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Triage tool

Madhukar Pai, Mark P Nicol, Catharina C Boehme
Rapid and accurate diagnosis is critical for timely initiation of anti-tuberculosis (TB) treatment, but many people with TB (or TB symptoms) do not have access to adequate initial diagnosis. In many countries, TB diagnosis is still reliant on sputum microscopy, a test with known limitations. However, new diagnostics are starting to change the landscape. Stimulated, in part, by the success and rollout of Xpert MTB/RIF, an automated, molecular test, there is now considerable interest in new technologies. The landscape looks promising with a pipeline of new tools, particularly molecular diagnostics, and well over 50 companies actively engaged in product development, and many tests have been reviewed by WHO for policy endorsement...
October 2016: Microbiology Spectrum
Michel Debacker, Filip Van Utterbeeck, Christophe Ullrich, Erwin Dhondt, Ives Hubloue
It is recognized that the study of the disaster medical response (DMR) is a relatively new field. To date, there is no evidence-based literature that clearly defines the best medical response principles, concepts, structures and processes in a disaster setting. Much of what is known about the DMR results from descriptive studies and expert opinion. No experimental studies regarding the effects of DMR interventions on the health outcomes of disaster survivors have been carried out. Traditional analytic methods cannot fully capture the flow of disaster victims through a complex disaster medical response system (DMRS)...
December 2016: Journal of Medical Systems
Yook Chin Chia
: Many cardiovascular disease (CVD) risk prediction tools have been developed in an attempt to identify those at highest risk in order for them to benefit from interventional treatment. The first CVD risk tool that was developed was the coronary heart disease risk tool by the Framingham Heart Study in 1998 (1). However the Framingham Risk Score could overestimate (or underestimate) risk in populations other than the US population. Hence several other risk engines have also been developed, primarily for a better fit in the communities in which the tools are to be used (2, 3)...
September 2016: Journal of Hypertension
Martin Carberry, John Harden
Early identification of patients with sepsis is key to the delivery of the sepsis 6 bundle including antibiotic therapy within an hour.[1-3] Demand versus capacity challenges in the Emergency Department (ED) led to delays in antibiotic and sepsis 6 delivery. An alerting tool was developed that provided criteria for Scottish Ambulance Service (SAS) Paramedics to alert the ED of potential sepsis patients. Data from patients presenting to the ED prior to the alerting process commencing (n=50) and during alerting (n=50) were analysed, a questionnaire was used to ascertain feedback from all staff groups; nurses doctors, and paramedics (n=38)...
2016: BMJ Quality Improvement Reports
Dakai Bian, Jason C Tsui, Mikhail Repin, Guy Garty, Helen Turner, Y Lawrence Yao, David J Brenner
Due to the need of high-speed and efficient biodosimetric assays for triage and therapy in the event of radiological or nuclear attack, a robotically based automated biodosimetry tool (RABiT) has been developed over the past few years. Adapting the micronucleus assay from filter plates to V-shaped plates presented challenges in the liquid handling, namely, cell splashing out of the V-shaped well plate during the cell harvesting, poor cell distribution on the bottom of the image plate during the dispensing, and cell loss from the image plate during the aspiration in the liquid handling process...
December 2016: Journal of Medical Devices
W Kelly Wu, Maame Yaa A B Yiadom, Sean P Collins, Wesley H Self, Ken Monahan
INTRODUCTION: A triage cardiology program, in which cardiologists provide consultation to the Emergency Department (ED), may safely reduce admissions. For patients with chest pain, the HEART Pathway may obviate the need for cardiology involvement, unless there is a difference between ED and cardiology assessments. Therefore, in a cohort concurrently evaluated by both specialties, we analyzed discordance between ED and cardiology HEART scores. METHODS: We performed a single-center, cross-sectional, retrospective study of adults presenting to the ED with chest pain who had a documented bedside evaluation by a triage cardiologist...
September 28, 2016: American Journal of Emergency Medicine
Ariel Brandwein, Kavita Patel, Myriam Kline, Peter Silver, Sandeep Gangadharan
OBJECTIVES: Patients with obstructive airway disease have varying degrees of pulsus paradoxus that correlate with illness severity. Pulsus paradoxus can be measured using plethysmography. We investigated whether plethysmograph (pleth) variability on admission to the pediatric emergency department (ED) could predict patient disposition. We hypothesized that patients with a larger pleth variability would have a higher likelihood of being admitted to a general pediatrics unit or the intensive care unit (ICU)...
October 6, 2016: Pediatric Emergency Care
Ilaria Bergese, Simona Frigerio, Marco Clari, Emanuele Castagno, Antonietta De Clemente, Elena Ponticelli, Enrica Scavino, Paola Berchialla
OBJECTIVES: Return visit (RV) to the emergency department (ED) is considered a benchmarking clinical indicator for health care quality. The purpose of this study was to develop a predictive model for early readmission risk in pediatric EDs comparing the performances of 2 learning machine algorithms. METHODS: A retrospective study based on all children younger than 15 years spontaneously returning within 120 hours after discharge was conducted in an Italian university children's hospital between October 2012 and April 2013...
October 6, 2016: Pediatric Emergency Care
Daniel B Mark, Kerry L Lee, Frank E Harrell
P values and hypothesis testing methods are frequently misused in clinical research. Much of this misuse appears to be owing to the widespread, mistaken belief that they provide simple, reliable, and objective triage tools for separating the true and important from the untrue or unimportant. The primary focus in interpreting therapeutic clinical research data should be on the treatment ("oomph") effect, a metaphorical force that moves patients given an effective treatment to a different clinical state relative to their control counterparts...
October 12, 2016: JAMA Cardiology
Wayne Varndell, Elizabeth Ryan, Alison Jeffers, Nadya Marquez-Hunt
AIM: The purpose of this prospective observational study was to characterise patients occupying the ambulance bay and to determine the ensuing nursing workload. BACKGROUND: The number of patients presenting to ED by ambulance is increasing. During periods of peak demand and access block in the ED, patients with ongoing care needs, requiring continual assessment and symptom management by emergency nurses can remain in the ambulance bay for extended periods of time...
October 7, 2016: Australasian Emergency Nursing Journal: AENJ
Jennifer Forshaw, Stephanie Raybould, Emilie Lewis, Mark Muyingo, Andrew Weeks, Kate Reed, Logan Manikam, Josaphat Byamugisha
BACKGROUND: Mulago National Referral Hospital has the largest maternity unit in sub-Saharan Africa. It is situated in Uganda, where the maternal mortality ratio is 310 per 100,000 live births. In 2010 a 'Traffic Light System' was set up to rapidly triage the vast number of patients who present to the hospital every day. The aim of this study was to evaluate the effectiveness of the obstetric department's triage system at Mulago Hospital with regard to time spent in admissions and to identify urgent cases and factors adversely affecting the system...
October 10, 2016: BMC Pregnancy and Childbirth
Andrew G Huff, Nathan Breit, Toph Allen, Karissa Whiting, Christopher Kiley
The Global Rapid Identification of Threats System (GRITS) is a biosurveillance application that enables infectious disease analysts to monitor nontraditional information sources (e.g., social media, online news outlets, ProMED-mail reports, and blogs) for infectious disease threats. GRITS analyzes these textual data sources by identifying, extracting, and succinctly visualizing epidemiologic information and suggests potentially associated infectious diseases. This manuscript evaluates and verifies the diagnoses that GRITS performs and discusses novel aspects of the software package...
2016: Interdisciplinary Perspectives on Infectious Diseases
Jayne Moquet, Stephen Barnard, Albena Staynova, Carita Lindholm, Octávia Monteiro Gil, Vanda Martins, Ute Rößler, Anne Vral, Charlot Vandevoorde, Maria Wojewódzka, Kai Rothkamm
PURPOSE: Within the EU RENEB project, seven laboratories have taken part in training and harmonisation activities to strengthen triage gamma-H2AX-based radiation exposure assessment. This has culminated in a second triage biodosimetry exercise. MATERIALS AND METHODS: Whole blood and separated lymphocyte samples were homogenously irradiated with (60)Co gamma rays at 0.5, 2.5 (blind samples), 0 and 2 Gy (reference samples). Following post-exposure incubations of 4 and 24 h, 16 samples were shipped on ice packs to each partner...
August 15, 2016: International Journal of Radiation Biology
Mark E Patterson, Derick Miranda, Greg Schuman, Christopher Eaton, Andrew Smith, Brad Silver
BACKGROUND: Leveraging "big data" as a means of informing cost-effective care holds potential in triaging high-risk heart failure (HF) patients for interventions within hospitals seeking to reduce 30-day readmissions. OBJECTIVE: Explore provider's beliefs and perceptions about using an electronic health record (EHR)-based tool that uses unstructured clinical notes to risk-stratify high-risk heart failure patients. METHODS: Six providers from an inpatient HF clinic within an urban safety net hospital were recruited to participate in a semistructured focus group...
2016: EGEMS
Julie Depuydt, Ans Baeyens, Stephen Barnard, Christina Beinke, Anett Benedek, Philip Beukes, Iwona Buraczewska, Firouz Darroudi, Stefania De Sanctis, Inmaculada Dominguez, Octávia Monteiro Gil, Valeria Hadjidekova, Enikő Kis, Ulrike Kulka, Florigio Lista, Katalin Lumniczky, Radhia M'kacher, Jayne Moquet, Doina Obreja, Ursula Oestreicher, Jelena Pajic, Nuria Pastor, Ljubomira Popova, Elisa Regalbuto, Michelle Ricoul, Laure Sabatier, Jacobus Slabbert, Sylwester Sommer, Antonella Testa, Hubert Thierens, Andrzej Wojcik, Anne Vral
PURPOSE: In the framework of the 'Realizing the European Network of Biodosimetry' (RENEB) project, two intercomparison exercises were conducted to assess the suitability of an optimized version of the cytokinesis-block micronucleus assay, and to evaluate the capacity of a large laboratory network performing biodosimetry for radiation emergency triages. Twelve European institutions participated in the first exercise, and four non-RENEB labs were added in the second one. MATERIALS AND METHODS: Irradiated blood samples were shipped to participating labs, whose task was to culture these samples and provide a blind dose estimate...
August 15, 2016: International Journal of Radiation Biology
Kalina Babeva, Jennifer L Hughes, Joan Asarnow
Suicide is the second leading cause of death among youth ages 10-24. An estimated 1.5 million US adolescents receive their primary health care in the emergency department (ED); this is particularly true for low-income and minority youths who often lack a regular source of care. ED visits can provide a window of opportunity to screen and identify youths with suicide and mental health risk, triage youths based on need, and facilitate effective follow-up care. Recently developed brief therapeutic assessment approaches have demonstrated success in improving rates of follow-up care after discharge from the ED...
November 2016: Current Psychiatry Reports
Rafael Guerrero-Preston, Blanca L Valle, Anne Jedlicka, Nitesh Turaga, Oluwasina Folawiyo, Francesca Pirini, Fahcina Lawson, Angelo Vergura, Maartje G Noordhuis, Amanda Dziedzic, Gabriela Perez, Marisa Renehan, Carolina Guerrero-Diaz, Edgardo De Jesus-Rodriguez, Teresa Díaz-Montes, Jose Rodriguez-Orengo, Keimari Méndez, Josefina Romaguera, Bruce J Trock, Liliana Florea, David Sidransky
Clinically useful molecular tools to triage women for a biopsy upon referral to colposcopy are not available. We aimed to develop a molecular panel to detect cervical intraepithelial neoplasia (CIN) grade 2 or higher lesions (CIN2+) in women with abnormal cervical cytology and high-risk HPV (HPV+). We tested a biomarker panel in cervical epithelium DNA obtained from 211 women evaluated in a cervical cancer clinic in Chile from 2006 to 2008. Results were verified in a prospective cohort of 107 women evaluated in a high risk clinic in Puerto Rico from 2013 to 2015...
September 26, 2016: Cancer Prevention Research
Dong Guo, Laura H Heitman, Adriaan P IJzerman
In the past decade drug research community has started to appreciate the indispensable role of ligand-receptor binding kinetics (BK) in drug discovery. Next to the classical equilibrium-based drug evaluation process with affinity and potency values as outcomes, kinetic investigation of the ligand-receptor interaction can aid compound triage in the hit-to-lead campaign and provide additional information to understand the molecular mechanism of drug action. Translational models incorporating BK are emerging as well, which represent powerful tools for the prediction of in vivo effects...
September 8, 2016: ACS Medicinal Chemistry Letters
Hiromi Chiba, Shinichiro Nagamitsu, Rieko Sakurai, Takayo Mukai, Hiroko Shintou, Kenshi Koyanagi, Yushiro Yamashita, Tatsuyuki Kakuma, Naohisa Uchimura, Toyojiro Matsuishi
Eating disorders (ED) are serious psychosomatic disorders that commonly occur in girls during adolescence. An increase in earlier onset ED has recently been suggested. Therefore, accurate assessment of eating attitudes in children is a necessary part of school mental health. The 26-item Children's Eating Attitudes Test (ChEAT-26) is widely used internationally to assess abnormal eating attitudes. The present study aimed to validate the Japanese version of the ChEAT-26. Participants were 7076 school children (aged 10-15years) from large, medium-sized, and small cities, and 44 children with anorexia nervosa...
September 10, 2016: Eating Behaviors
Yook Chin Chia
: Many cardiovascular disease (CVD) risk prediction tools have been developed in an attempt to identify those at highest risk in order for them to benefit from interventional treatment. The first CVD risk tool that was developed was the coronary heart disease risk tool by the Framingham Heart Study in 1998 (1). However the Framingham Risk Score could overestimate (or underestimate) risk in populations other than the US population. Hence several other risk engines have also been developed, primarily for a better fit in the communities in which the tools are to be used (2, 3)...
September 2016: Journal of Hypertension
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