Abstract：
:We compared a rapid, point-of-care multimarker protocol with a single and serial troponin I (TnI)-only protocol in 5,244 patients admitted to the emergency department with chest pain. The diagnosis of acute myocardial infarction (AMI) was based on a doubling myoglobin level accompanied by at least a 50% increase in the creatine kinase (CK)-MB level with no detectable TnI; a doubling of myoglobin level together with any detectable TnI; or a TnI level of 0.4 ng/mL (0.4 microg/L) or more, irrespective of myoglobin or CK-MB results. By using these new criteria, 145 of 148 cases were positive for AMI (positive predictive value [PPV], 92.4%) and 3 were negative, which were also negative by the core laboratory TnI assay. Twelve confirmed non-AMI cases were positive by the new protocol, with 10 of 12 confirmed by the core laboratory as positive for TnI. The negative predictive value (NPV) was 99.9% the overall diagnostic accuracy was 99.7%. The TnI-only protocol had a sensitivity of 68.2% with an NPV of 99.1%. With lower TnI-only cutoffs, 4 patients had false-negative results, and a PPV of 36.4% was observed. Our rapid multimarker protocol seems superior to a TnI-only approach for rapidly triaging patients with chest pain or AMI.
journal_name
Am J Clin Patholjournal_title
American journal of clinical pathologyauthors
Straface AL,Myers JH,Kirchick HJ,Blick KEdoi
10.1309/9GGNMURLJWJD88W3subject
Has Abstractpub_date
2008-05-01 00:00:00pages
788-95issue
5eissn
0002-9173issn
1943-7722pii
D66557738562542Njournal_volume
129pub_type
临床试验,杂志文章,多中心研究abstract：:Wild-type apolipoprotein A-I (apo A-I)-derived amyloid commonly occurs in atherosclerotic plaques. To clarify apo A-I amyloid formation, plasma levels of apo A-I and cholesterol were related to the presence of amyloid in atherosclerotic plaques in 15 patients with peripheral atherosclerosis, subjected to arterial reco...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/PJE6-X9E5-LX6K-NELY
更新日期：2001-02-01 00:00:00
abstract：:Data from 2.5 million glucose analyses on pools of lyophilized human quality control serum were used to evaluate analyte stability in the prereconstitution phase. Input information was from laboratories in Regional Quality Control Programs that use CAP Quality Assurance Service (QAS) data processing. Of 31 pools in us...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：
更新日期：1982-10-01 00:00:00
abstract：:To determine the diagnostic significance of the kappa/lambda ratio in germinal center (GC) B cells in Hashimoto thyroiditis (HT), we used 4-color flow cytometry to immunophenotype 27 samples (21 patients) of well-characterized HT B-cell clonality was analyzed further by polymerase chain reaction (PCR) of the immunoglo...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：
更新日期：2006-01-01 00:00:00
abstract：:An assessment of the infrequently performed protein-bound iodine determinations (PBI) and thyroxine (T4) determinations by column chromatography is presented after analysis of data contributed by participants in the 1976 College of American Pathologists Chemistry Survey Programs. The two technics yield comparable mean...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：
更新日期：1978-09-01 00:00:00
abstract：:Adenocarcinomas expressing gastric mucins often are accompanied by ectopic gastric mucosa or pyloric metaplasia. We have previously described mucinous bronchioloalveolar carcinoma (mucinous BAC) producing gastric mucins. In the lung tissue, mucous cells seemingly similar to gastric mucous cells are present in congenit...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/110.4.450
更新日期：1998-10-01 00:00:00
abstract：:Three activated partial thromboplastin time (APTT) reagent test systems, General Diagnostics Automated APTT, American Dade Actin FS, and Pacific Hemostasis (Thromboscreen KAPTT) reagent, containing different activators for the APTT assay, were evaluated for their precision and sensitivity to factor deficiencies in the...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/85.1.43
更新日期：1986-01-01 00:00:00
abstract：:Cervical cone biopsy has become an important surgical procedure for endocervical adenocarcinoma in situ (AIS), especially for patients who desire to retain their fertility. Establishing the usefulness of the endocervical margin status in cone biopsy specimens as a predictor of residual AIS is paramount. We examined th...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/109.6.727
更新日期：1998-06-01 00:00:00
abstract：OBJECTIVES:Timely reporting of immunosuppressant (ISP) drug level results is needed for transplant patient management. This study characterized the local ISP testing process, identified bottlenecks and implemented process improvements to meet turnaround time requirements. METHODS:Laboratory information time stamps, di...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/aqw087
更新日期：2016-08-01 00:00:00
abstract：:The effect of changes in cytology laboratory costs, including the costs of new technologies, on the cost-effectiveness of cervical cancer prevention has not been studied. Using University of Iowa laboratory detection rates and costs, a decision model determined the cost-effectiveness of the laboratory with and without...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/111.2.259
更新日期：1999-02-01 00:00:00
abstract：:Postmortem pathologic and bacteriologic reports were analyzed for 237 deaths occurring at a large institution for the mentally retarded from 1958 to 1973. Bronchopneumonia, aspiration pneumonia, and lipid pneumonia were frequently reported at autopsy, and in a total of 146 cases (61.6%) at least one type of pneumonia ...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/67.2.190
更新日期：1977-02-01 00:00:00
abstract：:A practical acidimetric assay for penicillinase production using penicillin and phenol red impregnated in paper discs was developed. Blank discs were first impregnated with buffered penicillin G and, after drying, with 1% phenol red. For use, a disc was added to a bacterial suspension made in saline solution. A yellow...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/75.4.557
更新日期：1981-04-01 00:00:00
abstract：:We performed a retrospective clinicopathologic study on sequential biopsy specimens from 90 patients with Philadelphia chromosome-positive chronic myelogenous leukemia to study therapy-specific effects of busulfan (28 patients), hydroxyurea (32 patients), and interferon-alfa (IFN-alfa; 30 patients). Bone marrow specim...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/XMGX-7HQ8-7PLU-LQ9M
更新日期：2000-07-01 00:00:00
abstract：OBJECTIVES:Ancillary molecular testing on tissue is available for mycobacterial disease; however, judicious use of highly sensitive tests, such as polymerase chain reaction (PCR) and sequencing, should be guided by histologic parameters. We sought to investigate the utility of performing acid-fast stains (AFS) on skin ...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/AJCPNM3J9TOIBRSK
更新日期：2014-04-01 00:00:00
abstract：:The effectiveness of fine-needle aspiration (FNA) increases with the number of needle passes, but needle passes are also associated with increased risk of adverse events. The trade-off between needle passes and adequacy has not been well characterized. Clinical studies are limited because of their inherent variability...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/AJCPEAKR4MO2GQBO
更新日期：2013-03-01 00:00:00
abstract：:To verify their clinical usefulness in diagnosis and early response to therapy of sideropenic anemia, we compared the behavior of the reticulocyte parameter (RET-Y), a raw measure dependent on size and content of the cell, generated by the Sysmex XE 2100, with the mean reticulocyte volume (MCVr) and mean reticulocyte ...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/W652-95DT-UWK7-U1HH
更新日期：2004-04-01 00:00:00
abstract：:We reviewed 500 consecutive soft tissue lesions referred for expert consultation to determine types of lesions and/or situations in which major discrepancies occur. Of 266 cases (53.2%) accompanied by a diagnosis, essential agreement with the second opinion was noted in 68%, minor discrepancy in 7%, and major discrepa...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/425H-NW4W-XC9A-005H
更新日期：2001-10-01 00:00:00
abstract：:The quality management program in the Division of Transfusion Medicine at our institution had evolved to the point that the program generally was perceived to be the sole responsibility of our Quality Unit (which was administratively independent of day-to-day operations). It became clear that this administrative model...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/UHKMFRFTDRJ7MJ58
更新日期：2005-10-01 00:00:00
abstract：OBJECTIVES:To examine high expression of tumor necrosis factor ligand superfamily member 13 (TNFSF13), which is correlated with several malignancies. METHODS:TNFSF13 messenger RNA expression in tumor cells and fibroblasts in a cohort of patients with non-small cell lung cancer (NSCLC) was analyzed by quantitative real...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/AJCP4JP8BZOMHEAW
更新日期：2014-02-01 00:00:00
abstract：:DRC (dendritic reticulum cell) antigen expression was studied in 38 cases of B-cell lymphomas including follicular lymphoma. The results of this study showed DRC-1 to be expressed in 1/3 of small lymphocytic; 3/3 of mantle zone lymphoma (MZL); 10/10 of follicular, small cleaved; 6/7 of follicular, mixed; 1/2 of follic...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/89.4.488
更新日期：1988-04-01 00:00:00
abstract：:Immunophenotypic analysis of acute leukemias is time consuming and often requires flow cytometric analysis. A 1-hour alkaline phosphatase-labeled streptavidin-biotin immunocytochemical procedure was evaluated as an alternative. Seventeen cases of acute leukemia, including 10 acute lymphocytic (ALL) and 7 acute nonlymp...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/97.6.876
更新日期：1992-06-01 00:00:00
abstract：OBJECTIVES:We describe the morphologic and immunohistochemical features of 17 endometrial stromal neoplasms, 16 sarcomas, and one stromal nodule. METHODS:We reviewed 35 cases interpreted as endometrial stromal neoplasms, but 17 high-grade endometrial stromal sarcomas (ESS) and one case of mixed endometrial sarcoma and...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/AJCPS88CMJRXZBWA
更新日期：2014-06-01 00:00:00
abstract：:This article describes the occurrence of a coenurus, the encysted larval stage of a cestode of the genus Multiceps, within the axilla of a 40-year-old Nigerian woman. The patient had a history of intraductal carcinoma of the breast two years prior to the finding of an ipsilateral axillary mass. Pathologic evaluation o...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/80.5.735
更新日期：1983-11-01 00:00:00
abstract：:The authors quantified creatine kinase MB (CK-MB) isoenzyme activity and mass in the serum of 81 uremic and 20 nonuremic (control) patients who had no clinical or electrocardiographic evidence of acute myocardial infarction. CK-MB was quantified by three methods: electrophoresis, the QuiCK-MB (International Immunoassa...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/87.1.103
更新日期：1987-01-01 00:00:00
abstract：:The Auto Microbic System (AMS) is an almost completely automated system, capable of identifying Enterobacteriaceae after 8 hours, and some glucose nonfermenters after 13 hours of incubation. The Autobac ID system is a mechanized, computer-assisted system capable of identifying Enterobacteriaceae and many nonfermentati...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/78.4.462
更新日期：1982-10-01 00:00:00
abstract：:Twenty-eight resected primary non-small cell lung carcinomas were studied for intratumoral DNA variability by flow cytometry (FCM). Three separate tissue specimens from each resected tumor were divided equally for FCM analysis and histologic evaluation. FCM analysis also was performed on fine-needle aspirates (FNAs) f...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/96.3.311
更新日期：1991-09-01 00:00:00
abstract：:The present study evaluated the origin of endothelial and epithelial cells, as well as of lymphocytes and macrophages, after lung transplantation. Biopsy specimens from patients who underwent lung and heart-lung transplantation and received organs of sex-mismatched donors were studied by means of nonisotopic in situ h...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/GAFN-5MPA-LY8E-DTPQ
更新日期：2001-04-01 00:00:00
abstract：:A case of microcystic adenoma (glycogen-rich cystadenoma) of the exocrine pancreas in a 62-year-old white female presenting with adult-onset diabetes mellitus is reported. Clinical, histopathologic, and ultrastructural findings are discussed with particular emphasis on the presence of myoepithelial cells, a morphologi...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/84.1.114
更新日期：1985-07-01 00:00:00
abstract：OBJECTIVES:To calculate the incidence of nondiagnostic (ND) colorectal (CR) polyp cases in which deeper tissue sectioning rendered new diagnostic information--particularly adenomas--in 2 laboratories staffed by the same pathologists. METHODS:After initial diagnosis, 100 ND CR polyps from each laboratory were reexamine...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1309/AJCPPXU66QZAZNYN
更新日期：2013-08-01 00:00:00
abstract：:Immunocytochemical assays for progesterone receptor (PR) using monoclonal antirabbit PR antibodies (PR-ICA) and for estrogen receptor (ER) (ER-ICA) were compared with radioligand binding (dextran-coated charcoal [DCC]) methods for receptor determination in patients with breast cancer. Immunocytochemical staining for P...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:Patients with nonhemolytic Lewis antibodies in the serum were transfused on the basis of major crossmatch compatibility alone. No adverse clinical affects were noted when 33 such patients received a total of 230 transfusions. Considerable savings in technologist time and reagent cost were realized by adopting this pol...
journal_title：American journal of clinical pathology
pub_type： 杂志文章
doi：10.1093/ajcp/76.3.294
更新日期：1981-09-01 00:00:00
