Usefulness of Adenosinetriphosphate Bioluminescence Assay (ATPmetry) for Monitoring the Reprocessing of Endoscopes

2015 ◽  
Vol 36 (12) ◽  
pp. 1437-1443 ◽  
Author(s):  
Pierre Batailler ◽  
Philippe Saviuc ◽  
Romain Picot-Gueraud ◽  
Jean-Luc Bosson ◽  
Marie-Reine Mallaret
Keyword(s):  
Teaching Hospital ◽  
Diagnostic Value ◽  
Interquartile Range ◽  
Diagnostic Study ◽  
Inclusion Criteria ◽  
Endoscopic Procedures ◽  
Complementary Approach ◽  
Colony Forming Units ◽  
Bioluminescence Assay ◽  
Acceptability Threshold

OBJECTIVETo assess the diagnostic value of an adenosinetriphosphate bioluminescence assay (ATPmetry) to monitor the effectiveness of the reprocessing of endoscopes compared with microbiologic sampling.DESIGNDiagnostic study.SETTINGA 2,200-bed teaching hospital performing 5,000 to 6,000 endoscopic procedures annually.INCLUSION CRITERIAAll samples from bronchial or gastrointestinal endoscopes whatever the context.METHODSSamples for microbiologic analysis and ATPmetry measurements were taken when each endoscope was inspected following reprocessing. Sampling was performed by flushing each endoscope with 300 mL Neutralizing Pharmacopeia Diluent thiosulfate rinsing solution divided equally between the endoscope channels. For each endoscope a series of 3 ATPmetry measurements were made on a vial containing the first jet from each channel and a second series on the whole sample.RESULTSOf 165 samples from endoscopes, 11 exceeded the acceptability threshold of 25 colony-forming units/endoscope. In the first jet collected, the median (interquartile range) level of ATPmetry was 30.5 (15.3–37.7) relative light units (RLU) for samples with 25 or fewer colony-forming units compared with 37.0 (34.7–39.3) RLU for samples with more than 25 colony-forming units (P=.008). For the whole sample, the median (interquartile range) level of ATPmetry was 24.8 (14.3–36.3) RLU and 36.3 (36.0–38.3) RLU (P=.006), respectively. After adjusting on the batch of cleansing solution used, no difference in ATPmetry values was found between microbiologically acceptable and unacceptable samples.CONCLUSIONATPmetry cannot be used as an alternative or complementary approach to microbiologic tests for monitoring the reprocessing of endoscopes in FranceInfect. Control Hosp. Epidemiol. 2015;36(12):1437–1443

scholarly journals External validation for sensitivity of the Ottawa subarachnoid hemorrhage rule in a Japanese tertiary teaching hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoharu Suzuki ◽  
David Itokazu ◽  
Yasuharu Tokuda
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Teaching Hospital ◽  
Tertiary Care ◽  
External Validation ◽  
False Negative ◽  
False Negative Rate ◽  
Prediction Rule ◽  
Japanese Patients ◽  
Inclusion Criteria ◽  
Tertiary Teaching

AbstractThe Ottawa subarachnoid hemorrhage (OSAH) rule is a validated clinical prediction rule for ruling out subarachnoid hemorrhage (SAH). Another SAH rule (Ottawa-like rule) was developed in Japan but was not well validated. We aimed to validate both rules by examining the sensitivity for ruling out SAH in Japanese patients diagnosed with SAH. We conducted a retrospective cohort study by reviewing the medical records of consecutive adult patients hospitalized with SAH at a tertiary-care teaching hospital in Japan who visited our emergency department between July 2009 and June 2019. Sensitivity and its 95% confidence interval (CI) were estimated for each rule for the diagnosis of SAH. In a total of 280 patients with SAH, 56 (20.0%) patients met the inclusion criteria and were analyzed for the OSAH rule, and a sensitivity of the OSAH rule was 56/56 (100%; 95% CI 93.6–100%). While, 126 (45%) patients met the inclusion criteria of the Ottawa-like rule, and the rule showed a sensitivity of 125/126 (99.2%; 95%CI 95.7–100%). The OSAH rule showed 100% sensitivity among our Japanese patients diagnosed with SAH. The implementation of the Ottawa-like rule should be cautious because the false-negative rate is up to 4%.

scholarly journals Immunocytochemistry Test of Protein BRAF Expression for Diagnosis of Well Differentiated Thyroid Carcinoma

2018 ◽  
Vol 11 (3) ◽  
pp. 843-849 ◽  
Author(s):  
I. Wayan Sudarsa ◽  
Elvis Deddy Kurniawan Pualillin ◽  
Putu Anda Tusta Adiputra ◽  
Ida Bagus Tjakra Wibawa Manuaba
Keyword(s):  
Positive Predictive Value ◽  
Thyroid Carcinoma ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Predictive Value ◽  
Preoperative Diagnosis ◽  
Area Under The Curve ◽  
Diagnostic Value ◽  
Differentiated Thyroid Carcinoma ◽  
Inclusion Criteria

Background: Thyroid carcinoma generally has a good prognosis. The main focus of current research on thyroid carcinoma is to increase the accuracy of preoperative diagnosis of thyroid nodules. When the result of fine needle aspiration biopsy (FNAB) is indeterminate, clinicians often have doubts in determining the surgical management. Objective: Protein BRAF expression analysis can help improve the accuracy of FNAB and optimize the management of differentiated thyroid carcinoma. Methods: This study is a diagnostic test performed from October 2016 at Sanglah General Hospital with 38 patients as subjects who fulfilled the inclusion criteria. Data is being presented in descriptive form before diagnostic test is done to determine sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of immunocytochemistry test for BRAF on indeterminate thyroid nodule. Results: Thirty-eight samples met the inclusion criteria during the study period. Three samples were male (7.9%) and 35 samples (92.1%) were female. The mean age of the sample was 45.21 years (SD ±10.910 years) with ages ranging from 23 to 66 years. Of the 12 samples undergoing isthmolobectomy, 7 samples (58.4%) were determined to be malignant from histopathological results. The sensitivity value of BRAF immunocytochemistry test is 45.45% with a specificity value of 81.25%, a positive predictive value of 76.92%, a negative predictive value of 52% and an accuracy of 60.50%. Analysis of the receiver operator (ROC) curve shows the area under the curve (AUC) of 63.4% with a confidence interval of 45.5–81.2%. Conclusion: Immunocytochemistry BRAF test have a reliable diagnostic value and can be taken into consideration in the preoperative diagnosis of thyroid malignancies.

scholarly journals A Comparison of Environmental Contamination by Patients Infected or Colonized with Methicillin-Resistant Staphylococcus aureus or Vancomycin-Resistant Enterococci: A Multicenter Study

2014 ◽  
Vol 35 (7) ◽  
pp. 872-875 ◽  
Author(s):  
Lauren P. Knelson ◽  
David A. Williams ◽  
Maria F. Gergen ◽  
William A. Rutala ◽  
David J. Weber ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Multicenter Study ◽  
Environmental Contamination ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Interquartile Range ◽  
Methicillin Resistant ◽  
Vancomycin Resistant Enterococci ◽  
Environmental Surfaces ◽  
Colony Forming Units ◽  
Vancomycin Resistant

A total of 1,023 environmental surfaces were sampled from 45 rooms with patients infected or colonized with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant enterococci (VRE) before terminal room cleaning. Colonized patients had higher median total target colony-forming units (CFU) of MRSA or VRE than did infected patients (median, 25 CFU [interquartile range, 0–106 CFU] vs 0 CFU [interquartile range, 0–29 CFU]; P = .033).Infect Control Hosp Epidemiol 2014;35(7):872–875

Efficacy of treatment with belladonna in children with severe pallid breath-holding spells

2018 ◽  
Vol 28 (7) ◽  
pp. 922-927 ◽  
Author(s):  
M. Cecilia Gonzalez Corcia ◽  
Adrien Bottosso ◽  
Isabelle Loeckx ◽  
Françoise Mascart ◽  
Guy Dembour ◽  
...  
Keyword(s):  
Positive Response ◽  
Treated Group ◽  
Interquartile Range ◽  
Breath Holding ◽  
Inclusion Criteria ◽  
Before And After ◽  
Single Difference ◽  
Baseline Characteristics ◽  
Receive Treatment

AbstractIntroductionPallid breath-holding spells are common and dramatic forms of recurrent syncope in infancy. They are very stressful despite their harmless nature and sometimes require treatment.ObjectiveThe objective of this study was to evaluate the efficacy of belladonna in severe breath-holding spells.MethodsThis is a multicentric, retrospective series involving 84 children with severe pallid breath-holding spells. Inclusion criteria were >1 pallid breath-holding spell with loss of consciousness, paediatric cardiology evaluation, and follow-up >6 months. In total, 45 patients received belladonna and 39 patients did not receive treatment, according to physician preference.ResultsMean age was 11 months, ranging from 4 to 18 months, with 54% of males. Mean spell duration was 30 seconds (interquartile range 15, 60), and the frequency was four episodes per month (interquartile range 0.5, 6.5). Comparison of baseline characteristics between groups showed similar demographics, with the single difference in the severity of the spells, being more severe in the treated group. When comparing the treated and non-treated groups at 3 months, only two (5%) patients had a complete remission in the first group, whereas 20 (44%) had remission in the belladonna group (p<0.01). When considering the characteristics of the spells before and after the initiation of treatment with belladonna, 75% of the patients presented a positive response, with 44% of the patients presenting with complete resolution of the spells (p<0.01). No major adverse reaction was reported, with only 5% minor adverse events.ConclusionsBelladonna is highly effective to alleviate severe breath-holding spells in young children, without any major adverse effects.

scholarly journals Ouvrier’s Modified Mini Mental State Examination as a screening test for cognitive impairment in school-aged children with epilepsy

2020 ◽  
Vol 60 (3) ◽  
pp. 136-40
Author(s):  
Hariadi Edi Saputra ◽  
Setyo Handryastuti ◽  
Irawan Mangunatmadja ◽  
Dwi Putro Widodo ◽  
Sudung O. Pardede
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Mental State ◽  
Predictive Value ◽  
Mini Mental State Examination ◽  
Diagnostic Value ◽  
Pediatric Epilepsy ◽  
Diagnostic Study ◽  
Long Time ◽  
State Examination

Background Epilepsy may affect children's development, including their cognitive function. The prevalence of cognitive impairment in epilepsy patients is quite high. Weschler Intelligence Scale for Children (WISC) takes a long time to administer and is expensive, so a simpler screening tool for cognitive evaluation is needed in pediatric epilepsy patients. Objective To assess the diagnostic value of Ouvrier’s Modified Mini Mental State Examination (MMSE) for detecting cognitive impairment in children aged 8-11 years with epilepsy. Methods This diagnostic study was conducted in December 2018 to February 2019 at Cipto Mangunkusumo and Fatmawati Hospitals in Jakarta. Data were collected with purposive sampling of children with epilepsy aged 8 to 11 years. Cognitive function was assessed by Ouvrier’s Modified MMSE and WISC. Ouvrier’s Modified MMSE was compared to WISC as and the gold standard. Results were analyzed using a 2x2 table. Results The prevalence of cognitive impairment in 8-11-year-old epilepsy patients was 72.9%. Ouvrier’s Modified MMSE had 83% sensitivity, 85% specificity, 94% positive predictive value, 65% negative predictive value, and 83% accuracy. Conclusions Ouvrier’s Modified MMSE has good diagnostic value, thus it may be useful for early detection of cognitive impairment in pediatric epilepsy.

scholarly journals Computerized tomography of the Thorax for surgical patients during the COVID-19 pandemic: Was it useful?

2021 ◽  
Author(s):  
Ahmed Ismail ◽  
Priya Sarkar ◽  
Balasundaram Muthiah ◽  
Nuha Yassin
Keyword(s):  
Surgical Planning ◽  
Statistical Significance ◽  
Diagnostic Value ◽  
Inclusion Criteria ◽  
Antibody Testing ◽  
Data Collection And Analysis ◽  
Retrospective Data Collection ◽  
Regulatory Bodies ◽  
Cost Implications ◽  
Negative Predictor

Objectives Diagnostic challenges during the COVID-19 pandemic forced the radiology regulating body to adopt the use of CT Chest as a triage and diagnostic tool, which was subsequently abandoned. The Royal Wolverhampton hospital followed both protocols. Here, we investigate the evidence behind this decision within the context of surgical admissions during the COVID-19 peak in our hospital. Methods Retrospective data collection and analysis of all surgical admissions between the 1st of March to the 31st of May. Data was collected from the radiology and electronic portal looking into patients undergoing CT chest to diagnose the presence of C-19 as well as swab results. Results 78 patients fulfilled our inclusion criteria. The scan either confirmed the presence or absence (4, 63 patients) of C-19 but was sometimes inconclusive (11 patients). Comparing these to the results of the swabs; CT showed sensitivity 42.86 %, Specificity 97.92%, and accuracy 90.91 %. In the inconclusive CT report group, chances of having a positive swab result were 45%: None of the scan results changed any of the surgical planning. Lymphocyte count in the context of surgical presentation did not have any statistical significance to predict the presence of C-19 (P=0.7). Cost implications on our cohort of patients for adding the chest CT is estimated to be around £31,000. Conclusion CT Thorax during the pandemic was a good negative predictor but had limited diagnostic value and did not change patient management. Newer, faster techniques of PCR swabs and antibody testing would be a better and cheaper alternative. Advances in knowledge This paper provides evidence to support the decision from the regulatory bodies not to use CT scan as a screening tool for COVID 19 diagnosis.

scholarly journals Diagnostic value of newborn foot length to predict gestational age

2017 ◽  
Vol 57 (4) ◽  
pp. 181
Author(s):  
Mutia Farah Fawziah ◽  
Bambang Soebagyo ◽  
Dwi Hidayah
Keyword(s):  
Likelihood Ratio ◽  
Gestational Age ◽  
Predictive Value ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Full Term ◽  
Anthropometric Measurement ◽  
Diagnostic Study ◽  
Foot Length

Background  Identification of gestational age, especially within 48 hours of birth, is crucial for newborns, as the earlier preterm status is detected, the earlier the child can receive optimal management. Newborn foot length is an anthropometric measurement which is easy to perform, inexpensive, and potentially efficient for predicting gestational age.Objective  To analyze the diagnostic value of newborn foot length in predicting gestational age.Methods  This diagnostic study was performed between October 2016 and February 2017 in the High Care Unit of Neonates at Dr. Moewardi General Hospital, Surakarta. A total of 152 newborns were consecutively selected and underwent right foot length measurements before 96 hours of age. The correlation between newborn foot length to classify as full term and gestational age was analyzed with Spearman’s correlation test because of non-normal data distribution. The cut-off point of newborn foot length was calculated by receiver operating characteristic (ROC) curve and diagnostic values of newborn foot length were analyzed by 2 x 2 table with SPSS 21.0 software.Results There were no significant differences between male and female newborns in terms of gestational age, birth weight, choronological age, and newborn foot length (P>0.05). Newborn foot length and gestational age had a significant correlation (r=0.53; P=0.000). The optimal cut-off newborn foot length to predict full term status was 7.1 cm. Newborn foot length below 7.1 cm had sensitivity 75%, specificity 98%, positive predictive value 94.3%, negative predictive value 90.6%, positive likelihood ratio 40.5, negative likelihood ratio 0.25, and post-test probability 94.29%, to predict preterm status in newborns.Conclusion  Newborn foot length can be used to predict gestational age, especially for the purpose of differentiating between preterm and full term newborns.

scholarly journals Delphi consensus on the diagnosis and treatment of patients with short stature in Spain: GROW-SENS study

2021 ◽  
Author(s):  
R. Corripio-Collado ◽  
C. Fernández-Ramos ◽  
I. González-Casado ◽  
F. Moreno-Macián ◽  
J.-P. López-Siguero ◽  
...  
Keyword(s):  
Short Stature ◽  
Treatment Adherence ◽  
Complete Blood Count ◽  
Hormone Treatment ◽  
Diagnostic Value ◽  
Diagnosis And Treatment ◽  
Response To Treatment ◽  
Diagnostic Study ◽  
Main Criterion ◽  
Delphi Consensus

Abstract Purpose To identify consensus aspects related to the diagnosis, monitoring, and treatment of short stature in children to promote excellence in clinical practice. Methods Delphi consensus organised in three rounds completed by 36 paediatric endocrinologists. The questionnaire consisted of 26 topics grouped into: (1) diagnosis; (2) monitoring of the small-for-gestational-age (SGA) patient; (3) growth hormone treatment; and (4) treatment adherence. For each topic, different questions or statements were proposed. Results After three rounds, consensus was reached on 16 of the 26 topics. The main agreements were: (1) diagnosis tests considered as a priority in Primary Care were complete blood count, biochemistry, thyroid profile, and coeliac disease screening. The genetic test with the greatest diagnostic value was karyotyping. The main criterion for initiating a diagnostic study was prediction of adult stature 2 standard deviations below the target height; (2) the main criterion for initiating treatment in SGA patients was the previous growth pattern and mean parental stature; (3) the main criterion for response to treatment was a significant increase in growth velocity and the most important parameter to monitor adverse events was carbohydrate metabolism; (4) the main attitude towards non-responding patients is to check their treatment adherence with recording devices. The most important criterion for choosing the delivery device was its technical characteristics. Conclusions This study shows the different degrees of consensus among paediatric endocrinologists in Spain concerning the diagnosis and treatment of short stature, which enables the identification of research areas to optimise the management of such patients.

scholarly journals Magnetic resonance cholangiopancreatography as a diagnostic tools to diagnose biliary atresia at Dr.Soetomo hospital

2019 ◽  
Vol 3 (2) ◽  
pp. 137
Author(s):  
Gina Noor Djalilah ◽  
Reny Widayanti ◽  
Bagus Setyoboedi ◽  
Sjamsul Arief
Keyword(s):  
Magnetic Resonance ◽  
Liver Biopsy ◽  
Biliary Atresia ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Diagnostic Value ◽  
Diagnostic Tools ◽  
Diagnostic Study ◽  
Cross Sectional

ABSTRACT Cholestasis jaundice results from diminished bile flow and/or excretion, and caused by a number of disorders such as biliary atresia (BA). Magnetic resonance cholangiopancreatography (MRCP) is widely accepted as one of the modalities for biliary system imaging; however, liver biopsy still generally used for BA diagnosis, especially in developing countries. This aim study was to evaluate the diagnostic value of biliary atresia from MRCP compared to the result of a liver biopsy. A cross-sectional for diagnostic study documented of hospitalized patients from June 2014 to June 2015. All patients had MRCP and liver biopsy examination. The collection of data including age, gender, clinical manifestation and the result of MRCP and liver biopsy with ROC to evaluate the sensitivity and specificity was done. Liver biopsy revealed of biliary atresia was made based on proliferation, degeneration, and fibrosis of bile ducts. ROC to evaluate the sensitivity and specificity was done. The sensitivity, specificity, negative predictive value, positive predictive value of MRCP in diagnosing BA were calculated. There were 16 patients enrolled in this study with a median age of diagnosis was 6 months old (range 3-11). There were nine female patients out of the 16 patient. The median age of jaundice onset was 5 days (range 2-14 days). All patients had hepatomegaly and splenomegaly. Histopathology from liver biopsy revealed biliary atresia in 12 patients. From the ROC curve, the sensitivity of MRCP was 87.5% and specificity 62.5% with PPV 70% and NPV 80%. Five patients underwent a Kasai procedure and revealed biliary atresia. MRCP is sensitive but not specific for diagnosing BA, and MRCP has moderate sensitivity and specificity for BA diagnosis.Keyword: biliary atresia, magnetic resonance cholangiopancreatography, liver biopsy, diagnostic test.Correspondence: [email protected] ABSTRAKIkterus dikarenakan kolestasis terjadi akibat berkurangnya aliran empedu dan/ atau ekskresi, dan dapat disebabkan oleh sejumlah gangguan seperti atresia biliaris (BA). Magnetic resonance cholangiopancreatography (MRCP) secara luas diterima sebagai salah satu modalitas untuk pencitraan sistem empedu, namun biopsi hati masih secara umum digunakan untuk diagnosis BA, terutama di negara berkembang. Studi ini bertujuan untuk mengevaluasi nilai diagnostik atresia biliaris dari MRCP ke hasil biopsi hati. Sebuah cross sectional untuk studi diagnostik didokumentasikan pasien rawat inap dari Juni 2014 hingga Juni 2015. Semua pasien menjalani MRCP dan pemeriksaan biopsi hati. Data usia, jenis kelamin, manifestasi klinis dan hasil MRCP dan biopsi hati dengan ROC untuk mengevaluasi sensitivitas dan spesifisitas dilakukan. Biopsi hati mengungkapkan atresia biliar dibuat berdasarkan proliferasi, degenerasi dan fibrosis saluran empedu. ROC untuk mengevaluasi sensitivitas dan spesifisitas yang dilakukan. Dilakukan perhitungan sensitivitas, spesifisitas, nilai prediktif negatif, nilai prediksi positif MRCP dalam mendiagnosis BA. Terdapat 16 pasien yang terdaftar dalam penelitian ini dengan median usia diagnosis adalah 6 (kisaran 3-11) bulan. Terdapat 9 perempuan dari 16 pasien tersebut. Usia rata-rata onset penyakit kuning adalah 5 (kisaran 2-14) hari. Semua pasien mengalami hepatomegali dan splenomegali. Histopatologi dari biopsi hati mengungkapkan atresia bilier pada 12 dari 16 pasien. Dari kurva ROC, sensitivitas MRCP adalah 87,5% dan spesifisitas 62,5% dengan PPV 70% dan NPV 80%. Lima pasien menjalani prosedur Kasai dan mengungkapkan atresia bilier. MRCP sensitif namun tidak spesifik untuk mendiagnosis BA dan MRCP memiliki sensitivitas dan spesifisitas sedang untuk diagnosis BA.Kata kunci: biliary atresia, magnetic resonance cholangiopancreatography, liver biopsy, diagnostic test.Korespondensi: [email protected]

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