (DM) and in healthy control subjects.

Methods And Results: Twenty-eight volunteers with DM and 19 control subjects underwent hyperinsulinemic clamps with maintained sequential hyperinsulinemic euglycemia (plasma glucose, 90 mg/dL [5.

The influence of liberal alcohol consumption on glucose metabolism in patients with type 1 diabetes: a pilot study.

Background: Little is known about the consequences of excessive alcohol ingestion in patients with type 1 diabetes.

Aim: To examine the metabolic effects of acute ingestion of liberal amounts of alcohol in patients with type 1 diabetes.

Design: A pilot study using a randomized, placebo controlled, double blind design in Hospital Clinical Research Unit.

Phospholipase D activity is essential for actin localization and actin-based motility in Dictyostelium.

PLD (phospholipase D) activity catalyses the generation of the lipid messenger phosphatidic acid, which has been implicated in a number of cellular processes, particularly the regulation of membrane traffic. In the present study, we report that disruption of PLD signalling causes unexpectedly profound effects on the actin-based motility of Dictyostelium. Cells in which PLD activity is inhibited by butan-1-ol show a complete loss of actin-based structures, accompanied by relocalization of F-actin into small clusters, and eventually the nucleus, without a visible fall in levels of F-actin.