scholarly journals Coronavirus Disease 2019 Serial Testing Among Hospitalized Patients in a Midwest Tertiary Medical Center, July–September 2020

2020 ◽  
Author(s):  
Takaaki Kobayashi ◽  
Alexandra Trannel ◽  
Stephanie A Holley ◽  
Mohammed A Alsuhaibani ◽  
Oluchi J Abosi ◽  
...  
Keyword(s):  
Incubation Period ◽  
Conversion Rate ◽  
Medical Center ◽  
Hospitalized Patients ◽  
Repeat Testing ◽  
Negative Test ◽  
Serial Testing

Abstract We implemented serial coronavirus disease 2019 testing for inpatients with a negative test on admission. The conversion rate (negative to positive) on repeat testing was 1%. We identified patients during their incubation period and hospital-onset cases, rapidly isolated them, and potentially reduced exposures. Serial testing and infectiousness determination were resource intensive.

scholarly journals The Wild West of Emergency Use Authorizations for SARS-CoV-2 Testing: What Could Be the True Sensitivity?

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S142-S143
Author(s):  
S Dalal ◽  
S Patel ◽  
J M Petersen ◽  
D Jhala
Keyword(s):  
Medical Center ◽  
Initial Result ◽  
Reference Laboratory ◽  
Test Results ◽  
Rt Pcr ◽  
Repeat Testing ◽  
Parallel Testing ◽  
Percent Agreement ◽  
Instructions For Use ◽  
Multiple Reference

Abstract Introduction/Objective SARS-CoV-2 is a pandemic that has required mobilization to meet urgent needs. In this mobilization, emergency use authorizations (EUA) have been issued by the FDA to expedite the deployment of these tests. This has led to a situation whereby sensitivity has not been rigorously studied for any of the assays with EUAs. Estimates can be extrapolated from the limited samples documented by the company in their instructions for use (IFU). Although the nationwide shortage of testing reagents prevent parallel testing of multiple platforms on all specimens, observations of repeat specimens at the Veteran Affairs Medical Center (VAMC) provides the first study in the literature of more complete data for SARS-CoV-2 nucleic acid (RT-PCR) assay on sensitivity on the Abbott (Abbott Park Ill) and Cepheid (Sunnyvale CA) assays. Methods A retrospective search was performed for all test results for SARS-CoV-2 by RT-PCR from 3/1/2020 to 4/14/2020 at Corporal Michael J. Crescenz Medical Center, in order to evaluate the sensitivity on Abbott m2000 and Cepheid platforms. Results across multiple reference laboratories and in-house testing platforms were collated in a table with all patients clinically requiring repeat testing recorded. Results 114/863 patients had repeat testing. The tests were performed initially by outside reference laboratories (25 patients), on the Abbott m2000 (63 patients), and Cepheid Infinity (26 patients). 15/114 (13%) had discordant results on repeat testing. This included 1 test initially done by a reference laboratory. 8 days after the initial result from the reference lab, a positive for the same patient was identified on the Abbott platform. 11 initial Abbott results were discordant on further repeat testing on two platforms - Abbott (6 patients) and Cepheid (5 patients) 1-6 days later. In addition, 3 initial Cepheid were discordant on further repeat testing by the same Cepheid platform (1-16 days later). Conclusion While the instructions for use for both platforms suggest 100% sensitivity and specificity (due to the 100% positive and negative percent agreement in limited specimens), the true sensitivity is less than 100%, particularly early in the course of the infection. In our study, the positive percent agreement (surrogate for sensitivity) was 83% for initial Abbott tests, 88% for initial Cepheid tests, and 95% by Reference laboratory platform.

The Ten Point Clock Test: A Quick Screen and Grading Method for Cognitive Impairment in Medical and Surgical Patients

1994 ◽  
Vol 24 (3) ◽  
pp. 229-244 ◽  
Author(s):  
Peter J. Manos ◽  
Rae Wu
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Deficits ◽  
Neuropsychological Tests ◽  
Medical Center ◽  
Neuropsychological Test ◽  
Hospitalized Patients ◽  
Surgical Patients ◽  
Tertiary Referral Center ◽  
The Mean ◽  
State Examination

Objective: The objective of this study was to evaluate the clinical utility of the ten point clock test in screening for and grading cognitive deficits in medical and surgical patients. Method: The setting was the hospital and clinics of Virginia Mason Medical Center, a tertiary referral center. Consecutive samples of hospitalized patients, and clinic outpatients—with and without a dementia—were administered the ten point clock test as well as a number of other neuropsychological tests and measures of cognitive impairment. Results: Clock scores correlated with neuropsychological test scores and with the mini-mental state examination. They were stable from rater to rater, and from day to day in stable patients. The mean clock score of elderly outpatient controls was 8.5, significantly different from the mean of 5.5 scored by patients with a dementia. A cut off score of seven identified 76 percent of outpatients with dementia and 78 percent of elderly controls. Clock scores correlated well with nurses' ratings of their inpatients' cognitive deficits (Spearman's rs = −0.61). The test was easy to administer, even to hospitalized patients. Conclusions: The ten point clock test is reliable, valid, and useful as a quick screen and grading method for cognitive deficits in medical and surgical patients.

Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

2018 ◽  
Vol 46 (7) ◽  
pp. 748-750 ◽  
Author(s):  
Julianna Desmarais ◽  
Cong-Qiu Chu
Keyword(s):  
Retrospective Study ◽  
Adverse Effects ◽  
Medical Center ◽  
Veterans Affairs ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Acute Gout ◽  
Efficacy And Safety ◽  
Inpatient Management ◽  
Gout Flares

Objective.To evaluate the efficacy and safety of anakinra in inpatient management of acute gout and pseudogout.Methods.Hospitalized patients with acute gout (n = 77) or pseudogout (n = 11) or both (n = 3) were analyzed for response to anakinra and adverse effects.Results.Half of all patients had comorbidities limiting the treatment choice. Anakinra was well tolerated, and 92% of gout flares and 79% of pseudogout flares responded to treatment.Conclusion.Anakinra is an effective and safe treatment for acute gout and pseudogout in hospitalized patients, particularly in those with comorbidities.

scholarly journals Institutional Blood Glucose Monitoring System for Hospitalized Patients: An Integral Component of the Inpatient Glucose Control Program

2009 ◽  
Vol 3 (5) ◽  
pp. 1168-1174 ◽  
Author(s):  
Mona Boaz ◽  
Zohar Landau ◽  
Zipora Matas ◽  
Julio Wainstein
Keyword(s):  
Blood Glucose ◽  
Diabetic Patient ◽  
Glucose Control ◽  
Medical Center ◽  
Control Program ◽  
Hospitalized Patients ◽  
Blood Glucose Monitoring ◽  
Diabetic Patients ◽  
Integral Component

Background: The ability to measure patient blood glucose levels at bedside in hospitalized patients and to transmit those values to a central database enables and facilitates glucose control and follow-up and is an integral component in the care of the hospitalized diabetic patient. Objective: The goal of this study was to evaluate the performance of an institutional glucometer employed in the framework of the Program for the Treatment of the Hospitalized Diabetic Patient (PTHDP) at E. Wolfson Medical Center, Holon, Israel. Methods: As part of the program to facilitate glucose control in hospitalized diabetic patients, an institutional glucometer was employed that permits uploading of data from stands located in each inpatient department and downloading of that data to a central hospital-wide database. Blood glucose values from hospitalized diabetic patients were collected from August 2007 to October 2008. The inpatient glucose control program was introduced gradually beginning January 2008. Results: During the follow-up period, more than 150,000 blood glucose measures were taken. Mean glucose was 195.7 ± 99.12 mg/dl during the follow-up period. Blood glucose values declined from 206 ± 105 prior to PTHDP (August 2007–December 2007) to 186 ± 92 after its inception (January 2008–October 2008). The decline was associated significantly with time ( r = 0.11, p < 0.0001). The prevalence of blood glucose values lower than 60 mg/dl was 1.48% [95% confidence interval (CI) 0.36%] prior to vs 1.55% (95% CI 0.37%) following implementation of the PTHDP. Concomitantly, a significant increase in the proportion of blood glucose values between 80 and 200 mg/dl was observed, from 55.5% prior to program initiation vs 61.6% after program initiation ( p < 0.0001). Conclusions: The present study was designed to observe changes in institution-wide glucose values following implementation of the PTHDP. Information was extracted from the glucometer system itself. Because the aforementioned study was not a clinical trial, we cannot rule out that factors other than introduction of the program could explain some of the variability observed. With these limitations in mind, it nevertheless appears that the PTHDP, of which the institutional glucometer is an integral, essential component, was associated with improved blood glucose values in the hospitalized diabetic patient.

Implementation of computerized add-on testing for hospitalized patients in a large academic medical center

2011 ◽  
Vol 49 (5) ◽  
Author(s):  
Ji Yeon Kim ◽  
Irina K. Kamis ◽  
Balaji Singh ◽  
Shalini Batra ◽  
Roberta H. Dixon ◽  
...  
Keyword(s):  
Medical Center ◽  
Academic Medical Center ◽  
Hospitalized Patients ◽  
Academic Medical

Parenteral Nutrition (PN) Use for Adult Hospitalized Patients: A Study of Usage in a Tertiary Medical Center

2007 ◽  
Vol 22 (2) ◽  
pp. 246-249 ◽  
Author(s):  
Mark H. DeLegge ◽  
Mary D. Basel ◽  
Chris Bannister ◽  
Amanda R. Budak
Keyword(s):  
Parenteral Nutrition ◽  
Medical Center ◽  
Hospitalized Patients

scholarly journals Incidence and Characteristics of Vancomycin Nonsusceptible Strains of Methicillin-Resistant Staphylococcus aureus at Hershey Medical Center

2008 ◽  
Vol 52 (12) ◽  
pp. 4510-4513 ◽  
Author(s):  
Klaudia Kosowska-Shick ◽  
Lois M. Ednie ◽  
Pamela McGhee ◽  
Kathy Smith ◽  
Cynthia D. Todd ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
False Positive ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Medical Center ◽  
Screening Method ◽  
Brain Heart Infusion ◽  
Methicillin Resistant ◽  
Repeat Testing ◽  
False Positivity ◽  
Positive Results

ABSTRACT All 982 methicillin-resistant Staphylococcus aureus strains collected from August 2006 to December 2007 were tested for vancomycin susceptibility by using 3-μg/ml vancomycin brain heart infusion screening plates, a vancomycin Etest, and a vancomycin/teicoplanin macro Etest. Three vancomycin-intermediate Staphylococcus aureus (VISA) (0.3%) and two heterogeneous VISA (0.2%) isolates were identified. The screening method yielded 895 cases of ≤1 colony and 87 positive results (with growth of >1 colony after 48 h); further Etests showed 82/87 isolates with growth on screening plates to be false positive. Repeat testing showed a false-positivity rate of only 15 of the original 87 isolates by plate screening.

Drug-induced liver injury: A 2-year retrospective study of 1169 hospitalized patients in a single medical center

Phytomedicine ◽  
2015 ◽  
Vol 22 (13) ◽  
pp. 1201-1205 ◽  
Author(s):  
Hong Jung Woo ◽  
Ha Yeon Kim ◽  
Eun Sol Choi ◽  
Young-hwan Cho ◽  
Youngchul Kim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Liver Injury ◽  
Medical Center ◽  
Hospitalized Patients ◽  
Drug Induced ◽  
Drug Induced Liver Injury

Evaluation of the Safety and Efficacy of Metformin Use in Hospitalized, Non–Critically Ill Patients

2020 ◽  
Vol 36 (3) ◽  
pp. 102-109
Author(s):  
Tahnia Alauddin ◽  
Sarah E. Petite
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Medical Center ◽  
Academic Medical Center ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Adverse Outcomes ◽  
Safety And Efficacy ◽  
Antihyperglycemic Therapy ◽  
Heart Failure Diagnosis

Background: Contraindications and precautions to metformin have limited inpatient use, and limited evidence exists evaluating metformin in hospitalized patients. Objective: This study aimed to determine the safety and efficacy of inpatient metformin use. Methods: This study was an observational, retrospective, cohort study at an academic medical center between June 1, 2016, and May 31, 2018. Hospitalized adults with type 2 diabetes mellitus receiving at least 1 metformin dose were included. The primary endpoint was to identify hospitalized patients using metformin with at least 1 contraindication or precautionary warning against use. Secondary endpoints included assessing metformin efficacy with glycemic control, characterizing adverse outcomes of inpatient metformin, and comparing the efficacy of metformin-containing regimens. Results: Two hundred patients were included. There were 126 incidences of potentially unsafe use identified in 111 patients (55.5%). The most common reasons were age ≥65 years (47%), heart failure diagnosis (7.5%), and metformin within 48 hours of contrast (6%). Metformin was contraindicated in 2 patients (1%) with an estimated glomerular filtration rate ≤30 mL/min/1.73 m2. The overall median daily blood glucose was 146 mg/dL (interquartile range [IQR] = 122-181). Patients were divided into 3 groups: metformin monotherapy, metformin plus oral antihyperglycemic therapy, and metformin plus insulin. The median daily blood glucoses were 129 mg/dL (IQR = 110-152), 154 mg/dL (IQR = 133-178), and 174 mg/dL (IQR = 142-203; P < .001), respectively. Two patients (1%) developed acute kidney injury, and no patients developed lactic acidosis. Conclusions: Metformin was associated with goal glycemic levels in hospitalized patients with no adverse outcomes. These results suggest the potential for metformin use in hospitalized, non–critically ill patients.

Sign in / Sign up

Export Citation Format

Share Document