The utility of clinical findings to predict laboratory values in hypertensive disorders of pregnancy

2016 ◽  
Vol 44 (3) ◽  
Author(s):  
Jane So ◽  
Elizabeth Young ◽  
Natalie Crnosija ◽  
Joseph Chappelle
Keyword(s):  
Severe Disease ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Clinical Findings ◽  
Bivariate Analysis ◽  
Test Results ◽  
Quadrant Pain ◽  
Laboratory Findings ◽  
Abnormal Laboratory ◽  
Laboratory Test Results

AbstractPreeclampsia is the 2A retrospective chart review of women who presented for evaluation of hypertension in pregnancy during 2010. Demographic information, medical history, symptoms, vital signs, and laboratory results were collected. Bivariate analysis was used to investigate associations between predictors and the outcome.Of the 481 women in the sample, 22 were identified as having abnormal laboratory test results (4.6%). Women who reported right upper quadrant pain or tenderness had significantly increased likelihood of having laboratory abnormalities compared to those without the complaint.Only a small percentage of women evaluated were determined to have abnormal laboratory findings, predominantly among women with severe preeclampsia. Right upper quadrant pain or tenderness was positively correlated with laboratory abnormalities. The restriction of laboratory analysis in women with clinical evidence of severe disease may be warranted – a broader study should, however, first be used to confirm our findings.

Herbal Remedies: Effects on Clinical Laboratory Tests

2006 ◽  
Vol 130 (4) ◽  
pp. 521-528 ◽  
Author(s):  
Amitava Dasgupta ◽  
David W. Bernard
Keyword(s):  
Chinese Medicine ◽  
Laboratory Test ◽  
Alternative Medicine ◽  
Clinical Laboratory ◽  
Herbal Remedies ◽  
Test Results ◽  
Abnormal Laboratory ◽  
St John's Wort ◽  
Laboratory Test Results ◽  
Laboratory Results

AbstractContext.—Complementary and alternative medicine (herbal medicines) can affect laboratory test results by several mechanisms.Objective.—In this review, published reports on effects of herbal remedies on abnormal laboratory test results are summarized and commented on.Data Sources.—All published reports between 1980 and 2005 with the key words herbal remedies or alternative medicine and clinical laboratory test, clinical chemistry test, or drug-herb interaction were searched through Medline. The authors' own publications were also included. Important results were then synthesized.Data Synthesis.—Falsely elevated or falsely lowered digoxin levels may be encountered in a patient taking digoxin and the Chinese medicine Chan Su or Dan Shen, owing to direct interference of a component of Chinese medicine with the antibody used in an immunoassay. St John's wort, a popular herbal antidepressant, increases clearance of many drugs, and abnormally low cyclosporine, digoxin, theophylline, or protease inhibitor concentrations may be observed in a patient taking any of these drugs in combination with St John's wort. Abnormal laboratory results may also be encountered owing to altered pathophysiology. Kava-kava, chaparral, and germander cause liver toxicity, and elevated alanine aminotransferase, aspartate aminotransferase, and bilirubin concentrations may be observed in a healthy individual taking such herbal products. An herbal product may be contaminated with a Western drug, and an unexpected drug level (such as phenytoin in a patient who never took phenytoin but took a Chinese herb) may confuse the laboratory staff and the clinician.Conclusions.—Use of alternative medicines may significantly alter laboratory results, and communication among pathologists, clinical laboratory scientists, and physicians providing care to the patient is important in interpreting these results.

Significance of Abuse Chemical Contamination of Returnable Dairy Containers: Hazard Assessment

1978 ◽  
Vol 41 (12) ◽  
pp. 965-973 ◽  
Author(s):  
JOHN M. GASAWAY
Keyword(s):  
Hazard Assessment ◽  
Pesticide Residues ◽  
Daily Intake ◽  
World Health ◽  
Test Results ◽  
Chemical Contamination ◽  
Laboratory Findings ◽  
Laboratory Test Results ◽  
Health Organization ◽  
Water Contents

Certain pesticide residues reabsorbed into milk (or water) contents when stored in LEXAN® resin and polyethylene plastic returnable milk containers that had been exposed to diluted pesticide products, washed, and subsequently filled. The significance of these laboratory test results is comprehensively discussed by attempting to characterize the nature of exposure to pesticide residues from a washed returnable dairy container, as opposed to exposure to milk containing pesticide residues of non-container origin. Laboratory findings are compared to actual public use experience with returnable plastic dairy containers. A hazard assessment is presented, which includes a comparison of quantities of pesticide residues found extracting with existing Federal milk tolerance standards, food tolerance standards, unavoidable contaminant food additive regulations, World Health Organization and Safe Drinking Water Committee acceptable daily intake values. The probability of purchase of milk that is contaminated with pesticide residues, where the washed returnable dairy container is the source, is presented.

scholarly journals Changes in liver function in patients with covid-19 and the demographics of the disease in a mid-sized city of Turkey: A retrospective analysis

2020 ◽  
Vol 7 (12) ◽  
pp. 739-744
Author(s):  
Huseyin Avni Demir
Keyword(s):  
Liver Function ◽  
Clinical Characteristics ◽  
Severe Disease ◽  
Close Monitoring ◽  
Test Results ◽  
Laboratory Findings ◽  
Icu Patients ◽  
Mortality And Morbidity ◽  
The Mean ◽  
Significant Mortality

Objective:  To define the clinical characteristics of patients hospitalized with COVID-19 in ICU and ward and to evaluate the significance of liver function test results. A new disease caused by SARS-CoV-2 has been devastating the world affecting millions of patients worldwide and leading the significant mortality and morbidity. Material and Methods: The demographic features of a cohort of 125 hospitalized patients between March 2020 and May 2020 were recorded. The clinical characteristics, laboratory findings, and mortality rates were analyzed. Results: A total of 125 patients hospitalized for COVID-19 diagnosis where 113 (90.4%) were followed-up in the ward and 12 (9.6%) were in ICU were included in the study. The mean age of the patients was 44.05±16.95 and 88 (70.4%) of the patients were male. The most common symptoms were in the following order: cough in 80 patients (64%), dyspnea in 40 (32%) and fever in 33 (26.4%). The leukocyte and neutrophil counts were significantly higher in ICU patients with COVID-19 compared to patients in the ward (p=0.002, p<0.05; respectively). The CRP and D-Dimer levels were found elevated in ICU patients with COVID-19 than in the ward (p<0.05; p<0.05, respectively). The AST level of patients with COVID-19 in ICU was significantly heightened than patients in the ward. Conclusion: The present study revealed that patients with elevated AST level were at great risk of progressing to severe disease those require close monitoring.

scholarly journals Evaluation of Children Referred to Pediatric Rheumatology Outpatient Clinic with Suspicious Laboratory Test Results

2021 ◽  
Author(s):  
Şerife Gül Karadağ ◽  
Hafize Emine Sönmez ◽  
Ayşe Tanatar ◽  
Nuray Aktay Ayaz
Keyword(s):  
Rheumatic Disease ◽  
Laboratory Test ◽  
Rheumatic Diseases ◽  
Outpatient Clinic ◽  
Pediatric Rheumatology ◽  
Connective Tissue Diseases ◽  
Test Results ◽  
Laboratory Findings ◽  
Laboratory Test Results ◽  
Rheumatology Outpatient

INTRODUCTION: We aimed to evaluate the patients who were referred to the pediatric rheumatology outpatient clinic with suspicious laboratory test results. METHODS: All patients who were referred to our outpatient clinic with suspicious laboratory test results between March 2018 and March 2019 were evaluated. RESULTS: A total of 273 new patients who were referred with suspicious laboratory test results were evaluated. Among them; 48% were girls and 52% were boys and they were referred mostly from the clinics of child health and diseases (70.3%). The most frequent indications for referrals were anti-streptolysin O (ASO) elevation (n=86) and anti-nuclear antibody (ANA) positivity (n=47), while 66% of the patients were not diagnosed with rheumatic disease. None of the patients without complaints but with suspicious laboratory test results (n=49) were diagnosed with rheumatic disease. While 64.6% of those diagnosed with rheumatic diseases had periodic fever syndrome, 17.1% had juvenile idiopathic arthritis, 8.5% had postinfectious arthritis, and the remaining 9.8% had connective tissue diseases, vasculitis and uveitis. DISCUSSION AND CONCLUSION: Laboratory findings alone in childhood rheumatic diseases are not significant in patients without complaints. The diagnosis of rheumatic diseases should be made with the patient’s complaints, history, family history and physical examination findings and supported by laboratory findings. With the rational use of laboratory tests; unnecessary health expenses can be prevented and referrals of patients with nonrheumatic diseases to pediatric rheumatology outpatient clinics can be prevented.

scholarly journals Clinical and Laboratory Findings in Patients with Potential SARS-CoV-2 Reinfection, May–July 2020

2021 ◽  
Author(s):  
James T Lee ◽  
Elisabeth M Hesse ◽  
Heather N Paulin ◽  
Deblina Datta ◽  
Lee S Katz ◽  
...  
Keyword(s):  
Medical Records ◽  
The United States ◽  
Clinical Findings ◽  
Initial Symptom ◽  
Emerging Infections ◽  
Rt Pcr ◽  
Laboratory Findings ◽  
Patient Demographics ◽  
Viral Culture ◽  
Laboratory Test Results

Abstract Background We investigated patients with potential SARS-CoV-2 reinfection in the United States during May–July 2020. Methods We conducted case finding for patients with potential SARS-CoV-2 reinfection through the Emerging Infections Network. Cases reported were screened for laboratory and clinical findings of potential reinfection followed by requests for medical records and laboratory specimens. Available medical records were abstracted to characterize patient demographics, comorbidities, clinical course, and laboratory test results. Submitted specimens underwent further testing, including RT-PCR, viral culture, whole genome sequencing, subgenomic RNA PCR, and testing for anti-SARS-CoV-2 total antibody. Results Among 73 potential reinfection patients with available records, 30 patients had recurrent COVID-19 symptoms explained by alternative diagnoses with concurrent SARS-CoV-2 positive RT-PCR, 24 patients remained asymptomatic after recovery but had recurrent or persistent RT-PCR, and 19 patients had recurrent COVID-19 symptoms with concurrent SARS-CoV-2 positive RT-PCR but no alternative diagnoses. These 19 patients had symptom recurrence a median of 57 days after initial symptom onset (interquartile range: 47 – 76). Six of these patients had paired specimens available for further testing, but none had laboratory findings confirming reinfections. Testing of an additional three patients with recurrent symptoms and alternative diagnoses also did not confirm reinfection. Conclusions We did not confirm SARS-CoV-2 reinfection within 90 days of the initial infection based on the clinical and laboratory characteristics of cases in this investigation. Our findings support current CDC guidance around quarantine and testing for patients who have recovered from COVID-19.

scholarly journals Using Domain Knowledge and Data-Driven Insights for Patient Similarity Analytics

2021 ◽  
Vol 11 (8) ◽  
pp. 699
Author(s):  
Ronald Wihal Oei ◽  
Hao Sen Andrew Fang ◽  
Wei-Ying Tan ◽  
Wynne Hsu ◽  
Mong-Li Lee ◽  
...  
Keyword(s):  
Domain Knowledge ◽  
Vital Signs ◽  
Data Driven ◽  
Test Results ◽  
Substantial Agreement ◽  
Health Records ◽  
Specific Patient ◽  
Knowledge Based ◽  
Medical Institutions ◽  
Laboratory Test Results

Patient similarity analytics has emerged as an essential tool to identify cohorts of patients who have similar clinical characteristics to some specific patient of interest. In this study, we propose a patient similarity measure called D3K that incorporates domain knowledge and data-driven insights. Using the electronic health records (EHRs) of 169,434 patients with either diabetes, hypertension or dyslipidaemia (DHL), we construct patient feature vectors containing demographics, vital signs, laboratory test results, and prescribed medications. We discretize the variables of interest into various bins based on domain knowledge and make the patient similarity computation to be aligned with clinical guidelines. Key findings from this study are: (1) D3K outperforms baseline approaches in all seven sub-cohorts; (2) our domain knowledge-based binning strategy outperformed the traditional percentile-based binning in all seven sub-cohorts; (3) there is substantial agreement between D3K and physicians (κ = 0.746), indicating that D3K can be applied to facilitate shared decision making. This is the first study to use patient similarity analytics on a cardiometabolic syndrome-related dataset sourced from medical institutions in Singapore. We consider patient similarity among patient cohorts with the same medical conditions to develop localized models for personalized decision support to improve the outcomes of a target patient.

scholarly journals Prognostic Value of Severity Score Change for Septic Shock in the Emergency Room

Diagnostics ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. 743
Author(s):  
Tae Sik Hwang ◽  
Hyun Woo Park ◽  
Ha Young Park ◽  
Young Sook Park
Keyword(s):  
Septic Shock ◽  
Laboratory Test ◽  
Emergency Room ◽  
Characteristic Curve ◽  
Vital Signs ◽  
Scoring Systems ◽  
Early Warning Score ◽  
Time Of Arrival ◽  
Test Results ◽  
Laboratory Test Results

The vital signs or laboratory test results of sepsis patients may change before clinical deterioration. This study examined the differences in prognostic performance when systemic inflammatory response syndrome (SIRS), Sequential Organ Failure Assessment (SOFA), quick SOFA (qSOFA) scores, National Early Warning Score (NEWS), and lactate levels were repeatedly measured. Scores were obtained at arrival to triage, 1 h after fluid resuscitation, 1 h after vasopressor prescription, and before leaving the emergency room (ER) in 165 patients with septic shock. The relationships between score changes and in-hospital mortality, mechanical ventilation, admission to the intensive care unit, and mortality within seven days were compared using areas under receiver operating characteristic curve (AUROCs). Scores measured before leaving the ER had the highest AUROCs across all variables (SIRS score 0.827 [0.737–0.917], qSOFA score 0.754 [0.627–0.838], NEWS 0.888 [0.826–0.950], SOFA score 0.835 [0.766–0.904], and lactate 0.872 [0.805–0.939]). When combined, SIRS + lactate (0.882 [0.804–0.960]), qSOFA + lactate (0.872 [0.808–0.935]), NEWS + lactate (0.909 [0.855–0.963]), and SOFA + lactate (0.885 [0.832–0.939]) showed improved AUROCs. In patients with septic shock, scoring systems show better predictive performances at the timepoints reflecting changes in vital signs and laboratory test results than at the time of arrival, and combining them with lactate values increases their predictive powers.

scholarly journals Emergence of Parechovirus A4 Central Nervous System Infections among Infants in Kansas City, Missouri, USA

2019 ◽  
Vol 57 (5) ◽  
Author(s):  
A. Sasidharan ◽  
C. J. Harrison ◽  
D. Banerjee ◽  
R. Selvarangan
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Kansas City ◽  
Maximum Temperature ◽  
Cns Infection ◽  
Test Results ◽  
Central Nervous System Infections ◽  
Laboratory Findings ◽  
Cns Infections ◽  
Laboratory Test Results

ABSTRACT Among known parechovirus (PeV) types infecting humans, PeV-A3 (formerly HPeV3) and PeV-A1 (formerly HPeV1) are associated with pediatric central nervous system (CNS) infections. The prevalence of PeV-A3 among hospitalized infants with sepsis-like illness and viral CNS infection is well described; however, the contribution of PeV-A4 to infant CNS infection is relatively unexplored. We report the first 11 U.S. cases of PeV-A4 CNS infections occurring in Kansas City infants during 2010 to 2016 and compare the clinical presentation with that of PeV-A3. PeV-positive cerebrospinal fluid (CSF) specimens from 2010 to 2016 underwent sequencing for genotyping. Among all PeV-CSF positives, PeV-A4 was detected in 11 CSF samples from 2010 to 2016. PeV-A4 was first detected in 2010 (n = 1/4), followed by detections in 2014 (n = 1/39), 2015 (n = 6/9), and 2016 (n = 3/33). The median age of PeV-A4-infected infants in weeks (median, 4; range, 1 to 8) was similar to that of infants infected with PeV-A3 (median, 4; range, 0.25 to 8). Clinical characteristics of PeV-A4 (n = 11) were compared with those of select PeV-A3-infected children (n = 34) with CNS infections and found to be mostly similar, although maximum temperature was higher (P = 0.017) and fever duration was shorter (P = 0.03) for PeV-A4 than for PeV-A3. Laboratory test results were also similar between genotypes, although they showed significantly lower peripheral white blood cell (P = 0.014) and absolute lymphocyte (P = 0.04) counts for PeV-A4 infants. Like PeV-A3, PeV-A4 caused summer-fall seasonal clusters of CNS infections in infants, with mostly similar presentations. Further surveillance is necessary to confirm potential differences in laboratory findings and in fever intensity/duration.

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