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Update on hypoparathyroidism.
Cusano, NE, Bilezikian, JP
Current opinion in rheumatology. 2019;(4):381-387
Abstract
PURPOSE OF REVIEW Hypoparathyroidism is a rare endocrine disorder characterized by low or insufficient parathyroid hormone (PTH) concentrations leading to hypocalcemia, hyperphosphatemia, and markedly reduced bone turnover. Despite being a rare disease, hypoparathyroidism has a profound impact on affected patients. RECENT FINDINGS Recent epidemiologic surveys demonstrate a prevalence of between 5.3 and 40/100 000, confirming the orphan status of this disease. There is a female predominance, and anterior neck surgery is the most common etiology. Recent studies have better elucidated the chronic manifestations of the disease, impacting quality of life and multiple organ systems including the renal, cardiovascular, and skeletal systems. There are now data on longer term use of parathyroid hormone (PTH) and PTH analogs. SUMMARY This review focuses on recent contributions to the literature on the prevalence and epidemiology of the disease, risk of chronic manifestations, and treatment with PTH(1-34) and rhPTH(1-84). Further research is needed to determine the pathophysiology of complications in hypoparathyroidism and whether interventions can decrease future risk of these complications. In addition, further data are needed with regards to more physiologic dosing regimens and long-term treatment with PTH and PTH analogs.
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2.
Review on Vitamin K Deficiency and its Biomarkers: Focus on the Novel Application of PIVKA-II in Clinical Practice.
Dong, R, Wang, N, Yang, Y, Ma, L, Du, Q, Zhang, W, Tran, AH, Jung, H, Soh, A, Zheng, Y, et al
Clinical laboratory. 2018;(4):413-424
Abstract
BACKGROUND Vitamin K (VK) is a co-factor of the γ-glutamyl carboxylase that catalyzes the conversion of glutamate residues to γ-carboxyglutamate in VK-dependent proteins. The carboxylation reaction imparts the essential calcium-binding residues for the biological function of several proteins involved in the process of coagulation and bone metabolism. VK deficiency is frequently encountered in newborns and can lead to fatal hemorrhagic complications. This review describes and discusses the clinical application of VK deficiency testing. METHODS References and data were researched in PubMed and reviewed. RESULTS In adults, VK deficiency is associated with uncontrolled bleeding, liver dysfunction, osteoporosis, and coronary diseases. An improved understanding of the role of VK deficiency in health and illness can be achieved by setting a gold-standard in the inter-laboratory estimations of VK. However, conventional methods used to measure the VK deficiency based upon the coagulation time lack sensitivity and specificity. Recently, the alterations in proteins induced by VK absence or antagonism (PIVKA) have proven to be suitable biomarkers for detecting VK deficiency. The measurement of PIVKA-II exhibits an enhanced sensitivity and specificity in comparison to other methods conventionally used for the assessment of VK deficiency in newborns and adults. CONCLUSIONS PIVKA-II could potentially be employed as an effective biomarker in the diagnosis of VK deficiency.
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3.
The potential role of oxytocin and perinatal factors in the pathogenesis of autism spectrum disorders - review of the literature.
Vanya, M, Szucs, S, Vetro, A, Bartfai, G
Psychiatry research. 2017;:288-290
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Abstract
Autism Spectrum Disorders (ASD) are characterized by: social and communication impairments, and by restricted repetitive behaviors. The aim of the present paper is to review abnormalities of oxytocin (OXT) and related congenital malformations in ASD. A literature search was conducted in the PubMed database up to 2016 for articles related to the pathomechanism of ASD, abnormalities of OXT and the OXT polymorphism in ASD. The pathomechanism of ASD has yet to be. The development of ASD is suggested to be related to abnormalities of the oxytocin-arginin-vasopressin system. Previous results suggest that OXT and arginine vasopressin (AVP) may play a role in the etiopathogenesis of ASD.
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[Production of an Anti-PIVKA-II Recombinant Single-Chain-Antibody in Escherichia Coli].
Satoh, H, Furukawa, E
Rinsho byori. The Japanese journal of clinical pathology. 2016;(10):1187-1191
Abstract
Protein induced by vitamin K absence or antagonist-II (PIVKA-II) is an abnormal prothrombin lacking gamma-carboxylation of the 10 glutamic-acid residues in the N-terminal region. PIVKA-II has been used as an effective biomarker of hepatocellular carcinoma (HCC) since the PIVKA-II level is not correlated with that of alpha-fetoprotein (AFP), which is another effective biomarker for HCC. Monoclonal antibodies for the clinical biomarker test are usually expensive because of their high production costs. Recently, many studies involving the expression of the recombinant globulin molecules in bacterial cells and plants have been con- ducted. These studies have enabled us to produce recombinant monoclonal antibodies at much lower costs. In this study, we first produced a hybridoma expressing a monoclonal antibody against PIVKA-II, and then we constructed and produced a single-chain fragment-variable antibody (scFv), created by the linking of variable regions of light- and heavy-chains of the PIVKA-II monoclonal antibody with a peptide linker of triplicated GGGGS. The scFv was expressed in E. coli and exhibited high specificity for PIVYKA-II binding, while its binding titer was low. [Review].
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Management of patients with respiratory infections in primary care: procalcitonin, C-reactive protein or both?
Meili, M, Müller, B, Kulkarni, P, Schütz, P
Expert review of respiratory medicine. 2015;(5):587-601
Abstract
Use of inflammatory biomarkers to guide antibiotic decisions has shown promising results in the risk-adapted management of respiratory tract infections, mainly in the inpatient setting. Several observational and interventional trials have investigated the benefits of procalcitonin (PCT) and C-reactive protein (CRP) testing in primary care. Both markers have shown promising results, although CRP is an inflammatory biomarker while PCT is more specific for bacterial infections. For CRP, point-of-care testing is widely established. Recently, sensitive point-of-care testing for PCT has also become available. A high-quality trial comparing these two markers for the management of patients in primary care is currently lacking. The aim of this paper is to review the existing literature investigating the use of PCT and CRP in primary care. The authors compare their performance for guiding antibiotic stewardship and analyze the cut-off values and endpoints to put these parameters into context in a low-acuity environment.
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6.
[[-2] proPSA: A Novel Marker of Prostate Cancer].
Ishikura, K
Rinsho byori. The Japanese journal of clinical pathology. 2015;(1):84-93
Abstract
Over the decades, prostate-specific antigen (PSA) has contributed to the early detection of and screening for prostate cancer (PCa). However, PSA is now in the spotlight due to issues of overdetection and subsequent overtreatment of PCa, causing a serious drawback in PSA-based screening. The challenge of a PSA assay for PCa detection is that the sensitivity is high, whereas the specificity is relatively low. With advancements in molecular biology and genomics, numbers of novel PCa markers has been discovered. One of the promising serum biomarkers is proPSA. proPSA is a pre-mature form of PSA. The molecules are fractions of free PSA, and [-2]proPSA contains 2 amino acids as N-terminus pro-peptides of PSA. Studies have shown the possibilities of using [-2] proPSA-related indices like the Prostate Health Index and %2PSA as tumor markers for diagnosis. [-2]proPSA-related indices have improved specificity compared to commonly used PSA and free PSA to detect PCa, while maintaining high-level sensitivity. Reports on clinical utilities of [-2]proPSA are rapidly increasing, and recent studies suggested the utility of [-2] proPSA-related indices for the enhancement of optimized treatment strategies and patient management. At present, several investigations which may reveal clinical utilities of [-2]proPSA are on-going in Japan. Attention: At the time of the submission of this article, [-2] proPSA had yet to be approved as an in vitro diagnostic test in Japan.
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7.
Vitamin K status in chronic kidney disease: a report of a study and a mini-review.
Voong, K, Harrington, D, Goldsmith, D
International urology and nephrology. 2013;(5):1339-44
Abstract
Hepatic vitamin K-dependent proteins (e.g., Factors II, VII, IX and X) form part of the clotting cascade. Factor II (FII)/Prothrombin incorporates 10 Glu residues on the N-terminal region that are γ-carboxylated to Gla residues by the action of γ-glutamyl carboxylase to confer biological activity. Vitamin K is also required for the normal function of Matrix Gla Protein (MGP)--one of several non-clotting-related extra-hepatic vitamin K-dependent proteins. MGP is known to have protective action against vascular calcification--indeed it is a powerful tissue-bound inhibitory mechanism and can be found in blood vessel walls. The mature protein is also dependent on activation by γ-glutamyl carboxylase enzyme to convert Glu residues in its amino acid sequence to Gla. This reaction can only take place when the enzyme is activated in the presence of vitamin K. It is of great potential interest to investigate whether subtle deficiencies of vitamin K may, through its effect on the action of MGP, be a contributing factor to vascular calcification in CKD patients, in whom CV disease is greatly accelerated and in whom vascular calcification is not only common, but progresses aggressively, and is something for which as yet there is no clinically applicable remedy.
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8.
Postmortem chemistry update part II.
Palmiere, C, Mangin, P
International journal of legal medicine. 2012;(2):199-215
Abstract
As a continuation of "Postmortem Chemistry Update Part I," Part II deals with molecules linked to liver and cardiac functions, alcohol intake and alcohol misuse, myocardial ischemia, inflammation, sepsis, anaphylaxis, and hormonal disturbances. A very important array of new material concerning these situations had appeared in the forensic literature over the last two decades. Some molecules, such as procalcitonin and C-reactive protein, are currently researched in cases of suspected sepsis and inflammation, whereas many other analytes are not integrated into routine casework. As in part I, a literature review concerning a large panel of molecules of forensic interest is presented, as well as the results of our own observations, where possible.
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Mid-regional pro-adrenomedullin in acute heart failure: a better biomarker or just another biomarker?
Potocki, M, Ziller, R, Mueller, C
Current heart failure reports. 2012;(3):244-51
Abstract
Circulating biomarkers have become increasingly important in diagnosing and risk-stratifying patients with heart failure (HF). While the natriuretic peptides have received much focus in the past decade, there is increasing interest in the role of other circulating biomarkers such as mid-regional proadrenomedullin (MR-proADM), a stable peptide of the precursor of adrenomedullin (ADM), responsible for volume regulation and electrolyte homeostasis. Increased levels of MR-proADM are associated with an increased risk of mortality and morbidity in patients with HF, independent of natriuretic peptides. MR-proADM outperforms all other established markers in the identification of patients at highest risk of death, particularly death within 30 days. The prognostic superiority has consistently been shown for various cardiovascular disease states, including acute heart failure. In this article, we discuss the potential role of MR-proADM in the syndrome of acute heart failure and its implication on prognosis and risk stratification.
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10.
[Primary hepatic actinomycosis concomitant with elevation of protein induced by vitamin K absence or antagonist II - report of a case].
Morita, Y, Sakaguchi, T, Shibasaki, Y, Oishi, K, Suzuki, A, Fukumoto, K, Inaba, K, Baba, S, Takehara, Y, Suzuki, S, et al
Nihon Shokakibyo Gakkai zasshi = The Japanese journal of gastro-enterology. 2011;(10):1735-42
Abstract
We report a case of primary hepatic actinomycosis showing elevation of serum protein induced by vitamin K absence or antagonist II (PIVKA-II). A 68-year-old man visited an affiliated hospital with a complaint of high fever and body weight loss. Hematological examination revealed severe inflammatory reactions and liver dysfunction. Abdominal CT showed a heterogeneous low density area composed of cystic and solid part. We suspected the cystic part with band-like enhancement to be a hepatic abscess and performed percutaneous transhepatic abscess drainage. Although inflammatory reactions decreased after the drainage, the solid part did not shrink and blood chemistry revealed elevation of PIVKA-II. Since we could not rule out the possibility of hepatoma, right hepatectomy was performed. Histological examination revealed actinomycetes. Although primary hepatic actinomycosis is a rare disease, it must be kept in mind in the differential diagnosis of the liver tumor.