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Objective: To evaluate the accuracy of a 2-h serial multiple biomarker (SMB) protocol for exclusion of myocardial infarction (MI) in the Emergency Department.
Methods: A prospective, multicentre, observational study enrolled patients undergoing evaluation for possible MI. Blood samples at presentation and 2 h later were analysed for myoglobin, creatinine kinase-MB, troponin-I and B-natriuretic peptide. Thrombolysis in Myocardial Infarction (TIMI) score and National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand (NHF/CSANZ) guideline for acute coronary syndrome were used to determine clinical risk. Primary outcome was MI diagnosed at index presentation. Secondary outcome was composite of all-cause mortality, MI and previously unplanned coronary revascularisation within 30 days.
Results: 1758 patients were recruited. 168 (11%) of 1501 with data sufficient for analysis had MI, and 223 (14%) of 1620 had a secondary outcome. SMB sensitivity and specificity were 0.90 (95% CI 0.84 to 0.94) and 0.41 (95% CI 0.39 to 0.44) for MI. For 30-day outcome, SMB sensitivity and specificity were 0.84 (95% CI 0.78 to 0.88) and 0.41 (95% CI 0.39 to 0.44), compared with standard 8-12 h troponin sensitivity and specificity of 0.79 (95% CI 0.73 to 0.84) and 0.96 (95% CI 0.95 to 0.97). Combined with risk scores, SMB had sensitivity and specificity for MI of 0.99 (0.96 to 1.00) and 0.11 (95% CI 0.09 to 0.12) for TIMI score 0, compared with 0.98 (95% CI 0.94 to 0.99) and 0.31 (95% CI 0.29 to 0.34) for NHF/CSANZ low/intermediate risk groups.
Conclusions: SMB alone is not sufficiently sensitive to exclude MI. Combined with risk scoring, SMB appears to identify patients at lower risk. This requires prospective validation.
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http://dx.doi.org/10.1136/emermed-2011-200667 | DOI Listing |
Br J Radiol
December 2024
Department of Radiology, Northern Jiangsu People's Hospital, Northern Jiangsu People's Hospital Affiliated to Yangzhou University, Yangzhou, China.
Objectives: To investigate the feasibility of radiomics models for predicting the source of hepatic metastases from gastrointestinal (GI) vs. non-gastrointestinal (non-GI) primary tumors on contrast enhanced CT(CECT).
Methods: 347 patients with liver metastases (180 from GI and 167 from non-GI) and abdominal CECT including arterial, portal venous, and delayed phases were divided into training (221) and validation (96) sets at a ratio of 7:3 and an independent testing set (30).
Hum Reprod
December 2024
IVIRMA Global Research Alliance, IVI Foundation, Health Research Institute La Fe, Valencia, Spain.
Study Question: Is it possible to predict an euploid chromosomal constitution and identify a transcriptomic profile compatible with extended embryonic development from RNA sequencing (RNA-Seq) data?
Summary Answer: It has been possible to obtain a karyotype comparable to preimplantation genetic testing for aneuploidy (PGT-A), in addition to a transcriptomic signature of embryos which might be suggestive of improved implantation capacity.
What Is Known Already: Conventional assessment of embryo competence, based on morphology and morphokinetic, lacks knowledge of molecular aspects and faces controversy in predicting ploidy status. Understanding the embryonic transcriptome is crucial, as gene expression influences development and implantation.
Lung India
January 2025
Department of Pulmonary Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Dhanvantari Nagar, Puducherry, India.
Background: The estimated incidence of pulmonary embolism (PE) is around 60-70 cases per 100,000 people annually. The overall mortality rate for massive PE is substantial, ranging from 18% to 65%. We can utilise changes in lung perfusion to stratify patients with PE acutely based on risk, highlighting its diagnostic and prognostic value.
View Article and Find Full Text PDFJ Orthop Traumatol
December 2024
Sapienza Universitiy, Rome, Italy.
Introduction: The plantar plate, also called the plantar ligament, is a fibrocartilaginous structure found in the metatarsophalangeal (MTP) and interphalangeal (IP) joints. Our study aimed to evaluate the role of magnetic resonance imaging (MRI) performed with the patient in the standard position or with joint hyperextension (the "stress test", ST) in the study of plantar plate (PP) disease that involves metatarsophalangeal joints.
Materials And Methods: All patients underwent forefoot MRI (Atroscan C, Esaote, Genoa, Italy), operating at 0.
Mikrochim Acta
December 2024
State Key Laboratory of Supramolecular Structure and Materials, Jilin University, Changchun, 130012, People's Republic of China.
A highly sensitive aptamer sensor (aptasensor) is proposed based on metal-organic frameworks-silver nanoparticles (AgNPs@MOF) to detect sulfadimethoxine (SDM) by surface-enhanced Raman spectroscopy (SERS). AgNPs@MOF with SERS activity was successfully fabricated by synthesizing AgNPs in situ on the surface of MIL-101(Fe), and SDM aptamer and Raman reporter 4-aminophenthiophenol (4-ATP) were selected as specific recognition elements and signal probes, respectively. When SDM was absent, the SDM aptamers were effectively adsorbed on the surface of AgNPs@MOF, thus keeping AgNPs@MOF in a dispersed state, resulting in a weakened SERS signal of 4-ATP.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!