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Management medical laboratories

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https://www.readbyqxmd.com/read/28448782/amcp-partnership-forum-driving-value-and-outcomes-in-oncology
#1
(no author information available yet)
Innovation in cancer treatment has provided a wealth of recently available therapeutic agents and a healthy drug pipeline that promises to change the way we approach this disease and the lives of those affected in the years to come. However, the majority of these new agents, many of which are targeted to specific genomic features of various tumors, may challenge the health care system's ability to afford cancer care. This innovation drives the need to focus on the value of the treatments provided to patients with cancer and on methods to optimize the efficiency of the dollars we spend, in addition to the clinical value itself...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28447899/the-american-college-of-surgeons-minimum-standards-for-hospitals-and-the-provision-of-high-quality-laboratory-services
#2
James R Wright
CONTEXT: - The first major project of the American College of Surgeons (Chicago, Illinois), founded in 1913, was implementing Minimum Standards for Hospitals. The 1918 standard (1) established medical staff organizations in hospitals; (2) restricted membership to licensed practitioners in good standing; (3) mandated that the medical staff work with hospital administration to develop and adopt regulations and policies governing their professional work; (4) required standardized, accessible medical records; and (5) required availability of diagnostic and therapeutic facilities...
May 2017: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/28447413/laboratory-measurement-of-the-direct-oral-anticoagulants-indications-and-impact-on-management-in-clinical-practice
#3
REVIEW
C Wright, R Brown, A Cuker
Although the direct oral anticoagulants (DOACs) do not require routine laboratory monitoring, there may be special situations in which measurement of drug levels is desirable. There is a paucity of information on how measurement of DOAC levels is used in clinical practice. We conducted a retrospective cohort study of dabigatran, rivaroxaban, and apixaban levels measured at our institution. Of 9793 patients with an active prescription for dabigatran, rivaroxaban, or apixaban in the electronic medical record during the 2...
May 2017: International Journal of Laboratory Hematology
https://www.readbyqxmd.com/read/28447134/-poisonings-in-germany-poisons-centres-medical-management-and-national-monitoring
#4
REVIEW
Herbert Desel, Helmut Hentschel, Andreas Stürer
BACKGROUND: Illnesses caused by exposure to extracorporeal artificial substances play a major role in emergency medicine, family medicine, and environmental medicine. OBJECTIVE: The current situation of medical poisoning management and national reporting of poisonings in Germany are described. MATERIALS UND METHODS: The information and data presented here are derived from a literature review and from stakeholder interviews. RESULTS AND CONCLUSION: Eight poison centres (PCs) offer consultation supporting the diagnosis and treatment of poisoning cases in Germany today...
April 26, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28446515/role-of-biomarkers-for-the-prevention-assessment-and-management-of-heart-failure-a-scientific-statement-from-the-american-heart-association
#5
REVIEW
Sheryl L Chow, Alan S Maisel, Inder Anand, Biykem Bozkurt, Rudolf A de Boer, G Michael Felker, Gregg C Fonarow, Barry Greenberg, James L Januzzi, Michael S Kiernan, Peter P Liu, Thomas J Wang, Clyde W Yancy, Michael R Zile
BACKGROUND AND PURPOSE: Natriuretic peptides have led the way as a diagnostic and prognostic tool for the diagnosis and management of heart failure (HF). More recent evidence suggests that natriuretic peptides along with the next generation of biomarkers may provide added value to medical management, which could potentially lower risk of mortality and readmissions. The purpose of this scientific statement is to summarize the existing literature and to provide guidance for the utility of currently available biomarkers...
April 26, 2017: Circulation
https://www.readbyqxmd.com/read/28446446/the-cardiovascular-health-in-ambulatory-care-research-team-performance-indicators-for-the-primary-prevention-of-cardiovascular-disease-a-modified-delphi-panel-study
#6
Jack V Tu, Laura C Maclagan, Dennis T Ko, Clare L Atzema, Gillian L Booth, Sharon Johnston, Karen Tu, Douglas S Lee, Arlene Bierman, Ruth Hall, R Sacha Bhatia, Andrea S Gershon, Sheldon W Tobe, Claudia Sanmartin, Peter Liu, Anna Chu
BACKGROUND: High-quality ambulatory care can reduce cardiovascular disease risk, but important gaps exist in the provision of cardiovascular preventive care. We sought to develop a set of key performance indicators that can be used to measure and improve cardiovascular care in the primary care setting. METHODS: As part of the Cardiovascular Health in Ambulatory Care Research Team initiative, we established a 14-member multidisciplinary expert panel to develop a set of indicators for measuring primary prevention performance in ambulatory cardiovascular care...
April 25, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28443263/a-1-month-old-infant-with-chylomicronemia-due-to-gpihbp1-gene-mutation-treated-by-plasmapheresis
#7
Mo Kyung Jung, Juhyun Jin, Hyun Ok Kim, Ahreum Kwon, Hyun Wook Chae, Seok Jin Kang, Duk Hee Kim, Ho-Seong Kim
Chylomicronemia is a severe type of hypertriglyceridemia characterized by chylomicron accumulation that arises from a genetic defect in intravascular lipolysis. It requires urgent and proper management, because serious cases can be accompanied by pancreatic necrosis or persistent multiple organ failure. We present the case of a 1-month-old infant with chylomicronemia treated by plasmapheresis. His chylomicronemia was discovered incidentally when lactescent plasma was noticed during routine blood sampling during a hospital admission for fever and irritability...
March 2017: Annals of Pediatric Endocrinology & Metabolism
https://www.readbyqxmd.com/read/28443139/maximal-testosterone-suppression-in-the-management-of-recurrent-and-metastatic-prostate-cancer
#8
REVIEW
Laurence Klotz, Rodney H Breau, Loretta L Collins, Martin E Gleave, Tom Pickles, Frederic Pouliot, Fred Saad
INTRODUCTION: Testosterone suppression, or androgen-deprivation therapy (ADT), is an established treatment for recurrent and metastatic prostate cancer (PCa). Based on the accuracy and sensitivity of early assays (c. 1960-1970), the castrate testosterone level was set at ≤1.7 nmol/l. Improved sensitivity of testosterone assays shows that both surgical and medical castration can achieve levels <0.7 nmol/l. However, the clinical implications and importance of maximum testosterone suppression remains a subject of controversy...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28439613/the-role-of-delayed-head-ct-in-evaluation-of-elderly-blunt-head-trauma-victims-taking-antithrombotic-therapy
#9
D Scantling, C Fischer, R Gruner, A Teichman, B McCracken, J Eakins
INTRODUCTION: Increasing active longevity has created an increasing surge of elderly trauma patients. The majority of these patients suffer blunt trauma and many are taking antithrombotic agents. The literature is mixed regarding the utility of routine repeat head CT in patients taking antithrombotic medications with a GCS of 15 and initial negative head CT. We hypothesized that scheduled delayed CT head 12 h after admission (D-CTH) in elderly blunt trauma victims would not identify clinically significant new hemorrhages or change management...
April 24, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28435477/acrodermatitis-enteropathica-in-a-pair-of-twins
#10
Abdullatif Al Rashed, Mohja Al Shehri, Feroze Kaliyadan
BACKGROUND: Acrodermatitis enteropathica (AE) is a rare autosomal recessive metabolic disorder. First described by Brandt in 1936 and was named by Danbolt. A mutation in the SLC39A4 gene on chromosome 8 q24.3 is responsible for this disorder, which encodes zinc transporter Zip4. The diagnosis is made by the clinical presentation and histopathology and laboratory tests. In this case, we reported a twin presented with a typical rash and low zinc level. To our knowledge, very few cases reported as a twin with typical acrodermatitis enteropathica presentation...
December 31, 2016: Journal of Dermatological Case Reports
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#11
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28429198/managing-the-perioperative-patient-on-direct-oral-anticoagulants
#12
Jordan Leitch, Janet van Vlymen
PURPOSE: Patients are increasingly treated with direct oral anticoagulants (DOACs) for the prevention of stroke due to non-valvular atrial fibrillation and for the treatment of venous thromboembolism. When these patients present for urgent or emergent surgical procedures, they present a challenge to the anesthesiologist who must manage perioperative risk due to anticoagulation. The purpose of this module is to review the literature surrounding the perioperative management of DOACs. Timing, laboratory monitoring, and availability of reversal agents are important considerations to optimize patients being treated with DOACs who require emergent surgery...
April 20, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28427801/-multimodality-imaging-in-the-cardiac-catheterization-laboratory
#13
Karine Warin-Fresse, Sébastien Hascoet, Patrice Guérin
Cardiac catheterization has greatly contributed to the progress made in the management of congenital heart diseases (CHD). Initially used in diagnosis, it allowed the understanding of heart diseases, their anatomy and hemodynamics. Gradually, the development of interventional cardiology has played a major role in the management of these malformations (Patent ductus arteriosus [PDA] and atrial septal defect [ASD] closure, pulmonary dilatation, percutaneous pulmonary valve implantation…). The development of such technology was made possible through the concomitant development of imaging techniques: fluoroscopy, ultrasound, MRI and CT...
April 17, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28424823/-coma-in-the-emergency-room
#14
M Braun, C J Ploner, T Lindner, M Möckel, W U Schmidt
Coma of unknown origin (CUO) is a frequent unspecific emergency symptom associated with a high mortality. A fast diagnostic work-up is essential given the wide spectrum of underlying diagnoses that are made up of approximately 50% primary central nervous system (CNS) pathologies and approximately 50% extracerebral, almost exclusively internal medical causes. Despite the high mortality associated with this symptom, there are currently no generally accepted management guidelines for adult patients presenting with CUO...
April 19, 2017: Der Nervenarzt
https://www.readbyqxmd.com/read/28422588/alterations-in-redox-homeostasis-during-recovery-from-unexplained-underperformance-syndrome-in-an-elite-international-rower
#15
Nathan A Lewis, Ann Redgrave, Mark Homer, Richard Burden, Wendy Martinson, Brian Moore, Charles R Pedlar
PURPOSE: This case study of an international rower examines a diagnosis of Unexplained Under Performance Syndrome (UUPS or Overtraining Syndrome) describing a full recovery and return to elite competition the same year. METHODS: On diagnosis and 4 and 14 months post-diagnosis, detailed assessments including physiological, nutritional, and biomarkers were made. RESULTS: Clinical examination and laboratory results for haematology, biochemistry, thyroid function, immunology, vitamins and minerals were unremarkable and did not explain the presentation and diagnosis...
April 19, 2017: International Journal of Sports Physiology and Performance
https://www.readbyqxmd.com/read/28419427/how-i-manage-children-with-neutropenia
#16
REVIEW
David C Dale
Neutropenia, usually defined as a blood neutrophil count <1·5 × 10(9) /l, is a common medical problem for children and adults. There are many causes for neutropenia, and at each stage in life the clinical pattern of causes and consequences differs significantly. I recommend utilizing the age of the child and clinical observations for the preliminary diagnosis and primary management. In premature infants, neutropenia is quite common and contributes to the risk of sepsis with necrotizing enterocolitis...
April 17, 2017: British Journal of Haematology
https://www.readbyqxmd.com/read/28417347/-serological-markers-of-viral-hepatitis-b-and-c-in-children-with-sickle-cell-disease-monitored-in-the-pediatrics-department-at-the-university-hospital-of-bobo-dioulasso-burkina-faso
#17
S A Kissou, M Koura, A Sawadogo, A-S Ouédraogo, H Traoré, E Kamboulé, W W F Zogona, B Nacro
Viral hepatitis B and C are universal public health problems. Burkina Faso is a high endemic area for hepatitis B. Patients with sickle cell disease are at risk. The aim of this study was to investigate and quantify the serological markers of viral hepatitis B and C among pediatric patients with sickle cell disease. This was a descriptive cross-sectional study, which took place from July to November 2014 at the Department of Pediatrics, University Hospital of Bobo- Dioulasso. The study included 44 SS and 26 SC sickle cell patients...
April 17, 2017: Bulletin de la Société de Pathologie Exotique
https://www.readbyqxmd.com/read/28415034/validation-of-a-new-mortality-risk-prediction-model-for-people-65-years-and-older-in-northwest-russia-the-crystal-risk-score
#18
Anna Turusheva, Elena Frolova, Vaes Bert, Eralda Hegendoerfer, Jean-Marie Degryse
BACKGROUND: Prediction models help to make decisions about further management in clinical practice. This study aims to develop a mortality risk score based on previously identified risk predictors and to perform internal and external validations. METHODS: In a population-based prospective cohort study of 611 community-dwelling individuals aged 65+ in St. Petersburg (Russia), all-cause mortality risks over 2.5 years follow-up were determined based on the results obtained from anthropometry, medical history, physical performance tests, spirometry and laboratory tests...
March 29, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28414671/three-s-a-crowd-an-extremely-rare-case-of-cor-triatriatum-dexter
#19
A Elagizi, R Marvin, G O'Bryan, V Vyas, L Arcement
INTRODUCTION: Cor triatriatum is a congenital cardiac anomaly in which the left (sinister) or right (dexter) atrium is divided into two compartments by residual embryonic tissue, resulting in a tri-atrial heart. As cor triatriatum dextrum can present clinically in various ways and have multiple associated cardiac anomalies, this report attempts to contribute to what is known about this exceedingly rare disorder. CASE: A 40 year old Hispanic man with a medical history of gastritis presented with complaints of palpitations, dizziness and bilateral lower extremity edema...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28412661/reliable-clinical-serum-analysis-with-reusable-electrochemical-sensor-toward-point-of-care-measurement-of-the-antipsychotic-medication-clozapine
#20
Mijeong Kang, Eunkyoung Kim, Thomas E Winkler, George Banis, Yi Liu, Christopher A Kitchen, Deanna L Kelly, Reza Ghodssi, Gregory F Payne
Clozapine is one of the most promising medications for managing schizophrenia but it is under-utilized because of the challenges of maintaining serum levels in a safe therapeutic range (1-3μM). Timely measurement of serum clozapine levels has been identified as a barrier to the broader use of clozapine, which is however challenging due to the complexity of serum samples. We demonstrate a robust and reusable electrochemical sensor with graphene-chitosan composite for rapidly measuring serum levels of clozapine...
April 12, 2017: Biosensors & Bioelectronics
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