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Clinical Reasoning and Diagnostic Errors
Published in Paul Cerrato, John Halamka, Reinventing Clinical Decision Support, 2020
Suppose Mr. Jones, 59 years old, with a history of hypertension, stroke, and elevated lipid levels arrives in the ED complaining of sudden-onset intense sub-sternal chest pain that radiates to his left leg but does not affect his left arm or jaw.22 An experienced clinician would likely begin to think intuitively about this patient’s diagnosis. Mr. Jones’ symptoms suggest coronary ischemia, that is, a loss of blood to the heart tissue. Naturally, the attending physician will want to do a detailed physical examination to look for more clues to help refine the list of differential diagnoses, as well as appropriate lab tests. One finding that stands out in Mr. Jones’ lab readings is an elevated troponin I level. Troponin is a muscle protein that can escape from heart tissue that has been damaged by an MI.
Putative role of multi-omics technologies in the investigation of persistent effects of COVID-19 on vital human organs
Published in Sanjeeva Srivastava, Multi-Pronged Omics Technologies to Understand COVID-19, 2022
Susmita Ghosh, Akanksha Salkar, Firuza Parikh
Troponin is a protein present in the heart muscle that regulates normal heart function. In COVID-19 patients, the troponin levels are often found to be elevated (Wang, Hu et al. 2020). In their study evaluating CMR findings in patients who have recently recovered from COVID-19, Puntmann et al. (2020) have reported that high-sensitivity troponin T (hsTnT) significantly elevated in 5 patients and detectable in 71 patients.
Calling 118
Published in Norbert Majerus, George Taninecz, Winning Innovation, 2022
Norbert Majerus, George Taninecz
“Junior, you’re going to have a cardiac catherization in a few minutes,” says Dr. Meglio. “The EKG info points to a heart attack, and the blood test already shows elevated levels of troponin, which also indicates myocardial infarction.”
Building memory devices from biocomposite electronic materials
Published in Science and Technology of Advanced Materials, 2020
Xuechao Xing, Meng Chen, Yue Gong, Ziyu Lv, Su-Ting Han, Ye Zhou
In 2010, a label-free detection of protein–protein interactions using a calmodulin (CaM)-modified nanowire transistor biosensor was showed by Lin et al. [95]. CaM is an acidic protein that regulates the binding of calcium ions. CaM that binds to calcium ions can combine with different proteins to regulate the physiological activities of the human body. The authors designed a CaM-modified silicon nanowire field-effect transistor (SiNW/FET) to detect calcium ions and related proteins. The reversible binding of CaM to the surface of SiNW-FET is based on the combination of glutathione (GSH) and glutathione S-transferase (GST). The authors developed a CaM/SiNW-FET by utilizing the reversible binding and dissociation between GSH and GST-labeled CaM (CaM-GST). GSH combines with SiNW-FET to form GSH/SiNW-FET, and then CaM-GST combines with GSH to form CaM/SiNW-FET to detect various target proteins through CaM–protein interaction. When the CaM and SiNW-FET are dissociated, the device went back to its original state (GSH/SiNW-FET). This device preparation strategy turns sensitive nanowire transistors into reusable biosensors for rapid screening of potential CaM-binding proteins (Figure 6(d)). Troponin can bind to CaM under calcium conditions and is used as a marker for the diagnosis of myocardial infarction. The authors carried out the detection of cardiac troponin I (TnI) using the designed CaM/SiNW-FET in the condition of calcium ions. After TnI was added, the conductance was decreased. The decrease of conductance in CaM/SiNW-FET channel was caused by the positive charge of TnI carried at pH 7.4. In order to examine the specificity of this effect, the authors carried out several control trials. The top graph presented in Figure 6(e) indicates that CaM/SiNW-FET shows no conductance change to avidin, which is also a positively charged protein. In addition, as shown in the middle panel of Figure 6(e), the biosensor did not respond to degenerative TnI, but the same device could detect TnI as is shown in the yellow region of Figure 6(e). Finally, in the absence of calcium, the device did not respond to TnI (Figure 6(e), bottom panel).