Acetaminophen-Induced Acute Kidney Failure

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Acetaminophen-Induced Acute Kidney Failure

Acetaminophen is a commonly used medicine for pain-relief.  During cold and flu season, it is common to resort to pain-relief medicines to relieve headaches, and ache and pain symptoms associated with a cold or flu as there is no cure.  However, the therapeutic range for acetaminophen is 10-30 mg/l, which is small and very easy to go over.  During cold and flu season, it is important to monitor the amount of paracetamol entering your body as acetaminophen is more dangerous than suspected.  At therapeutic levels, acetaminophen does not produce any adverse effects, however, long-term treatment, prolonged use, and taking a few more than the recommended dose can be severely damaging and fatal.  Accidental acetaminophen overdose took the lives of 1,500 people in the U.S between 2001 and 2010.  The Randox Acetaminophen assay is used to determine the concentration levels of acetaminophen in the blood to determine if an overdose has taken place.

 

It is commonly recognised that acetaminophen overdose causes hepatotoxicity, but it is less commonly recognised that it can also cause nephrotoxicity in less than 2% of patients.  Nephrotoxicity is toxicity of the kidneys and is often associated with a reduced amount of glutathione which is important for normal cellular metabolism in the kidneys.  The Randox Glutathione Reductase assay is required for the regeneration of reduced glutathione.  Glutathione is often discussed in association with the Randox Glutathione Peroxidase, which requires reduced glutathione for activation.  Both Glutathione reagents are unique to Randox.

 

Acute renal failure due to acetaminophen manifests as acute tubular necrosis, which can occur alone or in combination with hepatic necrosis.  Nephrotoxicity can also occur when the therapeutic levels of acetaminophen are not exceeded.  This most commonly occurs when acetaminophen is taken in combination with alcohol.  Upon testing acetaminophen levels and the results fall within the therapeutic range, the Randox Ethanol assay can test alcohol levels to determine if a combination of alcohol and acetaminophen caused nephrotoxicity.  Renal impairment may be more common than previously suspected as acute renal failure occurs in 10-40% of patients with severe hepatic necrosis.  Upon testing acetaminophen to determine toxicity, Randox also offer the following renal tests to test for nephrotoxicity:

 

For more information visit: https://www.randox.com/acetaminophen

To request an application for your specific analyser, contact reagents@randox.com


The Complete Solution to Cardiac Risk Assessment

“CVDs are the number 1 cause of death globally: more people die annually from CVDs than from any other cause”.  In 2015, roughly 17.7 million people died from CVD, representing 31% of all global deaths: 7.4 million were due to coronary heart disease and 6.7 million were due to stroke. (WHO, 2017)

 

Cardiac health and regular cardiovascular screening is important to enable risk factors to be detected in their earliest stages.  There are a few factors which contribute to CVD.  These include: smoking, unhealthy diet, excessive alcohol consumption, low physical activity levels.  Whilst there are only a few factors contributing to CVD, these can be maintained by the patient through living a healthy lifestyle including: quitting smoking, consuming no more than the recommended allowance of alcohol, cutting out junk food, and exercising for 30 minutes a day, 3 – 5 days a week.  In a perfect world, this would be easy and CVD would not be a global problem.  However, due to busy lifestyles, cravings, reduced willpower, and convenience, not all individuals in today’s world will be able to avoid CVDs.  Therefore, it is vitally important that individuals are tested for CVDs to detect them in the earliest stages to reduce damage, prevent further damage, or even death.  Furthermore, many individuals suffer from inherited cardiac risk factors, which stresses the need for accurate testing of both traditional and novel cardiac risk biomarkers.

 

Randox offer the complete solution to cardiac risk assessment including: RX analysers, traditional and novel reagents, internal quality control (Acusera), and external quality control (RIQAS).

 

RX Series

Randox has developed the RX series range of clinical chemistry analysers for high-quality semi-automated and fully automated testing. Choose between the RX misano, RX monaco, RX daytona+, RX imola, and the RX modena depending on the throughput of your laboratory. The RX series offers a suitable analyser for your laboratory’s needs.  For more information on the Randox RX series, please click here or email therxseries@randox.com

 

Reagents

As previously mentioned, early assessment of cardiac risk is vital. Randox offer a range of novel risk biomarkers for both very early and the genetic assessment of cardiac risk.

The niche Adiponectin assay allows for the early assessment of CVD.  Adiponectin levels are inversely correlated with abdominal visceral fat which has proven to be a strong predictor of T2DM.  Body-Mass Index (BMI) is a common method for determining which patients are classified as underweight, healthy, overweight or obese, however, BMI does not take into account gender, ethnicity or activity levels.  For example, measuring the BMI of athletes who have a high BMI due to muscle weighing heavier than fat would classify them as obese which is inaccurate.  Measuring adiponectin levels is therefore a much more reliable indicator of at-risk patients compared to BMI.

LDL cholesterol is often referred to as the ‘bad cholesterol’.  High concentrations of LDL-cholesterol is considered to be the most important clinical predictor, of all single parameters, with respect to coronary atherosclerosis.  However, sLDL is a smaller, more dense subfraction of LDL-cholesterol.   sLDL particles more readily permeate the inner arterial wall and are more susceptible to oxidation.  Individuals with a predominance of sLDL have a 3-fold increased risk of myocardial infarction.  Measurement of sLDL allows the clinician to get a more comprehensive picture of lipid risk factors and tailor treatment accordingly.

Elevated levels of Lp(a) are considered to be both a casual risk factor and independent genetic marker of atherosclerotic disorders.  The major challenge associated with Lp(a) measurement is the size variation of apo(a) within Lp(a).  Dependent upon the size of apo(a) in the assay calibrator, many assays under or overestimate apo(a) size in the patient sample.  Numerous commercially available products suffer apo(a) size related bias, resulting in an over estimation of Lp(a) in samples with large apo(a)molecules and an under estimation in samples with small apo(a) molecules.  The antibody used in the Randox method detects the complete Lp(a) molecule providing accurate and consistent results.  This was proven by the IFCC who developed a gold standard ELISA reference assay and compared 22 commercially available tests.  The Randox Lp(a) method displayed the least (minimal) amount of apo(a) size related bias, proving it be a superior offering.

HDL3 Cholesterol is a smaller and more dense subfraction of the HDL particle.  HDL is the scavenger of cholesterol within arterial walls and the levels of HDL3 is too low, the ability to remove this cholesterol is reduced.  Therefore, it is widely accepted that there is an inverse correlation between HDL3 and CVD risk.

Instrument Specific Applications (ISA’s) are available for a wide range of biochemistry analysers.  Contact us to enquire about your specific analyser.

For more information on Randox Reagents, please click here or email reagents@randox.com

 

Acusera – Internal Quality Control

The Acusera cardiac controls have been designed to cover a wide range of cardiac markers at clinical decision levels, eliminating the extra expense of an additional low level control.  The controls are available in a both liquid ready-to-use and lyophilized formats making them ideal for all situations and manufactured from 100% human serum a matrix similar to that of the patient is guaranteed.  For more information on the Randox Acusera internal quality control, please click here or email acusera@randox.com

 

RIQAS – External Quality Control

The RIQAS Liquid Cardiac EQA programme is designed to monitor the performance of up to 9clinically significant cardiac markers including: CK-MB mass, D-dimer, Digoxin, homocysteine, hsCRP, myoglobin, NT proBNP, troponin I, and troponin T.  RIQAS is ISO/IEC 17043 accredited and allows the registration of up to five instruments at no extra cost.  All samples are 100% human serum and provided in a liquid ready-to-use format for enhanced convenience.  Submit your results bi-weekly and view reports online via RIQAS.Net.  For more information on RIQAS, the world’s largest international EQA scheme, please click here or email acusera@randox.com

 

For further information, please contact the Randox PR team via email: randoxpr@randox.com or phone 028 9442 2413

cardiac

 


Liver Cirrhosis is a Global Health Burden

#LoveYourLiver this January.  This month, we are taking a closer look at Liver Cirrhosis.

 

Liver cirrhosis occurs when the healthy tissue of the liver is replaced with scar tissue (fibrosis) due to long-term liver damage.  Liver cirrhosis can result in liver failure which can be fatal.

 

Liver complications such as liver disease and cirrhosis can be detrimental if it is not treated or monitored.  Liver disease is the only major cause of death still increasing year-on-year.  Globally, deaths due to liver cirrhosis have increased from 676,000 in 1980 to over 1 million in 2010 (NCBI, 2014).   Cirrhosis and other chronic liver diseases have increased by 12.4% from 2006-2016 and was the cause of 1,256,900 deaths in 2016 (Global Burden of Disease, 2016).

There are a few factors that increase the risk of liver cirrhosis.  The three main factors are heavy alcohol consumption, an undiagnosed hepatitis infection, particularly hepatitis C, and non-alcoholic steatohepatitis (a more severe form of non-alcoholic fatty liver disease) due to obesity.

 

There are numerous symptoms associated with liver cirrhosis.  Some of the more severe symptoms include:

  • Jaundice – yellowing of the skin and whites of the eyes
  • Personality changes, confusion, difficulty concentrating, memory loss, or hallucinations
  • A tendency to bleed or bruise easily
  • In women, abnormal periods
  • In men, enlarged breasts, a swollen scrotum (the loose sac of skin that contains the testicles) or shrunken testicles
  • Vomiting
  • Diarrhea
  • Stomach pain – swollen or bloated stomach

Liver cirrhosis cannot be cured, but the aim of treatment is to manage the symptoms and complications, and to stop the condition getting worse.

#LoveYourLiver and prevent or reduce the symptoms of liver cirrhosis through: moderating alcohol consumption, not sharing needles to inject drugs, using a condom during sex, taking medications as prescribed, and maintaining a healthy weight.

 

The early stages of liver cirrhosis usually does not present any symptoms and is often first detected using routine blood tests.  Liver cirrhosis can be diagnosed and monitored through the following routine blood tests:

Alanine Aminotransferase (ALT)

ALT is one of the enzymes within the aminotransferases group and are among the most sensitive liver enzymes. The normal concentration levels of ALT in the blood are low, however, when the liver is damaged, such as liver cirrhosis, the levels of ALT increase.  During the diagnosis of liver cirrhosis, the root cause of the damage can be established, such as disease, drug or injury.  ALT is commonly measured alongside AST as part of the hepatic panel.

Aspartate Aminotransferase (AST)

AST is an enzyme found throughout the body. Elevated concentration levels of AST in the blood is directly correlated to the severity of the tissue damage.  AST also allows for the root cause of the damage to be diagnosed.  Excessive levels are indicative of damage due to acetaminophen overdose or acute viral hepatitis.  Moderately high levels are indicative of alcohol abuse.  Slightly high levels are indicative of cirrhosis.

AST is commonly measured alongside ALT as part of the hepatic panel, although ALT levels are higher in most types of liver damage.

Albumin

Albumin is a special protein made in the liver and provides the body with the proteins it requires to grow and repair tissue. The body requires a proper balance of albumin to prevent fluid from seeping out of blood vessels.  Decreased concentrations levels of this protein in the blood is an indicator of liver cirrhosis.

 

Randox supply a range of third party clinical diagnostic hepatic reagents to aid in the diagnosis and managing the complications of liver cirrhosis.  All reagents are available for use on a range of third party biochemistry analysers.  Randox offer the following hepatic reagents to diagnose liver cirrhosis:

Alanine Aminotransferase (ALT)

Aspartate Aminotransferase (AST)

Albumin

Randox also offer the following high performance and unique tests to diagnose liver cirrhosis:

5th Generation Bile Acids

Vanadate Oxidation Bilirubin

 

Why choose Randox reagents?

  • Randox offers the largest range of chemistries
  • Liquid ready-to-use reagents available
  • Automated applications for a wide range of clinical analysers
  • Excellent correlation to reference methods
  • Wide measuring ranges
  • Flexible pack sizes
  • Official accreditation to national and international standards including UKAS, ISO 13485:2003, and FDA.
  • Easy fit reagents
  • Easy read reagents

 

To request an application for your specific analyser, contact reagents@randox.com

 

For more information on liver function or to view our hepatic panel, visit https://www.randox.com/liverfunction/


Obesity: the disease, the problems, and the power of prevention

Earlier this year the World Obesity Federation made the stark statement that: “The early diagnosis and treatment of childhood obesity could be considered similar to vaccination.”

Essentially, they want to see this condition treated in the same way as chicken pox, measles and mumps: tackled – in the hope of eradication – by a strategic approach founded on proactive policies and early prevention.

Obesity in children and adolescents has risen tenfold in the last 40 years, according to a recent study by The Lancet. In Britain, one in ten young people aged between 5 and 19 is obese. Worryingly, the prevalence of obesity is actually higher in younger children than older ones.

The WHO first called for obesity to be understood as a disease in 1948, but back then it wasn’t even considered a risk factor for cardiovascular disease. In 1997 the WHO held a special conference on obesity and stated that: “the global epidemic projections for the next decade are so serious that public health action is urgently required.”

Then it was alarmed that the prevalence of men with a BMI greater than 30 was 15% and 16.5% in women. To think that it has now risen dramatically to 67% for men and 57% for women, highlights just how serious a problem obesity poses to society.

The calls for more countries to officially recognise it as a disease is based on the position that obesity meets the definition of a chronic, relapsing, progressive disease that causes organ damage.

Women and men who are obese are 12.5 and 5.2 times (respectively) more likely to develop diabetes than people who are a healthy weight. 90% of people with Type 2 diabetes are obese.

People with diabetes are then at a greater risk of a range of chronic health conditions including cardiovascular disease, blindness, amputation, kidney disease and depression than people without diabetes. Diabetes leads to a two-fold excess risk for cardiovascular disease, and diabetic retinopathy is the leading cause of preventable sight loss among people of working age in England and Wales.  About one in twenty people have diabetes, yet people with diabetes account for one quarter to one third of hospital admissions for cardiovascular disease.

According to Government figures released this year, people who have Type 2 diabetes are 28.4% more likely to die early than their peers.

Getting in front of this wave of diabetes will not only bring down the numbers of people affected but also see a positive impact on the numbers of obese people. As with all conditions – the earlier they are identified, the better. To do this, new methods of diagnosis are being developed.

A radical new test for a protein found in our blood called adiponectin can identify pre-diabetes. This is a game-changing diagnostic tool that empowers people with the knowledge that they are at risk, but may be able to avoid it through relatively simple lifestyle changes.

The adiponectin test is available from Randox – both for clinical use and also through our Randox Health clinics.  We have developed the most comprehensive health checks available on the market. These are so sensitive that in a range of conditions including diabetes we are able to identify signs of pre-illness.  This enables clients to make often simple changes to stay healthy.

We know that prevention works. The NHS carried out a study in 2016 which revealed an average 26% reduction in new cases of Type 2 diabetes in those participating in a diabetes prevention programme, compared with usual care.

 

To find out more, click here.

For further information please email: randoxpr@randox.com


Managing diabetes complications with Randox Reagents

The prevalence of diabetes is steadily increasing across the world, with approximately 422million people worldwide with diabetes and is currently one of the leading causes of death in the world. A diabetes diagnosis comes in three forms; Type 1 Diabetes Mellitus, Type 2 Diabetes Mellitus and Gestational Diabetes. Each type of diabetes can have long-term, detrimental effects to your health if it is not controlled, with some of the key complications being heart disease, kidney damage, retinopathy and even limb amputations.

Diabetes can be controlled through maintaining a healthy diet and regular exercise, however in situations where complications occur, innovative testing can aid in the prevention and management of detrimental consequences to patients.  Randox Reagents offer a range of high performance and unique tests which can be used to manage complications of diabetes such as:

Diabetic Nephropathy

Kidney disease is a life threatening complication of diabetes, commonly called diabetic nephropathy in patients with diabetes. Around 40% of people with diabetes develop diabetic nephropathy, characterised through prolonged periods of high glucose levels in the blood. To effectively monitor diabetic nephropathy, it is essential to test cystatin C levels in patients, which is a useful indicator of renal function in patients where creatinine measurements are unreliable. Unlike creatinine, cystatin C does not have a ‘blind area’ – up to 50% of renal function can be lost before significant creatinine elevation occurs. This makes cystatin C capable of detecting early stage kidney dysfunction in patients with diabetic nephropathy.

Microalbumin testing is also important to identify patients with diabetic nephropathy approximately 5-10 years earlier than proteinuria tests, helping to reduce the incidence of end stage renal disease. This is because low albumin concentrations in the urine are the earliest market of renal damage and therefore enable preventative measures to be taken.

Metabolic Syndrome

Metabolic syndrome is a severe complications of uncontrolled diabetes which contains a number of conditions which occur together, increasing your risk of heart disease, stroke and diabetes. Metabolic syndrome can be monitored through measuring Non-Esterified Fatty Acids (NEFA), which are molecules released from triglycerides by the action of the enzyme lipase and are transported in the blood bound to albumin. NEFA contributes a small proportion of the body’s fat, however they provide a large part of its energy, with elevated concentrations having adverse effects on both carbohydrate and lipid metabolism.

With the global burden of diabetes rising year on year, diabetes complications monitoring has never been more important. Randox Reagents offer a wide range of innovative testing to laboratories, to help clinicians accurately diagnose and monitor diabetes complications.

 

Download our diabetes brochures to find out about our full range of diabetes reagents

Randox reagents are available for a wide range of clinical chemistry analysers. For more information, please contact reagents@randox.com


Randox launching new product range at leading laboratory medicine event in USA

A group of 30 delegates from global healthcare company Randox Laboratories has this week travelled to the USA, to take part in the world’s largest diagnostics conference – in San Diego, California.

The American Association of Clinical Chemistry (AACC) Annual Meeting and Clinical Lab Expo, known as the leading event for laboratory medicine worldwide, is attended by over 20,000 delegates from across the globe, and offers Randox the opportunity to showcase their capabilities and to network with leading healthcare professionals and key decision makers.

Launching at this year’s event are a number of innovative and exciting new products, including a test for Acute Kidney Injury, a revolutionary diagnostic for small, dense low density lipoprotein (sLDL), a subtype of LDL cholesterol which is a vital risk marker for cardiovascular disease, and the latest in laboratory quality assurance software.

Chief Scientist at Randox Laboratories, John Lamont, who is heading up the delegation to the US, commented;

Our very significant investment in research and development means that we have more new tests in development than any other healthcare company in the world.  Each year at AACC we are able to bring a wealth of exciting new technologies to the American market, for a range of the world’s pressing health issues in need of the most urgent address. We look forward to showcasing our latest innovations at this year’s AACC conference, and to identifying further potential projects.”

Dr. Peter FitzGerald, Founder and Managing Director of Randox Laboratories, commented;

“We appreciate that post-Brexit there will of course be particular business challenges with regards to international business, but at Randox we will remain committed to developing new health diagnostic technologies in the areas where they are needed most, and to expanding the business in our key markets, such as the US.

“The USA is one of our most important markets and we have been exporting our diagnostic products there since the early 1980s. We will continue to nurture our presence there, the expansion of which will be supported by our soon to be opened facility in Kearneysville, West Virginia, which will enable us to strengthen our position in that market.”

AACC runs from the 30th July – 3rd August at the San Diego Convention Centre. Randox can be found at booth #3839.

For further information about Randox at AACC please contact Randox PR on 028 9445 1016 or email RandoxPR@randox.com


Celebrating the Randox Reagents R&D Team this Medical Laboratory Professionals Week!

Medical Laboratory Professionals Week (MLPW) is a week dedicated to increasing public understanding and appreciation for the clinical laboratory profession. During this week, we are taking the opportunity to celebrate the hard work of our Research and Development team. Allow us to provide you an insight into the life changing work of our scientists in the laboratories.

At Randox, our scientists work tirelessly to develop revolutionary diagnostic tests that are used in hospital and research laboratories across the globe.

We spoke to one of our biochemistry R&D Scientists to gain an insight into what working in a clinical chemistry laboratory entails. Emmett Donnelly, Clinical Chemistry R&D Scientist, is involved in the development of new reagents and the improvement of existing reagents. Emmett commented, “[My] role also involves the transfer and testing of existing chemistries onto new analyser platforms. Troubleshooting and resolving customer queries also forms part of a clinical analyst’s role”.  Emmett’s work is vital to ensure that patient tests are performing correctly, and to develop ground-breaking new technologies leading to better patient outcomes. To find out more about the work Emmett does, watch this video below.

Our scientists are committed to research and development and thrive knowing that their novel research is putting them at the forefront of clinical diagnostics.

In fact, prior to beginning work at Randox, Scott Paulin, Clinical Chemistry R&D team, took part in a three month expedition to Antarctica to intensely study human response-based research in athletes. A number of papers have been published in peer reviewed journals as a result of Scott’s research, as the findings have provided a useful insight into the physiological stress and responses associated with an Antarctic ultra-endurance race and nutritional counterstrategies to help maintain immune responses, function body weight and reduce stress markers. Read the full article here.

At Randox, our scientists are of the highest calibre, with vast experience and expertise which ensures we are producing the highest quality range of clinical diagnostic tests.

Excitingly as a result, American astronauts have enlisted our help to test their antioxidant levels before they go to space! This is essential as it ensures astronauts can survive long periods of time away from earth. To find out more about how important our Total Antioxidant Status (TAS) test is for astronauts, read our blog post here.

The invaluable work our scientists undertake in the laboratory is vital to ensure healthcare is advanced globally. Thanks to those in our Research and Development team, we are proud to be able to offer the widest range of clinical chemistry reagents and unique tests for medical diagnosis. Due to our scientist’s dedication to research, a continual focus is placed on developing tests that assess the risk of diseases, rather than diagnosing the illness after it has occurred. As a result, Randox are helping to change healthcare, as patients are provided the ability to take preventative action early. In the words of our R&D scientist Emmett Donnelly, “for me, my work supports the old saying prevention is better than cure”.

We hope you have enjoyed reading about our fantastic team of R&D Scientists! If you would like to find out more about the work of Randox Reagents, please get in contact by emailing: reagents@randox.com or click here to view our homepage.

laboratory


Inflammatory Biomarker Series: CRP

An inflammatory biomarker detects inflammation in the body. Inflammation is not just the immediate, short-term response of the body to an injury or infection. Inflammation within the body can be a long-term, chronic condition resulting in a number of health implications. In diagnostics, measurement of an inflammatory biomarker can not only detect acute inflammation but provide a marker of treatment response.

C-reactive protein (CRP) is an acute phase protein produced by the liver in response to inflammation, infection and tissue injury. CRP is a particularly beneficial inflammatory biomarker as it is detected much faster than other markers in the blood. Levels of CRP increase when inflammation occurs and therefore it can be a significant biomarker in a range of diseases, including the following.

Cardiovascular Disease

An increasing amount of research exists to suggest CRP is not only a useful, non-specific inflammatory biomarker, but it may have a direct influence on coronary heart disease and cardiac events1. Inflammation can occur when LDL cholesterol builds up in the artery walls causing atherosclerosis. Modifiable risk factors of atherosclerosis include smoking, diabetes, poor diet, high blood pressure and physical inactivity, all factors which subsequently increase the risk of heart attacks, ischemic stroke, peripheral artery disease and even vascular dementia2,3.

Studies have also shown that persistent low levels of CRP can contribute to a person developing CVD. Therefore using high sensitivity CRP as an inflammatory biomarker can detect low levels, helping to predict the likelihood of a patient developing CVD in the future.

Diabetes

Research suggests that inflammation in the body can influence the development of type 2 diabetes. With the ability to be managed through diet and exercise, type 2 diabetes is commonly associated with obesity. Research has shown that excess body fat can cause continuous chronic low-grade inflammation as a result of inflammatory cytokines and increased plasma levels of CRP. As a result, this chronic inflammation has the ability to cause insulin resistance leading to the development of type 2 diabetes4.

Rheumatoid Arthritis

A three year study which analysed the bone and joint health of 10,000 patient samples in India has found that inflammatory biomarkers, in particular CRP and ESR (Erythrocyte Sedimentation Rate) were raised in most of the samples compared to any other markers5. Although CRP is a non-specific inflammatory biomarker, it can be used alongside other tests, such as Rheumatoid Factor, to diagnose inflammatory joint diseases such as Rheumatoid Arthritis. Not only will CRP levels be higher due to chronic inflammation, but CRP levels can be monitored to assess levels of inflammation over time, allowing clinicians offer effective treatment.

Chronic Obstructive Pulmonary Disease (COPD)

COPD is a condition associated with inflammation of the lungs and airways. Studies have shown that measuring CRP levels is beneficial to detect exacerbations, when symptoms of COPD get suddenly worse and can last for several days. This is because CRP levels spike when exacerbations happen, causing lung function to deteriorate6.

Neonatal Bacterial Infections

CRP is one of the preferred and frequently used tests in neonatal units when diagnosing suspected bacterial infections, such as neonatal sepsis, in newborns who show signs on infection. Due to delayed synthesis during the inflammatory response, the sensitivity of CRP is lowest during early stages of infection. It is therefore critical that extremely low levels of CRP can be detected during diagnosis to distinguish whether symptoms are related to an infectious or non-infectious condition. This early detection then allows for rapid and appropriate neonatal treatment7.

Inflammatory Bowel Disease

Research suggests that using CRP as an inflammatory biomarker can help distinguish between Inflammatory Bowel Disorder (IBD) and Irritable Bowel Syndrome (IBS)8. Although IBD and IBS have some similarities in symptoms, IBD causes chronic inflammation, whereas IBS is a non-inflammatory condition. Therefore using CRP as a biomarker can allow clinicians to deliver a confident and accurate diagnosis.

For health professionals

Randox Laboratories manufacture a wide range routine and niche biochemistry reagents for use in both a research and clinical setting. With a wide measuring range, the Randox CRP assay will perform excellently to detect levels outside of the healthy range. Also available is a Full Range CRP assay particularly beneficial for use in a neonatal setting, and a High Sensitivity CRP assay, depending on your diagnostic requirements. For more information, please contact: reagents@randox.com

References:

  1. Shrivastava, A. K., Singh, H.V., Raizada, A. and Singh, S.K. C-reactive protein, inflammation and coronary heart disease. The Egyptian Heart Journal. 67, 89-97. (2015)
  2. American Heart Association. Inflammation and Heart Disease. Available from: https://goo.gl/d82Ynr  (2016)
  3. Harvard Health Publications. What you eat can fuel or cool inflammation. Harvard Health Publications. Available from: https://goo.gl/e8m3El (2007)
  4. Zeyda, M. and Stulnig, T. M.  Obesity, Inflammation, and Insulin Resistance – A Mini-Review. Gerontology 2009; 55:379-386 (2009)
  5. Mukherjeel, R.  Bone and joint health are crucial aspect, usually ignored by Indians. The Times of India. Available from: https://goo.gl/qluzhI (2016)
  6. Anderson, G. P.  COPD, asthma and C-reactive protein. European Respiratory Journal 2006; 27: 874-876. (2006)
  7. Hofer, N., Zacharias, E., Müller, W. and Resch, B.  An update on the Use of C-Reactive Protein in Early-Onset Neonatal Sepsis: Current Insights and New Tasks. Neonatology 2012; 102: 25-36 (2012)
  8. Silva, P.  Two Specific Proteins Allow the Exclusion of IBD in Patients with Irritable Bowel Syndrome. IBD News Today. Available from: https://goo.gl/pxMP53 (2015)
Inflammatory Biomarker: CRP


Randox Reagents: Solving the Problem of Heart Attack Misdiagnosis

A report has today revealed that almost a third of patients in England and Wales are being given a misdiagnosis following a heart attack, following a study of 243 NHS hospitals, conducted by researchers at Leeds University.

Timely evaluation of patients with chest pain and subsequently suspected heart attack is a major challenge for hospitals around the world, with chest pain typically representing around 5% of all visits to the Emergency Department (ED) and 25% of ED admissions. One of the biggest challenges facing emergency doctors now is how to prioritise people presenting with chest pain – to primarily deal with those suffering from a heart attack, and to be able to move those who are not, to a different ward, to alleviate the pressures of the overrun A&E departments.

Responding to the escalating misdiagnosis crisis in emergency hospitals across the globe, scientists at Randox Laboratories in the UK have developed a test which could help clinicians rule out heart attacks in patients immediately upon arrival at hospital; allowing clinicians to accurately prioritise those who have truly suffered heart attacks.

This Randox test, for Heart-type fatty acid-binding protein (H-FABP), is a highly sensitive biomarker for use in the earlier diagnosis of patients with suspected Acute Myocardial Infarction (AMI), enabling faster “rule-in” and “rule-out”. H-FABP is detectable as early as 30 minutes after chest pain onset, significantly earlier than traditionally used biomarkers such as Troponin or CK-MB , which typically require 6-12 hours to reach detectable concentrations.

Put simply, given that H-FABP is released earlier than traditional biomarkers used in diagnosing a heart attack, an earlier diagnosis is achievable.  

A succession of recent international clinical trials have demonstrated that by combining H-FABP, via this new laboratory assay, with the existing tests already used in hospitals for for Troponin I or Troponin T, the sensitivity and negative predictive value for ruling out AMIs is significantly improved.

Growing evidence indicates that even when one of the newer generation of “highly sensitive” Troponin assays is used, utilising the combination of Troponin and H-FABP is superior to Troponin alone.

The value of H-FABP is not just in positive diagnosis – but doctors are beginning to see it as a means of ‘ruling out heart attack’ when a patient presents at A&E with chest pain.

 

Please do get in touch if you would like to find out more about our H-FABP test, and how this can go a long way in solving the heart attack misdiagnosis crisis, by emailing reagents@randox.com


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