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Management medical laboratories

Mahdieh Arian, Azadeh Kamali, Mahbubeh Tabatabaeichehr, Parisa Arashnia
INTRODUCTION: Septic cavernous sinus thrombosis (CST) is a rare condition that can result in high mortality and morbidity rates if not treated immediately. CST may be aseptic or septic. Less common primary sites of infection include the tonsils, soft palate, middle ear, and orbit. Reported cases of middle ear infection are very rare, and response to treatment is poor. CASE PRESENTATION: The present study is a case report of acute otitis media which led to septic cavernous sinus thrombosis in a 56-year-old woman in Bojnord city, North Khorasan, Iran...
August 2016: Iranian Red Crescent Medical Journal
Tyler J Loftus, Kristina L Go, Steven J Hughes, Chasen A Croft, R Stephen Smith, Philip A Efron, Frederick A Moore, Scott C Brakenridge, Alicia M Mohr, Janeen R Jordan
BACKGROUND: Effective multidisciplinary management of gastrointestinal bleeding (GIB) requires effective communication. We instituted a protocol to standardize communication practices with the hypothesis that outcomes would improve following protocol initiation. METHODS: We performed a retrospective cohort analysis of 442 patients who required procedural management of acute GIB at our institution during a 50 month period spanning 25 months before and 25 months after implementation of a multidisciplinary communication protocol...
October 25, 2016: Journal of Trauma and Acute Care Surgery
Sonia Merino, Nekane Ibarluzea, Hiart Maortua, Begoña Prieto, Idoia Rouco, Maria-Asunción López-Aríztegui, Maria-Isabel Tejada
Fragile X-associated tremor/ataxia syndrome (FXTAS) and fragile X-associated primary ovarian insufficiency (FXPOI) are definitely related to the fragile X mental retardation 1 (FMR1) premutation (PM). Additional medical problems have also been associated with the PM, such as fibromyalgia, endocrine, and psychiatric disorders. To improve our understanding in the field, we reviewed all PM carriers and their reasons for any medical referrals from 104 fragile X families molecularly diagnosed in our laboratory and living in the Spanish Basque Country...
October 21, 2016: Genes
Travis E Wright, K Keely Boyle, Thomas R Duquin, John K Crane
BACKGROUND: Many studies have noted an increase in the number of recognized cases of invasive infections due to Propionibacterium acnes, especially after shoulder replacement surgery. The increase in the number of recognized cases of P. acnes, a nonspore-forming, anaerobic, Gram-positive organism, appears due to both an increase in the number of shoulder operations being performed and more specimens being sent for anaerobic cultures. Nevertheless, the optimal surgical and antibiotic management of P...
2016: Infectious Diseases
D Guenat, D Riethmuller, R Ramanah, A Morel, F Aubin, C Mougin, J-L Prétet
Prescription of an HPV test in practice will enable the clinician to optimize the monitoring and the management of patients, especially in the context of cervical cancer screening. Numerous HPV tests are available that present different analytical and clinical sensitivity and specificity. International recommendations on clinical performance of HPV tests used for cervical cancer screening have been published by a group of experts, and tests that meet these performance criteria should be used. Apart from the HPV detection kit, the whole circuit from sampling to report of the results must be considered...
October 19, 2016: Journal de Gynécologie, Obstétrique et Biologie de la Reproduction
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
October 14, 2016: Permanente Journal
Arun Agarwal, Aakanksha Agarwal
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes...
October 2016: Journal of the Association of Physicians of India
Theodore Pincus
An MDHAQ/RAPID3 (multidimensional health assessment questionnaire/routine assessment of patient index data) was developed from the HAQ over 25 years, based on observations made from completion by every patient (with all diagnoses) at every routine rheumatology visit since 1980. Modification of the HAQ was viewed as similar to improving a laboratory test, with a primary focus on clinical value for diagnosis, prognosis, and/or management, as well as feasibility for minimal effect on clinical workflow. Rigorous attention, was also directed to validity, reliability, other methodologic and technological considerations, but after clinical value and feasibility were established...
September 2016: Clinical and Experimental Rheumatology
Ayse Ruveyda Ugur, Hatice Turk Dagi, Bahadir Ozturk, Gulsum Tekin, Duygu Findik
BACKGROUND: Methicillin resistance is a serious health concern since it has spread among Staphylococcus aureus and coagulase-negative Staphylococci (CoNS) that are frequent community and nosocomial pathogens worldwide. Methicillin-resistant strains are often resistant to other classes of antibiotics, making their treatment difficult. Nigella sativa oil is known to be active against Gram-positive cocci, yet its in vitro cytotoxicity is rarely investigated, is a proper and powerful candidate for treatment of methicillin-resistant isolates...
July 2016: Pharmacognosy Magazine
Louise Dunphy, Prashanth Shetty, Rabinder Randhawa, Kharil Amir Rani, Yaw Duodu
A 39-year-old man, born in India but resident in the UK for 10 years, was travelling in America when he became feverish with an altered mentation. He reported a 10-day history of fever, photophobia, headache and fatigue. His medical history included hypothyroidism and migraine. He was a non-smoker, did not consume alcohol and denied a history of drug use. He was transferred to the emergency department. Laboratory investigations confirmed hyponatraemia (sodium 128 mmol/L). A chest radiograph confirmed no focal consolidation...
October 7, 2016: BMJ Case Reports
Jeremy D Brown, Scott Chapman, Patricia E Ferguson
OBJECTIVE: The objective of the present study is to determine whether a predictive rule could safely reduce the number of negative blood cultures collected in an Australian ED and to assess the clinical impact of positive results from blood cultures taken in the ED. METHODS: All positive blood cultures taken in the ED at a single facility were retrospectively identified for the calendar year 2012. Clinically significant bacteraemia episodes were assessed against a predictive rule using major and minor clinical and laboratory criteria gathered from medical records and pathology databases, and compared with a randomly generated sample of ED patient episode with negative blood cultures...
October 18, 2016: Emergency Medicine Australasia: EMA
Mojtaba Farjam, Hossein Bahrami, Ehsan Bahramali, Javad Jamshidi, Alireza Askari, Habibollah Zakeri, Reza Homayounfar, Hossein Poustchi, Reza Malekzadeh
BACKGROUND: Non-communicable diseases (NCDs) have become the main causes of morbidity and mortality even in rural areas of many developing countries, including Iran. In view of this increased risk, Fasa Cohort Study (FACS) has been established to assess the risk factors for NCDs with the ultimate goal of providing optimal risk calculators for Iranian population and finding grounds for interventions at the population level. METHODS: In a population-based cohort, at least 10,000 people within the age range of 35 to 70 years old from Sheshdeh, the suburb of Fasa city and its 24 satellite villages are being recruited...
October 18, 2016: BMC Public Health
John Howard, Vladimir Murashov, Paul Schulte
Synthetic biology is an emerging interdisciplinary field of biotechnology that involves applying the principles of engineering and chemical design to biological systems. Biosafety professionals have done an excellent job in addressing research laboratory safety as synthetic biology and gene editing have emerged from the larger field of biotechnology. Despite these efforts, risks posed by synthetic biology are of increasing concern as research procedures scale up to industrial processes in the larger bioeconomy...
October 18, 2016: Journal of Occupational and Environmental Hygiene
Monique Mostert, Anthony Bonavia
BACKGROUND Besides providing anesthesia for surgery, the anesthesiologist's role is to optimize the patient for surgery and for post-surgical recovery. This involves timely identification and treatment of medical comorbidities and abnormal laboratory values that could complicate the patient's perioperative course. There are several potential causes of anion and non-anion gap metabolic acidosis in surgical patients, most of which could profoundly affect a patient's surgical outcome. Thus, the presence of an acute acid-base disturbance requires a thorough workup, the results of which will influence the patient's anesthetic management...
October 18, 2016: American Journal of Case Reports
Adam W Bartlett, Ben Smith, C R Robert George, Brendan McMullan, Alison Kesson, Monica M Lahra, Dip Paed, Pamela Palasanthiran
BACKGROUND: Group B Streptococcus (GBS) is a recognized cause of sepsis and meningitis, particularly in infants. Early onset (<7 days) GBS disease has been well characterized, whereas the epidemiology of late onset disease (LOD, 7-89 days) and very late onset disease (VLOD, ≥90 days) is less well understood. The aims of this study were to assess risk factors, presentation, management, and outcome for GBS LOD and VLOD. METHODS: Microbiology laboratory databases and hospital diagnostic coding for Sydney Children's Hospital and the Children's Hospital at Westmead were investigated for patients ≥ 7 days of age diagnosed with GBS bloodstream infection or meningitis from 1st January 2000 to 31st December 2014 (15 years)...
October 3, 2016: Pediatric Infectious Disease Journal
Julie C Fitzgerald, Scott L Weiss, Niranjan Kissoon
OBJECTIVE: To review important articles in the field of pediatric shock and pediatric septic shock published subsequent to the Fifth Edition of the Rogers' Textbook of Pediatric Intensive Care. DATA SOURCES: The U.S. National Library of Medicine PubMed ( was searched for combination of the term "pediatric" and the following terms: "sepsis, septic shock, shock, antibiotics, extracorporeal membrane oxygenation, and steroid." The abstract lists generated by these searches were screened for potential inclusion...
September 30, 2016: Pediatric Critical Care Medicine
Sajan Agarwal, Bikrant Bihari Lal, Dinesh Rawat, Archana Rastogi, Kishore G S Bharathy, Seema Alam
OBJECTIVE: To study the clinical and laboratory profile of children with progressive familial intrahepatic cholestasis (PFIC) and evaluate their outcome. METHODS: The study is a retrospective review of all cases diagnosed with PFIC between January 2011 and July 2015. All children underwent histopathological examination and immunostaining. Management was done as per institute's protocol. RESULTS: There were a total of 24 PFIC cases (PFIC 1-2, PFIC 2-19, PFIC 3-3)...
September 2016: Journal of Clinical and Experimental Hepatology
Michael A Bohl, James Forseth, Peter Nakaji
BACKGROUND: Arginine vasopressin (AVP) is a common second-line or third-line vasopressor used in critically ill neurosurgical patients. Neurosurgical indications include hyperdynamic therapy for vasospasm, maintenance of cerebral perfusion pressure in patients with intracranial hypertension, and prevention of hypotension in patients with sepsis. CASE DESCRIPTION: A series of six neurosurgical patients receiving AVP infusions developed severe but transient diabetes insipidus (tDI) after cessation of AVP...
October 11, 2016: World Neurosurgery
Ryan Hakimi, Ankur Garg
PURPOSE OF REVIEW: Hemorrhagic stroke comprises approximately 15% to 20% of all strokes. This article provides readers with an understanding of the indications and significance of various neuroimaging techniques available for patients presenting with hemorrhagic strokes of distinct causes. RECENT FINDINGS: The most common initial neuroimaging study is a noncontrast head CT, which allows for the identification of hemorrhage. Once an intracranial hemorrhage has been identified, the pattern of blood and the patient's medical history, neurologic examination, and laboratory studies lead the practitioner to pursue further neuroimaging studies to guide the medical, surgical, and interventional management...
October 2016: Continuum: Lifelong Learning in Neurology
Ken Nash, Frank Ghinassi, Jaspreet S Brar, Abdulkader Alam, Mary Catherine Bohan, Kalyani Gopalan, Amie Carter, K N Roy Chengappa
OBJECTIVES: 1. A quality performance improvement (QI) project to implement an electronic screening and monitoring tool to record components of the metabolic syndrome (e-MSD) during clinic visits by persons with serious mental illness (SMI). 2. To encourage psychiatrists to use this tool in their documentation. METHODS: Working with the information technology staff, five psychiatrists developed, tested, revised and embedded the e-MSD tool into the medication management document within the electronic health record...
2016: Clinical Schizophrenia & related Psychoses
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