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Address for correspondence: A. Kirsten Woodend, RN, MSc, PhD, Assistant Professor, University of Ottawa, Faculty of Health Sciences, School of Nursing, 451 Smyth Road, Room 3247B, Ottawa, Ontario, K1H 8M5 Ph.: 613 ; 562-5800 ext. 8433, Fax: 613 ; 562-5443, e-mail: kwoodend uottawa.
Epitope or may cause conformational changes in the molecules 3133 ; . It has also been shown that the use of EDTA plasma may affect cTnI assay results 34 ; . The mechanism for the 14% average bias for EDTA-plasma results is not completely understood. EDTA may affect the alkaline phosphatase enzyme conjugate directly or change the stability of the cTnI molecule. EDTA plasma may be acceptable to aid in the diagnosis of MI and cardiac muscle damage. Different decision cutoffs may be required for this sample type. The absence of crossreactivity in the AccuTnI assay to other myofibrillar proteins demonstrates its high specificity for cTnI. Analytical interference from circulating anti-animal antibodies, especially HAMAs, heterophilic antibodies, or RFs, has been a serious problem in many commercial two-site sandwich cTnI immunoassays 35 ; . This incidence was very low in the AccuTnI assay. Low abnormal troponin values within the indeterminate zone i.e., between the URL and AMI cutoff points ; have been proposed to be indicative of myocardial injury in the clinical setting of ischemic MI 2, 3 ; . The 97.5 percentile URL, recommended by the NACB, has been replaced by the more recent ESC ACC expert committee consensus proposal that an increased value for cardiac troponin be defined as a measurement exceeding the 99 percentile of a reference control group, using an assay with a CV 10% at this value. Two recent editorials provided further clarification 36, 37 ; . To date, no troponin assays appear to achieve this target 13, 37 ; . The functional sensitivity of the AccuTnI assay corresponding to an imprecision CV ; of 10% ranged from 0.05 to 0.11 g L median, 0.06 ; , which exceeds the 99 percentile of reference controls at 0.04 g L. In the current study, none of the 254 control individuals had a cTnI value 0.06 g L. In separate clinical study, 62 of 68 91% ; non-AMI patients that had Access AccuTnI values above the 99 percentile URL 0.04 g L ; were found to have cardiac!
We thank Michael Plumb of the Health Quality Council of Alberta for guidance and expertise in preparing this paper. We also thank Lisa Hartling of the Department of Pediatrics, University of Alberta, for methodological and administrative support. Contributors: All authors contributed to conception and design of the study, analysis and interpretation of the data, revising the manuscript critically for important intellectual content, and all gave final approval of the version to be published. In addition, MT coordinated the project, screened articles for inclusion, and drafted the manuscript; SRM co-wrote and revised the manuscript and provided professional expertise to the project; DL screened articles for inclusion, collected articles, and contributed to the searching. CF conducted the search and co-wrote the Methods section. TPK co-wrote and edited the manuscript and provided methodological and administrative support. He is the guarantor. Funding: This report was produced under contract to the Health Quality Council of Alberta. SRM is a population health investigator supported by the Alberta Heritage Foundation for Medical Research and a new investigator supported by the Canadian Institutes of Health Research. Competing interests: None declared and prazosin.
DOPAMINE INTROPIN ; Class Sympathomimetic Description Dopamine is chemically related to epinephrine and norepinephrine. It acts primarily on alpha-1 and beta-1 adrenergic receptors, increasing systemic vascular resistance and exerting a positive inotropic effect on the heart. In addition, the actions of this drug on dopaminergic receptors dilate renal and splanchnic vasculature, maintaining blood flow. Dopamine is commonly used to treat hypotension associated with cardiogenic shock. Onset & Duration Onset: 2-4 min. Duration: 10-15 min.
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| The risk of cancer in BE may vary with the extent of columnar-lined esophagus. Short segment BE is defined as less than 3 cm in length of columnar-lined esophagus; traditional BE is defined as equal to 3 cm length. The risk of progression from BE to cancer was assessed in a prospective study in 235 patients with metaplasia.38 The study showed an increase in the incidence of adenocarcinoma as the extent of metaplasia increased, but the difference in cancer incidence among groups was not statistically significant Table 6 ; . In the absence of more definitive studies, the approach to management of patients with both shortand long-segment BE should be the same.
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