Identification of children for whom routine monitoring of aminoglycoside serum concentrations is not cost effective

1986 ◽  
Vol 109 (5) ◽  
pp. 897-901 ◽  
Author(s):  
Kenneth L. Massey ◽  
Leslie Hendeles ◽  
Allen Neims
Keyword(s):  
Cost Effective ◽  
Serum Concentrations ◽  
Routine Monitoring

Detection of enteroviruses in marine waters by direct RT-PCR and cell culture

1995 ◽  
Vol 31 (5-6) ◽  
pp. 323-328 ◽  
Author(s):  
K. A. Reynolds ◽  
C. P. Gerba ◽  
I. L. Pepper
Keyword(s):  
Cell Culture ◽  
Polymerase Chain Reaction Amplification ◽  
Cost Effective ◽  
The United States ◽  
Water Runoff ◽  
Rt Pcr ◽  
Marine Waters ◽  
Storm Water Runoff ◽  
Routine Monitoring ◽  
Reaction Amplification

Sewage outfalls and storm water runoff introduces pathogenic human enteric viruses into marine coastal waters, which may pose a potential public health risk. Although members of the enterovirus group have been suggested as possible indicators of sewage pollution in marine waters, the lack of rapid, sensitive and cost effective methods have prevented routine monitoring in the United States. This study compared traditional cell culture and direct RT-PCR (reverse transcriptase-polymerase chain reaction) amplification for detection of an enterovirus. Poliovirus could be recovered from 100 L of artificial seawater with an average efficiency of 77%, using adsorption and elution from electronegative filters. Viruses were eluted from the filters with 1.5% beef extract for viruses (BEV) adjusted to pH 9.5 and reconcentrated by organic flocculation to a volume of 30 mL. Substances which interfered with detection by RT-PCR were removed by treatment of the concentrates with sephadex and chelex resins. Direct RT-PCR could detect 2.5 and 0.025 PFU (plaque forming units) for single (25 cycles) and double PCR (2 × 25 cycles) in 10 μL of pure culture poliovirus samples, respectively. These methods are currently being applied to assess the occurrence of enteroviruses at marine bathing beaches influenced by sewage discharges.

Monitoring effluent quality in hypertrophic wastewater reservoirs using remote sensing

1996 ◽  
Vol 33 (8) ◽  
pp. 23-29 ◽  
Author(s):  
I. Dor ◽  
N. Ben-Yosef
Keyword(s):  
Water Quality ◽  
Theoretical Model ◽  
Principal Component ◽  
Cost Effective ◽  
Operational Parameters ◽  
Effluent Quality ◽  
Optical Images ◽  
Routine Monitoring ◽  
Cost Effective Method ◽  
Wastewater Quality

About one hundred and fifty wastewater reservoirs store effluents for irrigation in Israel. Effluent qualities differ according to the inflowing wastewater quality, the degree of pretreatment and the operational parameters. Certain aspects of water quality like concentration of organic matter, suspended solids and chlorophyll are significantly correlated with the water column transparency and colour. Accordingly optical images of the reservoirs obtained from the SPOT satellite demonstrate pronounced differences correlated with the water quality. The analysis of satellite multispectral images is based on a theoretical model. The model calculates, using the radiation transfer equation, the volume reflectance of the water body. Satellite images of 99 reservoirs were analyzed in the chromacity space in order to classify them according to water quality. Principal Component Analysis backed by the theoretical model increases the method sensitivity. Further elaboration of this approach will lead to the establishment of a time and cost effective method for the routine monitoring of these hypertrophic wastewater reservoirs.

504 Venous Thromboembolism Chemoprophylaxis in Burn Patients: A Literature Review and Single-institution Experience

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S88-S89
Author(s):  
Alice Liu ◽  
Raquel Minasian ◽  
Ellen Maniago ◽  
Justin Gillenwater ◽  
Warren L Garner ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Retrospective Studies ◽  
Factor Xa ◽  
Cost Effective ◽  
Incidence Rates ◽  
Endothelial Damage ◽  
Burn Patients ◽  
Vein Thrombosis ◽  
Routine Monitoring ◽  
Meta Analyses

Abstract Introduction Hospitalized burn patients meet the criteria for Virchow’s triad (endothelial damage, hypercoagulability, and stasis), predisposing them to venous thromboembolism (VTE). While the cost, morbidity, and mortality of VTE suggest a need for prevention in this population, unreliable reported VTE rates, variable and complicated prophylaxis regimens, and risks associated with chemoprophylaxis have prevented the establishment of a universal protocol. This paper reviews the thromboprophylaxis practices both in the literature and at our own institution. Methods A systematic review was conducted according to Preferred Reported Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines identifying studies pertaining to VTE chemoprophylaxis in burn patients. Additionally, medical records of patients admitted to an American Burn Association-verified burn center between June 2015 and June 2019 were retrospectively reviewed for patient demographics, chemoprophylaxis, and presence of VTE defined as either deep vein thrombosis (DVT) or pulmonary embolism (PE). Results 35 studies met inclusion criteria. In the 11 studies that reported VTE incidence, rates ranged widely from 0.27 to 23.3%. The two largest retrospective studies (n = 33,637 and 36,638) reported a VTE incidence of 0.61% and a DVT incidence of 0.8% in populations with unknown or inconsistently recorded chemoprophylaxis. Throughout the literature, prevention protocols were mixed, though a trend toward using dose-adjusted subcutaneous low molecular weight heparin based on serum anti-factor Xa level was noted. At our institution, 1440 patients were admitted over four years. At-risk patients received a simple chemoprophylaxis regimen of 5000U of subcutaneous unfractionated heparin every eight hours. No routine monitoring tests were performed to limit cost. Ten cases of DVT and two cases of PE were identified with an incidence of 0.69% and 0.14%, respectively, and a total VTE incidence of 0.83%. One patient developed heparin-induced thrombocytopenia (0.07%). There were no other heparin-associated complications. Conclusions VTE incidence rates reported in the literature are wide-ranging and poorly capture the effect of any one chemoprophylaxis regimen in the burn population. Our center uses a single, safe, and cost-effective protocol with a VTE rate comparable to that of large national retrospective studies. Applicability of Research to Practice VTE continues to represent a threat to the burn population. While simple and safe chemoprophylaxis regimens exist, the optimal prevention protocol remains elusive.

scholarly journals Quantification of carbohydrates in fruit juices using FTIR spectroscopy and multivariate analysis

2011 ◽  
Vol 26 (2) ◽  
pp. 93-104 ◽  
Author(s):  
Loredana F. Leopold ◽  
Nicolae Leopold ◽  
Horst-A. Diehl ◽  
Carmen Socaciu
Keyword(s):  
Ftir Spectroscopy ◽  
Multivariate Statistics ◽  
Sucrose Concentration ◽  
Principal Component ◽  
Cost Effective ◽  
Average Concentration ◽  
Fruit Juices ◽  
Routine Monitoring ◽  
Sweetness Intensity ◽  
High Sucrose Concentration

A combination of Fourier-transform infrared spectroscopy (FTIR) and multivariate statistics was applied as screening tool for the quantitative determination of carbohydrates, such as glucose, fructose and sucrose, in 28 processed commercial fruit juices and 5 genuine juices obtained from squeezed fruits. A number of 13 mixtures of glucose, fructose and sucrose standard solutions were prepared at different concentrations, scanned by attenuated total reflectance (ATR) FTIR spectroscopy and analyzed in the 900 and 1400 cm−1spectral range. Principal component analysis (PCA) of the standard carbohydrate solutions enabled a better understanding of the main sources of variability affecting the FTIR spectra. Also, PCA enabled the grouping of apple, orange and peach juices. Calibration models for each carbohydrate, using partial least squares (PLS) regression were developed and used for prediction purposes. Cross-validation procedures indicated correlations of 0.88, 0.92 and 0.98 for glucose, fructose and sucrose, respectively, between HPLC measured values and FTIR first derivative spectra estimates. Carbohydrates in the expected concentration ranges were found for most of the pure fruit labelled juices. The samples with 4–50% pure fruit juice content showed discrepancies from average concentration values of authentic juices, mainly a high sucrose concentration can flag sucrose addition to maintain the juice sweetness intensity. The present results confirmed the efficiency of FTIR spectroscopy, in combination with multivariate statistics, as a rapid, reliable and cost-effective tool for routine monitoring of multiple constituents in fruit juices, as quality indicators.

Extended Injection Intervals of Gonadotropins by Intradermal Administration in IVF Treatment

2021 ◽  
Author(s):  
Chao Chin Hsu ◽  
Rosie Hsu ◽  
Hui Hua Chang ◽  
Isabel Hsu ◽  
Sonam Dorjee
Keyword(s):  
Treatment Cycle ◽  
Cost Effective ◽  
Intradermal Injection ◽  
Serum Concentrations ◽  
Vitro Fertilization ◽  
Intradermal Administration ◽  
First Time ◽  
Recombinant Human Fsh ◽  
Additional Dosage

Abstract Context Gonadotropins can be administered every five days under intradermal injection in in vitro fertilization (IVF) treatment. Objective To explore the effectiveness of intradermal injection of recombinant human FSH (rhFSH) for women undergoing IVF. Materials and Methods Women who received their first time IVF enrolled in this prospective intervention in 2018. All women received a bolus of 900 IU rhFSH intradermally at day 2 of the treatment cycle followed by additional dosage of rhFSH at day 7 and/or day 10. The main outcome measures included the total dose of rhFSH and number of injections required, sequential serum FSH level detected, and number of mature oocytes retrieved. Results Seventy women completed the study. On average, 2.31±0.73 injections and 1662±397 IU of rhFSH were administered. While the baseline FSH level was 5.6±2.2 IU/L, the serum concentrations of FSH after rhFSH administration were 35.3±7.0 on the first day (24 hours) and 10.7±3.7 IU/L on the fifth day (120 hours). A total of 10.5±6.6 mature oocytes were retrieved, resulting in 7.3±5.1 pronuclear embryos; and 1.8±0.6 embryos were transferred to the uterus. Our findings resulted in 72% fertilization, 91% cleavage, 31% implantation, and 36% live birth rates. Although less larger follicles were found, non-inferiority results were noted in the mature oocytes retrieved, good embryos available and clinical pregnancy rate compared to those received conventional daily subcutaneous rhFSH administration. Conclusion Intradermal administration of rhFSH, with less dose of rhFSH and numbers of injection, may achieve the goal of a cost-effective and more patient-friendly regimen.

Venous Thromboembolism Chemoprophylaxis in Burn Patients: A Literature Review and Single-Institution Experience

2020 ◽  
Author(s):  
Alice Liu ◽  
Raquel A Minasian ◽  
Ellen Maniago ◽  
T Justin Gillenwater ◽  
Warren L Garner ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Retrospective Studies ◽  
Factor Xa ◽  
Cost Effective ◽  
Incidence Rates ◽  
Endothelial Damage ◽  
Burn Patients ◽  
Vein Thrombosis ◽  
Burn Center ◽  
Routine Monitoring

Abstract Hospitalized burn patients meet the criteria for Virchow’s triad (endothelial damage, hypercoagulability, and stasis), predisposing them to venous thromboembolism (VTE). Although the disease burden of VTE suggests a need for prevention in this population, unreliable reported VTE rates, costly and complicated prophylaxis regimens, and chemoprophylaxis risks have prevented the establishment of a universal protocol. This paper reviews thromboprophylaxis practices both in the literature and at our own institution. A systematic review was conducted according to PRISMA guidelines identifying studies pertaining to VTE chemoprophylaxis in burn patients. Additionally, medical records of patients admitted to an American Burn Association-verified burn center between June 2015 and June 2019 were retrospectively reviewed for demographics, chemoprophylaxis, and presence of VTE defined as either deep vein thrombosis (DVT) or pulmonary embolism (PE). Thirty-eight studies met inclusion criteria. In the 12 studies that reported VTE incidence, rates ranged widely from 0.25% to 47.1%. The two largest retrospective studies (n = 33,637 and 36,638) reported a VTE incidence of 0.61% and 0.8% in populations with unknown or inconsistently recorded chemoprophylaxis. Throughout the literature, prevention protocols were mixed, though a trend toward using dose-adjusted subcutaneous low molecular weight heparin based on serum anti-factor Xa level was noted. At our burn center, 1,068 patients met study criteria. At-risk patients received a simple chemoprophylaxis regimen of 5000U of subcutaneous unfractionated heparin every 8 hours. No routine monitoring tests were performed to limit cost. Nine cases of DVT and two cases of PE were identified with an incidence of 0.84% and 0.19%, respectively, and a total VTE incidence of 1.03%. Only one patient developed heparin-induced thrombocytopenia (HIT). No cases of other heparin-associated complications were observed. VTE incidence rates reported in the literature are wide-ranging and poorly capture the effect of any one chemoprophylaxis regimen in the burn population. Our center uses a single, safe, and cost-effective protocol effecting a low VTE rate comparable to that of large national retrospective studies.

scholarly journals Quantification of Glucose, Fructose and Sucrose in Apple Juices Using ATR-MIR Spectroscopy Coupled with Chemometry

1970 ◽  
Vol 66 (2) ◽  
Author(s):  
Loredana LEOPOLD ◽  
Horst DIEHL ◽  
Carmen SOCACIU
Keyword(s):  
Sucrose Concentration ◽  
Cost Effective ◽  
Average Concentration ◽  
Mir Spectroscopy ◽  
Routine Monitoring ◽  
Calibration Models ◽  
Sucrose Solutions ◽  
Sweetness Intensity ◽  
High Sucrose Concentration ◽  
Predicted Values

A combination of Fourier transform infrared spectroscopy (FTIR) and multivariate statistics (chemometry) was applied as a screening tool for the quantitative determination of carbohydrates, such as glucose, fructose and sucrose, in 11 processed commercial apple juices and 2 genuine juices obtained from squeezed apples. For calibration, a number of 24 mixtures of glucose, fructose and sucrose solutions (synthetic samples), at different concentrations were prepared and scanned in the 885 and 1500 cm-1 spectral range, using attenuated total reflectance (ATR) FTIR spectroscopy. Based on the mixtures spectra in the mid IR (MIR) region, we realized calibration models for each carbohydrate, using partial least squares (PLS) regression. The models were then used to predict the glucose, fructose and sucrose concentration in commercial apple juices, comparatively with concentrations in fresh, genuine juices, in order to assess the juice authenticity. The glucose concentrations (%, w/w) predicted for commercial juices ranged from 1.664 to 3.133 versus 3.1 for genuine fresh juices. The fructose concentrations (%, w/w) predicted for commercial juices ranged from 3.701 to 6.941 versus 9.2 for genuine fresh juices, while the sucrose concentrations (%, w/w) predicted for commercial juices ranged from 0.746 to 5.795 versus 1.38 for genuine fresh juices. The standard deviations of most predicted values are below 10%. Most juices exhibited glucose, fructose and sucrose concentrations in the expected range. However, several samples showed discrepancies from average concentration values, thus the authenticity of these juices could not be confirmed. Also, high sucrose concentration can flag adulterated juices, or indicates sucrose addition to maintain the juice sweetness intensity. Our results indicate ATR-MIR spectroscopy to be a rapid, accurate, non-destructive and cost-effective tool for routine monitoring of multiple constituents in apple juices, as quality and safety indicators.

scholarly journals Airborne environmental DNA for terrestrial vertebrate community monitoring

2021 ◽  
Author(s):  
Christina Lynggaard ◽  
Mads Frost Bertelsen ◽  
Casper V. Jensen ◽  
Matthew S. Johnson ◽  
Tobias Guldberg Froslev ◽  
...  
Keyword(s):  
Large Scale ◽  
Environmental Dna ◽  
Cost Effective ◽  
Monitoring Methods ◽  
Natural Ecosystems ◽  
Terrestrial Vertebrate ◽  
Detection Failure ◽  
Routine Monitoring ◽  
Community Monitoring ◽  
Wide Range

Assessing and studying the distribution, ecology, diversity and movements of species is key in understanding environmental and anthropogenic effects on natural ecosystems. Although environmental DNA is rapidly becoming the tool of choice to assess biodiversity there are few eDNA sample types that effectively capture terrestrial vertebrate diversity and those that do can be laborious to collect, require special permits and contain PCR inhibitory substances, which can lead to detection failure. Thus there is an urgent need for novel environmental DNA approaches for efficient and cost-effective large-scale routine monitoring of terrestrial vertebrate diversity. Here we show that DNA metabarcoding of airborne environmental DNA filtered from air can be used to detect a wide range of local vertebrate taxa. We filtered air at three localities in Copenhagen Zoo, detecting mammal, bird, amphibian and reptile species present in the zoo or its immediate surroundings. Our study demonstrates that airDNA has the capacity to complement and extend existing terrestrial vertebrate monitoring methods and could form the cornerstone of programs to assess and monitor terrestrial communities, for example in future global next generation biomonitoring frameworks.

scholarly journals Valproic Acid Concentrations in Mothers, Colostrum and Breastfed Infants during the Early Postpartum Period: Comparison with Concentrations Determined during Delivery and in the Mature Milk Period

Pharmaceutics ◽  
2021 ◽  
Vol 13 (12) ◽  
pp. 2074
Author(s):  
Ivana Kacirova ◽  
Milan Grundmann ◽  
Hana Brozmanova
Keyword(s):  
Valproic Acid ◽  
Serum Concentration ◽  
Lower Limit ◽  
Concentration Ratio ◽  
Maternal Serum ◽  
Serum Concentrations ◽  
Limit Of Quantification ◽  
Mature Milk ◽  
Breastfed Infants ◽  
Routine Monitoring

To obtain information on the transport of valproic acid from mothers to colostrum and breastfed infants, in this cohort study, valproic acid concentrations in maternal serum (90 subjects), colostrum and the serum of breastfed infants were analyzed in years 1993–2018, between the 2nd and 5th postnatal days. Valproic acid concentrations ranged from 4.3 to 66.5 mg/L (mean 31.2 ± 13.6 mg/L) in maternal serum, from 0.5 to 5.9 mg/L (mean 1.1 ± 1.2 mg/L) in milk, and from 0.5 to 42.9 mg/L (mean 15.4 ± 9.4 mg/L) in infant serum. The milk/maternal serum concentration ratio ranged from 0.01 to 0.22 (mean 0.04 ± 0.04), and the infant/maternal serum concentration ratio ranged from 0.01 to 1.61 (mean 0.51 ± 0.28). A significant correlation was found between serum concentrations of breastfed infants and milk concentrations, maternal serum concentrations, maternal daily dose, and dose related to maternal body weight. Valproic acid concentrations in milk and infant serum did not reach the lower limit of the reference range used for the general epileptic population, and three-quarters of the concentrations in milk were lower than the lower limit of quantification. Routine monitoring of serum concentrations of breastfed infants is not necessary. If signs of potential adverse reactions are noted, serum concentrations of the infants should be measured.

Routine monitoring of liver function tests in lung cancer resections – a necessary burden?

2019 ◽  
Vol 64 (3) ◽  
pp. 86-90
Author(s):  
NA Bradley ◽  
ED Kennedy ◽  
M Asif
Keyword(s):  
Decision Making ◽  
Liver Function ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
Liver Function Tests ◽  
Function Tests ◽  
Routine Monitoring ◽  
Effective Manner ◽  
Collect Patient Data

Background Increased availability of routine investigations results in significant over-investigation, burdening patients with unnecessary tests as well as increasing cost. We aimed to identify the extent of monitoring of liver function tests in lung resections, and to ascertain whether any impact on clinical decision-making occurred. Methods Cases were identified using theatre records coded as “lobectomy/bilobectomy” in the three-month period 20 June 2017 to 20 September 2017. Electronic records were used to collect patient data. Results A total of 91 cases were included; 77 (85%) patients had 1 set of pre-operative LFTs, 12 (13%) patients had 2 sets, and 2 (2%) patients had 0 sets; 69 (76%) had normal LFTs pre-operatively; 298 sets of LFTs were measured post-operatively, with a median of 3 sets per patient; 61 (67%) patients had either normal or static LFTs post-operatively, 13 (14%) had isolated rise in GGT, 16 (17%) had derangement of ALT and AST, and 1 patient (1%) had deranged ALP. Altered clinical decision-making due to LFTs derangement was recorded in two cases (2%). Conclusion Clinicians have an obligation to justify expense, and practise in a cost-effective manner. Our data suggest that the routine perioperative monitoring of LFTs in thoracic surgery does not give any clear benefit to patient care.

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