Cutpoints in clinical chemistry: time for fundamental reassessment

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...

Different methods, such as visual observance of metal-ion indicators, spectroscopic techniques, and potentiometric methods, can determine the endpoint of an EDTA titration.
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a result, EDTA...

The plasma drug concentration-time curve is a crucial tool in pharmacokinetics, representing the drug's concentration in plasma at different time intervals post-administration. This curve illustrates the drug's journey from absorption into the systemic circulation, distribution to body tissues, and eventual elimination through excretion or biotransformation.
Two pivotal parameters are the minimum effective concentration (MEC) and the minimum toxic concentration (MTC). The MEC is the lowest drug...

Therapeutic Drug Monitoring (TDM) is a clinical practice that measures specific drug levels in a patient's blood or body tissues to tailor drug therapy effectively. This monitoring is critical for managing drugs with narrow therapeutic indices like digoxin and phenytoin, ensuring they are both safe and effective. For instance, monitoring theophylline levels in asthma patients involves precision and sensitivity to adjust doses according to individual responses to therapy, ensuring efficacy and...

EDTA titration curves determine the free metal ion concentration. The titration curve represents the change in concentration of free metal ions (p function) as a function of the volume of EDTA added. This curve consists of three regions: before, at, and after equivalence points. Excess free metal ions are present before the equivalence point. Equal concentrations of metal ions and EDTA are present at the equivalence point. After the equivalence point, excess EDTA exists. This means slight...

Unlike direct titration, back-titration, and displacement titration, indirect titration is an EDTA titration method for quantifying anions. In the indirect titration method, anions are precipitated as their insoluble salts with excess metal ions. The filtrate containing the excess metal ions is directly titrated with standard EDTA until the endpoint is achieved. Another approach involves extracting the metal ion and back-titrating with standard EDTA to obtain the endpoint. In this way, the...