The potential use of blood culture systems for diagnosing intravascular catheter-related infections.

BACKGROUND: A microbiological method for the quantitative analysis of intravascular catheter infections using the BacT/Alert and Bactec blood culture systems is presented. METHODS: The number of bacteria present on an intravascular catheter surface was determined by the time to detection of positivity in a blood culture bottle inoculated with a suspension of bacteria shaken from the catheter surface. RESULTS: The new method was used to examine 573 intravascular catheters. In 94.6% of the cases, the results of microbiological analysis of catheters were in accordance with the patient's clinical condition. Twenty-eight (4.8%) cases were false positive and ten (1.7%) were false negative. Based on clinical signs, 49 cases of catheter-related sepsis were diagnosed. In 39 (79.6%) of those, the microbiological analysis of intravascular catheters was positive (kappa = 0.69). The most frequently detected pathogens were coagulase-negative staphylococci. CONCLUSIONS: In comparison to the current procedures, the new method is easier, faster, and capable of detecting the most common causative agents of catheter-related infections.

Role of ischemia-modified albumin in estimating the extent and scope of cardiac ischemia in patients with ST elevation myocardial infarction.

Ischemia-modified albumin (IMA) is a laboratory biomarker of cardiac ischemia. Our study aims to determine whether IMA can estimate or represent to any degree the extent of myocardial ischemia. We expect that the higher the marker of cardiac necrosis (maximum value after serial measurements) the greater the preceding cardiac ischemia, indicated by IMA in patients diagnosed with STEMI prior to direct percutaneous coronary intervention (PCI). We studied 216 patients indicated for direct PCI with a diagnosis of ST elevation myocardial infarction. Biochemical analysis of IMA was carried out using the albumin cobalt binding (ACB®) test. We also obtained relevant values for markers of myocardial necrosis (CK, CK-MB, cTnT). In all patients, there was an increased level of IMA prior to the procedure (116 ± 16.9 kU/l); also raised were levels of CK (17.32 µkat/l), CK-MB (4.85 µkat/l) and cTnT (2.97 µg/l) taken as the maximum values obtained after serial measurements at 12, 18, and 24 h after the procedure. We observed that there was no significant association between increase in IMA and cTnT (R2 = 0.0068, p = 0.483). This was also the case for CK-MB (R2 = 0.0011, p = 0.637). IMA does not estimate the extent of ischemia in patients with ST elevation myocardial infarction. However, its absence can be used qualitatively to rule out cardiac ischemia.

Glycine serum level in schizophrenia: relation to negative symptoms.

Glycine acts as an endogenous selective co-agonist at the glycine modulatory site of the NMDA (N-methyl-d-aspartate) receptor. Significantly decreased glycine serum levels were reported in patients with schizophrenia in comparison to healthy controls. Administration of glycine improved negative symptoms in patients with schizophrenia treated with antipsychotics in some clinical trials. We hypothesized that glycine serum levels might be associated with intensity of negative symptoms in schizophrenia. Fifty outpatients with the diagnosis of schizophrenia as defined by ICD-10 and fifty age- and gender-matched healthy controls were recruited into the study. Glycine serum levels were measured by high performance liquid chromatography (HPLC). We used the Positive and Negative Syndrome Scale (PANSS) and the Scale for the Assessment of Negative Symptoms (SANS) to assess the symptoms of schizophrenia in the patients. We found mean glycine serum levels to be significantly lower in patients than in controls. This difference was only caused by findings in the male study population. Glycine serum levels were negatively associated with intensity of negative symptoms assessed by the PANSS negative subscale and the SANS total scores in the patients. These data suggest a possible implication of NMDA receptor dysfunction in the pathogenesis of negative symptoms in schizophrenia.

D-serine serum levels in patients with schizophrenia: relation to psychopathology and comparison to healthy subjects.

OBJECTIVES: The main objective was to test the hypothesis of the association between D-serine serum levels and negative symptoms in patients with schizophrenia. Secondary objective was to examine the assumption of D-serine serum levels difference between a population of mostly chronic patients with schizophrenia and healthy controls. METHODS: We recruited outpatients with schizophrenia and age and gender matched healthy controls for the study. D-serine and total serine serum levels were measured by high-performance liquid chromatography (HPLC). The Positive and Negative Syndrome Scale (PANSS) and The Scale for the Assessment of Negative Symptoms (SANS) were used to assess schizophrenic symptoms. Non-parametric statistics was used to test the differences in D-serine and total serine serum levels and rank correlation was used to detect the associations with psychopathology. RESULTS: We did not find any differences between patients (n=50) and controls (n=50) in D-serine serum levels. Patients had significantly lower total serine serum levels and higher D-serine/total serine ratio. D-serine serum levels were not associated with the PANSS or the SANS total and subscales scores. Total se-rine serum levels inversely correlated with the SANS total and the PANSS negative symptom subscale scores. CONCLUSION: Decreased, not increased, serum levels of total serine negatively associated with intensity of negative symptoms were detected in patients with schizophrenia. We did not find any relationship between D-serine serum levels and negative symptoms among the patients. These findings do not agree with the previous reports of decreased D-serine and increased total serine serum levels in schizophrenia.

Use of the biochip microarray system in detection of myocardial injury caused by radiofrequency catheter ablation.

BACKGROUND: In a prospective study, we measured plasma markers of myocardial damage induced by radiofrequency catheter ablation (RFA) with the protein biochip microarray system. METHODS: A total of 32 consecutive patients undergoing RFA for atrioventricular nodal re-entry tachycardia (AVNRT), right atrial flutter (AFL) and atrial fibrillation (AF) were included in the study. Cardiac troponin I (cTnI), creatine kinase isoenzyme MB (CK-MB), heart-type fatty acid binding protein (hFABP) and glycogen phosphorylase BB (GPBB) were measured using biochip array technology at baseline and 24 h after the procedure. RESULTS: Values for all markers increased 24 h after RFA (cTnI: 0.92+/-0.49 microg/L vs. 0.33+/-0.06 microg/L, p<0.001; CK-MB: 3.79+/-2.04 microg/L vs. 1.85+/-0.55 microg/L, p<0.001; hFABP: 2.82+/-0.95 microg/L vs. 2.00+/-0.95 microg/L, p<0.001; GPBB: 9.07+/-5.83 microg/L vs. 4.70+/-2.50 microg/L, p<0.001). The correlations between plasma marker levels and RFA time were cTnI: r=0.63, p<0.01; CK-MB: r=0.75, p<0.01; hFABP: r=0.55, p<0.05, GPBB: r=0.51, p<0.05; the correlation between RFA time and number of RF applications was significant (r=0.81, p<0.001). Patients with RFA due to AF or flutter had elevated cTnI, CK-MB and hFABP levels compared to patients with AVNRT (cTnI: 1.14+/- 0.49 microg/L vs. 0.59+/-0.25 microg/L, p<0.05; CK-MB: 4.46+/- 2.07 microg/L vs. 2.81+/-1.54 mug/L, p<0.05; hFABP: 3.21+/- 0.98 microg/L vs. 2.25+/-0.54 microg/L, p<0.01). CONCLUSIONS: Myocardial injury induced by RFA can be detected by cTnI, CK-MB, hFABP and GPBB. Plasma cTnI, CK-MB and hFABP levels significantly increased in patients with AFL and AF compared to patients with AVNRT. The increase of cTnI, CK-MB and GPBB levels correlates with the total duration of RFA.