scholarly journals Experience on how to implement a preanalytical and POCT unit in Madrid’s IFEMA field hospital during this unprecedented COVID-19 emergency

2020 ◽  
Vol 30 (3) ◽  
pp. 360-362
Author(s):  
Jorge Díaz–Garzón ◽  
Marta Gómez ◽  
Antonio Buño ◽  
Manuela Simón ◽  
Olaia Rodriguez-Fraga ◽  
...  
Keyword(s):  
Personnel Selection ◽  
University Hospital ◽  
Medical Decision ◽  
Blood Gas ◽  
Sample Collection ◽  
Field Hospital ◽  
La Paz ◽  
Health Authorities ◽  
Laboratory Services ◽  
Spanish Health

To fight the virus SARS-CoV-2 spread to Europe from China and to give support to the collapsed public health system, the Spanish Health Authorities developed a field hospital located in the facilities of Madrid exhibition centre (IFEMA) to admit and treat patients diagnosed with SARS-CoV-2 infectious disease (COVID-19). The Department of Laboratory Medicine of La Paz University Hospital in Madrid (LMD-HULP) was designated to provide laboratory services. Due to the emergency, the IFEMA field hospital had to be prepared for patient admission in less than 1 week and the laboratory professionals had to collaborate in a multidisciplinary group to assure that resources were available to start on time. The LMD-HULP participated together with the managers in the design of the tests portfolio and the integration of the healthcare information systems (IS) (hospital IS, laboratory IS and POCT management system). Laboratorians developed a strategy to quickly train clinicians and nurses on test requests, sample collection procedures and management/handling of the POCT blood gas analyser both by written materials and training videos. The IFEMA´s preanalytical unit managed 3782 requests, and more than 11,000 samples from March 27th to April 30th. Furthermore, 1151 samples were measured by blood gas analysers. In conclusion, laboratory professionals must be resilient and have to respond timely in emergencies as this pandemic. The lab’s personnel selection, design and monitoring indicators to maintain and further improve the quality and value of laboratory services is crucial to support medical decision making and provide better patient care.

Essential Considerations in the Provision of Near-Patient Testing Facilities

1988 ◽  
Vol 25 (3) ◽  
pp. 220-225 ◽  
Author(s):  
Vincent Marks
Keyword(s):  
Quality Control ◽  
New Technologies ◽  
Clinical Laboratory ◽  
Sample Collection ◽  
Quality Assurance Programme ◽  
Laboratory Staff ◽  
Health Authorities ◽  
Laboratory Services ◽  
Analytical Services ◽  
Near Patient Testing

(1) Near-patient testing (NPT) is both practicable and in some situations desirable. (2) Like all new technologies its apparent simplicity often belies its complexity and masks the need for attention to detail in order to achieve optimum effects and avoid disasters. (3) Though technically unskilled individuals are capable of using it, they must undergo training in the elements of safety, sample collection, quality control, quantitation and documentation before being authorised to provide analytical services for patients. (4) Health Authorities should be encouraged to adopt a policy of integration of NPT and clinical laboratory services in order to reduce unplanned use and abuse of NPT facilities which is not only wasteful and divisive, but also dangerous. This has recently been emphasised in the United Kingdom by the release of a Hazard Notice (HN (Hazard) (87) 13) by the Department of Health and Social Security. The experienced clinical biochemist will, by virtue of training and experience, usually be the most suitable person in a Health District to advise on many of the issues involved in NPT. It should therefore, be the responsibility of laboratory staff to work with management, clinical, and nursing staff to: choose appropriate sites for the various levels of service to be provided to meet a clinical need; select the equipment and reagents to be employed; provide training in the use of the apparatus, quality control and safety; authorise accredited users and oversee the quality assurance programme. (5) Laboratory staff will need to involve themselves closely in the financial implications of NPT both for the laboratory's benefit and that of clinical practice within the hospital and/or community as a whole.

scholarly journals Factors Enhancing Serum Syndecan-1 Concentrations: A Large-Scale Comprehensive Medical Examination

2019 ◽  
Vol 8 (9) ◽  
pp. 1320
Author(s):  
Kazumasa Oda ◽  
Hideshi Okada ◽  
Akio Suzuki ◽  
Hiroyuki Tomita ◽  
Ryo Kobayashi ◽  
...  
Keyword(s):  
Large Scale ◽  
Prospective Observational Study ◽  
Nitrogen Concentration ◽  
Laboratory Data ◽  
University Hospital ◽  
Endothelial Glycocalyx ◽  
Sample Collection ◽  
Blood Samples ◽  
Triglyceride Concentration ◽  
Medical Examinations

Endothelial disorders are related to various diseases. An initial endothelial injury is characterized by endothelial glycocalyx injury. We aimed to evaluate endothelial glycocalyx injury by measuring serum syndecan-1 concentrations in patients during comprehensive medical examinations. A single-center, prospective, observational study was conducted at Asahi University Hospital. The participants enrolled in this study were 1313 patients who underwent comprehensive medical examinations at Asahi University Hospital from January 2018 to June 2018. One patient undergoing hemodialysis was excluded from the study. At enrollment, blood samples were obtained, and study personnel collected demographic and clinical data. No treatments or exposures were conducted except for standard medical examinations and blood sample collection. Laboratory data were obtained by the collection of blood samples at the time of study enrolment. According to nonlinear regression, the concentrations of serum syndecan-1 were significantly related to age (p = 0.016), aspartic aminotransferase concentration (AST, p = 0.020), blood urea nitrogen concentration (BUN, p = 0.013), triglyceride concentration (p < 0.001), and hematocrit (p = 0.006). These relationships were independent associations. Endothelial glycocalyx injury, which is reflected by serum syndecan-1 concentrations, is related to age, hematocrit, AST concentration, BUN concentration, and triglyceride concentration.

scholarly journals Occupational safety of pressurized intraperitoneal aerosol chemotherapy (PIPAC)

2017 ◽  
Vol 2 (3) ◽  
pp. 121-128 ◽  
Author(s):  
Wouter Willaert ◽  
Paul Sessink ◽  
Wim Ceelen
Keyword(s):  
Detection Limit ◽  
Occupational Safety ◽  
Health Hazard ◽  
University Hospital ◽  
Sample Collection ◽  
Position Detection ◽  
Outer Pair ◽  
Environmental Air ◽  
Water Seal

AbstractBackgroundPressurized intraperitoneal aerosol chemotherapy (PIPAC) has emerged as a novel method to treat extensive, small volume peritoneal metastases. The clinical use of chemotherapy containing aerosols represents a potential occupational health hazard. We report the results of toxicological analysis during the first two clinical PIPAC procedures performed at Ghent University Hospital.MethodsAfter extensive preparation and in vitro testing, two patients were treated with PIPAC: the first using doxorubicin (2.86 mg in 51.43 mL) and cisplatin (14.28 mg in 164.3 mL), the second using oxaliplatin (182.10 mg in 186.42 mL). A standardized safety checklist was developed and used. Aerosol delivery was combined with electrostatic precipitation (ePIPAC). The following samples were obtained at several time points and locations: environmental air, floor surface wipes, surgeon’s gloves, surgeon’s hand wipes, circuit filters, and fluid from the water seal collection chamber container placed along the closed aerosol waste evacuating line. Platinum concentration was measured in these samples using voltammetry. Sample collection and analysis were performed by an independent external laboratory.ResultsPlatinum was not detected on the four floor locations after both procedures (detection limit 0.02 ng/cm2). Similarly, no platinum was detected in environmental air during both PIPACs at the surgeon’s or anesthesiologist’s position (detection limit 4.0–27 ng/m3). No platinum contamination was detected on the hands, outer pair of gloves, or inner pair of gloves of the surgeon (detection limit 70 and 50 ng respectively). Platinum was not detected on the filters and in the air-seal container liquid.ConclusionsWith adequate preparation and precautions, a clinical PIPAC program can be established without measurable chemotherapy exposure to the operating room environment or healthcare workers.

scholarly journals Quality of Life in Patients with Psoriasis Seen in the Department of Dermatology, Antananarivo, Madagascar

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Fandresena Arilala Sendrasoa ◽  
Naina Harinjara Razanakoto ◽  
Volatantely Ratovonjanahary ◽  
Onivola Raharolahy ◽  
Irina Mamisoa Ranaivo ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Impact ◽  
Young Patients ◽  
The Body ◽  
University Hospital ◽  
Medical Decision ◽  
Cross Sectional ◽  
The Difference ◽  
The Impact

Background. Psoriasis is a chronic, inflammatory, and multifactorial dermatosis that impairs quality of life (QoL). Health-related QoL has become an important element in medical decision-making along with the effectiveness and the harmlessness of the treatments. Objective. To assess the impact of psoriasis in the QoL of patients with psoriasis by using the DLQI scales. Methods. A cross-sectional study from January to June 2018 was conducted in the Department of Dermatology of the University Hospital Joseph Raseta Befelatanana, Antananarivo, Madagascar, including patients more than 18 years old with mild to severe psoriasis. The severity of psoriasis was assessed using the “Psoriasis Area and Severity Index (PASI)”. QoL of patients with psoriasis was evaluated by using the DLQI scales. Results. 80 patients were included, their mean age was 36.5 years, and the male to female was 1.5 : 1. The mean DLQI score was 13.8. Symptoms, feelings, and psychic were the most altered dimensions. QoL was impaired in young patients, single, having medium level education. Even though patients with disease duration more than 5 years had higher DLQI score than other patients, the difference was not statistically significant (p=0.36). Furthermore, the clinical presentation of psoriasis did not influence the patient’s QoL (p=0.73). Patients with nail involvement had QoL impaired but the difference with another localization was not statistically significant (p=0.2). The quality of life was influenced by body area involved. The higher the body surface area involved, the more QoL is impaired (p=0.002). Furthermore, the higher the PASI, the more QoL is altered (p=0.002). Conclusion. Psoriasis has a negative impact in the quality of life in Malagasy patients with psoriasis, especially in younger and single patients. Worse quality of life is correlated to severity of psoriasis.

Open and Laparoscopic Partial Nephrectomy: Experience at La Paz University Hospital

2007 ◽  
Vol 1 (3) ◽  
pp. 125-129
Author(s):  
Alfredo Aguilera ◽  
Manuel P. Utrilla ◽  
Mario Mart&iacute;n ◽  
Manuel Gir&oacute;n ◽  
Jes&uacute;s Cisneros ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Laparoscopic Partial Nephrectomy ◽  
University Hospital ◽  
La Paz

scholarly journals Primary adenocarcinoma of the appendix: Experience at La Paz University Hospital of Madrid (1967–2014)

2016 ◽  
Vol 4 ◽  
pp. 23-26 ◽  
Author(s):  
Miguel León Arellano ◽  
Yannko González-Domínguez ◽  
Fernando Molina-Ortiz ◽  
María Alexandra Heras Garceau ◽  
Ramón Cantero ◽  
...  
Keyword(s):  
University Hospital ◽  
Primary Adenocarcinoma ◽  
La Paz

scholarly journals Necesidades educativas en la etapa infantil en menores con cardiopatías congénitas. Descripción de una cohorte y revisión de la bibliografía

2021 ◽  
Vol 39 (2) ◽  
pp. 395-418
Author(s):  
Mª del Rosario Mendoza Carretero ◽  
Susana Ares Segura ◽  
Belén Sáenz-Rico de Santiago
Keyword(s):  
Congenital Heart ◽  
Scientific Literature ◽  
University Hospital ◽  
Early Care ◽  
La Paz ◽  
Revisión Sistemática ◽  
Causes Of Mortality ◽  
Developmental Characteristics ◽  
The University ◽  
To Receive

Las cardiopatías congénitas (CC) constituyen una de las principales causas de mortalidad en España. Se quiere identificar la existencia de (co)morbilidades en el neurodesarrollo de estos menores para evidenciar la necesidad de participar en programas de Atención Temprana (AT) para optimizar su desarrollo y al mismo tiempo ofrecer una revisión sistemática a modo de estado de la cuestión de este campo de intervención. Se valoró, con la Escala de Desarrollo Infantil Bayley-III, a infantes cardiópatas ( 25 meses), en el Hospital Universitario La Paz, en el Hospital 12 de Octubre y en la Fundación Menudos Corazones. Se describen las características biomédicas y de desarrollo de 90 participantes. El 68% presenta un desarrollo cognitivo dentro del promedio, sucediendo lo mismo en el área del lenguaje (42%) y motor (44%). En estas últimas se evidencia un desarrollo normal-lento (35% y 24%, respectivamente) y limítrofe (15% y 12%). Congenital Heart Disease (CHD) is one of the leading causes of mortality in Spain. This study aims (i) to identify the existence of (co)morbidities in the neurodevelopment of a sample of these children and (ii) to demonstrate the need for them to receive educational intervention as soon as possible through early care programs so that their maturational development can be optimized. This study also presents a systematic review of the research available in the field. With the Bayley-III Child Development Scale, cardiac infants ( = 25.3 months) at the University Hospital La Paz, at the Hospital 12 de Octubre and the Menudos Corazones Foundation were assessed. The biomedical and developmental characteristics of 90 participants are described. 68% have an average cognitive development. Average rates were also reported for linguistic (42%) and motor (44%) development. For the latter category, normal-slow (35% and 24%, respectively) and bordeline (15% and 12%) development rates were found. The review of the scientific literature in this regard corroborates that the communicative-linguistic and the motor areas are the poorest dimensions of development.

scholarly journals Service-oriented Subscription Management of Medical Decision Data in the Intensive Care Unit

2008 ◽  
Vol 47 (04) ◽  
pp. 364-380 ◽  
Author(s):  
J. Decruyenaere ◽  
C. Danneels ◽  
K. Taveirne ◽  
K. Colpaert ◽  
E. Hoste ◽  
...  
Keyword(s):  
Intensive Care ◽  
Response Time ◽  
Support Services ◽  
Secure Communication ◽  
Smart Phone ◽  
University Hospital ◽  
Medical Decision ◽  
Medical Support ◽  
Service Oriented Architectures ◽  
Service Oriented

Summary Objectives: This paper addresses the design of a platform for the management of medical decision data in the ICU. Whenever new medical data from laboratories or monitors is available or at fixed times, the appropriate medical support services are activated and generate a medical alert or suggestion to the bedside terminal, the physician’s PDA, smart phone or mailbox. Since future ICU systems will rely ever more on medical decision support, a generic and flexible subscription platform is of high importance. Methods: Our platform is designed based on the principles of service-oriented architectures, and is fundamental for service deployment since the medical support services only need to implement their algorithm and can rely on the platform for general functionalities. A secure communication and execution environment are also provided. Results: A prototype, where medical support services can be easily plugged in, has been implemented using Web service technology and is currently being evaluated by the Department of Intensive Care of the Ghent University Hospital. To illustrate the platform operation and performance, two prototype medical support services are used, showing that the extra response time introduced by the platform is less than 150 ms. Conclusions: The platform allows for easy integration with hospital information systems. The platform is generic and offers user-friendly patient/service subscription, transparent data and service resource management and priority-based filtering of messages. The performance has been evaluated and it was shown that the response time of platform components is negligible compared to the execution time of the medical support services.

scholarly journals Real Life Experience in Clinical Practice with Recombinant Coagulation FVIII-Fc Fusion Protein

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 4929-4929
Author(s):  
Teresa Álvarez Roman ◽  
Elena Monzón Manzano ◽  
Ihosvany Fernandez-Bello ◽  
Mónica Martín ◽  
María Isabel Rivas Pollmar ◽  
...  
Keyword(s):  
Half Life ◽  
Research Funding ◽  
Hemophilia A ◽  
Trough Level ◽  
Real Life ◽  
University Hospital ◽  
Severe Hemophilia ◽  
Median Dose ◽  
La Paz ◽  
Before And After

Introduction: Efmoroctocog alfa (Elocta®) is a recombinant coagulation FVIII-Fc (rFVIIIFc), a fully recombinant fusion protein produced in human embryonic kidney cells, with an extended half-life used for the treatment and prevention of bleeding in patients with severe hemophilia A. Using rFVIIIFc for the treatment of severe hemophilia A patients received the approval of reimbursement in Spain at the end of 2016. Therefore, there are no many comparative data published about real life use of rFVIIIFc. Objective: This work aims to describe characteristics of the treatment of severe hemophilia A patients with rFVIIIFc and to compare its results with those previously obtained employing other FVIII products. Methods: This was an open-label non-interventional retrospective study reviewing patient characteristics and treatment outcomes before and after the use of rFVIIIFc. The La Paz University Hospital Ethics Committee approved the experimental protocol. Patients with severe hemophilia A without inhibitors being treated with rFVIIIFc since at least six months before study approval by Ethics Committee were included. The following data were collected for patients included in the study: dose (IU/kg) and prophylaxis treatment regimen, number of spontaneous and traumatic bleedings, annual bleeding rate (ABR) and FVIII trough level. The statistical analysis on the variables listed above comparing before and after rFVIIIFc usage was performed by the Biostatistics Unit of La Paz University Hospital with the statistical package SPSS v.18.0 (SPSS Inc., Chicago, IL, USA). Results: Twenty two severe hemophilia A patients (median age: 20 years old, ranging from 6 to 63 years) on prophylaxis with rFVIIIFc were considered to be included in this study, but two were excluded due to lack of data. Median follow-up period was 14 months (ranging from 6 to 28 months). Nineteen severe hemophilia A patients have been previously treated with rFVIII (two of them with other extended half-life product) and one with plasma-derived FVIII. Eight of the ten severe hemophilia A patients who presented an ABR greater than 0 with previous treatments reduced their ABR when treated with rFVIIIFc (Table 1). Among those patients with an ABR=0 with previously used FVIII products, only one increased to an ABR=1 when treated with Elocta® due to a traumatic bleeding. Table 1 shows ABR across all patients before and after rFVIIIFc. There was no difference in dose per injection between other FVIII products and rFVIIIFc (median dose for patients treated with other FVIII products: 46.0 IU/kg, ranging from 26 to 65 IU/kg; median dose for patients treated with rFVIIIFc: 46.5 IU/kg, ranging from 26 to 65 IU/kg). Nevertheless, a reduction was observed in administration frequency. Among the twelve patients who received treatment with other FVIII products every 48 hours, eleven came to receive rFVIIIFc 3 times a week and the one previously receiving a plasma-derived FVIII, to twice a week. Five of the patients receiving treatment 3 times a week reduced its frequency to twice per week. Three patients maintained the same schedule of administration. To note, one of the two patients receiving another prolonged half-life product maintained the schedule of treatment and the other reduced its frequency from every 48 hours to 3 times a week. FVIII trough level in plasma (% of FVIII), expressed as median (25th-75th percentile), was 1.1 (0.1-4.0) for rFVIIIFc treatment and 0.2 (0.0-1.9) for other FVIII products (p=0.06). Conclusions: 85% of the severe hemophilia A patients from our cohort reduced the weekly dose administration after beginning treatment with rFVIIIFc. Most of the patients increased plasma trough level of FVIII with rFVIIIFc. 45% of patients reduced and 40% kept their ABR=0 when they changed rFVIIIFc. These data suggest that treatment with rFVIIIFc gives a higher protection to severe hemophilia A patients. However, further research with larger sample size is required to investigate this. This work was supported by SOBI. NB holds a tenure track grant from FIS-FONDOS FEDER (CP14/00024). Disclosures Álvarez Roman: Takeda: Research Funding; Amgen: Consultancy, Speakers Bureau; NovoNordisk: Consultancy, Speakers Bureau; Novartis: Consultancy, Speakers Bureau; Bayer: Consultancy, Speakers Bureau; Pfizer: Consultancy, Speakers Bureau; Roche: Consultancy, Speakers Bureau; CSL Behring: Consultancy, Speakers Bureau; Sobi: Consultancy, Speakers Bureau. Fernandez-Bello:Novartis, Pfizer, ROCHE, Stago: Speakers Bureau. Martín:SOBI: Research Funding; Novartis, Pfizer, ROCHE, Novo Nordisk: Speakers Bureau. Rivas Pollmar:Novartis, Pfizer, ROCHE, Novo Nordisk: Speakers Bureau; SOBI: Research Funding. García Barcenilla:Bayer, Pfizer, Takeda, Novartis: Speakers Bureau; SOBI: Research Funding. Canales:SOBI: Research Funding; iQone: Honoraria; Karyopharm: Honoraria; Novartis: Honoraria; Takeda: Speakers Bureau; Gilead: Honoraria; Celgene: Honoraria; Janssen: Honoraria, Speakers Bureau; F. Hoffmann-La Roche Ltd: Honoraria, Speakers Bureau; Sandoz: Honoraria. Butta:Roche, Pfizer: Speakers Bureau; Novartis: Consultancy. Jimenez-Yuste:Bayer, CSL Behring, Grifols, Novo Nordisk, Octapharma, Pfizer, Roche, Sobi, Shire: Consultancy, Honoraria, Other: reimbursement for attending symposia/congresses , Research Funding, Speakers Bureau.

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