Comparison of procalcitonin and CrP in the postoperative course after lung decortication

Objective: The objective of this prospective study was to compare the clinical value of procalcitonin (PCT) and C-reactive protein (CrP) plasma concentrations in their postoperative course after decortication. Methods: Twenty-two patients requiring surgery for pleural empyema were chosen for this prospective study. Routine blood samples including CrP and PCT plasma concentrations were taken before the operation and on the 1st, 2nd, 3rd, and 7th postoperative day. Results: Due to infection PCT and CrP were elevated preoperatively. In the postoperative course both PCT and CrP reached peak-levels on day 2 with values up to 43.55ng/ml and 384.00mg/l, respectively. In PCT the rise was followed by a clear decrease in 20 (90.9 %) patients until day 7. In contrast the CrP levels decreased slowly and only seven (54.5%) patients had values of 100mg/l or below on day 7. PCT showed a better correlation with the clinic in case of septic course than CrP does. Conclusions: PCT reflects postoperative clinical course more accurately than CrP. Therefore, PCT is a more appropriate laboratory parameter to monitor patients after surgery for pleural empyem

Monographies on drugs, which are frequently analysed in the course of Therapeutic Drug Monitoring Monographien über Medikamente, die regelmässig im Rahmen des Therapeutic Drug Monitorings analysiert werden

In 1995 the working group "Drug Monitoring” of the Swiss Society of Clinical Chemistry (SSCC) has already published a printed version of drug monographs, which are now newly compiled and presented in a standardised manner. The aim of these monographs is to give an overview on the most important informations that are necessary in order to request a drug analysis or is helpful to interpret the results. Therefore, the targeted audience are laboratory health professionals or the receivers of the reports. There is information provided on the indication for therapeutic drug monitoring, protein binding, metabolic pathways and enzymes involved, elimination half life time and elimination routes as well as information on therapeutic or toxic concentrations. Because preanalytical considerations are of particular importance for therapeutic drug monitoring, there is also information given at which time the determination of the drug concentration is reasonable and when steady-state concentrations are reached after changing the dose. Furthermore, the stability of the drug and its metabolite(s), respectively, after blood sampling is described. For readers with a specific interest, references to important publications are given. The number of the monographs will be continuously enlarged. The updated files are presented on the homepage of the SSCC (www.sscc.ch). We hope that these monographs are helpful for you handling therapeutic drug monitoring and look forward to comments of the audienc

Prevalence and associated factors of viral hepatitis and transferrin elevations in 5036 patients admitted to the emergency room of a Swiss university hospital: cross-sectional study

BACKGROUND: The epidemiology of liver disease in patients admitted to emergency rooms is largely unknown. The current study aimed to measure the prevalence of viral hepatitis B and C infection and pathological laboratory values of liver disease in such a population, and to study factors associated with these measurements. METHODS: Cross-sectional study in patients admitted to the emergency room of a university hospital. No formal exclusion criteria. Determination of anti-HBs, anti-HCV, transferrin saturation, alanine aminotransferase, and obtaining answers from a study-specific questionnaire. RESULTS: The study included 5'036 patients, representing a 14.9% sample of the target population during the study period. Prevalence of anti-HBc and anti-HCV was 6.7% (95%CI 6.0% to 7.4%) and 2.7% (2.3% to 3.2%), respectively. Factors independently associated with positive anti-HBc were intravenous drug abuse (OR 18.3; 11.3 to 29.7), foreign country of birth (3.4; 2.6 to 4.4), non-white ethnicity (2.7; 1.9 to 3.8) and age > or =60 (2.0; 1.5 to 2.8). Positive anti-HCV was associated with intravenous drug abuse (78.9; 43.4 to 143.6), blood transfusion (1.7; 1.1 to 2.8) and abdominal pain (2.7; 1.5 to 4.8). 75% of all participants were not vaccinated against hepatitis B or did not know their vaccination status. Among anti-HCV positive patients only 49% knew about their infection and 51% reported regular alcohol consumption. Transferrin saturation was elevated in 3.3% and was associated with fatigue (prevalence ratio 1.9; 1.2 to 2.8). CONCLUSION: Emergency rooms should be considered as targets for public health programs that encourage vaccination, patient education and screening of high-risk patients for liver disease with subsequent referral for treatment if indicated

Multicentre evaluation of a new point-of-care test for the determination of NT-proBNP in whole blood

Background: The Roche CARDIAC proBNP point-of-care (POC) test is the first test intended for the quantitative determination of N-terminal pro-brain natriuretic peptide (NT-proBNP) in whole blood as an aid in the diagnosis of suspected congestive heart failure, in the monitoring of patients with compensated left-ventricular dysfunction and in the risk stratification of patients with acute coronary syndromes. Methods: A multicentre evaluation was carried out to assess the analytical performance of the POC NT-proBNP test at seven different sites. Results: The majority of all coefficients of variation (CVs) obtained for within-series imprecision using native blood samples was below 10% for both 52 samples measured ten times and for 674 samples measured in duplicate. Using quality control material, the majority of CV values for day-to-day imprecision were below 14% for the low control level and below 13% for the high control level. In method comparisons for four lots of the POC NT-proBNP test with the laboratory reference method (Elecsys proBNP), the slope ranged from 0.93 to 1.10 and the intercept ranged from 1.8 to 6.9. The bias found between venous and arterial blood with the POC NT-proBNP method was ≤5%. All four lots of the POC NT-proBNP test investigated showed excellent agreement, with mean differences of between −5% and +4%. No significant interference was observed with lipaemic blood (triglyceride concentrations up to 6.3mmol/L), icteric blood (bilirubin concentrations up to 582μmol/L), haemolytic blood (haemoglobin concentrations up to 62mg/L), biotin (up to 10mg/L), rheumatoid factor (up to 42IU/mL), or with 50 out of 52 standard or cardiological drugs in therapeutic concentrations. With bisoprolol and BNP, somewhat higher bias in the low NT-proBNP concentration range (<175ng/L) was found. Haematocrit values between 28% and 58% had no influence on the test result. Interference may be caused by human anti-mouse antibodies (HAMA) types 1 and 2. No significant influence on the results with POC NT-proBNP was found using volumes of 140-165μL. High NT-proBNP concentrations above the measuring range of the POC NT-proBNP test did not lead to false low results due to a potential high-dose hook effect. Conclusions: The POC NT-proBNP test showed good analytical performance and excellent agreement with the laboratory method. The POC NT-proBNP assay is therefore suitable in the POC setting. Clin Chem Lab Med 2006;44:1269-7

Lichen speciation is sparked by a substrate requirement shift and reproduction mode differentiation

Publisher Copyright: © 2022, The Author(s).We show that obligate lignicoles in lichenized Micarea are predominately asexual whereas most facultative lignicoles reproduce sexually. Our phylogenetic analyses (ITS, mtSSU, Mcm7) together with ancestral state reconstruction show that the shift in reproduction mode has evolved independently several times within the group and that facultative and obligate lignicoles are sister species. The analyses support the assumption that the ancestor of these species was a facultative lignicole. We hypothezise that a shift in substrate requirement from bark to wood leads to differentiation in reproduction mode and becomes a driver of speciation. This is the first example of lichenized fungi where reproduction mode is connected to substrate requirement. This is also the first example where such an association is demonstrated to spark lichen speciation. Our main hypothesis is that obligate species on dead wood need to colonize new suitable substrata relatively fast and asexual reproduction is more effective a strategy for successful colonization.Peer reviewe

Seven Micarea (Pilocarpaceae) species new to Germany and notes on deficiently known species in the Bavarian Forest

We report new records of 19, predominantly rare, Micarea species, mostly from dead wood in mixed montane forests characterized mainly by Norway spruce, European beech and silver fir in the Bavarian Forest National Park on the German-Czech border. Their ecology and key morphological features are discussed. Micarea contexta, M. fallax, M. melanobola, M. pseudomicrococca, M. pusilla, M. soralifera and M. tomentosa are reported for the first time from Germany. Micarea anterior, M. byssacea, M. elachista, M. laeta, M. micrococca and M. nowakii, in addition to the aforementioned, are reported as new for the Bavarian Forest National Park.We report new records of 19, predominantly rare, Micarea species, mostly from dead wood in mixed montane forests characterized mainly by Norway spruce, European beech and silver fir in the Bavarian Forest National Park on the German-Czech border. Their ecology and key morphological features are discussed. Micarea contexta, M. fallax. M. melanobola, M. pseudomicrococca, M. pusilla, M. soralifera and M. tomentosa are reported for the first time from Germany. Micarea anterior, M. byssacea, M. elachista, M. laeta, M. rnicrococca and M. nowakii, in addition to the aforementioned, are reported as new for the Bavarian Forest National Park.Peer reviewe

Phylogeny, morphology and chemistry reveal two new multispored species in the Lecanora subfusca group (Lecanoraceae, Ascomycota)

Two new multispored species from China, Lecanora anhuiensis Li J. Li &amp;amp; Printzen, sp. nov. and Lecanora pseudojaponica Li J. Li &amp;amp; Printzen, sp. nov. are described and illustrated here, based on morphological, chemical and molecular evidence. Lecanora anhuiensis is characterised by an epruinose, yellowish-brown to deep brown apothecial disc, an epihymenium with fine crystals, an amphithecium with small crystals, 16-spored asci and the presence of zeorin, in addition to atranorin. Lecanora pseudojaponica is characterised by an epruinose, red-brown apothecial disc, an epihymenium without crystals, an amphithecium with small crystals, 8 or 16- spored asci and the presence of zeorin and the stictic acid complex, in addition to atranorin. Phylogenetic reconstructions, based on mtSSU, nrITS and nrLSU suggest that these two species are members of the Lecanora subfusca group. They are compared with morphologically similar and phylogenetically related species, based on a nrITS dataset. Phylogenetic results show that the multispored taxa of Lecanora are polyphyletic. The number of ascospores per ascus appears to be a taxonomic character of minor importance. Detailed descriptions, discussions and figures for the two new species from China and a key for the multispored species of Lecanora worldwide are provided

The phylogeny and taxonomy of Upretia (Caloplacoideae, Teloschistaceae), reveal three new species from Southwestern China

Several specimens of Upretia from Southwest China are morphologically and phylogenetically distinct from currently recognized species in the genus. These specimens are here accommodated within a new species, Upretia zeorina Li J. Li &amp;amp; Printzen. It is characterized by an areolate to squamulose thallus with brown to blackish brown upper surface, pruinose, zeorine type apothecia, black discs, narrowly bacilliform conidia, and the production of gyrophoric acid. Two other specimens of Upretia from China are distinct from currently accepted species and tentatively referred to as Upretia sp. 1 and Upretia sp. 2. A key to all known species of Upretia is also provided