Biotin interference in immunoassay: a review for the laboratory scientist

2019 ◽  
Vol 56 (4) ◽  
pp. 424-430 ◽  
Author(s):  
Gordon Avery
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Case Reports ◽  
Scientific Committee ◽  
Care Providers ◽  
Safety Communication ◽  
Assay Format ◽  
Biotin Binding ◽  
Available Information ◽  
Laboratory Scientist

The recent FDA Biotin (Vitamin B7): Safety Communication – May Interfere with Lab Tests and A statement from the ACB Scientific Committee regarding biotin/vitamin B7 interference in immunoassays have raised into the laboratory consciousness the need to understand and to manage the issues around biotin interference with some immunoassays and to provide education and advice to health-care providers. In patients who are prescribed biotin or take biotin supplements, biotin has the potential to cause falsely low or falsely high results in immunoassays using streptavidin–biotin binding as part of the assay methodology. Streptavidin–biotin binding is used by many manufacturers; some manufacturers use it for most of their immunoassays, some for a few of their immunoassays and some manufacturers do not use this assay format at all. The direction and magnitude of interference and the concentration of biotin which affects an assay are highly variable and assay specific. There have been many papers and case reports published recently of biotin interference in immunoassay, and biotin interference is probably one of the most difficult types of inference to detect and to obviate. This review will assess the currently available information on this topic and review the steps the laboratory can take to reduce the risk of incorrect patient results being reported.

scholarly journals Molecular Tumor Board

2021 ◽  
Vol 5 (1) ◽  
pp. 1-2
Author(s):  
Nirmal Lamichhane
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Cancer Care ◽  
Treatment Plan ◽  
Tumor Board ◽  
Care Providers ◽  
Systematic Method ◽  
Molecular Tumor Board ◽  
Available Information

A tumor board is a meeting made up of specialized doctors and other health care providers who regularly gather to discuss cancer cases that are unusual and/or challenging. The goal is to decide on the best possible treatment plan for a patient as a group. This has become a very systematic method in cancer care and is useful in picking up all the available information about the patients, inputs of all concerned doctors and other health care personnels. Molecular Tumour boards are where the molecular informaion about the patients are discussed.

scholarly journals Community Presentations of Anaphylaxis in Tasmania: Who is administering the adrenaline?

2016 ◽  
Vol 13 (1) ◽  
Author(s):  
Dale Edwards ◽  
Melanie Blackhall ◽  
Rachael Berry
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Health Care Providers ◽  
Health Professionals ◽  
Case Reports ◽  
Retrospective Chart Review ◽  
Health Concern ◽  
Primary Data ◽  
Care Providers ◽  
Early Administration

Background: Anaphylaxis is a significant health concern within the community.  The early administration of adrenaline to patients experiencing anaphylaxis has long been recognised as the cornerstone of treatment.  Health-care providers, including general practitioners, nurses and paramedics, are well equipped to manage anaphylaxis through the administration of adrenaline.  Patients themselves also often have adrenaline auto injectors, allowing early self-management.  The objective of this study was to determine the rates of adrenaline administration and identify the administering persons for all anaphylaxis patients presenting to ambulance services in Tasmania from January 1st 2008 until December 31st 2011 by using a retrospective chart review.  Methods: Ambulance Tasmania electronic case reports (n=226 421) from the period January 1st 2008 to December 31st 2011 were searched for all cases fitting the parameters of anaphylaxis, allergy or allergic reaction.  Of these cases, 373 were given a final paramedic diagnosis of anaphylaxis and constituted the primary data for this report. Results: Ambulance Tasmania attended 373 patients during the study period that were given a final primary diagnosis of anaphylaxis - of these 59 (15.8%) were excluded, leaving 314 electronic records for analysis.  Of the cases identified, 71.7% (n=225) were administered adrenaline according to paramedic records.  Adrenaline was administered by a range of health professionals, including general practitioners (n=27), paramedics (n=159), ambulance volunteers (n=4), nurses (n=1) and other health professionals (n=3).  Adrenaline was self-administered by 12.4% (n=28) of patients, with an additional 11.6% (n=26) receiving adrenaline from a non-health care worker (layperson).  In 10.2% of cases (n=23) adrenaline was administered by more than one provider.  Administration of adrenaline prior to paramedic arrival was evident in fewer than 10% of cases treated with adrenaline (n=22). Conclusion: The early administration of adrenaline in anaphylaxis is often vital for patient recovery. This study shows that adrenaline is administered by a number of different providers, with early administration accounting for only 9.8% of presentations treated with adrenaline. These findings raise the question, is adrenaline being administered early enough and often enough to improve health outcomes?

scholarly journals SARS-CoV-2 Infection and Stroke: Coincident or Causal?

2020 ◽  
Author(s):  
Melanie Walker ◽  
Christopher C. Young ◽  
Malveeka Sharma ◽  
Michael R Levitt ◽  
David L Tirschwell ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Case Reports ◽  
Clinical Spectrum ◽  
Neurological Manifestations ◽  
Care Providers ◽  
Cerebrovascular Complications ◽  
Global Pandemic

Neurological manifestations of SARS-CoV-2 infection described in isolated case reports and single institutions do not accurately reflect the clinical spectrum of disease across all geographies in a global pandemic. Data collected during peak of the Covid-19 pandemic from stroke centers in five states reveal few similarities to what has recently been published. Given the diversity in phenotype, we caution policymakers and health care providers when considering cerebrovascular complications from SARS-CoV-2 infection.

Acute and Chronic Carbon Monoxide Toxicity from Tobacco Smoking

2019 ◽  
Author(s):  
Alyrene Dorey ◽  
Pieter Scheerlinck ◽  
Hoanvu Nguyen ◽  
Timothy Albertson
Keyword(s):  
Health Care ◽  
Carbon Monoxide ◽  
Health Care Providers ◽  
Tobacco Smoking ◽  
Case Reports ◽  
Care Providers ◽  
Cigarette Smokers ◽  
Comprehensive Search ◽  
Heavy Cigarette Smoker ◽  
Future Work

ABSTRACT Introduction: Carbon monoxide (CO) is produced from incomplete combustion of hydrocarbons and is a by-product of tobacco smoking. Chronic cigarette smokers often have carboxyhemoglobin (COHb) concentrations as high as 10%. We report a case of severely elevated COHb and polycythemia because of tobacco smoking and provide a review of the literature regarding elevated COHb in smokers. Materials and Methods: A comprehensive search of PubMed and Google Scholar was performed looking for articles on tobacco smoking and CO, COHb, CO poisoning, cigarettes, pipes, cigars and water pipes/hookah smokers. Result: COHb levels in frequent cigarette smokers generally range from 4.2% presmoking to 8.6% postsmoking. A heavy cigarette smoker presented twice with symptoms of CO toxicity and was found to have levels 21.8 to 24.2%. Cigar smokers have been found to have COHb ranging as high as 13.0 to 38.6% in case reports. Waterpipe or “hookah” smokers generally have COHb levels 10.1% +/−2.5% and case reports, and series of even higher levels associated with CO toxicity symptoms are common. Waterpipe smokers have been found to have COHb levels as high as 39.2% after smoking. Conclusions: Many active duty military and military veterans are tobacco smokers and these patients and their health care providers should be aware of the adverse effects of CO toxicity from tobacco smoking. Patients may have symptoms such as headaches, syncope, and ataxia in the setting of acute CO toxicity; however, the chronic effects of CO may not be completely understood. Future work could explore chronic CO toxicity and its effects on strength and exercise tolerance in military personnel and provide education to service members, veterans, and health care providers.

scholarly journals Fazio-Londe Syndrome and Patient-centered Nursing Care: A Case Report

2020 ◽  
Vol 6 (2) ◽  
pp. 135-144
Author(s):  
Mohammad Abdi ◽  
◽  
Maryam Jolfaei ◽  
Maryam Ghasemi ◽  
Mohammad Reza Dinmohammadi ◽  
...  
Keyword(s):  
Health Care ◽  
Case Report ◽  
Respiratory Distress ◽  
Health Care Providers ◽  
Nursing Care ◽  
Case Reports ◽  
Care Providers ◽  
Care Model ◽  
Patient Centered ◽  
Case Presentation

Introduction: Fazio-Londe disease is a genetic rare disorder manifesting by acute respiratory distress. This article is a case report of Fazio-Londe syndrome, its comparison with other case reports in the literature, and its patient-centered nursing care.  Case presentation: In this study, we reported a case with Fazio-Londe syndrome with respiratory distress, bulbar palsy, muscle weakness, and other symptoms.  Management and outcome: The patient was treated with oral riboflavin (100 mg/day), ribavirin (200 mg/day), and intramuscular Vit-B12 (1000 mg/day). She was managed using a patient-centered nursing care model.  Discussion: Health care providers should be aware of the new and constant symptoms of this rare disease. A patient-centered nursing care model is suggested to manage the disease.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

Using Technology to Improve Access to Health Care for Culturally and Linguistically Diverse Populations

2012 ◽  
Vol 19 (3) ◽  
pp. 71-76 ◽  
Author(s):  
Pauline A. Mashima
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Underserved Populations ◽  
Linguistically Diverse ◽  
Care Providers ◽  
Department Of Health ◽  
Use Of Technology ◽  
Access To Health ◽  
Improve Access

Important initiatives in health care include (a) improving access to services for disadvantaged populations, (b) providing equal access for individuals with limited or non-English proficiency, and (c) ensuring cultural competence of health-care providers to facilitate effective services for individuals from diverse racial and ethnic backgrounds (U.S. Department of Health and Human Services, Office of Minority Health, 2001). This article provides a brief overview of the use of technology by speech-language pathologists and audiologists to extend their services to underserved populations who live in remote geographic areas, or when cultural and linguistic differences impact service delivery.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

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