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https://www.readbyqxmd.com/read/29455911/trauma-theatre-productivity-does-the-individual-surgeon-anaesthetist-or-consultant-presence-matter
#1
Gareth S Turnbull, Mounir Hakimi, George J McLauchlan
INTRODUCTION: With rising NHS clinical and financial demands, improving theatre efficiency is essential to maintain quality of patient care. Consistent teams and consultant presence have been shown to improve outcomes and productivity in elective orthopaedic surgery. The aim of this study was to investigate the impact on trauma theatre productivity of different surgeons and anaesthetists working together in a Major Trauma Centre. The influence of consultant presence and weekend operating on productivity was also considered...
February 12, 2018: Injury
https://www.readbyqxmd.com/read/29444723/evaluation-of-the-xpert-mtb-rif-performance-on-tissues-potential-impact-on-airborne-infection-isolation-at-a-tertiary-cancer-care-center
#2
Tracy McMillen, Shauna C Usiak, Liang Hua Chen, Luz Gomez, Peter Ntiamoah, Meera R Hameed, Indre Budvytiene, Niaz Banaei, Mini Kamboj, N Esther Babady
OBJECTIVES In this study, we sought to evaluate the performance of the Xpert MTB/RIF (Cepheid) assay for the detection of Mycobacterium tuberculosis (MTB) complex DNA on fresh and formalin-fixed, paraffin-embedded (FFPE) tissue specimens from oncology patients in an area with a low prevalence of tuberculosis. We also aimed to retrospectively assess the potential impact of Xpert MTB/RIF on the duration of airborne infection isolation (AII). SETTING A 473-bed, tertiary-care cancer center in New York City. DESIGN A total of 203 tissue samples (101 FFPE and 102 fresh) were tested using Xpert MTB/RIF, including 133 pulmonary tissue samples (65...
February 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29436417/the-slow-march-toward-rapid-phenotypic-antimicrobial-susceptibility-testing-are-we-there-yet
#3
Christopher D Doern
Antimicrobial susceptibility testing (AST) provides critical information for the management of patients with infection. Gold standard methods for assessing organism susceptibility are still growth based and require incubation over relatively long periods of time. Until now, little progress has been made in developing rapid, growth based, phenotypic AST systems. This commentary puts the recently FDA-cleared Accelerate PhenoTest™ in context by providing a historical perspective on attempts to accelerate phenotypic susceptibility results (J Clin Microbiol XX, 2018, https://doi:10...
February 7, 2018: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/29436401/evaluation-of-a-hub-and-spoke-model-for-the-delivery-of-femtosecond-laser-assisted-cataract-surgery-within-the-context-of-a-large-randomised-controlled-trial
#4
Harry W Roberts, Vijay K Wagh, Isabella J M Mullens, Simone Borsci, Melody Z Ni, David P S O'Brart
AIMS: To test a hypothesis that cataract operating room (OR) productivity can be improved with a femtosecond laser (FL) using a hub-and-spoke model and whether any increase in productivity can offset additional costs relating to the FL. METHODS: 400 eyes of 400 patients were enrolled in a randomised-controlled trial comparing FL-assisted cataract surgery (FLACS) with conventional phacoemulsification surgery (CPS). 299 of 400 operations were performed on designated high-volume theatre lists (FLACS=134, CPS=165), where a hub-and-spoke FLACS model (1×FL, 2×ORs=2:1) was compared with independent CPS theatre lists...
February 7, 2018: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29431911/the-years-algorithm-for-suspected-pulmonary-embolism-shorter-visit-time-and-reduced-costs-at-the-emergency-department
#5
L M van der Pol, C E A Dronkers, T van der Hulle, P L den Exter, C Tromeur, C Heringhaus, A T A Mairuhu, M V Huisman, W B van den Hout, F A Klok
BACKGROUND: Recently, the safety of the YEARS algorithm, designed to simplify the diagnostic work-up of pulmonary embolism (PE), was demonstrated. We hypothesize that by design, YEARS would be associated with a shorter diagnostic emergency department (ED) visit time due to simultaneous assessment of pre-test probability and D-dimer level and reduction in CT-scans. AIM: To investigate whether implementation of the YEARS diagnostic algorithm is associated with a shorter ED visit time compared to the conventional algorithm and to evaluate the associated cost savings...
February 12, 2018: Journal of Thrombosis and Haemostasis: JTH
https://www.readbyqxmd.com/read/29426581/point-of-care-diagnostics-for-tuberculosis
#6
A L García-Basteiro, A DiNardo, B Saavedra, D R Silva, D Palmero, M Gegia, G B Migliori, R Duarte, E Mambuque, R Centis, L E Cuevas, S Izco, G Theron
The goals of the End TB strategy, which aims to achieve a 90% reduction in tuberculosis (TB) incidence and a 95% reduction in TB mortality by 2035, will not be achieved without new tools to fight TB. These include improved point of care (POC) diagnostic tests that are meant to be delivered at the most decentralised levels of care where the patients make the initial contact with the health system, as well as within the community. These tests should be able to be performed on an easily accessible sample and provide results in a timely manner, allowing a quick treatment turnaround time of a few minutes or hours (in a single clinical encounter), hence avoiding patient loss-to-follow-up...
February 6, 2018: Revista Portuguesa de Pneumologia
https://www.readbyqxmd.com/read/29423923/stewardship-opportunities-in-viral-pneumonia-why-not-the-immunocompromised
#7
N J Mercuro, R M Kenney, L Samuel, R J Tibbetts, G J Alangaden, S L Davis
Antimicrobial management of viral pneumonia has proven to be a challenge in hospitalized immunocompromised patients. A host of factors contribute to the dilemma, such as diagnostic uncertainty, lack of organism identification, and clinical status of the patient. Respiratory virus panel (RVP) use was compared between 131 immunocompromised patients who received send-out (n=56) versus in-house (n=75) testing. Antimicrobial optimization interventions consisted of antiviral addition/discontinuation, antibiotic discontinuation/de-escalation, or modification of immunosuppressive regimen...
February 8, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/29414181/recommendations-for-enterovirus-diagnostics-and-characterisation-within-and-beyond-europe
#8
REVIEW
Heli Harvala, Eeva Broberg, Kimberley Benschop, Natasa Berginc, Shamez Ladhani, Petri Susi, Claus Christiansen, James McKenna, David Allen, Phoebe Makiello, Georgina McAllister, Mirabelli Carmen, Katherina Zakikhany, Robert Dyrdak, Xiaohui Nielsen, Tina Madsen, Joel Paul, Catherine Moore, Karin von Eije, Antonio Piralla, Mieke Carlier, Laura Vanoverschelde, Randy Poelman, Andrés Anton, F Xavier López-Labrador, Laura Pellegrinelli, Kathrin Keeren, Melanie Maier, Hayley Cassidy, Stavros Derdas, Carita Savolainen-Kopra, Sabine Diedrich, Svein Nordbø, Javier Buesa, Jean-Luc Bailly, Fausto Baldanti, Andrew MacAdam, Audrey Mirand, Susanne Dudman, Isabelle Schuffenecker, Seilesh Kadambari, Johan Neyts, Michael J Griffiths, Jan Richter, Cristina Margaretto, Sheila Govind, Ursula Morley, Ortwin Adams, Sidsel Krokstad, Jonathan Dean, Margarita Pons-Salort, Birgit Prochazka, Maria Cabrerizo, Manasi Majumdar, Gaia Nebbia, Maryse Wiewel, Simon Cottrell, Peter Coyle, Javier Martin, Catrin Moore, Sofie Midgley, Peter Horby, Katja Wolthers, Peter Simmonds, Hubert Niesters, Thea K Fischer
Enteroviruses (EV) can cause severe neurological and respiratory infections, and occasionally lead to devastating outbreaks as previously demonstrated with EV-A71 and EV-D68 in Europe. However, these infections are still often underdiagnosed and EV typing data is not currently collected at European level. In order to improve EV diagnostics, collate data on severe EV infections and monitor the circulation of EV types, we have established European non-polio enterovirus network (ENPEN). First task of this cross-border network has been to ensure prompt and adequate diagnosis of these infections in Europe, and hence we present recommendations for non-polio EV detection and typing based on the consensus view of this multidisciplinary team including experts from over 20 European countries...
February 6, 2018: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
https://www.readbyqxmd.com/read/29402533/artificial-intelligence-and-machine-learning-in-radiology-opportunities-challenges-pitfalls-and-criteria-for-success
#9
James H Thrall, Xiang Li, Quanzheng Li, Cinthia Cruz, Synho DO, Keith Dreyer, James Brink
Worldwide interest in artificial intelligence (AI) applications, including imaging, is high and growing rapidly, fueled by availability of large datasets ("big data"), substantial advances in computing power, and new deep-learning algorithms. Apart from developing new AI methods per se, there are many opportunities and challenges for the imaging community, including the development of a common nomenclature, better ways to share image data, and standards for validating AI program use across different imaging platforms and patient populations...
January 31, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29386970/detection-of-respiratory-viruses-from-arti-patients-by-xtag-rvp-fast-v2-assay-and-conventional-methods
#10
Chee Sian Kuan, Su Mei Yew, Poh Sim Hooi, Lu Mei Lee, Kee Peng Ng
Introduction: Acute respiratory tract infections (ARTIs) are a major cause of morbidity and mortality in paediatric patients. Therefore, early detection of the viral aetiologies of ARTIs is essential for patient management and infection control. In this study, we evaluated the performance of a new multiplex polymerase chain reaction (PCR) assay (xTAG Respiratory Viral Panel [RVP] Fast v2) in the detection of respiratory viruses by comparing it with that of viral culture and direct immunofluorescence (IF) staining...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29386234/practice-guidelines-for-clinical-microbiology-laboratories-mycobacteria
#11
REVIEW
Betty A Forbes, Geraldine S Hall, Melissa B Miller, Susan M Novak, Marie-Claire Rowlinson, Max Salfinger, Akos Somoskövi, David M Warshauer, Michael L Wilson
Mycobacteria are the causative organisms for diseases such as tuberculosis (TB), leprosy, Buruli ulcer, and pulmonary nontuberculous mycobacterial disease, to name the most important ones. In 2015, globally, almost 10 million people developed TB, and almost half a million patients suffered from its multidrug-resistant form. In 2016, a total of 9,287 new TB cases were reported in the United States. In 2015, there were 174,608 new case of leprosy worldwide. India, Brazil, and Indonesia reported the most leprosy cases...
April 2018: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/29378352/atherothrombosis-and-thromboembolism-position-paper-from-the-second-maastricht-consensus-conference-on-thrombosis
#12
H M H Spronk, T Padro, J E Siland, J H Prochaska, J Winters, A C van der Wal, J J Posthuma, G Lowe, E d'Alessandro, P Wenzel, D M Coenen, P H Reitsma, W Ruf, R H van Gorp, R R Koenen, T Vajen, N A Alshaikh, A S Wolberg, F L Macrae, N Asquith, J Heemskerk, A Heinzmann, M Moorlag, N Mackman, P van der Meijden, J C M Meijers, M Heestermans, T Renné, S Dólleman, W Chayouâ, R A S Ariëns, C C Baaten, M Nagy, A Kuliopulos, J J Posma, P Harrison, M J Vries, H J G M Crijns, E A M P Dudink, H R Buller, Y M C Henskens, A Själander, S Zwaveling, O Erküner, J W Eikelboom, A Gulpen, F E C M Peeters, J Douxfils, R H Olie, T Baglin, A Leader, U Schotten, B Scaf, H M M van Beusekom, L O Mosnier, L van der Vorm, P Declerck, M Visser, D W J Dippel, V J Strijbis, K Pertiwi, A J Ten Cate-Hoek, H Ten Cate
Atherothrombosis is a leading cause of cardiovascular mortality and long-term morbidity. Platelets and coagulation proteases, interacting with circulating cells and in different vascular beds, modify several complex pathologies including atherosclerosis. In the second Maastricht Consensus Conference on Thrombosis, this theme was addressed by diverse scientists from bench to bedside. All presentations were discussed with audience members and the results of these discussions were incorporated in the final document that presents a state-of-the-art reflection of expert opinions and consensus recommendations regarding the following five topics: 1...
February 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29372083/discrepancies-between-planned-and-actual-operating-room-turnaround-times-at-a-large-rural-hospital-in-germany
#13
Regula Morgenegg, Franziska Heinze, Katharina Wieferich, Ralf Schiffer, Frank Stueber, Markus M Luedi, Dietrich Doll
Objectives: While several factors have been shown to influence operating room (OR) turnaround times, few comparisons of planned and actual OR turnaround times have been performed. This study aimed to compare planned and actual OR turnaround times at a large rural hospital in Northern Germany. Methods: This retrospective study examined the OR turnaround data of 875 elective surgery cases scheduled at the Marienhospital, Vechta, Germany, between July and October 2014...
November 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/29371194/development-and-implementation-of-a-centralized-comprehensive-refill-authorization-program-in-an-academic-health-system
#14
Matthew H Rim, Karen C Thomas, Brittanie Hatch, Michael Kelly, Linda S Tyler
PURPOSE: The development and implementation of a centralized, comprehensive, refill authorization (CCRA) program within an academic health system are described. SUMMARY: In order to improve continuity of care for our medically complicated patients, ambulatory pharmacy services developed and implemented a highly coordinated CCRA program for multiple community clinics within the system. To implement the CCRA program, we centralized the refill-request intake process to the Pharmacy Ambulatory Clinical Care Center (PAC3)...
February 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29366760/rapid-and-cost-effective-identification-and-antimicrobial-susceptibility-testing-in-patients-with-gram-negative-bacteremia-directly-from-blood-culture-fluid
#15
Christina Sakarikou, Anna Altieri, Maria Cristina Bossa, Silvia Minelli, Camilla Dolfa, Micol Piperno, Cartesio Favalli
Rapid pathogen identification (ID) and antimicrobial susceptibility testing (AST) in bacteremia cases or sepsis could improve patient prognosis. Thus, it is important to provide timely reports, which make it possible for clinicians to set up appropriate antibiotic therapy during the early stages of bloodstream infection (BSI). This study evaluates an in-house microbiological protocol for early ID as well as AST on Gram negative bacteria directly from positive monomicrobial and polymicrobial blood cultures (BCs)...
January 20, 2018: Journal of Microbiological Methods
https://www.readbyqxmd.com/read/29364212/whole-genome-sequencing-of-candida-glabrata-for-detection-of-markers-of-antifungal-drug-resistance
#16
Chayanika Biswas, Sharon C-A Chen, Catriona Halliday, Elena Martinez, Rebecca J Rockett, Qinning Wang, Verlaine J Timms, Rajat Dhakal, Rosemarie Sadsad, Karina J Kennedy, Geoffrey Playford, Deborah J Marriott, Monica A Slavin, Tania C Sorrell, Vitali Sintchenko
Candida glabrata can rapidly acquire mutations that result in drug resistance, especially to azoles and echinocandins. Identification of genetic mutations is essential, as resistance detected in vitro can often be correlated with clinical failure. We examined the feasibility of using whole genome sequencing (WGS) for genome-wide analysis of antifungal drug resistance in C. glabrata. The aim was torecognize enablers and barriers in the implementation WGS and measure its effectiveness. This paper outlines the key quality control checkpoints and essential components of WGS methodology to investigate genetic markers associated with reduced susceptibility to antifungal agents...
December 28, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29340299/prospective-study-of-the-feasibility-of-point-of-care-testing-strategy-for-carbapenem-resistant-organism-detection
#17
Rahul Pannala, Bruce Baldwin, Vijay Aluru, Thomas E Grys, Jordan Holmes, Laurence J Miller, M Edwyn Harrison, Cuong C Nguyen, Fred C Tenover, David Persing, Douglas O Faigel
Background/aims:  In an investigator-initiated, prospective study, we evaluated the feasibility of a five-gene sequence point-of-care (POC) testing strategy (Xpert CARBA-R Assay, Cepheid Inc., Sunnyvale, CA, USA), compared to reference laboratory PCR (48 - 72 hours turnaround time, two gene sequences), in patients undergoing endoscopic retrograde cholangiopancreatography (ERCP) and in a hospital outbreak investigation. Methods:  After informed consent, patients undergoing ERCP (September 2015 - April 2016, n = 191) at Mayo Clinic and potential hospital contacts (n = 9) of an index carbapenem-resistant organism (CRO)-positive inpatient were included...
January 2018: Endoscopy International Open
https://www.readbyqxmd.com/read/29334134/a-comprehensive-next-generation-sequencing-assay-for-the-diagnosis-of-epidermolysis-bullosa
#18
Anne W Lucky, Neha Dagaonkar, Karen Lammers, Ammar Husami, Diane Kissell, Kejian Zhang
BACKGROUND: Historically, diagnosis of epidermolysis bullosa has required skin biopsies for electron microscopy, direct immunofluorescence to determine which gene(s) to choose for genetic testing, or both. METHODS: To avoid these invasive tests, we developed a high-throughput next-generation sequencing (NGS)-based diagnostic assay called EBSEQ that allows simultaneous detection of mutations in 21 genes with known roles in epidermolysis bullosa pathogenicity. Mutations are confirmed with traditional Sanger sequencing...
January 15, 2018: Pediatric Dermatology
https://www.readbyqxmd.com/read/29333105/measures-and-metrics-for-feasibility-of-proof-of-concept-studies-with-human-immunodeficiency-virus-rapid-point-of-care-technologies-the-evidence-and-the-framework
#19
REVIEW
Nitika Pant Pai, Tiago Chiavegatti, Rohit Vijh, Nicolaos Karatzas, Jana Daher, Megan Smallwood, Tom Wong, Nora Engel
Objective: Pilot (feasibility) studies form a vast majority of diagnostic studies with point-of-care technologies but often lack use of clear measures/metrics and a consistent framework for reporting and evaluation. To fill this gap, we systematically reviewed data to (a) catalog feasibility measures/metrics and (b) propose a framework. Methods: For the period January 2000 to March 2014, 2 reviewers searched 4 databases (MEDLINE, EMBASE, CINAHL, Scopus), retrieved 1441 citations, and abstracted data from 81 studies...
December 2017: Point of Care
https://www.readbyqxmd.com/read/29332654/evaluation-of-loop-mediated-isothermal-amplification-lamp-assay-in-the-diagnosis-of-tubercular-lymphadenitis-a-pilot-study
#20
Baijayantimala Mishra, Vinaykumar Hallur, Bijayini Behera, C Preetam, Priti Nanda Mishra, Jyotirmayee Turuk, Prasanta Raghab Mohapatra
Tubercular lymphadenitis (TBLA) contributes to 30-40% of extrapulmonary TB cases in the immunocompetent individuals and 40-50% in people with HIV. Current diagnostic methods for TBLA like Gene-Xpert or PCR are costly and conventional methods like fine needle aspiration cytology, histopathology lack sensitivity and specificity. Culture which is considered as gold standard require high turnaround time. Loop mediated isothermal amplification (LAMP) assay has been developed as a novel technique for nucleic acid amplification and has shown promising results in the diagnosis of pulmonary tuberculosis...
January 2018: Indian Journal of Tuberculosis
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