Routine preoperative blood testing in pediatric neurosurgery

2013 ◽  
Vol 12 (6) ◽  
pp. 615-621 ◽  
Author(s):  
Fajer Almesbah ◽  
Tafadzwa Mandiwanza ◽  
Chandrasekaran Kaliaperumal ◽  
John Caird ◽  
Darach Crimmins
Keyword(s):  
Medical Records ◽  
Reference Range ◽  
Laboratory Data ◽  
Pediatric Neurosurgery ◽  
Clinical Indication ◽  
Test Results ◽  
Neurosurgical Department ◽  
Blood Tests ◽  
Financial Costs ◽  
The Cost

Object The frequency with which routine preoperative blood test results predict perioperative or postoperative complications is insignificant. The unnecessary ordering of routine tests increases the financial costs and patients' distress. The authors evaluated the effects of routine preoperative testing on patient management and the overall financial costs. Methods The authors retrospectively reviewed the medical records and laboratory data for 355 children admitted to the neurosurgical department for elective procedures over a 5-year period (January 2008–December 2012). They excluded all patients admitted for imaging or surgical procedures requiring local anesthesia, and they recorded the results of preoperative and previous (up to 6 months before surgery) blood tests and any abnormalities noted. Results As a result of the 3489 blood tests ordered preoperatively for 328 (94.6%) of the 355 patients, 29 abnormalities (9%) were detected. Most of these abnormal values were near the reference range, and none significantly affected the progression of scheduled procedures. For only 1 patient (0.28%) was the procedure cancelled because of an abnormality (preoperative partial thromboplastin time), which further testing showed to be a false-positive result. The cost of these tests over 5 years was 5205–10,410 euros ($6766–$13,533 US). Conclusions Preoperative tests should be selectively requested on the basis of clinical indication.

INCREASED SERUM CALCIUM IS NOT COMMON IN HOSPITALIZED PATIENTS WITH PRIMARY HYPERPARATHYROIDISM: A RETROSPECTIVE, OBSERVATIONAL STUDY

2020 ◽  
Vol 26 (3) ◽  
pp. 285-290
Author(s):  
Muhammad Abu Tailakh ◽  
Ahmad Yahia ◽  
Ilia Polischuck ◽  
Yair Liel
Keyword(s):  
Primary Hyperparathyroidism ◽  
Serum Calcium ◽  
Medical Records ◽  
Reference Range ◽  
Laboratory Data ◽  
Hospitalized Patients ◽  
Total Serum ◽  
Normal Reference Range ◽  
Total Serum Calcium ◽  
The Mean

Objective: Serum calcium levels often decrease during acute illness in patients with an intact calcium-regulating system. However, the dynamics of serum calcium levels in hospitalized patients with primary hyperparathyroidism (PHPT) have not yet been described. Methods: Clinical and laboratory data were retrospectively retrieved from the electronic medical records of patients with PHPT before, during, and after hospitalization for various reasons (excluding parathyroid surgery). Results: There were 99 nonselected patients with asymptomatic, hypercalcemic PHPT, hospitalized for various reasons; 42% were admitted for apparent infectious or septic conditions, and 58% were admitted for noninfectious conditions. Total serum calcium increased >0.5 mg/dL in 7.4% of the patients: 10.9% and 2.5% of the patients with noninfectious and infectious conditions, respectively. In 65.7% of the patients, the mean total serum calcium (TsCa), but not albumin-corrected calcium (corrCa), decreased significantly during hospitalization, down to below the upper limit of the reference range. Although prehospitalization TsCa and corrCa were similar in patients with infectious and noninfectious conditions, during hospitalization, TsCa was lower in patients with infectious conditions ( P = .02). Both TsCa and albumin returned to prehospitalization levels after recovery. Conclusion: TsCa increases in a minority of hospitalized PHPT patients. In the majority of hospitalized patients with PHPT, TsCa, but not corrCa, decreases to within the normal reference range, more so in patients with infectious conditions, obscuring the major characteristic of PHPT. Therefore, it is prudent to follow calcium and corrCa during hospitalization in patients with PHPT. Abbreviations: corrCa = albumin-corrected serum calcium; IQR = interquartile range; PHPT = primary hyperparathyroidism; PTH = parathyroid hormone; TsCa = total serum calcium

scholarly journals АВТОМАТИЗОВАНА КЛІНІЧНА БАЗА МОНІТОРИНГУ ХВОРИХ НА МУКОПОЛІСАХАРИДОЗ

2015 ◽  
Author(s):  
V. Z. Stetsiuk ◽  
N. H. Horovenko ◽  
A. Y. Savytskyi ◽  
N. A. Pichkur ◽  
K. K. Kytaiev
Keyword(s):  
General Solution ◽  
Medical Records ◽  
Patient Data ◽  
Patient Records ◽  
Test Results ◽  
Clinical Database ◽  
Data Search ◽  
Treatment Objective ◽  
The Cost

This article describes the complexity of managing medical records of patients with MPS and monitoring them throughout their live. A general solution of these problems is produced by implementing an automated clinical database for monitoring the patients with mucopolysacharidosis. This application is designed to record and store information about patients with six types of MPS . The user can create, edit, store patient records , which include such data as the patients passport information, visits, test results, method of treatment , objective status . Also, the application has such functions such as : patient data search using a variety of filters, tracking patients visits on current week, estimation of the total requirement of drugs and the cost of these drugs.

The multivariate reference range: an alternative interpretation of multi-test profiles.

1982 ◽  
Vol 28 (2) ◽  
pp. 259-265 ◽  
Author(s):  
J C Boyd ◽  
D A Lacher
Keyword(s):  
Normal Distribution ◽  
Degrees Of Freedom ◽  
Reference Range ◽  
Clinical Chemistry ◽  
Laboratory Data ◽  
Alternative Interpretation ◽  
Test Results ◽  
Chi Square ◽  
Exponential Transform ◽  
Kolmogorov Smirnov

Abstract To test the utility of multivariate interpretation of laboratory data, we developed a multivariate reference range based of the Mahalonobis distance (D2) measure. Results for 20 commonly measured clinical chemistry analytes were collated for two sophomore medical-school classes (118 and 143 individuals in 1979 and 1980, respectively). The data for each test were examined for fit to a gaussian (normal) distribution by using a Kolmogorov--Smirnov test. Those results discovered to have a non-normal distribution were "normalized" by used the of a two-stage log-exponential transform. After this transformation, the D2 distance for each student group followed the expected chi-square distribution with 20 degrees of freedom. For each student's D2 distance an associated chi-square percentile was derived, and a cutoff percentile (95%) was selected to differentiate multivariately the "normal" from "abnormal" test results. Whereas more than two-thirds of the students had univariate test abnormalities, fewer than 7% had abnormal multivariate D2 scores. Analysis showed that the multivariate reference range could sensitively detect minor variations of multiple analytes but could also be quite insensitive to highly abnormal results for a single analtye. The multivariate approach has promise as a tool to avoid unnecessary followup of falsely abnormal test results, but further study and validation in a clinical setting are required.

HUBUNGAN UMUR DAN PARITAS DENGAN PEMILIHAN ALAT KONTRASEPSI METODE OPERASI WANITA (MOW) DI POLIKLINIK KEBIDANAN RS BHAYANGKARA PALEMBANG TAHUN 2012

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Y. Widyastuti Y. Widyastuti
Keyword(s):  
Family Planning ◽  
Medical Records ◽  
Test Results ◽  
Family Planning Services ◽  
Chi Square ◽  
Cross Sectional ◽  
Planning Methods ◽  
Chi Square Test ◽  
Family Planning Methods ◽  
Selection Of

  ABSTRACT [In advanced countries the number of permanent contraception option ( kontap ) approximately 10 % of all national family planning methods , while in Indonesia reached approximately 5.7 % . Based on data obtained from medical records Bhayangkara Hospital Palembang in 2010 the number of achievement when seen from the percentage of contraceptive use is only 9.10 % The purpose of this study is known age and parity relationship with the selection of contraceptive methods Surgery Women ( MOW ) in Palembang RS.Bhayangkara obstetrics clinic in 2012 . This study uses the analytic survey with cross sectional approach . The population in this study were women who become new acceptors were recorded in medical records at the hospital . Palembang Bhayangkara Hospitals January 1, 2012 to December 31 in 2012 . The sample in this study is part of a whole number of new acceptors ( either using contraception methods MOW and other family planning methods ) were registered in the hospital . Palembang Police Hospitals of January 1, 2012 to December 31 years of data 2012.Analisa univariate and bivariate statistical Chi - Square test with significance level α = 0.05 . The results showed there were 80 respondents ( 46.3 % ) who became MOW contraceptive acceptors , acceptors who have old age by 45 respondents ( 56.3 % ) and who has a young age by 35 respondents ( 43.8 % ) . acceptors which have high parity were 44 respondents ( 55 % ) who had low parity and a total of 36 respondents ( 45 % ) . From the results of Chi-square test value obtained ρ = 0.00 is smaller than α = 0.05 . There is a significant correlation between age and the selection of MOW Chi square test results obtained ρ value = 0.00 and there was a significant association between parity with the election MOW Chi square test results obtained ρ value = 0 , . From these results , it is expected to power health, especially family planning services at the hospital . Palembang Police Hospitals in order to improve the quality of family planning services in an effective, efficient , and safe are considered particularly suitable for users of contraception OperatingMethodWomen(MOW).                                      ABSTRAK Di negara sudah maju jumlah pilihan kontrasepsi mantap (kontap) sekitar 10% dari semua metode KB nasional, sedangkan di Indonesia baru mencapai sekitar 5,7 %. Berdasarkan data yang diperoleh dari Rekam medik  Rumah Sakit Bhayangkara Palembang tahun 2010 Jumlah pencapain tersebut jika dilihat dari persentasi penggunaan kontrasepsi MOW hanya  9,10% Tujuan penelitian ini adalah diketahuinya hubungan umur dan paritas dengan pemilihan alat kontrasepsi Metode Operasi Wanita (MOW) di poliklinik kebidanan RS.Bhayangkara Palembang Tahun 2012. Penelitian ini menggunakan metode survey analitik dengan pendekatan cross sectional. Populasi dalam penelitian ini adalah wanita yang menjadi akseptor KB Baru yang tercatat di rekam medik  di RS. Bhayangkara Palembang tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012. Sampel dalam penelitian ini adalah sebagian dari seluruh jumlah akseptor KB Baru (baik yang menggunakan alat kontrasepsi Metode MOW maupun Metode KB lain) yang teregister di RS. Bhayangkara Palembang dari tanggal 1 januari 2012 sampai dengan 31 Desember  tahun 2012.Analisa data dilakukan secara univariat dan bivariat dengan uji statistik Chi-Square dengan tingkat kemaknaan α = 0,05. Hasil penelitian menunjukkan dari 80 responden terdapat (46,3%) yang menjadi akseptor kontrasepsi MOW, akseptor yang memiliki umur tua sebanyak 45 responden (56,3%) dan yang memiliki  umur muda sebanyak 35 responden (43,8%). akseptor yang memiliki paritas tinggi sebanyak 44 responden  (55%) dan yang memiliki  paritas rendah sebanyak 36 responden (45%). Dari hasil uji Chi square didapatkan ρ value = 0,00 lebih kecil dari α = 0,05. Ada hubungan yang bermakna antara umur dengan pemilihan MOW dari hasil uji Chi square didapatkan ρ value = 0,00 dan ada hubungan yang bermakna antara paritas dengan pemilihan MOW hasil uji Chi square didapatkan ρ value = 0,.Dari hasil penelitian ini, diharapkan kepada tenaga kesehatan khususnya pelayanan KB  di RS. Bhayangkara Palembang  agar dapat meningkatkan kualitas pelayanan KB secara efektif, efisien, dan aman yang dianggap cocok bagi penggunanya khususnya mengenai kontrasepsi Metode Operasi Wanita (MOW).    

scholarly journals Data standardization implementation and applications within and among diagnostic laboratories: integrating and monitoring enteric coronaviruses

2021 ◽  
pp. 104063872110021
Author(s):  
Giovani Trevisan ◽  
Leticia C. M. Linhares ◽  
Kent J. Schwartz ◽  
Eric R. Burrough ◽  
Edison de S. Magalhães ◽  
...  
Keyword(s):  
Seasonal Pattern ◽  
Laboratory Data ◽  
Information Management System ◽  
Transmissible Gastroenteritis Virus ◽  
Test Results ◽  
Diarrhea Virus ◽  
Oral Fluids ◽  
Transmissible Gastroenteritis ◽  
Technology Processes ◽  
Laboratory Information Management

Every day, thousands of samples from diverse populations of animals are submitted to veterinary diagnostic laboratories (VDLs) for testing. Each VDL has its own laboratory information management system (LIMS), with processes and procedures to capture submission information, perform laboratory tests, define the boundaries of test results (i.e., positive or negative), and report results, in addition to internal business and accounting applications. Enormous quantities of data are accumulated and stored within VDL LIMSs. There is a need for platforms that allow VDLs to exchange and share portions of laboratory data using standardized, reliable, and sustainable information technology processes. Here we report concepts and applications for standardization and aggregation of data from swine submissions to multiple VDLs to detect and monitor porcine enteric coronaviruses by RT-PCR. Oral fluids, feces, and fecal swabs were the specimens submitted most frequently for enteric coronavirus testing. Statistical algorithms were used successfully to scan and monitor the overall and state-specific percentage of positive submissions. Major findings revealed a consistently recurrent seasonal pattern, with the highest percentage of positive submissions detected during December–February for porcine epidemic diarrhea virus, porcine deltacoronavirus, and transmissible gastroenteritis virus (TGEV). After 2014, very few submissions tested positive for TGEV. Monitoring VDL data proactively has the potential to signal and alert stakeholders early of significant changes from expected detection. We demonstrate the importance of, and applications for, data organized and aggregated by using LOINC and SNOMED CTs, as well as the use of customized messaging to allow inter-VDL exchange of information.

scholarly journals The use of routine blood tests to assist the diagnosis of COVID-19 in symptomatic hospitalized patients

2021 ◽  
pp. 000456322199907
Author(s):  
IT Parsons ◽  
AT Parsons ◽  
E Balme ◽  
G Hazell ◽  
R Gifford ◽  
...  
Keyword(s):  
Cell Count ◽  
Retrospective Review ◽  
Blood Test ◽  
Patient Flow ◽  
White Cell Count ◽  
Area Under The Curve ◽  
White Cell ◽  
Test Results ◽  
Rt Pcr ◽  
Blood Tests

Introduction Specific patterns of blood test results are associated with COVID-19 infection. The aim of this study was to identify which blood tests could be used to assist in diagnosing COVID-19. Method A retrospective review was performed on consecutive patients referred to hospital with a clinical suspicion of COVID-19 over a period of four weeks. The patient’s clinical presentation and severe acute respiratory syndrome coronavirus 2 reverse-transcription polymerase chain reaction (SARS-CoV-2 RT-PCR) were recorded. The patients were divided by diagnosis into COVID (COVID-19 infection) or CONTROL (an alternate diagnosis). A retrospective review of consecutive patients over a further two-week period was used for the purposes of validation. Results Overall, 399 patients (53% COVID, 47% CONTROL) were analysed. White cell count, neutrophils and lymphocytes were significantly lower, while lactate dehydrogenase and ferritin were significantly higher, in the COVID group in comparison to CONTROL. Combining the white cell count, lymphocytes and ferritin results into a COVID Combined Blood Test (CCBT) had an area under the curve of 0.79. Using a threshold CCBT of –0.8 resulted in a sensitivity of 0.85 and a specificity of 0.63. Analysing this against a further retrospective review of 181 suspected COVID-19 patients, using the same CCBT threshold, resulted in a sensitivity of 0.73 and a specificity of 0.75. The sensitivity was comparable to the SARS-CoV-2 RT PCR. Discussion Mathematically combining the blood tests has the potential to assist clinical acumen allowing for rapid streaming and more accurate patient flow pending definitive diagnosis. This may be of particular use in low-resource settings.

Mechanical Behavior of Ti-6Al-4V Manufactured by Electron Beam Additive Fabrication

2013 ◽  
Author(s):  
Leila Ladani ◽  
Lalit Roy
Keyword(s):  
Mechanical Properties ◽  
Electron Beam ◽  
Lead Time ◽  
Aerospace Industry ◽  
Tensile Tests ◽  
Test Results ◽  
Great Resistance ◽  
Additive Fabrication ◽  
Anisotropy Effect ◽  
The Cost

Additive Layer Fabrication, in particular Electron Beam Additive Fabrication (EBAF), has recently drawn much attention for its special usability to fabricate intricately designed parts as a whole. It not only increases the production rate which reduces the production lead time but also reduces the cost by minimizing the amount of waste material to a great extent. Ti6Al4V is the most common type of material that is currently being fabricated using EBAF technique. This material has been used in aerospace industry for several reasons such as excellent mechanical properties, low density, great resistance to corrosion, and non-magnetism. The effects of build direction of layers (namely, addition of layers along one of the x, y & z directions with respect to the build table) and the anisotropy effect caused by it has not been explored vigorously. This anisotropy effect has been investigated in this work. Different mechanical properties such as Yield Strength (YS), Ultimate Tensile Strength (UTS), and Modulus of Elasticity (E) of these three types of Ti6Al4V are determined using tensile tests and are compared with literature. The tensile test results show that YS and UTS for flat-build samples have distinguishably higher values than those of the side-build and top-build samples.

Design of the Automatic Guided Vehicle Control System Applied to Automotive Logistics

2014 ◽  
Vol 644-650 ◽  
pp. 381-384
Author(s):  
Xin Zhang ◽  
Hao Zhou ◽  
Guo Song Liu
Keyword(s):  
Control System ◽  
Absolute Error ◽  
Vehicle Control ◽  
Test Results ◽  
Circuit Performance ◽  
Automatic Driving ◽  
Automatic Guided Vehicle ◽  
Distribution Logistics ◽  
Auto Parts ◽  
The Cost

In order to improve the efficiency of auto parts distribution logistics, to lower the cost of auto production in transportation logistics, and to reduce accidents, in this paper it is designed that an automatic guided vehicle control system to replace the manned tractors in the distribution sites. The system is equipped with an infrared homing device that can ensure the automated guided vehicle (AGV) along a predetermined route automatic driving at a given distribution information, without the needs to manually guided. Test results show that the circuit performance of AGV control system is stable to ensure the accuracy of the tracking in the practical application, and the mean absolute error of the tracking is less than 0.04m.

Predicting abnormal laboratory blood test results in the intensive care unit using novel features based on information theory and historical conditional probability (Preprint)

2021 ◽  
Author(s):  
Camilo E. Valderrama ◽  
Daniel J. Niven ◽  
Henry T. Stelfox ◽  
Joon Lee
Keyword(s):  
Machine Learning ◽  
Intensive Care ◽  
Conditional Probability ◽  
Blood Test ◽  
Laboratory Tests ◽  
Conditional Entropy ◽  
Admission Diagnosis ◽  
Test Results ◽  
Abnormal Laboratory ◽  
Blood Tests

BACKGROUND Redundancy in laboratory blood tests is common in intensive care units (ICU), affecting patients' health and increasing healthcare expenses. Medical communities have made recommendations to order laboratory tests more judiciously. Wise selection can rely on modern data-driven approaches that have been shown to help identify redundant laboratory blood tests in ICUs. However, most of these works have been developed for highly selected clinical conditions such as gastrointestinal bleeding. Moreover, features based on conditional entropy and conditional probability distribution have not been used to inform the need for performing a new test. OBJECTIVE We aimed to address the limitations of previous works by adapting conditional entropy and conditional probability to extract features to predict abnormal laboratory blood test results. METHODS We used an ICU dataset collected across Alberta, Canada which included 55,689 ICU admissions from 48,672 patients with different diagnoses. We investigated conditional entropy and conditional probability-based features by comparing the performances of two machine learning approaches to predict normal and abnormal results for 18 blood laboratory tests. Approach 1 used patients' vitals, age, sex, admission diagnosis, and other laboratory blood test results as features. Approach 2 used the same features plus the new conditional entropy and conditional probability-based features. RESULTS Across the 18 blood laboratory tests, both Approach 1 and Approach 2 achieved a median F1-score, AUC, precision-recall AUC, and Gmean above 80%. We found that the inclusion of the new features statistically significantly improved the capacity to predict abnormal laboratory blood test results in between ten and fifteen laboratory blood tests depending on the machine learning model. CONCLUSIONS Our novel approach with promising prediction results can help reduce over-testing in ICUs, as well as risks for patients and healthcare systems. CLINICALTRIAL N/A

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