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troponin I and troponin T and diabetes استفسار

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  • troponin I and troponin T and diabetes استفسار

    السلام عليكم ، احتاج الي افادتكم وتوجيهاتكم عن موضوع
    clinical signficant of Tryptone T & I in cardic infraction and related to longstand of diabetis miltues
    لو اعي زميل لديه اي موضوع او يعرف مراجع معينه تتكلم عن هذا الموضوع ادلني عليها وجذاكم الله عنا كل خير
    الشجن الاليم:sm199:

  • #2
    وعليكم السلام ورحمة الله وبركاتة

    سؤالك غير واضح؟؟ ماا تقصد بTryptone T,I
    هل تقصد troponin I and troponin T
    ___________________________________

    troponin I and troponin T (cardiac enzymes)


    Cardiac Troponins

    Troponins are protein components of striated muscle. There are three different troponins: troponin C, troponin T and troponin I. Troponins T and I are only found in cardiac muscle
    Troponin T (1)
    84% sensitivity for myocardial infarction 8 hours after onset of symptoms (1); 81% specificity (1)
    low specificity - 22% for unstable angina
    advantages
    highly sensitive for detecting myocardial ischaemia
    levels may help to stratify risk afterward
    Troponin I
    90% sensitivity for myocardial infarction 8 hours after onset of symptoms (1); 95% specificity (1)
    low specificity for unstable angina - 36% - note however that there is evidence that (2)
    troponin I elevation is useful for predicting in-hospital risk for unstable angina patients admitted to a community hospital. The association of ECG changes and high troponin I identifies a population at very high risk; however, the absence of both variables in patients with a diagnosis of unstable angina does not preclude the development of events

    rises after 3-6 hours (1)
    peaks at about 20 hours (1)
    general advantages (3)
    troponin T (cTnT) and troponin I (cTnI) are released only following cardiac damage
    CK and CK-MB are found in skeletal muscle as well as cardiac muscle - therefore if there is damage to skeletal muscle, elevations of CK and CK-MB will occur and can make the diagnosis of myocardial infarction difficult. In such a situation levels of cTnT and/or cTnI will not rise unless myocardial infarction has occurred
    troponin T and I are present for, and remain elevated, a long time
    unlike CK and CK-MB, cTnT and cTnI are released for much longer with cTnI detectable in the blood for up to 5 days and cTnT for 7-10 days following MI. This allows an MI to be detected if the patient presents late. For example, if a patient comes to the surgery with a history of chest pain 2-3 days ago, measurement of cTnT or cTnI will allow the diagnosis or exclusion of MI as a cause of the chest pain
    troponin T and I are very sensitive
    there is always a low level release of CK and CK-MB from skeletal muscle at a low level all the time so there is always a background value. This is not the case for the cardiac structural proteins such as cTnT and cTnI and therefore, they are very sensitive. Studies have revealed that about one third of patients admitted with unstable angina, in whom MI was apparently excluded by CK and CK-MB measurement, have raised levels of cTnT and cTnI. Follow up studies have revealed that these patients are at significantly greater risk of death, subsequent MI or readmission with unstable angina than patients who did not have detectable levels cTnT or cTnI
    general disadvantages (3)
    elevation of cTnT or TnI is absolutely indicative of cardiac damage, but this can occur as a result of causes other than MI e.g. myocarditis, coronary artery spasm from cocaine, severe cardiac failure,cardiac trauma from surgery or road traffic accident, and pulmonary embolus can cause cardiac damage with an accompanying elevation of cardiac troponin(s)
    failure to show a rise in cTnT or cTnI does not exclude the diagnosis of ischaemic heart disease
    both cTnT and cTnI may be elevated in patients with chronic renal failure and indicate a higher long-term risk of death. They can be distinguished from changes due to myocardial infarction by repeating the tests. Myocardial infarction causes a rise and fall in cTnT or cTnI, but in renal failure the elevated levels are sustained
    reference ranges may vary between laboratories and are dependent on methods of measurement used

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    • #3
      ردك جميل جدا ومشكور علي اهتمامك لو امكن ترسل لي المواقع او اسامي الكتب وتكون مشكور جدا وماقصرت تقبل تحياتي واحترامي
      الشجن الاليم:sm199:

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      • #4
        مرحبا انا اعملت مشروع تخرجي عن troponinواستعنت بموقع www.medscape.com

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        • #5
          cardiac totroponin I and troponin T
          (cTn) is high concentration in cardiomyocytes that high degree of cardiac specific.
          This protein released with very small area of myocardial damage as early as 1-3 hr after injury and level return to normal within 5-7 day.
          1. Serum concentrations of TnT begins to rise within a few hours of chest pain onset and peak by day 2, a plateau lasting from 2-5 days usually follows. It remains elevated beyond 7 days before returning to reference values.
          2. • The sensitivity of TnT for detecting AMI is 100% from 12 h – 5 days after chest pain onset.
          3. • It is useful for diagnosis of AMI in patients who do not seek medical attention within 2-3 days.
          4. Troponin I "TnI
            "
          5. • It is found in the myocardium in adults, making it extremely specific for cardiac disease.
          6. • TnT tends to remain elevated longer and maintain higher sensitivity after day 7 after infarct than TnI.
          7. Normal value Troponin I <0.35 ng/ml
          8. Troponin T <0.2 ng/ml
          9. Critical value >1.5 ng/ml[/LEFT
          ][/LEFT]

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          • #6
            جميل المجهود الرائع ده نتمنى المزيد

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            • #7
              من فضلك يرجى كتابة المرجع العلمى فى اسرع وقت . شكرا

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