Use Of Biomarkers In Patients Research Articles

New insights into the use of biomarkers in patients undergoing surgery for ulcerative colitis

New insights into the use of biomarkers in patients undergoing surgery for ulcerative colitis

New insights into the use of biomarkers in patients undergoing surgery for ulcerative colitis.

New insights into the use of biomarkers in patients undergoing surgery for ulcerative colitis.

Low compartment pressure and myoglobin levels in tibial fractures with suspected acute compartment syndrome

BackgroundThe intense ischemic pain of acute compartment syndrome can be difficult to discriminate from the pain related to an associated fracture. Lacking objective measures, the decision to perform fasciotomy is often only based on clinical findings and performed at a low threshold. Biomarkers of muscle cell damage might help to identify and monitor patients at risk. In patients with fractures, however, markers of muscle cell damage could be elevated because of other reasons associated with the trauma, which would make interpretation difficult. In a review of all patients who underwent emergency fasciotomy in our health care district we aimed to investigate the decision-making process and specifically the use of biomarkers in patients with and without fractures.MethodsIn the southeast health care region of Sweden 79 patients (60 men) with fractures (median age 26 years) and 42 patients (34 men) without associated fractures (median age 44 years) were treated with emergency fasciotomy of the lower leg between 2007 and 2016. Differences in clinical findings, p-myoglobin and p-creatine phosphokinase as well as pressure measurements were investigated.ResultsP-myoglobin was analyzed preoperatively in 20% of all cases and p-creatine phosphokinase in 8%. Preoperative levels of p-myoglobin were lower in patients with fractures (median 1065 μg/L, range 200–3700 μg/L) compared with those without fractures (median 7450 μg/L, range 29–31,000 μg/L), p < 0.05. Preoperative intracompartmental pressure was lower in the fracture group (median 45 mmHg, range 25–90 mmHg) compared with those without fractures (median 83 mmHg, range 18–130 mmHg), p < 0.05.ConclusionsBiomarkers are seldom used in the context of acute fasciotomy of the lower leg. Contrary to our expectations, preoperative levels of p-myoglobin and intracompartmental pressures were lower in fracture patients. These findings support differences in the underlying pathomechanism between the groups and indicate that biomarkers of muscle cell necrosis might play a more important role in the diagnosis of acute compartment syndrome than previously thought.

Cardiac biomarkers in acute coronary syndromes

Cardiac biomarkers play a significant role in the diagnosis, risk assessment, and management of patients with acute coronary syndromes (ACS). Several biomarkers identify different components of the pathophysiology of ACS: troponins are markers of myocyte necrosis, natriuretic peptides reflect neurohormonal activation and myocardial dysfunction, and C-reactive protein reflects various inflammatory processes. Whilst there are a number of established and novel biomarkers to assess ischemia, necrosis and myocardial dysfunction in coronary artery disease, it is probable that no single biomarker will emerge that provides appropriate information for all clinical settings of ACS. This suggests that ongoing efforts in plasma-based biomarker research should concentrate on the use of a multimarker approach to enhance our diagnosis, prognostic assessment, and management of patients with suspected ACS, as compared with using individual markers alone. It is recommended that current practice involve the selective use of biomarkers in patients in whom a more complete assessment of risk is desired. At present, routine biomarker measurement is not advocated until further data become available, which will support the benefit of specific therapeutic interventions.

Utilizing cardiac biomarkers to detect and prevent chemotherapy-induced cardiomyopathy.

The success achieved in advances in cancer therapy has been marred by development of cardiotoxicity, which causes significant morbidity and mortality. This has led to the development of surveillance protocols for cardiotoxicity utilizing multimodality imaging techniques and investigation of various drugs to treat and prevent cardiotoxicity in this subset of patients. Cardiac biomarkers hold important diagnostic and prognostic value in various cardiac diseases. In this review, we discuss the use of biomarkers in patients receiving chemotherapy, highlighting data behind the use of troponin, B-type natriuretic peptide, and myeloperoxidase. We also discuss the use of dexrazoxane, angiotensin-converting enzyme inhibitors, and beta blockers in the treatment and prevention of chemotherapy-induced cardiotoxicity. Cardiac biomarkers may serve an important role in selecting patients that are at high risk of cardiotoxicity and can potentially be used to guide the administration of drugs to treat and prevent cardiotoxicity.

Inflammation and peripheral arterial disease: The value of circulating biomarkers (Review)

Peripheral arterial disease (PAD) is a manifestation of atherosclerotic vascular disease and is often associated with other comorbidities, such as hypertension, diabetes and dyslipidemia. An increasing body of evidence supports the notion that inflammation plays an important role in the development and progression of PAD. A number of studies have investigated the association of various acute phase proteins, particularly C-reactive protein (CRP), with PAD. Apart from CRP, other circulating biomarkers, such as matrix metalloproteinases (MMPs), selectins and interleukin (IL)-1, IL-2, IL-6, IL-8 and IL-10 have been considered to play a role in the development of PAD. In this review, the role of these circulating biomarkers in PAD is discussed. Current data indicate that the appropriate use of biomarkers in patients with PAD may contribute to an early diagnosis, an enhanced knowledge of the developmental process of the disease, as well as to the subsequent improvement of current therapies and to the development of new ones.

Biomarkers and community-acquired pneumonia

Community-acquired pneumonia (CAP) is common, and the delivery of optimum care to patients with CAP is important to limit the associated substantial mortality and morbidity. Although severity assessment of patients...