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https://www.readbyqxmd.com/read/28443944/the-role-of-thromboelastometry-in-the-assessment-and-treatment-of-coagulopathy-in-liver-transplant-patients
#1
Raffael Pereira Cezar Zamper, Thiago Chaves Amorim, Luiz Guilherme Villares da Costa, Flávio Takaoka, Ary Serpa
Perioperative monitoring of coagulation is vital to assess bleeding risks, diagnose deficiencies associated with hemorrhage, and guide hemostatic therapy in major surgical procedures, such as liver transplantation. Routine static tests demand long turnaround time and do not assess platelet function; they are determined on plasma at a standard temperature of 37°C; hence these tests are ill-suited for intraoperative use. In contrast, methods which evaluate the viscoelastic properties of whole blood, such as thromboelastogram and rotational thromboelastometry, provide rapid qualitative coagulation assessment and appropriate guidance for transfusion therapy...
April 20, 2017: Einstein
https://www.readbyqxmd.com/read/28440963/clinical-sequencing-using-a-next-generation-sequencing-based-multiplex-gene-assay-in-patients-with-advanced-solid-tumors
#2
Tadayuki Kou, Masashi Kanai, Yoshihiro Yamamoto, Mayumi Kamada, Masahiko Nakatsui, Tomohiro Sakuma, Hiroaki Mochizuki, Akinori Hiroshima, Aiko Sugiyama, Eijiro Nakamura, Hidehiko Miyake, Sachiko Minamiguchi, Kyoichi Takaori, Shigemi Matsumoto, Hironori Haga, Hiroshi Seno, Shinji Kosugi, Yasushi Okuno, Manabu Muto
Advances in next-generation sequencing (NGS) technologies have enabled physicians to test for genomic alterations in multiple cancer-related genes at once in daily clinical practice. In April 2015, we introduced clinical sequencing using an NGS-based multiplex gene assay (OncoPrime(™) ) certified by the Clinical Laboratory Improvement Amendment. This assay covers the entire coding regions of 215 genes and the rearrangement of 17 frequently rearranged genes with clinical relevance in human cancers. The principal indications for the assay were cancers of unknown primary site, rare tumors, and any solid tumors that were refractory to standard chemotherapy...
April 25, 2017: Cancer Science
https://www.readbyqxmd.com/read/28435492/applying-systems-engineering-reduces-radiology-transport-cycle-times-in-the-emergency-department
#3
Benjamin A White, Brian J Yun, Michael H Lev, Ali S Raja
INTRODUCTION: Emergency department (ED) crowding is widespread, and can result in care delays, medical errors, increased costs, and decreased patient satisfaction. Simultaneously, while capacity constraints on EDs are worsening, contributing factors such as patient volume and inpatient bed capacity are often outside the influence of ED administrators. Therefore, systems engineering approaches that improve throughput and reduce waste may hold the most readily available gains. Decreasing radiology turnaround times improves ED patient throughput and decreases patient waiting time...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28434809/real-world-performance-of-the-new-us-hiv-testing-algorithm-in-medical-settings
#4
Kara G Marson, Robert Marlin, Phong Pham, Stephanie E Cohen, Diane Jones, Marguerite Roemer, Philip J Peters, Barbara Haller, Christopher D Pilcher
BACKGROUND: Our medical center laboratory recently adapted its 24/7, two-hourly testing program to use an ARCHITECT-Multispot-viral load (AR-MS-VL) algorithm in place of a previous rapid test-immunofluorescence (RT-IF) algorithm. OBJECTIVES: We evaluated screening test performance, acute case detection, turnaround time and ability to resolve HIV status under the new algorithm. STUDY DESIGN: We considered consecutive HIV tests from January to November 2015...
April 7, 2017: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/28425748/a-field-analysis-trial-comparing-the-turnaround-times-of-routine-and-stat-red-blood-cell-immunohematology-testing
#5
Katie Sackett, Andrea Kjell, Abigail M Schneider, Claudia S Cohn
The turnaround time (TAT) for pre-transfusion testing is important for prompt clinical decision-making. TAT includes the time between the arrival of the sample and the initiation of testing, plus the processing time (PT) required to generate and report a result. The TAT in larger blood banks is mostly dependent upon the capability of the analyzer used. In smaller blood banks, where manual work is often performed, the TAT is dependent on availability and experience of staff, testing resources, and workload. Our site performed a comparative analysis of the ORTHO VISION® (Ortho Clinical Diagnostics, Raritan, NJ) and the Echo® (Immucor, Norcross, GA) blood bank analyzers, using the TAT and PT of standard blood bank tests as the outcome metrics...
January 2017: Immunohematology
https://www.readbyqxmd.com/read/28400475/an-ex-vivo-platform-for-the-prediction-of-clinical-response-in-multiple-myeloma
#6
Ariosto S Silva, Maria D Silva, Praneeth Sudalagunta, Allison I Distler, Timothy Jacobson, Aunshka Collins, Tuan Nguyen, Jinming Song, Dung-Tsa Chen, Lu Chen, Christopher L Cubitt, Rachid Baz, Lia Perez, Dmitri Rebatchouk, William Dalton, James Greene, Robert A Gatenby, Robert J Gillies, Eduardo Sontag, Mark B Meads, Kenneth Shain
Multiple myeloma (MM) remains treatable but incurable. Despite a growing armamentarium of effective agents, choice of therapy, especially in relapse, still relies almost exclusively on clinical acumen. We have developed a system, EMMA (Ex vivo Mathematical Myeloma Advisor), consisting of patient-specific mathematical models parameterized by an ex vivo assay that reverse engineers the intensity and heterogeneity of chemosensitivity of primary cells from MM patients, allowing us to predict clinical response to up to 31 drugs within 5 days post-bone marrow biopsy...
April 11, 2017: Cancer Research
https://www.readbyqxmd.com/read/28399425/direct-identification-from-positive-blood-broth-culture-by-matrix-assisted-laser-desorption-ionization-time-of-flight-mass-spectrometry-maldi-tof-ms
#7
Maria Goreth Barberino, Marcio Silva Oliveira, Ana Carolina Palmeiras Arraes, Luís Cláudio Correia, Ana Verena Mendes
Bloodstream infections (BSIs) are among the most concerning bacterial infections. They are one of the leading causes of morbidity and mortality, and occur in 30-70% of critical care patients. The prompt identification of the causative microorganism can help choosing the appropriate antimicrobial therapy that will lead to better clinical outcomes. Blood culture is one of the most relevant tests for microbiological diagnosis of bacterial infections. The introduction of the MALDI-TOF microbiological diagnosis significantly decreased the time of identifying microorganisms...
April 8, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28395051/implementation-of-epic-beaker-clinical-pathology-at-stanford-university-medical-center
#8
Brent T Tan, Jennifer Fralick, William Flores, Cary Schrandt, Vicki Davis, Tom Bruynell, Lisa Wilson, John Christopher, Shirley Weber, Neil Shah
Objectives: To provide an account of implementation of the Epic Beaker 2014 clinical pathology module at Stanford University Medical Center and highlight strengths and weaknesses of the system. Methods: Based on a formal selection process, Stanford selected Epic Beaker to replace Sunquest as the clinical laboratory information system (LIS). The rationale included integration between the LIS and already installed Epic electronic medical record (EMR), reduction in the number of systems and interfaces, and positive patient identification (PPID)...
March 1, 2017: American Journal of Clinical Pathology
https://www.readbyqxmd.com/read/28391960/rapid-detection-of-urinary-tract-infections-via-bacterial-nuclease-activity
#9
Katie S Flenker, Elliot L Burghardt, Nirmal Dutta, William J Burns, Julia M Grover, Elizabeth J Kenkel, Tyler M Weaver, James Mills, Hyeon Kim, Lingyan Huang, Richard Owczarzy, Catherine A Musselman, Mark A Behlke, Bradley Ford, James O McNamara
Rapid and accurate bacterial detection methods are needed for clinical diagnostic, water, and food testing applications. The wide diversity of bacterial nucleases provides a rich source of enzymes that could be exploited as signal amplifying biomarkers to enable rapid, selective detection of bacterial species. With the exception of the use of micrococcal nuclease activity to detect Staphylococcus aureus, rapid methods that detect bacterial pathogens via their nuclease activities have not been developed. Here, we identify endonuclease I as a robust biomarker for E...
April 5, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
https://www.readbyqxmd.com/read/28390779/total-laboratory-automation-do-stat-tests-still-matter
#10
REVIEW
Alberto Dolci, Davide Giavarina, Sara Pasqualetti, Dominika Szőke, Mauro Panteghini
During the past decades the healthcare systems have rapidly changed and today hospital care is primarily advocated for critical patients and acute treatments, for which laboratory test results are crucial and need to be always reported in predictably short turnaround time (TAT). Laboratories in the hospital setting can face this challenge by changing their organization from a compartmentalized laboratory department toward a decision making-based laboratory department. This requires the implementation of a core laboratory, that exploits total laboratory automation (TLA) using technological innovation in analytical platforms, track systems and information technology, including middleware, and a number of satellite specialized laboratory sections cooperating with care teams for specific medical conditions...
April 5, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28389078/improving-operating-room-efficiency-in-academic-children-s-hospital-using-lean-six-sigma-methodology
#11
Edward P Tagge, Arul S Thirumoorthi, John Lenart, Carlos Garberoglio, Kenneth W Mitchell
BACKGROUND/PURPOSE: Lean Six Sigma (LSS) is a process improvement methodology that utilizes a collaborative team effort to improve performance by systematically identifying root causes of problems. Our objective was to determine whether application of LSS could improve efficiency when applied simultaneously to all services of an academic children's hospital. METHODS: In our tertiary academic medical center, a multidisciplinary committee was formed, and the entire perioperative process was mapped, using fishbone diagrams, Pareto analysis, and other process improvement tools...
March 18, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28386705/a-new-concept-and-a-comprehensive-evaluation-of-sysmex-uf-1000i%C3%A2-flow-cytometer-to-identify-culture-negative-urine-specimens-in-patients-with-uti
#12
T Monsen, P Ryden
Urinary tract infections (UTIs) are among the most common bacterial infections in men and urine culture is gold standard for diagnosis. Considering the high prevalence of culture-negative specimens, any method that identifies such specimens is of interest. The aim was to evaluate a new screening concept for flow cytometry analysis (FCA). The outcomes were evaluated against urine culture, uropathogen species and three conventional screening methods. A prospective, consecutive study examined 1,312 urine specimens, collected during January and February 2012...
April 6, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28379561/rule-out-outbreak-24-hour-metagenomic-next-generation-sequencing-for-characterizing-respiratory-virus-source-for-infection-prevention
#13
Alexander L Greninger, Alpana Waghmare, Amanda Adler, Xuan Qin, Janet L Crowley, Janet A Englund, Jane M Kuypers, Keith R Jerome, Danielle M Zerr
Background.: Metagenomic next-generation sequencing (mNGS) has been used to uncover unusual causes of infectious diseases but has not been used routinely for the investigation of putative nosocomial outbreaks. Here, we describe the use of mNGS during investigation of a cluster of human rhinovirus (HRV)-positive infections on a high-risk pulmonary ward. Methods.: We performed mNGS on 6 midnasal turbinate swabs from 4 case-patients and 10 swabs from 9 control outpatients that tested positive for enterovirus/rhinovirus by the FilmArray system...
April 4, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28379183/rapid-identification-of-pathogenic-variants-in-two-cases-of-charcot-marie-tooth-disease-by-gene-panel-sequencing
#14
Chi-Chun Ho, Shuk-Mui Tai, Edmond Chi-Nam Lee, Timothy Shin-Heng Mak, Timothy Kam-Tim Liu, Victor Wai-Lun Tang, Wing-Tat Poon
Charcot-Marie-Tooth disease (CMT) is a common inherited peripheral neuropathy affecting up to 1 in 1214 of the general population with more than 60 nuclear genes implicated in its pathogenesis. Traditional molecular diagnostic pathways based on relative prevalence and clinical phenotyping are limited by long turnaround time, population-specific prevalence of causative variants and inability to assess multiple co-existing variants. In this study, a CMT gene panel comprising 27 genes was used to uncover the pathogenic mutations in two index patients...
April 5, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28377205/molecular-testing-turnaround-time-for-non-small-cell-lung-cancer-in-routine-clinical%C3%A2-practice-confirms-feasibility-of-cap-iaslc-amp-guideline-recommendations-a-single-center-analysis
#15
Marcello DiStasio, Yigu Chen, Deepa Rangachari, Daniel B Costa, Yael K Heher, Paul A VanderLaan
INTRODUCTION: Molecular testing to identify targetable driver mutations is the standard of care for patients with advanced-stage non-small cell lung cancer. Recent guideline recommendations by the College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) established a benchmark turnaround time (TAT) target of 10 working days for results to be available to the treating oncologist and ≤ 3 days for specimens to arrive at a commercial testing laboratory if testing is not performed in-house...
March 14, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28376789/high-pre-diagnosis-attrition-among-patients-with-presumptive-mdr-tb-an-operational-research-from-bhopal-district-india
#16
Deepak Shewade, Arun M Kokane, Akash Ranjan Singh, Manoj Verma, Malik Parmar, Ashish Chauhan, Sanjay Singh Chahar, Manoj Tiwari, Sheeba Naz Khan, Vivek Gupta, Jaya Prasad Tripathy, Mukesh Nagar, Sanjai Kumar Singh, Pradeep Kumar Mehra, Ajay Mv Kumar
BACKGROUND: Pre-diagnosis attrition needs to be addressed urgently if we are to make progress in improving MDR-TB case detection and achieve universal access to MDR-TB care. We report the pre-diagnosis attrition, along with factors associated, and turnaround times related to the diagnostic pathway among patient with presumptive MDR-TB in Bhopal district, central India (2014). METHODS: Study was conducted under the Revised National Tuberculosis Control Programme setting...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28373362/pancreatic-cancer-genomes-implications-for-clinical-management-and-therapeutic-development
#17
EDITORIAL
Stephan B Dreyer, David K Chang, Peter Bailey, Andrew V Biankin
Pancreatic cancer has become the third leading cause of cancer-related death, with little improvement in outcomes despite decades of research. Surgery remains the only chance of cure, yet only 20% of patients will be alive at 5 years after pancreatic resection. Few chemotherapeutics provide any improvement in outcome, and even then, for approved therapies, the survival benefits are marginal. Genomic sequencing studies of pancreatic cancer have revealed a small set of consistent mutations found in most pancreatic cancers and beyond that, a low prevalence for targetable mutations...
April 1, 2017: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/28371134/strandadvantage-test-for-early-line-and-advanced-stage-treatment-decisions-in-solid-tumors
#18
Manimala Sen, Shanmukh Katragadda, Aarthi Ravichandran, Gouri Deshpande, Minothi Parulekar, Swetha Nayanala, Vikram Vittal, Weiming Shen, Melanie Phooi Nee Yong, Jemima Jacob, Sravanthi Parchuru, Kalpana Dhanuskodi, Kenneth Eyring, Pooja Agrawal, Smita Agarwal, Ashwini Shanmugam, Satish Gupta, Divya Vishwanath, Kiran Kumari, Arun K Hariharan, Sai A Balaji, Qiaoling Liang, Belen Robolledo, Vijayashree Gauribidanur Raghavendrachar, Mohammed Oomer Farooque, Cary J Buresh, Preveen Ramamoorthy, Urvashi Bahadur, Kalyanasundaram Subramanian, Ramesh Hariharan, Vamsi Veeramachaneni, Satish Sankaran, Vaijayanti Gupta
Comprehensive genetic profiling of tumors using next-generation sequencing (NGS) is gaining acceptance for guiding treatment decisions in cancer care. We designed a cancer profiling test combining both deep sequencing and immunohistochemistry (IHC) of relevant cancer targets to aid therapy choices in both standard-of-care (SOC) and advanced-stage treatments for solid tumors. The SOC report is provided in a short turnaround time for four tumors, namely lung, breast, colon, and melanoma, followed by an investigational report...
April 3, 2017: Cancer Medicine
https://www.readbyqxmd.com/read/28365410/performance-evaluation-of-direct-fluorescent-antibody-focus-diagnostics-simplexa%C3%A2-flu-a-b-rsv-and-multi-parameter-customized-respiratory-taqman%C3%A2-array-card-in-immunocompromised-patients
#19
Deborah Steensels, Marijke Reynders, Patrick Descheemaeker, Martin D Curran, Frédérique Jacobs, Olivier Denis, Marie-Luce Delforge, Isabel Montesinos
BACKGROUND: Molecular assays for diagnosis of Flu A, Flu B, and RSV with short turn-around-time (TAT) are of considerable clinical importance. In addition, rapid and accurate diagnosis of a large panel of viral and atypical pathogens can be crucial in immunocompromised patients. OBJECTIVES: First, to evaluate the performance of the Simplexa™ Direct assay system in comparison with direct fluorescent antibody (DFA) and customized Taqman® Array Card (TAC) testing for RSV, Flu A, and Flu B in immunocompromised patients...
March 30, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/28343420/portable-devices-and-mobile-instruments-for-infectious-diseases-point-of-care-testing
#20
Luc Bissonnette, Michel G Bergeron
Rapidity, simplicity, and portability are highly desirable characteristics of tests and devices designed for performing diagnostics at the point of care (POC), either near patients managed in healthcare facilities or to offer bioanalytical alternatives in external settings. By reducing the turnaround time of the diagnostic cycle, POC diagnostics can reduce the dissemination, morbidity, and mortality of infectious diseases and provide tools to control the global threat of antimicrobial resistance. Areas covered: A literature search of PubMed and Google Scholar, and extensive mining of specialized publications, Internet resources, and manufacturers' websites have been used to organize and write this overview of the challenges and requirements associated with the development of portable sample-to-answer diagnostics, and showcase relevant examples of handheld devices, portable instruments, and less mobile systems which may or could be operated at POC...
April 11, 2017: Expert Review of Molecular Diagnostics
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