Cardiac troponin 1: a highly sensitive and specific cardiac marker

The aim of the present study was to evaluate the early diagnostic sensitivity and specificity of cardiac troponin I [cTnI] as compared to the routinely used cardiac enzymes [total CK and CK-MB] in acute chest pain patients presenting to the Emergency Department [ED] within the first six hours of onset of pain. This study was conducted on 17 acute myocardial infarction [AMI] patients presenting to the Emergency Department [ED] within the first six hours from onset of chest pain, in addition to 36 non-AMI patients [11 patients with unstable angina, as well as 15 patients suffering from CRF and 10 patients with traumatic muscle injury]. The results were compared with those of 10 healthy age- and sex-matched control subjects. CTnI [measured by a chemiluminescent technique on Immulite system] proved to be the superior marker for early and accurate diagnosis of AMI during the first six hours of onset of chest pain as evidence by ROC curve analysis. The area under the curve [AUC] for cTnI was 0.955, that for CK-MB was 0.925, meanwhile that for total CK was 0.769. The optimum cutoff level of cTnI was 1.6 ng/ml. At this level, cTnI showed a diagnostic efficacy of 94.1%, 95.6%, respectively, with diagnostic efficacy of 95.2%. Although CK-MB showed a similar diagnostic sensitivity [94.1%], it had a much lower specificity [77.8%], hence resulting in a much lower diagnostic efficacy [82.3%], compared to cTnI. Total CK, on the other hand, showed a very low sensitivity [70.6%] and specificity [80%] with diagnostic efficacy of 82.3%

Intestinal absorptive status and gut contamination among Egyptian thalassemic children

In this study, the intestinal absorptive status and the prevalence of small bowel bacterial overgrowth were assessed in 72 thalassemic children. They were classified according to the onset of the disease, the splenic status and type of chelation therapy into three groups. Group I included 15 newly diagnosed cases. Group II included 30 thalassemic children receiving subcutaneous desferrioxamine [DF] as a chelation therapy [15 of them had intact spleen and 15 were splenectomized]. Group III included 27 patients receiving oral salicylhydroxamic acid [SHAM] as a chelation therapy [12 of them had intact spleen and 15 were splenectomized]. Fifteen healthy age and sex matched children served as controls. The results revealed that the levels of fecal alpha-1 antitrypsin [a marker of enteric protein loss] were significantly higher in all studied groups as compared with the control group. In conclusion, malabsorption was a common finding in thalassemic patients regardless of the duration, type of chelation therapy and whether splenectomized or not. Furthermore, small bowel bacterial overgrowth was also common in thalassemic cases, especially the splenectomized ones due to the profound immune disturbances occurring after splenectomy