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2021 ◽  
Author(s):  
Vijay Shyam-Sundar ◽  
Dan F Stein ◽  
Martina Spazzapan ◽  
Andrew Sullivan ◽  
Cathy Qin ◽  
...  

Objective: We performed a single-centre retrospective observational study investigating the association between troponin positivity in patients hospitalised with COVID-19 and increased mortality in the short term. Methods: All adults admitted with swab-proven RT-PCR COVID-19 to Homerton University Hospital (HUH) from 04.02.20 to 30.04.20 were eligible for inclusion. We retrospectively analysed demographic and biochemical data collected from the physical and electronic patient records according to the primary outcome of death at 28 days during hospital admission. Troponin positivity was defined above the upper limit of normal according to our local laboratory assay (>15.5ng/l for females, >34 ng/l for males). Univariate and multivariate logistical regression analyses were performed to evaluate the link between troponin positivity and death. Results: Mean length of stay for all 402 hospitalised COVID-19 patients at HUH was 9.1 days (SD 12.0). Mean age was 65.3 years for men compared to 63.8 years for women. A chi-squared test showed that survival of COVID-19 patients was significantly higher in those with a negative troponin (p = 3.23 x10-10) compared to those with a positive troponin. In the multivariate logistical regression, lung disease, age, troponin positivity and CPAP were all significantly associated with death, with an AUC of 0.8872, sensitivity of 0.9004 and specificity of 0.6292 for the model. Within this model, troponin positivity was independently associated with short term mortality (OR 3.23, 95% CI 1.53-7.16, p=0.00278). Conclusions: We demonstrated an independent association between troponin positivity and increased short-term mortality in COVID-19 in a London district general hospital.


2021 ◽  
Vol 162 (49) ◽  
pp. 1962-1967

Összefoglaló. Bevezetés: Az I. Patológiai és Kísérleti Rákkutató Intézet – a Semmelweis Egyetemen belüli diagnosztikai szolgáltatásnyújtás mellett – kiterjedt külső partneri hálózattal (vizsgálatmegrendelővel) bír. Az Intézet a napi működése során párhuzamosan használja az egyetem központi informatikai rendszerét, valamint belső, folyamattámogató alkalmazását (workflow management). A külsős partnerek hozzáférése vizsgálatfeladásra az egyetemi központi informatikai rendszerhez nincs biztosítva. A vizsgálatok rendelése papíralapú, a minta érkeztetésekor a klinikai adatok rögzítése manuális, kifejezetten humánerőforrás-igényes. Célkitűzés: Célunk volt a patológiai minták regisztrációjának egyszerűsítése és felgyorsítása, az adminisztratív folyamatok hatékonyságának javítása. Módszer: A kitűzött célt a minőségfejlesztésből ismert Plan-Do-Check-Act (Tervezés-Cselekvés-Ellenőrzés-Beavatkozás) ciklus módszereit alkalmazva kívántuk elérni, online, a mintavétel helyén elérhető, a meglévő belső folyamattámogató alkalmazáshoz kapcsolódó, szakterület-specifikus vizsgálatkérő felület kifejlesztésével. Eredmények: A vizsgálati minták regisztrációjának átlagos ideje 65%-kal csökkent az online vizsgálatkérő rendszerhez csatlakozott klinikai partnerek körében. Megbeszélés: Az elmúlt években tapasztalható volt, hogy kisebb, nem hatékonyan működtethető patológiai osztályok megszűntek, részben vagy egészben beolvadtak nagyobb diagnosztikai egységekbe. A humánerőforrás-problémák (elöregedő szakma a patológia) a fenti folyamatot minden bizonnyal tovább erősítik. Várható, hogy a nagyobb patológiai osztályokon a következő években a mintaszám tovább növekszik, a vizsgálatkérések egyre nagyobb hányada érkezik majd intézményen kívülről. Következtetés: A patológiai informatika fejlesztésekor figyelembe kell venni, hogy szükséges már a mintavétel helyén biztosítani az informatikai támogatást a minta nyomon követéséhez, nem elégséges csak a laboron belüli folyamatok kiszolgálása. Orv Hetil. 2021; 162(49): 1962–1967. Summary. Introduction: The 1st Department of Pathology and Experimental Cancer Research, Semmelweis University (Budapest, Hungary) has a broad network of clinical partners, many of which are non-university hospitals. A separate hospital information system and a local laboratory workflow management system is used at the Department. University clinics use the hospital information system for electronic requesting of tests. Non-university partners have no access to the systems, requesting tests is paper-based, registration of the requests at the pathology lab is manual and laborious. Objective: Our main objective was to improve the efficiency of the sample registration step of the pathology workflow. Method: Applying the Plan-Do-Check-Act procedure, a quality improvement project has been carried out and an online, subspecialty-based requesting application tool, interfaced with the current laboratory information system, was developed. Results: The average sample registration time improved with 65% among the early user partners. Discussion: The past years have shown smaller, inefficient pathology labs decreasing in number and integrated into larger regional diagnostic centers. Both issues of efficiency and quality assurance and problems rooted in human resources are drivers of further centralisation. The numbers of test requests and samples from non in-house partners are expected to be increased in the pathology labs in the future. Conclusion: Efficient and safe sample tracking has to start at the site of sample acquisition. State of the art laboratory information systems should support this expansion of competence. Orv Hetil. 2021; 162(49): 1962–1967.


2021 ◽  
Author(s):  
Ioana Damian ◽  
Simona Delia Nicoară

Diabetic retinopathy (DR) is one of the most frequent microvascular complications of diabetes. A large body of evidence supports the role of inflammation in the development and progression of DR. Currently, DR is diagnosed based on the presence of morphological lesions detected on fundus examination. Yet, there are other laboratory or imaging biomarker whose alteration precede DR lesions. This chapter will first briefly explain the role of inflammation in DR pathogenesis and will analyze the molecules involved. Further, it will discuss significant and recent studies that analyzed local laboratory or imaging inflammatory biomarkers in different DR stages. It will then focus on several potential inflammation-targeting therapies which proved to be effective in animal or human studies. Validation of these reviewed biomarkers would allow the identification of patients who do not respond to the current available treatment and could benefit from an adjunctive therapy.


Author(s):  
Larry W. Esposito

Saturn’s rings are not only a beautiful and enduring symbol of space, but astronomers’ best local laboratory for studying phenomena in thin cosmic disks like those where planets formed. All the giant planets have ring systems. Saturn’s are the biggest and brightest. Saturn’s rings are made of innumerable icy particles, ranging from the size of dust to that of football stadiums. Galileo discovered Saturn’s rings with his newly invented telescope, but they were not explained until Huygens described them as thin, flat disks surrounding the planet. In the space age, rings were found around the other giant planets in our solar system. Rings have been seen around asteroids and likely exist around exoplanets. Many of the ring structures seen are created by gravity from Saturn’s moons. Rings show both ongoing aggregation and disaggregation. After decades of study from space and by theoretical analysis, some puzzles still remain unexplained. There is evidence for youthful rings from Cassini results, but no good theory to explain their recent origin. A future Saturn Ring Observer mission would be able to determine the direct connections between the individual ring physical properties and the origin and evolution of larger structures.


Author(s):  
Charles L. Nagle ◽  
Ivana Rehman

Abstract Listener-based ratings have become a prominent means of defining second language (L2) users’ global speaking ability. In most cases, local listeners are recruited to evaluate speech samples in person. However, in many teaching and research contexts, recruiting local listeners may not be possible or advisable. The goal of this study was to hone a reliable method of recruiting listeners to evaluate L2 speech samples online through Amazon Mechanical Turk (AMT) using a blocked rating design. Three groups of listeners were recruited: local laboratory raters and two AMT groups, one inclusive of the dialects to which L2 speakers had been exposed and another inclusive of a variety of dialects. Reliability was assessed using intraclass correlation coefficients, Rasch models, and mixed-effects models. Results indicate that online ratings can be highly reliable as long as appropriate quality control measures are adopted. The method and results can guide future work with online samples.


Significance A rise in cases and deaths has increased pressure on the government over its sluggish vaccine roll-out. Despite an announcement recently that a local laboratory will soon begin producing the Russian Sputnik V vaccine, questions over vaccine negotiations and planned AstraZeneca supplies are mounting. Impacts Political concerns will increase vaccine hesitancy. Renewed lockdown measures will generate little compliance and will have more impact on the economy than the pandemic. A severe new winter wave would undermine prospects for economic recovery this year.


Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 370
Author(s):  
Joohyun Hong ◽  
Jiyun Lee ◽  
Minsuk Kwon ◽  
Ji-Yeon Kim ◽  
Jong-Won Kim ◽  
...  

Genetic diagnosis for human epidermal growth factor receptor 2-negative metastatic breast cancer patients with the germline BRCA (gBRCA) mutation has been emphasized since the development of polyadenosine diphosphate-ribose polymerase inhibitors. Myriad Genetics, Inc.’s (Salt Lake City, UT, USA) companion diagnostics service is almost exclusively used for genetic testing. The aim of this study was to compare the results of germline BRCA mutation tests returned by a local laboratory and those performed by Myriad. Between April 2014 and February 2018, 31 patients with gBRCA 1/2 mutation test results from both Samsung Medical Center (Seoul, Korea) and Myriad were enrolled. “Discordant: Opposite classification” was observed for only one among 27 (3.7%). This discrepancy was due to the detection of a deleterious large genomic rearrangement of BRCA 1 by Myriad. Samsung Medical Center performed multiple ligation-dependent probe amplifications (MLPA) to detect large genomic rearrangements only in high-risk patients. This one case was not suspected as high risk and MLPA was not performed. The concordant rate was 74.1% for all 27 patients. “Discordant: Laboratory’s uncertain classification” was found in 22.2% of the sample (six patients). All discrepancies were generated during interpretation of BRCA 2 gene sequencing. Further studies and standardization of genetic testing for BRCA 1/2 genes are required.


2021 ◽  
pp. 104063872199482
Author(s):  
Michael K. Martin

The local laboratory with a local client-base, that never needs to exchange information with any outside entity, is a dying breed. As marketing channels, animal movement, and reporting requirements become increasingly national and international, the need to communicate about laboratory tests and results grows. Local and proprietary names of laboratory tests often fail to communicate enough detail to distinguish between similar tests. To avoid a lengthy description of each test, laboratories need the ability to assign codes that, although not sufficiently user-friendly for day-to-day use, contain enough information to translate between laboratories and even languages. The Logical Observation Identifiers Names and Codes (LOINC) standard provides such a universal coding system. Each test—each atomic observation—is evaluated on 6 attributes that establish its uniqueness at the level of clinical—or epidemiologic—significance. The analyte detected, analyte property, specimen, and result scale combine with the method of analysis and timing (for challenge and metabolic type tests) to define a unique LOINC code. Equipping laboratory results with such universal identifiers creates a world of opportunity for cross-institutional data exchange, aggregation, and analysis, and presents possibilities for data mining and artificial intelligence on a national and international scale. A few challenges, relatively unique to regulatory veterinary test protocols, require special handling.


2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Shumpei Watanabe ◽  
Shuetsu Fukushi ◽  
Toshihiko Harada ◽  
Masayuki Shimojima ◽  
Tomoki Yoshikawa ◽  
...  

Abstract Background Nipah virus (NiV) is an emerging zoonotic paramyxovirus that causes severe encephalitis and respiratory disease with a high mortality rate in humans. During large outbreaks of the viral disease, serological testing of serum samples could be a useful diagnostic tool, which could provide information on not only the diagnosis of NiV disease but also the history of an individual with previous exposure to the virus, thereby supporting disease control. Therefore, an efficient method for the inactivation of NiV in serum samples is required for serological diagnosis. Methods We determined the optimal conditions for the inactivation of NiV infectivity in human serum using heating and UV treatment. The inactivation method comprised UV irradiation with a cover of aluminum foil for 30 min and heating at 56 °C for 30 min. Results With an optimized protocol for virus inactivation, NiV infectivity in serum samples (containing 6.0 × 105 TCID50) was completely inactivated. Conclusions We developed a recommended protocol for the effective inactivation of NiV. This protocol would enable a regional or local laboratory to safely transport or process samples, including NiV, for serological testing in its biosafety level-2 facility.


2020 ◽  
Author(s):  
Shumpei Watanabe ◽  
Shuetsu Fukushi ◽  
Toshihiko Harada ◽  
Masayuki Shimojima ◽  
Tomoki Yoshikawa ◽  
...  

Abstract Background: Nipah virus (NiV) is an emerging zoonotic paramyxovirus that causes severe encephalitis and respiratory disease with a high mortality rate in humans. During large outbreaks of the viral disease, serological testing of serum samples could be a useful diagnostic tool, which could provide information on not only the diagnosis of NiV disease but also the history of an individual with previous exposure to the virus, thereby supporting disease control. Therefore, an efficient method for the inactivation of NiV in serum samples is required for serological diagnosis. Methods: We determined the optimal conditions for the inactivation of NiV infectivity in human serum using heating and UV treatment. The inactivation method comprised UV irradiation with a cover of aluminum foil for 30 min and heating at 56°C for 30 min. Results: With an optimized protocol for virus inactivation, NiV infectivity in serum samples (containing 6.0 ×10 5 TCID 50 ) was completely inactivated. Conclusions: We developed a recommended protocol for the effective inactivation of NiV. This protocol would enable a regional or local laboratory to safely transport or process samples, including NiV, for serological testing in its biosafety level-2 facility.


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