Laboratory interpretative comments and guidance: clinical and operative outcomes on moderate to severe hyponatraemia patient management

2021 ◽  
pp. jclinpath-2021-207611
Author(s):  
Blanca Montero-San-Martín ◽  
Paloma Oliver ◽  
Pilar Fernandez-Calle ◽  
Juan J Sánchez-Pascuala Callau ◽  
Mariana Díaz Almirón ◽  
...  
Keyword(s):  
Point Of Care ◽  
Sodium Concentration ◽  
Clinical Settings ◽  
Laboratory Procedure ◽  
Gas Network ◽  
Operative Outcomes ◽  
Severe Hyponatraemia ◽  
Before And After ◽  
Time Required ◽  
Interpretative Comments

AimsHyponatraemia is the most common body fluid disorders but often goes unnoticed. Our laboratory incorporated a standardised procedure to help clinicians detect moderate/severe hyponatraemia. The study aims were to evaluate the outcomes on patient care and clinicians’ satisfaction.MethodsThe study, observational and retrospective, included 1839 cases, adult and paediatric patients, with sodium concentration <130 mmol/L. The procedure consisted of interpretative comments in the emergency and core laboratories report and the point-of-care testing blood gas network report. We evaluated hyponatraemia length in two equal periods: before and after the implementation. We conducted a survey addressed to the staff of the clinical settings involved to know their satisfaction.ResultsThe median hyponatraemia length decreased significantly from 4.95 hours (2.08–16.57) in the first period to 2.17 hours (1.06–5.39) in the second period. The lack of hyponatraemia patients follow-up was significantly less after the procedure implementation. The survey was answered by 92 (60 senior specialists and 32 residents) out of 110 clinicians surveyed. Ninety of them (98%) answered positively.ConclusionsWe have demonstrated the reduction in the time for diagnosing and management by physicians, the higher uniformity in the time required to solve hyponatraemia episodes following our laboratory procedure and the clinicians’ satisfaction.

A Point of Care Lateral Flow Assay for Rapid and Colorimetric Detection of Interleukin 6 and Perspectives in Bedside Diagnostics

2020 ◽  
Author(s):  
Carla Eiras
Keyword(s):  
Interleukin 6 ◽  
Limit Of Detection ◽  
Inflammatory Diseases ◽  
Point Of Care ◽  
Colorimetric Detection ◽  
Lateral Flow ◽  
Lateral Flow Assay ◽  
Aggregation Assay ◽  
Before And After ◽  
Bedside Diagnosis

Interleukin-6 (IL-6) is a multifunctional cytokine and high bloodstream levels of which have been associated with severe inflammatory diseases, such as dengue fever, sepsis, various cancers, and visceral leishmaniasis (VL). Rapid tests for the quantification of IL-6 would be of great assistance for the bedside diagnosis and treatment of diseases such as VL. We have developed a lateral flow assay (LFA) for rapid and colorimetric IL-6 detection, consisting of anti-IL-6 antibodies conjugated to gold nanoparticles (AuNPs). The optimal concentration of anti-IL-6 used in the conjugate was determined to be 800.0 μg/mL, based on an aggregation assay using LFA. A linear relationship between IL-6 standard concentration and color intensity was observed after 20 min, with a linear range between 1.25 ng/mL and 9,000 ng/mL. The limit of detection for this method was estimated a t0.38 ng/mL. The concentration of IL-6 in five patients with severe VL was measured using LFA, and the results were consistent with those obtained using the cytometric bead array (CBA) method. A thorough analysis of the LFA membranes’ surface morphology, before and after sample contact, was performed using atomic force microscopy (AFM).The prototype described here is still being tested and improved, but this LFA will undoubtedly be of great help in the clinical quantification of IL-6.

A Point of Care Lateral Flow Assay for Rapid and Colorimetric Detection of Interleukin 6 and Perspectives in Bedside Diagnostics

2020 ◽  
Author(s):  
Carla Eiras
Keyword(s):  
Interleukin 6 ◽  
Limit Of Detection ◽  
Inflammatory Diseases ◽  
Point Of Care ◽  
Colorimetric Detection ◽  
Lateral Flow ◽  
Lateral Flow Assay ◽  
Aggregation Assay ◽  
Before And After ◽  
Bedside Diagnosis

Interleukin-6 (IL-6) is a multifunctional cytokine and high bloodstream levels of which have been associated with severe inflammatory diseases, such as dengue fever, sepsis, various cancers, and visceral leishmaniasis (VL). Rapid tests for the quantification of IL-6 would be of great assistance for the bedside diagnosis and treatment of diseases such as VL. We have developed a lateral flow assay (LFA) for rapid and colorimetric IL-6 detection, consisting of anti-IL-6 antibodies conjugated to gold nanoparticles (AuNPs). The optimal concentration of anti-IL-6 used in the conjugate was determined to be 800.0 μg/mL, based on an aggregation assay using LFA. A linear relationship between IL-6 standard concentration and color intensity was observed after 20 min, with a linear range between 1.25 ng/mL and 9,000 ng/mL. The limit of detection for this method was estimated at a t0.38 ng/mL. The concentration of IL-6 in five patients with severe VL was measured using LFA, and the results were consistent with those obtained using the cytometric bead array (CBA) method. A thorough analysis of the LFA membranes’ surface morphology, before and after sample contact, was performed using atomic force microscopy (AFM). The prototype described here is still being tested and improved, but this LFA will undoubtedly be of great help in the clinical quantification of IL-6.

Pilot-scale neutralisation of underground mine water

1996 ◽  
Vol 34 (10) ◽  
pp. 141-149 ◽  
Author(s):  
J. P. Maree ◽  
G. J. van Tonder ◽  
P. Millard ◽  
T. C. Erasmus
Keyword(s):  
Mine Water ◽  
Contact Time ◽  
Pilot Scale ◽  
Underground Water ◽  
Underground Mine ◽  
Economic Feasibility ◽  
Fluidised Bed ◽  
Chemical Composition Of Water ◽  
Before And After ◽  
Time Required

Traditionally acid mine water is neutralised with lime (Ca(OH)2). Limestone (CaCO3) is a cheaper alternative for such applications. This paper describes an investigation aimed at demonstrating that underground mine water can be neutralised with limestone in a fluidised-bed. The contact time required between the limestone and the acid water, chemical composition of water before and after treatment, and economic feasibility of the fluidised bed neutralisation process are determined. A pilot plant with a capacity of 10k1/h was operated continuously underground in a gold mine. The underground water could be neutralised effectively using the limestone process. The pH of the water was increased from less than 3 to more than 7, the alkalinity of the treated water was greater than 120 mg/l (as CaCO3) and the contact time required between mine water and limestone was less than 10 min (the exact contact time depends on the limestone surface area). Chemical savings of 56.4% can be achieved compared to neutralisation with lime.

Comprehensive bedside point of care testing in critical ED patients: a before and after study

2015 ◽  
Vol 33 (6) ◽  
pp. 776-780 ◽  
Author(s):  
Adam J. Singer ◽  
Justin Williams ◽  
Maria Taylor ◽  
Deborah Le Blanc ◽  
Henry C. Thode
Keyword(s):  
Point Of Care ◽  
Point Of Care Testing ◽  
Before And After ◽  
Before And After Study

Mitochondrial Ca2+ uptake is important over low [Ca2+]i range in arterial smooth muscle

2002 ◽  
Vol 283 (6) ◽  
pp. H2431-H2439 ◽  
Author(s):  
Tomoko Kamishima ◽  
John M. Quayle
Keyword(s):  
Smooth Muscle ◽  
Decay Time ◽  
Removal Rate ◽  
Arterial Smooth Muscle ◽  
Carbonyl Cyanide ◽  
Before And After ◽  
Intracellular Ca ◽  
Arterial Smooth Muscle Cells ◽  
Time Required ◽  
Loaded Voltage

Mitochondrial Ca2+ uptake is usually thought to occur only when intracellular Ca2+concentration ([Ca2+]i) is high. We investigated whether mitochondrial Ca2+ removal participates in shaping [Ca2+]i signals in arterial smooth muscle over a low [Ca2+]irange. [Ca2+]i was measured using fura 2-loaded, voltage-clamped cells from rat femoral arteries. Both diazoxide and carbonyl cyanide m-chlorophenylhydrazone (CCCP) depolarized the mitochondria. Diazoxide application increased resting [Ca2+]i, suggesting that Ca2+ is sequestered in mitochondria. Over a low [Ca2+]i range, diazoxide and CCCP slowed Ca2+ removal rate, determined after a brief depolarization. When [Ca2+]i was measured during sustained depolarization to −30 mV, CCCP application increased [Ca2+]i. When Ca2+ transients were repeatedly evoked by caffeine applications, CCCP application elevated resting [Ca2+]i. Caffeine-induced Ca2+ transients were compared before and after CCCP application using the half decay time, or time required to reduce increase in [Ca2+]i by 50% ( t ½). CCCP treatment significantly increased t ½. These results suggest that Ca2+ removal to mitochondria in arterial smooth muscle cells may be important at a low [Ca2+]i.

scholarly journals Surgical Pathology Resident Rotation Restructuring at a Tertiary Care Academic Center

2017 ◽  
Vol 4 ◽  
pp. 237428951773634
Author(s):  
Chelsea R. Mehr ◽  
Amrom E. Obstfeld ◽  
Amanda C. Barrett ◽  
Kathleen T. Montone ◽  
Lauren E. Schwartz
Keyword(s):  
Resident Education ◽  
Tertiary Care ◽  
Turnaround Time ◽  
Surgical Pathology ◽  
Primary Sources ◽  
Road Map ◽  
Academic Center ◽  
Organ Systems ◽  
Before And After ◽  
Time Required

Changes in the field of pathology and resident education necessitate ongoing evaluation of residency training. Evolutionary change is particularly important for surgical pathology rotations, which form the core of anatomic pathology training programs. In the past, we organized this rotation based on subjective insight. When faced with the recent need to restructure the rotation, we strove for a more evidence-based process. Our approach involved 2 primary sources of data. We quantified the number of cases and blocks submitted per case type to estimate workload and surveyed residents about the time required to gross specimens in all organ systems. A multidisciplinary committee including faculty, residents, and staff evaluated the results and used the data to model how various changes to the rotation would affect resident workload, turnaround time, and other variables. Finally, we identified rotation structures that equally distributed work and created a point-based system that capped grossing time for residents of different experience. Following implementation, we retrospectively compared turnaround time and duty hour violations before and after these changes and surveyed residents about their experiences with both systems. We evaluated the accuracy of the point-based system by examining grossing times and comparing them to the assigned point values. We found overall improvement in the rotation following the implementation. As there is essentially no literature on the subject of surgical pathology rotation organization, we hope that our experience will provide a road map to improve pathology resident education at other institutions.

scholarly journals Statistical Analysis using traditional technique, Microsoft Excel and Predictive Analytic Software

10.17158/514 ◽  
2016 ◽  
Vol 19 (2) ◽  
Author(s):  
Jovelyn M. Durango ◽  
Carlito P. Yurango
Keyword(s):  
Statistical Analysis ◽  
Completion Time ◽  
Microsoft Excel ◽  
Instructional Tools ◽  
Traditional Technique ◽  
Significant Difference ◽  
Before And After ◽  
Computer Based ◽  
The One ◽  
Time Required

<p>The advent of technology has improved the way statistics is taught and learned. It is claimed that the use of computer-based instructional tools can actively explore the meaning of statistical concepts among the students, as well as enhance their learning experiences. This study aimed to compare three methods of statistical analysis namely, the traditional technique (use of the calculator), Microsoft Excel and Statistical Package for Social Sciences (SPSS) software. This investigation utilized the experimental design, specifically the One-Group Pretest – Posttest Design. There were six education students who self-assessed their attitude before and after the introduction of the use of various computation techniques and performed the statistical analysis considering also the completion time required for each process. Results of the study revealed an increase in the level of attitude among the respondents form the pretest to the posttest. Also, the cognitive level regardless of the approach was very high. However, the t-test failed to establish a significant difference in the attitude among the respondents. On the other hand, there were significant differences in both the test scores and completion time of the respondents in the three methods in favor of SPSS.</p><p> </p><p><strong>Keywords: </strong>Information technology, statistics, traditional technique, Microsoft excel, SPSS, comparative analysis, experimental research design, Davao City, Philippines. </p>

scholarly journals REDUCING THE NUMBER OF BACTERIAL COLONIES USING ECOCID®S (POTASSIUM PEROXYSULPHATE BASED DISINFECTANT) AT SMALL ANIMAL CLINIC

2020 ◽  
Vol 57 (2) ◽  
Author(s):  
Nataša Tozon ◽  
Majda Biasizzo ◽  
Leon Ščuka ◽  
Tamara Potočnik ◽  
Marjeta Redek ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clinical Study ◽  
Microbial Contamination ◽  
Small Animal ◽  
Before And After ◽  
Microbiological Testing ◽  
Sources Of Infection ◽  
Time Required ◽  
Paper Towels ◽  
Reduced Time

A clinical study has been conducted to test the efficacy of Ecocid® S, a biocidal agent. The active substance is potassium peroxysulphate and is used in clinical practice after the mechanical cleaning of various surfaces that act as potential sources of infection transmission. We determined 29 swabbing points, from which 87 samples were collected with cotton swabs. Swabs were submitted for microbiological testing to evaluate microbial contamination before cleaning, and before and after disinfection with Ecocid® S. We submitted 63 swabs from 21 swabbing points for further statistical analysis. Five swabs were excluded because the presence of bacteria in the swabs before disinfection had not been determined. The clinical study on the efficacy of Ecocid® S disinfectant showed that it is effective with an average reduction in contamination of 95.75%. The disinfectant was also active with a significantly reduced time of action: it was removed with dry paper towels from all sampling points, except the floor scales, only 5 to 10 minutes after application. The time required for the proper preparation of examination tables and other equipment in clinical practice is of vital importance for a smooth workflow.Key words: animals; disinfection; potassium peroxysulphate; Ecocid® S ZMANJŠANJE ŠTEVILA BAKTERIJ PO UPORABI RAZKUŽILA ECOCID®S (RAZKUŽILO NA OSNOVI KALIJEVEGA PEROKSISULFATA) V PROSTORIH KLINIKE ZA MALE ŽIVALIPovzetek: S klinično študijo smo želeli ugotoviti učinkovitosti biocidnega razkužila ECOCID®S. Aktivna snov v razkužilu je kalijev peroksisulfat, ki se na klinikah uporablja za razkuževanje različnih površin, ki predstavljajo ključna mesta za prenos okužb, po njihovem mehaničnem čiščenju. Določili smo 29 vzorčnih mest, na katerih smo z uporabo bombažnih brisov odvzeli 87 vzorcev. Z mikrobiološkim testiranjem smo ugotavljali stopnjo kontaminacije pred čiščenjem, ter pred in po razkuževanju z ECOCID®S. Za statistično obdelavo smo uporabili 63 rezultatov z 21 vzorčnih mest. Pet rezultatov je bilo izločenih iz obdelave, ker je bila že pred razkuževanjem stopnja kontaminacije pod mejo detekcije uporabljene metode. S klinično študijo učinkovitosti razkužila Ecocid®S smo ugotovili povprečno 95,75 % zmanjšanje števila kontaminantov po uporabi razkužila. Razkužilo je bilo učinkovito tudi ob skrajšanem času delovanja le 5 do 10 minut po nanosu. Zaradi zagotavljanja tekočega dela na kliniki je izredno pomemben čas, ki je potreben za ustrezno pripravo površin in druge opreme za pregled živali, zato je razkužilo Ecocid® S primerno za uporabo na veterinarskih klinikah, saj hitro in učinkovito zmanjša bakterijsko kontaminacijo.Ključne besede: živali; dezinfekcija; kalijev peroksisulfat; Ecocid® S

Hydration Status in Adolescent Judo Athletes Before and After Training in the Heat

2012 ◽  
Vol 7 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Anita M. Rivera-Brown ◽  
Roberto A. De Félix-Dávila
Keyword(s):  
Body Mass ◽  
Training Session ◽  
Well Being ◽  
Sodium Concentration ◽  
High Heat ◽  
The Body ◽  
Hydration Status ◽  
Before And After ◽  
Judo Athletes ◽  
Sweat Sodium

Adolescent judo athletes who train in tropical climates may be in a persistent state of dehydration because they frequently restrict fluids during daily training sessions to maintain or reduce their body weight and are not given enough opportunities to drink.Purpose:Determine the body hydration status of adolescent judo athletes before, immediately after, and 24 h after (24H) a training session and document sweat Na+ loss and symptoms of dehydration.Methods:Body mass and urine color and specific gravity (USG) were measured before, after, and 24 h after a training session in a high-heat-stress environment (29.5 ± 1.0°C; 77.7 ± 6.1% RH) in 24 adolescent athletes. Sweat sodium loss was also determined. A comparison was made between mid-pubertal (MP) and late pubertal (LP) subjects.Results:The majority of the subjects started training with a significant level of dehydration. During the training session, MP subjects lost 1.3 ± 0.8% of their pretraining body mass whereas LP subjects lost 1.9 ± 0.5% (P < .05). Sweat sodium concentration was 44.5 ± 23.3 mmol/L. Fluid intake from a water fountain was minimal. Subjects reported symptoms of dehydration during the session, which in some cases persisted throughout the night and the next day. The 24H USG was 1.028 ± 0.004 and 1.027 ± 0.005 g/mL for MP and LP, respectively.Conclusions:Adolescent judo athletes arrive to practice with a fluid deficit, do not drink enough during training, and experience symptoms of dehydration, which may compromise the quality of training and general well-being.

Contained Power Morcellation Versus Transvaginal Extraction for Retrieval of Laparoscopically Removed Myomas: A Comparison of Perioperative Outcomes

2018 ◽  
Vol 26 (1) ◽  
pp. 72-76 ◽  
Author(s):  
Aysen Boza ◽  
Selim Misirlioglu ◽  
Cagatay Taskiran ◽  
Bulent Urman
Keyword(s):  
Hospital Stay ◽  
Hospital Costs ◽  
Final Analysis ◽  
Perioperative Outcomes ◽  
Retrieval Time ◽  
Operative Outcomes ◽  
Specimen Retrieval ◽  
Estimated Blood Loss ◽  
Power Morcellation ◽  
Time Required

Objective. To evaluate clinical and operative outcomes of transvaginal extraction (TVE) and contained power morcellation (CPM) for myoma retrieval after laparoscopic myomectomy. Materials and Methods. Prospective data from 35 consecutive cases using CPM were compared with retrospective data of all cases using TVE from December 2014 to January 2017. Patients were matched 1:1 based on myoma diameter. A total of 62 women were included in the final analysis. Specimen retrieval was performed using the TVE or CPM within an insufflated isolation bag. Results. Age, body mass index, mode of prior obstetric delivery, history of previous abdominal surgery, indication for myomectomy, and the myoma(s) characteristics were similar between groups. Retrieval time was significantly shorter in the TVE group compared with the CPM group: 10 minutes (3-15 minutes) versus 17 minutes (14-42 minutes); P < .001. Time required for placement of the instruments was 9.7 minutes for the isolation bag and 0.5 minutes for the vaginal extractor. Additional analgesic administration for pain relief was necessary in 13 patients (42%) in the TVE group and 23 patients (72%) in the CPM group ( P = .01). Total cost of the hospital stay was significantly higher in the CPM group compared with the TVE group ( P < .001). Estimated blood loss and duration of hospital stay were similar between groups. Conclusion. Both CPM and TVE can be used for safe retrieval of large myomas that are removed laparoscopically. Compared with CPM, TVE was associated with a shorter retrieval time, less postoperative pain, and less hospital costs.

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