Pub Date : 2024-06-03DOI: 10.1093/clinchem/hvae069
Melanie L Yarbrough, Rebekah E Dumm, Lynn Bry, Brendan J Kelly, Drew Schwartz, Aayushi Uberoi
{"title":"Microbiome-Based Diagnostics for Disease: Where Are We Now and Where Are We Headed?","authors":"Melanie L Yarbrough, Rebekah E Dumm, Lynn Bry, Brendan J Kelly, Drew Schwartz, Aayushi Uberoi","doi":"10.1093/clinchem/hvae069","DOIUrl":"10.1093/clinchem/hvae069","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1093/clinchem/hvae054
Nader Rifai, William Meredith, Kevin Brown, Sarah A Erdahl, Paul J Jannetto
{"title":"High Lead Levels in 2 Independent and Authenticated Locks of Beethoven's Hair.","authors":"Nader Rifai, William Meredith, Kevin Brown, Sarah A Erdahl, Paul J Jannetto","doi":"10.1093/clinchem/hvae054","DOIUrl":"10.1093/clinchem/hvae054","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1093/clinchem/hvad217
Lama Ghazi, Kassem Farhat, Melanie P Hoenig, Thomas J S Durant, Joe M El-Khoury
Background: Acute kidney injury (AKI) is a serious complication affecting up to 15% of hospitalized patients. Early diagnosis is critical to prevent irreversible kidney damage that could otherwise lead to significant morbidity and mortality. However, AKI is a clinically silent syndrome, and current detection primarily relies on measuring a rise in serum creatinine, an imperfect marker that can be slow to react to developing AKI. Over the past decade, new innovations have emerged in the form of biomarkers and artificial intelligence tools to aid in the early diagnosis and prediction of imminent AKI.
Content: This review summarizes and critically evaluates the latest developments in AKI detection and prediction by emerging biomarkers and artificial intelligence. Main guidelines and studies discussed herein include those evaluating clinical utilitiy of alternate filtration markers such as cystatin C and structural injury markers such as neutrophil gelatinase-associated lipocalin and tissue inhibitor of metalloprotease 2 with insulin-like growth factor binding protein 7 and machine learning algorithms for the detection and prediction of AKI in adult and pediatric populations. Recommendations for clinical practices considering the adoption of these new tools are also provided.
Summary: The race to detect AKI is heating up. Regulatory approval of select biomarkers for clinical use and the emergence of machine learning algorithms that can predict imminent AKI with high accuracy are all promising developments. But the race is far from being won. Future research focusing on clinical outcome studies that demonstrate the utility and validity of implementing these new tools into clinical practice is needed.
背景：急性肾损伤（AKI急性肾损伤（AKI）是一种严重的并发症，影响高达 15%的住院患者。早期诊断对于防止不可逆转的肾损伤至关重要，否则会导致严重的发病率和死亡率。然而，AKI 在临床上是一种无声综合征，目前的检测主要依赖于测量血清肌酐的升高，而血清肌酐是一种不完善的标记物，对发生 AKI 的反应可能很慢。在过去的十年中，生物标记物和人工智能工具的形式出现了新的创新，可帮助早期诊断和预测即将发生的 AKI：本综述总结并批判性评估了利用新兴生物标记物和人工智能检测和预测 AKI 的最新进展。本文讨论的主要指南和研究包括评估替代滤过标志物（如胱抑素 C）和结构损伤标志物（如中性粒细胞明胶酶相关脂褐素和组织金属蛋白酶抑制剂 2 与胰岛素样生长因子结合蛋白 7）的临床应用，以及机器学习算法在成人和儿童 AKI 检测和预测中的应用。摘要：检测 AKI 的竞争正在升温。监管部门批准了部分生物标志物用于临床，机器学习算法的出现也能高精度地预测即将发生的 AKI，这些都是很有希望的发展。但这场竞赛还远未结束。未来的研究需要侧重于临床结果研究，以证明将这些新工具应用于临床实践的实用性和有效性。
{"title":"Biomarkers vs Machines: The Race to Predict Acute Kidney Injury.","authors":"Lama Ghazi, Kassem Farhat, Melanie P Hoenig, Thomas J S Durant, Joe M El-Khoury","doi":"10.1093/clinchem/hvad217","DOIUrl":"10.1093/clinchem/hvad217","url":null,"abstract":"<p><strong>Background: </strong>Acute kidney injury (AKI) is a serious complication affecting up to 15% of hospitalized patients. Early diagnosis is critical to prevent irreversible kidney damage that could otherwise lead to significant morbidity and mortality. However, AKI is a clinically silent syndrome, and current detection primarily relies on measuring a rise in serum creatinine, an imperfect marker that can be slow to react to developing AKI. Over the past decade, new innovations have emerged in the form of biomarkers and artificial intelligence tools to aid in the early diagnosis and prediction of imminent AKI.</p><p><strong>Content: </strong>This review summarizes and critically evaluates the latest developments in AKI detection and prediction by emerging biomarkers and artificial intelligence. Main guidelines and studies discussed herein include those evaluating clinical utilitiy of alternate filtration markers such as cystatin C and structural injury markers such as neutrophil gelatinase-associated lipocalin and tissue inhibitor of metalloprotease 2 with insulin-like growth factor binding protein 7 and machine learning algorithms for the detection and prediction of AKI in adult and pediatric populations. Recommendations for clinical practices considering the adoption of these new tools are also provided.</p><p><strong>Summary: </strong>The race to detect AKI is heating up. Regulatory approval of select biomarkers for clinical use and the emergence of machine learning algorithms that can predict imminent AKI with high accuracy are all promising developments. But the race is far from being won. Future research focusing on clinical outcome studies that demonstrate the utility and validity of implementing these new tools into clinical practice is needed.</p>","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139650415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1093/clinchem/hvae017
Jacob D Siegel, Christine J Ko
{"title":"Using Shame as a Signal to Talk about Suicide.","authors":"Jacob D Siegel, Christine J Ko","doi":"10.1093/clinchem/hvae017","DOIUrl":"10.1093/clinchem/hvae017","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140027549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1093/clinchem/hvae037
{"title":"Correction to: Lower Limits for Reporting High-Sensitivity Cardiac Troponin Assays and Impact of Analytical Performance on Patient Misclassification.","authors":"","doi":"10.1093/clinchem/hvae037","DOIUrl":"10.1093/clinchem/hvae037","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-09DOI: 10.1093/clinchem/hvae064
Ravinder Sodi
{"title":"Niacin and Risk of Cardiovascular Events: Deciphering the Paradox.","authors":"Ravinder Sodi","doi":"10.1093/clinchem/hvae064","DOIUrl":"https://doi.org/10.1093/clinchem/hvae064","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141418255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1093/clinchem/hvae026
Joe M El-Khoury, Tony Badrick, Elvar Theodorsson
{"title":"Time to Reevaluate the 95% Inclusion Criteria for Defining Reference Intervals?","authors":"Joe M El-Khoury, Tony Badrick, Elvar Theodorsson","doi":"10.1093/clinchem/hvae026","DOIUrl":"10.1093/clinchem/hvae026","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140142878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1093/clinchem/hvae036
Andrew St John, Christopher P Price, Rogier Hopstaken, Patrick McGinley, Stacy Melanson, Maurice O'Kane, Annalise E Zemlin
{"title":"Challenges Associated with the Effective Implementation of New Laboratory Tests-The International Experience.","authors":"Andrew St John, Christopher P Price, Rogier Hopstaken, Patrick McGinley, Stacy Melanson, Maurice O'Kane, Annalise E Zemlin","doi":"10.1093/clinchem/hvae036","DOIUrl":"10.1093/clinchem/hvae036","url":null,"abstract":"","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":7.1,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-02DOI: 10.1093/clinchem/hvae022
Louisiane Courcelles, Maria Stoenoiu, Vincent Haufroid, Marilucy Lopez-Sublet, Lidvine Boland, Loris Wauthier, Christophe Beauloye, Dominique Maiter, Andrzej Januszewicz, Reinhold Kreutz, Alexandre Persu, Damien Gruson
Background: Secondary hypertension (SH) is a form of high blood pressure caused by an identifiable underlying condition. Although, it accounts for a small fraction of the overall hypertensive population, detection and management of SH is of utmost importance, because SH phenotypes carry a high cardiovascular risk and can possibly be cured by timely treatment.
Content: This review focuses on the endocrine causes of SH, such as primary aldosteronism, Cushing syndrome, thyroid disease, pheochromocytoma and paraganglioma, acromegaly, and rare monogenic forms. It discusses current biomarkers, analytical methods, and diagnostic strategies, highlighting advantages and limitations of each approach. It also explores the emerging -omics technologies that can provide a comprehensive and multidimensional assessment of SH and its underlying mechanisms.
Summary: Endocrine SH is a heterogeneous and complex condition that requires proper screening and confirmatory tests to avoid diagnostic delays and improve patient outcomes. Careful biomarker interpretation is essential due to potential interferences, variability, and method-dependent differences. Liquid chromatography-tandem mass spectrometry is a superior method for measuring low-concentration hormones and metabolites involved in SH, but it requires expertise. Omics approaches have great potential to identify novel biomarkers, pathways, and targets for SH diagnosis and treatment, especially considering its multifactorial nature.
背景：继发性高血压（SH）是一种由可识别的潜在疾病引起的高血压。虽然继发性高血压在整个高血压人群中只占一小部分，但由于继发性高血压的表型具有很高的心血管风险，及时治疗有可能治愈，因此对继发性高血压的检测和管理至关重要：本综述侧重于 SH 的内分泌病因，如原发性醛固酮增多症、库欣综合征、甲状腺疾病、嗜铬细胞瘤和副神经节瘤、肢端肥大症以及罕见的单基因病。报告讨论了当前的生物标记物、分析方法和诊断策略，强调了每种方法的优势和局限性。摘要：内分泌 SH 是一种异质性的复杂疾病，需要进行适当的筛查和确诊试验，以避免诊断延误并改善患者预后。由于潜在的干扰、可变性和方法依赖性差异，对生物标志物进行仔细解读至关重要。液相色谱-串联质谱法是测量 SH 所涉及的低浓度激素和代谢物的一种优越方法，但它需要专业知识。Omics 方法在确定 SH 诊断和治疗的新型生物标记物、途径和靶点方面具有巨大潜力，特别是考虑到 SH 的多因素性质。
{"title":"Laboratory Testing for Endocrine Hypertension: Current and Future Perspectives.","authors":"Louisiane Courcelles, Maria Stoenoiu, Vincent Haufroid, Marilucy Lopez-Sublet, Lidvine Boland, Loris Wauthier, Christophe Beauloye, Dominique Maiter, Andrzej Januszewicz, Reinhold Kreutz, Alexandre Persu, Damien Gruson","doi":"10.1093/clinchem/hvae022","DOIUrl":"10.1093/clinchem/hvae022","url":null,"abstract":"<p><strong>Background: </strong>Secondary hypertension (SH) is a form of high blood pressure caused by an identifiable underlying condition. Although, it accounts for a small fraction of the overall hypertensive population, detection and management of SH is of utmost importance, because SH phenotypes carry a high cardiovascular risk and can possibly be cured by timely treatment.</p><p><strong>Content: </strong>This review focuses on the endocrine causes of SH, such as primary aldosteronism, Cushing syndrome, thyroid disease, pheochromocytoma and paraganglioma, acromegaly, and rare monogenic forms. It discusses current biomarkers, analytical methods, and diagnostic strategies, highlighting advantages and limitations of each approach. It also explores the emerging -omics technologies that can provide a comprehensive and multidimensional assessment of SH and its underlying mechanisms.</p><p><strong>Summary: </strong>Endocrine SH is a heterogeneous and complex condition that requires proper screening and confirmatory tests to avoid diagnostic delays and improve patient outcomes. Careful biomarker interpretation is essential due to potential interferences, variability, and method-dependent differences. Liquid chromatography-tandem mass spectrometry is a superior method for measuring low-concentration hormones and metabolites involved in SH, but it requires expertise. Omics approaches have great potential to identify novel biomarkers, pathways, and targets for SH diagnosis and treatment, especially considering its multifactorial nature.</p>","PeriodicalId":10690,"journal":{"name":"Clinical chemistry","volume":null,"pages":null},"PeriodicalIF":9.3,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140130898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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