The enzymatic method for the determination of serum creatinine is accepted as one of the most accurate methods in a clinical laboratory. This method was used on a biochemistry auto analyzer (Cobas Integra 400) to determine serum creatinine at the laboratory of University Hospital – Pleven. The characteristics and reliability of this enzymatic method for creatinine were compared with the Jaffe kinetic method. Effects of some interfering substances like bilirubin and glucose on the Jaffe kinetic method and the enzymatic method were compared. Glucose and bilirubin inhibit the reaction between creatinine and alkaline picrate. Glucose slowly reduces picric acid to picrate, while the bilirubin present in a sample is oxidized to biliverdin under alkaline conditions. This leads to a decrease in absorbance at 520 nm. We measured creatinine in serum samples with the enzymatic method and the Jaffe kinetic method in samples divided into four groups: group I –samples without bilirubin and glucose ; group II –samples with high level of glucose; group III - samples with high level of bilirubin, group IV – all samples. For Group I, the correlation coefficient obtained by comparing the enzymatic creatinine method and Jaffe's kinetic method was R = 0.983. There was a very good agreement between the two methods in terms of correlation coefficient even in the samples with high levels of glucose or bilirubin.
Significant losses of functional proteins such as hormones and hormone-binding proteins are seen in patients suffering from proteinuria. Studies have reported loss of thyroid hormones and thyroxine-binding globulin in the urine. There is evidence that subclinical hypothyroidism is six times more common in patients with proteinuria than in healthy people. The parameters of the effect of proteinuria on thyroid function have not been fully studiedyet.We investigated 74 patients with qualitatively established proteinuria, of whom 34 men and 40 women, without diagnosed thyroid disease. The average age of the patients was 60.9 years. We tested 20 free controls for free thyroxine (FT4), thyroid stimulating hormone (TSH), creatinine and albumin in serum, and the quantity of urine protein. The mean results found for TSH were higher in the patients with proteinuria than in those of the controls (2.719 mU/l vs 1.78 mU/l). For FT4, the mean result in the patients with proteinuria was 17.04 pmol/l vs 16.39 pmol/l. in the controls. A correlation was sought between TSH and FT4 levels and all the laboratory parameters we tested. Patients with proteinuria had higher TSH levels, probably due to the loss of thyroid hormones in the urine. However, these losses cannot lead to clinically proven hypothyroidism.
The rising incidence of bronchial asthma and obesity in children raises the question of whether there is a link between them. Chronic low-grade systemic inflammation could be one of the linking mechanisms. We aimed to determine the serum concentrations of high-sensitive C-reactive protein (hs-CRP), interleukin 6 (IL-6) and tumour necrosis factor a (TNF-a) in children with asthma and obesity and to seek a relationship between these inflammatory markers and asthma control. We investigated 88 children aged 6 to 17 years - 25 asthmatic obese children (AsOb), 25 asthmatic non-obese children (AsNOb), 19 obese non-asthmatic children (ObNAs), and 19 non-obese non-asthmatic children as controls. Serum levels of IL-6 and hs-CRP were significantly increased in asthmatic obese and ObNAs compared to AsNOb and the control group. Serum TNF-a concentration was similar in the four studied groups. There were no statistically significant differences in serum levels of these inflammatory markers between controlled and partially controlled/uncontrolled asthmatics (obese and non-obese). Knowing the possible mechanisms of interaction between bronchial asthma and obesity would contribute to a more effective therapeutic approach in these patients.
Preeclampsia (PE) is characterized by hypertension and proteinuria after the 20th gestational week (GW). It is a significant cause of maternal and fetal perinatal morbidity and mortality during pregnancy. There is increasing evidence suggesting that PE is due to an impaired balance between maternal placental angiogenic and antiangiogenic factors that harm maternal vascular endothelium. The study aimed to assess the clinical and financial aspects of introducing into practice the soluble fms-like tyrosine kinase (sFlt-1) to placental growth factor (PlGF) ratio test to improve the management of preeclampsia and adverse pregnancy outcome, intrauterine growth retardation, iatrogenic prematurity, and placental abruption.
We report a case study in which we used the sFlt-1/PlGF ratio in the management of a high-risk pregnancy. Unnecessary hospitalization was avoided, and the patient was managed appropriately.
Affective disorders, including depression, are of great social importance and lead to serious everyday life infringement and disability. Affective disorders are one of the main causes of suicide causes. Anxiety disorders represent a variety of psychic disorders that often lead to disability. Anxiety and depression syndromes together are often seen in patients. Vitamin B12 (cobalamin) is the only vitamin containing cobalt. Our aim was to investigate, evaluate and compare depression and increased anxiety and serum Vitamin B12 level in patients with depression, in patients with Vitamin B12 deficiency anemia and healthy controls. We investigated 74 subjects – 38 patients and 36 healthy controls. Serum Vitamin B12 level was measured in all participants. It is assumed that normal ranges of Vitamin B12 level vary. The most recently accepted ones are 200 to 900 pg/ml. In cases of levels below 200 pg/ml, a therapy with vitamin B12 should be applied. On the other hand, the level necessary for normal biochemical processes is higher – 250 pg/ml. In our study, serum Vitamin B12 level in more than 50% of patients with depression/anxiety was below 200 pg/ml, and in more than 60% of these patients it was below 250 pg/ml.