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https://www.readbyqxmd.com/read/29185372/recent-advances-in-the-microbiological-diagnosis-of-bloodstream-infections
#1
Walter Florio, Paola Morici, Emilia Ghelardi, Simona Barnini, Antonella Lupetti
Rapid identification (ID) and antimicrobial susceptibility testing (AST) of the causative agent(s) of bloodstream infections (BSIs) are essential for the prompt administration of an effective antimicrobial therapy, which can result in clinical and financial benefits. Immediately after blood sampling, empirical antimicrobial therapy, chosen on clinical and epidemiological data, is administered. When ID and AST results are available, the clinician decides whether to continue or streamline the antimicrobial therapy, based on the results of the in vitro antimicrobial susceptibility profile of the pathogen...
November 29, 2017: Critical Reviews in Microbiology
https://www.readbyqxmd.com/read/29180545/implementation-of-a-standardized-medication-therapy-management-plus-approach-within-primary-care
#2
Emily J Schwartz, Jacques Turgeon, Jay Patel, Parag Patel, Hetal Shah, Amalia M Issa, Orsula V Knowlton, Calvin H Knowlton, Kevin T Bain
PURPOSE: The purpose of this study was to implement a clinical pharmacist-led medication therapy management (MTM) service within a primary-care setting that is enhanced by 1) a clinical decision support system (CDSS) that includes a unique combination of medication risk mitigation factors, which aids the pharmacist in interpreting the medication profile, and 2) pharmacogenomics (PGx) testing. METHODS: This was a service implementation study, whereby Medicare beneficiaries were eligible if they were patients of Elmwood Family Physicians, a private family, primary care practice with 2 locations in New Jersey, and were on at least 7 medications...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29176010/three-year-customer-satisfaction-survey-in-laboratory-medicine-in-a-chinese-university-hospital
#3
Siqi Guo, Yifei Duan, Xiaojuan Liu, Yongmei Jiang
BACKGROUND: Customer satisfaction is a key quality indicator of laboratory service. Patients and physicians are the ultimate customers in medical laboratory, and their opinions are essential components in developing a customer-oriented laboratory. METHODS: A longitudinal investigation of customer satisfaction was conducted through questionnaires. We designed two different questionnaires and selected 1200 customers (600 outpatients and 600 physicians) to assess customer satisfaction every other year from 2012 to 2016...
November 27, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29175969/time-and-motion-studies-of-national-health-service-cataract-theatre-lists-to-determine-strategies-to-improve-efficiency
#4
Harry W Roberts, James Myerscough, Simone Borsci, Melody Ni, David P S O'Brart
AIM: To provide a quantitative assessment of cataract theatre lists focusing on productivity and staffing levels/tasks using time and motion studies. METHODS: National Health Service (NHS) cataract theatre lists were prospectively observed in five different institutions (four NHS hospitals and one private hospital). Individual tasks and their timings of every member of staff were recorded. Multiple linear regression analyses were performed to investigate possible associations between individual timings and tasks...
November 24, 2017: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/29170019/evaluation-of-a-rapid-and-sensitive-rt-qpcr-assay-for-the-detection-of-ebola-virus
#5
M Biava, F Colavita, A Marzorati, D Russo, D Pirola, A Cocci, A Petrocelli, M Guanti Delli, G Cataldi, T A Kamara, A S Kamara, K Konneh, A Cannas, S Coen, S Quartu, S Meschi, M B Valli, A Mazzarelli, C Venditti, G Grassi, G Rozera, C Castilletti, A Mirazimi, M R Capobianchi, G Ippolito, R Miccio, A Di Caro
BACKGROUND: The 2013-2016 Ebola virus disease (EVD) outbreak showed a lack of diagnostic point-of-care methods. Currently, EBOV diagnosis relies on quantitative reverse-transcription-PCR (RT- qPCR), highly specific and sensitive, but requiring skilled personnel and well-equipped laboratories. In field settings, these factors and others, such as samples' time of collection and transportation, determine a prolonged turnaround-time to final results. In outbreak scenarios, a rapid and transportable method could eliminate issues of cohorting suspected and actual EVD patients for lack of diagnostic certainty...
November 20, 2017: Journal of Virological Methods
https://www.readbyqxmd.com/read/29169784/fast-track-registration-a-way-to-increase-efficiency-in-the-ir-division
#6
David P Duncan, Bryan E Wessel, Michael A Schacht, Lu Anne V Dinglasan, George W Mader, Melissa H Potts, Mahmoud Samman, Martin S Vyleta, Douglas M Coldwell
PURPOSE: To evaluate changes in patient registration process at an academic 2-suite IR Division to determine if moving registration from the waiting room to the vascular holding area decreased amount of time patients spent in the Radiology Department and improved start times. MATERIALS AND METHODS: A data collection sheet was created by evaluating patient-related processes; event timestamps were recorded on the sheet. The control group consisted of 33 patients who registered using the traditional process...
November 21, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29169287/point-of-care-testing-poct-and-evidence-based-laboratory-medicine-eblm-does-it-leverage-any-advantage-in-clinical-decision-making
#7
Christopher Florkowski, Andrew Don-Wauchope, Nuria Gimenez, Karina Rodriguez-Capote, Julien Wils, Annalise Zemlin
Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870...
November 23, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29164374/fixed-dose-4-factor-prothrombin-complex-concentrate-for-the-emergent-reversal-of-warfarin-a-retrospective-analysis
#8
Greta Astrup, Preeyaporn Sarangarm, Allison Burnett
Published literature suggests that a fixed-dose 4-factor prothrombin complex concentrate (4FPCC) may be efficacious in managing warfarin-associated hemorrhage, however the ideal dose is still unclear. The purpose of this evaluation was to determine the efficacy of fixed-dose 4FPCC in reducing the International Normalized Ratio (INR) to ≤ 1.5 among warfarin patients with need for urgent or emergent anticoagulation reversal. Starting October 2016, our institution changed from standard 4FPCC FDA-labeled dosing based on the patient's presenting INR and weight, to a fixed-dose of 1500 units for all patients requiring urgent or emergent warfarin reversal...
November 21, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29161406/evaluation-of-the-bacterioscan-216dx-for-standalone-preculture-screen-of-preserved-urine-specimens-in-a-clinical-setting
#9
Amity L Roberts, Upasana Joneja, Tatiana Villatoro, Eileen Andris, Judith A Boyle, James Bondi
Background: The BacterioScan 216Dx laser microbial growth monitoring system was evaluated as an option for preurine culture screening of preserved urine specimens at an acute care medical center. Methods: The BacterioScan 216Dx system performance characteristics and the economic impact (cost effectiveness) for the laboratory were assessed. Urinalysis performance compared to urine culture was assessed if urinalysis was ordered as part of the patient care set. Results: When compared to urine culture, the BacterioScan had an overall performance with corresponding 95% confidence intervals of 76% (68-83) sensitivity, 84% (80-87) specificity, 55% (48-63) positive predictive value, and 93% (90-95) negative predictive value for 610 randomly selected preserved urine specimens...
November 17, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29132499/use-of-medical-emergency-call-data-as-a-marker-of-quality-of-emergency-department-care-in-the-post-national-emergency-access-target-era
#10
Lorraine Westacott, Judy Graves, Mohsina Khatun, John Burke
Objectives Any new model of care should always be accompanied by rigorous monitoring to ensure that there are no negative consequences, especially any that impact upon patient safety. In 2013, 'THERMoSTAT' (Two- Hour Evaluation and Referral Model for Shorter Turnaround Times), an emergency department model of care developed by Royal Brisbane and Women's Hospital staff was launched to gain efficiencies and improve hospital National Emergency Access Target (NEAT) compliance. The aim of this study was to trial the use of medical emergency call data as a novel marker of the quality of care delivered by our emergency department...
November 14, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/29120913/effectiveness-of-specimen-collection-technology-in-the-reduction-of-collection-turnaround-time-and-mislabeled-specimens-in-emergency-medical-surgical-critical-care-and-maternal-child-health-departments
#11
April M Saathoff, Ryan MacDonald, Erundina Krenzischek
The objective of this study was to evaluate the impact of specimen collection technology implementation featuring computerized provider order entry, positive patient identification, bedside specimen label printing, and barcode scanning on the reduction of mislabeled specimens and collection turnaround times in the emergency, medical-surgical, critical care, and maternal child health departments at a community teaching hospital. A quantitative analysis of a nonrandomized, pre-post intervention study design evaluated the statistical significance of reduction of mislabeled specimen percentages and collection turnaround times affected by the implementation of specimen collection technology...
November 8, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/29117578/practical-issues-in-implementing-whole-genome-sequencing-in-routine-diagnostic-microbiology
#12
REVIEW
John W A Rossen, Alexander W Friedrich, Jacob Moran-Gilad
BACKGROUND: next generation sequencing (NGS) is increasingly being used in clinical microbiology. Like every new technology that is being adopted in microbiology, the integration of NGS into clinical and routine workflows needs to be carefully managed. AIM: to review the practical aspects of implementing bacterial whole genome sequencing (WGS) in routine diagnostic laboratories. SOURCES: review of the literature and expert opinion. CONTENT: in this review, we discuss when and how to integrate whole genome sequencing (WGS) in the routine workflow of the clinical laboratory...
November 5, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29111448/next-generation-sequencing-as-a-follow-up-test-in-an-expanded-newborn-screening-programme
#13
Smon Andraz, Repic Lampret Barbka, Groselj Urh, Zerjav Tansek Mojca, Kovac Jernej, Perko Dasa, Bertok Sara, Battelino Tadej, Trebusak Podkrajsek Katarina
OBJECTIVES: Contrary to many western European countries, most south-eastern European countries do not have an expanded newborn screening (NBS) program using tandem mass spectrometry. This study would represent one of the first expanded NBS studies in south-eastern Europe and will enable the estimation of the incidences of IEM in Slovenia. We proposed an expanded NBS approach including next-generation sequencing (NGS) as a confirmational analysis. DESIGN & METHODS: We conducted a pilot study of expanded NBS for selected inborn errors of metabolism (IEM) in Slovenia including 10,048 NBS cards...
October 27, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/29110862/low-pre-diagnosis-attrition-but-high-pre-treatment-attrition-among-patients-with-mdr-tb-an-operational-research-from-chennai-india
#14
Hemant Deepak Shewade, Dina Nair, Joel S Klinton, Malik Parmar, J Lavanya, Lakshmi Murali, Vivek Gupta, Jaya Prasad Tripathy, Soumya Swaminathan, Ajay M V Kumar
BACKGROUND: Worldwide, there's concern over high pre-diagnosis and pre-treatment attritions or delays in Multidrug resistant tuberculosis (MDR-TB) diagnosis and treatment pathway (DTP). We conducted this operational research among patients with presumptive MDR-TB in north and central Chennai, India to determine attrition and turnaround times (TAT) at various steps of DTP and factors associated with attrition. METHODS: Study was conducted in Revised National Tuberculosis Control Programme setting...
December 2017: Journal of Epidemiology and Global Health
https://www.readbyqxmd.com/read/29109009/rapid-optimized-flow-cytometric-crossmatch-fcxm-assays-the-halifax-and-halifaster-protocols
#15
Robert S Liwski, Anna L Greenshields, David M Conrad, Cathi Murphey, Robert A Bray, Jorge Neumann, Howard M Gebel
The flow cytometric crossmatch (FCXM) assay, which detects the presence of donor specific HLA antibodies in patient sera, is a cornerstone of HLA compatibility testing. Since relatively long FCXM assay turnaround times may contribute to transplant delays and increased graft ischemia time, we developed and validated two modified crossmatch procedures, namely the Halifax and Halifaster FCXM protocols. These protocols reduce FCXM assay time >60% and simplify their set-up without compromising quality or sensitivity...
November 3, 2017: Human Immunology
https://www.readbyqxmd.com/read/29095814/proband-only-medical-exome-sequencing-as-a-cost-effective-first-tier-genetic-diagnostic-test-for-patients-without-prior-molecular-tests-and-clinical-diagnosis-in-a-developing-country-the-china-experience
#16
Xuyun Hu, Niu Li, Yufei Xu, Guoqiang Li, Tingting Yu, Ru-En Yao, Lijun Fu, Jiwen Wang, Lei Yin, Yong Yin, Ying Wang, Xingming Jin, Xiumin Wang, Jian Wang, Yiping Shen
PurposeTo evaluate the performance of proband-only medical exome sequencing (POMES) as a cost-effective first-tier diagnostic test for pediatric patients with unselected conditions.MethodsA total of 1,323 patients were tested by POMES, which targeted 2,742 known disease-causing genes. Clinical relevant variants were Sanger-confirmed in probands and parents. We assessed the diagnostic validity and clinical utility of POMES by means of a survey questionnaire.ResultsPOMES, ordered by 136 physicians, identified 512 pathogenic or likely pathogenic variants associated with over 200 conditions...
November 2, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29076868/molecular-versus-culture-based-testing-for-gastrointestinal-infection
#17
Louissa R Macfarlane-Smith, Shadia Ahmed, Mark H Wilcox
PURPOSE OF REVIEW: Molecular-based diagnostic methods for the detection of gastrointestinal pathogens are becoming increasingly commonplace in microbiology laboratories. This review aims to summarize recent developments in this field and discuss the clinical application and limitations of implementing these techniques. RECENT FINDINGS: Recent evaluations of multiplex PCR assays show increased sensitivity whenever compared with standard microbiological culture-based methods...
October 25, 2017: Current Opinion in Gastroenterology
https://www.readbyqxmd.com/read/29061374/analytical-validation-of-a-next-generation-sequencing-assay-to-monitor-immune-responses-in-solid-tumors
#18
Jeffrey M Conroy, Sarabjot Pabla, Sean T Glenn, Blake Burgher, Mary Nesline, Antonios Papanicolau-Sengos, Jonathan Andreas, Vincent Giamo, Felicia L Lenzo, Fiona C L Hyland, Angela Omilian, Wiam Bshara, Moachun Qin, Ji He, Igor Puzanov, Marc S Ernstoff, Mark Gardner, Lorenzo Galluzzi, Carl Morrison
We have developed a next-generation sequencing assay to quantify biomarkers of the host immune response in formalin-fixed, paraffin-embedded (FFPE) tumor specimens. This assay aims to provide clinicians with a comprehensive characterization of the immunologic tumor microenvironment as a guide for therapeutic decisions on patients with solid tumors. The assay relies on RNA-sequencing (seq) to semiquantitatively measure the levels of 43 transcripts related to anticancer immune responses and 11 transcripts that reflect the relative abundance of tumor-infiltrating lymphocytes, as well as on DNA-seq to estimate mutational burden...
October 20, 2017: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/29046268/multisite-semiautomated-clinical-data-repository-for-duplication-15q-syndrome-study-protocol-and-early-uses
#19
Oluwaseun Jessica Ajayi, Ebony Jeannae Smith, Teeradache Viangteeravat, Eunice Y Huang, Naga Satya V Rao Nagisetty, Nora Urraca, Laina Lusk, Brenda Finucane, Dimitrios Arkilo, Jennifer Young, Shafali Jeste, Ronald Thibert, Lawrence T Reiter
BACKGROUND: Chromosome 15q11.2-q13.1 duplication syndrome (Dup15q syndrome) is a rare disorder caused by duplications of chromosome 15q11.2-q13.1, resulting in a wide range of developmental disabilities in affected individuals. The Dup15q Alliance is an organization that provides family support and promotes research to improve the quality of life of patients living with Dup15q syndrome. Because of the low prevalence of this condition, the establishment of a single research repository would have been difficult and more time consuming without collaboration across multiple institutions...
October 18, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29043982/preanalytical-influence-of-pneumatic-tube-delivery-system-on-results-of-routine-biochemistry-and-haematology-analysis
#20
Morgane Petit, Louis Mine, Tiffany Pascreau, Chantal Brouzes, Sandrine Majoux, Delphine Borgel, Jean-Louis Beaudeux, Dominique Lasne, Carole Hennequin
Pneumatic tube delivery system (PTS) enables to reduce considerably turnaround times. The aim of the study was to assess the influence of the PTS on the quality of routine biochemical and hematological tests in our laboratory. Blood samples from 6 hospitalized patients and 8 healthy volunteers were analyzed. Blood samples were delivered to the laboratory by a PTS and by a human courier. We performed the following analysis: ionized calcium, sodium, potassium, lactate deshydrogenase (LDH), aspartate aminotransferase (ASAT), arterial blood gas, complete blood count and coagulation test as prothrombin time, activated partial thromboplastin time, factors V and VIII...
October 18, 2017: Annales de Biologie Clinique
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