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https://www.readbyqxmd.com/read/29045063/evaluating-manufacturing-process-profile-comparability-with-multivariate-equivalence-testing-case-study-of-cell-culture-small-scale-model-transfer
#1
Yang Cao, Daniel Obeng, Guodong Hui, Luting Xue, Yukun Ren, Xianjie Yu, Fei Wang, Chad Atwell
This paper studies the Generalized Mahalanobis Distance (GMD) approach proposed by Hoffelder(1) which measures the dissimilarity of two multivariate Gaussian distributions with arbitrary covariance matrices and unequal sample sizes. This investigation demonstrated that, with appropriate adjustment, the GMD approach can achieve the targeted nominal Type I error and provide sufficient power for testing equivalence between two profile populations. The adjusted GMD approach was applied to examine the equivalence of harvest profiles between a 12L small scale model and 2000L manufacturing scale in a transfer study performed at Sanofi Speciality Care Framingham Biologics...
October 16, 2017: Biotechnology Progress
https://www.readbyqxmd.com/read/29034303/validation-of-capillary-blood-analysis-and-capillary-testing-mode-on-the-epoc-point-of-care-system
#2
Jing Cao, Rachel Edwards, Janette Chairez, Sridevi Devaraj
BACKGROUND: Laboratory test in transport is a critical component of patient care, and capillary blood is a preferred sample type particularly in children. This study evaluated the performance of capillary blood testing on the epoc Point of Care Blood Analysis System (Alere Inc). METHODS: Ten fresh venous blood samples was tested on the epoc system under the capillary mode. Correlation with GEM 4000 (Instrumentation Laboratory) was examined for Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pO2, pCO2, and pH, and correlation with serum tested on Vitros 5600 (Ortho Clinical Diagnostics) was examined for creatinine...
December 2017: Pract Lab Med
https://www.readbyqxmd.com/read/29032164/a-portable-microfluidic-aptamer-tethered-enzyme-capture-aptec-biosensor-for-malaria-diagnosis
#3
Lewis A Fraser, Andrew B Kinghorn, Roderick M Dirkzwager, Shaolin Liang, Yee-Wai Cheung, Bryce Lim, Simon Chi-Chin Shiu, Marco S L Tang, Dean Andrew, Joseph Manitta, Jack S Richards, Julian A Tanner
There is a critical need for better biosensors for the detection and diagnosis of malaria. We previously developed a DNA aptamer that recognises the Plasmodium falciparum lactate dehydrogenase (PfLDH) enzyme with high sensitivity and specificity. The aptamer was integrated into an Aptamer-Tethered Enzyme Capture (APTEC) assay as a laboratory-based diagnostic approach. However, a portable equipment-free point-of-care aptamer-mediated biosensor could have a significant impact on malaria diagnosis in endemic regions...
October 4, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/29025961/phosphate-replacement-in-the-critically-ill-potential-implications-for-military-patients
#4
A E Coulden, L J Rickard, N Crooks, N Arora
BACKGROUND: Severe hypophosphataemia in the intensive care unit (ICU) setting has been widely associated with adverse clinical outcomes across multiple organ systems, as well as increased mortality. However, the clinical significance of mild or moderate hypophosphataemia remains uncertain. This can lead to heterogeneous phosphate replacement protocols across different institutions. The aim of this study was to assess the significance of mild and moderate hypophosphataemia on clinical outcomes across several organ systems...
October 12, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28988172/haemodynamic-response-to-crystalloids-or-colloids-in-shock-an-exploratory-subgroup-analysis-of-a-randomised-controlled-trial
#5
Nicholas Heming, Souheil Elatrous, Samir Jaber, Anne Sylvie Dumenil, Joël Cousson, Xavier Forceville, Antoine Kimmoun, Jean Louis Trouillet, Jérôme Fichet, Nadia Anguel, Michael Darmon, Claude Martin, Sylvie Chevret, Djillali Annane
OBJECTIVE: To compare the haemodynamic effect of crystalloids and colloids during acute severe hypovolaemic shock. DESIGN: Exploratory subgroup analysis of a multicentre randomised controlled trial (Colloids Versus Crystalloids for the Resuscitation of the Critically Ill, CRISTAL, ClinicalTrials.gov NCT00318942). SETTING: CRISTAL was conducted in intensive care units in Europe, North Africa and Canada. PARTICIPANTS: Current analysis included all patients who had a pulmonary artery catheter in place at randomisation...
October 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28970659/prognostic-value-of-venous-to-arterial-carbon-dioxide-difference-during-early-resuscitation-in-critically-ill-patients-with-septic-shock
#6
Tamer Abdallah Helmy, Ehab Mahmoud El-Reweny, Farahat Gomaa Ghazy
CONTEXT: The partial pressure of venous to arterial carbon dioxide gradient (PCO2 gap) is considered as an alternative marker of tissue hypoperfusion and has been used to guide treatment for shock. AIMS: The aim of this study was to investigate the prognostic value of venous-to-arterial carbon dioxide difference during early resuscitation of patients with septic shock and compared it with that of lactate clearance and Acute Physiology and Chronic Health Evaluation II (APACHE-II) score...
September 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28966921/echocardiographic-evaluation-of-hemodynamics-in-neonates-and-children
#7
REVIEW
Yogen Singh
Hemodynamic instability and inadequate cardiac performance are common in critically ill children. The clinical assessment of hemodynamic status is reliant upon physical examination supported by the clinical signs such as heart rate, blood pressure, capillary refill time, and measurement of the urine output and serum lactate. Unfortunately, all of these parameters are surrogate markers of cardiovascular well-being and they provide limited direct information regarding the adequacy of blood flow and tissue perfusion...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28961222/pro-inflammatory-versus-immunomodulatory-effects-of-silver-nanoparticles-in-the-lung-the-critical-role-of-dose-size-and-surface-modification
#8
Francesca Alessandrini, Antje Vennemann, Silvia Gschwendtner, Avidan U Neumann, Michael Rothballer, Tanja Seher, Maria Wimmer, Susanne Kublik, Claudia Traidl-Hoffmann, Michael Schloter, Martin Wiemann, Carsten B Schmidt-Weber
The growing use of silver nanoparticles (Ag-NPs) in consumer products raises concerns about their toxicological potential. The purpose of the study was to investigate the size- and coating-dependent pulmonary toxicity of Ag-NPs in vitro and in vivo, using an ovalbumin (OVA)-mouse allergy model. Supernatants from (5.6-45 µg/mL) Ag50-PVP, Ag200-PVP or Ag50-citrate-treated NR8383 alveolar macrophages were tested for lactate dehydrogenase and glucuronidase activity, tumor necrosis factor (TNF)-α release and reactive oxygen species (ROS) production...
September 29, 2017: Nanomaterials
https://www.readbyqxmd.com/read/28893316/intraosseous-blood-samples-for-point-of-care-analysis-agreement-between-intraosseous-and-arterial-analyses
#9
Milla Jousi, Simo Saikko, Jouni Nurmi
BACKGROUND: Point-of-care (POC) testing is highly useful when treating critically ill patients. In case of difficult vascular access, the intraosseous (IO) route is commonly used, and blood is aspirated to confirm the correct position of the IO-needle. Thus, IO blood samples could be easily accessed for POC analyses in emergency situations. The aim of this study was to determine whether IO values agree sufficiently with arterial values to be used for clinical decision making. METHODS: Two samples of IO blood were drawn from 31 healthy volunteers and compared with arterial samples...
September 11, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28888332/machine-learning-based-electronic-triage-more-accurately-differentiates-patients-with-respect-to%C3%A2-clinical-outcomes-compared-with-the-emergency-severity-index
#10
Scott Levin, Matthew Toerper, Eric Hamrock, Jeremiah S Hinson, Sean Barnes, Heather Gardner, Andrea Dugas, Bob Linton, Tom Kirsch, Gabor Kelen
STUDY OBJECTIVE: Standards for emergency department (ED) triage in the United States rely heavily on subjective assessment and are limited in their ability to risk-stratify patients. This study seeks to evaluate an electronic triage system (e-triage) based on machine learning that predicts likelihood of acute outcomes enabling improved patient differentiation. METHODS: A multisite, retrospective, cross-sectional study of 172,726 ED visits from urban and community EDs was conducted...
September 6, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28869492/the-lactate-albumin-ratio-a-valuable-tool-for-risk-stratification-in-septic-patients-admitted-to-icu
#11
Michael Lichtenauer, Bernhard Wernly, Bernhard Ohnewein, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Alexander Lauten, Paul Christian Schulze, Uta C Hoppe, Malte Kelm, Christian Jung
The lactate/albumin ratio has been reported to be associated with mortality in pediatric patients with sepsis. We aimed to evaluate the lactate/albumin ratio for its prognostic relevance in a larger collective of critically ill (adult) patients admitted to an intensive care unit (ICU). A total of 348 medical patients admitted to a German ICU for sepsis between 2004 and 2009 were included. Follow-up of patients was performed retrospectively between May 2013 and November 2013. The association of the lactate/albumin ratio (cut-off 0...
September 2, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28866112/hemodynamic-assessment-of-patients-with-septic-shock-using-transpulmonary-thermodilution-and-critical-care-echocardiography-a-comparative-study
#12
Philippe Vignon, Emmanuelle Begot, Arnaud Mari, Stein Silva, Loïc Chimot, Pierre Delour, Frédéric Vargas, Bruno Filloux, David Vandroux, Julien Jabot, Bruno François, Nicolas Pichon, Marc Clavel, Bruno Levy, Michel Slama, Béatrice Riu-Poulenc
BACKGROUND: To assess the agreement between transpulmonary thermodilution (TPT) and critical care echocardiography (CCE) in ventilated patients with septic shock. METHODS: Ventilated patients in sinus rhythm requiring advanced hemodynamic assessment for septic shock were included in this prospective multicenter descriptive study. Patients were assessed successively using TPT and CCE in random order. Data were interpreted independently at bedside by two investigators who proposed therapeutic changes on the basis of predefined algorithms...
September 1, 2017: Chest
https://www.readbyqxmd.com/read/28836153/agreement-between-venous-and-arterial-blood-gas-analysis-of-acid-base-status-in-critical-care-and-ward-patients-a-retrospective-cohort-study
#13
Claudio M Martin, Fran Priestap
PURPOSE: To determine whether the use of venous blood gases can be a suitable alternative to arterial sampling to evaluate acid-base status. METHODS: The database of the clinical laboratory in a large academic hospital was searched for records of venous blood gas analysis and an arterial sample taken within ten minutes from the same patient. Bland-Altman analyses of pH, pCO2, and lactate were performed for samples obtained from patients separately from within and outside the intensive care unit (ICU)...
August 23, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28834108/influence-of-hang-time-and-location-on-bacterial-contamination-of-intravenous-bags-in-a-veterinary-emergency-and-critical-care-setting
#14
Julien Guillaumin, Nichole M Olp, Karissa D Magnusson, Amy L Butler, Joshua B Daniels
OBJECTIVE: To assess the rate of bacterial contamination of fluid and ports in intravenous bags in a veterinary emergency room (ER) and intensive care unit (ICU). DESIGN: Experimental model. SETTING: Ninety intravenous fluid bags of lactated balanced-electrolytes solution (1 L) hung in a university hospital. INTERVENTIONS: Bags were hung in 2 different locations in the ER (sink and bins) and one location in the ICU (sink) for 11 days...
September 2017: Journal of Veterinary Emergency and Critical Care
https://www.readbyqxmd.com/read/28826408/the-association-of-early-combined-lactate-and-glucose-levels-with-subsequent-renal-and-liver-dysfunction-and-hospital-mortality-in-critically-ill-patients
#15
Pedro Freire Jorge, Nienke Wieringa, Eva de Felice, Iwan C C van der Horst, Annemieke Oude Lansink, Maarten W Nijsten
BACKGROUND: The development of renal and liver dysfunction may be accompanied by initially subtle derangements in the gluconeogenetic function. Discrepantly low glucose levels combined with high lactate levels might indicate an impaired Cori cycle. Our objective was to examine the relation between early lactate and glucose levels with subsequent renal and liver dysfunction and hospital mortality in critically ill patients. METHODS: Over a 4-year period (2011 to 2014), all adult patients admitted to our adult 48-bed teaching hospital intensive care unit (ICU) for at least 12 h were retrospectively analyzed...
August 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28813175/qualitative-analysis-of-registered-nurses-perceptions-of-lactation-assessment-tools-why-and-how-they-are-completed
#16
Joan Esper Kuhnly, Donna J Chapman
BACKGROUND: Although lactation assessment tools are consistently used in clinical practice, there is no evidence describing registered nurses' perspectives regarding the purpose and thought processes involved when conducting a breastfeeding assessment. Research aim: This study aimed to explore registered nurses' perceptions on the purpose of lactation assessment tools and the thought processes involved in completing one. METHODS: Seven focus groups were held from April 2015 through July 2015, in coordination with regional and international lactation and perinatal conferences...
August 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28806494/body-piercing-motivations-and-implications-for-health
#17
REVIEW
Cheri Van Hoover, Carol-Ann Rademayer, Cindy L Farley
Body piercing has evolved from a behavior once considered extreme to an accepted choice among the general population. Earlobe piercing is so common that it is now considered a normative behavior. The motivations for choosing body piercing have changed and are associated with piercing site and number of piercings chosen by the individual. Meanings ascribed to body piercing were traditionally related to enhanced sexual desirability and experience, but now range from the innocuous, such as a fashion statement, to the risk laden, such as nonsuicidal self-injury...
August 14, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28798724/vasopressin-and-oxytocin-reduce-food-sharing-behavior-in-male-but-not-female-marmosets-in-family-groups
#18
Jack H Taylor, Allison A Intorre, Jeffrey A French
Oxytocin (OT) is critical for lactation and maternal care, but OT and the related nonapeptide vasopressin are important for caregiving behaviors in fathers and alloparents as well. This experiment tested the effects of vasopressin and OT on food sharing in marmoset families. We treated caregivers (parents, siblings) with intranasal vasopressin, OT, or saline, and then paired them with the youngest marmoset in the family. Caregivers were given preferred food, and then observed for food sharing and aggressive behavior with young marmosets...
2017: Frontiers in Endocrinology
https://www.readbyqxmd.com/read/28765741/experience-with-mechanical-circulatory-support-for-medically-intractable-low-cardiac-output-in-a-pediatric-intensive-care-unit
#19
Jung Bin Park, Jae Gun Kwak, Hong-Gook Lim, Woong-Han Kim, Jeong Ryul Lee, Yong Jin Kim
BACKGROUND AND OBJECTIVES: Mechanical circulatory support with extracorporeal membrane oxygenation (ECMO) and ventricular assist device has always been the optimal choice for treating the majority of medically intractable low cardiac output case. We retrospectively investigated our institution's outcomes and variables associated with a high risk of mortality. SUBJECTS AND METHODS: From 1999 to 2014, 86 patients who were of pediatric age or had grown-up congenital heart disease underwent mechanical circulatory support for medically intractable low cardiac output in our pediatric intensive care unit...
July 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28764215/comparative-evaluation-of-accuracy-of-pulse-oximeters-and-factors-affecting-their-performance-in-a-tertiary-intensive-care-unit
#20
Anupam Kumar Singh, Malvinder Singh Sahi, Bablesh Mahawar, Sajjan Rajpurohit
INTRODUCTION: Pulse oximetry is a widely used tool, unfortunately there is a paucity of data investigating its accuracy in Intensive Care Units (ICU) and if they are able to meet mandated FDA criteria as claimed by them in critically ill patients. AIM: To assess bias, precision and accuracy of pulse oximeters used in ICU and factors affecting them. MATERIALS AND METHODS: A prospective cohort study, including 129 patients admitted to the ICU of a tertiary referral centre...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
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