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https://www.readbyqxmd.com/read/28435491/agreement-between-serum-assays-performed-in-ed-point-of-care-and-hospital-central-laboratories
#1
Meir Dashevsky, Steven L Bernstein, Carol L Barsky, Richard A Taylor
INTRODUCTION: Point-of-care (POC) testing allows for more time-sensitive diagnosis and treatment in the emergency department (ED) than sending blood samples to the hospital central laboratory (CL). However, many ED patients have blood sent to both, either out of clinical custom, or because clinicians do not trust the POC values. The objective of this study was to examine the level of agreement between POC and CL values in a large cohort of ED patients. METHODS: In an urban, Level I ED that sees approximately 120,000 patients/year, all patients seen between March 1, 2013, and October 1, 2014, who had blood sent to POC and CL labs had levels of agreement measured between serum sodium, potassium, blood urea nitrogen (BUN), creatinine, and hematocrit...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28426457/race-differences-in-initial-presentation-early-treatment-and-1-year-outcomes-of-pediatric-crohn-s-disease-results-from-the-improvecarenow-network
#2
Jennifer L Dotson, Michele Cho, Josh Bricker, Michael D Kappelman, Deena J Chisolm, Gitit Tomer, Wallace V Crandall
BACKGROUND: Racially disparate care has been shown to contribute to suboptimal health care outcomes for minorities. Using the ImproveCareNow network, we investigated differences in management and outcomes of pediatric patients with Crohn's disease at diagnosis and 1-year postdiagnosis. METHODS: ImproveCareNow is a learning health network for pediatric inflammatory bowel disease. It contains prospective, longitudinal data from outpatient encounters. This retrospective study included all patients with Crohn's disease ≤21 years, September 2006 to October 2014, with the first recorded encounter ≤90 days from date of diagnosis and an encounter 1 year ±60 days...
May 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28422699/hemorrhage-prediction-models-in-surgical-intensive-care-bedside-monitoring-data-adds-information-to-lab-values
#3
Marco De Pasquale, Travis Moss, Sergio Cerutti, James Calland, Douglas Lake, Randall Moorman, Manuela Ferrario
Hemorrhage is a frequent complication in surgery patients; its identification and management have received increasing attention as a target for quality improvement in patient care in the Intensive Care Unit (ICU). The purposes of this work were i) to find an early detection model for hemorrhage by exploring the range of data mining methods that are currently available, and ii) to compare prediction models utilizing continuously measured physiological data from bedside monitors to those using commonly obtained laboratory tests...
April 12, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28397461/analytical-and-clinical-validation-of-a-point-of-care-cardiac-troponin-t-test-with-an-improved-detection-limit
#4
Carsten Jungbauer, Julian Hupf, Evangelos Giannitsis, Johann Frick, Anna Slagman, Christoph Ehret, Nicolas Herbert, Christine Jung, Rainer Zerback, Thomas Bertsch, Michael Christ
BACKGROUND: The point-of-care test Roche CARDIAC POC Troponin T (PoC TnT) is an improved assay which has been developed for the Roche cobas h 232 system. METHODS: We performed a multicentre evaluation (four sites) to assess the analytical performance of the PoC TnT assay and to compare it with the central laboratory Elecsys® troponin T high sensitive (lab cTnT-hs) assay. RESULTS: The relative mean differences found in method comparisons of PoC TnT vs...
April 1, 2017: Clinical Laboratory
https://www.readbyqxmd.com/read/28386035/empagliflozin-and-cerebrovascular-events-in-patients-with-type-2-diabetes-mellitus-at-high-cardiovascular-risk
#5
Bernard Zinman, Silvio E Inzucchi, John M Lachin, Christoph Wanner, David Fitchett, Sven Kohler, Michaela Mattheus, Hans J Woerle, Uli C Broedl, Odd Erik Johansen, Gregory W Albers, Hans Christoph Diener
BACKGROUND AND PURPOSE: In the EMPA-REG OUTCOME trial (Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients), empagliflozin added to standard of care in patients with type 2 diabetes mellitus and high cardiovascular risk reduced the risk of 3-point major adverse cardiovascular events, driven by a reduction in cardiovascular mortality, with no significant difference between empagliflozin and placebo in risk of myocardial infarction or stroke. In a modified intent-to-treat analysis, the hazard ratio for stroke was 1...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28383467/the-effect-of-blood-transfusion-on-compensatory-reserve-a-prospective-clinical-trial
#6
Avi Benov, Ori Yaslowitz, Tal Hakim, Rotem Amir-Keret, Roy Nadler, Anat Brand, Elon Glassberg, Avi Yitzhak, Victor A Convertino, Haim Paran
BACKGROUND: Bleeding activates the body's compensatory mechanisms, causing changes in vital signs to appear late in the course of progressive blood loss. These vital signs are maintained even when up to 30% to 40% of blood volume is lost. Laboratory tests such as hemoglobin, hematocrit, lactate, and base deficit levels do not change during acute phase of bleeding. The compensatory reserve measurement (CRM) represents a new paradigm that measures the total of all physiological compensatory mechanisms, using noninvasive photoplethysmography to read changes in arterial waveforms...
April 5, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28383377/evaluation-of-introduction-of-a-delayed-cord-clamping-protocol-for-premature-neonates-in-a-high-volume-maternity-center
#7
Lilly Y Liu, Joe M Feinglass, Janine Y Khan, Susan E Gerber, William A Grobman, Lynn M Yee
OBJECTIVE: To evaluate adherence to a delayed cord clamping protocol for preterm births in the first 2 years after its introduction, perform a quality improvement assessment, and determine neonatal outcomes associated with protocol implementation and adherence. METHODS: This is a retrospective cohort study of women delivering singleton neonates at 23-32 weeks of gestation in the 2 years before (preprotocol) and 2 years after (postprotocol) introduction of a 30-second delayed cord clamping protocol at a large-volume academic center...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28375886/unplanned-readmissions-following-outpatient-hand-and-elbow-surgery
#8
Mohamed Noureldin, Elizabeth B Habermann, Daniel S Ubl, Sanjeev Kakar
BACKGROUND: Unplanned readmission following surgery is a quality metric that helps surgeons assess initiatives targeted at improving patient care. We utilized the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to determine the rates, causes, and predictors of unplanned 30-day readmissions after outpatient elective hand and elbow surgery. METHODS: The ACS-NSQIP database was queried using hand-and-elbow-specific Current Procedural Terminology (CPT) codes to retrospectively identify patients who had undergone outpatient hand or elbow surgery in 2012 and 2013...
April 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28365104/can-we-safely-decrease-intensive-care-unit-admissions-for-children-with-high-grade-isolated-solid-organ-injuries-using-the-shock-index-pediatric-age-adjusted-and-hematocrit-to-modify-apsa-admission-guidelines
#9
Mary Arbuthnot, Lindsey Bendure Armstrong, David P Mooney
BACKGROUND: In 2000, the American Pediatric Surgical Association (APSA) disseminated consensus practice guidelines for the management of blunt liver and splenic injury which included intensive care unit (ICU) admission for children with grade IV injuries. We sought to determine if we could better predict which children with isolated solid organ injuries (SOI) underwent an ICU-level intervention, thus necessitating ICU admission. METHODS: Children with isolated liver, spleen, or kidney injuries admitted to the ICU from November 2003 to August 2015 were identified in our trauma registry, and data were extracted from the medical record...
March 16, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28340166/complete-blood-count-reference-ranges-from-a-rural-haitian-ambulatory-care-clinic
#10
Robert F Downey
Background: At rural healthcare centers in developing countries, it is difficult to recruit healthy individuals for reference range studies. So, in this study, I evaluated complete blood count (CBC) data to determine reference ranges for a rural Haitian population. Methods: A convenience sample of laboratory records was reviewed to obtain CBC results for 157 adult patients with normal screening examination results. Central 95% reference ranges were determined for male and female subjects...
March 10, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/28298021/prophylactic-nimodipine-treatment-and-improvement-in-hearing-outcome-after-vestibular-schwannoma-surgery-a-combined-analysis-of-a-randomized-multicenter-phase-iii-trial-and-its-pilot-study
#11
Christian Scheller, Andreas Wienke, Marcos Tatagiba, Alireza Gharabaghi, Kristofer F Ramina, Oliver Ganslandt, Barbara Bischoff, Johannes Zenk, Tobias Engelhorn, Cordula Matthies, Thomas Westermaier, Gregor Antoniadis, Maria Teresa Pedro, Veit Rohde, Kajetan von Eckardstein, Thomas Kretschmer, Malte Kornhuber, Jörg Steighardt, Michael Richter, Fred G Barker, Christian Strauss
OBJECT In clinical routines, neuroprotective strategies in neurosurgical interventions are still missing. A pilot study (n = 30) and an analogously performed Phase III trial (n = 112) pointed to a beneficial effect of prophylactic nimodipine and hydroxyethyl starch (HES) in vestibular schwannoma (VS) surgery. Considering the small sample size, the data from both studies were pooled. METHODS The patients in both investigator-initiated studies were assigned to 2 groups. The treatment group (n = 70) received parenteral nimodipine (1-2 mg/hour) and HES (hematocrit 30%-35%) from the day before surgery until the 7th postoperative day...
February 24, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28295397/red-blood-cell-transfusions-can-induce-proinflammatory-cytokines-in-preterm-infants
#12
Carlo Dani, Chiara Poggi, Elena Gozzini, Valentina Leonardi, Alice Sereni, Rosanna Abbate, Anna Maria Gori
BACKGROUND: The risk of developing red blood cell (RBC) transfusion-associated necrotizing enterocolitis (TANEC) in preterm infants has recently been emphasized. Our aim was to assess changes in cytokine serum levels after RBC transfusions in a cohort of very preterm infants to evaluate their possible proinflammatory effect. STUDY DESIGN AND METHODS: We carried out a prospective observational study. One transfusion event was studied in infants less than 32 weeks' gestation and more than 7 days old (n = 20) admitted to a tertiary neonatal intensive care unit...
May 2017: Transfusion
https://www.readbyqxmd.com/read/28287000/risk-factors-and-clinical-outcome-of-profound-thrombocytopenia-in-adult-patients-with-denv-infections
#13
Amreeta Dhanoa, Ganeswrie Rajasekaram, Sharifah Syed Hassan, Amutha Ramadas, Nur Amelia Azreen Adnan, Chun Fatt Lau, Teik Seng Chan, Chin Fang Ngim
Severe thrombocytopenia is common in dengue virus (DENV) infections. However, studies focusing on the role of profound thrombocytopenia (PT) (nadir platelet counts ≤ 20 000/mm(3)) in DENV infections are scarce. This study aims to identify the associated features and outcome of DENV patients with PT. It involves 237 adult hospitalized patients who were DENV PCR positive. The presence of comorbidity (AOR = 4.625; 95% CI = 1.113-19.230), higher admission hematocrit (AOR = 1.213; 95% CI = 1.067-1.379), lower admission albumin (AOR = 0...
March 13, 2017: Platelets
https://www.readbyqxmd.com/read/28286647/investigation-of-the-immune-effects-of-scutellaria-baicalensis-on-blood-leukocytes-and-selected-organs-of-the-chicken-s-lymphatic-system
#14
Bożena Króliczewska, Stanisław Graczyk, Jarosław Króliczewski, Aleksandra Pliszczak-Król, Dorota Miśta, Wojciech Zawadzki
BACKGROUND: The health of chickens and the welfare of poultry industry are central to the efforts of addressing global food security. Therefore, it is essential to study chicken immunology to maintain and improve its health and to find novel and sustainable solutions. This paper presents a study on investigation of the effect of Scutellaria baicalensis root (SBR) on the immune response of broiler chicken, especially on lymphocytes and heterophils reactivity, regarding their contribution to the development of immunity of the chickens...
2017: Journal of Animal Science and Biotechnology
https://www.readbyqxmd.com/read/28285280/effect-of-delayed-cord-clamping-on-hematocrit-and-thermal-and-hemodynamic-stability-in-preterm-neonates-a-randomized-controlled-trial
#15
Niraj Kumar Dipak, Ruchi Nimish Nanavat, Nand Kishore Kabra, Anita Srinivasan, Anitha Ananthan
OBJECTIVE: To evaluate the short term clinical effects of delayed cord clamping in preterm neonates. DESIGN: Randomized controlled trial. SETTING: A tertiary care neonatal unit from October 2013 to September 2014. PARTICIPANTS: 78 mothers with preterm labor between 27 to 316/7 weeks gestation. INTERVENTION: Early cord clamping (10 s), delayed cord clamping (60 s) or delayed cord clamping (60 s) along with intramuscular ergometrine (500 µg) administered to the mother...
February 15, 2017: Indian Pediatrics
https://www.readbyqxmd.com/read/28283250/feasibility-of-anesthesia-maintenance-with-sevoflurane-during-cardiopulmonary-bypass-a-pilot-pharmacokinetics-study
#16
Roberta Meroni, Stefano Gianni, Marcello Guarnieri, Francesco Saglietti, Marco Gemma, Alberto Zangrillo, Elena Bignami
OBJECTIVE: Adequate maintenance of hypnosis during anesthesia throughout surgery using sevoflurane alone was investigated. In addition, sevoflurane pharmacokinetics during cardiopulmonary bypass were analyzed. DESIGN: This was a pilot pharmacokinetic study. SETTING: Tertiary care university hospital. PARTICIPANTS: The study comprised 10 patients aged between 18 and 75 years who underwent elective mitral valve surgery...
December 18, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28276728/determinants-of-high-on-treatment-platelet-reactivity-and-agreement-between-verifynow-and-multiplate-assays
#17
Dorota Danielak, Anna Komosa, Aleksandra Tomczak, Agnieszka Graczyk-Szuster, Maciej Lesiak, Franciszek Główka, Marta Karaźniewicz-Łada
Dual antiplatelet therapy with clopidogrel is a regimen used before and after drug-eluting stent (DES) implantation. Point-of-care platelet reactivity assays are easy-to-use methods to determine adequate response to the drug. The aim of this study was a comparison of the two platelet reactivity assays: Multiplate(®) and VerifyNow(®) and an identification of factors potentially influencing the results of these tests, including common genetic polymorphisms. The study included 39 patients receiving 75 mg clopidogrel daily before angioplasty with DES implantation...
May 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28267682/a-retrospective-descriptive-comparative-study-to-identify-patient-variables-that-contribute-to-the-development-of-deep-tissue-injury-among-patients-in-intensive-care-units
#18
Holly Kirkland-Kyhn, Oleg Teleten, Machelle Wilson
Deep tissue injury (DTI) may develop in critically ill patients despite implementation of preventive interventions. A retrospective, descriptive study was conducted in a 620-bed, level 1 trauma, academic medical center with 7 adult intensive care units ([ICUs] cardiac surgery, trauma surgery, burn surgery, med-surgery, neurosurgery, medical, and transfer) among patients treated from January 1, 2010 to January 1, 2015. All patients 18 years of age or older that developed a sacral DTI that evolved into a Stage 3, Stage 4, or unstageable hospital-acquired pressure ulcers (HAPU) in the ICU were included...
February 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28267463/early-inpatient-calculation-of-laboratory-based-30-day-readmission-risk-scores-empowers-clinical-risk-modification-during-index-hospitalization
#19
Benjamin D Horne, Deborah Budge, Andrew L Masica, Lucy A Savitz, José Benuzillo, Gabriela Cantu, Alejandra Bradshaw, Raymond O McCubrey, Tami L Bair, Colleen A Roberts, Kismet D Rasmusson, Rami Alharethi, Abdallah G Kfoury, Brent C James, Donald L Lappé
Improving 30-day readmission continues to be problematic for most hospitals. This study reports the creation and validation of sex-specific inpatient (i) heart failure (HF) risk scores using electronic data from the beginning of inpatient care for effective and efficient prediction of 30-day readmission risk. METHODS: HF patients hospitalized at Intermountain Healthcare from 2005 to 2012 (derivation: n=6079; validation: n=2663) and Baylor Scott & White Health (North Region) from 2005 to 2013 (validation: n=5162) were studied...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28266049/standardization-of-transfusion-practice-in-organ-donors-using-the-digital-intern-an-electronic-decision-support-algorithm
#20
Joseph P Connor, Ashley M Cunningham, Thomas Raife, William N Rose, Joshua E Medow
BACKGROUND: Prospective clinical trials support restrictive thresholds for red blood cell (RBC) transfusion. Nonsurvivable donors are a major source of organs for transplantation. The Digital Intern (DI) is a computer algorithm to standardize donor care that includes a more restrictive transfusion threshold. The impact of standardized and restrictive RBC transfusion in organ donors, as determined by the DI, has not been reported. STUDY DESIGN AND METHODS: We conducted a retrospective cohort study to compare the transfusion practice of the DI (n = 100) to a historic group of physician-managed donors (n = 90)...
March 7, 2017: Transfusion
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