scholarly journals An Effective Approach for Endocrine Dynamic Function Tests Workflow and Reporting Using Cerner Millennium®

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S50-S51
Author(s):  
J M Asinas ◽  
W Khaiwi ◽  
A Miller ◽  
P Newland
Keyword(s):  
Word Processing ◽  
Laboratory Data ◽  
Priority Rules ◽  
Function Tests ◽  
Dynamic Function ◽  
Stimulation Tests ◽  
Medical Technologists ◽  
Discrete Task ◽  
Conclusion Section ◽  
Clinical Biochemist

Abstract Introduction/Objective Endocrine dynamic function testing (DFT), also known as hormone stimulation tests, are indispensable tools in the endocrine practice. Common pitfalls of ineffective testing and misdiagnosis are due to incorrect sample recordings, delay in sample collections and disorganized or confusing result presentation. Clinical and laboratory data deserves careful attention and discrepancies must be reviewed by a clinical biochemist before releasing results for proper patient diagnosis. The main objective of this Cerner DFT project is to design and implement Cerner Millennium applications for effective management and organized result reporting of hospital-wide DFT protocols. Methods/Case Report The DFT Cerner workflow is uniquely designed in-house and known as a pioneer build for Cerner Millenium. The design involves the use of Cerner Discern Analytics 2.0 and clinical modules to complete such a complex build. Five DFT panels are defined as care-sets with specific hormone discrete task assays (DTA). For each care-set, an ‘order sentence’ is created to produce the order priority rules. The DFT panels can only be requested as future orders in PowerChart and activated by the medical staff upon collection of the baseline sample. On Cerner PathNet, results are pre-verified by the medical technologists then auto-filtered in the clinical Review Queue (RQ) module for final verification and addition of comments by the biochemistry consultant. A word processing template is used to collate the results and present the summary of the DFT report where standardized canned comments are added using pre-defined codes. Results (if a Case Study enter NA) See Conclusion Section Conclusion The Cerner DFT project mproves the diagnosis and treatment of patients with hormone disorders. Before, there was a danger of misdiagnosis when samples are individually requested producing separate reports with no organized presentation. Report comments from the clinical biochemist consultant also served as good diagnostic guidance. This quality initiative has definitely improved the previous and long term issues of endocrine dynamic function tests.

scholarly journals Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

2020 ◽  
Vol 15 (8) ◽  
pp. 1399-1407 ◽  
Author(s):  
Marco Vincenzo Lenti ◽  
◽  
Federica Borrelli de Andreis ◽  
Ivan Pellegrino ◽  
Catherine Klersy ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Intensive Care ◽  
Liver Function ◽  
Laboratory Data ◽  
Liver Function Tests ◽  
Gamma Glutamyl Transpeptidase ◽  
Function Tests ◽  
Altered Liver ◽  
The Impact ◽  
Internal Medicine Unit

Abstract Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.

Do we need method specific cortisol cut off limits for dynamic function tests?

2014 ◽  
Author(s):  
Kate Braha ◽  
Suzannah Phillips ◽  
John Dutton ◽  
Anna Milan
Keyword(s):  
Function Tests ◽  
Dynamic Function

An audit of dynamic function tests: errors in the timing of blood specimens

1993 ◽  
Vol 39 (1) ◽  
pp. 97-100
Author(s):  
J. H. Barth ◽  
M. D. Page ◽  
I. R. Bailey
Keyword(s):  
Function Tests ◽  
Dynamic Function ◽  
Blood Specimens

scholarly journals Evaluation of Prepubertal Patients with Suspected Neurosecretory Dysfunction of Growth Hormone Secretion: Diagnostic Steps and Treatment Response

2017 ◽  
Vol 2017 ◽  
pp. 1-11
Author(s):  
Carmen Sydlik ◽  
Claudia Weißenbacher ◽  
Julia Roeb ◽  
Susanne Bechtold-Dalla Pozza ◽  
Heinrich Schmidt
Keyword(s):  
Growth Hormone ◽  
Hormone Secretion ◽  
Laboratory Data ◽  
Growth Hormone Secretion ◽  
Diagnostic Procedures ◽  
Gh Treatment ◽  
Gh Secretion ◽  
Significant Difference ◽  
Stimulation Tests

Background and Aims. Existence and diagnostic procedures of neurosecretory dysfunction of growth hormone (NSD) are still a matter of debate. The aim of our study was (a) to find out if prediagnostic auxological and laboratory data could serve as an indicator for pathologic and normal spontaneous GH-secretion and (b) to evaluate the response to GH-therapy in NSD-patients. Methods. Of 90 children (unicentric study) with normal response to GH-stimulation tests, in whom 12-hour night profiles for GH-secretion were performed, 49 were diagnosed with NSD (NSD group). Their auxologic data, IGF-I/IGFBP3-levels as well as the night profiles, were analysed and compared to those of the non-NSD group. Additionally, follow-up auxological data of the GH-treated NSD-patients were collected. Results. Prediagnostic auxologic and laboratory data did not differ between the two groups. Instead, for all analysed criteria of spontaneous GH-secretion (number of peaks, maximal and mean secretion) a significant difference was found. Children with NSD showed a good response to GH-treatment after 1 (ΔH-SDS +0,77 ± 0,48) as well as 4 years (+1,51 ± 0,75). Conclusion. According to our results, analysing spontaneous GH-secretion remains the only method to identify NSD. Yet, as response to GH-treatment is comparable to results in idiopathic GHD, it is worth to consider this diagnosis.

scholarly journals A Retrospective Study in Dengue Positive Cases - Hematological and Biochemical Parameters (Liver Function Tests, Renal Function Tests) Correlation

2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1489-1493
Author(s):  
Volga Harikrishnan ◽  
Naveen Kumar M
Keyword(s):  
Liver Function ◽  
Dengue Fever ◽  
Laboratory Data ◽  
Elevated Serum ◽  
Liver Function Tests ◽  
Common Finding ◽  
Severe Dengue ◽  
Albumin Concentration ◽  
Serum Glutamic Oxaloacetic Transaminase ◽  
Function Tests

Dengue fever is the most common arboviral infection in the world, and it is a disease with a broad clinical spectrum and a wide variety of presentations, ranging from asymptomatic to an undifferentiated fever (viral syndrome) to the more severe forms such as severe dengue (SD) or Dengue hemorrhagic fever (DHF). The diagnosis of dengue fever is carried out based on clinical, epidemiological and laboratory data. Among laboratory tests, both non-specific [blood count, platelet count, tourniquet test, prothrombin time (PT), activated partial thromboplastin time (APTT), liver function tests and serum albumin concentration] and specific tests (viral isolation tests and serology for antibody examination) are used. The principle aim of our study is to assess and compare the biochemical and haematological parameters of patients with dengue. In our study population, the peak frequency of the patients who were dengue positive was on the age group between 21 and 30 years (44%), and it was more common among males. The most common serological indicator of dengue fever was the presence of NS1 antibody. High haematocrit (56%) was found in most of the patients, and the next common finding was thrombocytopenia (51%). Elevated Serum glutamic oxaloacetic transaminase seen in 53% of cases and Elevated Serum glutamic pyruvic transaminase, Alkaline Phosphatase, Serum Bilirubin, Serum creatinine and Serum urea were found in 41%, 11%,7%, 4%, 3%of cases respectively. The knowledge about these parameters helps the clinician in early diagnosis of the cases and initiation of the management measures before the drastic clinical features of the disease sets. 

scholarly journals Diagnostic value of abdominal sonography in confirmed COVID-19 intensive care patients

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohsen Ahmed Abdelmohsen ◽  
Buthaina M. Alkandari ◽  
Vikash K. Gupta ◽  
Ahmed Adel ElBeheiry
Keyword(s):  
Intensive Care ◽  
Laboratory Data ◽  
Liver Function Tests ◽  
Diagnostic Value ◽  
World Health ◽  
Imaging Findings ◽  
Abdominal Sonography ◽  
Intensive Care Patients ◽  
Abdominal Symptoms ◽  
Function Tests

Abstract Background In December 2019, a large outbreak of a novel coronavirus infection occurred in Wuhan, China. The pneumonic disease caused by this virus is called coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). As case numbers have increased worldwide, gastro-intestinal symptoms like diarrhea, constipation, abdominal pain, and vomiting have been increased, these symptoms associated with positive laboratory results including abnormal liver function tests, renal function tests, and D-Dimer levels. Although there are multiple articles evaluated the imaging findings in HRCT of COVID-19 patients that helped in understanding the disease course and potential complications in the chest, yet there are—to our knowledge—limited data about the abdominal imaging findings of the course and potential abdominal complications of COVID-19 notably in the intensive care units (ICU). Results Forty-one sonographic examinations were done for 30 confirmed COVID-intensive care patients presented with abdominal symptoms. Of the 30 patients, 26 were males (86.66%), and 4 were females (13.3%), the average age of the patients was 57.7 years old. The most common sonographic observation was hepatomegaly (n, 23/41, 56%) and biliary system disease (n, 17/41, 41.4%); the imaging findings were correlated with the clinical and laboratory data. CT examination when indicated (in our study to assess hematomas for active extravasation and to assess bowel obstruction and its level). Conclusion Abdominal sonographic imaging was often performed for inpatients with COVID-19. Hepatobiliary dysfunction as well as nephropathy was the most common imaging findings.

A Macintosh Interface for the Cameca Camebax-Micro Electron Microprobe

1990 ◽  
Vol 48 (1) ◽  
pp. 438-439
Author(s):  
Carl E. Henderson
Keyword(s):  
Electron Microprobe ◽  
Processing Speed ◽  
Word Processing ◽  
State Of The Art ◽  
Computer Control ◽  
Third Party ◽  
Disk Storage ◽  
The Past ◽  
User Facility ◽  
Instrument Control

Over the past few years it has become apparent in our multi-user facility that the computer system and software supplied in 1985 with our CAMECA CAMEBAX-MICRO electron microprobe analyzer has the greatest potential for improvement and updating of any component of the instrument. While the standard CAMECA software running on a DEC PDP-11/23+ computer under the RSX-11M operating system can perform almost any task required of the instrument, the commands are not always intuitive and can be difficult to remember for the casual user (of which our laboratory has many). Given the widespread and growing use of other microcomputers (such as PC’s and Macintoshes) by users of the microprobe, the PDP has become the “oddball” and has also fallen behind the state-of-the-art in terms of processing speed and disk storage capabilities. Upgrade paths within products available from DEC are considered to be too expensive for the benefits received. After using a Macintosh for other tasks in the laboratory, such as instrument use and billing records, word processing, and graphics display, its unique and “friendly” user interface suggested an easier-to-use system for computer control of the electron microprobe automation. Specifically a Macintosh IIx was chosen for its capacity for third-party add-on cards used in instrument control.

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