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Management medical laboratories

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https://www.readbyqxmd.com/read/28226335/repeated-quantitative-urine-toxicology-analysis-may-improve-chronic-pain-patient-compliance-with-opioid-therapy
#1
Nebojsa Nick Knezevic, Omar M Khan, Afsaneh Beiranvand, Kenneth D Candido
BACKGROUND: Even though serious efforts have been undertaken by different medical societies to reduce opioid use for treating chronic benign pain, many Americans continue to seek pain relief through opioid consumption. Assuring compliance of these patients may be a difficult aspect of proper management even with regular behavioral monitoring. OBJECTIVE: The purpose of this study was to accurately assess the compliance of chronic opioid-consuming patients in an outpatient setting and evaluate if utilizing repeated urine drug testing (UDT) could improve compliance...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225374/characterizing-the-toxicity-and-dose-effect-profile-of-tramadol-ingestions-in-children
#2
Gina L Stassinos, Lawrence Gonzales, Wendy Klein-Schwartz
OBJECTIVES: Tramadol can cause life-threatening toxicity in overdose; however, data on its toxicity in children are lacking. This study investigates toxicity associated with tramadol ingestions in children. The hypothesis is that children will experience dose-related central nervous system and respiratory depression and seizures. METHODS: A retrospective evaluation of cases from the National Poison Center Data System between January 1, 2000, and December 31, 2013, was performed...
February 21, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28224767/effect-of-accreditation-on-accuracy-of-diagnostic-tests-in-medical-laboratories
#3
Mi Ae Jang, Young Ahn Yoon, Junghan Song, Jeong Ho Kim, Won Ki Min, Ji Sung Lee, Yong Wha Lee, You Kyoung Lee
BACKGROUND: Medical laboratories play a central role in health care. Many laboratories are taking a more focused and stringent approach to quality system management. In Korea, laboratory standardization efforts undertaken by the Korean Laboratory Accreditation Program (KLAP) and the Korean External Quality Assessment Scheme (KEQAS) may have facilitated an improvement in laboratory performance, but there are no fundamental studies demonstrating that laboratory standardization is effective...
May 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28221274/pharmacy-use-in-the-first-year-of-the-veterans-choice-program-a-mixed-methods-evaluation
#4
Walid F Gellad, Francesca E Cunningham, Chester B Good, Joshua M Thorpe, Carolyn T Thorpe, Brandi Bair, KatieLynn Roman, Susan L Zickmund
BACKGROUND: The Veterans Choice Program (VCP) was created to ensure timely access to health care in the Department of Veterans Affairs (VA). Under this program, medications may be ordered by select non-VA clinicians to be dispensed by VA pharmacies, creating new challenges in ensuring medication safety. OBJECTIVES: To examine pharmaceutical use during the first year of the VCP and to understand barriers and facilitators for VA pharmacists to dispensing medications under the VCP...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28220025/management-of-cancer-in-the-older-age-person-an-approach-to-complex-medical-decisions
#5
Maria Vallet-Regí, Miguel Manzano, Leocadio Rodriguez-Mañas, Marta Checa López, Matti Aapro, Lodovico Balducci
The management of cancer in older aged people is becoming a common problem due to the aging of the population. There are many variables determining the complex situation that are interconnected. Some of them can be assessed, such as risk of mortality and risk of treatment complications, but many others are still unknown, such as the course of disease, the host-related factors that influence cancer aggressiveness, and the phenotype heralding risk of permanent treatment-related damage.This article presents a dynamic and personalized approach to older people with cancer based on our experience on aging, cancer, and their biological interactions...
February 20, 2017: Oncologist
https://www.readbyqxmd.com/read/28216180/utility-of-16s-rrna-pcr-performed-on-clinical-specimens-in-patient-management
#6
A Akram, M Maley, I Gosbell, T Nguyen, R Chavada
BACKGROUND: Broad range PCR 16S rRNA can be used for detection and identification of bacteria from clinical specimens in patients with high suspicion of infection and negative cultures. Aim of this study was 1) to compare 16S rRNA PCR (16S) results with microbiological cultures 2) to assess utility of 16S on antimicrobial therapy 3) to compare the yield of 16S on different type of clinical specimen and cost analysis of test. METHODS: A retrospective study was done on different clinical specimens which had 16S performed over 3 years (2012-2015)...
February 16, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28215830/initial-urological-evaluation-and-management-of-children-with-neurogenic-bladder-due-to-myelomeningocele
#7
Cristian Sager, Carol Burek, Juan Pablo Corbetta, Santiago Weller, Javier Ruiz, Ramiro Perea, Enrique Lago, Yesica Gomez, Victor Durán, Juan Carlos López
INTRODUCTION: The proactive management of children with myelomeningocele (MMC) has contributed to decreasing their progression to end-stage renal disease, thanks to early urological evaluation and timing implementation of treatments. OBJECTIVE: To demonstrate that early urological evaluation of the urinary tract in MMC shows functional alterations in most cases, and that it requires medical intervention, even when in some cases the complementary imaging studies do not show any abnormalities...
January 30, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28215027/economic-burden-of-patients-affected-by-non-small-cell-lung-cancer-nsclc-the-life-study
#8
Maria Rita Migliorino, Antonio Santo, Giampiero Romano, Diego Cortinovis, Domenico Galetta, Oscar Alabiso, Giacomo Cartenì, Sabrina Vari, Gianpiero Fasola, Antonio Pazzola, Dario Giuffrida, Alberto Zaniboni, Alberto Caprioli, Flavia Longo, Valentina Acciai, Filippo de Marinis
PURPOSE: Non-small cell lung cancer (NSCLC) is a condition with significant clinical burden for patients and relevant economic impact. Limited evidence exists on the management costs of NSCLC patients, especially in the late phases of the disease. The main objective of this analysis was to evaluate the economic impact of clinical management of NSCLC patients in the Italian population. METHODS: This evaluation was an economic analysis of the observational and multicentre study LIFE, which described the therapeutic approach in routine clinical practice for NSCLC patients, progressing after first-line treatment...
February 18, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28210634/potential-of-a-pharmacogenetic-guided-algorithm-to-predict-optimal-warfarin-dosing-in-a-high-risk-hispanic-patient-role-of-a-novel-nqo1-2-polymorphism
#9
Dagmar F Hernandez-Suarez, Karla Claudio-Campos, Javier E Mirabal-Arroyo, Bianca A Torres-Hernández, Angel López-Candales, Kyle Melin, Jorge Duconge
Deep abdominal vein thrombosis is extremely rare among thrombotic events secondary to the use of contraceptives. A case to illustrate the clinical utility of ethno-specific pharmacogenetic testing in warfarin management of a Hispanic patient is reported. A 37-year-old Hispanic Puerto Rican, non-gravid female with past medical history of abnormal uterine bleeding on hormonal contraceptive therapy was evaluated for abdominal pain. Physical exam was remarkable for unspecific diffuse abdominal tenderness, and general initial laboratory results-including coagulation parameters-were unremarkable...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28205271/lean-six-sigma-methodologies-improve-clinical-laboratory-efficiency-and-reduce-turnaround-times
#10
Tamer C Inal, Ozlem Goruroglu Ozturk, Filiz Kibar, Salih Cetiner, Selcuk Matyar, Gulcin Daglioglu, Akgun Yaman
BACKGROUND: Organizing work flow is a major task of laboratory management. Recently, clinical laboratories have started to adopt methodologies such as Lean Six Sigma and some successful implementations have been reported. This study used Lean Six Sigma to simplify the laboratory work process and decrease the turnaround time by eliminating non-value-adding steps. METHODS: The five-stage Six Sigma system known as define, measure, analyze, improve, and control (DMAIC) is used to identify and solve problems...
February 15, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28203573/multiple-brain-abscesses-in-an-immunocompetent-patient-with-factor-v-leiden-mutation
#11
Saeed Zubair Zafar, Najwa Pervin, Sukesh Manthri, Mukul Bhattarai
Multiple brain abscesses in an immunocompetent patient is a challenging clinical problem in the medical world despite advances in imaging techniques, laboratory diagnostics, surgical interventions, and antimicrobial treatment. It is a clinical entity that typically tends to occur in the presence of known predisposing factors. Clinicians seek to determine the potential risk factors responsible for the development of brain abscess because it is very crucial for management of this life-threatening condition. At times, like in our case, there are clinical situations where it is difficult to reveal any traditional risk factors...
October 2016: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28203278/efficacy-of-granulocyte-and-monocyte-apheresis-for-antibiotic-refractory-pouchitis-after-proctocolectomy-for-ulcerative-colitis-an-open-label-prospective-multicentre-study
#12
Takayuki Yamamoto, Toshiaki Tanaka, Tadashi Yokoyama, Takahiro Shimoyama, Hiroki Ikeuchi, Motoi Uchino, Toshiaki Watanabe
BACKGROUND: Granulocyte and monocyte apheresis (GMA) has shown therapeutic efficacy in active ulcerative colitis (UC). We thought that in patients with pouchitis after proctocolectomy for UC, GMA might produce immunological effects in the intestinal mucosa, and improve clinical symptoms. This prospective study was to evaluate the efficacy of GMA for antibiotic-refractory pouchitis after proctocolectomy for UC. METHODS: A total of 13 patients with pouchitis disease activity index (PDAI) > 7 unresponsive to 2 weeks of antibiotic therapy were included...
February 2017: Therapeutic Advances in Gastroenterology
https://www.readbyqxmd.com/read/28199935/surgical-management-of-a-giant-parathyroid-adenoma-through-minimal-invasive-parathyroidectomy-a-case-report
#13
Georgios Sahsamanis, Konstantinos Gkouzis, Stavros Samaras, Dionysios Pinialidis, Georgios Dimitrakopoulos
INTRODUCTION: Primary hyperparathyroidism is a common endocrine disorder mostly associated to parathyroid adenomas. Although those tend to be small in size, rare cases of giant parathyroid adenomas may be present. CASE PRESENTATION: A 42year old female was admitted in our department due to weakness and vague abdominal pain for the past 8 months. Preoperative laboratory exams indicated primary hyperparathyroidism as a cause to her symptomatology, with elevated values of parathormone and normal values of serum calcium...
January 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28199934/mixed-corticomedullary-adrenal-carcinoma-case-report-comparison-in-features-treatment-and-prognosis-with-the-other-two-reported-cases
#14
Mhd Belal Alsabek, Riad Alhmaidi, Bader Ghazzawi, Ghiath Hamed, Alhadi Alseoudi
INTRODUCTION: Adrenal corticomedullary adenoma was reviewed in many cases in PubMed Library, While the coincidence corticomedullary adrenal carcinoma in the same gland was just described in two cases in the medical literature. Our case is the third to be reported and was treated with surgery and adjuvant chemotherapy and followed for two years. PRESENTATION OF CASE: A 50-year-old man suffered from a mass effect in the left abdominal side. While the laboratory showed a mild elevation in the levels of both serum cortisol and 24h urine cortisol, radiological images were highly suggested an adrenal malignant tumor without metastasis...
January 31, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28197879/impact-of-xpert-mrsa-sa-blood-culture-pcr-assay-on-management-of-positive-blood-cultures-in-obstetric-patients-a-retrospective-audit
#15
A Page, S O'Rourke, M Brennan, L Clooney, D Le Blanc, J Griffin, M Eogan, R J Drew
BACKGROUND: The Xpert MRSA/SA blood culture assay (Cepheid, USA) is a rapid PCR test which can be used for positive blood cultures where Gram-positive cocci in clusters are seen. It can detect Staphylococcus aureus and also the mecA gene, which encodes for β-lactam resistance. The assay was introduced into the Rotunda Hospital for positive blood cultures to allow earlier detection of MRSA and methicillin susceptible S. aureus. AIM: To assess the impact of the Xpert MRSA/SA blood culture assay on the management of obstetric patients with a positive blood culture where Gram-positive cocci in clusters were seen...
February 14, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28190508/navigating-the-clinical-trial-pathway-conception-design-execution-and-results-dissemination
#16
John S Sampalis, Joanne Watson, Stella Boukas, Marianna Boukas, Natalie Harvey, Sanjay Machado, Michel Bordeleau, Emmanouil Rampakakis
Dr Sampalis is founder, Chief Executive Officer, and Chief Scientific Officer of JSS Medical Research Inc, founded in 1997. He is a tenured professor of Surgery and Epidemiology & Biostatistics of McGill University, the University of Montreal and University of Laval. Recognized as a leading clinical epidemiologist and one of the top trauma researchers in Canada, he possesses extensive expertise in health services research, clinical trials, and offers services as a Research and Epidemiological Consultant for numerous pharmaceutical companies, hospitals and government organizations and agencies...
March 2017: Surgery
https://www.readbyqxmd.com/read/28187795/management-of-the-comatose-patient
#17
E F M Wijdicks
Coma has many causes but there are a few urgent ones in clinical practice. Management must start with establishing the cause and an attempt to reverse or attenuate some of the damage. This may include early neurosurgical intervention, efforts to reduce brain tissue shift and raised intracranial pressure, correction of markedly abnormal laboratory abnormalities, and administration of available antidotes. Supporting the patient's vital signs, susceptible to major fluctuations in a changing situation, remains the most crucial aspect of management...
2017: Handbook of Clinical Neurology
https://www.readbyqxmd.com/read/28186393/chronic-fatigue-in-ehlers-danlos-syndrome-hypermobile-type
#18
Alan Hakim, Inge De Wandele, Chris O'Callaghan, Alan Pocinki, Peter Rowe
Chronic fatigue is an important contributor to impaired health-related quality of life in Ehlers-Danlos syndrome. There is overlap in the symptoms and findings of EDS and chronic fatigue syndrome. A proportion of those with CFS likely have EDS that has not been identified. The evaluation of chronic fatigue in EDS needs to include a careful clinical examination and laboratory testing to exclude common causes of fatigue including anemia, hypothyroidisim, and chronic infection, as well as dysfunction of major physiological or organ systems...
February 10, 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
https://www.readbyqxmd.com/read/28185442/the-role-of-ancillary-tests-in-the-evaluation-and-management-of-patients-with-negative-and-non-diagnostic-pancreatic-cyst-aspirates
#19
Suzanne M Selvaggi
BACKGROUND: Fine needle aspiration of pancreatic cystic lesions has its limitations as the cytology is often paucicellular to acellular. This study reports on the value of ancillary tests, amylase and carcinoembryonic, in the evaluation and management of patients with negative and non-diagnostic pancreatic cysts. METHODS: From January 1, 2010 through December 31, 2015, the Cytopathology Laboratory processed 119 pancreatic cyst aspirates of which 51(43%) were negative and 52(44%) were non-diagnostic and form the basis of this study...
February 10, 2017: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/28181666/a-partnership-model-to-improve-population-health-screening-for-noncommunicable-conditions-and-their-common-risk-factors-qazvin-islamic-republic-of-iran
#20
S Alikhani, B Damari
Early findings and management of health conditions are among the key functions of health care systems. We developed a partnership framework to establish an extended primary health care-based selective screening service for the entire population of a small town as a key project of Qazvin Health Plan, Qazvin, Islamic Republic of Iran. Eight scientific associations and a diverse technical taskforce extensively reviewed evidence to adapt the grade A and B preventive recommendations of the American Preventive Service Taskforce...
February 1, 2017: Eastern Mediterranean Health Journal, la Revue de Santé de la Méditerranée Orientale
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