WorldWideScience

Sample records for pre-operative blood tests

  1. SRS Software Verification Pre Operational and Startup Test

    Energy Technology Data Exchange (ETDEWEB)

    HILL, L.F.

    2000-10-18

    This document defines testing for the software used to control the Sodium Removal System (SRS). The testing is conducted off-line from the. physical plant by using a simulator built-in to the software. This provides verification of proper software operation prior to performing the operational acceptance tests with the actual plant hardware.

  2. Pre-operative laboratory testing: A prospective study on comparison and cost analysis

    Directory of Open Access Journals (Sweden)

    Venkatesh H Keshavan

    2016-01-01

    Full Text Available Background and Aims : Pre-operative investigations are performed before any surgical intervention under anaesthesia. Many are considered as routine. However, there are no clear guidelines regarding these in India. We aim to look at the relevance of the laboratory investigations ordered routinely and their cost implications compared with the National Institute of Clinical Excellence (NICE guidelines. Methods: This prospective study was carried out at a tertiary care hospital. A total of 163 patients scheduled for elective surgical procedures were included in this study. Neither the surgeons nor anaesthesiologists involved in the case were aware of the study. The laboratory investigations of the patients who underwent surgery were noted. All values were categorised as normal or abnormal and they were assessed as indicated or unindicated based on NICE guidelines. Results: One hundred and sixty-three patients were subjected to a total of 984 tests. Forty three patients (26% were subjected to tests as per NICE guidelines. Of the 984 tests, 515 tests were unindicated (52%. Out of the 515 unindicated tests, 7 (1.3% were abnormal. None of these seven tests required any intervention or change of anaesthetic plan. The most common unindicated tests done were cardiac echocardiography and chest X-ray (92.5% and 93% respectively. The additional cost incurred towards unindicated tests was 63% of the total cost for the tests. Conclusion: Pre-operative laboratory investigations add to cost significantly. Patient premorbid conditions and surgical grade should guide the clinician to request for the relevant laboratory tests.

  3. Minor elective surgical procedures using general anesthesia in children with sickle cell anemia without pre-operative blood transfusion.

    Science.gov (United States)

    Fu, Teresa; Corrigan, Nicole J; Quinn, Charles T; Rogers, Zora R; Buchanan, George R

    2005-07-01

    Pre-operative red blood cell (RBC) transfusions are often recommended for patients with sickle cell disease (SCD) who require elective surgery under general anesthesia. However, definitive randomized studies demonstrating the benefit of transfusions in this setting have not been conducted. In particular, the merits of transfusion prior to minor or low-risk surgical procedures in children with SCD have not been demonstrated. We hypothesized that children with sickle cell anemia (Hb SS) who have minor elective surgical procedures develop few complications even without pre-operative transfusion. We accessed our Comprehensive Sickle Cell Program's Database to identify all such procedures performed during a 13-year period. Medical records were reviewed to characterize the surgical procedure, the use of transfusions, and perioperative complications. Twenty-eight children with Hb SS had a total of 38 minor surgical procedures. No perioperative transfusions were given in 34 of the cases (85%). Five of these 34 surgeries (15%) were associated with minor post-operative complications (fever or transient pain). No post-operative acute chest syndrome was encountered. Minor or low-risk elective surgical procedures in children with Hb SS may not routinely require pre-operative transfusion. A randomized clinical trial to compare transfusion with no transfusion for minor surgical procedures is needed.

  4. Pre-operative blood donation versus acute normovolemic hemodilution in cardiac surgery

    Directory of Open Access Journals (Sweden)

    Mohammad Rezvan Nobahar

    2014-01-01

    Full Text Available Introduction: Acute normovolemic hemodilution (ANH and preoperative autologous blood donation (PABD have questionable efficacy, viral and bacterial infection risks, intermittent blood shortages as homeostasis problem, electrolyte and hemodynamic disturbances. Materials and Methods: In this cross sectional survey, we studied 70 patients undergoing open heart coronary artery bypass grafts [CABG] and different valvular replacement 1 ml surgery (35 in ANH, 35 in PABD in Shaheed Modares - Hospital. We measured electrolytes and homeostatic factors to evaluate the influence of two transfusion methods on homeostatic function and hemodynamic balance. Results: We compared 70 patients (38 male [54.3%] and 32 female [45.7%] with mean age 54.8 years undergoing open heart surgery (CABG and valvular. In ANH group, significant decrease was detected in Na (28.5% K (2.5%, prothrombin time (PT (88.57%, partial thromboplastin time (PTT (94.28%, creatine phosphokinase (CPK (11.4%, lactic dehydrogenase (LDH (11.43%, albumin (Alb (17.14%, globulin (91.43% and total protein (80%. Mean initial and post-operative hemoglobin was 14.12 ± 1.06 versus 11.97 ± 0.98, hematocrit 42.22 ± 3.45 versus 35.40 ± 2.88, systolic blood pressure 124.1 ± 14.4 versus 110.88 ± 15.6 (reduction 22.86% diastolic blood pressure 76.02 ± 10 versus 69.26 ± 11 (reduction 3% and pulse rate was 75.45 ± 10 versus 84.45 ± 12 (12% in this case difference between two groups was strongly significant (P = 0.001. In PABD group, significant decrease was detected in Na (20%, K (2.5%, PT (91.43% PTT (80%, CPK (8.57%, LDH (5.72%, Alb (57.15%, globulin (71.43% and total-protein (62.85%, the value of hemodynamic changes were in normal range. Conclusion: Though autologous blood transfusion (ANH and PABD was preferable to allogeneic transfusion in cardiac surgical patients; but PABD offers more advantages in homeostasis, hemodynamic stability and electrolyte balance.

  5. Role of Pre-Operative Blood Transfusion and Subcutaneous Fat Thickness as Risk Factors for Surgical Site Infection after Posterior Thoracic Spine Stabilization.

    Science.gov (United States)

    Osterhoff, Georg; Burla, Laurin; Werner, Clément M L; Jentzsch, Thorsten; Wanner, Guido A; Simmen, Hans-Peter; Sprengel, Kai

    2015-06-01

    Surgical site infections (SSIs) increase morbidity and mortality rates and generate additional cost for the healthcare system. Pre-operative blood transfusion and the subcutaneous fat thickness (SFT) have been described as risk factors for SSI in other surgical areas. The purpose of this study was to assess the impact of pre-operative blood transfusion and the SFT on the occurrence of SSI in posterior thoracic spine surgery. In total, 244 patients (median age 55 y; 97 female) who underwent posterior thoracic spine fusions from 2008 to 2012 were reviewed retrospectively. Patient-specific characteristics, pre-operative hemoglobin concentration/hematocrit values, the amount of blood transfused, and the occurrence of a post-operative SSI were documented. The SFT was measured on pre-operative computed tomography scans. Surgical site infection was observed in 26 patients (11%). The SFT was 13 mm in patients without SSI and 14 mm in those with infection (p=0.195). The odds ratio for patients with pre-operative blood transfusion to present with SSI was 3.1 (confidence interval [CI] 1.4-7.2) and 2.7 (CI 1.1-6.4) when adjusted for age. There was no difference between the groups with regard to pre-operative hemoglobin concentration (p=0.519) or hematocrit (p=0.908). The SFT did not differ in the two groups. Allogeneic red blood cell transfusion within 48 h prior to surgery was an independent risk factor for SSI after posterior fusion for the fixation of thoracic spine instabilities. Pre-operative blood transfusion tripled the risk, whereas SFT had no influence on the occurrence of SSI.

  6. Anesthesiologists’ and surgeons’ perceptions about routine pre-operative testing in low-risk patients: application of the Theoretical Domains Framework (TDF) to identify factors that influence physicians’ decisions to order pre-operative tests

    Science.gov (United States)

    2012-01-01

    Background Routine pre-operative tests for anesthesia management are often ordered by both anesthesiologists and surgeons for healthy patients undergoing low-risk surgery. The Theoretical Domains Framework (TDF) was developed to investigate determinants of behaviour and identify potential behaviour change interventions. In this study, the TDF is used to explore anaesthesiologists’ and surgeons’ perceptions of ordering routine tests for healthy patients undergoing low-risk surgery. Methods Sixteen clinicians (eleven anesthesiologists and five surgeons) throughout Ontario were recruited. An interview guide based on the TDF was developed to identify beliefs about pre-operative testing practices. Content analysis of physicians’ statements into the relevant theoretical domains was performed. Specific beliefs were identified by grouping similar utterances of the interview participants. Relevant domains were identified by noting the frequencies of the beliefs reported, presence of conflicting beliefs, and perceived influence on the performance of the behaviour under investigation. Results Seven of the twelve domains were identified as likely relevant to changing clinicians’ behaviour about pre-operative test ordering for anesthesia management. Key beliefs were identified within these domains including: conflicting comments about who was responsible for the test-ordering (Social/professional role and identity); inability to cancel tests ordered by fellow physicians (Beliefs about capabilities and social influences); and the problem with tests being completed before the anesthesiologists see the patient (Beliefs about capabilities and Environmental context and resources). Often, tests were ordered by an anesthesiologist based on who may be the attending anesthesiologist on the day of surgery while surgeons ordered tests they thought anesthesiologists may need (Social influences). There were also conflicting comments about the potential consequences associated with

  7. Anesthesiologists' and surgeons' perceptions about routine pre-operative testing in low-risk patients: application of the Theoretical Domains Framework (TDF) to identify factors that influence physicians' decisions to order pre-operative tests.

    Science.gov (United States)

    Patey, Andrea M; Islam, Rafat; Francis, Jill J; Bryson, Gregory L; Grimshaw, Jeremy M

    2012-06-09

    Routine pre-operative tests for anesthesia management are often ordered by both anesthesiologists and surgeons for healthy patients undergoing low-risk surgery. The Theoretical Domains Framework (TDF) was developed to investigate determinants of behaviour and identify potential behaviour change interventions. In this study, the TDF is used to explore anaesthesiologists' and surgeons' perceptions of ordering routine tests for healthy patients undergoing low-risk surgery. Sixteen clinicians (eleven anesthesiologists and five surgeons) throughout Ontario were recruited. An interview guide based on the TDF was developed to identify beliefs about pre-operative testing practices. Content analysis of physicians' statements into the relevant theoretical domains was performed. Specific beliefs were identified by grouping similar utterances of the interview participants. Relevant domains were identified by noting the frequencies of the beliefs reported, presence of conflicting beliefs, and perceived influence on the performance of the behaviour under investigation. Seven of the twelve domains were identified as likely relevant to changing clinicians' behaviour about pre-operative test ordering for anesthesia management. Key beliefs were identified within these domains including: conflicting comments about who was responsible for the test-ordering (Social/professional role and identity); inability to cancel tests ordered by fellow physicians (Beliefs about capabilities and social influences); and the problem with tests being completed before the anesthesiologists see the patient (Beliefs about capabilities and Environmental context and resources). Often, tests were ordered by an anesthesiologist based on who may be the attending anesthesiologist on the day of surgery while surgeons ordered tests they thought anesthesiologists may need (Social influences). There were also conflicting comments about the potential consequences associated with reducing testing, from negative

  8. Anesthesiologists’ and surgeons’ perceptions about routine pre-operative testing in low-risk patients: application of the Theoretical Domains Framework (TDF to identify factors that influence physicians’ decisions to order pre-operative tests

    Directory of Open Access Journals (Sweden)

    Patey Andrea M

    2012-06-01

    Full Text Available Abstract Background Routine pre-operative tests for anesthesia management are often ordered by both anesthesiologists and surgeons for healthy patients undergoing low-risk surgery. The Theoretical Domains Framework (TDF was developed to investigate determinants of behaviour and identify potential behaviour change interventions. In this study, the TDF is used to explore anaesthesiologists’ and surgeons’ perceptions of ordering routine tests for healthy patients undergoing low-risk surgery. Methods Sixteen clinicians (eleven anesthesiologists and five surgeons throughout Ontario were recruited. An interview guide based on the TDF was developed to identify beliefs about pre-operative testing practices. Content analysis of physicians’ statements into the relevant theoretical domains was performed. Specific beliefs were identified by grouping similar utterances of the interview participants. Relevant domains were identified by noting the frequencies of the beliefs reported, presence of conflicting beliefs, and perceived influence on the performance of the behaviour under investigation. Results Seven of the twelve domains were identified as likely relevant to changing clinicians’ behaviour about pre-operative test ordering for anesthesia management. Key beliefs were identified within these domains including: conflicting comments about who was responsible for the test-ordering (Social/professional role and identity; inability to cancel tests ordered by fellow physicians (Beliefs about capabilities and social influences; and the problem with tests being completed before the anesthesiologists see the patient (Beliefs about capabilities and Environmental context and resources. Often, tests were ordered by an anesthesiologist based on who may be the attending anesthesiologist on the day of surgery while surgeons ordered tests they thought anesthesiologists may need (Social influences. There were also conflicting comments about the potential

  9. Adenoid and tonsil surgeries in children: How relevant is pre-operative blood grouping and cross-matching?

    Directory of Open Access Journals (Sweden)

    Lucky Onotai

    2013-01-01

    Full Text Available Background: As a part of pre-operative evaluation, several otolaryngologists group and cross-match blood routinely for children undergoing adenoid and tonsil surgeries. This practice has generated several debates either in support or against this practice. The aim of this study is to critically evaluate the incidence of post-tonsillectomy (with or without adenoidectomy bleeding and blood transfusions in otherwise healthy children with adenoid/tonsil pathologies conducted in the University of Port Harcourt Teaching Hospital (UPTH. Patients and Methods: A descriptive retrospective study of children who underwent adenoid and tonsil surgeries in the Department of Ear, Nose and Throat (ENT surgery of UPTH from January 2003 to December 2012. Children with family history of bleeding disorders and derangement of clotting profile as well as different co-morbidity like sickle cell disease were excluded from this study. The patients′ data were retrieved from the registers of ENT out-patient clinics, theatre registers and patients case notes. Demographic data, indications for surgery, preoperative investigations, complications and management outcomes were recorded and analyzed. Results: Out of 145 children that had adenoid and tonsil surgeries; only 100 met the criteria for this study. The study subjects included 65 males and 35 females (male: female ratio 1.9:1 belonging to 0-16 years age group (mean age: 3.46 ± 2.82 years. The age group of 3-5 years had the highest (n = 40, 40% number of surgeries. Adenotonsillectomy was the commonest (n = 85, 85% surgery performed on patients who had obstructive sleep apnea (OSA. The commonest (n = 6, 6% complication was haemorrhage, and only few (n = 3, 3% patients had blood transfusion. However, mortality was recorded in some (n = 3, 3% patients. Conclusion: This study confirms that the incidence of post adenoidectomy/tonsillectomy bleeding in otherwise healthy children is low and rarely requires blood transfusion

  10. Pre-operative anaemia.

    Science.gov (United States)

    Clevenger, B; Richards, T

    2015-01-01

    Pre-operative anaemia is a relatively common finding, affecting a third of patients undergoing elective surgery. Traditionally associated with chronic disease, management has historically focused on the use of blood transfusion as a solution for anaemia in the peri-operative period. Data from large series now suggest that anaemia is an independent risk associated with poor outcome in both cardiac and non-cardiac surgery. Furthermore, blood transfusion does not appear to ameliorate this risk, and in fact may increase the risk of postoperative complications and hospital length of stay. Consequently, there is a need to identify, diagnose and manage pre-operative anaemia to reduce surgical risk. Discoveries in the pathways of iron metabolism have found that chronic disease can cause a state of functional iron deficiency leading to anaemia. The key iron regulatory protein hepcidin, activated in response to inflammation, inhibits absorption of iron from the gastrointestinal tract and further reduces bioavailability of iron stores for red cell production. Consequently, although iron stores (predominantly ferritin) may be normal, the transport of iron either from the gastrointestinal tract or iron stores to the bone marrow is inhibited, leading to a state of 'functional' iron deficiency and subsequent anaemia. Since absorption from the gastrointestinal tract is blocked, increasing oral iron intake is ineffective, and studies are now looking at the role of intravenous iron to treat anaemia in the surgical setting. In this article, we review the incidence and impact of anaemia on the pre-operative patient. We explain how anaemia may be caused by functional iron deficiency, and how iron deficiency anaemia may be diagnosed and treated.

  11. Pre-operative investigations: yield and conformity to national guidelines.

    Science.gov (United States)

    Juliana, H; Lim, T A; Inbasegaran, K

    2003-03-01

    Routine ordering of pre-operative investigations yields a low true positive rate and is not cost effective. In this study, case notes of 251 adults who underwent elective surgery were reviewed. Pre-operative investigations were classified as 'indicated' or 'not indicated', based on the national guidelines. Only 56% of all tests done were indicated. The overall rates of expected and unexpected abnormal values from pre-operative blood investigations were 51.1% and 34.4% respectively. This study found that selective testing based on guidelines was beneficial. However, the results also suggest that the local guidelines need to be reviewed.

  12. Blood sugar test - blood

    Science.gov (United States)

    ... blood glucose level ( hypoglycemia ) may be due to: Hypopituitarism (a pituitary gland disorder) Underactive thyroid gland or ... tonic-clonic seizure Glucagon blood test Glucagonoma Hyperthyroidism Hypopituitarism Hypothyroidism Insulinoma Low blood sugar Multiple endocrine neoplasia ( ...

  13. Pre-operational environmental monitoring plan for the Device Assembly Facility at the Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Ferate, F.D.

    1995-01-01

    Nuclear explosives operations have been and may continue to be an important component of the DOE mission at the NTS. This mission has been to conduct the nation`s nuclear testing program in a safe, secure, and efficient manner while assuring full compliance with state and federal regulations, and DOE order`s and directives. These operations have generally included assembly, disassembly or modification, staging, transportation, and tesbng of nuclear explosive devices. They may also include maintenance, repair, retrofit, and surveillance. The Device Assembly Facility (DAF) was constructed to provide a dedicated facility in which to prepare nuclear explosives assemblies for their intended disposition. This facility will provide for combined operations (replacing two separate facilities) and incorporates state-of-the-art safety and security features while minimizing the risks of environmental impacts. The facility has been completed but not yet operated, so the impacts to be considered will b e based on normal operations and not on the impacts of construction activities. The impacts will arise from nuclear explosives operations that require the handling of high explosives in combination with special nuclear materials. Wastes from operation of the earlier device assembly facilities have included grams of epoxies, pints of solvents, and small quantities of waste explosives. These are hazardous (includes radioactive) wastes and are disposed of in accordance with state and federal regulations. Assuming similar operations at the DAF, non-hazardous (includes non-radioactive) solid waste would be transported to a permitted landfill. Waste explosives would be sent to the Area 11 Explosive Ordnance Disposal Unit. Other hazardous waste would be sent to the Area 5 Radioactive Waste.Management Site for shipment or burial.

  14. Focused parathyroidectomy without intraoperative parathormone testing is safe after pre-operative localization with (18)F-Fluorocholine PET/CT.

    Science.gov (United States)

    Hocevar, M; Lezaic, L; Rep, S; Zaletel, K; Kocjan, T; Sever, M J; Zgajnar, J; Peric, B

    2017-01-01

    A focused surgical approach based on pre-operative localization replaced the classical four-gland exploration in patients with primary hyperparathyroidism (PHP). Sestamibi scanning and ultrasound are most often used localization modalities with reported sensitivity of 54-100% for identification of single gland disease. The aim of this study was to analyze the results of pre-operative localization with (18)F-Fluorocholine PET/CT (FCh-PET) in patients with PHP. A retrospective review of 151 patients with PHP who underwent surgery after pre-operative localization with FCh-PET was performed. Only a focused parathyroidectomy without ioPTH testing had been done in patients with single adenoma on FCh-PET. Primary outcome was operative failure, defined as persistent PHP. According to pre-operative FCh-PET 126 (83,4%) patients had single adenoma, 22 (14,5%) multiglandular disease and the test was negative in only two patients. Intraoperative failure experienced 4/126 patients (3,3%) with single adenoma. Removed parathyroid glands were normal in three and hyperplastic in one patient with intraoperative failure. A limited bilateral neck exploration with ioPTH testing was used in 14/22 patients with double adenoma and a classical four-gland exploration without ioPTH testing was used in 8/22 patients with more than two pathological glands according to pre-operative FCh-PET. Intraoperative failure experienced 2/22 patients (9,1%). In two patients with negative FCh-PET a classical four-gland exploration without ioPTH testing was used and one experienced intraoperative failure. A preoperative localization with FCh-PET is a reliable test in patients with PHP. Patients with a single adenoma on FCh-PET can safely undergo a focused parathyroidectomy without ioPTH testing.

  15. Novel application of pre-operative vertebral body embolization to reduce intraoperative blood loss during a three-column spinal osteotomy for non-oncologic spinal deformity.

    Science.gov (United States)

    Tuchman, Alexander; Mehta, Vivek A; Mack, William J; Acosta, Frank L

    2015-04-01

    Three column osteotomies (3CO) of the lumbar spine are powerful corrective procedures used in the treatment of kyphoscoliosis. Their efficacy comes at the cost of high reported complication rates, notably significant estimated blood loss (EBL). Previously reported techniques to reduce EBL have had modest efficacy. Here we describe a potential technique to decrease EBL during pedicle subtraction osteotomy (PSO) of the lumbar spine by means of pre-operative vertebral body embolization - a technique traditionally used to reduce blood loss prior to spinal column tumor resection. We present a 62-year-old man with iatrogenic kyphoscoliosis who underwent staged deformity correction. Stage 1 involved thoracolumbar instrumentation followed by transarterial embolization of the L4 vertebral body through bilateral segmental arteries. A combination of polyvinyl alcohol particles and Gelfoam (Pfizer, New York, NY, USA) were used. Following embolization there was decreased angiographic blood flow to the small vessels of the L4 vertebral body, while the segmental arteries remained patent. Stage 2 consisted of an L4 PSO and fusion. The EBL during the PSO procedure was 1L, which compared favorably to that during previous PSO at this institution as well as to quantities reported in previous literature. There have been no short term (5 month follow-up) complications attributable to the vertebral body embolization or surgical procedure. Although further investigation into this technique is required to better characterize its safety and efficacy in reducing EBL during 3CO, we believe this patient illustrates the potential utility of pre-operative vertebral embolization in the setting of non-oncologic deformity correction surgery.

  16. Cardio-pulmonary exercise testing: An objective approach to pre-operative assessment to define level of perioperative care.

    Science.gov (United States)

    Bhagwat, Milind; Paramesh, Kaggere

    2010-07-01

    Cardiopulmonary exercise testing is a non-invasive, objective method of assessing integrated response of heart, lungs and musculoskeletal system to incremental exercise. Though it has been in use for a few decades, the recent rise in its use as a preoperative test modality is reviewed. A brief account of cardiopulmonary exercise test, as it is carried out in practice and its applications, is given. The physiological basis is explained and relationship of pathophysiology of poor exercise capacity with various test variables is discussed. Its use for prediction of postoperative morbidity in various noncardiopulmonary surgical procedures is reviewed.

  17. Catecholamine blood test

    Science.gov (United States)

    Norepinephrine -- blood; Epinephrine -- blood; Adrenalin -- blood; Dopamine -- blood ... A blood sample is needed. ... the test. This is especially true if both blood and urine catecholamines are to be measured. You ...

  18. Blood Count Tests

    Science.gov (United States)

    Your blood contains red blood cells (RBC), white blood cells (WBC), and platelets. Blood count tests measure the number and types of cells in your blood. This helps doctors check on your overall health. ...

  19. Myoglobin blood test

    Science.gov (United States)

    Serum myoglobin; Heart attack - myoglobin blood test; Myositis - myoglobin blood test; Rhabdomyolysis - myoglobin blood test ... too high, it can damage the kidneys. This test is ordered when your health care provider suspects ...

  20. Home blood sugar testing

    Science.gov (United States)

    Diabetes - home glucose testing; Diabetes - home blood sugar testing ... Usual times to test your blood sugar are before meals and at bedtime. Your provider may ask you to check your blood sugar 2 hours after a meal or ...

  1. Glucagon blood test

    Science.gov (United States)

    ... type I - glucagon test; Hypoglycemia - glucagon test; Low blood sugar - glucagon test ... A blood sample is needed . ... When the needle is inserted to draw blood, some people feel ... Afterward, there may be some throbbing or a slight bruise. This ...

  2. Ketones blood test

    Science.gov (United States)

    ... Ketones - serum; Nitroprusside test; Ketone bodies - serum; Ketones - blood ... A blood sample is needed. ... When the needle is inserted to draw blood, some people feel slight ... there may be some throbbing or a slight bruise. This soon ...

  3. CEA blood test

    Science.gov (United States)

    Carcinoembryonic antigen blood test ... A blood sample is needed . ... When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing or a slight bruise. ...

  4. Blood Gases Test

    Science.gov (United States)

    ... known as: Arterial Blood Gases; ABGs Formal name: Arterial Blood Gas Analysis Related tests: Electrolytes , Bicarbonate , BUN , Creatinine , Emergency and ... lives higher than sea level. Results from an arterial blood gas analysis are not diagnostic; they should be used in ...

  5. Iron therapy for pre-operative anaemia.

    Science.gov (United States)

    Ng, Oliver; Keeler, Barrie D; Mishra, Amitabh; Simpson, Alastair; Neal, Keith; Brookes, Matthew J; Acheson, Austin G

    2015-12-22

    Pre-operative anaemia is common and occurs in up to 76% of patients. It is associated with increased peri-operative allogeneic blood transfusions, longer hospital lengths of stay and increased morbidity and mortality. Iron deficiency is one of the most common causes of this anaemia. Oral iron therapy has traditionally been used to treat anaemia but newer, safer parenteral iron preparations have been shown to be more effective in other conditions such as inflammatory bowel disease, chronic heart failure and post-partum haemorrhage. A limited number of studies look at iron therapy for the treatment of pre-operative anaemia. The aim of this Cochrane review is to summarise the evidence for use of iron supplementation, both enteral and parenteral, for the management of pre-operative anaemia. The objective of this review is to evaluate the effects of pre-operative iron therapy (enteral or parenteral) in reducing the need for allogeneic blood transfusions in anaemic patients undergoing surgery. We ran the search on 25 March 2015. We searched the Cochrane Injuries Group's Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library), Ovid MEDLINE(R), Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily and Ovid OLDMEDLINE(R), EMBASE Classic and EMBASE (Ovid), CINAHL Plus (EBSCO), PubMed, clinical trials registries, conference abstracts, and we screened reference lists. We included all randomised controlled trials (RCTs) which compared pre-operative iron monotherapy to placebo, no treatment, standard of care or another form of iron therapy for anaemic adults undergoing surgery. Anaemia was defined by haemoglobin values less than 13 g/dL for males and 12 g/dL for non-pregnant females. Data were collected by two authors on the proportion of patients who receive a blood transfusion, amount of blood transfused per patient (units) and haemoglobin measured as continuous variables at pre-determined time-points: pre

  6. Chloride test - blood

    Science.gov (United States)

    ... disease Antidiuretic hormone blood test Gastric suction Heart failure - overview Hyperventilation Ions Metabolic acidosis Multiple endocrine neoplasia (MEN) II Proximal renal tubular acidosis Respiratory acidosis Sodium blood test Review Date 5/3/2015 Updated by: Laura J. ...

  7. Ethylene glycol blood test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003564.htm Ethylene glycol blood test To use the sharing features on ... enable JavaScript. This test measures the level of ethylene glycol in the blood. Ethylene glycol is a type ...

  8. BUN - blood test

    Science.gov (United States)

    Blood urea nitrogen ... A blood sample is needed. Most of the time blood is drawn from a vein located on the inside ... Many medicines can interfere with blood test results. Your health ... if you need to stop taking any medicines before you have this ...

  9. Rh Factor Blood Test

    Science.gov (United States)

    Tests and Procedures Rh factor blood test By Mayo Clinic Staff Rhesus (Rh) factor is an inherited protein found on the surface of ... If your blood has the protein, you're Rh positive. If your blood lacks the protein, you' ...

  10. Porphyrins - blood test

    Science.gov (United States)

    ... Blood test References Chernecky CC, Berger BJ. Porphyrins, quantitative - blood. In: Chernecky CC, Berger BJ, eds. Laboratory ... Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare ...

  11. Blood Test: Bilirubin

    Science.gov (United States)

    ... Your 1- to 2-Year-Old Blood Test: Bilirubin KidsHealth > For Parents > Blood Test: Bilirubin A A A What's in this article? What ... Análisis de sangre: bilirrubina What It Is A bilirubin test measures the level of bilirubin (a byproduct ...

  12. [Pre-operative screening tests for lung cancer using the analysis of expired gas with exercise testing--principally VO2 max/m2].

    Science.gov (United States)

    Nagamatsu, Y; Ono, H; Hiraki, H; Matsuo, T; Mitsuoka, M; Takamori, S; Hayashi, A; Yamana, H; Hayashida, R; Kakegawa, T

    1994-10-01

    The analysis of expired gas with exercise testing was conducted preoperatively with lung cancer patients in order to examine the relationship between maximum oxygen consumption (VO2 max) and postoperative complications, determining the cut-off of VO2 max/m2. The usefulness of the test as a preoperative screening test for both pulmonary ventilation and circulation was evaluated in comparison to pulmonary ventilation tests with spirometry and pulmonary circulation tests with Swan-Ganz catheter. Preoperative VO2 max/m2 was calculated from VO2 max in 111 patients with lung cancer who underwent lobectomy of more than one lobe. Also preoperatively conducted were pulmonary ventilation tests by spirometry and pulmonary circulation tests using the Swan-Ganz catheter to measure VC, %VC, FEV1.0, FEV1.0%, mean pulmonary arterial pressure (PPA) and cardiac output coefficient (C.I.). Form theses measurements, VC/m2, FEV1.0/m2 and total pulmonary vascular resistance (TPVR) were calculated. After the cut-off values of VO2 max/m2 were set tentatively at three stages, 600, 650 and 700 ml/min/m2 based on the incidence of postoperative complications, the 111 patients were divided into two groups in each cut-off value; one with VO2 max/m2 greater than the cut-off value and the other less than the cut-off value. Comparison of measurements obtained by spirometry between the two groups disclosed significant differences (p < 0.001) in VC/m2, %VC and FEV1.0/m2 in all cut-off values. Similarly, comparison of measurements obtained using the Swan-Ganz catheter between the two groups yielded significant differences (p < 0.05 to p < 0.01) in PPA and TPVR in all cut-off values.(ABSTRACT TRUNCATED AT 250 WORDS)

  13. Vitamin A blood test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003570.htm Vitamin A blood test To use the sharing features on this page, please enable JavaScript. The vitamin A test measures the level of vitamin A ...

  14. Pre-operative haematological investigations in paediatric orofacial cleft repair: Any relevance to management outcome?

    Directory of Open Access Journals (Sweden)

    Anthony T Adenekan

    2012-01-01

    Full Text Available Aim and Objectives: To determine the value of routine pre-operative haematologic investigations in children undergoing orofacial cleft repair. Background: Although routine pre-operative laboratory screening tests are carried out traditionally, some studies suggest that they are not absolutely necessary in the management of elective surgical patients. Materials and Methods: This is a prospective cohort study carried out at a tertiary health facility located in Nigeria. A review of the laboratory investigations in 116 paediatric orofacial cleft patients undergoing surgery during a 6-year period was undertaken. Pre-operative laboratory investigations and peri-operative transfusion records were analysed for the frequency and impact of abnormal results on treatment plan and outcome using the Statistical Packages for the Social Scientists 16.0. Results: All the children had pre-operative packed cell volume (PCV check on admission for surgery. The PCV ranged from 23% to 43%, mean was 32.9 (±3.7%. Twenty-two children (18.6% had sub-optimal PCV (<30%. Patients with the lowest PCV values (23% and 26% were transfused pre-operatively. The lowest post-operative PCV was 23%, mean 30.8 (±3.3%. There was no occasion of post-operative blood transfusion. Eighty-six patients (72.9% had full or partial serum electrolyte and urea analysis. Screening for sickle-cell disease was rarely done. Fourteen intra- and post-operative complications were recorded. None of these were predictable by the results of pre-operative screening tests carried out. All the children were discharged home in satisfactory condition. Conclusions: Routine laboratory testing has minimal impact on management and outcome of orofacial cleft surgeries. However, haematocrit screening may be appropriate, particularly in clinically pale patients.

  15. CO2 blood test

    Science.gov (United States)

    Bicarbonate test; HCO3-; Carbon dioxide test; TCO2; Total CO2; CO2 test - serum ... Many medicines can interfere with blood test results. Your health care provider will tell you if you need to stop taking any medicines before you have this test. DO ...

  16. Pre-operative pain and sensory function in groin hernia

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

    2009-01-01

    mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... pain is not related to findings of hyperalgesia or other changes in sensory function that may support pain-induced pre-operative neuroplasticity as a pathogenic mechanism for the development of persistent postherniotomy pain....

  17. ALP - blood test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003470.htm ALP - blood test To use the sharing features on this page, please enable JavaScript. Alkaline phosphatase (ALP) is a protein found in all body tissues. ...

  18. Luteinizing hormone (LH) blood test

    Science.gov (United States)

    ICSH - blood test; Luteinizing hormone - blood test; Interstitial cell stimulating hormone - blood test ... to temporarily stop medicines that may affect the test results. Be sure to tell your provider about ...

  19. Antibody Blood Tests

    Science.gov (United States)

    ... What do I do if I have a negative blood test (or panel) but I’m still having symptoms? While it is rare, it is possible for patients to have a negative antibody test results and still have celiac disease. ...

  20. Predictive potential of pre-operative functional neuroimaging in patients treated with subthalamic stimulation

    Energy Technology Data Exchange (ETDEWEB)

    Sestini, Stelvio; Castagnoli, Antonio [Ospedale Misericordia e Dolce, Department of Diagnostic Imaging, Nuclear Medicine Unit, Prato (Italy); Pupi, Alberto; Sciagra, Roberto [University of Florence, Department of Clinical Physiopathology, Nuclear Medicine Unit, Florence (Italy); Ammannati, Franco; Ramat, Silvia; Sorbi, Sandro [University of Florence, Department of Neurological and Psychiatric Sciences, Florence (Italy); Mansi, Luigi [University II Naples, Department of Diagnostic Imaging, Nuclear Medicine Unit, Naples (Italy)

    2010-01-15

    The aim of this study was to investigate the predictive potential of pre-operative regional cerebral blood flow (rCBF) in the pre-supplementary motor area (pre-SMA) and clinical factors in Parkinson's disease (PD) patients treated with subthalamic nucleus (STN) stimulation. Ten patients underwent rCBF SPECT and motor Unified Parkinson's Disease Rating Scale (UPDRS) pre- and post-operatively during stimulation at 5 and 42 months. Statistical parametric mapping (SPM) was used to extract rCBF values in the pre-SMA because it is related with motor improvement. Post-operative outcomes included motor response to stimulation and percent improvement in UPDRS. Pre-operative predictors were explored by correlation test, linear regression and multivariate analyses. Higher pre-operative rCBF in the pre-SMA and younger age were associated with favourable outcomes at 5 and 42 months. Pre-operative rCBF results were significantly associated with baseline clinical factors. This study shows that PD patients with younger age have higher rCBF values in the pre-SMA and better outcome, thus giving the rationale to the hypothesis that STN stimulation could be considered early in the course of disease. (orig.)

  1. Flushable reagent stool blood test

    Science.gov (United States)

    Stool occult blood test - flushable home test; Fecal occult blood test - flushable home test ... This test is performed at home with disposable pads. You can buy the pads at the drug store without ...

  2. Blood Pressure Test

    Science.gov (United States)

    ... an online personal health record or blood pressure tracker, for example. This gives you the option of ... lower your blood pressure. Exercise regularly. Regular physical activity can help lower your blood pressure and keep ...

  3. Magnesium blood test

    Science.gov (United States)

    Magnesium - blood ... A blood sample is needed. ... When the needle is inserted to draw blood, some people feel slight pain. Others feel a prick or stinging. Afterward, there may be some throbbing or a slight bruise. This soon ...

  4. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children......Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  5. Ferritin blood test

    Science.gov (United States)

    Serum ferritin level; Iron deficiency anemia - ferritin ... The amount of ferritin in the blood (serum ferritin level) is directly related to the amount of iron stored in your body. Iron is needed to make healthy red blood cells. These ...

  6. Pre-operative fasting guidelines: an update

    DEFF Research Database (Denmark)

    Søreide, E; Eriksson, L I; Hirlekar, G

    2005-01-01

    Liberal pre-operative fasting routines have been implemented in most countries. In general, clear fluids are allowed up to 2 h before anaesthesia, and light meals up to 6 h. The same recommendations apply for children and pregnant women not in labour. In children...

  7. Prolactin blood test

    Science.gov (United States)

    ... test; Amenorrhea - prolactin test; Breast leakage - prolactin test; Prolactinoma - prolactin test; Pituitary tumor - prolactin test ... hypothyroidism ) Kidney disease Pituitary tumor that makes prolactin (prolactinoma) Other pituitary tumors and diseases in the area ...

  8. Cord blood testing

    Science.gov (United States)

    ... is born. The umbilical cord is the cord connecting the baby to the mother's womb. Cord blood ... ADAM Health Solutions. About MedlinePlus Site Map FAQs Customer Support Get email updates Subscribe to RSS Follow ...

  9. Nitroblue tetrazolium blood test

    Science.gov (United States)

    ... chemical called nitroblue tetrazolium (NBT) into a deep blue color. ... Normally, the white blood cells turn blue when NBT is added. This means that the cells should be able to kill bacteria and protect the person ...

  10. Blood Urea Nitrogen Test

    Science.gov (United States)

    Advertisement Proceeds from website advertising help sustain Lab Tests Online. AACC is a not-for-profit organization and does not endorse non-AACC products and services. Advertising & Sponsorship: Policy | Opportunities ...

  11. Blood Culture Test

    Science.gov (United States)

    Advertisement Proceeds from website advertising help sustain Lab Tests Online. AACC is a not-for-profit organization and does not endorse non-AACC products and services. Advertising & Sponsorship: Policy | Opportunities ...

  12. Pre-operative antiseptic skin preparation.

    Science.gov (United States)

    Murkin, Claire Elizabeth

    Theatre nurses use antiseptic skin preparation products every day, but little thought seems to be given as to why a surgeon has a particular preference for one antiseptic skin preparation over another - whether it is for its efficacy, safety or application properties. Woodhead et al (2004) states that nurses still work in a ritualistic environment. Rituals are 'any action performed according to custom, without understanding the reasons why it is being practised'. Nursing practice should be evidence-based; nurses should understand the rationale behind the choice of a particular antiseptic, and be knowledgable about the clinical effectiveness of antiseptic's use pre-operatively, to achieve optimum results. This article focuses on the main types of antiseptic skin preparation while highlighting each product's activity and the relevant considerations for choosing the appropriate product for each patient. Theatre staff need to emphasize the importance of skin preparation and the correct application techniques, while educating the scrub team and surgeons with respect to skin preparation.

  13. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2012-01-01

    Full Text Available Background and Aims: Alpha-2 agonists are being increasingly used as adjuncts in general anaesthesia, and the present study was carried out to investigate the ability of intravenous dexmedetomidine in decreasing the dose of opioids and anaesthetics for attenuation of haemodynamic responses during laryngoscopy and tracheal intubation. Methods: One hundred patients scheduled for elective general surgery were randomized into two groups: D and F (n=50 in each group. Group D were administered 1 μg/kg each of dexmedetomidine and fentanyl while group F received 2 μg/kg of fentanyl pre-operatively. Thiopental was given until eyelash reflex disappeared. Anaesthesia was maintained with 33:66 oxygen: nitrous oxide. Isoflurane concentration was adjusted to maintain systolic blood pressure within 20% of the pre-operative values. Haemodynamic parameters were recorded at regular intervals during induction, intubation, surgery and extubation. Statistical analysis was carried out using analysis of variance, chi-square test, Student′s t test and Mann-Whitney U test. Results: The demographic profile was comparable. The pressor response to laryngoscopy, intubation, surgery and extubation were effectively decreased by dexmedetomidine, and were highly significant on comparison (P50% by the administration of dexmedetomidine. The mean recovery time was also shorter in group D as compared with group F (P=0.014. Conclusions: Dexmedetomidine is an excellent drug as it not only decreased the magnitude of haemodynamic response to intubation, surgery and extubation but also decreased the dose of opioids and isoflurane in achieving adequate analgesia and anaesthesia, respectively.

  14. Pre-operative pain and sensory function in groin hernia

    DEFF Research Database (Denmark)

    Aasvang, Eske K; Hansen, Jeanette B; Kehlet, Henrik

    2009-01-01

    mechanism. AIMS: To investigate the correlation between pre-operative pain intensity and sensory functions in the groin hernia area. METHODS: Patients with unilateral groin hernia were examined preoperatively by quantitative sensory testing (thermal, mechanical, and pressure [detection and pain thresholds...... (rho=-0.413, p=0.049), indicating a paradoxical association between level of mechanical pain threshold and magnitude of spontaneous pain. No other sensory modality was significantly correlated to pain intensity. New/increased pain during repetitive pinprick stimulation (wind-up) was seen in 3 patients......]) and assessments were correlated to patients' reports of intensity and frequency of spontaneous pain in the groin area. RESULTS: Forty-two patients were examined, whereof one was excluded since no hernia was found intraoperatively. Mechanical pain threshold was inversely correlated with spontaneous pain intensity...

  15. Blood serum mercury test report.

    Science.gov (United States)

    Vandenberge, J; Moodie, A S; Keller, R E

    1977-06-01

    A clinical blood serum mercury test of 111 dentists and auxiliaries revelaed that more than 50% had above normal serum mercury levels. This study showed that there may be a mercury health hazard in some dental environments. Acute mercury poisoning may be corrected simply by removing the cause, but long-term chronic effects are not known. Frequent screening of offices and personnel is advised. Experience reported here indicates that large amounts of mercury vapor are emitted when an amalgam carrier is heated over a flame ot dislodge particles, and also, that water-covered amalgam scrap relesases mercury vapor.

  16. Home Use Tests: Fecal Occult Blood

    Science.gov (United States)

    ... Procedures In Vitro Diagnostics Home Use Tests Fecal Occult Blood Share Tweet Linkedin Pin it More sharing ... test kit to measure the presence of hidden (occult) blood in your stool (feces). What is fecal ...

  17. Blood Test: Hemoglobin A1C

    Science.gov (United States)

    ... 2014 previous 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Diabetes Control: Why It's Important Monitoring Blood Sugar Helping Kids Deal With Injections and Blood Tests Blood Test: Hemoglobin ... Center Word! Glycosylated Hemoglobin Test (Hemoglobin A1c) Medical ...

  18. An anaesthetic pre-operative assessment clinic reduces pre-operative inpatient stay in patients requiring major vascular surgery.

    LENUS (Irish Health Repository)

    O'Connor, D B

    2012-02-01

    BACKGROUND: Patients undergoing major vascular surgery (MVS) require extensive anaesthetic assessment. This can require extended pre-operative stays. AIMS: We investigated whether a newly established anaesthetic pre-operative assessment clinic (PAC) would reduce the pre-operative inpatient stay, avoid unnecessary investigations and facilitate day before surgery (DBS) admissions for patients undergoing MVS. PATIENT AND METHODS: One year following and preceding the establishment of the PAC the records of patients undergoing open or endovascular aortic aneurysm repair, carotid endarterectomy and infra-inguinal bypass were reviewed to measure pre-operative length of stay (LoS). RESULTS: Pre-operative LoS was significantly reduced in the study period (1.85 vs. 4.2 days, respectively, P < 0.0001). Only 12 out of 61 patients in 2007 were admitted on the DBS and this increased to 33 out of 63 patients (P = 0.0002). No procedure was cancelled for medical reasons. CONCLUSION: The PAC has facilitated accurate outpatient anaesthetic assessment for patients requiring MVS. The pre-operative in-patient stay has been significantly reduced.

  19. Surgical bleeding after pre-operative unfractionated heparin and low molecular weight heparin for coronary bypass surgery.

    Science.gov (United States)

    Renda, Giulia; Di Pillo, Raffaele; D'Alleva, Alberto; Sciartilli, Adolfo; Zimarino, Marco; De Candia, Erica; Landolfi, Raffaele; Di Giammarco, Gabriele; Calafiore, Antonio; De Caterina, Raffaele

    2007-03-01

    Since the impairment of platelet function may cause excess peri-operative bleeding, pre-operative discontinuation of aspirin and heparin bridging are common for cardiac surgery. We evaluated the impact of pre-operative administration of enoxaparin and unfractionated heparin (UFH) on coagulation parameters and peri-operative bleeding in patients undergoing elective coronary artery bypass grafting (CABG) surgery after discontinuation of aspirin. Forty-three patients with three-vessel coronary artery disease undergoing elective CABG surgery discontinued aspirin and were randomized to receive either UFH 180 UI/Kg x 2/day s.c. or enoxaparin 100 UI/Kg x 2/day s.c. until 12 h before surgery (median pre-operative treatment 8 days, range 6-12 days). Surgery was performed as usual with UFH. Neither UFH nor any low molecular weight heparin was given in the immediate post-operative period. The effects of UFH and enoxaparin were monitored by the activated partial thromboplastin time (aPTT) and the Enox-test (sensitive to factor Xa inhibition) using a Rapidpoint Coagulation Analyzer. aPTT and factor Xa activity were also measured by standard methods. Peri-operative bleeding and the nadirs of hemoglobin concentration, hematocrit and platelet count were monitored post-operatively. Patients in the two groups were similar for number of bypasses, on-pump time, total surgery time, and time from the last heparin administration. Coagulation parameters increased significantly and similarly at 30 min and 6 h with both treatments, but returned within the normal range at 12 h. Hemoglobin, hematocrit and platelet counts significantly decreased to the same extent after CABG and re-normalized at the same time. Transfusional requirements of blood and plasma units were similar in the two groups. From the kinetics of coagulation parameters and the evaluation of bleeding, enoxaparin is a safe alternative to UFH as a bridging therapy to CABG after discontinuation of aspirin.

  20. Processing, testing and selecting blood components.

    Science.gov (United States)

    Jones, Alister; Heyes, Jennifer

    Transfusion of blood components can be an essential and lifesaving treatment for many patients. However, components must comply with a number of national requirements to ensure they are safe and fit for use. Transfusion of incorrect blood components can lead to mortality and morbidity in patients, which is why patient testing and blood selection are important. This second article in our five-part series on blood transfusion outlines the requirements for different blood components, the importance of the ABO and RhD blood group systems and the processes that ensure the correct blood component is issued to each patient.

  1. Impact of value based breast cancer care pathway implementation on pre-operative breast magnetic resonance imaging utilization

    Science.gov (United States)

    McCray, Devina K. S.; Grobmyer, Stephen R.

    2017-01-01

    Background Bilateral breast magnetic resonance imaging (MRI) is commonly used in the diagnostic workup of breast cancer (BC) to assess extent of disease and identify occult foci of disease. However, evidence for routine use of pre-operative MRI is lacking. Breast MRI is costly and can lead to unnecessary tests and treatment delays. Clinical care pathways (care paths) are value-based guidelines, which define management recommendations derived by expert consensus and available evidence based data. At Cleveland Clinic, care paths created for newly diagnosed BC patients recommend selective use of pre-operative MRI. We evaluated the number of pre-operative MRIs ordered before and after implementing an institution wide BC care paths in April 2014. Methods A retrospective review was conducted of BC cases during the years 2012, 2014, and part of 2015. Patient, tumor and treatment characteristics were collected. Pre-operative MRI utilization was compared before and after care path implementation. Results We identified 1,515 BC patients during the study period. Patients were more likely to undergo pre-operative MRI in 2012 than 2014 (OR: 2.77; Pcare path indications. Conclusions Implementation of online BC care paths at our institution was associated with a decreased use of pre-operative MRI overall and in patients without a BC care path indication, driving value based care through the reduction of pre-operative breast MRIs. PMID:28210553

  2. Fecal Occult Blood Test and Fecal Immunochemical Test

    Science.gov (United States)

    ... Visit Global Sites Search Help? Fecal Occult Blood Test and Fecal Immunochemical Test Share this page: Was this page helpful? Also ... Test Common Questions Ask Us Related Pages The Test How is it used? When is it ordered? ...

  3. Blood Test: Immunoglobulin A (IgA)

    Science.gov (United States)

    ... to 2-Year-Old Blood Test: Immunoglobulin A (IgA) KidsHealth > For Parents > Blood Test: Immunoglobulin A (IgA) Print A A A What's in this article? ... Questions en español Análisis de sangre: inmunoglobulina A (IgA) What It Is An IgA test measures the ...

  4. Beta-carotene blood test

    Science.gov (United States)

    Carotene test ... anything for up to 8 hours before the test. You may also be asked not to eat ... vitamin A (carotene) for 48 hours before the test. Your provider may also tell you to temporarily ...

  5. Parathyroid hormone-related protein blood test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003691.htm Parathyroid hormone-related protein blood test To use the ... features on this page, please enable JavaScript. The parathyroid hormone-related protein (PTH-RP) test measures the ...

  6. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    Directory of Open Access Journals (Sweden)

    Andrew Cook

    2014-01-01

    Full Text Available It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty. We present analysis of perioperative blood tests and transfusion rates in 107 patients undertaking unilateral hybrid hip resurfacing arthroplasty by the senior author at a single institution over a three-year period. We conclude that routine perioperative testing of haemoglobin levels for hip resurfacing arthroplasty procedures does not assist in clinical management. We recommend that postoperative blood testing only be considered should the patient demonstrate clinical signs of symptomatic anaemia or if particular clinical circumstances necessitate.

  7. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score.

    Science.gov (United States)

    Li, Dana; Troelsen, A; Ingelsrud, L; Husted, H; Gromov, K

    2017-02-16

    The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this study was to identify possible factors that may explain the variance of pre-operative FJS levels and evaluate the relationship between pre-operative FJS and pre-operative Oxford Knee Score (OKS). Four-hundred and six individual knees undergoing primary TKA between 2014 and 2016 were included in the study. Age, gender, body mass index (BMI), pre-operative FJS and pre-operative OKS were obtained maximum 2 weeks prior to surgery. Kellgren-Lawrence (K-L) grade, alignment and joint space width (JSW) were evaluated on pre-operative radiographs. Mean FJS was 21.1 ± 15.6. Females, younger patients and patients with high BMI had significantly the worst pre-operative FJS (p < 0.005). Females scored 6.5 FJS points lower than males. A 0.2-point increase in FJS for every added year indicated improvement in knee awareness with age. A 0.4-point decrease in FJS points for every added BMI point indicated worse knee awareness with higher BMI. There was a strong positive correlation between pre-operative FJS and pre-operative OKS according to the Spearman's rank order test (p < 0.005). Females, younger patients and patients with high BMI had significantly the worst pre-operative joint awareness. FJS had a strong positive correlation to OKS in pre-operative patients for primary TKA. This information can be used for improved patient selection; clinically continuous low FJS despite weight loss and/or the passing of time may be indication for TKA. Prospective cohort study, Level II.

  8. Parathyroid hormone (PTH) blood test

    Science.gov (United States)

    ... excess calcium supplements or certain antacids, that contain calcium carbonate or sodium bicarbonate (baking soda) Parathyroid glands do ... More 25-hydroxy vitamin D test Bone tumor Calcium ... level Malabsorption Milk-alkali syndrome Multiple endocrine neoplasia (MEN) I Multiple ...

  9. 21 CFR 640.53 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.53 Section 640.53 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Cryoprecipitate § 640.53 Testing the blood. (a) Blood... sample of blood collected at the time of collecting the source blood, and such sample container shall...

  10. Acknowledging the results of blood tests

    DEFF Research Database (Denmark)

    Torkilsheyggi, Arnvør Martinsdottir á; Hertzum, Morten

    At the studied hospital, physicians from the Medical and Surgical Departments work some of their shifts in the Emergency Department (ED). Though icons showing the blood-test process were introduced on electronic whiteboards in the ED, these icons did not lead to increased attention to test...

  11. Pre-operative echocardiogram in hip fracture patients with cardiac murmur- an audit

    Directory of Open Access Journals (Sweden)

    Talkhani Imtiyaz

    2011-09-01

    Full Text Available Abstract Background All hip fracture patients with a cardiac murmur have an echocardiogram as a part of their preoperative work-up in our unit. We performed a retrospective audit to assess the impact of obtaining a pre-operative echocardiogram on the management of hip fracture patients. Methods All hip fracture patients (N = 349 between 01/06/08 and 01/06/09 were included in the study. 29 patients had pre-operative echocardiogram (echo group. A computer generated randomised sample of 40 patients was generated from N, 'non-echo' group. Data was obtained from medical records and the Hospital Information Support System (HISS. The groups were compared using Student's t test. Approval was obtained locally from the clinical governance department for this project. Results Age and gender distribution were similar in both groups. Indication for echo was an acute cardiac abnormality in 4 cases. 25 patients had echo for no new cardiac problem (indication being cardiac murmur in 23 patients and extensive cardiac history in 2 cases. Cardiology opinion was sought in 5 cases. No patient required cardiac surgery or balloon angioplasty preoperatively. Patients having pre-operative echo had significant delay to surgery (average 2.7 days, range 0-6 days compared to 'non-echo' group (average 1.1 days, range 0-3 days, (p Conclusion We have developed departmental guidelines for expediting echo requests in hip fracture patients with cardiac murmur. A liaison has been established with our cardiology department to prioritise such patients on the Echocardiography waiting list, to prevent unnecessary avoidable delay. Careful patient selection for pre-operative echocardiography is important to avoid unnecessary delay to surgery.

  12. An evaluation of factors influencing the assessment time in a nurse practitioner-led anaesthetic pre-operative assessment clinic.

    Science.gov (United States)

    Hawes, R H; Andrzejowski, J C; Goodhart, I M; Berthoud, M C; Wiles, M D

    2016-03-01

    Elective patients undergoing anaesthetic pre-operative assessment are usually allocated the same period of time with a nurse practitioner, leading to potential inefficiencies in patient flow through the clinic. We prospectively collected data on 8519 patients attending a pre-operative assessment clinic. The data set were split into derivation and validation cohorts. Standard multiple regressions were used to construct a model in the derivation cohort, which was then tested in the validation cohort. Due to missing data, 2457 patients were not studied, leaving 5892 for analysis (3870 in the derivation cohort and 2022 in the validation cohort). The mean (SD) pre-operative assessment time was 46 (12) min. Age, ASA physical status, nurse practitioner and surgical specialty all influenced the time spent in pre-operative assessment. The predictive equations calculated using the derivation cohort, based on age and ASA physical status, correctly estimated duration of consultation to within 20% of the maximum predicted time in 74.2% of the validation cohort. We conclude that if age and ASA physical status are known before the pre-operative assessment consultation, it could allow appointment times to be allocated more accurately.

  13. Acute gallbladder torsion - a continued pre-operative diagnostic dilemma

    Directory of Open Access Journals (Sweden)

    Desrochers Randal

    2011-04-01

    Full Text Available Abstract Acute gallbladder volvulus continues to remain a relatively uncommon process, manifesting itself usually during exploration for an acute surgical abdomen with a presumptive diagnosis of acute cholecystitis. The pathophysiology is that of mechanical organo-axial torsion along the gallbladder's longitudinal axis involving the cystic duct and cystic artery, and with a pre-requisite of local mesenteric redundancy. The demographic tendency is septua- and octo-genarians of the female sex, and its overall incidence is increasing, this being attributed to increasing life expectancy. We discuss two cases of elderly, fragile women presenting to the emergency department complaining of sudden onset right upper quadrant abdominal pain. Their subsequent evaluation suggested acute cholecystitis. Ultimately both were taken to the operating room where the correct diagnosis of gallbladder torsion was made. Pre-operative diagnosis continues to be a major challenge with only 4 cases reported in the literature diagnosed with pre-operative imaging; the remainder were found intra-operatively. Consequently, a delay in diagnosis can have devastating patient outcomes. Herein we propose a necessary high index of suspicion for gallbladder volvulus in the outlined patient demographic with symptoms and signs mimicking acute cholecystitis.

  14. Pre-operative stroke and neurological disability do not independently affect short- and long-term mortality in infective endocarditis patients.

    Science.gov (United States)

    Diab, Mahmoud; Guenther, Albrecht; Sponholz, Christoph; Lehmann, Thomas; Faerber, Gloria; Matz, Anna; Franz, Marcus; Witte, Otto W; Pletz, Mathias W; Doenst, Torsten

    2016-10-01

    Infective endocarditis (IE) is still associated with high morbidity and mortality. The impact of pre-operative stroke on mortality and long-term survival is controversial. In addition, data on the severity of neurological disability due to pre-operative stroke are scarce. We analysed the impact of pre-operative stroke and the severity of its related neurological disability on short- and long-term outcome. We retrospectively reviewed our data from patients operated for left-sided IE between 01/2007 and 04/2013. We performed univariate (Chi-Square and independent samples t test) and multivariate analyses. Among 308 consecutive patients who underwent cardiac surgery for left-sided IE, pre-operative stroke was present in 87 (28.2 %) patients. Patients with pre-operative stroke had a higher pre-operative risk profile than patient without it: higher Charlson comorbidity index (8.1 ± 2.6 vs. 6.6 ± 3.3) and higher incidence of Staphylococcus aureus infection (43 vs. 17 %) and septic shock (37 vs. 19 %). In-hospital mortality was equal but 5-year survival was significantly worse with pre-operative stroke (33.1 % vs. 45 %, p = 0.006). 5-year survival was worst in patients with severe neurological disability compared to mild disability (19.0 vs. 0.58 %, p = 0.002). However, neither pre-operative stroke nor the degree of neurological disability appeared as an independent risk factor for short or long-term mortality by multivariate analysis. Pre-operative stroke and the severity of neurological disability do not independently affect short- and long-term mortality in patients with infective endocarditis. It appears that patients with pre-operative stroke present with a generally higher risk profile. This information may substantially affect decision-making.

  15. 21 CFR 864.6550 - Occult blood test.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occult blood test. 864.6550 Section 864.6550 Food... DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a) Identification. An occult blood test is a device used to detect occult blood in urine or feces. (Occult blood...

  16. 21 CFR 640.14 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.14 Section 640.14 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Red Blood Cells § 640.14 Testing the blood. Blood from which Red Blood Cells are prepared shall be tested as prescribed in § 610.40 of this chapter...

  17. Blood Group ABO Genotyping in Paternity Testing.

    Science.gov (United States)

    Bugert, Peter; Rink, Gabriele; Kemp, Katharina; Klüter, Harald

    2012-06-01

    BACKGROUND: The ABO blood groups result from DNA sequence variations, predominantly single nucleotide and insertion/deletion polymorphisms (SNPs and indels), in the ABO gene encoding a glycosyltransferase. The ABO blood groups A(1), A(2), B and O predominantly result from the wild type allele A1 and the major gene variants that are characterized by four diallelic markers (261G>del, 802G>A, 803G>C, 1061C>del). Here, we were interested to evaluate the impact of ABO genotyping compared to ABO phenotyping in paternity testing. METHODS: The major ABO alleles were determined by PCR amplification with sequence-specific primers (PCR-SSP) in a representative sample of 1,335 blood donors. The genotypes were compared to the ABO blood groups registered in the blood donor files. Then, the ABO phenotypes and genotypes were determined in 95 paternity trio cases that have been investigated by 12 short tandem repeat (STR) markers before. We compared statistical parameters (PL, paternity likelihood; PE, power of exclusion) of both blood grouping approaches. RESULTS: The prevalence of the major ABO alleles and genotypes corresponded to the expected occurrence of ABO blood groups in a Caucasian population. The low resolution genotyping of 4 diallelic markers revealed a correct genotype-phenotype correlation in 1,331 of 1,335 samples (99.7%). In 60 paternity trios with confirmed paternity of the alleged father based on STR analysis both PL and PE of the ABO genotype was significantly higher than of the ABO phenotype. In 12 of 35 exclusion cases (34.3%) the ABO genotype also excluded the alleged father, whereas the ABO phenotype excluded the alleged father only in 7 cases (20%). CONCLUSION: In paternity testing ABO genotyping is superior to ABO phenotyping with regard to PL and PE, however, ABO genotyping is not sufficient for valid paternity testing. Due to the much lower mutation rate compared to STR markers, blood group SNPs in addition to anonymous SNPs could be considered for

  18. Blood Group ABO Genotyping in Paternity Testing

    Science.gov (United States)

    Bugert, Peter; Rink, Gabriele; Kemp, Katharina; Klüter, Harald

    2012-01-01

    Background The ABO blood groups result from DNA sequence variations, predominantly single nucleotide and insertion/deletion polymorphisms (SNPs and indels), in the ABO gene encoding a glycosyltransferase. The ABO blood groups A1, A2, B and O predominantly result from the wild type allele A1 and the major gene variants that are characterized by four diallelic markers (261G>del, 802G>A, 803G>C, 1061C>del). Here, we were interested to evaluate the impact of ABO genotyping compared to ABO phenotyping in paternity testing. Methods The major ABO alleles were determined by PCR amplification with sequence-specific primers (PCR-SSP) in a representative sample of 1,335 blood donors. The genotypes were compared to the ABO blood groups registered in the blood donor files. Then, the ABO phenotypes and genotypes were determined in 95 paternity trio cases that have been investigated by 12 short tandem repeat (STR) markers before. We compared statistical parameters (PL, paternity likelihood; PE, power of exclusion) of both blood grouping approaches. Results The prevalence of the major ABO alleles and genotypes corresponded to the expected occurrence of ABO blood groups in a Caucasian population. The low resolution genotyping of 4 diallelic markers revealed a correct genotype-phenotype correlation in 1,331 of 1,335 samples (99.7%). In 60 paternity trios with confirmed paternity of the alleged father based on STR analysis both PL and PE of the ABO genotype was significantly higher than of the ABO phenotype. In 12 of 35 exclusion cases (34.3%) the ABO genotype also excluded the alleged father, whereas the ABO phenotype excluded the alleged father only in 7 cases (20%). Conclusion In paternity testing ABO genotyping is superior to ABO phenotyping with regard to PL and PE, however, ABO genotyping is not sufficient for valid paternity testing. Due to the much lower mutation rate compared to STR markers, blood group SNPs in addition to anonymous SNPs could be considered for future

  19. FDA Recommends All Blood Donations Be Tested for Zika

    Science.gov (United States)

    ... FDA Recommends All Blood Donations Be Tested for Zika Updated guidance provides further protection for U.S. blood ... entire blood supply be routinely screened for the Zika virus. In February, the FDA recommended testing of ...

  20. Identifying and assessing anxiety in pre-operative patients.

    Science.gov (United States)

    Pritchard, Michael John

    Increasing demands for hospitals to be more efficient mean that patients attending for an operation are generally admitted on the day of surgery. As a result, healthcare professionals have little time to talk to the patient to ascertain his or her wellbeing, to check for any signs of anxiety and ask whether the patient requires further information about the forthcoming procedure. Healthcare professionals should be encouraged to use appropriate interventions to identify and assess anxious patients. There are several instruments available to measure the patient's level of pre-operative anxiety. This article reviews the Amsterdam Preoperative Anxiety and Information Scale, which is easy for patients to complete and may help to identify which individuals need extra support.

  1. 21 CFR 640.33 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.33 Section 640.33 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) BIOLOGICS ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Plasma § 640.33 Testing the blood. (a) Blood...

  2. 21 CFR 640.5 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.5 Section 640.5 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Whole Blood § 640.5 Testing the blood. All laboratory tests shall be made on a specimen of blood taken from the donor at the time of collecting the unit...

  3. Pre-operative history of depression and cognitive changes in bariatric surgery patients.

    Science.gov (United States)

    Alosco, Michael L; Spitznagel, Mary Beth; Strain, Gladys; Devlin, Michael; Cohen, Ronald; Crosby, Ross D; Mitchell, James E; Gunstad, John

    2015-01-01

    Obesity-associated cognitive impairments may be partially reversible through bariatric surgery. Depression, a prevalent comorbidity in bariatric surgery candidates, is linked with cognitive impairment and poorer surgical outcomes in other populations. No study has examined the effects of pre-operative depression on cognitive changes in bariatric surgery patients. Sixty-seven bariatric surgery patients completed a computerized cognitive test battery prior to surgery and 12 months post-operatively. The structured clinical interview for the DSM-IV Axis I disorders assessed major depressive disorder (MDD). Pre-surgery history of MDD was found in 47.8% of patients, but was not associated with greater baseline cognitive impairments. Repeated measures revealed improved cognitive abilities 12 months after surgery. Pre-surgery history of MDD did not influence post-operative cognitive function. Pre-operative history of MDD did not limit post-operative cognitive improvements. Larger studies with extended follow-ups are needed to clarify our findings and identify factors (e.g. older age) that may modify cognitive changes following surgery.

  4. 21 CFR 640.23 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.23 Section 640.23 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.23 Testing the blood. (a) Blood from... this chapter and § 640.5 (a), (b), and (c). (b) The tests shall be performed on a sample of...

  5. Tuberculosis in Children: New diagnostic Blood Tests

    Directory of Open Access Journals (Sweden)

    F Kakkar

    2010-01-01

    Full Text Available The interferon-gamma-release assays were developed to overcome the pitfalls and logistic difficulties of the tuberculin skin test (TST for the diagnosis of latent tuberculosis infection (LTBI. These blood tests measure the in vitro production of interferon-gamma by sensitized lymphocytes in response to Mycobacterium tuberculosis-specific antigens. Two interferon-gamma-release assays are registered for use in Canada: the QuantiFERON-TB Gold In-Tube assay (Cellestis Inc, Australia and the T.SPOT–TB test (Oxford Immunotec, United Kingdom. Evaluation of these tests has been hampered by the lack of a gold standard for LTBI, and limited paediatric data on their use. It appears that they are more specific than the TST, and may be useful for evaluating TST-positive patients at low risk of true LTBI. Moreover, they may add sensitivity if used in addition to the TST in immunocompromised patients, very young children and close contacts of infectious adults. A summary of these tests, their limitations and their application to clinical paediatric practice are described.

  6. Do pre-operative knee laxity values influence post-operative ones after anterior cruciate ligament reconstruction?

    Science.gov (United States)

    Signorelli, C; Bonanzinga, T; Lopomo, N; Marcheggiani Muccioli, G M; Bignozzi, S; Filardo, G; Zaffagnini, S; Marcacci, M

    2013-08-01

    The objective of this study was to verify whether pre-reconstruction laxity condition effects post-reconstruction outcome. A total of 100 patients who underwent navigated Anterior Cruciate Ligament (ACL) reconstruction were included in the study and knee laxity analysed retrospectively. The knee was assessed in six different laxity tests before and after ACL reconstruction, namely antero-posterior (AP) and internal-external (IE) at 30° and 90°, and varus-valgus (VV) rotations at 0° and 30° of flexion. For each test, the least square (LS) fitting line based on pre-operative-to-post-operative laxity value was calculated. To what degree the post-operative laxity value is explainable by the corresponding pre-operative condition was evaluated by the LS line slope. Post-operatively, for each single patient, the grade of laxity decreased at any evaluated test. The strongest influence of pre-operative-to-post-operative laxity values was found during IE30 and IE90 tests. While AP30 and VV0 tests seem to be those in which the post-reconstruction laxity was barely affected by the pre-surgery condition. The analysis of the global laxity reduction confirms the previous results. Following this hypothesis, our study remarks on the importance of combined lesions to secondary restraints and the importance of fully understanding the residual laxity to optimize the surgical technique.

  7. Pre-operative chemotherapy and radiotherapy in breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Goldhirsch, A. [Division of Medical Oncology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Viale, G. [Division of Pathology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Zurrida, S.; Veronesi, P. [Division of Senology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Orecchia, A. [Service of Radiology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Luini, A. [Division of Senology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy); Noberasco, C.; Minchella, I.; Nole' , F.; Colleoni, M. [Division of Medical Oncology, Istituto Europeo di Oncologia, Via Ripamonti 435, 20121 Milan (Italy)

    1998-04-01

    Primary systemic treatment of breast cancer with cytotoxics yields a high response rate and allows conservative surgical procedures in bulky tumours. In order to maximise local control of disease, two innovations were introduced in a pilot study. The first was to identify the good responders after three cycles of chemotherapy and to treat them with three additional cycles. The second was to also give this group of patients a full dose of radiotherapy before surgery with the aim of verifying the rate of pathological complete remissions in view of a possible treatment of breast primary with chemoradiotherapy only. Patients were treated with doxorubicin 60 mg/m{sup 2} and cyclophosphamide, 600 mg/m{sup 2} both intravenously on day 1, every 21 days for three courses. Partial or complete responders received three more courses followed by radiotherapy (50 Gy plus a 10 Gy boost). The others underwent immediate surgery. A total of 32 patients (median age, 50 years; range 28-69 years); performance status, 0-1; T{sub 2} 22, T{sub 3} 8, T{sub 4} 2) were enrolled and were evaluable for response and side-effects. 9 patients had only three cycles of chemotherapy due to absence of response and 23 patients had six cycles of chemotherapy. Overall, 7 patients had a complete remission, 16 a partial remission and 9 had stable disease, for an overall response rate of 72% (95% confidence interval 53-86%). In the group of patients that completed the programme, two complete pathological remissions were observed and 5 patients had only microfoci of tumour. No toxic death or grade III-IV toxicities were observed. Mild or moderate side-effects included mucositis, nausea/vomiting and leucopenia. In conclusion, our results indicate that the addition of radiotherapy to pre-operative chemotherapy did not significantly enhance the incidence of pathological complete remissions. New primary treatment approaches should be explored in this subset of patients in order to improve outcome. (Copyright (c

  8. Nanoscale Test Strips for Multiplexed Blood Analysis

    Science.gov (United States)

    Chan, Eugene

    2015-01-01

    A critical component of the DNA Medicine Institute's Reusable Handheld Electrolyte and Lab Technology for Humans (rHEALTH) sensor are nanoscale test strips, or nanostrips, that enable multiplexed blood analysis. Nanostrips are conceptually similar to the standard urinalysis test strip, but the strips are shrunk down a billionfold to the microscale. Each nanostrip can have several sensor pads that fluoresce in response to different targets in a sample. The strips carry identification tags that permit differentiation of a specific panel from hundreds of other nanostrip panels during a single measurement session. In Phase I of the project, the company fabricated, tested, and demonstrated functional parathyroid hormone and vitamin D nanostrips for bone metabolism, and thrombin aptamer and immunoglobulin G antibody nanostrips. In Phase II, numerous nanostrips were developed to address key space flight-based medical needs: assessment of bone metabolism, immune response, cardiac status, liver metabolism, and lipid profiles. This unique approach holds genuine promise for space-based portable biodiagnostics and for point-of-care (POC) health monitoring and diagnostics here on Earth.

  9. Pre-operative renal arterial embolisation does not provide survival benefit in patients with radical nephrectomy for renal cell carcinoma.

    Science.gov (United States)

    May, M; Brookman-Amissah, S; Pflanz, S; Roigas, J; Hoschke, B; Kendel, F

    2009-08-01

    Currently, there is no widespread use of percutaneous renal artery embolisation (PRAE) as a pre-operative treatment in the management of renal cell carcinoma (RCC). There is also a scarcity of studies concerning the potential benefits of this procedure. All patients with RCC who underwent pre-operative PRAE before nephrectomy (n = 227) and all patients solely undergoing surgery (n = 607) at our institution from 1992 to 2006 were included. Information on techniques used, perioperative transfusion requirements, pathological and clinical variables, acute toxicity and complications were obtained from a retrospective review of medical records. Propensity modelling techniques were used to compare cancer-specific survival (CSS) and overall survival (OS) in both groups. Propensity scores were calculated from a logistic matching model including age, gender, clinical tumour size, grading, pN stage, cM stage, pT stage, histology and microvascular invasion. This resulted in 189 matches. The mean follow-up of the entire group of matched patients was 81 months. The 5-year actuarial CSS and OS for the total group of matched patients was 80.8% and 73.9%, respectively. CSS and OS did not show any significant differences between the matched treatment groups. There were no statistical differences in surgical complications between all patients treated with pre-operative PRAE (n = 227) and all patients without PRAE (n = 607), except for blood transfusion (61% vs 24%; ppost-embolization syndrome, including lumbar pain, fever, nausea, hypertension and macroscopic haematuria, were reported by 202 patients (89%), in most cases being mild and self-limited. There is no conclusive evidence that pre-operative PRAE provides survival benefits in the management of surgically resected RCC.

  10. ROLE OF PRE-OPERATIVE INVESTIGATIONS IN PREVENTING THE POST-OPERATIVE COMPLICATIONS OF THYROID SURGERY

    Directory of Open Access Journals (Sweden)

    Kamreddy Ashok

    2015-11-01

    Full Text Available Thyroid surgeries are performed worldwide for various indications. In the past complications of thyroid surgeries were reported more than 24%. With an increase in accuracy in Cytological reporting, non-invasive radiological investigations to know the extent of the tumor and infiltration of malignant tumors, the complications are reduced to less than 4%. AIM: To evaluate the predictability of pre-operative investigations in preventing the post-operative complications of thyroid surgery. MATERIALS AND METHODS: A prospective study conducted on 86 patients by investigating before thyroid surgeries with FNAC, ultrasonography, CT scan, X-ray Neck lateral view, MRI, 2D ECHO of Cardia, isotope scanning, video laryngoscopy and thyroid function tests. Demographic characteristics of the patients and indications for thyroid surgeries were used to predict the post-operative complications. Post-operative investigations included serum calcium levels, Thyroid function tests and serum Electrolyte levels to diagnose the complications. RESULTS: sensitivity of FNAC was 93.33%, ultra sound Neck was 92.83%, serum calcium was 89.16%, in thyroid function tests it was 77.66%. With X-Ray Neck the specificity was 57.66%, CT scan was 44.50%, MRI was 15%, and isotope study was 30.6%, Doppler study was 33.83% and 2DEcho was 27.83%. Pre-operative assessment was Airway obstruction 3.48%, hematoma formation 4.65%, RLN palsy 3.48%, Hypocalcaemia 33.72%, wound infection 4.65% were the complications encountered. CONCLUSIONS: Thorough investigations prior to surgery of thyroid, proper selection of the surgical procedure, tumor location knowledge, understanding the pathophysiology of the thyroid disease and type of anesthesia gives confidence to the surgeon and avoids complications. The methods applied in the present study had a definitive role in preventing hypocalcaemia with an incidence of 33.72% and RLN palsy 3.48%. These were added upon by the experience of the operating

  11. [Effectiveness of pre-operative education in reducing anxiety in surgical patients].

    Science.gov (United States)

    Díez-Álvarez, Esther; Arrospide, Arantzazu; Mar, Javier; Alvarez, Uzuri; Belaustegi, Alazne; Lizaur, Belen; Larrañaga, Aintzane; Arana, Jose M

    2012-01-01

    To evaluate the effectiveness of a structured pre-operative interview conducted by operating room nurses in order to reduce the pre-operative anxiety of patients, and to determine the profile of patients who can benefit from it. A randomised double-blind and prospective trial was conducted on a sample of 335 patients scheduled for surgery in two regional hospitals in the Basque Region of Spain, Alto Deba Hospital and Mendaro Hospital. We compared the alternative of using a structured briefing (test group) with the current situation without any formal intervention (control group). The effectiveness of the procedure was determined using the STAI state anxiety self-assessment questionnaire. The Chi-squared statistic was used to assess the differences in factors and the Student t-test for comparison of means in the continuous variables. The impact of the intervention on measures of state anxiety and trait anxiety was found to be not statistically significant, although the mean state anxiety state was slightly lower in the intervention group (18.96) than in the controls (20.03). Women undergoing surgery in the specialty of gynaecology showed the higher state anxiety compared with other specialties. As regards trait anxiety a higher ASA level is associated with higher anxiety. Furthermore, the consumption of psychotropic drugs is also related to a higher level of trait anxiety. The preoperative visit can be helpful when patients are selected according to specific characteristics: by type of anaesthesia, gender, or type of surgery. There may also be beneficial effects when preoperative education is tailored according to patient's anxiety risk. The time immediately before surgery may not be the best time for conducting the visit, as this may make the patients more anxious. Copyright © 2011 Elsevier España, S.L. All rights reserved.

  12. Pre-operative therapeutic eyelid hygiene in the prevention of complications following excimer laser vision correction

    Directory of Open Access Journals (Sweden)

    V. V. Kurenkov

    2014-07-01

    Full Text Available Purpose: to assess the effectiveness of pre-operative therapeutic eyelid hygiene in the prevention and treatment of dry eye and meibomian glands dysfunction following excimer laser vision surgery.Methods: In enrolled 144 patients (288 eyes, ocular surface and meibomian glands functions were evaluated before and following refractive surgery (LASIK and REIK. In pre- and post-operative period, standard ophthalmological studies were performed, including best-corrected visual acuity determination, biomicroscopy, Schirmer’s test and Norn’s test (tear break-up time. In pre-operative pe- riod, ocular surface microbial profile was assessed. Subjective symptoms of impaired tear production were revealed via questioning. In study group (70 patients, 140 eyes, therapeutic eyelid hygiene using Blefarogel 1 or Blefarogel 2 (Ltd. Heltec-Medica, Moscow, Russia was prescribed one week before surgery. In control group, no therapeutic eyelid hygiene was prescribed. All patients were received antibacterial treatment including Vigamox (Alcon, Fort Worth, tX. In both groups, Natural tears and Systane Ultra (Alcon were used as tear replacement therapy.Results: Complex treatment, including therapeutic eyelid hygiene in study group, significantly improved tear film and ocular sur- face health as well as meibomian glands functions. Inflammatory complications rate was estimated as 5.7% in study group and 10.6% in control group.Conclusion: therapeutic eyelid hygiene is highly effective in the prophylaxis and treatment of post-operative complications duу to ocular surface pathology and meibomian glands dysfunction. the procedure is safe and can be recommended as a part of complex preventive treatment before excimer laser vision correction.

  13. Pre-operative therapeutic eyelid hygiene in the prevention of complications following excimer laser vision correction

    Directory of Open Access Journals (Sweden)

    V. V. Kurenkov

    2012-01-01

    Full Text Available Purpose: to assess the effectiveness of pre-operative therapeutic eyelid hygiene in the prevention and treatment of dry eye and meibomian glands dysfunction following excimer laser vision surgery.Methods: In enrolled 144 patients (288 eyes, ocular surface and meibomian glands functions were evaluated before and following refractive surgery (LASIK and REIK. In pre- and post-operative period, standard ophthalmological studies were performed, including best-corrected visual acuity determination, biomicroscopy, Schirmer’s test and Norn’s test (tear break-up time. In pre-operative pe- riod, ocular surface microbial profile was assessed. Subjective symptoms of impaired tear production were revealed via questioning. In study group (70 patients, 140 eyes, therapeutic eyelid hygiene using Blefarogel 1 or Blefarogel 2 (Ltd. Heltec-Medica, Moscow, Russia was prescribed one week before surgery. In control group, no therapeutic eyelid hygiene was prescribed. All patients were received antibacterial treatment including Vigamox (Alcon, Fort Worth, tX. In both groups, Natural tears and Systane Ultra (Alcon were used as tear replacement therapy.Results: Complex treatment, including therapeutic eyelid hygiene in study group, significantly improved tear film and ocular sur- face health as well as meibomian glands functions. Inflammatory complications rate was estimated as 5.7% in study group and 10.6% in control group.Conclusion: therapeutic eyelid hygiene is highly effective in the prophylaxis and treatment of post-operative complications duу to ocular surface pathology and meibomian glands dysfunction. the procedure is safe and can be recommended as a part of complex preventive treatment before excimer laser vision correction.

  14. Anti-glomerular basement membrane blood test

    Science.gov (United States)

    ... used to diagnose certain kidney diseases, such as Goodpasture syndrome and anti-glomerular basement membrane disease. ... the blood may mean any of the following: Anti-glomerular basement membrane disease Goodpasture syndrome

  15. Incarcerated femoral hernia containing the right uterine tube. A pre-operative diagnosis is possible.

    Science.gov (United States)

    Engin, Omer; Cicek, Ebru; Oner, Soner Recai; Yildirim, Mehmet

    2011-01-01

    The incarcerated femoral hernia containing the right uterine tube is very rare to see. The case report is important to accumulate knowledge of very rare cases. The diagnosis of the case was established pre-operatively with abdominal computerized tomography (CT) On CT examination, the mass in the hernia sac was not connected with the intestines and a tubal structure on the right side of the uterus was shown to extend out of the abdomen. In the operation, the right uterine tube(RUT) was reduced into the abdomen after its blood supply was shown to be normal. A hernia repair was performed. Sometimes in obese patients, incarcerated femoral or inguinal hernias may not been noted. Ultrasonography, CT and magnetic resonance imaging (MRI) is used frequently to diagnose abdominal wall hernias. The organs in the incarcerated sac must be examined carefully and the viability must be checked. The surgeon must decide whether or not to resect the organs. In our case, strangulation was not found and polypropylene mesh was not used for hernia repair due to a fear of infection of the prosthesis. Incarceration of the uterine tube in the sac is traumatic and this condition may lead to infection. Such conditions may lead to ectopic pregnancy. The patient must be informed about ectopic pregnancy due to a previous incarceration of the tube because ectopic pregnancy may be fatal.

  16. Multidetector computed tomography (MDCT angiography of thoracic aortic coarctation in pediatric patients: Pre-operative evaluation

    Directory of Open Access Journals (Sweden)

    Mohamad Zakaryia Al-Azzazy

    2014-03-01

    Conclusion: We concluded that MDCT angiography with multiplanar and three dimensional techniques can be considered the modality of choice for pre-operative assessment of coarctation of the thoracic aorta in pediatric patients.

  17. An optical approach for non-invasive blood clot testing

    Science.gov (United States)

    Kalchenko, Vyacheslav; Brill, Alexander; Fine, Ilya; Harmelin, Alon

    2007-02-01

    Physiological blood coagulation is an essential biological process. Current tests for plasma coagulation (clotting) need to be performed ex vivo and require fresh blood sampling for every test. A recently published work describes a new, noninvasive, in vivo approach to assess blood coagulation status during mechanical occlusion1. For this purpose, we have tested this approach and applied a controlled laser beam to blood micro-vessels of the mouse ear during mechanical occlusion. Standard setup for intravital transillumination videomicroscopy and laser based imaging techniques were used for monitoring the blood clotting process. Temporal mechanical occlusion of blood vessels in the observed area was applied to ensure blood flow cessation. Subsequently, laser irradiation was used to induce vascular micro-injury. Changes in the vessel wall, as well as in the pattern of blood flow, predispose the area to vascular thrombosis, according to the paradigm of Virchow's triad. In our experiments, two elements of Virchow's triad were used to induce the process of clotting in vivo, and to assess it optically. We identified several parameters that can serve as markers of the blood clotting process in vivo. These include changes in light absorption in the area of illumination, as well as changes in the pattern of the red blood cells' micro-movement in the vessels where blood flow is completely arrested. Thus, our results indicate that blood coagulation status can be characterized by non-invasive, in vivo methodologies.

  18. [Pre-operative correction of severe scoliosis by halo and walking-frame system (author's transl)].

    Science.gov (United States)

    Durand, Y; Rigault, P; Pouliquen, J C; le Henaff, J C

    1980-01-01

    Ten cases of very severe scoliotic curves have been corrected pre-operatively by permanent traction with a halo suspended at a walking-frame device. The mean initial angulation was 110 degrees and the mean pre-operative correction was 48% for a mean use of two months. This procedure permits the patients a sub-normal activity, gives a good correction as "halo-cast" or "halo-pelvic" and avoids all cutaneous, neurological or psychological complications.

  19. Random blood glucose testing in dental practice

    DEFF Research Database (Denmark)

    Barasch, Andrei; Safford, Monika M; Qvist, Vibeke

    2012-01-01

    The prevalence of diabetes mellitus (DM) has been increasing. Instances of patients' not having received a diagnosis have been reported widely, as have instances of poor control of DM or prediabetes among patient's who have the disease. These facts indicate that blood glucose screening is needed....

  20. Prostate-specific antigen (PSA) blood test

    Science.gov (United States)

    Prostate-specific antigen; Prostate cancer screening test; PSA ... special steps are needed to prepare for this test. ... Reasons for a PSA test: This test may be done to screen for prostate cancer. It is also used to follow people after prostate cancer ...

  1. The association between radiographic severity and pre-operative function in patients undergoing primary knee replacement for osteoarthritis

    DEFF Research Database (Denmark)

    Dowsey, Michelle M; Dieppe, Paul; Lohmander, Stefan

    2012-01-01

    To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement.......To determine the association between radiographic osteoarthritis (OA) and pre-operative function in patients undergoing primary knee replacement....

  2. Evaluation of VDRL test in Sudanese blood donors.

    Science.gov (United States)

    Omer, E F; El Sheikh, F S; Khalil, I A

    1982-04-01

    2201 blood donors and 199 patients with sexually transmitted diseases (STD) were tested with the Venereal Disease Research Laboratory (VDRL) and the fluorescent treponemal antibody-absorption (FTA-ABS) tests. The VDRL test was found positive in 30 (1.36%) of the blood donors and 11 (5.5%) of the patients. Syphilis was confirmed by FTA-ABS test in one patient (0.5%) but not in blood donors. The biological false positive (BFP) reactions were 1.36% in blood donors and 5.0% in control patients. The place of VDRL test as a screening test for syphilis and the low rate of its seroreactivity among blood donors was discussed. The BFP reactions were reviewed to assist in the interpretation of the VDRL test which was evaluated on the basis of the control specimens. It was concluded that syphilis should be excluded before blood is transfused and the VDRL test should remain the screening test of choice in the blood transfusion service.

  3. Influence of Blood Collection Systems on Coagulation Tests

    Directory of Open Access Journals (Sweden)

    Soner Yavaş

    2012-12-01

    Full Text Available OBJECTIVE: Coagulation tests are influenced by pre-analytic conditions such as blood collection systems. Change of glass collection tubes with plastic ones will cause alteration of the test results. The aim of this study was to compare three plastic blood collection tubes with a standard glass blood collection tube and each plastic collection tube with the other two for possible additional tube-to- tube differences. METHODS: A total of 284 blood samples were obtained from 42 patients receiving warfarin during their routine controls, besides 29 healthy volunteers. Subgroup analyses were done according to health status. RESULTS: Our study demonstrated that different blood collection tubes have a statistically significant influence on coagulation tests. The magnitude of the effect depends on the tube used. However most of the tests performed on samples obtained from any tube correlated significantly with results obtained from other tube samples. CONCLUSION: Although blood collection tubes with different brands or properties will have distinct effects on coagulation tests, the influence of these blood collection tubes may be relatively small to interfere with decision-making on dose prescription, therefore lack clinical importance. Correlations between the results showed that, one of these plastic blood collection tubes tested in our study, can be used interchangably for a wide variety of coagulation assays.

  4. Automated nucleic acid amplification testing in blood banks: An additional layer of blood safety

    Directory of Open Access Journals (Sweden)

    Pragati Chigurupati

    2015-01-01

    Full Text Available Context: A total of 30 million blood components are transfused each year in India. Blood safety thus becomes a top priority, especially with a population of around 1.23 billion and a high prevalence rate of human immunodeficiency virus (HIV, hepatitis B virus (HBV and hepatitis C virus (HCV in general population. Nucleic acid amplification testing (NAT in blood donor screening has been implemented in many developed countries to reduce the risk of transfusion-transmitted viral infections (TTIs. NAT takes care of the dynamics of window period of viruses and offers the safest blood pack for donation. Aims: The aim of this study is to show the value of NAT in blood screening. Settings and Design: Dhanavantari Blood Bank, Rajahmundry, Andhra Pradesh, India. Subjects and Methods: Over a period of 1 year from January 2012 to December 2012, a total number of 15,000 blood donor samples were subjected to tests for HIV, HBV, and HCV by enzyme-linked immunosorbent assay (ELISA method and 8000 ELISA nonreactive samples were subjected for NAT using multiplex polymerase chain reaction technology. Results: Of the 15,000 donors tested, 525 were seroreactive. In 8000 ELISA negative blood samples subjected to NAT, 4 donor samples were reactive for HBV. The NAT yield was 1 in 2000. Conclusions: NAT could detect HIV, HBV, and HCV cases in blood donor samples those were undetected by serological tests. NAT could interdict 2500 infectious donations among our approximate 5 million annual blood donations.

  5. Pre-operational monitor system of large inland lake water quality with MODIS imagery

    Science.gov (United States)

    Xiaoyu, Zhang; Dingtian, Yang; Xiaofeng, Zhang; Difeng, Wang; Shujing, Li; Delu, Pan

    2005-10-01

    EOS\\MODIS data have been proved a suitable and relative low-cost complementary tool to monitor large inland lake water quality for its re-visit frequency, moderate spatial and spectral resolution and appropriate channels designed for inversing water quality parameters. In this study, by the support of hi-tech research and development program of China, Lake water quality remote monitoring pre-operational system (LWQRMPS) was constructed aimed for practical monitoring of Taihu Lake water quality. The main water quality parameters including Chl-a and SPM, TN and TP inversion algorithm were developed. These parameters were obtained every month from time series fusion satellite data. With the routine trophic state evaluation system, the water quality was assessed every month based on the above retrieved MODIS water quality parameters, varied level of eutrophic area was computed. The obvious high reflectance in near-infrared spectrum caused by blue-green algal bloom support the application of 250m MODIS data in the algal bloom emergency monitor. Therefore, MODIS data were utilized successfully for inversing water quality parameters, evaluating eutrophication status, and detecting algal bloom in near real time. Standard thematic maps were produced and distributed to corresponding management departments. The accuracy of products and retrieve algorithm for operational use were tested with separate data sets. The result suggested that system is good enough for practical monitoring water quality of large size lakes and acquired identification.

  6. Galactose-1-phosphate uridyltransferase blood test

    Science.gov (United States)

    Galactosemia screen; GALT; Gal-1-PUT ... This is a screening test for galactosemia. In normal diets, most galactose comes from the breakdown ( metabolism ) of lactose, which is found in milk and dairy products. One out ...

  7. Pre-operative and early post-operative factors associated with surgical site infection after laparoscopic sleeve gastrectomy.

    Science.gov (United States)

    Ruiz-Tovar, Jaime; Oller, Inmaculada; Llavero, Carolina; Arroyo, Antonio; Muñoz, Jose Luis; Calero, Alicia; Diez, María; Zubiaga, Lorea; Calpena, Rafael

    2013-08-01

    Surgical procedures on obese patients are expected to have a high incidence of surgical site infection (SSI). The identification of pre-operative or early post-operative risk factors for SSI may help the surgeon to identify subjects in risk and adequately optimize their status. We conducted a study of the association of comorbidities and pre- and post-operative analytical variables with SSI following laparoscopic sleeve gastrectomy for the treatment of morbid obesity. We performed a prospective study of all morbidly obese patients undergoing laparoscopic sleeve gastrectomy as a bariatric procedure between 2007 and 2011. An association of clinical and analytical variables with SSI was investigated. The study included 40 patients with a mean pre-operative body mass index (BMI) of 51.2±7.9 kg/m(2). Surgical site infections appeared in three patients (7.5%), of whom two had an intra-abdominal abscess located in the left hypochondrium and the third had a superficial incisional SSI. Pre-operatively, a BMI >45 kg/m(2) (OR 8.7; p=0.008), restrictive disorders identified by pulmonary function tests (OR 10.0; p=0.012), a serum total protein concentration 30 mcg/dL (OR 13.0; p=0.003), and a mean corpuscular volume (MCV) 128 mg/dL (OR 4.7; p=0.012) and hemoglobin <11g/dL (OR 7.5; p=0.002) were associated with SSI. The study supports the role of restrictive lung disorders and the values specified above for preoperative BMI, serum total protein and cortisol concentrations, and MCV, and of post-operative anemia and hyperglycemia as risk factors for SSI. In these situations, the surgeon must be aware of and seek to control these risk factors.

  8. Ebola Blood Test May Help Predict Survival Chances

    Science.gov (United States)

    ... page: https://medlineplus.gov/news/fullstory_163165.html Ebola Blood Test May Help Predict Survival Chances Findings ... help determine a person's chance of surviving an Ebola infection, researchers say. "It is not just defining ...

  9. Blood Test Might Someday Distinguish Early Depression, Schizophrenia

    Science.gov (United States)

    ... html Blood Test Might Someday Distinguish Early Depression, Schizophrenia A screen is still in development stages but ... doctors to tell the difference between depression and schizophrenia, especially early on. Now, researchers say they're ...

  10. Is It Parkinson's or Something Else? Blood Test Might Tell

    Science.gov (United States)

    ... https://medlineplus.gov/news/fullstory_163484.html Is It Parkinson's or Something Else? Blood Test Might Tell ... for prime time," Parkinson's disease experts said. But, it marks progress in the quest for an objective ...

  11. High-resolution CT: pre-operative assessment of chronic and recurrent rhinosinusitis

    Energy Technology Data Exchange (ETDEWEB)

    Ferrie, J.C. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Vandermarcq, P. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Azais, O. [Dept. of Radiology A, University Hospital, 86 Poitiers (France); Klossek, J.M. [Dept. of Oto-Rhino-Laryngology, University Hospital, 86 Poitiers (France); Drouineau, J. [Dept. of Radiology A, University Hospital, 86 Poitiers (France)

    1993-04-01

    The better understanding of chronic and recurrent rhinosinusitis and the advance in endoscopic endonasal surgery have modified the radiological pre-operative investigation of this condition. The ethmoid labyrinth, not accessible to the endoscope, may be explored by axial and coronal high-resolution thin section (2 mm) CT. We have reviewed 100 CT scans with endoscopic correlation in order to assess the accuracy of this pre-operative method. This anatomical study reveals the presence and extent of parasinus diseases which are usually concentrated in the area of the ostiomeatal unit. The anatomic variations of the lateral nasal wall that have been reporded as predisposing to sinusitis and the morphologic variations altering the relationships of the ethmoid with the orbits and the brain were also studied. This pre-operative radiological assessment is currently necessary for functional and safe surgery. (orig.)

  12. Evaluation of intraoperative bleeding during an endoscopic surgery of nasal polyposis after a pre-operative single dose versus a 5-day course of corticosteroid.

    Science.gov (United States)

    Atighechi, Saeid; Azimi, Mohammad Reza; Mirvakili, Seyyed Abbas; Baradaranfar, Mohammad Hossein; Dadgarnia, Mohammad Hossein

    2013-09-01

    Nasal polyps are associated with the inflammation of the nasal cavity and the sinus mucosa. When medical treatment cannot solve a patient's problem, a functional endoscopic sinus surgery may be indicated. Bleeding impairs the surgery field during operation and increases the operation risk and time. Pre-operative corticosteroids can reduce bleeding during surgery. In this study, we have evaluated the effect of pre-operative single-dose prednisolone (1 mg/Kg/dose 24 h before surgery) versus 5-day prednisolone (1 mg/Kg/day before operation) on the bleeding volume and the surgery field quality during FESS. In this mono blind randomized clinical trial, 80 patients with bilateral nasal polyps were randomly assigned in two groups. The first group (A) received a single dose of 1 mg/Kg/dose prednisolone on the day before the surgery. The second group (B) received 1 mg/Kg/day prednisolone for 5 days before the operation. The patients were operated on under general anesthesia through the same protocol. The mean arterial blood pressure was 70-80 mm Hg in both groups. The surgeons were not aware of the patients' group. The bleeding volume and the surgeons' opinion about the surgery field quality were recorded at the end of the procedure and analyzed by Chi-square and t test. The two groups were not significantly different in their overall demographic and clinical characteristics. The mean bleeding volume during the operation was 266.5 ± 96.31 ml in group A and 206 ± 52.81 ml in group B; there was a significant difference between the groups (P value = 0.038). There was no significant difference between the groups in the surgeons' opinion about the surgery field quality (P value = 0.09). In conclusion, unlike a single dose (1 mg/kg/dose), treatment with 5-day prednisolone (1 mg/kg/day) can reduce blood loss during FESS more efficiently and may improve the surgery field quality slightly. But this difference is not clinically significant.

  13. Blood: Tests Used to Assess the Physiological and Immunological Properties of Blood

    Science.gov (United States)

    Quinn, J. G.; Tansey, E. A.; Johnson, C. D.; Roe, S. M.; Montgomery, L. E. A.

    2016-01-01

    The properties of blood and the relative ease of access to which it can be retrieved make it an ideal source to gauge different aspects of homeostasis within an individual, form an accurate diagnosis, and formulate an appropriate treatment regime. Tests used to determine blood parameters such as the erythrocyte sedimentation rate, hemoglobin…

  14. Evaluation of Verigene Blood Culture Test Systems for Rapid Identification of Positive Blood Cultures.

    Science.gov (United States)

    Kim, Jae-Seok; Kang, Go-Eun; Kim, Han-Sung; Kim, Hyun Soo; Song, Wonkeun; Lee, Kyu Man

    2016-01-01

    The performance of molecular tests using the Verigene Gram-Positive and Gram-Negative Blood Culture nucleic acid tests (BC-GP and BC-GN, resp.; Naosphere, Northbrook, IL, USA) was evaluated for the identification of microorganisms detected from blood cultures. Ninety-nine blood cultures containing Gram-positive bacteria and 150 containing Gram-negative bacteria were analyzed using the BC-GP and BC-GN assays, respectively. Blood cultures were performed using the Bactec blood culture system (BD Diagnostic Systems, Franklin Lakes, NJ, USA) and conventional identification and antibiotic-susceptibility tests were performed using a MicroScan system (Siemens, West Sacramento, CA, USA). When a single strain of bacteria was isolated from the blood culture, Verigene assays correctly identified 97.9% (94/96) of Gram-positive bacteria and 93.8% (137/146) of Gram-negative bacteria. Resistance genes mecA and vanA were correctly detected by the BC-GP assay, while the extended-spectrum β-lactamase CTX-M and the carbapenemase OXA resistance gene were detected from 30 cases cultures by the BC-GN assay. The BC-GP and BC-GN assays showed high agreement with conventional identification and susceptibility tests. These tests are useful for rapid identification of microorganisms and the detection of clinically important resistance genes from positive Bactec blood cultures.

  15. Effect of investments on fundamentals and market reaction on pre-operational and operational Brazilian companies for the period 2006-2012

    Directory of Open Access Journals (Sweden)

    Marco Antonio Pereira

    2016-03-01

    Full Text Available ABSTRACT This paper provides evidence on the market reaction to corporate investment decisions whose shareholder value is largely attributed to growth options. The exploratory research raised pre-operational companies and their operational pairs on the same economy segments. It had the purpose of investigating the existence of statistical differentiation from financial indicators that reflect the installed assets and growth assets, and then study the market reaction to changes in fixed assets as a signaling element about investment decisions. The formation process of operational assets and shareholder value almost exclusively dependent on asset growth stands out in the pre-operational companies. As a result, differentiation tests confirmed that the pre-operational companies had their value especially derived on growth options. The market reaction was particularly bigger in pre-operational companies with abnormal negative stock returns, while the operational companies had positive returns, which may indicate that the quality of the investment is judged based on the financial disclosure. Additionally, operational companies' investors await the disclosure to adjust their prices. We conclude that the results are consistent with the empirical evidence and the participants in financial markets to long-term capital formation investments should give that special attention.

  16. Pre-operative embolization facilitating a posterior approach for the surgical resection of giant sacral neurogenic tumors.

    Science.gov (United States)

    Chen, Kangwu; Zhou, Ming; Yang, Huilin; Qian, Zhonglai; Wang, Genlin; Wu, Guizhong; Zhu, Xiaoyu; Sun, Zhiyong

    2013-07-01

    The present study aimed to assess a posterior approach for the surgical resection of giant sacral neurogenic tumors, and to evaluate the oncological and functional outcomes. A total of 16 patients with giant sacral neurogenic tumors underwent pre-operative embolization and subsequent posterior sacral resection between January 2000 and June 2010. Benign tumors were identified in 12 cases, while four cases exhibited malignant peripheral nerve sheath tumors (MPNSTs). An evaluation of the operative techniques used, the level of blood loss, any complications and the functional and oncological outcomes was performed. All tumor masses were removed completely without intra-operative shock or fatalities. The mean tumor size was 17.5 cm (range, 11.5-28 cm) at the greatest diameter. The average level of intra-operative blood loss was 1,293 ml (range, 400-4,500 ml). Wound complications occurred in four patients (25%), including three cases of cutaneous necrosis and one wound infection. The mean follow-up time was 59 months (range, 24-110 months). Tumor recurrence or patient mortality as a result of the disease did not occur in any of the patients with benign sacral neurogenic tumors. The survival rate of the patients with malignant lesions was 75% (3/4 patients) since 25 % (1/4 patients) had multiple local recurrences and succumbed to the disease. The patients with benign tumors scored an average of 92.8% on the Musculoskeletal Tumor Society (MSTS) score functional evaluation, while the patients with malignant tumors scored an average of 60.3%. A posterior approach for the surgical resection of giant sacral neurogenic tumors, combined with pre-operative embolization may be safely conducted with satisfactory oncological and functional outcomes.

  17. Rapid pre-operative diagnosis of ileal hernia through the foramen of ...

    African Journals Online (AJOL)

    We report a case of IHFW in which multi-detector computed tomography ... of blood tests and biochemical investigations were normal. A plain abdominal ... lesser omentum (containing the hepatic artery, portal vein and bile duct), caudal to the ...

  18. Chronic pre-operative opioid use and acute pain after fast-track total knee arthroplasty

    DEFF Research Database (Denmark)

    Aasvang, E K; Lunn, T H; Hansen, T B;

    2016-01-01

    BACKGROUND: Pre-operative opioid use has been suggested to increase post-operative pain and opioid consumption after total knee arthroplasty (TKA), but previous studies are either retrospective or inhomogeneous with regard to surgical procedures or control of analgesic regimes, or with few opioid...

  19. Target motion predictions for pre-operative planning during needle-based interventions

    NARCIS (Netherlands)

    Buijs, op den Jorn; Abayazid, Momen; Korte, de Chris L.; Misra, Sarthak

    2011-01-01

    During biopsies, breast tissue is subjected to displacement upon needle indentation, puncture, and penetration. Thus, accurate needle placement requires pre-operative predictions of the target motions. In this paper, we used ultrasound elastography measurements to non-invasively predict elastic prop

  20. Pre-operative patient preparation in the prevention of surgical site infections.

    Science.gov (United States)

    McBride, Tara; Beamer, Jennifer

    2007-12-01

    In 1999 the Ontario Ministry of Health and Long-Term Care granted funding to St. Mary's General Hospital for a Regional Cardiac Care Center. In July 2003 the cardiac surgery program opened. During the program-planning phase, protocols and procedures related to patient preparation for cardiac surgery were developed. To share policies, protocols and patient teaching tools developed from research driven, evidenced based standards of practice. To complete a one-year review (January to December 2004) and assess the compliance rates with pre-operative patient preparation procedures on all Coronary Artery Bypass Graft (CABG) cardiac surgery patients. Retrospective chart review. 191 bed community-based Regional Cardiac Care Centre. All adult patients undergoing Coronary Artery Bypass Graft (CABG) surgery from January 1st 2004 to December 31st 2004. Compliance rate following patient education related to pre-operative washes, assessing completion of pre-operative washes, and location of clipping relative to the Cardiovascular Operating Room (CVOR). A team of Registered Nurses was able to effectively implement policies and protocols within a cardiac surgery program that meet the recommended standards of care of the Centers for Disease Control and Prevention (CDC), Operating Room Nurses Association of Canada (ORNAC) and Safer Health Care Now! Initiative. A retrospective chart review has demonstrated that staff consistently apply and document care in accordance with the developed pre-operative wash and hair clipping protocols.

  1. Donor Infectious Disease Testing Multinational assessment of blood ...

    African Journals Online (AJOL)

    Donor Infectious Disease Testing Multinational assessment of blood-borne virus testing and transfusion safety on the African continent... ... AFRICAN JOURNALS ONLINE (AJOL) · Journals · Advanced Search · USING AJOL · RESOURCES ... for poor quality, to define a consensus strategy based on appropriate assays; and

  2. 21 CFR 862.1130 - Blood volume test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood volume test system. 862.1130 Section 862.1130 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES CLINICAL CHEMISTRY AND CLINICAL TOXICOLOGY DEVICES Clinical Chemistry Test Systems §...

  3. DNA methylation profiling for a confirmatory test for blood, saliva, semen, vaginal fluid and menstrual blood.

    Science.gov (United States)

    Lee, Hwan Young; Jung, Sang-Eun; Lee, Eun Hee; Yang, Woo Ick; Shin, Kyoung-Jin

    2016-09-01

    The ability to predict the type of tissues or cells from molecular profiles of crime scene samples has important practical implications in forensics. A previously reported multiplex assay using DNA methylation markers could only discriminate between 4 types of body fluids: blood, saliva, semen, and the body fluid which originates from female reproductive organ. In the present study, we selected 15 menstrual blood-specific CpG marker candidates based on analysis of 12 genome-wide DNA methylation profiles of vaginal fluid and menstrual blood. The menstrual blood-specificity of the candidate markers was confirmed by comparison with HumanMethylation450 BeadChip array data obtained for 58 samples including 12 blood, 12 saliva, 12 semen, 3 vaginal fluid, and 19 skin epidermis samples. Among 15CpG marker candidates, 3 were located in the promoter region of the SLC26A10 gene, and 2 of them (cg09696411 and cg18069290) showed high menstrual blood specificity. DNA methylation at the 2CpG markers was further tested by targeted bisulfite sequencing of 461 additional samples including 49 blood, 52 saliva, 34 semen, 125 vaginal fluid, and 201 menstrual blood. Because the 2 markers showed menstrual blood-specific methylation patterns, we modified our previous multiplex methylation SNaPshot reaction to include these 2 markers. In addition, a blood marker cg01543184 with cross reactivity to semen was replaced with cg08792630, and a semen-specific unmethylation marker cg17621389 was removed. The resultant multiplex methylation SNaPshot allowed positive identification of blood, saliva, semen, vaginal fluid and menstrual blood using the 9CpG markers which show a methylation signal only in the target body fluids. Because of the complexity in cell composition, menstrual bloods produced DNA methylation profiles that vary with menstrual cycle and sample collection methods, which are expected to provide more insight into forensic menstrual blood test. Moreover, because the developed

  4. Developmental validation of a novel lateral flow strip test for rapid identification of human blood (Rapid Stain Identification--Blood).

    Science.gov (United States)

    Schweers, Brett A; Old, Jennifer; Boonlayangoor, P W; Reich, Karl A

    2008-06-01

    Human blood is the body fluid most commonly encountered at crime scenes, and blood detection may aid investigators in reconstructing what occurred during a crime. In addition, blood detection can help determine which items of evidence should be processed for DNA-STR testing. Unfortunately, many common substances can cause red-brown stains that resemble blood. Furthermore, many current human blood detection methods are presumptive and prone to false positive results. Here, the developmental validation of a new blood identification test, Rapid Stain Identification--Blood (RSID--Blood), is described. RSID--Blood utilizes two anti-glycophorin A (red blood cell membrane specific protein) monoclonal antibodies in a lateral flow strip test format to detect human blood. We present evidence demonstrating that this test is accurate, reproducible, easy to use, and highly specific for human blood. Importantly, RSID--Blood does not cross-react with ferret, skunk, or primate blood and exhibits no high-dose hook effect. Also, we describe studies on the sensitivity, body fluid specificity, and species specificity of RSID--Blood. In addition, we show that the test can detect blood from a variety of forensic exhibits prior to processing for DNA-STR analysis. In conclusion, we suggest that RSID--Blood is effective and useful for the detection of human blood on forensic exhibits, and offers improved blood detection when compared to other currently used methods.

  5. The role of pre-operative and post-operative glucose control in surgical-site infections and mortality.

    Directory of Open Access Journals (Sweden)

    Christie Y Jeon

    Full Text Available BACKGROUND AND OBJECTIVE: The impact of glucose control on surgical-site infection (SSI and death remains unclear. We examined how pre- and post-operative glucose levels and their variability are associated with the risk of SSI or in-hospital death. METHODS: This retrospective cohort study employed data on 13,800 hospitalized patients who underwent a surgical procedure at a large referral hospital in New York between 2006 and 2008. Over 20 different sources of electronic data were used to analyze how thirty-day risk of SSI and in-hospital death varies by glucose levels and variability. Maximum pre- and post-operative glucose levels were determined for 72 hours before and after the operation and glucose variability was defined as the coefficient of variation of the glucose measurements. We employed logistic regression to model the risk of SSI or death against glucose variables and the following potential confounders: age, sex, body mass index, duration of operation, diabetes status, procedure classification, physical status, emergency status, and blood transfusion. RESULTS: While association of pre- and post-operative hyperglycemia with SSI were apparent in the crude analysis, multivariate results showed that SSI risk did not vary significantly with glucose levels. On the other hand, in-hospital deaths were associated with pre-operative hypoglycemia (OR = 5.09, 95% CI (1.80, 14.4 and glucose variability (OR = 1.14, 95% CI (1.03, 1.27 for 10% increase in coefficient of variation. CONCLUSION: In-hospital deaths occurred more often among those with pre-operative hypoglycemia and higher glucose variability. These findings warrant further investigation to determine whether stabilization of glucose and prevention of hypoglycemia could reduce post-operative deaths.

  6. [Cardiopulmonary exercise testing before and after blood donation].

    Science.gov (United States)

    Dellweg, D; Siemon, K; Mahler, F; Appelhans, P; Klauke, M; Köhler, D

    2008-06-01

    The link between haemoglobin and physical performance was established a long time ago and is the underlying principle of blood doping. Blood loss on the other hand decreases physical capacity. The aim of this study is to evaluate physical performance loss and underlying mechanisms following voluntary blood donation. Eleven voluntary subjects (four female) completed a symptom-limiting cardio-pulmonary exercise test before and after blood donation (500 mL blood). The haemoglobin value decreased by 1.2 mg/dL (9%, p blood donation, respectively (p = 0.001). Subjects who practise recreational endurance sports appear to be more effected by endurance loss. The haemoglobin value was the only significant predictor of maximal oxygen uptake in regression analysis (p blood donation. Haemoglobin decline accounts for the decreased oxygen uptake. As a consequence thereof the anaerobic transition occurs earlier. Subjects not engaged in regular sports activity did not experience a decline in their capacity. Inclusion of the haemoglobin value into equations predicting maximal oxygen uptake could improve prediction precision.

  7. The VDRL test in a blood transfusion service.

    Science.gov (United States)

    Beal, R W; Merry, D J

    1975-11-01

    A survey has been made of the results of 12 months' VDRL screening in a blood transfusion service. Positive VDRL tests were found on 318 of the 73 350 blood donations collected during 1974. Thirty-four tests confirming specific treponemal infection were found in 24 donors. A battery of confirmatory tests showed the remaining 284 positive VDRL reactions from 235 donors to be biological false positive (BFP) results, and, of these, one-third were considered entirely negative by the reference laboratory. BFP reactions were commoner in female donors than in males, and a higher incidence than expected was observed in younger female donors and older male donors. A marked seasonal incidence was noted, 65% of all BFP tests from the transfusion service being found in the four colder months of May to August. Although some differences exist between the group as a whole and the 36 donors (15.3%) found to have BFP results on more than one occasion during the year, there is little evidence from these studies to suggest that regular blood donation per se is a contributing factor to the finding of a BFP result in VDRL screening. It is probable that the population tested regularly by the blood transfusion service reflects a small but representative sample of the community as a whole.

  8. Pre-operative perfusion skewness and kurtosis are potential predictors of progression-free survival after partial resection of newly diagnosed glioblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Paik, Wo Yul [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Kim, Ho Sung; Choi, Choong Gon; Kim, Sang Joon [Dept. of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2016-02-15

    To determine whether pre-operative perfusion skewness and kurtosis derived from normalized cerebral blood volume (nCBV) histograms are associated with progression-free survival (PFS) of patients after partial resection of newly diagnosed glioblastoma. A total of 135 glioblastoma patients who had undergone partial resection of tumor (resection of < 50% of pre-operative tumor volume or surgical biopsy) confirmed with immediate postsurgical MRI and examined with both conventional MRI and dynamic susceptibility contrast (DSC) perfusion MRI before the surgery were retrospectively reviewed in this study. They had been followed up post-surgical chemoradiotherapy for tumor progression. Using histogram analyses of nCBV derived from pre-operative DSC perfusion MRI, patients were sub-classified into the following four groups: positive skewness and leptokurtosis (group 1); positive skewness and platykurtosis (group 2); negative skewness and leptokurtosis (group 3); negative skewness and platykurtosis (group 4). Kaplan-Meier analysis and multivariable Cox proportional hazards regression analysis were performed to determine whether clinical and imaging covariates were associated with PFS or overall survival (OS) of these patients. According to the Kaplan-Meier method, median PFS of group 1, 2, 3, and 4 was 62, 51, 39, and 41 weeks, respectively, with median OS of 82, 77, 77, and 72 weeks, respectively. In multivariable analyses with Cox proportional hazards regression, pre-operative skewness/kurtosis pattern (hazard ratio: 2.98 to 4.64; p < 0.001), Karnofsky performance scale score (hazard ratio: 1.04; p = 0.003), and post-operative tumor volume (hazard ratio: 1.04; p = 0.02) were independently associated with PFS but not with OS. Higher skewness and kurtosis of nCBV histogram before surgery were associated with longer PFS in patients with newly diagnosed glioblastoma after partial tumor resection.

  9. The effect of pre-operative methylprednisolone on early endothelial damage after total knee arthroplasty

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Viktoria Oline; Ostrowski, S R; Lindberg-Larsen, M

    2017-01-01

    We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee...... arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime. The outcomes included changes...... and 2 h, 6 h and 24 h after surgery, with complete sampling from 63 patients for analyses. Methylprednisolone significantly reduced markers of endothelial damage at 24 h following surgery compared with saline (methylprednisolone group vs. control group, adjusted means (SEM)) expressed by circulating...

  10. Changing the Price of Marriage: Evidence from Blood Test Requirements

    Science.gov (United States)

    Buckles, Kasey; Guldi, Melanie; Price, Joseph

    2011-01-01

    We use state repeals of blood test requirements (BTRs) for a marriage license that occurred between 1980 and 2008 to examine the impact of changes in the price of marriage on the marriage decision. Using a within-group estimator that holds constant state and year effects and exploits variation in the repeal dates of BTRs across states, we find…

  11. Advances in Fecal Occult Blood Tests: The FIT Revolution

    NARCIS (Netherlands)

    G.P. Young; E.L. Symonds (Erin L.); J.E. Allison (James E.); S.R. Cole (Stephen R.); C.G. Fraser (Callum G.); S. Halloran (S.); E.J. Kuipers (Ernst); H.E. Seaman (Helen E.)

    2015-01-01

    textabstractThere is a wide choice of fecal occult blood tests (FOBTs) for colorectal cancer screening. Goal: To highlight the issues applicable when choosing a FOBT, in particular which FOBT is best suited to the range of screening scenarios. Four scenarios characterize the constraints and expectat

  12. Decisional pathways in breast augmentation: how to improve outcomes through accurate pre-operative planning.

    Science.gov (United States)

    Nava, Maurizio B; Rocco, Nicola; Tunesi, Gianfranco; Catanuto, Giuseppe; Rancati, Alberto; Dorr, Julio

    2017-04-01

    Breast augmentation is the most commonly performed surgical procedure in aesthetic plastic surgery. Accurate pre-operative planning is crucial to obtain the best outcomes. We present our planning method deriving from a more than 30-year experience in aesthetic breast surgery, matching together patients tissues' characteristics and patients' wishes. We schematized our planning method in an easy-to-use flow diagram to help the decisional process in breast augmentation.

  13. Prognostic value of pre-operative serum CA 15.3 levels in breast cancer.

    Science.gov (United States)

    Martín, Arancha; Corte, Ma Daniela; Alvarez, Ana Ma; Rodriguez, Juan Carlos; Andicoechea, Alejandro; Bongera, Miguel; Junquera, Sara; Pidal, Diego; Allende, Teresa; Muñiz, José L García; Vizoso, Francisco

    2006-01-01

    CA15.3 (also known as MUCI) is the most widely used marker in breast cancer. The aim of the present work was the evaluation of the prognostic value of preoperative serum CA15.3 levels in patients with primary breast cancer. This study included 818 women with a histologically verified diagnosis of invasive breast cancer. The serum values of CA15.3 were investigated at the time of primary diagnosis by means of an immunoradiometric assay based on the "sandwich" principle. The median follow-up period of patients free of recurrence was 38 months. Pre-operative CA15.3 serum levels ranged from 6 to 452 U/ml. Elevated CA15.3 levels (>30 U/ml) were found in 15.2% of patients. Statistical analysis showed that pre-operative CA15.3 serum levels were significantly higher in patients with large size tumors (T3 or T4) (p = 0.0001), as well as in those with node-positive tumors (p = 0.0001). In the univariate analysis, high CA15.3 levels were significantly associated with a lower probability of both relapse-free and overall survival in the overall group of patients (p = 0.0001 and p = 0.004, respectively) and in the subgroup with node-positive breast cancer (p = 0.001 and p = 0.03, respectively). In addition, multivariate analysis demonstrated that pre-operative levels of the antigen were significantly and independently associated with relapse-free survival in the overall group of patients, as well as in the subgroup of patients with node-positive breast cancer (p = 0.02 and p = 0.01, respectively). These results show that high pre-operative CA15.3 levels correlate with large size tumors and the presence of lymph node metastases and suggest that this antigen could be used as an additional prognostic marker.

  14. ROLE OF B - SCAN ULTRASONOGRAPHY IN EVALUATION OF PRE - OPERATIVE CATARACT P ATIENTS

    OpenAIRE

    Navneet

    2015-01-01

    The purpose of this study was to visualize the status of posterior segment with diagnostic toll of B - scan ultrasound in pre - operative dense cataract patients. METHOD S : Diagnostic B - scan ultrasound was done on 200 cataract patients from the age group of 10 to 80 years of both the sexes. The machine used for the a bove study was B - scan machine – (SONOMED, E - ZSCAN AB 5500 +) with frequency 10 MHz. RESULTS: Out...

  15. A study of a pre-operative intervention in patients with diabetes undergoing cardiac surgery.

    Science.gov (United States)

    Lee, G A; Wyatt, S; Topliss, D; Walker, K Z; Stoney, R

    2014-01-01

    Coronary heart disease is common in Type 2 diabetes and often requires cardiac surgery. However poorer outcomes have been reported including increased rates of post-operative infection and prolonged hospital stay. The aim of the study was to determine the feasibility and acceptability of a specialist consultation model (pre-operative medical and educational intervention) for type 2 diabetes in the cardiac surgery setting. Twenty four patients were assigned usual care or to the intervention group. The intervention group were assessed by a diabetes clinical nurse consultant, dietitian, and endocrinologist during a pre-operative visit. Specific diabetes questionnaires were administered, education was delivered, and protocol-driven changes to the medical regimen were instituted. Length of stay, incidence of post-operative complications, and number of post-operative inpatient review endocrinology visits required were recorded. Twenty four patients with a pre-operative HbA(1c) greater than 6.5% (48 mmol/mol) were studied (17 males and 7 females). In the usual care group (n = 15), HbA(1c) pre-operatively was 7.2% (55.2 mmol/mol) compared to 10.1% (86.9 mmol/mol) in the intervention group (n = 9). Six weeks post-operatively HbA(1c) fell significantly in the intervention group by 1.9% (to 8.2% [66.1 mmol/mol]) compared to a reduction of 1.2% (to 7.0% [53 mmol/mol]) in the usual care group (p cardiac surgery.

  16. Congenital hip disease in adults: terminology, classification, pre-operative planning and management.

    Science.gov (United States)

    Karachalios, T; Hartofilakidis, G

    2010-07-01

    This paper reviews the current knowledge relating to the management of adult patients with congenital hip disease. Orthopaedic surgeons who treat these patients with a total hip replacement should be familiar with the arguments concerning its terminology, be able to recognise the different anatomical abnormalities and to undertake thorough pre-operative planning in order to replace the hip using an appropriate surgical technique and the correct implants and be able to anticipate the clinical outcome and the complications.

  17. Real time blood testing using quantitative phase imaging.

    Directory of Open Access Journals (Sweden)

    Hoa V Pham

    Full Text Available We demonstrate a real-time blood testing system that can provide remote diagnosis with minimal human intervention in economically challenged areas. Our instrument combines novel advances in label-free optical imaging with parallel computing. Specifically, we use quantitative phase imaging for extracting red blood cell morphology with nanoscale sensitivity and NVIDIA's CUDA programming language to perform real time cellular-level analysis. While the blood smear is translated through focus, our system is able to segment and analyze all the cells in the one megapixel field of view, at a rate of 40 frames/s. The variety of diagnostic parameters measured from each cell (e.g., surface area, sphericity, and minimum cylindrical diameter are currently not available with current state of the art clinical instruments. In addition, we show that our instrument correctly recovers the red blood cell volume distribution, as evidenced by the excellent agreement with the cell counter results obtained on normal patients and those with microcytic and macrocytic anemia. The final data outputted by our instrument represent arrays of numbers associated with these morphological parameters and not images. Thus, the memory necessary to store these data is of the order of kilobytes, which allows for their remote transmission via, for example, the cellular network. We envision that such a system will dramatically increase access for blood testing and furthermore, may pave the way to digital hematology.

  18. Scintigraphic techniques in primary hyperparathyroidism: from pre-operative localisation to intra-operative imaging

    Energy Technology Data Exchange (ETDEWEB)

    Rubello, Domenico [S. Maria della Misericordia Hospital, Service of Nuclear Medicine, Rovigo (Italy); Gross, Milton D. [Department of Veterans Affairs Health System, Nuclear Medicine Service, Ann Arbor, MI (United States); Mariani, Giuliano [University of Pisa, Regional Center of Nuclear Medicine, Pisa (Italy); Al-Nahhas, Adil [Hammersmith Hospital, Department of Nuclear Medicine, London (United Kingdom)

    2007-06-15

    Primary hyperparathyroidism (PHPT) is an increasingly diagnosed disease worldwide. In most cases, PHPT is related to the presence of a solitary parathyroid adenoma (PA). Fifty percent or more of newly diagnosed PHPT patients are asymptomatic, and there is debate among endocrinologists and endocrine surgeons about whether or not such patients should be treated. Usually, in a PHPT patient with a solitary PA that is well localised pre-operatively, a parathyroidectomy with limited or minimally invasive neck exploration is offered. The diffusion of minimally invasive neck exploration procedures is a consequence of the significant improvement in the accuracy of pre-operative imaging (mainly scintigraphic) techniques; these techniques have changed the surgical strategy to PHPT, from the wide traditional bilateral neck exploration to limited neck exploration. The present review considers developments during the past 10-15 years with regard to both the accuracy of pre-operative localising imaging techniques and intra-operative minimally invasive procedures in order to provide endocrinologists and endocrine surgeons with further information about the newly available diagnostic and therapeutic tools for use in PHPT patients with a solitary PA. (orig.)

  19. Pre-operative sestamibi-technetium subtraction scintigraphy in primary hyperparathyroidism: Experience with 156 consecutive patients

    Energy Technology Data Exchange (ETDEWEB)

    Jones, J. Mark; Russell, Colin F.J.; Ferguson, W. Rodney; Laird, James D

    2001-07-01

    AIM: The aim of this study was to assess the usefulness of pre-operative sestamibi-technetium subtraction scintigraphy in a large cohort of patients with primary hyperparathyroidism (HPT). MATERIALS AND METHODS: A group of 156 consecutive patients with biochemically proven HPT underwent sestamibi-technetium subtraction scintigraphy before cervical exploration. Images were interpreted and reported prospectively and influenced the extent of surgical exploration. The intraoperative findings were compared retrospectively with the pre-operative scintigram reports in 154 individuals with technically satisfactory scintigrams. RESULTS: Of the 154 patients with satisfactory scintigrams, 122 (78.2%) demonstrated a single focus of activity following subtraction, 31 (19.9%) had negative findings and the remaining scintigram showed four foci of activity. At operation 138 (89.6%) solitary adenomas were removed, 13 patients (8.4%) had multi-gland disease and in three individuals (2.0%) no abnormal parathyroid tissue was found. The pre-operative scintigram accurately localized 91 of 98 (92.9%) solitary tumours weighing > 500 mg but only 18 of 35 (51.4%) adenomas weighing < 500 mg, (P < 0.0001). Overall sensitivity of sestamibi-technetium scintigraphy for localizing single parathyroid adenomas was 83.7%. CONCLUSION: Sestamibi-technetium subtraction scintigraphy will accurately localize a high proportion of solitary parathyroid adenomas but its usefulness is diminished by its inability to consistently identify smaller tumours. Jones, J.M. et al. (2001)

  20. Does pre-operative physiotherapy improve outcomes from lower limb joint replacement surgery? A systematic review.

    Science.gov (United States)

    Ackerman, Ilana N; Bennell, Kim L

    2004-01-01

    A systematic review of randomised controlled trials was performed to evaluate the effectiveness of pre-operative physiotherapy programmes on outcome following lower limb joint replacement surgery. A search of relevant key terms was used to find suitable trials, with five papers meeting the inclusion criteria for the review. The methodological quality of the trials was rated using the PEDro scale. Estimates of the size of treatment effects were calculated for each outcome in each trial, with 95% confidence intervals calculated where sufficient data were provided. Of the three trials pertaining to total knee replacement, only very small mean differences were found between control and intervention groups for all of the outcome measures. Where confidence intervals could be calculated, these showed no clinically important differences between the groups. Two papers (one study) pertaining to total hip replacements found significant improvements in WOMAC scores, hip strength and range of movement, walking distance, cadence, and gait velocity for the intervention group, compared to a control group. Estimates of treatment effect sizes for these outcomes were larger than for the total knee replacement studies, with confidence intervals showing potentially clinically important differences between group means. However, as the intervention group also received an additional intensive post-operative physiotherapy program, these results cannot be attributed solely to the pre-operative program. This systematic review shows that pre-operative physiotherapy programmes are not effective in improving outcome after total knee replacement but their effect on outcome from total hip replacement cannot be adequately determined.

  1. Interpreting pre-operative mastoid computed tomography images: comparison between operating surgeon, radiologist and operative findings.

    Science.gov (United States)

    Badran, K; Ansari, S; Al Sam, R; Al Husami, Y; Iyer, A

    2016-01-01

    This study aimed to compare the interpretations of temporal bone computed tomography scans by an otologist and a radiologist with a special interest in temporal bone imaging. It also aimed to determine the usefulness of this imaging modality. A head and neck radiologist and an otologist separately reported pre-operative computed tomography images using a structured proforma. The reports were then compared with operative findings to determine their accuracy and differences in interpretations. Forty-eight patients who underwent pre-operative computed tomography scans in a 30-month period were identified. Six patients were excluded because complete operative findings had not been recorded. Positive and negative predictive values and accuracy of the anatomical and pathological findings were calculated for 42 patients by both reporters. The accuracy was found to be less than 80 per cent, except for identification of the tegmen and lateral semicircular canal erosion. Overall, there was no significant difference in interpretations of computed tomography scans between reporters. There was a slight difference in interpretation for tympanic membrane retraction, facial canal erosion and lateral semicircular canal fistula and/or erosion. Pre-operative computed tomography scanning of the temporal bone is useful for predicting anatomy for surgical planning in patients with chronic otitis media, but its reliability remains questionable.

  2. ROLE OF PRE-OPERATIVE NO HAIR REMOVAL ON SURGICAL S ITE INFECTION

    Directory of Open Access Journals (Sweden)

    Ashok Y.

    2013-05-01

    Full Text Available ABSTRACT: This prospective study evaluate the influence of p re-operative no hair removal on surgical site infection in all abdominal and groin surgeries. As there are very few articles about pre - operative no hair removal and its effect at surgica l site in all types of wound. We are presenting thi s original article. Prospective review of 417 patients operated in Kris hna Hospital and Research Center, Karad. Between JAN-2010 to JAN-2011. The study contains cl ean, clean contaminated and dirty wound with two type of skin preparation. All the endogenous an d exogenous factors affecting post-operative surgical site are kept constant except surgical sit e skin preparation like shaving by razor or no hair removal at surgical site. In this study, we are compared role of hair removal and it impact of SSI. We had 8.21 % SSI rate by using razor shaving as skin preparation whi ch is compared with pre-operative no hair removal. It had only 2.38% rate of SSI. The differe nce between standard error of two prospective is more than twice (P<0.05. So it is clear that preop erative no hair removal at surgical site is effecti ve procedure to prevent SSI in all wound type. We are using this pre-operative no hair removal practically for all surgical intervention in our ho spital.

  3. 21 CFR 864.9175 - Automated blood grouping and antibody test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood grouping and antibody test system... Manufacture Blood and Blood Products § 864.9175 Automated blood grouping and antibody test system. (a) Identification. An automated blood grouping and antibody test system is a device used to group erythrocytes...

  4. Principles of dielectric blood coagulometry as a comprehensive coagulation test.

    Science.gov (United States)

    Hayashi, Yoshihito; Brun, Marc-Aurèle; Machida, Kenzo; Nagasawa, Masayuki

    2015-10-06

    Dielectric blood coagulometry (DBCM) is intended to support hemostasis management by providing comprehensive information on blood coagulation from automated, time-dependent measurements of whole blood dielectric spectra. We discuss the relationship between the series of blood coagulation reactions, especially the aggregation and deformation of erythrocytes, and the dielectric response with the help of clot structure electron microscope observations. Dielectric response to the spontaneous coagulation after recalcification presented three distinct phases that correspond to (P1) rouleau formation before the onset of clotting, (P2) erythrocyte aggregation and reconstitution of aggregates accompanying early fibrin formation, and (P3) erythrocyte shape transformation and/or structure changes within aggregates after the stable fibrin network is formed and platelet contraction occurs. Disappearance of the second phase was observed upon addition of tissue factor and ellagic acid for activation of extrinsic and intrinsic pathways, respectively, which is attributable to accelerated thrombin generation. A series of control experiments revealed that the amplitude and/or quickness of dielectric response reflect platelet function, fibrin polymerization, fibrinolysis activity, and heparin activity. Therefore, DBCM sensitively measures blood coagulation via erythrocytes aggregation and shape changes and their impact on the dielectric permittivity, making possible the development of the battery of assays needed for comprehensive coagulation testing.

  5. Comparison of 3D reconstruction of mandible for pre-operative planning using commercial and open-source software

    Science.gov (United States)

    Abdullah, Johari Yap; Omar, Marzuki; Pritam, Helmi Mohd Hadi; Husein, Adam; Rajion, Zainul Ahmad

    2016-12-01

    3D printing of mandible is important for pre-operative planning, diagnostic purposes, as well as for education and training. Currently, the processing of CT data is routinely performed with commercial software which increases the cost of operation and patient management for a small clinical setting. Usage of open-source software as an alternative to commercial software for 3D reconstruction of the mandible from CT data is scarce. The aim of this study is to compare two methods of 3D reconstruction of the mandible using commercial Materialise Mimics software and open-source Medical Imaging Interaction Toolkit (MITK) software. Head CT images with a slice thickness of 1 mm and a matrix of 512x512 pixels each were retrieved from the server located at the Radiology Department of Hospital Universiti Sains Malaysia. The CT data were analysed and the 3D models of mandible were reconstructed using both commercial Materialise Mimics and open-source MITK software. Both virtual 3D models were saved in STL format and exported to 3matic and MeshLab software for morphometric and image analyses. Both models were compared using Wilcoxon Signed Rank Test and Hausdorff Distance. No significant differences were obtained between the 3D models of the mandible produced using Mimics and MITK software. The 3D model of the mandible produced using MITK open-source software is comparable to the commercial MIMICS software. Therefore, open-source software could be used in clinical setting for pre-operative planning to minimise the operational cost.

  6. Bruises, blood coagulation tests and the battered child syndrome.

    Science.gov (United States)

    Lee, A C

    2008-06-01

    Cutaneous bruises are a common symptom and a sign of injury and blood coagulation disorders in childhood. A carefully-taken history, coupled with a thorough physical examination, would lead to the diagnosis, or guide the clinician to the necessary laboratory investigations. Most children suffering from non-accidental injury can have their diagnosis established on clinical grounds alone and do not require laboratory investigation. An initial screening with full blood counts, prothrombin time and activated partial thromboplastin time will be adequate in most cases if laboratory investigation is indicated, but the clinician must be aware of the limitations of these tests. The finding of an abnormal coagulation test does not exclude child abuse as it can be a consequence of maltreatment, or the two conditions may coexist. Whenever necessary, the opinion of a haematologist should be sought in order to obtain an accurate diagnosis, which is essential for subsequent management and the prevention of further injury in the case of child abuse.

  7. Implementation of immunochemical faecal occult blood test in general practice

    DEFF Research Database (Denmark)

    Juul, Jakob Søgaard; Bro, Flemming; Hornung, Nete

    2016-01-01

    anvendelsen af immunochemical faecal occult blood test (iFOBT) i almen praksis. iFOBT detekterer humant globin i fæces og indikerer gastrointestinal blødning. Studiet udgør en del af et ph.d.-studie, der bidrager med ny viden til at optimere udredningen af patienter med tarmkræft. Der er et stort behov...

  8. Pre-operative concurrent chemoradiotherapy for stage IIIA (N2) Non-Small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyu Chan; Ahn, Yong Chan; Park, Keun Chil [College of Medicine, Sungkyunkwan Univ., Seoul (Korea, Republic of)] [and others

    1999-06-01

    This is to evaluate the acute complication, resection rate, and tumor down-staging after pre-operative concurrent chemoradiotherapy for stage IIIA (N2) non-small cell lung cancer. Fifteen patients with non-small cell lung cancer were enrolled in this study from May 1997 to June 1998 in Samsung Medical Center. The median age of the patients was 61 (range, 45-67) years and male to female ratio was 12:3. Pathologic types were squamous cell carcinoma (11) and adenocarcinoma (4). Pre-operative clinical tumor stages were cT1 in 2 patients, cT2 in 12, and cT3 in 1 and all were N2. Ten patients were proved to be N2 with mediastinoscopic biopsy and five had clinically evident mediastinal lymph node metastases on the chest CT scans. Pre-operative radiation therapy field included the primary tumor, the ipsilateral hilum, and the mediastinum. Total radiation dose was 45 Gy over 5 weeks with daily dose of 1.8 Gy. Pre-operative concurrent chemotherapy consisted of two cycles of intraventous cis-Platin (100 mg/m{sup 2}) on day 1 and oral Etoposide (50 mg/m{sup 2}/day) on days 1 through 14 with 4 weeks' interval. Surgery was followed after the pre-operative re-evaluation including chest CT scan in 3 weeks of the completion of the concurrent chemoradiotherapy if there was no evidence of disease progression. Full dose radiation therapy was administered to all the 15 patients. Planned two cycles of chemotherapy was completed in 11 patients and one cycle was given to four. One treatment related death of acute respiratory distress syndrome occurred in 15 days of surgery. Hospital admission was required in three patients including one with radiation pneumonitis and two with neutropenic fever. Hematologic complications and other acute complications including esophagitis were tolerable. Resection rate was 92.3% (12/13) in 13 patients excluding two patients who refused surgery. Pleural seeding was found in one patient after thoracotomy and tumor resection was not feasible. Post

  9. Pre-operative function, motivation and duration of symptoms predict sporting participation after total hip replacement.

    Science.gov (United States)

    Ollivier, M; Frey, S; Parratte, S; Flecher, X; Argenson, J N

    2014-08-01

    There is little in the literature on the level of participation in sports which patients undertake after total hip replacement (THR). Our aims in this study were to determine first, the level of sporting activity, second, the predictive factors for returning to sporting activity, and third, the correlation between participation in sports and satisfaction after THR. We retrospectively identified 815 patients who had undergone THR between 1995 and 2005. All were asked to complete a self-administered questionnaire regarding their sporting activity. A total of 571 patients (71%) met the inclusion criteria and completed the evaluation. At a mean follow-up of 9.8 years (sd 2.9), 366 patients (64%) returned to sporting activity as defined by a University of California at Los Angeles (UCLA) score of > 5. The main reasons that patients had for refraining from sports were fear of dislocation (65; 31.6%), avoiding wear (52; 25.4%), and the recommendation of the surgeon (34; 16.6%). There was a significant relationship between higher post-operative participation in sport in those patients with a higher pre-operative Harris hip score (HHS) (p = 0.0074), motivation to participate in sporting activities (p = 0.00022) and a shorter duration of symptoms (p = 0.0034). Finally, there was a correlation between age (p = 0.00013), UCLA score (p = 0.012) and pre-operative HHS (p = 0.00091) and satisfaction. In conclusion, we found that most patients participate in sporting activity after THR, regardless of the advice of their surgeon, and that there is a correlation between the level of participation and pre-operative function, motivation, duration of symptoms and post-operative satisfaction. ©2014 The British Editorial Society of Bone & Joint Surgery.

  10. Pre-operative Tei Index does not predict left ventricular function immediately after mitral valve repair

    Directory of Open Access Journals (Sweden)

    Chirojit Mukherjee

    2012-01-01

    Full Text Available Echocardiographic assessment of systolic left ventricular (LV function in patients with severe mitral regurgitation (MR undergoing mitral valve (MV repair can be challenging because the measurement of ejection fraction (EF or fractional area change (FAC in pathological states is of questionable value. The aim of our study was to evaluate the usefulness of the pre-operative Tei Index in predicting left ventricular EF or FAC immediately after MV repair. One hundred and thirty patients undergoing MV repair with sinus rhythm pre- and post-operatively were enrolled in this prospective study. Twenty-six patients were excluded due to absence of sinus rhythm post-operatively. Standard transesophageal examination(IE 33,Philips,Netherlands was performed before and after cardiopulmonary bypass according to the guidelines of the ASE/SCA. FAC was determined in the transgastric midpapillary short-axis view. LV EF was measured in the midesophageal four- and two-chamber view. For calculation of the Tei Index, the deep transgastric and the midesophageal four-chamber view were used. Statistical analysis was performed with SPSS 17.0. values are expressed as mean with standard deviation. LV FAC and EF decreased significantly after MV repair (FAC: 56±12% vs. 50±14%, P<0.001; EF: 58±11 vs. 50±12Έ P<0.001. The Tei Index decreased from 0.66±0.23 before MV repair to 0.41±0.19 afterwards (P<0.001. No relationship between pre-operative Tei Index and post-operative FAC or post-operative EF were found (FAC: r=−0.061, P=0.554; EF: r=−0.29, P=0.771. Conclusion: Pre-operative Tei Index is not a good predictor for post-operative FAC and EF in patients undergoing MV repair.

  11. Pre-operative simulation of periacetabular osteotomy via a three-dimensional model constructed from salt

    Directory of Open Access Journals (Sweden)

    Fukushima Kensuke

    2017-01-01

    Full Text Available Introduction: Periacetabular osteotomy (PAO is an effective joint-preserving procedure for young adults with developmental dysplasia of the hip. Although PAO provides excellent radiographic and clinical results, it is a technically demanding procedure with a distinct learning curve that requires careful 3D planning and, above all, has a number of potential complications. We therefore developed a pre-operative simulation method for PAO via creation of a new full-scale model. Methods: The model was prepared from the patient’s Digital Imaging and Communications in Medicine (DICOM formatted data from computed tomography (CT, for construction and assembly using 3D printing technology. A major feature of our model is that it is constructed from salt. In contrast to conventional models, our model provides a more accurate representation, at a lower manufacturing cost, and requires a shorter production time. Furthermore, our model realized simulated operation normally with using a chisel and drill without easy breakage or fissure. We were able to easily simulate the line of osteotomy and confirm acetabular version and coverage after moving to the osteotomized fragment. Additionally, this model allowed a dynamic assessment that avoided anterior impingement following the osteotomy. Results: Our models clearly reflected the anatomical shape of the patient’s hip. Our models allowed for surgical simulation, making realistic use of the chisel and drill. Our method of pre-operative simulation for PAO allowed for the assessment of accurate osteotomy line, determination of the position of the osteotomized fragment, and prevented anterior impingement after the operation. Conclusion: Our method of pre-operative simulation might improve the safety, accuracy, and results of PAO.

  12. Pre-operative simulation of periacetabular osteotomy via a three-dimensional model constructed from salt

    Science.gov (United States)

    Fukushima, Kensuke; Takahira, Naonobu; Uchiyama, Katsufumi; Moriya, Mitsutoshi; Takaso, Masashi

    2017-01-01

    Introduction: Periacetabular osteotomy (PAO) is an effective joint-preserving procedure for young adults with developmental dysplasia of the hip. Although PAO provides excellent radiographic and clinical results, it is a technically demanding procedure with a distinct learning curve that requires careful 3D planning and, above all, has a number of potential complications. We therefore developed a pre-operative simulation method for PAO via creation of a new full-scale model. Methods: The model was prepared from the patient’s Digital Imaging and Communications in Medicine (DICOM) formatted data from computed tomography (CT), for construction and assembly using 3D printing technology. A major feature of our model is that it is constructed from salt. In contrast to conventional models, our model provides a more accurate representation, at a lower manufacturing cost, and requires a shorter production time. Furthermore, our model realized simulated operation normally with using a chisel and drill without easy breakage or fissure. We were able to easily simulate the line of osteotomy and confirm acetabular version and coverage after moving to the osteotomized fragment. Additionally, this model allowed a dynamic assessment that avoided anterior impingement following the osteotomy. Results: Our models clearly reflected the anatomical shape of the patient’s hip. Our models allowed for surgical simulation, making realistic use of the chisel and drill. Our method of pre-operative simulation for PAO allowed for the assessment of accurate osteotomy line, determination of the position of the osteotomized fragment, and prevented anterior impingement after the operation. Conclusion: Our method of pre-operative simulation might improve the safety, accuracy, and results of PAO. PMID:28186873

  13. Urine Test Strips to Exclude Cerebral Spinal Fluid Blood

    Directory of Open Access Journals (Sweden)

    Marshall, Robin A

    2011-02-01

    Full Text Available Introduction: Determining the presence or absence of red blood cells (RBC or their breakdown products in cerebrospinal fluid (CSF is essential for the evaluation of subarachnoid hemorrhage (SAH in headache patients. Current methodology for finding blood in the CSF is either spectrophotometric detection of pigment, which is time consuming and labor intensive, or visual assesment of samples for color change (xanthochromia, which is inaccurate. Bayer Multistix® urine test strips are designed to test urine for RBC by detecting the presence of hemoglobin. The aim of this pilot study was to evaluate the perfomance of urine reagent test strips for ruling out the presence of RBC in CSF.Methods: We compared color changes on Multistix® urine test strips to the standard of spectrophotometric absorbtion at 415nm and initial RBC counts in 138 visually clear CSF samples.Results: We performed Pearson Chi-Square and likelihood ratios on the results and found a correlation between a negative result on the urine test strip and less than 5 RBC per high power field and a spectrophotometric absorbance of less than 0.02% at 415nm in a CSF sample.Conclusion: These results warrant further investigation in the form of a prospective clinical validation as it may alter the emergency department evaluation for SAH. [West J Emerg Med. 2011;12(1:63-66.

  14. The effect of pre-operative optimization on post-operative outcome in Crohn's disease resections

    DEFF Research Database (Denmark)

    El-Hussuna, Alaa; Iesalnieks, Igors; Horesh, Nir

    2017-01-01

    on the post-operative outcome in CD. METHOD: This is a multicentre retrospective cohort study. The primary outcome was 30-day post-operative complications. Secondary outcomes were intra-abdominal septic complications, surgical site infection (SSI), re-operation, length of post-operative stay in a hospital......BACKGROUND: The timing of surgical intervention in Crohn's disease (CD) may depend on pre-operative optimization (PO) which includes different interventions to decrease the risk for unfavourable post-operative outcome. The objective of this study was to investigate the effect of multi-model PO...

  15. Evaluation of pre-operative staging of renal cell cancer with cine MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uematsu, Hidemasa; Inoue, Hiroshi; Hayashi, Koji; Kitagawa, Akane; Yamamori, Sanae; Ishitoya, Satoshi; Ogura, Keiji [Rakuwakai Otowa Hospital, Kyoto (Japan); Yamada, Hiroki; Ishii, Yasushi

    1994-12-01

    To assess the utility of single section cine MR images in evaluation of extrarenal invasion of renal cell cancer. Six patients who subsequently underwent definitive surgery were examined. Sequential twenty FLASH images were acquired in coronal and parasagittal single section during one respiratory cycle. These images were evaluated in cine-loop mode to assess tumoral movement with adjacent structures. Cine MR images showed that the tumor in one patient were fixed to the spleen and the tumors in five patients showed free movement. At pathologic examination, cine MR findings were proved correct in all patients. Cine MR images may be useful for pre-operative evaluation of extrarenal invasion. (author).

  16. Pre-operative testing for pregnancy in Dublin day surgery units.

    LENUS (Irish Health Repository)

    Wong, L F A

    2013-06-01

    The safety of anaesthetic agents in early pregnancy cannot be guaranteed. Certain types of surgery, particularly gynaecological, may also be dangerous. It is therefore important to ensure that, female patients are not inadvertently pregnant when undergoing elective surgery. Different hospitals have different policies and guidelines in place to determine female patients\\' pregnancy status prior to elective surgery.

  17. [Simplified preparation of test-red blood cells for ABO blood grouping in a laboratory in Madagascar].

    Science.gov (United States)

    Rasamiravaka, T; Andrianarivelo, A M; Ramarison, G; Rakoto-Alson, A O; Rasamindrakotroka, A

    2011-10-01

    To ensure self-sufficiency and lower costs associated with reagent red blood cells, some medical laboratories produce their own test-red blood cells for plasma ABO blood grouping. However, given the vital importance of blood goup testing, it is essential to verify the reliability of these cells. The purpose of this study was to assess the quality of laboratory-made ABO test-red blood cells. This study comparing house made and commercially available test-red blood cells was carried out at the Medical Biology Training and Research Laboratory in Madagascar. This laboratory is attended by people wishing to obtain their blood group card. In this population, no discrepancy was found between the red cell and plasma tests. Comparison of test-red blood cells with commercially available reagent red blood cells showed no difference in reactivity in the first four days of conservation. However a decrease in the reactivity of house made cells appeared on the 5th day. House made red blood cells are costless than commercially available reagent red blood cells mainly due to the simplified method of preparation. However, since laboratory-made cells progressivley lose antigenic reactivity quicly, production must be repeated regularly and good internal quality control is necessary to ensure reliability.

  18. CT pre-operative planning of a new semi-implantable bone conduction hearing device

    Energy Technology Data Exchange (ETDEWEB)

    Law, Eric K.C.; Bhatia, Kunwar S.S. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Hong Kong, SAR (China); Tsang, Willis S.S.; Tong, Michael C.F. [Prince of Wales Hospital, The Chinese University of Hong Kong, Department of Otorhinolaryngology, Head and Neck Surgery, Hong Kong, SAR (China); Shi, Lin [The Chinese University of Hong Kong, Department of Medicine and Therapeutics, Hong Kong, SAR (China); The Chinese University of Hong Kong, Chow Yuk Ho Technology Center for Innovative Medicine, Hong Kong, SAR (China)

    2016-06-15

    Accommodating a novel semi-implantable bone conduction hearing device within the temporal bone presents challenges for surgical planning. This study describes the utility of CT in pre-operative assessment of such an implant. Retrospective review of pre-operative CT, clinical and surgical records of 16 adults considered for device implantation. Radiological suitability was assessed on CT using 3D simulation software. Antero-posterior (AP) dimensions of the mastoid bone and minimum skull thickness were measured. CT planning results were correlated with operative records. Eight and five candidates were suitable for device placement in the transmastoid and retrosigmoid positions, respectively, and three were radiologically unsuitable. The mean AP diameter of the mastoid cavity was 14.6 mm for the transmastoid group and 4.6 mm for the retrosigmoid group (p < 0.05). Contracted mastoid and/or prior surgery were predisposing factors for unsuitability. Four transmastoid and five retrosigmoid positions required sigmoid sinus/dural depression and/or use of lifts due to insufficient bone capacity. A high proportion of patients being considered have contracted or operated mastoids, which reduces the feasibility of the transmastoid approach. This finding combined with the complex temporal bone geometry illustrates the importance of careful CT evaluation using 3D software for precise device simulation. (orig.)

  19. Association between elevated pre-operative glycosylated hemoglobin and post-operative infections after non-emergent surgery

    Directory of Open Access Journals (Sweden)

    Joseph M. Blankush

    2016-09-01

    Conclusions: The risk factors of post-operative infection are multiple and likely synergistic. While pre-operative HbA1c level is not independently associated with risk of post-operative infection, there are scenarios and patient subgroups where pre-operative HbA1c is useful in predicting an increased risk of infectious complications in the post-operative period.

  20. Relationship between the inability to climb two flights of stairs and outcome after major non-cardiac surgery: implications for the pre-operative assessment of functional capacity.

    Science.gov (United States)

    Biccard, B M

    2005-06-01

    Functional capacity is an integral component of the pre-operative evaluation of the cardiac patient for non-cardiac surgery. Stair climbing capacity has peri-operative prognostic importance. It may predict survival after lung resection and complications after major non-cardiac surgery. However, stair climbing cannot determine the aerobic metabolic capacity necessary to survive the peri-operative stress response. The potential benefits and current limitations of cardiopulmonary exercise testing to determine peri-operative aerobic capacity are discussed. Principles for the selection of an appropriate screening test of aerobic function are put forward.

  1. [Pre-operative smoking cessation does not always reduce the incidence of surgical site infection after gastrointestinal surgery].

    Science.gov (United States)

    Kuri, Michioki; Yamada, Terumasa; Nakagawa, Masashi; Tanigami, Hironobu; Kishi, Yoshihiko

    2011-02-01

    Centers for Disease Control (CDC) recommend pre-operative smoking cessation to reduce the risk of surgical site infection (SSI). However, whether pre-operative smoking cessation reduces the incidence of SSI for gastrointestinal surgery is unclear. We investigated whether pre-operative smoking cessation reduces the incidence of SSI among patients undergoing gastrointestinal surgery. The study subjects were 512 consecutive patients undergoing gastrointestinal surgery at Osaka Medical Center for Cancer and Cardiovascular Diseases. SSI occurrence was determined by the hospital SSI surveillance team. Pre-operative smoking status was obtained by interview, and the patients were divided into four groups. Information on age, sex, operation time, operational organ, American Society of Anesthesiologists physical status (ASA-PS), elective or emergency surgery, co-existing procedures, use of scopes, ileo-colostomy, properties of drain tube, use of floss, and wound contamination was obtained from the medical records. The relationship between smoking status and incidence of SSI, and risk factors associated with the incidence of SSI were investigated. SSI occurred in 83 patients. Pre-operative smoking status had no relation with the incidence of SSI. Operation time, gallbladder and pancreatic surgery, colon surgery, emergency surgery, co-existing procedures, ilea-colostomy, closed drain, usage of floss, and wound contamination were related significantly with SSI. Pre-operative smoking cessation does not reduce the incidence of SSI. However, since continuation of smoking has no benefits for the safety of surgery, anesthesiologists must advice patients to quit smoking before surgery.

  2. Counterview: Pre-operative breast MRI (magnetic resonance imaging) is not recommended for all patients with newly diagnosed breast cancer.

    Science.gov (United States)

    Solin, Lawrence J

    2010-02-01

    For the woman with a newly diagnosed early stage breast cancer, the routine use of pre-operative breast MRI (magnetic resonance imaging) is not indicated beyond conventional breast imaging (i.e., mammography with correlation ultrasound as indicated). There is no consistent evidence that a pre-operative breast MRI confers a benefit to the patient by improving clinical outcomes or surgical procedures. In a meta-analysis of studies reporting on the use of pre-operative breast MRI for the patient with an established index cancer, multifocal or multicentric disease was found on breast MRI in 16% of the patients, a rate substantially higher than the rate of local recurrence after breast conserving surgery plus definitive radiation treatment. In the largest retrospective study of patients treated with breast conserving surgery plus radiation, no gain was found for adding a breast MRI to conventional breast imaging. No randomized clinical trial has been designed to evaluate long term clinical outcomes associated with adding a pre-operative breast MRI. Adding pre-operative breast MRI can alter clinical management in ways that are potentially harmful to patients, for example, increased ipsilateral mastectomies, increased contralateral prophylactic mastectomies, increased work-ups, and delay to definitive surgery. In summary, the routine use of pre-operative breast MRI is not warranted for the typical patient with a newly diagnosed early stage breast cancer.

  3. Evaluation of automated blood pressure measurements during exercise testing.

    Science.gov (United States)

    Hossack, K F; Gross, B W; Ritterman, J B; Kusumi, F; Bruce, R A

    1982-11-01

    Measurements of systolic (SBP) and diastolic (DBP) blood pressure were made at rest and during symptom-limited exercise with an automated blood pressure measuring device (EBPM). Comparisons were made between the EBPM readings and those made with mercury manometer. Correlations were high (SBP r = 0.92, DBP r = 0.80) when readings were made in the same arm, but were less satisfactory when the cuffs were on different arms (SBP r = 0.80, DBP r = 0.46). The correlation between two mercury manometer readings was SBP r = 0.90, and DBP r = 0.75. Comparison between EBPM and intra-arterial measurements were similar (SBP r = 0.74, DBP r = 0.79) to comparison between mercury manometer and intra-arterial measurements (SBP r = 0.81, DBP r = 0.61). The EBPM detected SBP at consistently higher levels than did physicians, which may be an advantage in the noisy environment of an exercise test. There was a definite tendency for physicians to record blood pressure to the nearest 10 mm Hg, whereas the frequency distribution curve for EBPM measurements was smoother. The EBPM operated satisfactorily at rest and during maximal exercise and gave as reliable measurements as a physician using a mercury manometer and, in the small number of available cases, detected exertional hypotension more often than the physician.

  4. Molecular neuropsychology: creation of test-specific blood biomarker algorithms.

    Science.gov (United States)

    O'Bryant, Sid E; Xiao, Guanghua; Barber, Robert; Cullum, C Munro; Weiner, Myron; Hall, James; Edwards, Melissa; Grammas, Paula; Wilhelmsen, Kirk; Doody, Rachelle; Diaz-Arrastia, Ramon

    2014-01-01

    Prior work on the link between blood-based biomarkers and cognitive status has largely been based on dichotomous classifications rather than detailed neuropsychological functioning. The current project was designed to create serum-based biomarker algorithms that predict neuropsychological test performance. A battery of neuropsychological measures was administered. Random forest analyses were utilized to create neuropsychological test-specific biomarker risk scores in a training set that were entered into linear regression models predicting the respective test scores in the test set. Serum multiplex biomarker data were analyzed on 108 proteins from 395 participants (197 Alzheimer patients and 198 controls) from the Texas Alzheimer's Research and Care Consortium. The biomarker risk scores were significant predictors (p neuropsychological tests. With the exception of premorbid intellectual status (6.6%), the biomarker risk scores alone accounted for a minimum of 12.9% of the variance in neuropsychological scores. Biomarker algorithms (biomarker risk scores and demographics) accounted for substantially more variance in scores. Review of the variable importance plots indicated differential patterns of biomarker significance for each test, suggesting the possibility of domain-specific biomarker algorithms. Our findings provide proof of concept for a novel area of scientific discovery, which we term 'molecular neuropsychology'. Copyright © 2013 S. Karger AG, Basel.

  5. Blood-Mimicking Fluid for Testing Ultrasonic Diagnostic Instrument

    Science.gov (United States)

    Tanaka, Kouhei; Yoshida, Tomoji; Sato, Kazuishi; Kondo, Toshio; Yasukawa, Kazuhiro; Miyamoto, Nobuaki; Taniguchi, Masahiko

    2012-07-01

    We present a blood-mimicking fluid (BMF) for the Doppler test object of medical diagnostic instruments. Accurate measurement in a flow Doppler test requires a BMF that has the acoustic velocity and density defined in the International Electrotechnical Commission (IEC) standard, and furthermore, they must be stable over time. To formulate a fluid with the desired density and acoustic velocity, we have developed a new fluid made of glycerine and water-soluble silicone oil. The new BMF includes dispersed polystyrene particles as scatterers. The density of the liquid can be adjusted to maintain it at the same value as that of the polystyrene particles, thus ensuring neutral buoyancy of the particles. The MBF was stable over a period of 2 weeks, during which the density and acoustic velocity did not change.

  6. Blood glucose rise after lactose tolerance testing in infants.

    Science.gov (United States)

    Paige, D M; Mellits, E D; Chiu, F Y; Davis, L; Bayless, T M; Cordano, A

    1978-02-01

    Lactose tolerance tests are used clinically to screen children and infants. It is assumed that absorption of a lactose challenge in infants would occur in a predictable pattern prior to weaning. Twenty-one infants from 3 to 12 months of age were studied. The maximum blood glucose rise over fasting levels ranged from 11.0 to 62.0 mg/100 ml; the mean was 32.6 mg/100 ml. Six infants had a maximum rise of less than 20 mg/100 ml. Eleven infants (52%) had a maximum rise of greater than 30 mg/100 ml. Signs of intolerance were not noted in any subject. Weight and length were normally disturbed. Results indicate the variance in glucose rise existing within a population of infants growing normally and consuming milk. Gastric emptying, digestion, and absorption may influence the blood glucose rise after a lactose test. Established glucose levels used as an index to lactose absorption in older children and adults may not accurately reflect lactase activity in infants.

  7. Pre-operative risk scores for the prediction of outcome in elderly people who require emergency surgery

    Directory of Open Access Journals (Sweden)

    Bates Tom

    2007-06-01

    Full Text Available Abstract Background The decision on whether to operate on a sick elderly person with an intra-abdominal emergency is one of the most difficult in general surgery. A predictive risk-score would be of great value in this situation. Methods A Medline search was performed to identify those predictive risk-scores relevant to sick elderly patients in whom emergency surgery might be life-saving. Results Many of the risk scores for surgical patients include the operative findings or require tests which are not available in the acute situation. Most of the relevant studies include younger patients and elective surgery. The Glasgow Aneurysm Score and Hardman Index are specific to ruptured aortic aneurysm while the Boey Score and the Hacetteppe Score are specific to perforated peptic ulcer. The Reiss Index and Fitness Score can be used pre-operatively if the elements of the score can be completed in time. The ASA score, which includes a significant element of subjective clinical judgement, can be augmented with factors such as age and urgency of surgery but no test has a negative predictive value sufficient to recommend against surgical intervention without clinical input. Conclusion Risk scores may be helpful in sick elderly patients needing emergency abdominal surgery but an experienced clinical opinion is still essential.

  8. Using 3 Tesla magnetic resonance imaging in the pre-operative evaluation of tongue carcinoma.

    Science.gov (United States)

    Moreno, K F; Cornelius, R S; Lucas, F V; Meinzen-Derr, J; Patil, Y J

    2017-09-01

    This study aimed to evaluate the role of 3 Tesla magnetic resonance imaging in predicting tongue tumour thickness via direct and reconstructed measures, and their correlations with corresponding histological measures, nodal metastasis and extracapsular spread. A prospective study was conducted of 25 patients with histologically proven squamous cell carcinoma of the tongue and pre-operative 3 Tesla magnetic resonance imaging from 2009 to 2012. Correlations between 3 Tesla magnetic resonance imaging and histological measures of tongue tumour thickness were assessed using the Pearson correlation coefficient: r values were 0.84 (p Tesla magnetic resonance imaging had 83 per cent sensitivity, 82 per cent specificity, 82 per cent accuracy and a 90 per cent negative predictive value for detecting cervical lymph node metastasis. In this cohort, 3 Tesla magnetic resonance imaging measures of tumour thickness correlated highly with the corresponding histological measures. Further, 3 Tesla magnetic resonance imaging was an effective method of detecting malignant adenopathy with extracapsular spread.

  9. Routine pre-operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures

    DEFF Research Database (Denmark)

    Bøtker, M T; Vang, M L; Grøfte, T;

    2014-01-01

    with focused ultrasonography in patients undergoing urgent surgical procedures. Methods We performed pre-operative focused cardiopulmonary ultrasonography in patients aged 18 years or above undergoing urgent surgical procedures at pre-defined study days. Known and unexpected cardiopulmonary pathology...... was recorded, and subsequent changes in the anesthesia technique or supportive actions were registered. Results A total of 112 patients scheduled for urgent surgical procedures were included. Their mean age (standard deviation) was 62 (21) years. Of these patients, 24% were American Society....... Unexpected pathology leading to changes in anesthesia technique or supportive actions was only disclosed in a group of patients above the age of 60 years and/or in ASA class ≥ 3. Conclusion Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical...

  10. ART THERAPY MANAGEMENT IN THE PRE-OPERATIVE PERIOD IN PEDIATRICS

    Directory of Open Access Journals (Sweden)

    Ana Cláudia Afonso Valladares

    2004-04-01

    Full Text Available Every child, particularly those who will be submitted to surgery, needs to express themselves, createand establish relationships with the world. This study was based on qualitative studies which were, in turn,substantiated on the behavioral changes of patients and their images. It was developed in the pediatric clinic of apublic hospital in the city of Goiânia/GO in a two years’ period (1998-2000. The target population consisted ofhospitalized children in the pre-operative process. It was concluded that great therapeutic benefit was achievedfrom the use of art therapy for this population as it helped the children to recover their mental balance, thusstrengthening a healthier side of the child which had been deadened by the illness, hospitalization and treatment.

  11. Terminal valve of sapheno-femoral junction: a comparative assessment between pre-operative color-duplex ultrasound and intra-operative evaluation

    Directory of Open Access Journals (Sweden)

    Attilio Cavezzi

    2013-01-01

    Full Text Available According to literature data, up to 59% of incompetent great saphenous veins (GSV have no reflux at the terminal valve (TV of the saphenofemoral junction (SFJ. The aim was to compare color duplex ultrasound (CDU investigation and direct intra-operative assessment of competence of the TV at SFJ. A prospective comparative study was performed on 28 patients, who consecutively presented for surgical intervention for their primary varicose veins of the lower limbs with GSV incompetence. CDU assessment was performed pre-operatively to define GSV and SFJ terminal valve morphology and hemodynamics. Under local anesthesia these patients underwent SFJ disconnection (crossectomy and segmental inverted saphenous stripping of the incompetent GSV tract + phlebectomy of the varicose tributaries. SFJ disconnection was performed in four stages in an ascending fashion: I division of GSV below the lower SFJ tributaries, II disconnection of lower SFJ tributaries, III disconnection of upper tributaries, IV flush to CFV ligature of GSV stump. After the completion of stage I, the SFJ stump was opened and kept open when needed throughout the subsequent stages, in order to highlight any possible blood leak through the SFJ stump. To highlight intraoperative blood leak from SFJ stump visual observation was carried out both during respiration and when performing Valsalva maneuver and manual compression of homolateral iliac fossa. As to pre-operative CDU all limbs showed GSV reflux and they were divided in two groups according to TV competence (group A or incompetence (group B. Group A comprised 18 patients (6 M and 12 F, mean age 50.6 years. Group B included 10 patients (4 M and 6 F, mean age 54.8 years. Mean calibre of GSV at proximal/mid thigh was 6.4 mm in group A and 7.8 in group B. Concerning the intra-operative findings: in the group A, 5 patients had blood leak in the SFJ stump after stage I, 4 patients showed blood leak after stage II. After completion of stage III

  12. 78 FR 13069 - Draft Guidance for Industry: Recommendations for Screening, Testing, and, Management of Blood...

    Science.gov (United States)

    2013-02-26

    ...The Food and Drug Administration (FDA) is announcing the availability of a draft document entitled ``Guidance for Industry: Recommendations for Screening, Testing, and Management of Blood Donors and Blood and Blood Components Based on Screening Tests for Syphilis,'' dated March 2013. The draft guidance document provides revised recommendations for screening and testing of donors and management......

  13. Increasing the specificity of the forensic luminol test for blood.

    Science.gov (United States)

    Quickenden, T I; Cooper, P D

    2001-01-01

    It is shown that the presumptive luminol chemiluminescence test for the presence of traces of blood can be made more determinative by measuring the peak emission wavelength of the luminol chemiluminescence. When sprayed onto a surface containing traces of human haemoglobin, a 1 g/L solution of aqueous luminol containing 7 g/L sodium perborate gives an emission peak at 455 +/- 2 nm, whereas the same mixture gives an emission peak at 430 +/- 3 nm when sprayed onto a surface containing traces of sodium hypochlorite (household bleach). This spectral difference can readily be determined using spectroscopic equipment that either scans the spectrum before significant luminescence decay occurs or corrects the spectrum for the effects of any decay. It was found that bovine haemoglobin and human haemoglobin showed no significant spectral differences.

  14. GlobVolcano pre-operational services for global monitoring active volcanoes

    Science.gov (United States)

    Tampellini, Lucia; Ratti, Raffaella; Borgström, Sven; Seifert, Frank Martin; Peltier, Aline; Kaminski, Edouard; Bianchi, Marco; Branson, Wendy; Ferrucci, Fabrizio; Hirn, Barbara; van der Voet, Paul; van Geffen, J.

    2010-05-01

    The GlobVolcano project (2007-2010) is part of the Data User Element programme of the European Space Agency (ESA). The project aims at demonstrating Earth Observation (EO) based integrated services to support the Volcano Observatories and other mandate users (e.g. Civil Protection) in their monitoring activities. The information services are assessed in close cooperation with the user organizations for different types of volcano, from various geographical areas in various climatic zones. In a first phase, a complete information system has been designed, implemented and validated, involving a limited number of test areas and respective user organizations. In the currently on-going second phase, GlobVolcano is delivering pre-operational services over 15 volcanic sites located in three continents and as many user organizations are involved and cooperating with the project team. The set of GlobVolcano offered EO based information products is composed as follows: Deformation Mapping DInSAR (Differential Synthetic Aperture Radar Interferometry) has been used to study a wide range of surface displacements related to different phenomena (e.g. seismic faults, volcanoes, landslides) at a spatial resolution of less than 100 m and cm-level precision. Permanent Scatterers SAR Interferometry method (PSInSARTM) has been introduced by Politecnico of Milano as an advanced InSAR technique capable of measuring millimetre scale displacements of individual radar targets on the ground by using multi-temporal data-sets, estimating and removing the atmospheric components. Other techniques (e.g. CTM) have followed similar strategies and have shown promising results in different scenarios. Different processing approaches have been adopted, according to data availability, characteristic of the area and dynamic characteristics of the volcano. Conventional DInSAR: Colima (Mexico), Nyiragongo (Congo), Pico (Azores), Areanal (Costa Rica) PSInSARTM: Piton de la Fournaise (La Reunion Island

  15. Comparisons of home blood glucose testing and glycated protein measurements.

    Science.gov (United States)

    Lee, P D; Sherman, L D; O'Day, M R; Rognerud, C L; Ou, C N

    1992-04-01

    We examined the relationships between 4 glycated protein assays and home blood glucose monitoring (HBGM) in 26 children with poorly-controlled insulin-dependent diabetes mellitus (IDDM) during a period of improved management. At 2 week intervals for 6 visits (12 weeks in total), HBGM records were collected and a blood sample was obtained for measurement of glycated proteins and glucose. Assays included glycated hemoglobin (GHb) and glycated serum proteins (GP) by boronate affinity chromatography, hemoglobin A1C by PolyCAT A high performance liquid chromatography (HAC) and fructosamine (FA). All 4 glycated protein levels declined significantly over the 12 week period. Significant correlations between the glycated proteins and HBGM were observed over 2 week intervals. None of the 4 assays were affected by the glucose level in the sample. Changes in mean HBGM readings over 2 week intervals were correlated with both FA and GP with wide prediction intervals. Over cumulative 2 week intervals, which may more accurately reflect longitudinal trends, all 4 glycated proteins were correlated with mean HBGM readings. At each cumulative interval, GHb and GP showed the largest variation with MBG, while FA showed the least variation with MBG. Our data indicate that of the 4 assays tested, FA has limited clinical values as compared to other glycated protein assays, whereas assays based on boronate affinity chromatography (GHb and GP) provide the most useful clinical indicators of short-term changes in glycemic control. The clinical utility of a new HPLC method for determination of glycated hemoglobins is also demonstrated.

  16. Collection, processing and testing of bone, corneas, umbilical cord blood and haematopoietic stem cells by European Blood Alliance members

    DEFF Research Database (Denmark)

    Närhi, M; Natri, O; Desbois, I;

    2013-01-01

    A questionnaire study was carried out in collaboration with the European Blood Alliance (EBA) Tissues and Cells (T&C) working group. The aim was to assess the level of involvement and commonality of processes on the procurement, testing and storage of bone, corneas, umbilical cord blood (UCB...

  17. Pre-operational safety appraisal Tritiated Scrap Recovery Facility, Mound facility

    Energy Technology Data Exchange (ETDEWEB)

    Dauby, J.J.; Flanagan, T.M.; Metcalf, L.W.; Rhinehammer, T.B.

    1996-07-01

    The purpose of this report is to identify, assess, and document the hazards which are associated with the proposed operation of the Tritiated Scrap Recovery Facility at Mound Facility. A Pre-operational Safety Appraisal is a requirement as stated in Department of Energy Order 5481.1, Safety Analysis and Review System. The operations to be conducted in the new Tritiated Scrap Waste Recovery Facility are not new, but a continuation of a prime mission of Mound`s i.e. recovery of tritium from waste produced throughout the DOE complex. The new facility is a replacement of an existing process started in the early 1960`s and incorporates numerous design changes to enhance personnel and environmental safety. This report also documents the safety of a one time operation involving the recovery of tritium from material obtained by the Department of Energy from the State of Arizona. This project will involve the processing of 240,000 curies of tritium contained in glass ampoules that were to be used in items such as luminous dial watches. These were manufactured by the now defunct American Atomics Corporation, Tucson, Arizona.

  18. Pre-operative MRI of anorectal anomalies in the newborn period

    Energy Technology Data Exchange (ETDEWEB)

    McHugh, K. [Dept. of Radiology, John Radcliffe Hospital, Oxford (United Kingdom); Dudley, N.E. [Dept. of Paediatric Surgery, John Radcliffe Hospital, Oxford (United Kingdom); Tam, P. [Dept. of Paediatric Surgery, John Radcliffe Hospital, Oxford (United Kingdom)

    1995-11-01

    Nine infants (six boys, three girls) with anorectal anomalies were examined in the immediate newborn period, prior to corrective surgery, with MRI. Three high, one intermediate and five low anomalies were found at MRI - one patient with a `low` lesion was subsequently found at surgery 2 months later to have a high anorectal anomaly. This infant had passed meconium per urethram soon after the MRI study, prompting the need for a protective colostomy and stressing the importance of a thorough clinical examination of babies with anorectal malformations. The MRI results and findings at surgery were in agreement in all other patients (n=8). Hydronephrosis was evident in two and renal agenesis in one patient. Sacrococcygeal hypoplasia was found in two and two hemivertebrae in one infant. No spinal cord lesion was identified. One fistula was evident on MRI but four were later found at surgery. Uniformly hyperintense T1 signal meconium was seen in all nine newborns, allowing for easy differentiation of rectal contents from rectal wall and the adjacent musculature. MRI can provide useful information regarding the development of the puborectal and external anal sphincter muscles, can help guide the pull-through procedure and help predict future continence pre-operatively in the newborn period. (orig.)

  19. Superconducting Super Collider site environmental report for calendar year 1991. Pre-operational

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-05-01

    This is the first annual SER prepared for the SSC project. It is a pre-operational report, intended primarily to describe the baseline characterization of the Ellis County, Texas site that has been developed subsequent to the Environmental Impact Statement (EIS) and the Supplemental Environmental impact Statement (SEIS). As such, the emphasis will be on environmental compliance efforts, including monitoring and mitigation programs. The SER also reports on the measures taken to meet the commitments made in the EIS and SEIS. These measures are detailed in the Mitigation Action Plan (MAP) (Department of Energy (DOE), 1991), which was prepared following the signing of the Record of Decision (ROD) to construct the SSC in Texas. The SER will continue to be preoperational until the first high-energy (20 trillion electron volt or TeV) protons collisions are observed, at which point the SSC will become operational. At that time, the SER will place more emphasis on the radiological monitoring program. This SER will report on actions taken in 1991 or earlier and briefly mention some of those planned for calendar year 1992. AU actions completed in 1992 will be addressed in the SER for calendar year 1992.

  20. ROLE OF B - SCAN ULTRASONOGRAPHY IN EVALUATION OF PRE - OPERATIVE CATARACT P ATIENTS

    Directory of Open Access Journals (Sweden)

    Navneet

    2015-03-01

    Full Text Available The purpose of this study was to visualize the status of posterior segment with diagnostic toll of B - scan ultrasound in pre - operative dense cataract patients. METHOD S : Diagnostic B - scan ultrasound was done on 200 cataract patients from the age group of 10 to 80 years of both the sexes. The machine used for the a bove study was B - scan machine – (SONOMED, E - ZSCAN AB 5500 + with frequency 10 MHz. RESULTS: Out of total 200 patients, 23 (traumatic & non traumatic cataract were found having posterior segment lesions. Out of 23, 14 patients belong to non - traumatic cata ract group and 9 patients belong to traumatic cataract group. 5 Patients (25% had PVD and 2 patients (1% had asteroid hyalosis and 1(0.55 patient had intraocular foreign body, 2(1% had posterior staphyloma. In non - traumatic cataract group, 74.5% were i n the range of 50 - 60 years of age. In traumatic cataract group, 47.3% were in the age group 10 - 19 years. In non - traumatic cataract group, 72(39.7% were male and female were 109(60.2%. In traumatic cataract group, male were 14(73.6% and female were 3(26. 3% . CONCLUSION: It was concluded that B - scan ultrasound could be a useful tool for detection of hidden posterior segment lesions in dense cataract patients.

  1. Advance pre-operative chlorhexidine reduces the incidence of surgical site infections in knee arthroplasty.

    Science.gov (United States)

    Zywiel, Michael G; Daley, Jacqueline A; Delanois, Ronald E; Naziri, Qais; Johnson, Aaron J; Mont, Michael A

    2011-07-01

    Surgical site infections following elective knee arthroplasties occur most commonly as a result of colonisation by the patient's native skin flora. The purpose of this study was to evaluate the incidence of deep surgical site infections in knee arthroplasty patients who used an advance cutaneous disinfection protocol and who were compared to patients who had peri-operative preparation only. All adult reconstruction surgeons at a single institution were approached to voluntarily provide patients with chlorhexidine gluconate-impregnated cloths and a printed sheet instructing their use the night before and morning of surgery. Records for all knee arthroplasties performed between January 2007 and December 2008 were reviewed to determine the incidence of deep incisional and periprosthetic surgical site infections. Overall, the advance pre-operative protocol was used in 136 of 912 total knee arthroplasties (15%). A lower incidence of surgical site infection was found in patients who used the advance cutaneous preparation protocol as compared to patients who used the in-hospital protocol alone. These findings were maintained when patients were stratified by surgical infection risk category. No surgical site infections occurred in the 136 patients who completed the protocol as compared to 21 infections in 711 procedures (3.0%) performed in patients who did not. Patient-directed skin disinfection using chlorhexidine gluconate-impregnated cloths the evening before, and the morning of, elective knee arthroplasty appeared to effectively reduce the incidence of surgical site infection when compared to patients who underwent in-hospital skin preparation only.

  2. Pre-operative detection of thyroid pyramidal lobes by ultrasound and computed tomography.

    Science.gov (United States)

    Ryu, Ji Hwa; Kim, Dong Wook; Kang, Taewoo

    2014-07-01

    This study aimed to assess the diagnostic accuracy of pre-operative ultrasound (US) and computed tomography (CT) for detecting thyroid pyramidal lobe (TPL). A single radiologist prospectively performed thyroid US and retrospectively reviewed neck CT to detect TPLs in 135 consecutive patients scheduled for thyroid surgery. The location, size and superior extent of each TPL and its separation or continuity with the main thyroid gland were assessed by thyroid US, neck CT and surgery. The prevalence of TPLs as diagnosed by thyroid US, neck CT and surgery was 58.5% (79/135), 56.3% (76/135) and 60% (81/135), respectively. We compared US and CT detection of TPLs with surgical data to determine their sensitivity (85.2% and 91.4%), specificity (81.5% and 94.4%), positive (87.3% and 96.1%) and negative (78.6% and 87.9%) predictive values and accuracy (83.7% and 92.6%). For detecting TPLs, both neck CT and thyroid US have good diagnostic value, although neck CT is more accurate than thyroid US.

  3. Forensic Identification of Human Blood: comparison of two one-step presumptive tests for blood screening of crime scene samples.

    Directory of Open Access Journals (Sweden)

    Ana Flávia Belchior Andrade

    2014-08-01

    Full Text Available Blood is the most common body fluid found at crime scenes. One-step presumptive tests have been designed as a rapid immunological test for the qualitative detection of human hemoglobin in stool samples (faecal occult blood their usefulness for forensic purposes has been demonstrated before. In this study we compare Hexagon OBTI kit and FOB One-step Bioeasy kit sensitivity in the analysis of diluted blood samples. With Hexagon OBTI, positive test results are achieved in whole blood dilutions up to 1:1.000. Sensitivity decreased with aged samples, if samples were not stored under low temperatures regardless of which presumptive test is used. Whole blood tests must take into consideration that “hook” effect may interfere. Comparing both tests, OBTI Hexagon Kit is more sensible to detect diluted blood, showing a wider detection window in all conditions. This is interesting when analyzing forensic samples as forensic analysts usually do not know about the history of the analyzed sample before its collection.

  4. Efficacy of pre-operative progressive resistance training on post-operative outcomes in patients undergoing total knee arthroplasty

    DEFF Research Database (Denmark)

    Skoffer, Birgit; Maribo, Thomas; Mechlenburg, Inger;

    2015-01-01

    OBJECTIVE: To investigate the efficacy of 4 weeks of pre-operative and 4-week post-operative progressive resistance training (PRT) compared to 4 weeks of post-operative PRT only on functional performance, muscle strength and patient-reported outcomes in patients undergoing total knee arthroplasty...

  5. Rescue pre-operative treatment with Lugol’s solution in uncontrolled Graves’ disease

    Science.gov (United States)

    Falhammar, Henrik

    2017-01-01

    Background Graves’ disease is a common cause of hyperthyroidism. Three therapies have been used for decades: pharmacologic therapy, surgery and radioiodine. In case of adverse events, especially agranulocytosis or hepatotoxicity, pre-treatment with Lugol’s solution containing iodine/potassium iodide to induce euthyroidism before surgery could be advocated, but this has rarely been reported. Methods All patients hospitalised due to uncontrolled hyperthyroidism at the Karolinska University Hospital 2005–2015 and treated with Lugol’s solution were included. All electronic files were carefully reviewed manually, with focus on the cause of treatment and admission, demographic data, and effects of iodine on thyroid hormone levels and pulse frequency. Results Twenty-seven patients were included. Lugol’s solution had been chosen due to agranulocytosis in 9 (33%), hepatotoxicity in 2 (7%), other side effects in 11 (41%) and poor adherence to medication in 5 (19%). Levels of free T4, free T3 and heart rate decreased significantly after 5–9 days of iodine therapy (free T4 53–20 pmol/L, P = 0.0002; free T3 20–6.5 pmol/L, P = 0.04; heart rate 87–76 beats/min P = 0.0007), whereas TSH remained unchanged. Side effects were noted in 4 (15%) (rash n = 2, rash and vomiting n = 1, swelling of fingers n = 1). Thyroidectomy was performed in 26 patients (96%) and one was treated with radioiodine; all treatments were without serious complications. Conclusion Treatment of uncontrolled hyperthyroidism with Lugol’s solution before definitive treatment is safe and it decreases thyroid hormone levels and heart rate. Side effects were limited. Lugol’s solution could be recommended pre-operatively in Graves’ disease with failed medical treatment, especially if side effects to anti-thyroid drugs have occurred. PMID:28325735

  6. Can pre-operative computed tomography predict the need for a thoracic approach for removal of retrosternal goitre?

    Science.gov (United States)

    Qureishi, Ali; Garas, George; Tolley, Neil; Palazzo, Fausto; Athanasiou, Thanos; Zacharakis, Emmanouil

    2013-01-01

    A best evidence topic was written according to a structured protocol. The question addressed was whether in patients with retrosternal goitre the need for a thoracic approach can be predicted using pre-operative CT. A total of 381 papers were identified using the reported search protocol of which 7 represented the best evidence to answer the clinical question. The authors, journal, date, country of publication, patient group studied, study type, relevant outcomes and results are tabulated. The evidence on this subject is poor, none of the studies were randomised, only one used controls (historical) and all studies were retrospective. Despite these limitations, CT represents the gold-standard imaging modality in the pre-operative evaluation of patients with retrosternal goitre. CT is essential to define the extent and position of a retrosternal goitre. The literature suggests that CT is the single most valuable pre-operative investigation predicting whether a sternotomy or lateral thoracotomy will be necessary for removal of the retrosternal goitre. Although pre-operative CT does not have the precision to predict whether a thoracic approach is required in all cases, the presence of certain radiological features such as extension of the goitre below the aortic arch or into the posterior mediastinum, a dumbbell shape and a thoracic component that is wider than the thoracic inlet are all associated with the need for a thoracic approach. In some cases a pre-operative CT will not only determine that a thoracic approach is mandatory but it will also guide the surgeon upon the type of thoracic approach.

  7. From pre-operative cardiac modeling to intra-operative virtual environments for surgical guidance: an in vivo study

    Science.gov (United States)

    Linte, Cristian A.; Wierzbicki, Marcin; Moore, John; Wedlake, Christopher; Wiles, Andrew D.; Bainbridge, Daniel; Guiraudon, Gérard M.; Jones, Douglas L.; Peters, Terry M.

    2008-03-01

    As part of an ongoing theme in our laboratory on reducing morbidity during minimally-invasive intracardiac procedures, we developed a computer-assisted intervention system that provides safe access inside the beating heart and sufficient visualization to deliver therapy to intracardiac targets while maintaining the efficacy of the procedure. Integrating pre-operative information, 2D trans-esophageal ultrasound for real-time intra-operative imaging, and surgical tool tracking using the NDI Aurora magnetic tracking system in an augmented virtual environment, our system allows the surgeons to navigate instruments inside the heart in spite of the lack of direct target visualization. This work focuses on further enhancing intracardiac visualization and navigation by supplying the surgeons with detailed 3D dynamic cardiac models constructed from high-resolution pre-operative MR data and overlaid onto the intra-operative imaging environment. Here we report our experience during an in vivo porcine study. A feature-based registration technique previously explored and validated in our laboratory was employed for the pre-operative to intra-operative mapping. This registration method is suitable for in vivo interventional applications as it involves the selection of easily identifiable landmarks, while ensuring a good alignment of the pre-operative and intra-operative surgical targets. The resulting augmented reality environment fuses the pre-operative cardiac model with the intra-operative real-time US images with approximately 5 mm accuracy for structures located in the vicinity of the valvular region. Therefore, we strongly believe that our augmented virtual environment significantly enhances intracardiac navigation of surgical instruments, while on-target detailed manipulations are performed under real-time US guidance.

  8. Greater pre-operative anxiety, pain and poorer function predict a worse outcome of a total knee arthroplasty.

    Science.gov (United States)

    Alattas, Sharifah Adla; Smith, Toby; Bhatti, Maria; Wilson-Nunn, Daniel; Donell, Simon

    2016-10-12

    Around 10-30 % of patients are dissatisfied with the results of their total knee arthroplasty (TKA). This review aimed to identify and evaluate the predictors of outcome measured by the three domains of health-related quality of life (pain, stiffness and function). The focus was on pre-operative psychological factors as related to other patient-related variables. A systematic search was performed using the following databases: MEDLINE, PubMed, AMED, CINAHL, PsychINFO, SciFinder, Scopus, EMBASE, Cochrane, Lilacs, Web of Science and ScienceDirect. The quality of identified studies was assessed using the Critical Appraisal Skills Programme Cohort checklist. Ten studies met the eligibility criteria. From these, nine patient-related predictors of outcome were identified (depression, anxiety, age at surgery, gender (being female), medical co-morbidities, BMI, level of education, pre-operative pain severity and pre-operative knee function). Greater anxiety, pre-operative pain and function were the most significant factors to predict a poorer outcome of a TKA. The results of depression, gender (female), medical co-morbidities, BMI and level of education were variable among the included studies. There was very little evidence to support older age at operation as a predictor of poorer outcome. Patients experiencing high levels of pain before surgery should be informed of the chances of improvement by having a TKA. A validated psychological screening tool that separates depression and anxiety is recommended as part of the pre-operative assessment stage. Patients presenting with symptoms of depression and anxiety should be identified and consulted before a TKA. II.

  9. A modified isometric test to evaluate blood pressure control with ...

    African Journals Online (AJOL)

    be measured during effort to evaluate hypertension ... achieved by a variety of medications. However, appro- ... aspirin, and 5 were non-insulin-dependent diabetics. Isometric ... Blood pressure was then measured at baseline (no treat- ment) ...

  10. Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes

    Directory of Open Access Journals (Sweden)

    Peter Novak

    2016-01-01

    Full Text Available Objective. The head-up tilt test is widely used for evaluation of orthostatic intolerance. Although orthostatic symptoms usually reflect cerebral hypoperfusion, the cerebral blood flow velocity (CBFv profile in orthostatic syndromes is not well described. This study evaluated CBFv and cardiovascular patterns associated with the tilt test in common orthostatic syndromes. Methods. This retrospective study analyzed the tilt test of patients with history of orthostatic intolerance. The following signals were recorded: ECG, blood pressure, CBFv using transcranial Doppler, respiratory signals, and end tidal CO2. Results. Data from 744 patients were analyzed. Characteristic pattern associated with a particular orthostatic syndrome can be grouped into abnormalities predominantly affecting blood pressure (orthostatic hypotension, orthostatic hypertension syndrome, vasomotor oscillations, and neurally mediated syncope—cardioinhibitory, vasodepressor, and mixed, cerebral blood flow (orthostatic hypoperfusion syndrome, primary cerebral autoregulatory failure, and heart rate (tachycardia syndromes: postural tachycardia syndrome, paroxysmal sinus tachycardia, and inappropriate sinus tachycardia. Psychogenic pseudosyncope is associated with stable CBFv. Conclusions. The tilt test is useful add-on in diagnosis of several orthostatic syndromes. However diagnostic criteria for several syndromes had to be modified to allow unambiguous pattern classification. CBFv monitoring in addition to blood pressure and heart rate may increase diagnostic yield of the tilt test.

  11. Cerebral Blood Flow, Heart Rate, and Blood Pressure Patterns during the Tilt Test in Common Orthostatic Syndromes

    Science.gov (United States)

    2016-01-01

    Objective. The head-up tilt test is widely used for evaluation of orthostatic intolerance. Although orthostatic symptoms usually reflect cerebral hypoperfusion, the cerebral blood flow velocity (CBFv) profile in orthostatic syndromes is not well described. This study evaluated CBFv and cardiovascular patterns associated with the tilt test in common orthostatic syndromes. Methods. This retrospective study analyzed the tilt test of patients with history of orthostatic intolerance. The following signals were recorded: ECG, blood pressure, CBFv using transcranial Doppler, respiratory signals, and end tidal CO2. Results. Data from 744 patients were analyzed. Characteristic pattern associated with a particular orthostatic syndrome can be grouped into abnormalities predominantly affecting blood pressure (orthostatic hypotension, orthostatic hypertension syndrome, vasomotor oscillations, and neurally mediated syncope—cardioinhibitory, vasodepressor, and mixed), cerebral blood flow (orthostatic hypoperfusion syndrome, primary cerebral autoregulatory failure), and heart rate (tachycardia syndromes: postural tachycardia syndrome, paroxysmal sinus tachycardia, and inappropriate sinus tachycardia). Psychogenic pseudosyncope is associated with stable CBFv. Conclusions. The tilt test is useful add-on in diagnosis of several orthostatic syndromes. However diagnostic criteria for several syndromes had to be modified to allow unambiguous pattern classification. CBFv monitoring in addition to blood pressure and heart rate may increase diagnostic yield of the tilt test. PMID:27525257

  12. Can latent heat safely warm blood? – in vitro testing of a portable prototype blood warmer

    Directory of Open Access Journals (Sweden)

    McEwen Mark P

    2007-08-01

    Full Text Available Abstract Background Trauma/retrieval patients are often in shock and hypothermic. Treatment of such patients usually involves restoring their blood volume with transfusion of blood (stored at 2°C – 6°C and/or crystalloids or colloids (stored at ambient temperature. Rapid infusion of these cold fluids can worsen or even induce hypothermia in these patients. Warming of intravenous fluids at accident sites has traditionally been difficult due to a lack of suitable portable fluid warmers that are not dependent on mains electrical or battery power. If latent heat, the heat released when a liquid solidifies (an inherently temperature limiting process can warm intravenous fluids, portable devices without a reliance on electrical energy could be used to reduce the incidence of hypothermia in trauma patients. Methods Rapid infusion of red cells into patients was timed to sample typical clinical flow rates. An approved dry heat blood warmer was compared with a prototype blood warmer using a supercooled liquid latent heat storage material, to warm red cells whilst monitoring inlet and outlet temperatures. To determine the effect of warming on red cell integrity compared to the normal storage lesion of blood, extracellular concentrations of potassium, lactate dehydrogenase and haemoglobin were measured in blood which had been warmed after storage at 2°C – 6°C for 1 to 42 days. Results A prototype latent heat fluid warmer consistently warmed red cells from approximately 4°C to approximately 35°C at typical clinical flow rates. Warming of stored blood with latent heat did not affect red cell integrity more than the approved dry heat blood warmer. Conclusion Using latent heat as an energy source can satisfactorily warm cold blood or other intravenous fluids to near body temperature, without any adverse affects.

  13. Effects of post-sampling analysis time, type of blood samples and collection tubes on values of blood gas testing.

    Science.gov (United States)

    Smajić, Jasmina; Kadić, Damira; Hasić, Sabaheta; Serdarević, Nafija

    2015-08-01

    To investigate effects of post-sampling analysis time, a type of blood samples and collection tubes on blood gas testing. This study included 100 patients at the Clinic for Pulmonary Diseases, Clinical Centre Sarajevo. The partial pressure of oxygen (pO2) and carbon dioxide (pCO2), and the oxygen saturation level of hemoglobin (sO2) were analyzed in the arterial blood samples (ABS) and capillary blood samples (CBS) by a potentiometric method using a blood gas analyzer ABL 555 (Radiometer, Copenhagen, Denmark). Paired measurements of ABS were performed within 15 minutes and after 60 minutes from sampling and compared. The results of CBS obtained within 15 minutes were compared with matching ABS results, as well as the results obtained from CBS within 15 minutes taken into glass and plastic tubes. pO2 and sO2 values were significantly lower after 60 minutes compared to those within 15 minutes in ABS (9.20±1.89 vs. 9.51±1.95 and 91.25±5.03 vs. 92.40±4.5; pblood values were not influenced significantly (p>0.05). The length of post-sampling analysis time, a type of blood samples and collection tubes have significant impact on blood oxygen parameters. Analysis within 15 minutes after blood sampling is considered as appropriate. Copyright© by the Medical Assotiation of Zenica-Doboj Canton.

  14. Whiteboard Icons to Support the Blood-Test Process in an Emergency Department

    DEFF Research Database (Denmark)

    Torkilsheyggi, Arnvør Martinsdottir á; Hertzum, Morten; From, Gustav

    2013-01-01

    The competent treatment of emergency department (ED) patients requires an effective and efficient process for handling laboratory tests such as blood tests. This study investigates how ED clinicians go about the process, from ordering blood tests to acknowledging their results and, specifically......, assesses the use of whiteboard icons to support this process. On the basis of observation and interviews we find that the blood-test process is intertwined with multiple other temporal patterns in ED work. The whiteboard icons, which indicate four temporally distinct steps in the blood-test process......, support the nurses in maintaining the flow of patients through the ED and the physicians in assessing test results at timeouts. The main results of this study are, however, that the blood-test process is temporally and collaboratively complex, that the whiteboard icons pass by most of this complexity...

  15. Minimally invasive fixation in tibial plateau fractures using an pre-operative and intra-operative real size 3D printing.

    Science.gov (United States)

    Giannetti, Silvio; Bizzotto, Nicola; Stancati, Andrea; Santucci, Attilio

    2017-03-01

    The purpose of our study was to compare the outcome after minimally invasive reconstruction and internal fixation with and without the use of pre- and intra-operative real size 3D printing for patients with displaced tibial plateau fractures (TPFs). We prospectively followed up 40 consecutive adult patients with closed TPF who underwent surgical treatment of reconstruction of the tibial plateau with the use of minimally invasive fixation. Sixteen patients (group 1) were operated using a pre-operative and intra-operative real size 3D-model, while 24 patients (group 2) were operated without 3D-model printing, but using only pre-operative and intra-operative 3D Tc-scan images. The mean operating time was 148.2±15.9min for group 1 and 174.5±22.2min for group 2 (p=0.041). In addition, the mean intraoperative blood loss was less in group 1 (520mL) than in group 2 (546mL) (p=0.534). After discharge, all patients were followed up at 6 weeks, 12 weeks, 6 months, 1year and then every year post surgically and radiographic evaluation was carried out each time using clinical and radiological Rasmussen's score, with no significant differences between the two groups. Two patients (group 2) developed infection which resolved within 3 weeks after usage of antibiotics. Neither superficial nor deep infections were present in group 1. In all patients, no non-union occurred. No intraoperative, perioperative, or postoperative complications, such as loss of valgus correction, bone fractures, or metallic plate failures were detected at follow-up. In patients operated with the use of 3D-model printing, we found a significant reduction in surgical time. Moreover, the technique without a 3D-model increased the patient's and the surgeon's exposure to radiation.

  16. The determination of phenazone in blood plasma for obtained sistem suitable test of monitoring drug level

    OpenAIRE

    Mochamad Lazuardi

    2007-01-01

    The determining of Phenazone to human blood plasma from healthy man after separated by solid phase extraction (SPE) and spectroscopic measurements has been investigated. The objective of that research was to obtain system suitable test for determine the Phenazone level in biological fluids (human blood plasma), for new performed dosage regimented in clinical dentistry. The method can be divided into the following four steps. 1. Centrifugation the blood sample, 2. Extraction from blood plasma ...

  17. Considerations of red blood cell molecular testing in transfusion medicine.

    Science.gov (United States)

    Svensson, Annika M; Delaney, Meghan

    2015-01-01

    The field of transfusion medicine is on the threshold of a paradigm shift, as the technology for genotyping of red blood cell antigens, including US FDA-approved arrays, is now moving into standard practice. Access to cost-efficient, high-resolution genotyping has the potential to increase the quality of care by decreasing the risk for alloimmunization and incompatible transfusions in individuals on long-term blood transfusion protocols, including patient groups with hemoglobinopathies and other chronic diseases. Current and future applications of molecular methods in transfusion medicine and blood banking are discussed, with emphasis on indications for genotyping in various clinical scenarios. Furthermore, limitations of the current gold standard methodology and serology, as well as of contemporary molecular methodology, are examined.

  18. A native whole blood test for the evaluation of blood-surface interaction: determination of thromboxane production.

    Science.gov (United States)

    Mantovani, E; Marconi, W; Cebo, B; Togna, A R; Togna, G; Caprino, L

    1984-05-01

    The method developed to evaluate the hemocompatibility of artificial materials involves the determination of thromboxane production during the clotting of rabbit blood, in test tubes of different materials. The concentration of serum TXB2 obtained after incubation of whole blood in glass test tubes, for 40 min at 37 degrees C, averaged 416.8 +/- 23.3 ng/ml (mean +/- SE). Polymethylpentene, recognised as having a relatively poor blood compatibility, elicited 309.5 +/- 17.2 ng/ml of serum TXB2, while silicone and Avcothane, considered of better hemocompatibility, showed thromboxane levels of 276.2 +/- 28.2 and 222.9 +/- 31.5 ng/ml, respectively. These values validate the usefulness of the proposed method as a preliminary in vitro screening test of artificial materials intended for biomedical application.

  19. Post-test probability for neonatal hyperbilirubinemia based on umbilical cord blood bilirubin, direct antiglobulin test, and ABO compatibility results.

    Science.gov (United States)

    Peeters, Bart; Geerts, Inge; Van Mullem, Mia; Micalessi, Isabel; Saegeman, Veroniek; Moerman, Jan

    2016-05-01

    Many hospitals opt for early postnatal discharge of newborns with a potential risk of readmission for neonatal hyperbilirubinemia. Assays/algorithms with the possibility to improve prediction of significant neonatal hyperbilirubinemia are needed to optimize screening protocols and safe discharge of neonates. This study investigated the predictive value of umbilical cord blood (UCB) testing for significant hyperbilirubinemia. Neonatal UCB bilirubin, UCB direct antiglobulin test (DAT), and blood group were determined, as well as the maternal blood group and the red blood cell antibody status. Moreover, in newborns with clinically apparent jaundice after visual assessment, plasma total bilirubin (TB) was measured. Clinical factors positively associated with UCB bilirubin were ABO incompatibility, positive DAT, presence of maternal red cell antibodies, alarming visual assessment and significant hyperbilirubinemia in the first 6 days of life. UCB bilirubin performed clinically well with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95 % CI 0.80-0.84). The combined UCB bilirubin, DAT, and blood group analysis outperformed results of these parameters considered separately to detect significant hyperbilirubinemia and correlated exponentially with hyperbilirubinemia post-test probability. Post-test probabilities for neonatal hyperbilirubinemia can be calculated using exponential functions defined by UCB bilirubin, DAT, and ABO compatibility results. • The diagnostic value of the triad umbilical cord blood bilirubin measurement, direct antiglobulin testing and blood group analysis for neonatal hyperbilirubinemia remains unclear in literature. • Currently no guideline recommends screening for hyperbilirubinemia using umbilical cord blood. What is New: • Post-test probability for hyperbilirubinemia correlated exponentially with umbilical cord blood bilirubin in different risk groups defined by direct antiglobulin test and ABO blood group

  20. Blood Lactate Response to the CF (Canadian Forces) EXPRES Test

    Science.gov (United States)

    1988-11-01

    control hypertension. Beta blockers cause a moderate decrease in blood pressure, a pronounced reduc- tion in heart rate, and no change in stroke volume...45-57. 23. Van Baak, M.A., Bohm, R.O.B., Arends, B.G., Van Hooff, M.E.J., Rahn, K.H. (1987). Long-term antihypertensive therapy with beta - blockers : submaximal

  1. Can EGFR mutation status be reliably determined in pre-operative needle biopsies from adenocarcinomas of the lung?

    DEFF Research Database (Denmark)

    Lindahl, Kim Hein; Sørensen, Flemming Brandt; Jonstrup, Søren Peter

    2015-01-01

    The identification of EGFR mutations in non-small-cell lung cancer is important for selecting patients, who may benefit from treatment with EGFR tyrosine kinase inhibitors. The analysis is usually performed on cytological aspirates and/or histological needle biopsies, representing a small fraction......-operative biopsies (131 histological and 70 cytological) and on the surgical specimens, using PCR. Samples with low tumour cell fraction were assigned to laser micro-dissection (LMD). We found nine (4.5%) patients with EGFR mutation in the lung tumour resections, but failed to identify mutation in one...... of the corresponding pre-operative, cytological specimens. Several (18.4%) analyses of the pre-operative biopsies were inconclusive, especially in case of biopsies undergoing LMD and regarding exon 21 analysis. Discrepancy of mutation status in one patient may reflect intra-tumoural heterogeneity or technical issues...

  2. Changes in biological markers, particularly hormone receptors, due to pre-operative chemotherapy (epirubicin/docetaxel in operable breast cancer

    Directory of Open Access Journals (Sweden)

    Rumiko Tashima

    2011-12-01

    Full Text Available We investigated the correlation between biological markers prior to pre-operative chemotherapy with epirubicin and docetaxel (ET therapy and the effect of treatment as well as the clinically significant changes in biological markers before and after chemotherapy. Since April 2002, 52 patients with tumors ≥3 cm in diameter or lymph node metastases have received pre-operative ET chemotherapy. The items investigated were ER/PgR, proliferative activity (MIB-1, etc. The correlation of changes in these factors between pre- and post-treatment status and the clinical and pathological responses was investigated. Clinical response was 82%, BCS rate was 67%. Pathological response was 31.4%. The ER/PgR positive cell rate significantly decreased from 48%/32% to 37%/14%. The MIB-1 decreased from 48% to 27%. The pathological response was significantly high in patients with low ER/PgR-positive rates and those with high MIB-1 values.

  3. Blood test could predict risk of heart attack and subsequent death.

    Science.gov (United States)

    2017-01-18

    A high-sensitivity blood test, known as a troponin test, could predict the risk of heart attack and death and patients' response to statins, say researchers from the Universities of Edinburgh and Glasgow.

  4. Pre-operative use of anti-TNF-alpha agents and the risk of post-operative complications in patients with Crohn's disease--a nationwide cohort study

    DEFF Research Database (Denmark)

    Nørgård, Bente Mertz; Nielsen, J.; Qvist, N.

    2013-01-01

    BACKGROUND: A possible negative role of pre-operative use of antitumour necrosis factor-alpha (anti-TNF-alpha) agents on post-operative outcomes in Crohn's disease (CD) patients is still debated. AIM: To examine the impact of pre-operative anti-TNF-alpha agents on post-operative outcomes 30 and 6...

  5. Pre-operative use of anti-TNF-α agents and the risk of post-operative complications in patients with ulcerative colitis - a nationwide cohort study

    DEFF Research Database (Denmark)

    Nørgård, B M; Nielsen, J; Qvist, N;

    2012-01-01

    It is still controversial whether pre-operative anti-tumour necrosis factor-alpha (anti-TNF-α) agents increase post-operative complications in patients with ulcerative colitis (UC).......It is still controversial whether pre-operative anti-tumour necrosis factor-alpha (anti-TNF-α) agents increase post-operative complications in patients with ulcerative colitis (UC)....

  6. Role of routine pre-operative screening venous duplex ultrasound in morbidly obese patients undergoing bariatric surgery

    Directory of Open Access Journals (Sweden)

    P Praveen Raj

    2017-01-01

    Full Text Available Background/Aims: It is well established that obesity is a strongly associated risk factor for post-operative deep vein thrombosis (DVT. Physical effects and pro-thrombotic, pro-inflammatory and hypofibrinolytic effects of severe obesity may predispose to idiopathic DVT (pre-operatively because of which bariatric patients are routinely screened before surgery. The aim of this study was to audit the use of routine screening venous duplex ultrasound in morbidly obese patients before undergoing bariatric surgery. Methods: We retrospectively reviewed 180 patients who underwent bariatric surgery from August 2013 to August 2014 who had undergone pre-operative screening bilateral lower-extremity venous duplex ultrasound for DVT. Data were collected on patient's demographics, history of venous thromboembolism, prior surgeries and duplex ultrasound details of the status of the deep veins and superficial veins of the lower limbs. Results: No patients had symptoms or signs of DVT pre-operatively. No patient gave history of DVT. No patient was found to have iliac, femoral or popliteal vein thrombosis. Superficial venous disease was found in 17 (8%. One patient had a right lower limb venous ulcer. Conclusion: Thromboembolic problems in the morbidly obese before bariatric surgery are infrequent, and screening venous duplex ultrasound can be done in high-risk patients only.

  7. Toward an Inexpensive Test for Vitamin D Levels in Blood

    Science.gov (United States)

    2014-12-01

    chromatography-mass spectrometry (LC-MS/MS). Various synthetic redox mediators were tried and cobalt sepulchrate trichloride (Co(sep)3+/2+) was found to...25(OH)D (circulating form of vitamin D in blood) levels. 15. SUBJECT TERMS Cytochrome P450, mediated electrochemistry, direct electron chemistry...activity of the enzyme using non-natural redox mediators . This work provides a path forward for developing this enzyme into a biosensor for Vitamin D

  8. Prognostic and diagnostic value of moderate intensity stress test with blood pressure control

    Directory of Open Access Journals (Sweden)

    V. N. Marchenko

    2014-01-01

    Full Text Available In spite of age and blood pressure values at rest,hypertensive response to moderate intensity stress testingis characterized by increasing ofprobable beginning of cardiac infarction, stroke or coronary disease in 1.36 times. The hypertensive response to stress test in people with normal blood pressure values at rest (independent of other risk factors is characterized by increasing risk of future hypertension more than in 2 times. Antihypertensive drugs affect blood pressure values differently during the stress testing. The prognosis of blood pressure values during daily physical activity is necessary for antihypertensive treatment. Low availability of convenient instruments and methodological tools for continuous measurement of blood pressure (similar to Spiroarteriocardiorhythmograph, Finapres duringthe dosed physical loads constrain wide use of stress tests with controlled blood pressure in medical practice.

  9. Whole-blood hemagglutination inhibition test for venereal disease research laboratory (VDRL) antibodies.

    Science.gov (United States)

    Meyer, M P; Baughn, R E

    2000-09-01

    Nontreponemal antibody tests such as the Venereal Disease Research Laboratory (VDRL) test are carried out on serum and widely used as screening tests for syphilis. The aim of the present study was to develop a screening test for syphilis making use of whole blood and VDRL liposomes. Antibody to human red blood cells was conjugated to VDRL liposomes and reacted with a diluted sample of patient whole blood. A total of 951 samples were tested by the new test and the VDRL tube test. All 49 VDRL samples positive by the VDRL test showed inhibition of hemagglutination in the whole-blood test (sensitivity, 100%). Of 902 samples with negative results by the VDRL test, 901 caused hemagglutination when tested with the liposomes (specificity, 99.9%). The hemagglutination inhibition method tests for syphilis in a simple one-step procedure in which whole blood is added to a tube containing liposomes. The new test has potential for point-of-care testing in developing countries.

  10. Comparative study of Treponemal and non-Treponemal test for screening of blood donated at a blood center

    Directory of Open Access Journals (Sweden)

    Narinder Kaur Naidu

    2012-01-01

    Full Text Available The non-Treponemal tests such as Rapid Plasma Reagin test (RPR or the Venereal Disease Reference Laboratory test are the most commonly used test for screening of syphilis in the blood centers in India. Now, with the availability of Enzyme-linked immunosorbent assay (ELISA and Immunochromatographic assays in the market, we decided to evaluate these assays in comparison with Treponema pallidum Haemagglutination Assay (TPHA which was considered as a gold standard for this study. A total of 8 685 samples of voluntary blood donors were tested on Trepolisa 3.0 and then the initially reactive samples were retested in duplicate on the same assay as well as on Omega Pathozyme, RPR, RAPHA (Rapid Anti-Treponema pallidum Assay, and TPHA. Of the 158 initially reactive samples, 104 were repeatedly reactive on the same assay, 85 were reactive with RPR, 77 were reactive with RAPHA, 60 were reactive on Omega, and 53 were confirmed reactive on TPHA. 48 (56.4% of the results on RPR were biological false positive, while 21.9% of results were false negative on RPR. We evaluated that Omega Pathozyme was quite in agreement with TPHA as compared with Trepolisa 3.0, RAPHA, and RPR. We concluded that Omega Pathozyme (ELISA can be considered as a suitable test for screening of syphilis in a blood center.

  11. Assessment of a Standardized Pre-Operative Telephone Checklist Designed to Avoid Late Cancellation of Ambulatory Surgery: The AMBUPROG Multicenter Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Sonia Gaucher

    Full Text Available To assess the impact of a standardized pre-operative telephone checklist on the rate of late cancellations of ambulatory surgery (AMBUPROG trial.Multicenter, two-arm, parallel-group, open-label randomized controlled trial.11 university hospital ambulatory surgery units in Paris, France.Patients scheduled for ambulatory surgery and able to be reached by telephone.A 7-item checklist designed to prevent late cancellation, available in five languages and two versions (for children and adults, was administered between 7 and 3 days before the planned date of surgery, by an automated phone system or a research assistant. The control group received standard management alone.Rate of cancellation on the day of surgery or the day before.The study population comprised 3900 patients enrolled between November 2012 and September 2013: 1950 patients were randomized to the checklist arm and 1950 patients to the control arm. The checklist was administered to 68.8% of patients in the intervention arm, 1002 by the automated phone system and 340 by a research assistant. The rate of late cancellation did not differ significantly between the checklist and control arms (109 (5.6% vs. 113 (5.8%, adjusted odds ratio [95% confidence interval] = 0.91 [0.65-1.29], (p = 0.57. Checklist administration revealed that 355 patients (28.0% had not undergone tests ordered by the surgeon or anesthetist, and that 254 patients (20.0% still had questions concerning the fasting state.A standardized pre-operative telephone checklist did not avoid late cancellations of ambulatory surgery but enabled us to identify several frequent causes.ClinicalTrials.gov NCT01732159.

  12. Assessment of a Standardized Pre-Operative Telephone Checklist Designed to Avoid Late Cancellation of Ambulatory Surgery: The AMBUPROG Multicenter Randomized Controlled Trial

    Science.gov (United States)

    Marchand-Maillet, Florence; Baron, Gabriel; Douard, Richard; Béthoux, Jean-Pierre

    2016-01-01

    Objectives To assess the impact of a standardized pre-operative telephone checklist on the rate of late cancellations of ambulatory surgery (AMBUPROG trial). Design Multicenter, two-arm, parallel-group, open-label randomized controlled trial. Setting 11 university hospital ambulatory surgery units in Paris, France. Participants Patients scheduled for ambulatory surgery and able to be reached by telephone. Intervention A 7-item checklist designed to prevent late cancellation, available in five languages and two versions (for children and adults), was administered between 7 and 3 days before the planned date of surgery, by an automated phone system or a research assistant. The control group received standard management alone. Main Outcome Measures Rate of cancellation on the day of surgery or the day before. Results The study population comprised 3900 patients enrolled between November 2012 and September 2013: 1950 patients were randomized to the checklist arm and 1950 patients to the control arm. The checklist was administered to 68.8% of patients in the intervention arm, 1002 by the automated phone system and 340 by a research assistant. The rate of late cancellation did not differ significantly between the checklist and control arms (109 (5.6%) vs. 113 (5.8%), adjusted odds ratio [95% confidence interval] = 0.91 [0.65–1.29], (p = 0.57)). Checklist administration revealed that 355 patients (28.0%) had not undergone tests ordered by the surgeon or anesthetist, and that 254 patients (20.0%) still had questions concerning the fasting state. Conclusions A standardized pre-operative telephone checklist did not avoid late cancellations of ambulatory surgery but enabled us to identify several frequent causes. Trial Registration ClinicalTrials.gov NCT01732159 PMID:26829478

  13. Potential Impact of Rapid Blood Culture Testing for Gram-Positive Bacteremia in Japan with the Verigene Gram-Positive Blood Culture Test

    Science.gov (United States)

    Matsuda, Mari; Iguchi, Shigekazu; Mizutani, Tomonori; Hiramatsu, Keiichi; Tega-Ishii, Michiru; Sansaka, Kaori; Negishi, Kenta; Shimada, Kimie; Umemura, Jun; Notake, Shigeyuki; Yanagisawa, Hideji; Yabusaki, Reiko; Araoka, Hideki; Yoneyama, Akiko

    2017-01-01

    Background. Early detection of Gram-positive bacteremia and timely appropriate antimicrobial therapy are required for decreasing patient mortality. The purpose of our study was to evaluate the performance of the Verigene Gram-positive blood culture assay (BC-GP) in two special healthcare settings and determine the potential impact of rapid blood culture testing for Gram-positive bacteremia within the Japanese healthcare delivery system. Furthermore, the study included simulated blood cultures, which included a library of well-characterized methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococci (VRE) isolates reflecting different geographical regions in Japan. Methods. A total 347 BC-GP assays were performed on clinical and simulated blood cultures. BC-GP results were compared to results obtained by reference methods for genus/species identification and detection of resistance genes using molecular and MALDI-TOF MS methodologies. Results. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%). The time for identification and antimicrobial resistance detection by BC-GP was significantly shorter compared to routine testing especially at the cardiology hospital, which does not offer clinical microbiology services on weekends and holidays. Conclusion. BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing.

  14. Potential Impact of Rapid Blood Culture Testing for Gram-Positive Bacteremia in Japan with the Verigene Gram-Positive Blood Culture Test

    Directory of Open Access Journals (Sweden)

    Ken Kikuchi

    2017-01-01

    Full Text Available Background. Early detection of Gram-positive bacteremia and timely appropriate antimicrobial therapy are required for decreasing patient mortality. The purpose of our study was to evaluate the performance of the Verigene Gram-positive blood culture assay (BC-GP in two special healthcare settings and determine the potential impact of rapid blood culture testing for Gram-positive bacteremia within the Japanese healthcare delivery system. Furthermore, the study included simulated blood cultures, which included a library of well-characterized methicillin-resistant Staphylococcus aureus (MRSA and vancomycin-resistant enterococci (VRE isolates reflecting different geographical regions in Japan. Methods. A total 347 BC-GP assays were performed on clinical and simulated blood cultures. BC-GP results were compared to results obtained by reference methods for genus/species identification and detection of resistance genes using molecular and MALDI-TOF MS methodologies. Results. For identification and detection of resistance genes at two clinical sites and simulated blood cultures, overall concordance of BC-GP with reference methods was 327/347 (94%. The time for identification and antimicrobial resistance detection by BC-GP was significantly shorter compared to routine testing especially at the cardiology hospital, which does not offer clinical microbiology services on weekends and holidays. Conclusion. BC-GP generated accurate identification and detection of resistance markers compared with routine laboratory methods for Gram-positive organisms in specialized clinical settings providing more rapid results than current routine testing.

  15. The appropriateness of preoperative blood testing: A retrospective ...

    African Journals Online (AJOL)

    Canadian or European population groups. The SA population has lower ... of the attending doctor's assessment of the clinical condition of the ... Birmingham and Lambeth liver evaluation testing strategies (BALLETS):. A prospective cohort ...

  16. Nanoscale Test Strips for Multiplexed Blood Analysis Project

    Data.gov (United States)

    National Aeronautics and Space Administration — The goal of our nanoscale test strips, or nanostrips, is to provide rapid, low-cost, powerful multiplexed analyses in a diminutive form so that whole body health...

  17. 21 CFR 864.7140 - Activated whole blood clotting time tests.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Activated whole blood clotting time tests. 864.7140 Section 864.7140 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... pulmonary embolism by measuring the coagulation time of whole blood. (b) Classification. Class II...

  18. Rapid prototyping of centrifugal microfluidic modules for point of care blood testing

    CSIR Research Space (South Africa)

    Madzivhandila, Phophi

    2016-11-01

    Full Text Available We present modular centrifugal microfluidic devices that enable a series of blood tests to be performed towards a full blood count. The modular approach allows for rapid prototyping of device components in a generic format to complete different...

  19. Blood tests: One too many? Evaluating blood requesting guidance developed for acute patients admitted to trauma and orthopaedic units.

    Science.gov (United States)

    Faulkner, Alastair; Reidy, Mike; Scicluna, Gabrielle; Love, Gavin J; Joss, Judith

    2016-03-01

    In a recently published report from the Academy of Medical Royal Colleges, around 20% of clinical practice which encompasses blood science investigations is considered wasteful. Blood tests including liver function tests (LFTs), C-reactive protein (CRP), coagulation screens, and international normalising ratios (INR) are frequently requested for patients who undergo emergency hospital admission. The paucity of guidance available for blood requesting in acute trauma and orthopaedic admissions can lead to inappropriate requesting practices and over investigation. Acute admissions over a period of one month were audited retrospectively for the frequency and clinical indications of requests for LFTs, coagulation screens/INR, and CRP. The total number of blood tests requested for the duration of the patient's admission was recorded. Initial auditing of 216 admissions in January 2014 demonstrated a striking amount of over-investigation. Clinical guidelines were developed with multidisciplinary expert input and implemented within the department. Re-audit of 233 admissions was carried out in September 2014. Total no. of LFTs requested: January 895, September 336 (-62.5%); coagulation screens/INR requested: January 307, September 210 (-31.6%); CRPs requested: January 894, September 317 (-64.5%). No. of blood requests per patient: January (M=4.81, SD 4.75), September (M=3.60, SD=4.70). Approximate combined total cost of LFT, coagulation/INR, CRP in January £2674.14 and September £1236.19 (-£1437.95, -53.77%). A large decrease was observed in admission requesting and subsequent monitoring (p<0.01) following the implementation. This both significantly reduced cost and venepuncture rates.

  20. Non-invasive prenatal paternity testing from maternal blood.

    Science.gov (United States)

    Wagner, Jasenka; Dzijan, Snjezana; Marjanović, Damir; Lauc, Gordan

    2009-01-01

    Prenatal paternity analysis can be performed only after invasive sampling of chorionic villi or amnionic fluid. Aiming to enable noninvasive paternity testing, we attempted to amplify fetal alleles from maternal plasma. Cell-free DNA was isolated from plasma of 20 pregnant women and amplified with ampFLSTR Identifiler and ampFLSTR Yfiler kits. Unfortunately, autosomal fetal alleles were heavily suppressed by maternal DNA, and the only locus that was reliably amplified with AmpFLSTR Identifiler kit was amelogenin, which revealed only fetal gender. Much better success was obtained with AmpFLSTR Yfiler kit, which, in the case of male fetuses, successfully amplified between six and 16 fetal loci. All amplified fetal alleles matched the alleles of their putative fathers, confirming the tested paternity. To the best of our knowledge, this is a first report of noninvasive prenatal paternity testing.

  1. Impact of a confirmatory RhD test on the correct serologic typing of blood donors

    Directory of Open Access Journals (Sweden)

    Luciana Cayres Schmidt

    2015-10-01

    Full Text Available BACKGROUND: The RHD gene is highly polymorphic, which results in a large number of RhD variant phenotypes. Discrepancies in RhD typing are still a problem in blood banks and increase the risk of alloimmunization. In this study, the RhD typing strategy at a blood bank in Brazil was evaluated.METHODS: One-hundred and fifty-two samples typed as RhD negative and C or E positive by routine tests (automated system and indirect antiglobulin test using the tube technique were reevaluated for RhD status by three methods. The method with the best performance was implemented and evaluated for a period of one year (n = 4897 samples. Samples that were D positive exclusively in the confirmatory test were submitted to molecular analysis.RESULTS: The gel test for indirect antiglobulin testing with anti-D immunoglobulin G (clone ESD1 presented the best results. Seventy samples (1.43% previously typed as RhD negative showed reactivity in the gel test for indirect antiglobulin testing and were reclassified as D positive. D variants that may cause alloimmunization, such as weak D type 2 and partial DVI, were detected.CONCLUSION: The confirmatory RhD test using the gel test for indirect antiglobulin testing represents a breakthrough in transfusion safety in this blood center. Our results emphasize the importance of assessing the blood group typing strategy in blood banks.

  2. Pre-operative flexion contracture determines the functional outcome of haemophilic arthropathy treated with total knee arthroplasty.

    Science.gov (United States)

    Atilla, B; Caglar, O; Pekmezci, M; Buyukasik, Y; Tokgozoglu, A M; Alpaslan, M

    2012-05-01

    End-stage haemophiliac arthropathy can be successfully treated with total knee arthroplasty. However, the functional results may not be as good as anticipated and certain pre-op knee characteristics may alter the functional results. The purpose of this study was to evaluate the functional outcome of TKA in haemophilic patients with specific attention to final range of motion and residual flexion contracture of the joint. Twenty-one consecutive patients were retrospectively reviewed. The average age was 34 years with an average follow-up of 5.7 years. Functional status was evaluated with Hospital for Special Surgery Knee Score. Receiving Operating Characteristics analysis was used to determine the threshold of pre-operative flexion contracture degree to avoid residual knee contracture. The range of motion was increased in 16 joints and unchanged in three joints and decreased in the remaining two. Preoperative average range of motion was 37.6°, improved to 57.1° post-operatively. The average knee score increased from 27.85 (15-30) points pre-operatively to 79.42 (12-94) points at the last follow-up. The degree of pre-operative flexion contracture was found to be a good predictor for residual flexion contracture. (Specificity: 85.7%, sensitivity: 100%, cut-off: 27.5°). Total knee replacement improves the quality of life in patients with advanced haemophilic arthropathy. Statistical analysis revealed that pre-op flexion contracture of 27.5° is an important threshold. Patients should be operated before that stage to gain maximum benefit with minimal gait abnormalities. © 2011 Blackwell Publishing Ltd.

  3. [Impact of pre-operative uric acid on acute kidney injury after cardiac surgery in elderly patients].

    Science.gov (United States)

    Xu, Jiaqi; Chen, Yuanhan; Liang, Xinling; Hu, Penghua; Cai, Lu; An, Shengli; Li, Zhilian; Shi, Wei

    2014-11-01

    To investigate the impact of pre-operative uric acid on acute kidney injury (AKI) after cardiac surgery in elderly patients. Clinical data were collected from 936 elderly patients (age ≥ 60 years) undergoing cardiac surgery with cardiopulmonary bypass in Guangdong General Hospital between January 2005 and May 2011. The baseline serum creatinine was defined as the latest serum creatinine before surgery, and AKI was diagnosed according to RIFLE criteria. Patients were divided into three groups according to the sex-specific cutoff values of serum uric acid tertiles (group A: ≤ 384.65 µmol/L in men, and ≤ 354.00 µmol/L in women; group B:384.66-476.99 µmol/L in men and 354.01-437.96 µmol/L in women; group C: ≥ 477.00 µmol/L in men and ≥ 437.97 µmol/L in women). Multivariate logistic regression analysis was used to analyze the independent risk factors for AKI. Among 936 elderly patients, 576 cases (61.5%) developed AKI. Mean uric acid concentration was higher in AKI patients than in Non-AKI patients ( (436.6 ± 119.1) µmol/L vs. (398.0 ± 107.2) µmol/L, P cardiac surgery, eGFRsurgery, cardiopulmonary bypass operation time, aortic cross-clamping time, pre-operative angiotensin converting enzyme inhibitor or angiotensin II receptor blockers and lipid-lowering drugs use, early postoperative angiotensin converting enzyme inhibitor or angiotensin II receptor blockers, diuretics and digoxin use, post-operation central venous pressure, risk of post operative AKI was significantly higher in group C than in group A (OR:1.897, 95%CI: 1.270-2.833, P = 0.002). Pre-operative elevated uric acid is an independent risk factor of AKI after cardiac surgery in elderly patients.

  4. Blood

    Science.gov (United States)

    ... Also, blood is either Rh-positive or Rh-negative. So if you have type A blood, it's either A positive or A negative. Which type you are is important if you need a blood transfusion. And your Rh factor could be important ...

  5. The prognostic value of pre-operative predicted forced vital capacity in corrective spinal surgery for Duchenne's muscular dystrophy.

    Science.gov (United States)

    Harper, C M; Ambler, G; Edge, G

    2004-12-01

    The majority of patients with Duchenne's muscular dystrophy require corrective spinal surgery for scoliosis to maintain seated balance and to slow the progression of respiratory compromise, thereby facilitating nursing and enhancing their quality of life. Traditionally patients with a pre-operative forced vital capacity (PFVC) of 30% or below predicted have been denied this surgery as it was thought that the incidence of postoperative complications was unacceptably high. We present data collected prospectively from 45 consecutive operations undertaken in our unit. These cases indicate that there is no clinically significant difference in operative and postoperative outcomes between patients with PFVC > 30% and vital.

  6. Viscoelastic behaviour of human blood and polyacrylamide model fluids for heart valve testing

    Science.gov (United States)

    Lerche, Dietmar; Vlastos, Georgios; Koch, Brigitte; Pohl, Manfred; Affeld, Klaus

    1993-06-01

    New heart valves and other cardiovascular assist systems have to be tested for hydrodynamic performance. In place of human blood simple model fluids like glycerol solutions are employed often due to ethical and practical reasons. But blood exhibits complex non-Newtonian and viscoelastic behaviour. Rheological blood properties are reviewed based on literature and own experimental results. Furthermore we studied polymer solutions with respect to blood-like flow behaviour. Rheology was assessed by means of the low shear rotational viscometer (LS 40, Mettler-Toledo, Switzerland) under stationary and dynamic shear conditions (variation of frequency and angular displacement).

  7. Screening for Saponins Using the Blood Hemolysis Test. An Undergraduate Laboratory Experiment.

    Science.gov (United States)

    Sotheeswaran, Subramaniam

    1988-01-01

    Describes an experiment for undergraduate chemistry laboratories involving a chemical found in plants and some sea animals. Discusses collection and identification of material, a hemolysis test, preparation of blood-coated agar plates, and application of samples. (CW)

  8. Value of routine blood tests for prediction of mortality risk in hip fracture patients

    DEFF Research Database (Denmark)

    Mosfeldt, Mathias; Pedersen, Ole B; Riis, Troels

    2012-01-01

    There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission.......There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission....

  9. The ethics of blood testing as an element of doping control in sport.

    Science.gov (United States)

    Browne, A; Lachance, V; Pipe, A

    1999-04-01

    Sport authorities continue to confront a variety of perplexing issues as they attempt to address effectively and efficiently the problems posed by doping. The emergence of the phenomena of blood doping and the administration of erythropoietin have added to the challenges faced by doping control authorities. Some sport organizations have introduced blood tests in an attempt to deal with these issues despite the absence of any effective test for the detection of the administration of homologous blood products or eythropoietin. A number of ethical issues are raised by such developments. Even in the presence of an effective test it is suggested that the decision to implement a specific testing approach can be reached by considering the wishes of a hypothetical "Fair Competitor" and an analysis of the costs involved. In this respect the Fair Competitor assumes in the sport community the role that the "reasonable person" occupies in law, permitting an analysis of a proposed course of action. In making any decision regarding the implementation of any test, a Fair Competitor would be guided by considerations of the postulated advantage and incidence of a doping technique, the likelihood of false positive and negative results, the risk of unwanted consequences of a testing process, and a concern that a specific test not accelerate the likelihood of the use of other doping methods. This approach is applied to a consideration of the appropriateness of blood testing in sport. It is concluded, using such an analysis, that in their present state of development, blood tests should not be implemented. It is recognized that certain sport authorities currently use blood tests to exclude competitors whose blood values exceed certain predetermined levels on the grounds of concerns regarding health and safety. Screening of this kind is beyond the purview of this discussion.

  10. Evaluation and Improved Use of Fecal Occult Blood Test in the Constipated Child.

    Science.gov (United States)

    Kilway, Denise M

    2016-01-01

    This quality improvement project examined the use of fecal occult blood test in the constipated child in a pediatric gastroenterology outpatient clinic. A retrospective chart review was completed on 100 children seen for an initial visit with the gastroenterology provider. The number of fecal occult blood tests performed and the child's coinciding symptoms were tallied and compared with the North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations. An educational intervention was held with the pediatric gastroenterology providers consisting of a PowerPoint presentation summarizing aims of the quality improvement project and reviewing recommendations for use of fecal occult blood test in the constipated child. Pre- and post-intervention chart review data sets were compared. Results showed a 19.6% decrease in the use of fecal occult blood tests performed during the post-intervention timeframe. However, when used in conjunction with North American Society of Pediatric Gastroenterology, Hepatology, and Nutrition recommendations, the appropriateness of fecal occult blood test use increased by 71.4% in the post-intervention patients. Reviewing the recommendations with gastroenterology providers assisted in optimizing the meaningful use of fecal occult blood test, improving quality and safety of care for children seen in the pediatric gastroenterology outpatient clinic.

  11. Application of quantitative ethanol detector (QED) test kit to measure ethanol concentration in blood samples.

    Science.gov (United States)

    Biwasaka, H; Tokuta, T; Sasaki, Y; Niitsu, H; Kumagai, R; Aoki, Y

    2001-12-27

    In this paper, the applicability of the quantitative ethanol detector (QED) test kit for screening of ethanol concentrations in blood samples was investigated. The pretreatment of blood using the sulfosalicylic acid solution and the three-way stopcock followed by membrane filtration gave satisfactory results. The ethanol concentrations in whole blood samples (n=61) determined by QED correlated well with those determined by gas chromatography; the correlation coefficient indicated 0.990. Because a high correlation coefficient (0.928) was also confirmed in trial by investigators, QED test should be highly considered for ethanol screening in forensic praxis.

  12. Comparison of PCR, Wright agglutination test and blood culture for diagnosis of brucellosis in suspected patients.

    Science.gov (United States)

    Hekmatimoghaddam, Seyedhosssein; Sadeh, Maryam; Khalili, Mohammad Bagher; Mollaabedin, Mansour; Sazmand, Alireza

    2013-11-15

    Brucellosis has long been prevalent in Iran, with considerable medical and economic importance. Timely diagnosis is needed for early management and effective prevention of its consequences in human beings and animals. Current diagnostic methods impose peculiar challenges in terms of analytical method performance. This study compares diagnostic sensitivity, specificity, predictive Value of Positive (PVP) and Predictive Value of Negative (PVN) for Polymerase Chain Reaction (PCR), Wright agglutination test and blood culture used for patients suspected of brucellosis. In 120 patients clinically suspected of brucellosis and referred by physicians to the Yazd central Medical Laboratory, some relevant demographic, occupational, nutritional and clinical data were collected. Also, venous blood samples were drawn for diagnosis of brucellosis using PCR, Wright agglutination test and blood culture techniques. The most frequent symptom of patients was arthralgia (82 cases, 68.3%). PCR was positive in 25 cases (20.8%), wright test in 21 patients (17.5%) and blood culture in 6 cases (5%). In 20 out of 21 wright-positive cases, PCR was positive and all of the culture-positive patients had positive PCR. Sensitivity, specificity, PVP and PVN of blood culture compared to PCR (as the gold standard test) were 24, 100, 100 and 86%, respectively, but the above parameters when PCR is compared with blood culture (as gold standard) were 100, 83, 24 and 95%, respectively. PCR has better analytical performances than blood culture for diagnosis of brucellosis and is suitable for confirmation of Wright-positive cases.

  13. [Perioperative salvage and use of autologous blood].

    Science.gov (United States)

    Larsen, B; Dich-Nielsen, J O

    1999-01-18

    Pre-operative blood donation gives ready availability of large volumes of patient compatible blood, up to four units and five when erythropoietin is used. It is recommended that autologous pre-donated blood is leucocyte depleted immediately after the donation. During normovolaemic haemodilution it is mandatory to monitor haemodynamics during the donation. Usually 1-2 units are removed pre-operatively and returned during or after the operation. Intra and postoperative salvage and recycling is performed either with washing and haemoconcentration of the blood or with salvage and immediate retransfusion. When salvaged blood is retransfused unwashed there are high levels of free haemoglobin, degradation products of fibrin/fibrinogen, interleukin-6 and activated complement. Clinically, this has not been shown to be of importance. Taking the patient's health status into account, we suggest that a level of B-haemoglobin should be determined pre-operatively to indicate use of transfusions both with autologous and allogeneic blood.

  14. Development of BIM Execution Plan for BIM Model Management during the Pre-Operation Phase: A Case Study

    Directory of Open Access Journals (Sweden)

    Yu-Cheng Lin

    2016-02-01

    Full Text Available Building information modeling (BIM technologies use precise geometry and relevant data to enhance and improve the maintenance performance of facilities integrated with 3D object-oriented computer aided design (CAD. Although most owners agree on the potential benefits of integrating BIM technologies with facility management (FM, they must overcome many problems to plan and develop effective BIM execution plans for FM implementation. This study proposes and develops a BIM execution plan for BIM model management for FM during the pre-operation phase. Through the application of the proposed BIM execution plan, BIM can be effectively implemented during the operation and maintenance phases. In order to verify the proposed methodology and demonstrate its effectiveness in practice, the BIM execution plan is then applied in a selected case study of a building project in Taiwan. The combined results demonstrate that the proposed BIM execution plan is an effective approach for operation and maintenance management. The advantage of the proposed BIM execution plan lies not only in improving the efficiency of maintenance management work when integrated with BIM technologies, but also in maximizing the value and benefits of BIM to support maintenance management. Finally, limitations, difficulties, and suggestions are summarized for further development of the BIM execution plan for BIM model management during the pre-operation phase.

  15. Quantification of respiratory depression during pre-operative administration of midazolam using a non-invasive respiratory volume monitor

    Science.gov (United States)

    Gonzalez Castro, Luis N.; Mehta, Jaideep H.; Brayanov, Jordan B.; Mullen, Gary J.

    2017-01-01

    Background Pre-operative administration of benzodiazepines can cause hypoventilation—a decrease in minute ventilation (MV)—commonly referred to as “respiratory compromise or respiratory depression.” Respiratory depression can lead to hypercarbia and / or hypoxemia, and may heighten the risk of other respiratory complications. Current anesthesia practice often places patients at risk for respiratory complications even before surgery, as respiratory monitoring is generally postponed until the patient is in the operating room. In the present study we examined and quantified the onset of respiratory depression following the administration of a single dose of midazolam in pre-operative patients, using a non-invasive respiratory volume monitor that reports MV, tidal volume (TV), and respiratory rate (RR). Methods Impedance-based Respiratory Volume Monitor (RVM) data were collected and analyzed from 30 patients prior to undergoing orthopedic or general surgical procedures. All patients received 2.0 mg of midazolam intravenously at least 20 minutes prior to the induction of anesthesia and the effects of midazolam on the patient's respiratory function were analyzed. Results Within 15 minutes of midazolam administration, we noted a significant decrease in both MV (average decrease of 14.3% ± 5.9%, pbenzodiazepines affect primarily TV rather than RR. Such respiratory monitoring data provide the opportunity for individualizing dosing and adjustment of clinical interventions, especially important in elderly patients. With additional respiratory data, clinicians may be able to better identify and quantify respiratory depression, reduce adverse effects, and improve overall patient safety. PMID:28235069

  16. Pre-operative urinary tract infection: is it a risk factor for early surgical site infection with hip fracture surgery? A retrospective analysis.

    Science.gov (United States)

    Yassa, Rafik Rd; Khalfaoui, Mahdi Y; Veravalli, Karunakar; Evans, D Alun

    2017-03-01

    The aims of the current study were to determine whether pre-operative urinary tract infections in patients presenting acutely with neck of femur fractures resulted in a delay to surgery and whether such patients were at increased risk of developing post-operative surgical site infections. A retrospective review of all patients presenting with a neck of femur fracture, at a single centre over a one-year period. The hospital hip fracture database was used as the main source of data. UK University Teaching Hospital. All patients (n = 460) presenting across a single year study period with a confirmed hip fracture. The presence of pre-operative urinary tract infection, the timing of surgical intervention, the occurrence of post-operative surgical site infection and the pathogens identified. A total of 367 patients were operated upon within 24 hours of admission. Urinary infections were the least common cause of delay. A total of 99 patients (21.5%) had pre-operative urinary tract infection. Post-operatively, a total of 57 (12.4%) patients developed a surgical site infection. Among the latter, 31 (54.4%) did not have a pre-operative urinary infection, 23 (40.4%) patients had a pre-operative urinary tract infection, 2 had chronic leg ulcers and one patient had a pre-operative chest infection. Statistically, there was a strong relationship between pre-operative urinary tract infection and the development of post-operative surgical site infection (p-value: 0.0005). The results of our study indicate that pre-operative urinary tract infection has a high prevalence amongst those presenting with neck of femur fractures, and this is a risk factor for the later development of post-operative surgical site infection.

  17. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma

    OpenAIRE

    Cheng-Chi Lee; Chung-Ming Chen; Shih-Tseng Lee; Kuo-Chen Wei; Ping-Ching Pai; Cheng-Hong Toh; Chi-Cheng Chuang

    2015-01-01

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective...

  18. Comparison of Result Times Between Urine and Whole Blood Point-of-care Pregnancy Testing.

    Science.gov (United States)

    Gottlieb, Michael; Wnek, Kristopher; Moskoff, Jordan; Christian, Errick; Bailitz, John

    2016-07-01

    Point-of-care (POC) pregnancy testing is commonly performed in the emergency department (ED). One prior study demonstrated equivalent accuracy between urine and whole blood for one common brand of POC pregnancy testing. Our study sought to determine the difference in result times when comparing whole blood versus urine for the same brand of POC pregnancy testing. We conducted a prospective, observational study at an urban, academic, tertiary care hospital comparing the turnaround time between order and result for urine and whole blood pregnancy tests collected according to standard protocol without intervention from the investigators. After the blood was collected, the nurse would place three drops onto a Beckman Coulter ICON 25 Rapid HCG bedside pregnancy test and set a timer for 10 minutes. At the end of the 10 minutes, the result and time were recorded on an encoded data sheet and not used clinically. The same make and model analyzer was also used for urine tests in the lab located within the ED. The primary outcome was the difference in mean turnaround time between whole blood in the ED and urine testing in the adjacent lab results. Concordance between samples was assessed as a secondary outcome. 265 total patients were included in the study. The use of whole blood resulted in a mean time savings of 21 minutes (95% CI 16-25 minutes) when compared with urine (presults, with one false negative urine specimen with a quantitative HCG level of 81 mIU/L. Our results suggest that the use of whole blood in place of urine for bedside pregnancy testing may reduce the total result turnaround time without significant changes in accuracy in this single-center study.

  19. Validation of four Helicobacter pylori rapid blood tests in a multi-ethnic Asian population

    Institute of Scientific and Technical Information of China (English)

    Lee-Guan Lim; Khay-Guan Yeoh; Bow Ho; Seng-Gee Lim

    2005-01-01

    AIM: To validate the accuracy of four rapid blood tests in the diagnosis of Helicobacter pylori.METHODS: Consecutive dyspeptic patients scheduled for endoscopy at the National University Hospital,Singapore, were interviewed and had blood drawn for serology. The first 109 patients were tested with BM-test (BM), Pyloriset Screen (PS) and QuickVue (QV), and the next 99 subjects were tested with PS and Unigold (UG).Endoscopies were performed blinded to rapid blood test results and biopsies were taken for culture and rapid urease test. Urea breath tests were performed after endoscopies. The rapid blood test results were compared with four reference tests (rapid urease test, culture,serology, and breath test).RESULTS: The study population composed of 208patients (mean age 43.1 years; range 18-73 years; 119males; 174 Chinese). The number of evaluable patientsfor BM, QV, UG and PS were 102, 102, 95, and 197,respectively. The sensitivity and specificity, respectively were: PS 80.2%, 95.8%; UG 55.9%, 100%; QV 43.3%,100%; BM 67.2%, 97.1%.CONCLUSION: The rapid blood test kits showed high specificity and positive predictive value (97-100%), while sensitivity and negative predictive value ranged widely (43%-80% and 47%-73%, respectively). Among test kits, PS showed the best sensitivity (80%), best negative predictive value (73%) and best negative likelihood ratio (0.207). PS had a specificity of 96%, positive predictive value of 97% and positive likelihood ratio of 19.1.

  20. Fabrication and testing of novel blood separation devices based on microchannel bend structures

    Science.gov (United States)

    Blattert, C.; Jurischka, R.; Schoth, A.; Kerth, P.; Menz, W.

    2005-02-01

    Most clinical chemistry tests are performed on cell-free serum or plasma. Therefore micro assay devices for blood tests require integrated on-chip microfluidics for separation of plasma or serum from blood. Polymers are ideally suited for these applications due to their material properties and their applicability for high volume production. These requirements are achieved by a new on-chip blood separation technique based on microchannel bend structures and a rapid processing technology for micro assay devices using injection molding or hot embossing. Different prototype polymer chips with channel dimensions down to 20 μm and aspect ratios of 4 have been fabricated by injection molding and hot embossing. The inserts for the molding tools were fabricated by an UV-LIGA technology. The separation efficiency of these chips has been tested with human blood samples. The results show different separation efficiencies up to 100 % for blood cells and plasma depending on microchannel geometry as well as cell concentration. As compared to present microfluidic devices for the separation of blood cells like filters, membranes or filtration by diffusion the microchannel bend is an integrated on-chip blood separation method. It combines the advantages of rapid separation times and a simple geometry that leads to cost-effective high volume production using injection molding.

  1. [Results of Training for Personnel Involved in Blood-Transfusion Testing Outside of Regular Work Hours at Saga University Hospital].

    Science.gov (United States)

    Yamada, Marie; Yamada, Naotomo; Higashitani, Takanori; Ohta, Shoichiro; Sueoka, Eisaburo

    2015-11-01

    Laboratory testing prior to blood transfusion outside of regular hours in many hospitals and clinics is frequently conducted by technicians without sufficient experience in such testing work. To obtain consistent test results regardless of the degree of laboratory experience with blood transfusion testing, the number of facilities introducing automated equipment for testing prior to blood transfusion is increasing. Our hospital's blood transfusion department introduced fully automated test equipment in October of 2010 for use when blood transfusions are conducted outside of regular hours. However, excessive dependence on automated testing can lead to an inability to do manual blood typing or cross-match testing when necessitated by breakdowns in the automated test equipment, in the case of abnormal specimen reactions, or other such case. In addition, even outside of normal working hours there are more than a few instances in which transfusion must take place based on urgent communications from clinical staff, with the need for prompt and flexible timing of blood transfusion test and delivery of blood products. To address this situation, in 2010 we began training after-hours laboratory personnel in blood transfusion testing to provide practice using test tubes manually and to achieve greater understanding of blood transfusion test work (especially in cases of critical blood loss). Results of the training and difficulties in its implementation for such after-hours laboratory personnel at our hospital are presented and discussed in this paper. [Original

  2. The status of failure and reliability testing of artificial blood pumps.

    Science.gov (United States)

    Patel, Sonna M; Throckmorton, Amy L; Untaroiu, Alexandrina; Allaire, Paul E; Wood, Houston G; Olsen, Don B

    2005-01-01

    Artificial blood pumps are today's most promising bridge-to-transplant, bridge-to-recovery, and destination therapy solutions for patients with congestive heart failure. There is a critical need for increased reliability and safety as the next generation of artificial blood pumps approach final development for long-term destination therapy. To date, extensive failure and reliability studies of these devices are considered intellectual property and thus remain unpublished. Presently, the Novacor N100PC, Thoratec VAD, and HeartMate LVAS (IP and XVE) comprise the only four artificial blood pumps commercially available for the treatment of congestive heart failure in the United States. The CardioWest TAH recently received premarket approval from the US Food and Drug Administration. With investigational device exemptions, the AB-180, AbioCor, LionHeart, DeBakey, and Flowmaker are approved for clinical testing. Other blood pumps, such as the American BioMed-Baylor TAH, CorAide, Cleveland Clinic-Nimbus TAH, HeartMate III, Hemadyne, and MagScrew TAH are currently in various stages of mock loop and animal testing, as indicated in published literature. This article extensively reviews in vitro testing, in vivo testing, and the early clinical testing of artificial blood pumps in the United States, as it relates to failure and reliability. This detailed literature review has not been published before and provides a thorough documentation of available data and testing procedures regarding failure and reliability of these various pumps.

  3. A comparison of the presumptive luminol test for blood with four non-chemiluminescent forensic techniques.

    Science.gov (United States)

    Webb, Joanne L; Creamer, Jonathan I; Quickenden, Terence I

    2006-01-01

    Presumptive blood detection tests are used by forensic investigators to detect trace amounts of blood or to investigate suspicious stains. Through the years, a number of articles have been published on the popular techniques of the day. However, there is no single paper that critiques and compares the five most common presumptive blood detection tests currently in use: luminol, phenolphthalein (Kastle-Meyer), leucomalachite green, Hemastix and the forensic light source. The present authors aimed to compare the above techniques with regard to their sensitivity, ease of use and safety. The luminol test was determined to be the most sensitive of the techniques, while Hemastix is a suitable alternative when the luminol test is not appropriate.

  4. A sample-to-result system for blood coagulation tests on a microfluidic disk analyzer.

    Science.gov (United States)

    Lin, Chia-Hui; Liu, Cheng-Yuan; Shih, Chih-Hsin; Lu, Chien-Hsing

    2014-09-01

    In this report, we describe in detail a microfluidic analyzer, which is able to conduct blood coagulation tests using whole blood samples. Sample preparation steps, such as whole blood aliquoting and metering, plasma separation, decanting, and mixing with reagents were performed in sequence through microfluidic functions integrated on a disk. Both prothrombin time (PT) and activated partial thromboplastin time (aPTT) were carried out on the same platform and the test results can be reported in 5 min. Fifty clinical samples were tested for both PT and aPTT utilizing the microfluidic disk analyzer and the instrument used in hospitals. The test results showed good correlation and agreement between the two instruments.

  5. Noninvasive cerebral blood oxygenation monitoring: clinical test of multiwavelength optoacoustic system

    Science.gov (United States)

    Petrov, Y. Y.; Prough, D. S.; Petrova, I.; Patrikeev, I. A.; Cicenaite, I.; Esenaliev, R. O.

    2007-02-01

    Continuous monitoring of cerebral blood oxygenation is critically important for treatment of patients with life-threatening conditions like severe brain injury or during cardiac surgery. We designed and built a novel multiwavelength optoacoustic system for noninvasive, continuous, and accurate monitoring of cerebral blood oxygenation. We use an Optical Parametric Oscillator as a light source. We successfully tested the system in vitro as well as in vivo in large animals (sheep) through thick tissues overlying blood vessels which drain venous blood out of the brain (e.g., superior sagittal sinus or jugular vein). Here we present the results of clinical tests of the system for continuous noninvasive cerebral blood oxygenation monitoring in the internal jugular vein of healthy volunteers. We applied our custom-built optoacoustic probe (which incorporated a wide-band acoustic transducer and an optical fiber) to the neck area overlying the internal jugular vein. We performed measurements with volunteers at 18 wavelengths in the near-infrared spectral range. Despite a thick layer of overlying connective tissue and low energy used in the experiments, we recorded signals with high signal-to-noise ratios for all volunteers. We found that the temporal (independent of signal amplitude) parameters of recorded profiles for different levels of blood oxygenation correlated well with the spectrum of effective attenuation coefficients of blood.

  6. Blood splash in lambs-a preliminary study using the one-stage prothrombin time test.

    Science.gov (United States)

    Restall, D J

    1981-02-01

    Lambs from a flock in which a high incidence of blood splash had been detected were examined using the one-stage prothrombin test. For comparison lambs from a commercial slaughter line were also examined. All the affected lambs and 35·4% from the slaughter line had extended prothrombin times, and a relationship between extended prothrombin times and the occurrence of blood splash was established. Investigation of the pastures grazed by the affected flock showed the presence of coumarin producing plants and grasses. Some coumarin drugs prolong one-stage prothrombin times, and more importantly, induce capillary fragility, thus predisposing animals to blood splash.

  7. Application of Nexfin noninvasive beat-to-beat arterial blood pressure monitoring in autonomic function testing.

    Science.gov (United States)

    Sipkens, Laura M; Treskes, Kaij; Ariese-Beldman, Karin; Veerman, Derk P; Boer, Christa

    2011-10-01

    Evaluation of autonomic function responses is increasingly important for risk prediction and hemodynamic evaluation in the ambulant and perioperative setting, but requires a noninvasive arterial blood pressure measurement device. This study describes whether a novel noninvasive beat-to-beat arterial blood pressure measurement device (Nexfin HD) is able to reproducibly reflect autonomic function responses in healthy volunteers. Noninvasive beat-to-beat arterial blood pressure measurements (Nexfin HD) were performed in 20 healthy men of 22 ± 3 years. Measurements were performed during supine steady state, controlled breathing (0.125 Hz), passive leg raising, a controlled Valsalva maneuver, and a quick stand test. Finally, relative changes in pulse pressure during autonomic function testing and the test-retest reproducibility were determined. Autonomic function tests induced beat-to-beat arterial blood pressure changes that were accurately monitored by the Nexfin device. The intraclass correlation coefficients for systolic and diastolic arterial blood pressure measurements during supine steady state were agreeable [0.91 (0.82-0.96) and 0.84 (0.69-0.93), respectively]. The reproducibility of blood pressure changes during controlled breathing, passive leg raising, and Valsalva maneuver averaged 0.92 (0.82-0.96), 0.76 (0.50-0.90), and 0.94 (0.89-0.97), respectively. The reproducibility of the pulse pressure variation (PPV) as calculated from controlled breathing-induced changes in the arterial blood pressure (13 ± 5%) was high [0.96 (0.93-0.98)]. This study shows that noninvasive beat-to-beat Nexfin HD arterial blood pressure measurements reproducibly reflect autonomic function responses in healthy volunteers.

  8. An assessment of various blood collection and transfer methods used for malaria rapid diagnostic tests

    Directory of Open Access Journals (Sweden)

    Baik Fred

    2007-11-01

    Full Text Available Abstract Background Four blood collection and transfer devices commonly used for malaria rapid diagnostic tests (RDTs were assessed for their consistency, accuracy and ease of use in the hands of laboratory technicians and village health workers. Methods Laboratory technicians and village health workers collected blood from a finger prick using each device in random order, and deposited the blood either on filter paper or into a suitable casette-type RDT. Consistency and accuracy of volume delivered was determined by comparing the measurements of the resulting blood spots/heights with the measurements of laboratory-prepared pipetted standard volumes. The effect of varying blood volumes on RDT sensitivity and ease of use was also observed. Results There was high variability in blood volume collected by the devices, with the straw and the loop, the most preferred devices, usually transferring volumes greater than intended, while the glass capillary tube and the plastic pipette transferring less volume than intended or none at all. Varying the blood volume delivered to RDTs indicated that this variation is critical to RDT sensitivity only when the transferred volume is very low. Conclusion None of the blood transfer devices assessed performed consistently well. Adequate training on their use is clearly necessary, with more development efforts for improved designs to be used by remote health workers, in mind.

  9. Clinical and pathological response to pre-operative crizotinib in a patient with ALK-translocated NSCLC

    Directory of Open Access Journals (Sweden)

    Catania C

    2016-11-01

    Full Text Available A 65-year-old non-smoker female was diagnosed with lung adenocarcinoma clinically staged as IV M1a because of bilateral pulmonary lesions. After a differential response to chemotherapy, further analyses allowed us to re-stage the tumor as a synchronous bilateral local disease with unilateral ALK (Anaplastic lymphoma kinase rearrangement. Combined treatment with chemotherapy, crizotinib and surgery, with clinical and pathological tumor-response to pre-operative crizotinib, obtained complete tumors remission, and the patient is still disease free after 11 months since the last tumor resection. As far as we know this is the first report of a clinical and pathological regression of an early-stage ALK-rearranged NSCLC treated with neo-adjuvant crizotinib. This report supports further studies to assess activity and efficacy of ALK–inhibitors in neoadjuvant setting.

  10. Quantification of respiratory depression during pre-operative administration of midazolam using a non-invasive respiratory volume monitor.

    Science.gov (United States)

    Gonzalez Castro, Luis N; Mehta, Jaideep H; Brayanov, Jordan B; Mullen, Gary J

    2017-01-01

    Pre-operative administration of benzodiazepines can cause hypoventilation-a decrease in minute ventilation (MV)-commonly referred to as "respiratory compromise or respiratory depression." Respiratory depression can lead to hypercarbia and / or hypoxemia, and may heighten the risk of other respiratory complications. Current anesthesia practice often places patients at risk for respiratory complications even before surgery, as respiratory monitoring is generally postponed until the patient is in the operating room. In the present study we examined and quantified the onset of respiratory depression following the administration of a single dose of midazolam in pre-operative patients, using a non-invasive respiratory volume monitor that reports MV, tidal volume (TV), and respiratory rate (RR). Impedance-based Respiratory Volume Monitor (RVM) data were collected and analyzed from 30 patients prior to undergoing orthopedic or general surgical procedures. All patients received 2.0 mg of midazolam intravenously at least 20 minutes prior to the induction of anesthesia and the effects of midazolam on the patient's respiratory function were analyzed. Within 15 minutes of midazolam administration, we noted a significant decrease in both MV (average decrease of 14.3% ± 5.9%, pmidazolam administration on clinically significant respiratory parameters (MV, TV and RR) using a non-invasive RVM, uncovering that the respiratory depressive effect of benzodiazepines affect primarily TV rather than RR. Such respiratory monitoring data provide the opportunity for individualizing dosing and adjustment of clinical interventions, especially important in elderly patients. With additional respiratory data, clinicians may be able to better identify and quantify respiratory depression, reduce adverse effects, and improve overall patient safety.

  11. Pre-operative sequential chemo- and radiochemotherapy in locally advanced carcinomas of the lower oesophagus and gastro-oesophageal junction

    Energy Technology Data Exchange (ETDEWEB)

    Wilke, H.; Mueller, C. [Department of Internal Medicine (Cancer Research), Essen University Medical School, D-45 122 Essen (Germany); Walz, M.K. [Department of General Surgery, Essen University Medical School, D-45 122 Essen (Germany); Stuschke, M. [Department of Radiotherapy, Essen University Medical School, D-45 122 Essen (Germany); Vanhoefer, U.; Stahl, M. [Department of Internal Medicine (Cancer Research), Essen University Medical School, D-45 122 Essen (Germany)

    1998-04-01

    The purpose of this trial was to examine the feasibility of intensive, sequential chemo- and radiochemotherapy followed by surgery in patients with locally advanced carcinomas of the lower oesophagus and the gastro-oesophageal junction (GO junction). The chemotherapy consisted of two courses of 6 weekly administrations of 5-fluorouracil (5-FU) (2.0 g/m{sup 2}, 24 h infusion) and folinic acid (FA) (500 mg/m{sup 2}, 2 h infusion) combined with twice weekly cisplatin (50 mg/m{sup 2}, 1 h infusion). Irradiation of 30 Gy was given concurrently with one course of cisplatin and etoposide. 25 patients with locally advanced (T3-T4 NX M0) squamous cell or adenocarcinoma of the lower oesophagus and GO junction were included and evaluated. Toxicity was usually mild to moderate (WHO grade 1 and 2) with mucositis as the most important side-effect of the pre-operative treatment. Of the patients, 94 and 88% completed the chemo- and radiochemotherapy according to the protocol, respectively. A major response (=partial remission with subjective improvement) to chemotherapy was achieved in 6/10 patients with squamous cell carcinoma and 10/15 with adenocarcinoma. 19 patients had subsequent surgery and complete resection was achieved in 16 (3 patients had intra-abdominal metastases observed at laparotomy). The operative mortality rate was 16% (3/19). 10 of the 16 patients with tumour resection had a pathological complete response. 15 patients (43%) remain alive at a median follow-up of 20 months and the median survival exceeds 16+ months. Our data suggest that this intensive pre-operative chemoradiotherapy programme is feasible and remarkably effective in patients with locally advanced carcinomas of the lower oesophagus or GO junction. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

  12. In vitro blood flow model with physiological wall shear stress for hemocompatibility testing-An example of coronary stent testing.

    Science.gov (United States)

    Engels, Gerwin Erik; Blok, Sjoerd Leendert Johannes; van Oeveren, Willem

    2016-09-18

    Hemocompatibility of blood contacting medical devices has to be evaluated before their intended application. To assess hemocompatibility, blood flow models are often used and can either consist of in vivo animal models or in vitro blood flow models. Given the disadvantages of animal models, in vitro blood flow models are an attractive alternative. The in vitro blood flow models available nowadays mostly focus on generating continuous flow instead of generating a pulsatile flow with certain wall shear stress, which has shown to be more relevant in maintaining hemostasis. To address this issue, the authors introduce a blood flow model that is able to generate a pulsatile flow and wall shear stress resembling the physiological situation, which the authors have coined the "Haemobile." The authors have validated the model by performing Doppler flow measurements to calculate velocity profiles and (wall) shear stress profiles. As an example, the authors evaluated the thrombogenicity of two drug eluting stents, one that was already on the market and one that was still under development. After identifying proper conditions resembling the wall shear stress in coronary arteries, the authors compared the stents with each other and often used reference materials. These experiments resulted in high contrast between hemocompatible and incompatible materials, showing the exceptional testing capabilities of the Haemobile. In conclusion, the authors have developed an in vitro blood flow model which is capable of mimicking physiological conditions of blood flow as close as possible. The model is convenient in use and is able to clearly discriminate between hemocompatible and incompatible materials, making it suitable for evaluating the hemocompatible properties of medical devices.

  13. Effects of Recovery Type after a Kickboxing Match on Blood Lactate and Performance in Anaerobic Tests

    OpenAIRE

    Ouergui, Ibrahim; Hammouda, Omar; Chtourou, Hamdi; Gmada, Nabil; Franchini, Emerson

    2014-01-01

    Purpose To verify whether active recovery (AR) applied after a kickboxing match resulted in better performance in anaerobic tests when compared to passive recovery (PR). Methods Eighteen kickboxers volunteered to participate on a Kickboxing match preceded and followed by anaerobic tests: squat jump (SJ), the counter movement jump (CMJ) and the upper-body Wingate test. Blood lactate (BL), heart rate (HR) and rate of perceived exertion (RPE) were analyzed before and after rounds. The recovery s...

  14. Multicenter evaluation of the Verigene Gram-negative blood culture nucleic acid test for rapid detection of bacteria and resistance determinants in positive blood cultures.

    Science.gov (United States)

    Uno, Naoki; Suzuki, Hiromichi; Yamakawa, Hiromi; Yamada, Maiko; Yaguchi, Yuji; Notake, Shigeyuki; Tamai, Kiyoko; Yanagisawa, Hideji; Misawa, Shigeki; Yanagihara, Katsunori

    2015-12-01

    The Verigene Gram-Negative Blood Culture Nucleic Acid Test (BC-GN) is a microarray-based assay that enables rapid detection of 9 common Gram-negative bacteria and 6 resistance determinants directly from positive blood cultures. We compared the performance of BC-GN with currently used automated systems, testing 141 clinical blood cultures and 205 spiked blood cultures. For identification of BC-GN target organisms in clinical and spiked blood cultures, the BC-GN assay showed 98.5% (130/132) and 98.9% (182/184) concordance, respectively. Of 140 resistance genes positively detected in clinical and spiked blood cultures with the BC-GN test, 139 (99.3%) were confirmed by PCR, and the detection results were consistent with the resistance phenotypes observed. The BC-GN assay, thus, can potentially improve care for sepsis patients by enabling timely detection and targeted antimicrobial therapy.

  15. Red cell antigen prevalence predicted by molecular testing in ethnic groups of South Texas blood donors.

    Science.gov (United States)

    Aranda, Lorena I; Smith, Linda A; Jones, Scott; Beddard, Rachel

    2015-01-01

    Alloimmunization to red blood cell antigens is seen in patients receiving chronic blood transfusion. Knowing the prevalence of blood group antigens of the different ethnicities of South Texas donors can provide better management of rare blood inventory for patients in this geographical area. A total of 4369 blood donors were tested and analyzed for various antigens in the following blood group systems: ABO, Rh, Kell, Duffy, Kidd, MNS, Lutheran, Dombrock, Landsteiner-Wiener, Diego, Colton, and Scianna. Donors tested to be group 0 or A were serologically tested for the Rh (C, E, c, e) antigens. Those that tested as presumably R1R1, R2R2, or Ror were then genotyped. Donors constituted three major ethnicities: black (18.3%), Hispanic (36.3%), and Caucasian (41.1%); ethnicities comprised of Asian, American Indian, multiracial, and other accounted for the remaining donors (4.3%). The most likely common Rh phenotype for each ethnicity is as follows: black -Ror (44.4%), Hispanic -R1R1 (59.0%), and Caucasian -R1R1 (38.9%). The prevalence of Kell, Duffy, and Kidd blood group system antigens in black and Caucasian donors is comparable with published reports for the entire U.S. The black South Texas donor population had an 8.8 percent increase in prevalence of the Fy(a+b-) phenotype as compared with these published reports; the Hispanic South Texas donor population had a prevalence of 36.1 percent of the Fy(a+b-) phenotype. Regarding the Diego blood group system, the Hispanic donor population in South Texas had a prevalence of 93.5 percent for the Di(a-b+) phenotype as compared with published reports for the entire U.S. (>99.9%). The Hispanic population had a prevalence of 7.9 percent of donors testing as M-N+S-s+ as compared with 20.2 percent and 15.6 percent for black and Caucasian donors, respectively. This study helped us determine the prevalence of each of the blood group antigens in the South Texas donor population to establish and maintain adequate rare inventory of

  16. Prediction of Acute Mountain Sickness using a Blood-Based Test

    Science.gov (United States)

    2016-01-01

    1 Award Number: W81XWH-11-2-0034 TITLE: Prediction of Acute Mountain Sickness using a Blood-Based Test PRINCIPAL INVESTIGATOR: Robert Roach...Acute Mountain Sickness using a Blood-Based Test 5a. CONTRACT NUMBER: 5b. GRANT NUMBER W81XWH-11-2-0034 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S...from a sample taken at sea level could be used to successfully predict in 9 out of 10 individuals who went on to develop acute mountain sickness or

  17. Hand-held echocardiography in the setting of pre-operative cardiac evaluation of patients undergoing non-cardiac surgery: results from a randomized pilot study.

    Science.gov (United States)

    Cavallari, Ilaria; Mega, Simona; Goffredo, Costanza; Patti, Giuseppe; Chello, Massimo; Di Sciascio, Germano

    2015-06-01

    Transthoracic echocardiography is not a routine test in the pre-operative cardiac evaluation of patients undergoing non-cardiac surgery but may be considered in those with known heart failure and valvular heart disease or complaining cardiac symptoms. In this setting, hand-held echocardiography (HHE) could find a potential application as an alternative to standard echocardiography in selected patients; however, its utility in this context has not been investigated. The aim of this pilot study was to evaluate the conclusiveness of HHE compared to standard echocardiography in this subset of patients. 100 patients scheduled for non-cardiac surgery were randomized to receive a standard exam with a Philips Ie33 or a bedside evaluation with a pocket-size imaging device (Opti-Go, Philips Medical System). The primary endpoint was the percentage of satisfactory diagnosis at the end of the examination referred as conclusiveness. Secondary endpoints were the mean duration time and the mean waiting time to perform the exams. No significant difference in terms of conclusiveness between HHE and standard echo was found (86 vs 96%; P = 0.08). Mean duration time of the examinations was 6.1 ± 1.2 min with HHE and 13.1 ± 2.6 min with standard echocardiography (P cardiac surgery, since it provided similar information but it was faster and earlier performed compared to standard echocardiography.

  18. Liver fibrosis diagnosis by blood test and elastography in chronic hepatitis C: agreement or combination?

    Science.gov (United States)

    Calès, P; Boursier, J; Lebigot, J; de Ledinghen, V; Aubé, C; Hubert, I; Oberti, F

    2017-04-01

    In chronic hepatitis C, the European Association for the Study of the Liver and the Asociacion Latinoamericana para el Estudio del Higado recommend performing transient elastography plus a blood test to diagnose significant fibrosis; test concordance confirms the diagnosis. To validate this rule and improve it by combining a blood test, FibroMeter (virus second generation, Echosens, Paris, France) and transient elastography (constitutive tests) into a single combined test, as suggested by the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America. A total of 1199 patients were included in an exploratory set (HCV, n = 679) or in two validation sets (HCV ± HIV, HBV, n = 520). Accuracy was mainly evaluated by correct diagnosis rate for severe fibrosis (pathological Metavir F ≥ 3, primary outcome) by classical test scores or a fibrosis classification, reflecting Metavir staging, as a function of test concordance. Score accuracy: there were no significant differences between the blood test (75.7%), elastography (79.1%) and the combined test (79.4%) (P = 0.066); the score accuracy of each test was significantly (P < 0.001) decreased in discordant vs. concordant tests. Classification accuracy: combined test accuracy (91.7%) was significantly (P < 0.001) increased vs. the blood test (84.1%) and elastography (88.2%); accuracy of each constitutive test was significantly (P < 0.001) decreased in discordant vs. concordant tests but not with combined test: 89.0 vs. 92.7% (P = 0.118). Multivariate analysis for accuracy showed an interaction between concordance and fibrosis level: in the 1% of patients with full classification discordance and severe fibrosis, non-invasive tests were unreliable. The advantage of combined test classification was confirmed in the validation sets. The concordance recommendation is validated. A combined test, expressed in classification instead of score, improves this rule and validates the

  19. Prediction of Long-term Post-operative Testosterone Replacement Requirement Based on the Pre-operative Tumor Volume and Testosterone Level in Pituitary Macroadenoma.

    Science.gov (United States)

    Lee, Cheng-Chi; Chen, Chung-Ming; Lee, Shih-Tseng; Wei, Kuo-Chen; Pai, Ping-Ching; Toh, Cheng-Hong; Chuang, Chi-Cheng

    2015-11-05

    Non-functioning pituitary macroadenomas (NFPAs) are the most prevalent pituitary macroadenomas. One common symptom of NFPA is hypogonadism, which may require long-term hormone replacement. This study was designed to clarify the association between the pre-operative tumor volume, pre-operative testosterone level, intraoperative resection status and the need of long-term post-operative testosterone replacement. Between 2004 and 2012, 45 male patients with NFPAs were enrolled in this prospective study. All patients underwent transsphenoidal surgery. Hypogonadism was defined as total serum testosterone levels of testosterone to patients with defined hypogonadism or clinical symptoms of hypogonadism. Hormone replacement for longer than 1 year was considered as long-term therapy. The need for long-term post-operative testosterone replacement was significantly associated with larger pre-operative tumor volume (p = 0.0067), and lower pre-operative testosterone level (p = 0.0101). There was no significant difference between the gross total tumor resection and subtotal resection groups (p = 0.1059). The pre-operative tumor volume and testosterone level impact post-operative hypogonadism. By measuring the tumor volume and the testosterone level and by performing adequate tumor resection, surgeons will be able to predict post-operative hypogonadism and the need for long-term hormone replacement.

  20. A qualitative study of the pre-operative preparation of children, young people and their parents' for planned continence surgery: experiences and expectations.

    Science.gov (United States)

    Bray, Lucy; Callery, Peter; Kirk, Sue

    2012-07-01

    The aim of this study is to explore children's, young people's and parents' pre-operative experiences of continent stoma formation. Current research investigating continent stoma surgery focuses on surgical outcomes including complication rates, adherence to management regimes, self-management practices and levels of continence achieved. Despite reports of pre-operative anxiety in families undergoing continent stoma surgery, there has been a lack of research exploring pre-operative experiences, information needs or decision-making processes in this group. A qualitative study. Forty-nine semi-structured interviews were conducted with 17 children, young people and their parents. Data were collected at key points in the surgical process that aimed to represent a longitudinal perspective of continent stoma formation. The interviews suggested that children's, young people's and parents' information needs in relation to the long-term implications of surgery and for their day-to-day lives were not being adequately met. The preparation process was described as being positively influenced by contact with a nurse specialist, being given time to make the decision and having access to different sources of information. Decisions regarding life-long planned surgery can be challenging. The individual involvement and information needs of children, young people and their parents need to be recognised during pre-operative preparation. Health professionals need to discuss the holistic implications of continent stoma surgery and provide families with the time and opportunity to consider surgery and access relevant sources of information pre-operatively. © 2012 Blackwell Publishing Ltd.

  1. Cross reaction and forensic comparison of blood testing done by private and public sector laboratories

    Directory of Open Access Journals (Sweden)

    Christian Stadler

    2017-06-01

    Full Text Available Blood evidence consists of one of the most important forensic pieces. However, it is not always easy to identify a stain as blood. The best and fastest way of doing so, is by using rapid screening derived from immunochromatographic tests to spot hemoglobin. However, cross reaction between species might be an issue since hemoglobin of other animals could be present, especially considering crimes against fauna, outdoor crime scenes with an easy access for animals, and human and domestic animal trauma cases. According to the particular structure in each country there are private and/or public laboratories working in this field. Methods and resources from private and public sectors are different, and procedures also differ from country to country. The main objective of our work was to validate the presence of human blood using interspecific samples and the criteria defined by each lab using rapid blood detection test kits from the public sector related to forensic analysis in Brazil and from the private sector in Germany. As a secondary goal, we have evaluated sensibility, the Hook Effect and pH effect in some commercially available kits. Our results showed that the tests carried out are suitable for the detection of human blood in forensic samples using methods commonly employed in the public and private sectors.

  2. Incentivizing Blood Donation: Systematic Review and Meta-Analysis to Test Titmuss’ Hypotheses

    Science.gov (United States)

    2013-01-01

    Objectives: Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Method: Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. Results: The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91–1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). Conclusion: The limited evidence suggests that Titmuss’ hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PMID:24001244

  3. Incentivizing blood donation: systematic review and meta-analysis to test Titmuss' hypotheses.

    Science.gov (United States)

    Niza, Claudia; Tung, Burcu; Marteau, Theresa M

    2013-09-01

    Titmuss hypothesized that paying blood donors would reduce the quality of the blood donated and would be economically inefficient. We report here the first systematic review to test these hypotheses, reporting on both financial and nonfinancial incentives. Studies deemed eligible for inclusion were peer-reviewed, experimental studies that presented data on the quantity (as a proxy for efficiency) and quality of blood donated in at least two groups: those donating blood when offered an incentive, and those donating blood with no offer of an incentive. The following were searched: MEDLINE, EMBASE and PsycINFO using OVID SP, CINAHL via EBSCO and CENTRAL, the Cochrane Library, Econlit via EBSCO, JSTOR Health and General Science Collection, and Google. The initial search yielded 1100 abstracts, which resulted in 89 full papers being assessed for eligibility, of which seven studies, reported in six papers, met the inclusion criteria. The included studies involved 93,328 participants. Incentives had no impact on the likelihood of donation (OR = 1.22 CI 95% 0.91-1.63; p = .19). There was no difference between financial and nonfinancial incentives in the quantity of blood donated. Of the two studies that assessed quality of blood, one found no effect and the other found an adverse effect from the offer of a free cholesterol test (β = 0.011 p < .05). The limited evidence suggests that Titmuss' hypothesis of the economic inefficiency of incentives is correct. There is insufficient evidence to assess their likely impact on the quality of the blood provided. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  4. False negative fecal occult blood tests due to delayed sample return in colorectal cancer screening.

    NARCIS (Netherlands)

    Rossum, L.G.M. van; Rijn, A.F. van; Oijen, M.G.H. van; Fockens, P.; Laheij, R.J.F.; Verbeek, A.L.M.; Jansen, J.B.M.J.; Dekker, E.

    2009-01-01

    Delayed return of immunochemical fecal occult blood test (iFOBT) samples to a laboratory might cause false negatives because of hemoglobin degradation. Quantitative iFOBT's became increasingly more accepted in colorectal cancer screening. Therefore, we studied the effects of delay between sampling a

  5. Endoscopic Follow-Up of Positive Fecal Occult Blood Testing in the Ontario FOBT Project

    Directory of Open Access Journals (Sweden)

    Lawrence Paszat

    2007-01-01

    Full Text Available BACKGROUND: The Ontario FOBT Project is a pilot study of fecal occult blood testing (FOBT for colorectal cancer screening conducted among age-eligible volunteers (50 to 75 years in 12 of 37 public health regions in Ontario.

  6. Validation of a new blood-mimicking fluid for use in Doppler flow test objects

    NARCIS (Netherlands)

    Ramnarine, KV; Nassiri, DK; Hoskins, PR; Lubbers, J

    1998-01-01

    A blood-mimicking fluid (BMF) suitable for use in Doppler flow test objects is described and characterised, The BMF consists of 5 mu m diameter nylon scattering particles suspended in a fluid base of water, glycerol, dextran and surfactant, The acoustical properties of various BMF preparations were

  7. Non-invasive prediction of blood lactate response to constant power outputs from incremental exercise tests.

    Science.gov (United States)

    Sullivan, C S; Casaburi, R; Storer, T W; Wasserman, K

    1995-01-01

    We determined the ability of gas exchange analyses during incremental exercise tests (IXT) to predict blood lactate levels associated with a range of constant power output cycle ergometer tests. Twenty-seven healthy young men performed duplicate IXT and four 15-min constant power output tests at intensities ranging from moderate to very severe, before and after a training program. End-exercise blood lactate levels were approximated from superficial venous samples obtained 60 s after each constant power output test. From IXT, the power outputs corresponding to peak oxygen uptake (Wmax) and lactic acidosis threshold (WLAT), were determined. We examined the ability of four measures of exercise intensity to predict blood lactate levels for power outputs above the LAT: (1) power output (W), (2) power difference (W-WLAT), (3) power fraction (W/Wmax) and (4) power difference to delta ratio [(W-WLAT)/(Wmax-WLAT)]. Correlation coefficients were r = 0.38, 0.69, 0.75, and 0.81, respectively. The best linear regression prediction equation was: lactate (mmol.l-1) = 12.2[(W-WLAT)/(Wmax-WLAT)] + 0.7 mmol.l-1. This relationship was not significantly affected by training, despite increased values of LAT and peak oxygen uptake. Normalizing exercise intensity to the range of power outputs between WLAT and Wmax provided an estimate of blood lactate response to constant power outputs with a standard error of the estimate of 1.66 mmol.l-1.

  8. A comparison of the effect of two doses of oral melatonin with oral midazolam and placebo on pre-operative anxiety, cognition and psychomotor function in children: A randomised double-blind study

    Science.gov (United States)

    Kurdi, Madhuri S; Muthukalai, Sindhu Priya

    2016-01-01

    Background and Aims: Melatonin (MT), a naturally occurring pituitary hormone has a sleep promoting effect. There are very few studies on pre-operative oral MT (0.2–0.5 mg/kg) in children. We planned a study to assess the efficacy of oral MT in two doses and compare it with oral midazolam and placebo for pre-operative anxiolysis, sedation, maintenance of cognition and psychomotor skills, parental separation behaviour and venepuncture compliance. Methods: This prospective double-blind randomised study was conducted after ethical committee approval on 100 children aged 5–15 years, American Society of Anaesthesiologists physical status I and II undergoing elective surgery at our hospital from January 1, 2014, to December 31, 2014. Mentally disordered children were excluded from the study. They were randomised into four groups of 25 each (A, B, C, D) to receive either oral MT 0.5 mg/kg or 0.75 mg/kg or oral midazolam 0.5 mg/kg or placebo 45–60 min, respectively, before induction. The child's anxiety, cognition and psychomotor function before and after pre-medication, behaviour during the parental separation and venepuncture were appropriately scored. Kruskal–Wallis analysis of variance for intergroup and Wilcoxon matched pairs tests for intragroup comparisons of data were applied. Results: The four groups were comparable regarding mean age, weight and sex. The anxiety score reductions in the three groups when compared to placebo were statistically significant. Children receiving MT 0.75 mg/kg had maximum anxiolysis and venepuncture compliance (P < 0.05). Cognition was decreased with maximum sedation, successful parental separation and psychomotor impairment in the midazolam group (P < 0.05). Conclusion: Oral MT (0.5 mg/kg and 0.75 mg/kg) in children decreases pre-operative anxiety without impairing cognitive and psychomotor functions, the 0.75 mg/kg dose being most effective.

  9. Umbilical Cord Blood Use for Admission Blood Tests of VLBW (Very Low Birth Weight) Preterm Neonates: A Multi-center Randomized Clinical Trial

    Science.gov (United States)

    2016-09-12

    collection of information if it does not display a currently valid OMB control number. Umbilical Cord Blood Use for Admission Blood Tests of VLBW Preterm...to help decrease the risk of anemia and the need for transfusion. These include delayed cord clamping , cord stripping, erythropoiesis stimulating...transcutaneous measurements[3, 6]. Another approach used to decrease the risk of anemia and need for transfusion is the use of umbilical cord blood

  10. Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres

    Directory of Open Access Journals (Sweden)

    Puhl Wofhart

    2009-02-01

    Full Text Available Abstract Background Total hip joint replacement (THR is a high volume, effective intervention for hip osteoarthritis (OA. However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation. Methods A minimum of 50 consecutive, consenting patients coming to primary THR for primary hip OA in each of the 20 participating orthopaedic centres entered the study. Pre-operative data included demographics, employment and educational attainment, drug utilisation, and involvement of other joints. Each subject completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC – Likert version 3.1. Other data collected at the time of surgery included the prosthesis used and American Society of Anaesthesiologists (ASA status. Pre-operative radiographs were read by the same three readers for Kellgren and Lawrence (K&L grading and Osteoarthritis Research Society International (OARSI atlas features. Regression analyses were carried out. Results Data from 1327 subjects has been analysed. The mean age of the group was 65.7 years, and there were more women (53.4% than men. Most (79% were ASA status 1 or 2. Reported disease duration was 5 years or less in 69.2%. Disease in other joint sites was common. Radiographs were available in 1051 subjects and the K&L grade was 3 or 4 in 95.8%. There was much more variation in clinical severity (WOMAC score; the mean total WOMAC score was 59.2 (SD 16.1. The radiographic severity showed no correlation with WOMAC scores. Significantly higher WOMAC scores (worse disease were seen in older people, women, those with obesity, those with worse general health, and those with lower educational attainment. Conclusion 1. Clinical disease severity

  11. Variations in the pre-operative status of patients coming to primary hip replacement for osteoarthritis in European orthopaedic centres.

    Science.gov (United States)

    Dieppe, Paul; Judge, Andrew; Williams, Susan; Ikwueke, Ifeoma; Guenther, Klaus-Peter; Floeren, Markus; Huber, Joerg; Ingvarsson, Thorvaldur; Learmonth, Ian; Lohmander, L Stefan; Nilsdotter, Anna; Puhl, Wofhart; Rowley, David; Thieler, Robert; Dreinhoefer, Karsten

    2009-02-10

    Total hip joint replacement (THR) is a high volume, effective intervention for hip osteoarthritis (OA). However, indications and determinants of outcome remain unclear. The 'EUROHIP consortium' has undertaken a cohort study to investigate these questions. This paper describes the variations in disease severity in this cohort and the relationships between clinical and radiographic severity, and explores some of the determinants of variation. A minimum of 50 consecutive, consenting patients coming to primary THR for primary hip OA in each of the 20 participating orthopaedic centres entered the study. Pre-operative data included demographics, employment and educational attainment, drug utilisation, and involvement of other joints. Each subject completed the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC - Likert version 3.1). Other data collected at the time of surgery included the prosthesis used and American Society of Anaesthesiologists (ASA) status. Pre-operative radiographs were read by the same three readers for Kellgren and Lawrence (K&L) grading and Osteoarthritis Research Society International (OARSI) atlas features. Regression analyses were carried out. Data from 1327 subjects has been analysed. The mean age of the group was 65.7 years, and there were more women (53.4%) than men. Most (79%) were ASA status 1 or 2. Reported disease duration was 5 years or less in 69.2%. Disease in other joint sites was common.Radiographs were available in 1051 subjects and the K&L grade was 3 or 4 in 95.8%. There was much more variation in clinical severity (WOMAC score); the mean total WOMAC score was 59.2 (SD 16.1). The radiographic severity showed no correlation with WOMAC scores.Significantly higher WOMAC scores (worse disease) were seen in older people, women, those with obesity, those with worse general health, and those with lower educational attainment. 1. Clinical disease severity varies widely at the time of THR for OA. 2. In advanced hip OA

  12. Usefullness of routine use of fecal occult blood test in a hospital setting

    Directory of Open Access Journals (Sweden)

    Simona Ravnik

    2006-12-01

    Full Text Available Background: Fecal occult blood test, hematest, is a well excepted non-invasive method used for detecting different diseases of the gastrointestinal tract. It was proven in different randomized studies that usage of this simple method may facilitate further diagnostic and therapeutic treatment.Patients and methods: The retrospective analysis includes patients, which were admitted to the gastroenterological and endoscopy department of the General hospital Maribor in the last quarter of the year 2005. In all patients fecal occult blood test was performed.Results: We examined 200 patients, 104 women and 96 men, average age 63.9 years, SD±16.9, ranging from 21 to 97 years. Positive hematest was discovered in 76 patients (38 %. The source of hemorrhage from the upper digestive tract was confirmed in 37 patients (48.6 % of all positive tests and from the lower digestive tract in 34 patients (46 % of all positive tests. The most frequent causes of hemorrhage from the lower digestive tract were chronic inflammatory bowel disease (13.1 % of all positive tests, colorectal cancer (10.5 % and polyps (6.6 %. The source of hemorrhage was not located in five patients (6.6 % of all positive tests despite the accurate diagnostic procedure.Conclusions: By performing a fecal occult blood screening in non-symptomatic patients, we can make an essential step towards discovering different gastrointestinal diseases, even colorectal cancer in its early, limited form, when the effect of treatment is greatest.

  13. Hepatitis B core antibody testing in Indian blood donors: A double-edged sword!

    Directory of Open Access Journals (Sweden)

    R N Makroo

    2012-01-01

    Full Text Available Background: Until lately, anti-HBc antibodies were considered an effective marker for occult Hepatitis B virus (HBV infection and have served their role in improving blood safety. But, with the development of advanced tests for HBV DNA detection, the role of anti-HBc in this regard stands uncertain. Materials and Methods: Anti-HBc and HBsAg ELISA and ID-NAT tests were run in parallel on donor blood samples between April 1, 2006 and December 31, 2010 at the Department of Transfusion Medicine, Indraprastha Apollo Hospitals, New Delhi. A positive ID-NAT was followed by Discriminatory NAT assay. Results: A total of 94 247 samples were tested with a total core positivity rate of 10.22%. We identified nearly 9.17% of donors who were reactive for anti-HBc and negative for HBsAg and HBV DNA. These are the donors who are potentially non-infectious and may be returned to the donor pool. Conclusion: Although anti HBc testing has a definite role in improving blood safety, centers that have incorporated NAT testing may not derive any additional benefit by performing anti-HBc testing, especially in resource-limited countries like ours.

  14. Heat stress attenuates the increase in arterial blood pressure during the cold pressor test.

    Science.gov (United States)

    Cui, Jian; Shibasaki, Manabu; Low, David A; Keller, David M; Davis, Scott L; Crandall, Craig G

    2010-11-01

    The mechanisms by which heat stress impairs the control of blood pressure leading to compromised orthostatic tolerance are not thoroughly understood. A possible mechanism may be an attenuated blood pressure response to a given increase in sympathetic activity. This study tested the hypothesis that whole body heating attenuates the blood pressure response to a non-baroreflex-mediated sympathoexcitatory stimulus. Ten healthy subjects were instrumented for the measurement of integrated muscle sympathetic nerve activity (MSNA), mean arterial blood pressure (MAP), heart rate, sweat rate, and forearm skin blood flow. Subjects were exposed to a cold pressor test (CPT) by immersing a hand in an ice water slurry for 3 min while otherwise normothermic and while heat stressed (i.e., increase core temperature ~0.7°C via water-perfused suit). Mean responses from the final minute of the CPT were evaluated. In both thermal conditions CPT induced significant increases in MSNA and MAP without altering heart rate. Although the increase in MSNA to the CPT was similar between thermal conditions (normothermia: Δ14.0 ± 2.6; heat stress: Δ19.1 ± 2.6 bursts/min; P = 0.09), the accompanying increase in MAP was attenuated when subjects were heat stressed (normothermia: Δ25.6 ± 2.3, heat stress: Δ13.4 ± 3.0 mmHg; P < 0.001). The results demonstrate that heat stress can attenuate the pressor response to a sympathoexcitatory stimulus.

  15. The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test.

    Science.gov (United States)

    Wiles, Jonathan D; Allum, Simon R; Coleman, Damian A; Swaine, Ian L

    2008-01-15

    Currently, it is not possible to prescribe isometric exercise at an intensity that corresponds to given heart rates or systolic blood pressures. This might be useful in optimizing the effects of isometric exercise training. Therefore, the aim of this study was to explore the relationships between isometric exercise intensity and both heart rate and systolic blood pressure during repeated incremental isometric exercise tests. Fifteen participants performed seated isometric double-leg knee extension, during which maximum voluntary contraction (MVC) was assessed, using an isokinetic dynamometer. From this, a corresponding peak electromyographic activity (EMG(peak)) was determined. Subsequently, participants performed two incremental isometric exercise tests (at least 48 h apart) at 10, 15, 20, 25, and 30% EMG(peak), during which steady-state heart rate and systolic blood pressure were recorded. In all participants, there were linear relationships between %EMG(peak) and heart rate (r at least 0.91; P blood pressure (r at least 0.92; P 0.50) or elevations (P > 0.10) for either of the relationships. Therefore, these linear relationships could be used to identify isometric exercise training intensities that correspond to precise heart rates or systolic blood pressures. Training performed in this way might provide greater insight into the underlying mechanisms for the cardiovascular adaptations that are known to occur as a result.

  16. Advantages and Challenges of Dried Blood Spot Analysis by Mass Spectrometry Across the Total Testing Process

    Science.gov (United States)

    Zakaria, Rosita; Allen, Katrina J.; Koplin, Jennifer J.; Roche, Peter

    2016-01-01

    Introduction Through the introduction of advanced analytical techniques and improved throughput, the scope of dried blood spot testing utilising mass spectrometric methods, has broadly expanded. Clinicians and researchers have become very enthusiastic about the potential applications of dried blood spot based mass spectrometric applications. Analysts on the other hand face challenges of sensitivity, reproducibility and overall accuracy of dried blood spot quantification. In this review, we aim to bring together these two facets to discuss the advantages and current challenges of non-newborn screening applications of dried blood spot quantification by mass spectrometry. Methods To address these aims we performed a key word search of the PubMed and MEDLINE online databases in conjunction with individual manual searches to gather information. Keywords for the initial search included; “blood spot” and “mass spectrometry”; while excluding “newborn”; and “neonate”. In addition, databases were restricted to English language and human specific. There was no time period limit applied. Results As a result of these selection criteria, 194 references were identified for review. For presentation, this information is divided into: 1) clinical applications; and 2) analytical considerations across the total testing process; being pre-analytical, analytical and post-analytical considerations. Conclusions DBS analysis using MS applications is now broadly applied, with drug monitoring for both therapeutic and toxicological analysis being the most extensively reported. Several parameters can affect the accuracy of DBS measurement and further bridge experiments are required to develop adjustment rules for comparability between dried blood spot measures and the equivalent serum/plasma values. Likewise, the establishment of independent reference intervals for dried blood spot sample matrix is required. PMID:28149263

  17. Comparison of local Salmonella pullorum antigen with imported product in whole blood agglutination test

    Directory of Open Access Journals (Sweden)

    Priyani Medewewa

    Full Text Available Background: Salmonellosis is considered as one of the most important diseases in poultry as it causes devastating losses in chicken industry. Proper identification of the infected and carrier birds is required to control the disease among chickens. In field situation whole blood agglutination test is performed in order to identify carriers of Pullorum and Fowl typhoid particularly, in breeder operations. In this test, serum antibodies are detected by using a specially made antigen for this purpose. In Sri Lanka, three antigen products are used commonly in whole blood agglutination test. Objectives: This study was carried out to compare these two locally available S. Pullorum antigen products and to determine any difference in the efficacy. Methods:“Shaver Brown” commercial layer birds (70 in number were used in the experiment. Birds were inoculated orally with 1.8X109cfu/ml of S. Pullorum at 16 weeks age. After Three weeks post inoculation, blood was collected from each bird and Whole blood agglutination test was performed using both antigen products. Fifteen (15 inoculated hens were selected randomly and cloacal swabs were cultured on cultured Agar on same day of serum collected. Results: In this study, there was no significant difference observed between two antigens to detect carrier birds by whole blood agglutination test. Salmonella was not isolated from cloacal swabs since no observed excretion of Salmonella Pullorum through faces. All cloacal swabs gave negative results, when cultured on artificial Agar. Conclusion: Both antigen can be used effectively to detect carrier birds under the control program in country. [Vet World 2012; 5(9.000: 546-548

  18. EFFECT OF PRANAYAMA ON BLOOD PRESSURE AND HEART RATE IN HYPERREACTOR TO COLD PRESSOR TEST

    Directory of Open Access Journals (Sweden)

    Krishan Bihari

    2014-07-01

    Full Text Available INTRODUCTION: Stress is a dangerous and significant problem of World, which affects physical, mental, behavioral, and emotional health. Yoga has been reported to control stress, to be beneficial in treating stress related disorders, improving autonomic functions, lower blood pressure, increase strength and flexibility of muscles, improve the sense of well-being, slow ageing process, control breathing, reducing signs of oxidative stress and improving spiritual growth. AIMS: The aim of present study was to investigate whether regular practice of Yoga for three months can reduce the cardiovascular hyper-reactivity induced by cold pressor test. MATERIALS AND METHODS: The study group comprised 62 healthy male subjects of 17-27 years age group. Initially there were 30 hyper reactors to cold pressor test. The hyper-reactivity of 23 volunteers converted to hypo-reactivity after the yoga therapy of three months (76.66%. Other parameters like basal blood pressure, rise in blood pressure, pulse rate and rate of respiration were also statistically significantly reduced (by using student ‘t’ test. STATISTICAL ANALYSIS: 2 tail student‘t’ test was done by using the standard formulas. RESULTS: Regular practice of yoga significantly reduces the cardiovascular hyper-reactivity in basal blood pressure, rise in blood pressure after one minute of cold stress, heart rate, and rate of respiration, after three month of yoga practice. CONCLUSION: Regular practice of yoga for three months reduced the cardiovascular hyper-reactivity to cold pressor test in subjects, who were hyper reactive to cold stress, possibly by inducing parasympathetic predominance and cortico-hypothalamomedullary inhibition.

  19. Nucleic acid testing: Is it the only answer for safe Blood in India?

    Directory of Open Access Journals (Sweden)

    N K Naidu

    2016-01-01

    Full Text Available Background: With the implementation of NAT in countries around the world, there is a growing pressure on the transfusion services in India to adopt NAT testing. India has about 2545 licensed Blood Centres. The Transfusion Services in India are fragmented, poorly regulated and the quality standards are poorly implemented. Blood Centres are still dependent on replacement/family donors and in most places laboratory testing for Transfusion transmitted infections is not quality assured, laboratory equipment are not calibrated and maintained, and validation of results is not carried out. Against the current scenario introducing NAT for screening of blood donors in India would pose a challenge. Aim: To study the prudence of universal NAT testing in India. Materials and Methods : A retrospective study of 5 years from 2008-2012 was undertaken to study the true reactivity of donors using WHO strategy II and III and therefore the true seroprevalence of TTI infections in the donor populations. Results : The true reactivity of the donors was much less as compared to the initially reactive donors due to the use of a well designed testing algorithm. In addition having a total voluntary blood collection along with good pre-donation counseling program also reduces the transmission of infections. Conclusions : What India essentially needs to do is religiously implement the strategies outlined in the WHO Aide-memoire. The blood should be collected only from voluntary non remunerative and repeat donors , there should be stringent donor selection with pre-donation counseling instituted. Strict implementation of quality management system, development of well defined testing startegies and strong haemovigilance system could take us a step in the right direction.

  20. Females, younger patients and patients with high BMI have the highest pre-operative knee awareness measured using the Forgotten Joint Score

    DEFF Research Database (Denmark)

    Li, Dana; Troelsen, A; Ingelsrud, L

    2017-01-01

    PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim of this s......PURPOSE: The Forgotten Joint Score (FJS) is a novel measurement for patients' awareness of their knee in daily life. By identifying factors that could explain pre-operative FJS levels, the clinician could better prioritize and single out patients who would benefit most from TKA. The aim...

  1. It's More Than a Blood Test: Patients' Perspectives on Noninvasive Prenatal Testing.

    Science.gov (United States)

    Farrell, Ruth M; Mercer, Mary Beth; Agatisa, Patricia K; Smith, Marissa B; Philipson, Elliot

    2014-06-19

    Noninvasive prenatal testing (NIPT) offers pregnant women a new risk assessment tool for fetal aneuploidy that is superior to conventional screening tests. We conducted focus groups with women who were currently pregnant or had recently delivered in the past year to characterize their perspectives about NIPT and to explore factors they would consider during decision making about its use. Women identified accuracy, early timing, testing ease, and determination of fetal sex as advantages of NIPT over other screens, and the noninvasive method of NIPT as an advantage over diagnostic tests. False positive and false negative results, anxiety, cost and insurance coverage were seen as disadvantages of NIPT. Women who do not want fetal aneuploidy information most likely will not undergo NIPT, despite its advantages over other screening tests. However, given its advantages, the decision to have NIPT is straightforward for women who want genetic information about the fetus. Women emphasized the need to make autonomous, private, and informed choices about NIPT, as they would with any prenatal genetic testing option. These perspectives may guide clinicians to conduct effective and clinically relevant counseling with pregnant women who consider utilizing this new genetic technology.

  2. It’s More Than a Blood Test: Patients’ Perspectives on Noninvasive Prenatal Testing

    Directory of Open Access Journals (Sweden)

    Ruth M. Farrell

    2014-06-01

    Full Text Available Noninvasive prenatal testing (NIPT offers pregnant women a new risk assessment tool for fetal aneuploidy that is superior to conventional screening tests. We conducted focus groups with women who were currently pregnant or had recently delivered in the past year to characterize their perspectives about NIPT and to explore factors they would consider during decision making about its use. Women identified accuracy, early timing, testing ease, and determination of fetal sex as advantages of NIPT over other screens, and the noninvasive method of NIPT as an advantage over diagnostic tests. False positive and false negative results, anxiety, cost and insurance coverage were seen as disadvantages of NIPT. Women who do not want fetal aneuploidy information most likely will not undergo NIPT, despite its advantages over other screening tests. However, given its advantages, the decision to have NIPT is straightforward for women who want genetic information about the fetus. Women emphasized the need to make autonomous, private, and informed choices about NIPT, as they would with any prenatal genetic testing option. These perspectives may guide clinicians to conduct effective and clinically relevant counseling with pregnant women who consider utilizing this new genetic technology.

  3. Effect of rivaroxaban on blood coagulation using the viscoelastic coagulation test ROTEM™.

    Science.gov (United States)

    Casutt, M; Konrad, C; Schuepfer, G

    2012-11-01

    This study investigated the influence of the oral direct inhibitor of factor Xa rivaroxaban on blood coagulation measured by rotation thrombelastometry ROTEM™. Blood was obtained from 11 healthy male volunteers before and 2.5 h after oral administration of 10 mg rivaroxaban. In addition to standard coagulation tests clot formation was measured by ROTEM™ analyzing extrinsic (Extem) and intrinsic thrombelastometry (Intem). Significant differences to the baseline values were found in the Extem clotting time (Extem-CT, 58 ± 9 s and 87 ± 17 s, p coagulation by rivaroxaban.

  4. Is Tc99m-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in Osteosarcoma?

    Directory of Open Access Journals (Sweden)

    Vahidreza Dabbagh Kakhki

    2013-10-01

    Full Text Available Objectives: Multidrug resistance (MDR, which may be due to the over expression of P-glycoprotein (Pgp and/or MRP, is a major problem in neoadjuvant chemotherapy of osteosarcoma. The aim of this study was to investigate the role of Tc-99m MIBI scan for predicting the response to pre-operative chemotherapy. Materials and Methods: Twenty-five patients (12 males and 13 females, aged between 8 and 52y with osteosarcoma were studied. Before the chemotherapy, planar 99mTc-MIBI anterior and posterior images were obtained 10-min [tumor-to-background ratio: (T1/B110min] and 3-hr after tracer injection. After completion of chemotherapy, again 99mTc-MIBI scan was performed at 10-min after tracer injection. In addition to calculation of decay corrected tumor to background (T/B ratios ,  using the 10-min and 3-hr images of the pre-chemotherapy scintigraphy , percent wash-out rate (WR% of 99mTc-MIBI was calculated. Using the 10-min images of the pre- and post-chemotherapy scans, the percent reduction in uptake at the tumor site after treatment (Red% was also calculated. Then after surgical resection, tumor response was assessed by percentage of necrosis. Results: All patients showed significant 99mTc-MIBI uptake in early images. Only 9 patients showed good response to chemotherapy (necrosis≥90% while 16 patients were considered as non-responder (necrosis

  5. Image analysis of the inner ear with CT and MR imaging; Pre-operative assessment for cochlear implant surgery

    Energy Technology Data Exchange (ETDEWEB)

    Kumakawa, Kohzoh; Takeda, Hidehiko; Mutoh, Naoko; Miyakawa, Kohichi (Toranomon Hospital, Tokyo (Japan)); Yukawa, Kumiko; Funasaka, Sohtaro

    1992-06-01

    Recent progress in magnetic resonance imaging (MRI) has made it possible to obtain detailed images of the inner ear by delineating the lymphatic fluid within the labyrinth. We analyzed CT scans and MR imaging in 70 ears manifesting profound deafness owing to inner ear lesions and compared their detective ability for inner ear lesions. The following results were obtained. CT scan examination showed slight to extensive ossification of the labyrinth in six ears (9%), whereas MRI examination revealed low to absent signal intensity of the inner ear in nine ears (13%). Therefore, it was concluded that MRI is more sensitive in detecting abnormalities of the inner ear than CT scan. MRI provided useful information as to whether the cochlear turn is filled with lymphatic fluid or obstructed. This point was one of the greatest advantages of MRI over CT scan. Abnormal findings in either or both the CT scan and the MRI were detected in suppurative labyrinthitis occurring secondary to chronic otitis media, bacterial meningitis and in inner ear trauma. However, such abnormal findings were not detected in patients with idiopathic progressive sensorineural hearing loss, ototoxity or sudden deafness. These findings should be taken into consideration in pre-operative assessment of cochlear implant candidates. (author).

  6. Radioguided surgery and the GOSTT concept: From pre-operative image and intraoperative navigation to image-assisted excision.

    Science.gov (United States)

    Bowles, H; Sánchez, N; Tapias, A; Paredes, P; Campos, F; Bluemel, C; Valdés Olmos, R A; Vidal-Sicart, S

    Radio-guided surgery has been developed for application in those disease scheduled for surgical management, particularly in areas of complex anatomy. This is based on the use of pre-operative scintigraphic planar, tomographic and fused SPECT/CT images, and the possibility of 3D reconstruction for the subsequent intraoperative locating of active lesions using handheld devices (detection probes, gamma cameras, etc.). New tracers and technologies have also been incorporated into these surgical procedures. The combination of visual and acoustic signals during the intraoperative procedure has become possible with new portable imaging modalities. In daily practice, the images offered by these techniques and devices combine perioperative nuclear medicine imaging with the superior resolution of additional optical guidance in the operating room. In many ways they provide real-time images, allowing accurate guidance during surgery, a reduction in the time required for tissue location and an anatomical environment for surgical recognition. All these approaches have been included in the concept known as (radio) Guided intraOperative Scintigraphic Tumour Targeting (GOSTT). This article offers a general view of different nuclear medicine and allied technologies used for several GOSTT procedures, and illustrates the crossing of technological frontiers in radio-guided surgery. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

  7. PRA in Design: Increasing Confidence in Pre-Operational Assessments of Risks (Results of a Joint NASA/NRC Workshop)

    Science.gov (United States)

    Youngblood, Robert; Dezfuli, Homayoon; Siu, Nathan

    2010-01-01

    In late 2009, the National Aeronautics and Space Administration (NASA) and the U.S. Nuclear Regulatory Commission (NRC) jointly organized a workshop to discuss technical issues associated with application of risk assessments to early phases of system design. The workshop, which was coordinated by the Idaho National Laboratory, involved invited presentations from a number of PRA experts in the aerospace and nuclear fields and subsequent discussion to address the following questions: (a) What technical issues limit decision-makers' confidence in PRA results, especially at a pre-operational phase of the system life cycle? (b) What is being done to address these issues'? (c) What more can be done ? The workshop resulted in participant observations and suggestions on several technical issues, including the pursuit of non-traditional approaches to risk assessment and the verification and validation of risk models. The workshop participants also identified several important non-technical issues, including risk communication with decision makers, and the integration of PRA into the overall design process.

  8. Validation studies of an immunochromatographic 1-step test for the forensic identification of human blood.

    Science.gov (United States)

    Hochmeister, M N; Budowle, B; Sparkes, R; Rudin, O; Gehrig, C; Thali, M; Schmidt, L; Cordier, A; Dirnhofer, R

    1999-05-01

    An immunochromatographic 1-step test for the detection of fecal occult blood was evaluated for applicability for the forensic identification of human blood in stained material. The following experiments were conducted: 1) determination of the sensitivity and specificity of the assay; 2) evaluation of different extraction media for bloodstains (sterile water, Tris buffer pH 7.5 provided in the test kit, 5% ammonia); 3) analysis of biological samples subjected to a variety of environmental insults; and 4) evaluation of casework samples. This immunochromatographic 1-step occult blood test is specific for human (primate) hemoglobin and is at least an order of magnitude more sensitive than previous methods for detecting human hemoglobin in bloodstains. The antigen is insensitive to a variety of environmental insults, except for exposure to certain detergents and household bleaches and prolonged exposure to certain preparations of luminol. The entire assay can be conducted in field testing conditions within minutes. When in the laboratory the supernatant from a DNA extraction is used for the assay, there is essentially no consumption of DNA for determining the presence of human hemoglobin in a forensic sample. The data demonstrate that this test is robust and suitable for forensic analyses.

  9. Cell free fetal DNA testing in maternal blood of Romanian pregnant women

    Directory of Open Access Journals (Sweden)

    Viorica E Radoi

    2015-10-01

    Full Text Available Background: The discovery of circulating fetal DNA in maternal blood led to the discovery of new strategies to perform noninvasive testing for prenatal diagnosis. Objective: The purpose of the study was to detect fetal aneuploidy at chromosomes 13, 18, 21, X, and Y by analysis of fetal cell-free DNA from maternal blood, without endangering pregnancy. Materials and Methods: This retrospective study has been performed in Bucharest at Medlife Maternal and Fetal Medicine Department between 2013-2014. In total 201 women were offered noninvasive prenatal test. Maternal plasma samples were collected from women at greater than 9 weeks of gestation after informed consent and genetics counseling. Results: From 201 patients; 28 (13.93% had screening test with high risk for trisomy 21, 116 (57.71% had advanced maternal age, 1 (0.49% had second trimester ultrasound markers and the remaining 56 patients (27.86% performed the test on request. Of those patients, 189 (94.02% had a “low risk” result (99% risk all for trisomy 21 (T21. T21 was confirmed by amniocentesis in 1 patient and the other 4 patients declined confirmation. The 7 remaining patients (3.48% had a low fetal fraction of DNA. Conclusion: It is probably that prenatal diagnosis using fetal DNA in maternal blood would play an increasingly role in the future practice of prenatal testing because of high accuracy.

  10. Comparative Evaluation of Four Presumptive Tests for Blood to Detect Epithelial Injury on Fish

    Energy Technology Data Exchange (ETDEWEB)

    Colotelo, Alison HA; Smokorowski, Karen; Haxton, Tim; Cooke, Steven J.

    2014-06-01

    Current methods of fish epithelial injury detection are limited to gross macroscopic examination that has a subjective bias as well as an inability to reliably quantify the degree of injury. Fluorescein, a presumptive test for blood, has been shown to have the capability to detect and quantify fish epithelial injury. However, there are several other presumptive tests for blood (Bluestar*, phenolphthalein, and HemastixH) that may have benefits over the use of fluorescein, particularly for field research on wild fish. This study investigated the capabilities of these four tests to detect and quantify a variety of injuries commonly encountered by fish (abrasion, cuts, fin frays, and punctures) using the freshwater bluegill Lepomis macrochirus as a model. Fluorescein was consistently found to be the most reliable (i.e., detected the highest proportion of true positive results and rarely detected false positive reactions) of the four presumptive tests for blood compared. Further testing was conducted to examine the reliability of fluorescein. By 24 h after an injury was inflicted, the injury was no longer detectable by fluorescein, and when fluorescein was applied to an injured fish, the fluorescein was no longer detectable 3 h after application. In a comparison of two common anaesthetics used in fisheries research, there was no significant difference in the proportion of injury detected when 3- aminobenzoic acid ethyl ester methanesulfate (tricaine) was used compared with a clove oil and ethanol (1:9) solution. In summary, fluorescein was the most reliable presumptive test for blood examined in this study for the detection and quantification of recent (hours) fish epithelial injury.

  11. Early detection of Haemonchus contortus infection in sheep using three different faecal occult blood tests

    Directory of Open Access Journals (Sweden)

    A.V. Rodríguez

    2015-07-01

    Full Text Available Haemonchus contortus is a blood-sucking parasite causing the presence of faecal occult blood (FOB. The objective was to study three different FOB tests in order to have a new indicator of H. contortus infection in sheep that could be included in the genetic evaluation system as an alternative selection criterion to faecal worm egg count (FEC. A total of 29 Corriedale lambs were experimentally infected with 10.000 larvae of H. contortus. Stool samples were recorded for FEC and FOB tests (Hexagon, Hematest® and Multistix®, blood for packed cell volume (PCV, haemoglobin, white and red blood cell count (RBC, and FAMACHA© for scoring anaemia. At the end of the experiment lambs were slaughtered to worm burden count. Field infection was achieved in 309 Merino lambs under natural parasite challenge. FEC data were normalized through logarithmic transformation (LnFEC. Pearson correlation was estimated to examine the relationship between all traits. The three tests were able to detect the presence of FOB at day 11. FEC, PCV and RBC decreased to sub-normal values from day 18. FAMACHA© score 3 was considered to be indicative of anaemia. Most of the correlations were of high magnitude, with the exception of Multistix® test that was moderately correlated with haematological parameters, LnFEC and FEC. In field infection, most samples were negative to FOB tests and the correlations were lower than those calculated under experimental infection. In conclusion, FOB tests were able to detect haemonchosis earlier than FEC under high experimental parasite challenge. However, they were not able to detect FOB under natural mixed parasite challenge. FAMACHA© and PCV demonstrated to be good indicators of Haemonchosis, having moderate to high correlations with FEC.

  12. Sensitive KIT D816V mutation analysis of blood as a diagnostic test in mastocytosis

    DEFF Research Database (Denmark)

    Kielsgaard Kristensen, Thomas; Vestergaard, Hanne; Bindslev-Jensen, Carsten;

    2014-01-01

    The recent progress in sensitive KIT D816V mutation analysis suggests that mutation analysis of peripheral blood (PB) represents a promising diagnostic test in mastocytosis. However, there is a need for systematic assessment of the analytical sensitivity and specificity of the approach in order...... the mutation in PB in nearly all adult mastocytosis patients. The mutation was detected in PB in 78 of 83 systemic mastocytosis (94%) and 3 of 4 cutaneous mastocytosis patients (75%). The test was 100% specific as determined by analysis of clinically relevant control patients who all tested negative. Mutation...

  13. The Sympathetic Release Test: A Test Used to Assess Thermoregulation and Autonomic Control of Blood Flow

    Science.gov (United States)

    Tansey, E. A.; Roe, S. M.; Johnson, C. J.

    2014-01-01

    When a subject is heated, the stimulation of temperature-sensitive nerve endings in the skin, and the raising of the central body temperature, results in the reflex release of sympathetic vasoconstrictor tone in the skin of the extremities, causing a measurable temperature increase at the site of release. In the sympathetic release test, the…

  14. The Sympathetic Release Test: A Test Used to Assess Thermoregulation and Autonomic Control of Blood Flow

    Science.gov (United States)

    Tansey, E. A.; Roe, S. M.; Johnson, C. J.

    2014-01-01

    When a subject is heated, the stimulation of temperature-sensitive nerve endings in the skin, and the raising of the central body temperature, results in the reflex release of sympathetic vasoconstrictor tone in the skin of the extremities, causing a measurable temperature increase at the site of release. In the sympathetic release test, the…

  15. Detection of cancer cells in peripheral blood with nested RT-PCR and itssignificance in patients with gastric carcinomas

    Institute of Scientific and Technical Information of China (English)

    Jia Zeng Xia; Hao Ran Yin; Zheng Gang Zhu; Min yan

    2000-01-01

    AIM To study the detection of micrometastasis in peripheral blood of patients with gastric carcinomas andits clinical significance.METHODS A cytokeratin 19 (CK19)-specific nested reverse transcriptase-polimerase chain reaction (RT-PCR) assay was developed to detect CK19 expressing cancer cells, the sensitivity was determined by serialdilution method using CK19 expressing gastric cancer cells, the specificity was assessed by examining 12negative controls and 12 positive controls. Then pre-operative peripheral blood from 42 patients with gastriccancer was detected and the relationship between positive results and biological behavior was studied.RESULTS CK19mRNA was expressed in all the 12 gastric cancer tissues but not in peripheral blood from12 healthy individuals;sensitivity of nested RT-PCR amplification for CK19mRNA was confirmed to be 1/106 by serial dilution method using human gastric cancer line SGC-7901; micrometastases in pre-operativeperipheral blood were detected in 13 (30,9%) patients with gastric carcinomas, the frequency ofmicrometastasis in peripheral blood was significantly correlated with tumor size,depth of invasion and TNMstage (x2 test, P<0.05).CONCLUSION Nested RT-PCR amplification for CK19mRNA is a sensitive and specific method for thedetection of micrometastases in peripheral blood in gastric cancer patients; pre-operative detection ofmicrometastasis in peripheral blood may be helpful in the prediction of tumor progression.

  16. The effects of transport by pneumatic tube system on blood cell count, erythrocyte sedimentation and coagulation tests

    OpenAIRE

    Koçak, Fatma Emel; Yöntem, Mustafa; Yücel, Özlem; Çilo, Mustafa; Genç, Özlem; Meral, Ayfer

    2013-01-01

    Introduction: Today, the pneumatic tube transport system (PTS) is used frequently because of its advantages related to timing and speed. However, the impact of various types of PTS on blood com-ponents is unknown. The aim of this study was to examine the influence of PTS on the quality of rou-tine blood cell counts, erythrocyte sedimentation, and certain blood coagulation tests. Materials and methods: Paired blood samples were obtained from each of 45 human volunteers and evaluated by bloo...

  17. Evaluation of a PCR test for detection of treponema pallidum in swabs and blood.

    Science.gov (United States)

    Grange, P A; Gressier, L; Dion, P L; Farhi, D; Benhaddou, N; Gerhardt, P; Morini, J P; Deleuze, J; Pantoja, C; Bianchi, A; Lassau, F; Avril, M F; Janier, M; Dupin, N

    2012-03-01

    Syphilis diagnosis is based on clinical observation, serological analysis, and dark-field microscopy (DFM) detection of Treponema pallidum subsp. pallidum, the etiological agent of syphilis, in skin ulcers. We performed a nested PCR (nPCR) assay specifically amplifying the tpp47 gene of T. pallidum from swab and blood specimens. We studied a cohort of 294 patients with suspected syphilis and 35 healthy volunteers. Eighty-seven of the 294 patients had primary syphilis, 103 had secondary syphilis, 40 had latent syphilis, and 64 were found not to have syphilis. The T. pallidum nPCR results for swab specimens were highly concordant with syphilis diagnosis, with a sensitivity of 82% and a specificity of 95%. Reasonable agreement was observed between the results obtained with the nPCR and DFM methods (kappa = 0.53). No agreement was found between the nPCR detection of T. pallidum in blood and the diagnosis of syphilis, with sensitivities of 29, 18, 14.7, and 24% and specificities of 96, 92, 93, and 97% for peripheral blood mononuclear cell (PBMC), plasma, serum, and whole-blood fractions, respectively. HIV status did not affect the frequency of T. pallidum detection in any of the specimens tested. Swab specimens from mucosal or skin lesions seemed to be more useful than blood for the efficient detection of the T. pallidum genome and, thus, for the diagnosis of syphilis.

  18. Automatic system for blood donors control with seropositive results in epidemiological tests.

    Directory of Open Access Journals (Sweden)

    Ariel Menéndez Barrios

    2008-04-01

    Full Text Available Background: Prevention of infectious diseases transmission through blood transfusion is one of the biggest challenges in the transfusion field of medicine. Objective: to design a computerized system for blood donors control with seropositive results in epidemiological tests. Methods: A system designed by the Provincial Blood Bank using Microsoft Access as a data base system and DELFHI 7 as associated language. It runs under Windows 2000 or any other superior system with 64 RAM and do not need special requirements of software or hardware. It includes the following data: Full name, age, sex, race, Id number, home address, number of the clinical record in the blood bank, date when the trial took place in each patient, kind of disease diagnosed, technical data of the trial such as: fluorescence, sectional level of the 1st trial as well as the repetition, name of the technician who performed it. Results: It permits to consult general data of donors as well as the disease diagnosed. It also permits to elaborate reports of these patients from any PC of the blood bank acceding with the security password of the program. Conclusions: It constitutes a beneficial tool which permits to improve the notification system established in the program of the web about sexually transmitted diseases from the Minister of Public Health in Cuba.

  19. Impact of nucleic acid amplification test on screening of blood donors in Northern Pakistan.

    Science.gov (United States)

    Niazi, Saifullah Khan; Bhatti, Farhat Abbas; Salamat, Nuzhat; Ghani, Eijaz; Tayyab, Muhammad

    2015-07-01

    The Armed Forces Institute of Transfusion located in Rawalpindi, Northern Pakistan, acts as a regional blood center with more than 50,000 donations collected annually. Nucleic acid amplification testing (NAT) was introduced in our institution in September 2012 for screening all seronegative blood donors. The study was conducted from September 21, 2012, to September 20, 2013. Samples from the seronegative donors were run on cobas s 201 platform (Roche) in pools of six. Reactive donors were followed up for further confirmatory testing to rule out false-positive results. Viral load estimation was done for all NAT-reactive donors. After serologic screening of 56,772 blood donors, 2334 were found to be reactive; 719 (1.27%) were reactive for hepatitis B surface antigen, 1046 (1.84%) for antibody to hepatitis C virus (anti-HCV), 12 (0.02%) for antibody to human immunodeficiency virus, and 557 (0.98%) for syphilis antibodies. A total of 27 NAT-reactive donors were confirmed after testing 54,438 seronegative donors, with an overall NAT yield of one in 2016 donors: 23 for hepatitis B virus (HBV) DNA (HBV NAT yield, 1:2367) and four for HCV RNA (HCV NAT yield, 1:13,609). The residual risk after NAT implementation, calculated for the first-time blood donors, was 62.5 and 4.4 per million donors for HBV and HCV, respectively. NAT has improved the safety of blood products at our transfusion institution. Confirmation of NAT results must always be done either on follow-up samples or on samples from the retrieved frozen plasma bag. © 2015 AABB.

  20. Testing of models of flow-induced hemolysis in blood flow through hypodermic needles.

    Science.gov (United States)

    Chen, Yangsheng; Kent, Timothy L; Sharp, M Keith

    2013-03-01

    Hemolysis caused by flow in hypodermic needles interferes with a number of tests on blood samples drawn by venipuncture, including assays for metabolites, electrolytes, and enzymes, causes discomfort during dialysis sessions, and limits transfusion flow rates. To evaluate design modifications to address this problem, as well as hemolysis issues in other cardiovascular devices, computational fluid dynamics (CFD)-based prediction of hemolysis has potential for reducing the time and expense for testing of prototypes. In this project, three CFD-integrated blood damage models were applied to flow-induced hemolysis in 16-G needles and compared with experimental results, which demonstrated that a modified needle with chamfered entrance increased hemolysis, while a rounded entrance decreased hemolysis, compared with a standard needle with sharp entrance. After CFD simulation of the steady-state velocity field, the time histories of scalar stress along a grid of streamlines were calculated. A strain-based cell membrane failure model and two empirical power-law blood damage models were used to predict hemolysis on each streamline. Total hemolysis was calculated by weighting the predicted hemolysis along each streamline by the flow rate along each streamline. The results showed that only the strain-based blood damage model correctly predicted increased hemolysis in the beveled needle and decreased hemolysis in the rounded needle, while the power-law models predicted the opposite trends. © 2013, Copyright the Authors. Artificial Organs © 2013, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  1. [Identification and antimicrobial susceptibility testing of positive blood culture isolates from briefly incubated solid medium cultures].

    Science.gov (United States)

    Ballestero-Téllez, Mónica; Recacha, Esther; de Cueto, Marina; Pascual, Álvaro

    2016-02-16

    Mass spectrometry Matrix-Assisted Laser Desorption-Ionization Time-of-Flight (MALDI-TOF) helps in the rapid identification of microorganisms causing blood stream infection. Rapid and reliable methods are required to decrease the turnaround time for reporting antimicrobial susceptibility results from blood culture isolates. An evaluation was performed on the reliability of a method for antimicrobial susceptibility testing of positive blood culture isolates from briefly incubated solid medium cultures. The agreement between the evaluated and standard methods was 99.3%. The major and minor error rates were 0.4% and 0.3%, respectively, and no very major errors were observed. The inoculation of briefly incubated solid medium cultures into antimicrobial susceptibility testing panels is an easy and reliable technique, and helps to decrease the turnaround time for reporting antimicrobial susceptibility results of positive blood cultures. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  2. The impact of actual and perceived disease severity on pre-operative psychological well-being and illness behaviour in adult congenital heart disease patients.

    Science.gov (United States)

    Callus, Edward; Utens, Elisabeth M W J; Quadri, Emilia; Ricci, Cristian; Carminati, Mario; Giamberti, Alessandro; Chessa, Massimo

    2014-04-01

    The purpose of this study was to investigate whether the objective medical parameters related to congenital heart disease and patients' ratings of cardiac disease severity were related to psychological well-being and illness behaviour during the pre-operative period. A total of 143 patients (63 male patients; 16-73 years old) with congenital heart disease evaluated the severity of their cardiac condition using a numerical rating scale ranging from 0, indicating the least severe condition, to 100, indicating the most severe condition. Psychological well-being was assessed using the Psychological General Well-Being Index (total score ≤ 60 indicating severe distress) and illness behaviour using the Illness Behavior Questionnaire. Pre-operative psychological well-being was not related to the objective medical parameters reflecting cardiac disease severity. In contrast, total psychological well-being scores correlated significantly with patients' subjective ratings of disease severity (p Illness Behavior Questionnaire, the scores on denial were higher and those on hypochondria were lower compared with other hospitalised patients. This study shows that the perception of cardiac disease severity, and not the medical parameters in congenital heart disease, is related to the patients' pre-operative psychological state. Thus, more importance needs to be given to assessing the patients' pre-operative perception and psychological state independently of cardiac severity. Targeted interventions with regard to the cardiac condition are recommended.

  3. A 20-year retrospective analysis of CT-based pre-operative identification of pulmonary metastases in patients with osteosarcoma: A single-center review.

    Science.gov (United States)

    Heaton, Todd E; Hammond, William J; Farber, Benjamin A; Pallos, Valerie; Meyers, Paul A; Chou, Alexander J; Price, Anita P; LaQuaglia, Michael P

    2017-01-01

    Cooperative studies support complete metastasectomy in osteosarcoma (OS). Pre-operative CT is used to identify and quantify metastases and can facilitate minimally invasive techniques. Here we assess the accuracy of pre-operative CT compared to findings at thoracotomy and its change over time. We reviewed OS thoracotomies performed at our institution from 1996 to 2015. The number of metastases identified on pre-operative chest CT was compared to the number of metastases seen on pathology (both metastases with viable cells and non-viable, osteoid-only metastases). Eighty-eight patients underwent 161 thoracotomies with a median of 14days (range, 1-85) between CT and surgery, a median of 2 CT-identified lesions (range, 0-15), and a median of 4 resected lesions (range, 1-25). In 56 (34.8%) cases, more metastases were found surgically than were seen on CT, and among these, 34 (21.1%) had a greater number of viable metastases. There was poor overall correlation between CT and pathology findings (Kendall Tau-b=0.506), regardless of CT slice thickness, decade of thoracotomy, or total number of CT-identified lesions. CT accuracy in pre-operatively quantifying OS pulmonary metastases has not improved in recent decades. Consequently, we recommend an open technique with direct lung palpation for complete identification and resection of OS pulmonary metastases. Level IV, retrospective study with no comparison group. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Fear of movement in pre-operative patients with a lumbar stenosis and or herniated disc : Factor structure of the Tampa scale for kinesiophobia

    NARCIS (Netherlands)

    van Wilgen, C. Paul; Stewart, Roy; Stegeman, P. T. Patrick; Coppes, Maarten; van Wijhe, Marten

    2010-01-01

    The presence of fear of movement is related to higher disability rates in several patient groups. The purpose of this study was first to analyze fear of movement and the relation with pain and disability in pre-operative patients with low back pain and radiculopathy and secondly to analyze the

  5. A systematic review of pre-operative predictors of post-operative depression and anxiety in individuals who have undergone coronary artery bypass graft surgery.

    Science.gov (United States)

    McKenzie, Louise H; Simpson, Jane; Stewart, Marie

    2010-01-01

    In addition to the physical benefits, another important objective of coronary artery bypass graft (CABG) surgery is improvement of health-related quality of life. The aim of this systematic review is to provide an overview of the literature relating to the pre-operative prediction of post-operative depression and anxiety in individuals who have undergone CABG surgery. Forty-six studies were identified through a literature search of electronic databases conducted using explicit inclusion and exclusion criteria. The study characteristics, methodological features, and psychometric and clinical outcomes were summarised in a systematic manner. Collective appraisal of the studies indicated that symptoms of depression and anxiety exhibited after CABG surgery are best predicted by pre-operative measures of functioning in that area. Papers were inconclusive with respect to the predictive qualities of gender and age. Further research is required to clarify the predictive values of these and other factors, including pre-morbid ill health and socio-economic status. The findings of this review indicate a range of pre-operative predictors of post-operative depression and anxiety in patients with CABG. Chief among these are pre-operative depression and anxiety. These findings have clinical implications concerning the importance of pre and post-operative psychological assessment and intervention for individuals at risk of poor psychological recovery.

  6. INFLUENCE OF PRE OPERATIVE PHYSICAL THERAPY EDUCATION AND EXERCISE ON POST OPERATIVE SHOULDER RANGE OF MOTION AND FUNCTIONAL ACTIVITES IN SUBJECTS WITH MODIFIED RADICAL MASTECTOMY

    Directory of Open Access Journals (Sweden)

    Y. Lokapavani

    2014-10-01

    Full Text Available Background: Modified radical mastectomy is a frequent surgery employed as a therapeutic procedure in patients with breast carcinoma with involvement of axillary lymph nodes. Many patients suffer from severe shoulder complaints after axillary lymph node dissection even with postoperative rehabilitation. Pre-operative exercise and education are recommended to reduce the incidence of breast cancer related upper limb dysfunction; it will shorten the recovery time. The objectives of the study are to determine the influence of pre-operative physiotherapy on shoulder ROM using goniometer in subjects with modified radical mastectomy and to determine the influence of pre-operative physiotherapy on functional activities using shoulder pain and disability index (SPADI in subjects with modified radical mastectomy. Methods: 30 Subjects of adult women included in the study who met the inclusion criteria, divided into 2 groups. Experimental Group received preoperative physical therapy education and exercises 1-2 weeks before surgery and routine physical therapy protocol after surgery. Control Group received standard education brochure preoperatively and routine physical therapy post operatively. Measurements included shoulder ROM and functional evaluation using goniometer and SPADI. Measurements were taken at baseline i.e., pre operatively, post operatively at 4th day after removal of drains, and 1month after surgery. Results: All measures were significantly reduced after surgery, but most recovered after 1month of surgery and attained functional level in experimental Group. Conclusion: This study provides experimental evidence that preoperative education and exercise influence the postoperative shoulder ROM and functional activities after modified radical mastectomy.

  7. Pre-operative assessment of cancer in the elderly (PACE) : A comprehensive assessment of underlying characteristics of elderly cancer patients prior to elective surgery

    NARCIS (Netherlands)

    Pope, D.; Ramesh, H.; Gennari, R.; Corsini, G.; Maffezzini, M.; Hoekstra, H. J.; Mobarak, D.; Sunouchi, K.; Stotter, A.; West, C.; Audisio, R. A.

    2006-01-01

    Background: Cancer is a disease that particularly affects the elderly and, although surgery is the first treatment choice, many elderly cancer patients do not receive standard surgery because they are considered unfit for treatment due to an inaccurate estimation of operative risk. Pre-operative Ass

  8. Current Challenges Towards the Development of a Blood Test for Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Jose A. Santiago

    2014-10-01

    Full Text Available Parkinson’ disease (PD is the second most prevalent neurodegenerative disease worldwide. To date, there is no disease-modifying agent, and current medical treatment only provides symptomatic benefits. Early diagnosis of PD would be useful in clinical practice to identify patients for clinical trials, test potential drugs and neuroprotective agents and track their therapeutic effect. Considerable progress has been made in the discovery and validation of diagnostic biomarkers for PD. In particular, blood-based biomarkers have shown promise in identifying PD patients in samples from independent clinical trials. Evaluation of these biomarkers in de novo patients and individuals at risk for PD remains a top priority. Here, we review the current advances and challenges toward the clinical translation of these biomarkers into a blood-based test for PD.

  9. [Detection of fetal nucleated red blood cells in the maternal circulation by Kleihauer test].

    Science.gov (United States)

    Liu, Wei-Yu; Jin, Chun-Lian; Liu, Li-Ying; Lin, Chang-Kun; Wang, Yan; Sun, Kai-Lai

    2007-03-01

    Maternal blood was obtained from 18 pregnant women at 7 to 25 weeks of gestation. After Percoll discontinuous density gradient centifugation, the fetal nucleated red blood cells (NRBCs) were stained with Kleihauer test. Positive fetal cells appeared with an intense red cytoplasmic staining while maternal cells with adult haemoglobin were colourless. Individual positive NRBC was collected by micromanipulator and whole genome amplification was then performed to determine sex and STR status. This allowed the simultaneous verification of the fetal origin of NRBC and prenatal diagnosis of genetic diseases. The non-invasive prenatal genetic diagnosis of 9 fetuses at high risk of Duchenne muscular dystrophy (DMD) was completed successfully. The Kleihauer test is a rapid, simple and direct chemical staining method to select fetal cells and can be applied in prenatal diagnosis.

  10. Blood typing

    Science.gov (United States)

    A blood sample is needed. The test to determine your blood group is called ABO typing. Your blood sample is mixed with antibodies against type A and B blood. Then, the sample is checked to see whether ...

  11. Axillary fine needle aspiration cytology for pre-operative staging of patients with screen-detected invasive breast carcinoma.

    LENUS (Irish Health Repository)

    Hayes, Brian D

    2012-02-01

    INTRODUCTION: Fine needle aspiration cytology (FNAC) of radiologically abnormal axillary lymph nodes in patients with breast cancer can identify patients suitable for primary axillary clearance (AC) rather than sentinel node biopsy, enabling surgical axillary staging by a single operation. This study assessed the accuracy of FNAC in predicting positive axillary lymph nodes. METHODS: 161 patients with screen-detected invasive carcinoma and who had pre-operative FNAC of a radiologically abnormal axillary lymph node were identified from two screening units, The axillary FNAC reports were correlated with sentinel node biopsy and AC reports, and sensitivity, specificity, positive (PPV) and negative (NPV) predictive values were calculated. RESULTS: FNAC had a moderate sensitivity (66.3%) and NPV (71.8%), and a high specificity (98.7%) and PPV (98.3%). Most patients (86%) had a single axillary operation. The sensitivity was highest in grade 3 (81.8%) and ductal type (77.8%) tumours. The sensitivity was lower in tumours of special type (34.8%), grade 1 tumours (50%) and those without lymphovascular invasion (LVI) (55.9%). The NPV was highest in pT1 (86.7%) and in grade 1 (84.5%) tumours, and lowest (44%) in tumours with LVI. The PPV was 100% in grade 1 and 3 tumours, stage pT2 and pT3 tumours and those without LVI, and was high (>96%) in all other groups. In lymph-node-positive patients, the mean number of lymph nodes involved was higher in the case of a positive (6.4) than negative FNAC (4.4). CONCLUSIONS: FNAC of ultrasonically abnormal axillary lymph nodes achieved surgical staging by a single operation in most patients with screen-detected invasive breast carcinoma, with moderate sensitivity and high specificity.

  12. Effect of pre-operative neoadjuvant chemo-radiotherapy and surgical treatment on resectable esophageal cancer: a Meta-analysis

    Directory of Open Access Journals (Sweden)

    Wei ZHU

    2011-08-01

    Full Text Available Objective To explore the effect of pre-operative adjuvant chemo-radiotherapy and surgical treatment on resectable esophageal cancer.Methods By searching Medline,CENTRAL(the Cochrane Central Register of Controlled trials,EMBASE,CBM(China Biology Medicine and CNKI(China National Knowledge Infrastructure by computer,the data of randomized controlled trials(RCTs of neoadjuvant chemoradiotherapy and surgical treatment for resectable esophageal cancer were selected and analyzed using Stata 11.0 statistical software.The study population was patients with resectable early or medium stage esophageal cancer,the intervention was neoadjuvant chemoradiotherapy(include sequential chemoradiotherapy and concurrent chemoradiotherapy followed with surgical resection,the outcome indices were 1-and 3-year survival rates and local recurrence rate.The combined odds ratio(OR,relative risk(RR and their 95% confidence interval(CI were calculated to estimate the results.Results Nine articles including a total of 1156 patients were finally analyzed in the Meta-analysis.Among all the patients,579 received neoadjuvant chemoradiotherapy(study group and 577 received surgical treatment only(control group.Compared the study group and control group,the OR of 1-and 3-year survival rate was 1.06(95%CI=0.94-1.19,Z=0.97,P=0.33 and 1.30(95%CI=1.07.-1.57,Z=2.67,P=0.008,respectively,and the RR of local recurrence rate was 0.75(95%CI=0.50-1.12,Z=1.40,P=0.162.Conclusions Neoadjuvant chemoradiotherapy could improve the 3-year survival rate of patients with resectable esophageal cancer,but could not decrease the local recurrence rate.

  13. Effect of Pre-Operative Use of Medications on the Risk of Surgical Site Infections in Patients Undergoing Cardiac Surgery.

    Science.gov (United States)

    Eton, Vic; Sinyavskaya, Liliya; Langlois, Yves; Morin, Jean François; Suissa, Samy; Brassard, Paul

    2016-10-01

    Median sternotomy, the most common means of accessing the heart for cardiac procedures, is associated with higher risk of surgical site infections (SSIs). A limited number of studies reporting the impact of medication use prior to cardiac surgery on the subsequent risk of SSIs usually focused on antibacterial prophylaxis. The objective of the current study was to evaluate the effect of medications prescribed commonly to cardiac patients on the risk of incident SSIs. The study analyzed data on consecutive cardiac surgery patients undergoing median sternotomy at a McGill University teaching hospital between April 1, 2011 and October 31, 2013. Exposure of interest was use of medications for heart disease and cardiovascular conditions in the seven days prior to surgery and those for comorbid conditions. The main outcome was SSIs occurring within 90 d after surgery. Univariate and multivariate logistic regression (adjusted odds ratio [AOR]) was used to evaluate the effect. The cohort included 1,077 cardiac surgery patients, 79 of whom experienced SSIs within 90 d of surgery. The rates for sternal site infections and harvest site infections were 5.8 (95% confidence interval [CI]: 4.4-7.3) and 2.5 (95% CI: 1.4-3.7) per 100 procedures, respectively. The risk of SSI was increased with the pre-operative use of immunosuppressors/steroids (AOR 3.47, 95% CI: 1.27-9.52) and α-blockers (AOR 3.74, 95% CI: 1.21-1.47). Our findings support the effect of immunosuppressors/steroids on the risk of SSIs and add evidence to the previously reported association between the use of anti-hypertensive medications and subsequent development of infection/sepsis.

  14. Influence of mechanical trauma of blood and hemolysis on PFA-100 testing.

    Science.gov (United States)

    Lippi, Giuseppe; Fontana, Rossana; Avanzini, Paola; Aloe, Rosalia; Ippolito, Luigi; Sandei, Franca; Favaloro, Emmanuel J

    2012-01-01

    Although the appropriate quality of samples is essential for platelet function testing, information is lacking on interference from mechanical trauma of blood and hemolysis on PFA-100 analyzer. Citrated blood collected from nine healthy volunteers was divided into three aliquots. The first aliquot ('A') was processed without further manipulation, whereas the second and third were subjected to mechanical trauma by two ('aliquot B') or four passages ('aliquot C') through a very fine needle (30 gauge) to produce hemolysis and cell trauma mimicking poor sample collection. Samples were tested on PFA-100 and Advia 2120, and plasma then separated and tested for lactate dehydrogenase (LDH) and hemolysis index. Negligible hemolysis was present in aliquot A (hemolysis index 0.2 ± 0.1, cell-free hemoglobin 0-0.5 g/l), whereas an increasing amount was present in aliquots B (hemolysis index of 13.1 ± 1.8, cell-free hemoglobin 6.0-6.5 g/l) and C (hemolysis index 24.0 ± 1.1, cell-free hemoglobin 11.5-12.0 g/l). Increases in LDH, and concomitant reductions in platelet and red blood cell counts were observed in aliquots B and C. In hemolyzed aliquots B, four out of nine samples yielded 'flow obstruction' with both PFA-100 agonist cartridges, whereas the closure times were dramatically prolonged in the remaining five samples. In hemolyzed aliquots C, flow obstruction was recorded in six of nine samples for collagen and ADP and all samples for collagen and epinephrine, whereas closure times of collagen and ADP in the remaining three samples were dramatically prolonged. Mechanical trauma of blood causing hemolysis makes PFA-100 testing unreliable. When flow obstructions are observed, the potential presence of hemolysis should be investigated.

  15. New method for rapid Susceptibility Testing on blood culture with HB&L system: preliminary data

    Directory of Open Access Journals (Sweden)

    Vincenzo Rondinelli

    2010-12-01

    Full Text Available Blood culture, although represents the gold standard in detecting the ethiological agent of sepsis, is rather rarely required in relation to the real diagnostic importance. The result of this test depends in fact on many factors (sample volume, time of collection, accuracy, antibiotic therapy, contamination, number of drawings, drawing site, interpretation difficulties, etc. that are often considered by many clinicians so limited as to doubt about their actual value. The disadvantages are therefore represented by the lack of standardization but also by the low sensitivity and above all by the technical times too long for the clinical needs. Blood culture begins with the drawing of samples from the “septic” patient followed incubation of the bottles in automatic thermostated systems. In case of positive result (36 hours, the culture is Gram stained and streaked on solid media in order to obtain isolated colonies for the identification and the susceptibility testing (48 hours from positive result. The long time required for pathogen identification and susceptibility testing involves empirical broad spectrum antibiotic therapy that can promote the increase of bacterial resistance but also patient management costs. A clinically useful report should be available on short notice in order to guide the clinician to choose the most appropriate antibiotic. The microbiologist has therefore the hard work of reviewing the organization and the management of the procedures.We have therefore started to consider the possibility of treating the blood as an biological liquid in order to quickly determine the susceptibility of bacteria to antibiotics.

  16. A study of common interferences with the forensic luminol test for blood.

    Science.gov (United States)

    Quickenden, T I; Creamer, J I

    2001-01-01

    A wide range of domestic and industrial substances that might be mistaken for haemoglobin in the forensic luminol test for blood were examined. The substances studied were in the categories of vegetable or fruit pulps and juices; domestic and commercial oils; cleaning agents; an insecticide; and various glues, paints and varnishes. A significant number of substances in each category gave luminescence intensities that were comparable with the intensities of undiluted haemoglobin, when sprayed with the standard forensic solution containing aqueous alkaline luminol and sodium perborate. In these cases the substance could be easily mistaken for blood when the luminol test is used, but in the remaining cases the luminescence intensity was so weak that it is unlikely that a false-positive test would be obtained. In a few cases the brightly emitting substance could be distinguished from blood by a small but detectable shift of the peak emission wavelength. The results indicated that particular care should be taken to avoid interferences when a crime scene is contaminated with parsnip, turnip or horseradish, and when surfaces coated with enamel paint are involved. To a lesser extent, some care should be taken when surfaces covered with terracotta or ceramic tiles, polyurethane varnishes or jute and sisal matting are involved.

  17. Effects of applying continuous care model on blood tests in hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Rahimi A

    2008-06-01

    Full Text Available Background: The kidney is a complex and vital organ, regulating the electrolyte and fluid status of the human body. In clients with a chronic disease, such as end-stage renal disease, functioning status and hematologic indexes are different than among the general population. Electrolyte and hematologic changes may induce many illnesses for such patients. The purpose of this study is to determine the effects of applying the continuous hemodialysis (HD the blood test results of HD patients.Methods: This quasi-experimental, before-after study included 38 HD patients from Hamedan, Iran in 2005. Subjects were selected using simple randomized sampling and were assigned to one group for the purpose of this research and investigated over a period of six months. Data collection tools included demographic questionnaire and control check lists. The first phase of the research involved orientation of the control group, which was limited to completion of the questionnaires and control check lists. Immediately after, the same patients became the case group, upon which continuous HD was applied and hemoglobin, hematocrit, blood urea nitrogen (BUN, potassium, sodium, and albumin tests were performed. Statistical analysis of the data employed SPSS (version 13, descriptive statistics, paired t-test and the Friedman test.Results: In this group, 47.2% of the subjects were male and 52.8% female. Data analysis shows that, using repeated measurement ANOVA test, a significant relationship between application of the continuous HD and improvement in hemoglobin, hematocrit, BUN, potassium, sodium, and albumin levels (p<0.05. conclusion: Application of continuous HD causes a significant improvement in the blood test results of HD patients. We recommend that continuous HD be used, whenever appropriate, to resolve the common causes of complications in HD clients, including abnormal levels of electrolytes, especially potassium and phosphorus, as well as BUN and creatinine.

  18. Preparation of a blood culture pellet for rapid bacterial identification and antibiotic susceptibility testing.

    Science.gov (United States)

    Croxatto, Antony; Prod'hom, Guy; Durussel, Christian; Greub, Gilbert

    2014-10-15

    Bloodstream infections and sepsis are a major cause of morbidity and mortality. The successful outcome of patients suffering from bacteremia depends on a rapid identification of the infectious agent to guide optimal antibiotic treatment. The analysis of Gram stains from positive blood culture can be rapidly conducted and already significantly impact the antibiotic regimen. However, the accurate identification of the infectious agent is still required to establish the optimal targeted treatment. We present here a simple and fast bacterial pellet preparation from a positive blood culture that can be used as a sample for several essential downstream applications such as identification by MALDI-TOF MS, antibiotic susceptibility testing (AST) by disc diffusion assay or automated AST systems and by automated PCR-based diagnostic testing. The performance of these different identification and AST systems applied directly on the blood culture bacterial pellets is very similar to the performance normally obtained from isolated colonies grown on agar plates. Compared to conventional approaches, the rapid acquisition of a bacterial pellet significantly reduces the time to report both identification and AST. Thus, following blood culture positivity, identification by MALDI-TOF can be reported within less than 1 hr whereas results of AST by automated AST systems or disc diffusion assays within 8 to 18 hr, respectively. Similarly, the results of a rapid PCR-based assay can be communicated to the clinicians less than 2 hr following the report of a bacteremia. Together, these results demonstrate that the rapid preparation of a blood culture bacterial pellet has a significant impact on the identification and AST turnaround time and thus on the successful outcome of patients suffering from bloodstream infections.

  19. Effectiveness of saliva and fingerprints as alternative specimens to urine and blood in forensic drug testing.

    Science.gov (United States)

    Kuwayama, Kenji; Miyaguchi, Hajime; Yamamuro, Tadashi; Tsujikawa, Kenji; Kanamori, Tatsuyuki; Iwata, Yuko T; Inoue, Hiroyuki

    2016-07-01

    In forensic drug testing, it is important to immediately take biological specimens from suspects and victims to prove their drug intake. We evaluated the effectiveness of saliva and fingerprints as alternative specimens to urine and blood in terms of ease of sampling, drug detection sensitivity, and drug detection periods for each specimen type. After four commercially available pharmaceutical products were administered to healthy subjects, each in a single dose, their urine, blood, saliva, and fingerprints were taken at predetermined sampling times over approximately four weeks. Fourteen analytes (the administered drugs and their main metabolites) were extracted from each specimen using simple pretreatments, such as dilution and deproteinization, and were analyzed using liquid chromatography/mass spectrometry (LC/MS). Most of the analytes were detected in saliva and fingerprints, as well as in urine and blood. The time-courses of drug concentrations were similar between urine and fingerprints, and between blood and saliva. Compared to the other compounds, the acidic compounds, for example ibuprofen, acetylsalicylic acid, were more difficult to detect in all specimens. Acetaminophen, dihydrocodeine, and methylephedrine were detected in fingerprints at later sampling times than in urine. However, a relationship between the drug structures and their detection periods in each specimen was not found. Saliva and fingerprints could be easily sampled on site without using special techniques or facilities. In addition, fingerprints could be immediately analyzed after simple and rapid treatment. In cases where it would be difficult to immediately obtain urine and blood, saliva and fingerprints could be effective alternative specimens for drug testing. Copyright © 2015 John Wiley & Sons, Ltd.

  20. Value of standardised exercise tests and blood biochemistry in the selection and training of breeding stallions.

    Science.gov (United States)

    Sloet van Oldruitenborgh-Oosterbaan, M M; Wensing, T; Barneveld, A; Breukink, H J

    1991-10-19

    Stallions selected by the Royal Dutch Warmblood Society were submitted to a standardised lungeing test at the beginning and at the end of a 100-day test of performance and ability. The heart rate, haematology and biochemistry values obtained in the first lungeing test showed no significant differences between the 15 stallions which were rejected by the Royal Dutch Warmblood Society during the first month of the 100-day test, the 15 stallions rejected during the last month and the 11 stallions which were approved for registration in the studbook. The 26 stallions submitted to the second lungeing test had significantly lower heart rates and blood lactate concentrations than in the first test. The standardised lungeing test had no value in predicting the rejection or approval of the stallions, and the fitness of a stallion at the beginning of the 100-day test did not influence its chance of being approved as a breeding stallion. The differences between the results of the first and the second tests suggest that the fitness of the stallions improved during the 100-day test.

  1. Evaluation for secondary causes of headache: the role of blood and urine testing.

    Science.gov (United States)

    Loder, Elizabeth; Cardona, Luzma

    2011-02-01

    Most patients presenting for evaluation of headache meet diagnostic criteria for a benign, primary headache disorder based on history and physical examination findings alone. No further testing is needed in such cases. Additional diagnostic evaluation is needed in cases that do not meet criteria for a primary headache disorder or which are associated with unusual or worrisome features. This article will review secondary causes of headache listed in the International Classification of Headache Disorders-II in which blood and urine testing might aid in diagnosis. We offer recommendations for diagnostic evaluation when these disorders are suspected causes of headache.

  2. The Importance of Blood Routine Test of Blood Smear%血常规检验中血涂片分析的重要性

    Institute of Scientific and Technical Information of China (English)

    鲁锐

    2016-01-01

    Objective To analysis the importance of blood smear in the routine blood test analysis.Methods 523 cases of patients were chosen in our hospital, during the inspection results to iflter, and divided into two groups, the blood samples will be two groups of patients are uniifed blood smear analysis, compare two groups patients in blood smear analysis after the false negative rate and false positive rate, complications and blood smear analysis results.Results The observation group patients blood smear of routine blood test analysis and incidence of complications after blood smear analysis results better than the control group patients, observation group patients with routine blood test blood smear analysis false negative rate is better than the control group after the false positive rate (P<0.05). Conclusion Artificial blood smear analysis method is applied to routine blood test, has certain application value, can provide more reliable diagnostic basis for clinical doctors.%目的:分析血常规检验中血涂片分析的重要性。方法选取我院进行血常规检验的患者523例,对其检验结果进行筛选,并分成两组,将两组患者的血液标本均统一进行血涂片分析,比较两组患者在血涂片分析后的假阴性率、假阳性率、并发症发生率和血涂片分析结果。结果实验组进行血常规检验的患者血涂片分析后的并发症发生率和血涂片分析结果优于对照组患者,实验组进行血常规检验的患者血涂片分析后假阴性率优于对照组假阳性率(P<0.05)。结论人工血涂片分析方式应用于血常规检验中,有其肯定的应用价值,可以为临床医生提供更为可靠的诊断依据。

  3. Patient factors associated with non-attendance at colonoscopy after a positive screening faecal occult blood test.

    Science.gov (United States)

    Plumb, Andrew A; Ghanouni, Alex; Rainbow, Sandra; Djedovic, Natasha; Marshall, Sarah; Stein, Judith; Taylor, Stuart A; Halligan, Steve; Lyratzopoulos, Georgios; von Wagner, Christian

    2017-03-01

    Background Screening participants with abnormal faecal occult blood test results who do not attend further testing are at high risk of colorectal cancer, yet little is known about their reasons for non-attendance. Methods We conducted a medical record review of 170 patients from two English Bowel Cancer Screening Programme centres who had abnormal guaiac faecal occult blood test screening tests between November 2011 and April 2013 but did not undergo colonoscopy. Using information from patient records, we coded and categorized reasons for non-attendance. Results Of the 170 patients, 82 were eligible for review, of whom 66 had at least one recorded reason for lack of colonoscopy follow-up. Reasons fell into seven main categories: (i) other commitments, (ii) unwillingness to have the test, (iii) a feeling that the faecal occult blood test result was a false positive, (iv) another health issue taking priority, (v) failing to complete bowel preparation, (vi) practical barriers (e.g. lack of transport), and (vii) having had or planning colonoscopy elsewhere. The most common single reasons were unwillingness to have a colonoscopy and being away. Conclusions We identify a range of apparent reasons for colonoscopy non-attendance after a positive faecal occult blood test screening. Education regarding the interpretation of guaiac faecal occult blood test findings, offer of alternative confirmatory test options, and flexibility in the timing or location of subsequent testing might decrease non-attendance of diagnostic testing following positive faecal occult blood test.

  4. [THE PERCENTAGE OF BLOOD SERUM TESTS WITH HEMOLYSIS IN DIFFERENT GROUPS OF PATIENTS].

    Science.gov (United States)

    Moshkin, A V

    2015-06-01

    In the process of laboratory analysis most of the errors occur at the pre-analytical stage. The percentage of blood serum tests with hemolysis is largely applied as an indicator of quality of sampling and transport of blood tests in laboratory. The study was carried out to analyze percentage of tests with hemolysis in different groups of in- and out-patients. The percentage of tests with hemolysis was estimated according actual recommendation of IFCC working group "Laboratory Errors and Patient Safety" as percentage oftests with free hemoglobin more than 0.5 g/l of total amount of serum tests analyzed on biochemical analyzer capable to measure hemolysis index. The hemolysis was identified in 199 (1.4%) out of 14 170 samples. The large dispersion of results in different groups of patient was established. In children younger than 7 years treated in hospital percentage of hemolysis amounted to 2.44%, in patients of reanimation department - 2.38%. In adult patients of hospital this indicator of quality ranged from 0.31% to 1.59%. In two groups of out-patients this indicator amounted to 0.36% (clinic personnel, dispensarization) and 1.81% (out-patients). Such a dispersion complicates inter-laboratory comparison of quality according this particular indicator. The necessity is substantiated to apply more efforts concerning harmonization of indicators of quality in laboratory medicine.

  5. The determination of phenazone in blood plasma for obtained sistem suitable test of monitoring drug level

    Directory of Open Access Journals (Sweden)

    Mochamad Lazuardi

    2007-09-01

    Full Text Available The determining of Phenazone to human blood plasma from healthy man after separated by solid phase extraction (SPE and spectroscopic measurements has been investigated. The objective of that research was to obtain system suitable test for determine the Phenazone level in biological fluids (human blood plasma, for new performed dosage regimented in clinical dentistry. The method can be divided into the following four steps. 1. Centrifugation the blood sample, 2. Extraction from blood plasma and, 3. Separation by SPE with manual pressured, 4. Elution to SPE followed by the measurement on a spectrophotometer in the ultra violet region. The critical value of  │t │at the 5% confidence level indicates that there is no systematic error in the linearity proposed method. Recoveries for this research were obtained at ranging 93.460 to 95.598%. The coefficient variation precision of this procedure was clearly good at smallest than 2%. The analytical procedure can be carried out in one working operation as a monitored therapeutic activity.

  6. Evaluation of latex agglutination tests for fibrin-fibrinogen degradation products in the forensic identification of menstrual blood.

    Science.gov (United States)

    Akutsu, Tomoko; Watanabe, Ken; Motani, Hisako; Iwase, Hirotaro; Sakurada, Koichi

    2012-01-01

    The identification of menstrual blood is important when discriminating menstruation from vaginal trauma in sexual assault cases. The aim of this study was to evaluate two fibrin-fibrinogen degradation product (FDP)-latex agglutination test kits, FDPL® Test (FDP-L) and FDP Plasma "RD" (FDP-P), for their ability to forensically identify menstrual blood. Sensitivity and specificity of the two kits were compared for menstrual blood and various body fluids, and the sensitivity of the FDP-latex agglutination test kit was also compared with that of an immunochromatographic test for human hemoglobin. The robustness of the FDP-latex agglutination test was compared with that of gene expression analysis of menstrual blood specific markers. The FDP-L kit was more sensitive than the FDP-P kit, but it cross-reacted with peripheral bloodstains from healthy volunteers. The FDP-P kit was specific for menstrual blood, with the exception of postmortem blood samples, and was not affected by other body fluids. In an FDP-negative menstrual blood sample, the sensitivity of human hemoglobin detection was lower than for FDP-positive samples and peripheral blood stains, suggesting that determination of human hemoglobin could be useful in interpreting negative results in the FDP-latex agglutination test. In menstrual blood samples incubated in wet conditions, FDP was found to be a robust marker in the identification of menstrual blood compared with mRNA markers. FDP-P testing was shown to be a suitable and highly efficient rapid screening test for the laboratory identification of menstrual blood.

  7. Orthostatic blood pressure test for risk stratification in patients with hypertrophic cardiomyopathy.

    Directory of Open Access Journals (Sweden)

    Julia Münch

    Full Text Available Hypertrophic cardiomyopathy (HCM is the most common cause of sudden cardiac death (SCD in young adults, mainly ascribed to ventricular tachycardia (VT. Assuming that VT is the major cause of (pre- syncope in HCM patients, its occurrence is essential for SCD risk stratification and primarily preventive ICD-implantation. However, evidence of VT during syncope is often missing. As the differentiation of potential lethal causes for syncope such as VT from more harmless reasons is crucial, HCM patients were screened for orthostatic dysregulation by using a simple orthostatic blood pressure test.Over 15 months (IQR [9;20] 100 HCM patients (55.8±16.2 yrs, 61% male were evaluated for (pre-syncope and VT (24h-ECGs, device-memories within the last five years. Eighty patients underwent an orthostatic blood pressure test. Logistic regression models were used for statistical analysis.In older patients (>40 yrs a positive orthostatic test result increased the chance of (pre- syncope by a factor of 63 (95%-CI [8.8; 447.9], p<0.001; 93% sensitivity, 95%-CI [76; 99]; 74% specificity, 95%-CI [58; 86]. No correlation with VT was shown. A prolonged QTc interval also increased the chance of (pre- syncope by a factor of 6.6 (95%-CI [2.0; 21.7]; p=0.002.The orthostatic blood pressure test is highly valuable for evaluation of syncope and presyncope especially in older HCM patients, suggesting that orthostatic syncope might be more relevant than previously assumed. Considering the high complication rates due to ICD therapies, this test may provide useful information for the evaluation of syncope in individual risk stratification and may help to prevent unnecessary device implantations, especially in older HCM patients.

  8. CTP在颅内动脉狭窄支架成形术中的术前评估价值%Pre-operative evaluation value of CT perfusion imaging in intravascular stenting of intracranial arterial stenosis

    Institute of Scientific and Technical Information of China (English)

    袁晖; 赵振伟; 曲友直; 袁阳; 杨震

    2013-01-01

    Objective To analyze the changes of CT brain perfusion imaging parameters before and after stent-assisted angioplasty in severe symptomatic intracranial atherosclerotic, and to investigate the pre-operative evaluation value of computed tomography perfusion (CTP) imaging. Methods A total of 58 cases of intracranial stenosis (the degree of stenosis >70% ) were divided into low perfusion group and normal perfusion group through pre-operative CTP imaging. The patients were performed with CTP again to evaluate the cerebral hemodynamic changes 3 months after intracranial stent-assisted angioplasty. The relative perfusion parameters including regional cerebral blood flow (rCBF).regional cerebral blood volume (rCBV), regional mean transit time (rMTT), and regional time to peak (rTTP) in both groups were compared. The curative effects of both groups were compared. Results rCBF, rMTT, and rTTP were improved significantly (P < 0.05) in the low perfusion group after treatment. The post-treatment follow-up indicated that the incidence of ischemic events in the low perfusion group were significantly lower than the normal perfusion group (P < 0. 05). The number of patients with mRS ≤ 2 was increased and better function improvement was obtained in the low perfusion group than the normal perfusion group (P < 0. 05). Conclusion According to pre-operative CTP parameters, it plays an important guiding role for the pre-operative assessment in treatment of severe symptomatic intracranial atherosclerotic stenosis.%目的 分析CT脑灌注成像(CTP)在重度症状性颅内动脉狭窄支架成形术前后的变化,探讨其对术前评估的价值.方法 根据术前CTP将58例颅内动脉狭窄程度>70%患者分为低灌注组和正常灌注组,术后3个月查CTP,比较相对局部脑血流量(rCBF)、脑血容量(rCBV)、平均通过时间(rMTT)、达峰时间(rTTP)变化及疗效.结果 低灌注组术后rCBF、rMTT、rTTP改善明显(P<0.05).低灌注组术后缺血事件

  9. [Digital blood flow measurement by venous occlusion plethysmography in Raynaud's phenomenon. Value of the rewarming test].

    Science.gov (United States)

    Cristol, R; Debray, J

    1986-01-01

    The fingertip blood flow measured by mercury strain gauge plethysmography with venous occlusion, at 22 degrees C room temperature, had significantly lower mean values in 190 patients with Raynaud's phenomenon (55 men aged 49 yrs +/- 16, 135 women aged 48 yrs +/- 16) than in 40 age and sex matched controls: 18 ml/100 ml/minute +/- 14.6 versus 35 ml/100 ml/minute +/- 15 at level p less than 0.01. The mean fingertip blood flow was significantly lower (p less than 0.01) in 31 cases of scleroderma and 32 cases of pulpar necrosis (respectively 13 ml +/- 13 and 11 ml +/- 8) than in 55 cases of primary Raynaud's disease (no detectable etiology and normal capillaroscopy 5 years after onset) or in 34 cases of mild Raynaud's phenomenon (respectively 21.6 +/- 16 and 24.4 +/- 18). A warming test (both hands in water at 45 degrees C during 3 minutes) was performed in 50 cases with low basal fingertip blood flow. It induced a "normalized" flow in 22 cases (mostly primary or mild Raynaud), a partly improved flow in 20 cases (mostly secondary Raynaud) and no improvement in 8 cases (scleroderma). The warming test appears to be clinically useful to assess the vasospasm and the vasodilating capabilities.

  10. Detection of malaria infection in blood transfusion: a comparative study among real-time PCR, rapid diagnostic test and microscopy: sensitivity of Malaria detection methods in blood transfusion.

    Science.gov (United States)

    Hassanpour, Gholamreza; Mohebali, Mehdi; Raeisi, Ahmad; Abolghasemi, Hassan; Zeraati, Hojjat; Alipour, Mohsen; Azizi, Ebrahim; Keshavarz, Hossein

    2011-06-01

    The transmission of malaria by blood transfusion was one of the first transfusion-transmitted infections recorded in the world. Transfusion-transmitted malaria may lead to serious problems because infection with Plasmodium falciparum may cause rapidly fatal death. This study aimed to compare real-time polymerase chain reaction (real-time PCR) with rapid diagnostic test (RDT) and light microscopy for the detection of Plasmodium spp. in blood transfusion, both in endemic and non-endemic areas of malaria disease in Iran. Two sets of 50 blood samples were randomly collected. One set was taken from blood samples donated in blood bank of Bandar Abbas, a city located in a malarious-endemic area, and the other set from Tehran, a non-endemic one. Light microscopic examination on both thin and thick smears, RDTs, and real-time PCR were performed on the blood samples and the results were compared. Thin and thick light microscopic examinations of all samples as well as RDT results were negative for Plasmodium spp. Two blood samples from endemic area were positive only with real-time PCR. It seems that real-time PCR as a highly sensitive method can be helpful for the confirmation of malaria infection in different units of blood transfusion organization especially in malaria-endemic areas where the majority of donors may be potentially infected with malaria parasites.

  11. Factors affecting initial training success of blood glucose testing in captive chimpanzees (Pan troglodytes).

    Science.gov (United States)

    Reamer, Lisa A; Haller, Rachel L; Thiele, Erica J; Freeman, Hani D; Lambeth, Susan P; Schapiro, Steven J

    2014-01-01

    Type 2 diabetes can be a problem for captive chimpanzees. Accurate blood glucose (BG) readings are necessary to monitor and treat this disease. Thus, obtaining voluntary samples from primates through positive reinforcement training (PRT) is critical. The current study assessed the voluntary participation of 123 chimpanzees in BG sampling and investigated factors that may contribute to individual success. All subjects participate in regular PRT sessions as part of a comprehensive behavioral management program. Basic steps involved in obtaining BG values include: voluntarily presenting a finger/toe; allowing digit disinfection; holding for the lancet device; and allowing blood collection onto a glucometer test strip for analysis. We recorded the level of participation (none, partial, or complete) when each chimpanzee was first asked to perform the testing procedure. Nearly 30% of subjects allowed the entire procedure in one session, without any prior specific training for the target behavior. Factors that affected this initial successful BG testing included sex, personality (chimpanzees rated higher on the factor "openness" were more likely to participate with BG testing), and past training performance for "present-for-injection" (chimpanzees that presented for their most recent anesthetic injection were more likely to participate). Neither age, rearing history, time since most recent anesthetic event nor social group size significantly affected initial training success. These results have important implications for captive management and training program success, underlining individual differences in training aptitude and the need for developing individual management plans in order to provide optimal care and treatment for diabetic chimpanzees in captivity.

  12. Is Tc99m-MIBI scintigraphy a predictor of response to pre-operative neoadjuvant chemotherapy in Osteosarcoma?

    Directory of Open Access Journals (Sweden)

    Mohammad Gharehdaghi

    2013-10-01

    Full Text Available Introduction: Multidrug resistance (MDR, which may be due to the over expression of P-glycoprotein (Pgp and/or MRP, is a major problem in neoadjuvant chemotherapy of osteosarcoma. The aim of this study was to investigate the role of Tc-99m MIBI scan for predicting the response to pre-operative chemotherapy. Materials and Methods: Twenty-five patients (12 males and 13 females, aged between 8 and 52y with osteosarcoma were studied. Before the chemotherapy, planar 99mTc-MIBI anterior and posterior images were obtained 10-min [tumor-to-background ratio: (T1/B110min] and 3-hr after tracer injection. After completion of chemotherapy, again 99mTc-MIBI scan was performed at 10-min after tracer injection. In addition to calculation of decay corrected tumor to background (T/B ratios , using the 10-min and 3-hr images of the pre-chemotherapy scintigraphy , percent wash-out rate (WR% of 99mTc-MIBI was calculated. Using the 10-min images of the pre- and post-chemotherapy scans, the percent reduction in uptake at the tumor site after treatment (Red% was also calculated. Then after surgical resection, tumor response was assessed by percentage of necrosis. Results: All patients showed significant 99mTc-MIBI uptake in early images. Only 9 patients showed good response to chemotherapy (necrosis≥90% while 16 patients were considered as non-responder (necrosis<90%. There was no statistical significant difference between non-responders and responders in (T1/B110min.There was a significant negative correlation between WR% and percentage of necrosis (P=0.001. On the other hand, there was a significant correlation between Red% and percentage of necrosis (P<0.001.There was also statistical significant difference in WR% and Red% between non-responders and responders (both P< 0.001. Conclusion: Washout rate of 99mTc-MIBI in pre-chemotherapy scintigraphy as well as Red% using pre- and post-chemotherapy MIBI scintigraphy are useful methods for predicting response to

  13. Pre-operative radiochemotherapy of primarily non-resectable rectal cancer; Praeoperative Radiochemotherapie bei primaer inoperablen Rektumkarzinomen

    Energy Technology Data Exchange (ETDEWEB)

    Keilholz, L. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Dworak, O. [Erlangen-Nuernberg Univ., Erlangen (Germany). Abt. fuer Pathologie; Dunst, J. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik; Koeckerling, F. [Erlangen-Nuernberg Univ., Erlangen (Germany). Chirurgische Klinik; Schwarz, B. [Erlangen-Nuernberg Univ., Erlangen (Germany). Abt. fuer Pathologie; Sauer, R. [Erlangen-Nuernberg Univ., Erlangen (Germany). Strahlentherapeutische Klinik

    1995-02-01

    Twenty patients with non-resectable rectal cancer (Mason CS III-VI) have been irradiated from September 1989 through February 1994. The total dose, calculated at the isocenter, was 50,4 Gy with 5 fractions of 1.8 Gy per week with a small volume boost in selected cases. Chemotherapy was administered on 5 consecutive days in week 1 and 5 with 1000 mg/m{sup 2} 5-FU per day as continuous infusion over 120 hours. The treatment was well tolerated. Acute toxicity included 1 grade III-dermatitis, 7 grade II-enteritis, 1 grade III- and 3 grade II-leucopenia. Seventeen out of 20 patients were resected 6 weeks after radiochemotherapy, 3 patients had no surgery (1 toxic death due to septicemia, 1 refusal of surgery after complete remission, 1 thrombocytopenia due to liver cirrhosis), all 3 had at least partial remission of their tumors. Fourteen out of 17 (82%) resections were curative (R0) with 1 additional R1- and 2 R2-resections. Ten out of 14 (71%) curative resected patients had no lymph node metastasis. A detailed histological examination showed regression in 15/16 tumors with fibrosis and vascular wall changes. Nine out of 16 patients had only minimal residual tumor. In this pilot study, pre-operative radiochemotherapy was well tolerated. (orig.) [Deutsch] An der Strahlentherapeutischen Klinik haben wir im Zeitraum September 1989 bis Februar 1994 20 Patienten mit primaer nicht resektablen Rektumkarzinomen (CS III-IV nach Mason) praeoperativ bestrahlt (fuenf Fraktionen pro Woche, Einzeldosis 1,8 Gy im Isozentrum, Gesamtdosis 50,4 Gy grossvolumig, in Einzelfaellen Boost bis maximal 68 Gy). Simultan erfolgte in der ersten und fuenften Therapiewoche eine 120-Stunden-Dauerinfusion mit 1000 mg/m{sup 2} 5-FU pro Tag. Die Radiochemotherapie wurde gut toleriert. Es traten bei einem Patienten eine Grad-III-Dermatitis, bei sieben eine Grad-II-Enteritis, bei einem Patienten eine Grad-III- und bei drei Patienten eine Grad-II-Leukozytopenie auf. 17/20 Patienten wurden etwa sechs

  14. Comparison of Nonculture Blood-Based Tests for Diagnosing Invasive Aspergillosis in an Animal Model.

    Science.gov (United States)

    White, P Lewis; Wiederhold, Nathan P; Loeffler, Juergen; Najvar, Laura K; Melchers, Willem; Herrera, Monica; Bretagne, Stephane; Wickes, Brian; Kirkpatrick, William R; Barnes, Rosemary A; Donnelly, J Peter; Patterson, Thomas F

    2016-04-01

    The EuropeanAspergillusPCR Initiative (EAPCRI) has provided recommendations for the PCR testing of whole blood (WB) and serum/plasma. It is important to test these recommended protocols on nonsimulated "in vivo" specimens before full clinical evaluation. The testing of an animal model of invasive aspergillosis (IA) overcomes the low incidence of disease and provides experimental design and control that is not possible in the clinical setting. Inadequate performance of the recommended protocols at this stage would require reassessment of methods before clinical trials are performed and utility assessed. The manuscript describes the performance of EAPCRI protocols in an animal model of invasive aspergillosis. Blood samples taken from a guinea pig model of IA were used for WB and serum PCR. Galactomannan and β-d-glucan detection were evaluated, with particular focus on the timing of positivity and on the interpretation of combination testing. The overall sensitivities for WB PCR, serum PCR, galactomannan, and β-d-glucan were 73%, 65%, 68%, and 46%, respectively. The corresponding specificities were 92%, 79%, 80%, and 100%, respectively. PCR provided the earliest indicator of IA, and increasing galactomannan and β-d-glucan values were indicators of disease progression. The combination of WB PCR with galactomannan and β-d-glucan proved optimal (area under the curve [AUC], 0.95), and IA was confidently diagnosed or excluded. The EAPRCI-recommended PCR protocols provide performance comparable to commercial antigen tests, and clinical trials are warranted. By combining multiple tests, IA can be excluded or confirmed, highlighting the need for a combined diagnostic strategy. However, this approach must be balanced against the practicality and cost of using multiple tests.

  15. Pre-operative antiseptic shower and bath policy decreases the rate of S. aureus and methicillin-resistant S. aureus surgical site infections in patients undergoing joint arthroplasty.

    Science.gov (United States)

    Colling, Kristin; Statz, Catherine; Glover, James; Banton, Kaysie; Beilman, Greg

    2015-04-01

    Surgical site infection (SSI) following joint arthroplasty increases length of stay, hospital cost, and leads to patient and healthcare provider dissatisfaction. Due to the presence of non-biologic implants (the prosthetic joint) in these procedures, infection is often devastating and treatment of the infection is more difficult. For this reason, prevention of SSI is of crucial importance in this population. Staphylococcus aureus colonizes the nares of approximately 30-40% of the population, is the most common pathogen causing SSI, and is associated with high morbidity and mortality rate. A pre-operative shower or bath with an antiseptic is an inexpensive and effective method of removal of these transient skin pathogens prior to the procedure and may be used to decrease SSI. We hypothesize that a preoperative antiseptic shower or bath will decrease the rate of SSI. A retrospective review was performed at two affiliated hospitals within the same system, one with a hospital-wide policy enforcing pre-operative antiseptic shower or bath and the other with no policy, with cases included from January 2010 to June 2012. International Classification of Disease-Ninth Revision-Clinical Modification (ICD-9-CM) codes and chart review were used to identify patients undergoing joint arthroplasty and to identify those with SSI. Two thousand three-hundred forty-nine arthroplasties were performed at the University of Minnesota Medical Center, a tertiary-care hospital with a pre-operative antiseptic shower or bath policy in place. An additional 1,693 procedures were performed at Fairview Ridges Hospital, a community hospital with no pre-operative policy. There was no difference in the rate of SSI between the two hospitals (1.96% vs. 1.95%; p=1.0). However, the rate of SSI caused by S. aureus was significantly decreased by pre-operative antiseptic shower/bath (17% vs. 61%; p=0.03), as was the rate of methicillin-resistant S. aureus (MRSA) infections (2% vs. 24% p=0.002). A pre-operative

  16. Inconsistent detection of changes in cerebral blood volume by near infrared spectroscopy in standard clinical tests.

    Science.gov (United States)

    Canova, D; Roatta, S; Bosone, D; Micieli, G

    2011-06-01

    The attractive possibility of near infrared spectroscopy (NIRS) to noninvasively assess cerebral blood volume and oxygenation is challenged by the possible interference from extracranial tissues. However, to what extent this may affect cerebral NIRS monitoring during standard clinical tests is ignored. To address this issue, 29 healthy subjects underwent a randomized sequence of three maneuvers that differently affect intra- and extracranial circulation: Valsalva maneuver (VM), hyperventilation (HV), and head-up tilt (HUT). Putative intracranial ("i") and extracranial ("e") NIRS signals were collected from the forehead and from the cheek, respectively, and acquired together with cutaneous plethysmography at the forehead (PPG), cerebral blood velocity from the middle cerebral artery, and arterial blood pressure. Extracranial contribution to cerebral NIRS monitoring was investigated by comparing Beer-Lambert (BL) and spatially resolved spectroscopy (SRS) blood volume indicators [the total hemoglobin concentration (tHb) and the total hemoglobin index, (THI)] and by correlating their changes with changes in extracranial circulation. While THIe and tHbe generally provided concordant indications, tHbi and THIi exhibited opposite-sign changes in a high percentage of cases (VM: 46%; HV: 31%; HUT: 40%). Moreover, tHbi was correlated with THIi only during HV (P < 0.05), not during VM and HUT, while it correlated with PPG in all three maneuvers (P < 0.01). These results evidence that extracranial circulation may markedly affect BL parameters in a high percentage of cases, even during standard clinical tests. Surface plethysmography at the forehead is suggested as complementary monitoring helpful in the interpretation of cerebral NIRS parameters.

  17. [Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test].

    Science.gov (United States)

    Bokov, P; Delclaux, C

    2016-02-01

    Resting pulmonary function tests (PFT) include the assessment of ventilatory capacity: spirometry (forced expiratory flows and mobilisable volumes) and static volume assessment, notably using body plethysmography. Spirometry allows the potential definition of obstructive defect, while static volume assessment allows the potential definition of restrictive defect (decrease in total lung capacity) and thoracic hyperinflation (increase in static volumes). It must be kept in mind that this evaluation is incomplete and that an assessment of ventilatory demand is often warranted, especially when facing dyspnoea: evaluation of arterial blood gas (searching for respiratory insufficiency) and measurement of the transfer coefficient of the lung, allowing with the measurement of alveolar volume to calculate the diffusing capacity of the lung for CO (DLCO: assessment of alveolar-capillary wall and capillary blood volume). All these pulmonary function tests have been the subject of an Americano-European Task force (standardisation of lung function testing) published in 2005, and translated in French in 2007. Interpretative strategies for lung function tests have been recommended, which define abnormal lung function tests using the 5th and 95th percentiles of predicted values (lower and upper limits of normal values). Thus, these recommendations need to be implemented in all pulmonary function test units. A methacholine challenge test will only be performed in the presence of an intermediate pre-test probability for asthma (diagnostic uncertainty), which is an infrequent setting. The most convenient exertional test is the 6-minute walk test that allows the assessment of walking performance, the search for arterial desaturation and the quantification of dyspnoea complaint.

  18. Understanding Blood Counts

    Science.gov (United States)

    ... Lab and Imaging Tests Understanding Blood Counts Understanding Blood Counts Understanding Blood Counts SHARE: Print Glossary Blood cell counts give ... your blood that's occupied by red cells. Normal Blood Counts Normal blood counts fall within a range ...

  19. Operational feasibility of using whole blood in the rapid HIV testing algorithm of a resource-limited settings like Bangladesh

    OpenAIRE

    Munshi, Saif U.; Oyewale, Tajudeen O.; Begum, Shahnaz; Uddin, Ziya; Tabassum, Shahina

    2016-01-01

    Background Serum-based rapid HIV testing algorithm in Bangladesh constitutes operational challenge to scaleup HIV testing and counselling (HTC) in the country. This study explored the operational feasibility of using whole blood as alternative to serum for rapid HIV testing in Bangladesh. Methods Whole blood specimens were collected from two study groups. The groups included HIV-positive patients (n = 200) and HIV-negative individuals (n = 200) presenting at the reference laboratory in Dhaka,...

  20. Testing of a centrifugal blood pump with a high efficiency hybrid magnetic bearing.

    Science.gov (United States)

    Locke, Dennis H; Swanson, Erik S; Walton, James F; Willis, John P; Heshmat, Hooshang

    2003-01-01

    The purpose of this article is to present test results for a second generation, high efficiency, nonpulsatile centrifugal blood pump that is being developed for use as a left ventricular assist device (LVAD). The LVAD pump uses a hybrid passive-active magnetic bearing support system that exhibits extremely low power loss, low vibration, and high reliability under transient conditions and varying pump orientations. A unique feature of the second generation design configuration is the very simple and direct flow path for both main and washing blood flows. The pump was tested in both vertical and horizontal orientations using a standard flow loop to demonstrate the performance and durability of the second generation LVAD. Steady state and transient orientation pump operating characteristics including pressure, flow, speed, temperatures, vibration, and rotor orientation were measured. During the tests, pump performance was mapped at several operating conditions including points above and below the nominal design of 5 L/min at 100 mm Hg pressure rise. Flow rates from 2 to 7 L/min and pressure rises from 50 to 150 mm Hg were measured. Pump speeds were varied during these tests from 2,500 to 3,500 rpm. The nominal design flow of 5 L/min at 100 mm Hg pressure rise was successfully achieved at the design speed of 3,000 rpm. After LVAD performance testing, both 28 day continuous duty and 5 day transient orientation durability tests were completed without incident. A hydrodynamic backup bearing design feasibility study was also conducted. Results from this design study indicate that an integral hydrodynamic backup bearing may be readily incorporated into the second generation LVAD and other magnetically levitated pump rotors.

  1. Improving Detection of Prediabetes in Children and Adults: Using Combinations of Blood Glucose Tests

    Directory of Open Access Journals (Sweden)

    Ike Solomon Okosun

    2015-11-01

    Full Text Available Aim: To determine combinations of blood glucose tests: oral glucose tolerance (OGT, fasting plasma glucose (FBG and hemoglobin A1C (HbA1C that are associated with highest diagnostic rates of prediabetes in non-diabetic American children and adults.Methods: The 2007-2008 U.S. National Health and Nutrition Examination Surveys data were used for this study. Overall and specific prevalence of prediabetes (defined using OGT+FPG, OGT+HbA1C, HbA1C+FPG and OGT+FPG+HbA1C tests were determined across age, race/ethnicity, sex and BMI categories.Results: FPG+HbA1C test was associated with significantly higher diagnostic rates of prediabetes across age, race/ethnicity and BMI. Estimates of overall prevalence of prediabetes using OGT+FPG, OGT+HbA1C, HbA1C+FPG and OGT+FPG+HbA1C tests were 20.3%, 24.2%, 33% and 34.3%, respectively. Compared to OGT+FPG, the use of HbA1C+FPG test in screening was associated with 44.8%, 135%, 38.6% and 35.9% increased prevalence of prediabetes in non-Hispanic White, non-Hispanic Black, Mexican-American and other racial/ethnic men, respectively. The corresponding values in women were 67.8%, 140%, 37.2% and 42.6%, respectively. Combined use of all blood glucose tests did not improve the overall and gender-specific prediabetes prevalence beyond what was observed using HbA1C+FPG test.Conclusions: HbA1C criteria were associated with higher diagnosis rates of prediabetes than FPG and OGT tests in non-diabetic American children and adults. Using a combination of HbA1C and FPG test in screening for prediabetes reduces intrinsic systematic bias in using just HbA1C testing and offers the benefits of each test. A well-defined HbA1C that takes into consideration race/ethnicity, gender, age and body mass index may improve detection of prediabetes in population and clinical settings.

  2. Can pre-operative axial CT imaging predict syndesmosis instability in patients sustaining ankle fractures? Seven years' experience in a tertiary trauma center

    Energy Technology Data Exchange (ETDEWEB)

    Yeung, Tsz Wai; Chan, Chung Yan Grace; Chan, Wun Cheung Samuel; Yuen, Ming Keung [Tuen Mun Hospital, Department of Radiology, Tuen Mun (China); Yeung, Yuk Nam [Tune Mun Hospital, Department of Orthopaedics and Traumatology, Tuen Mun (China)

    2015-06-01

    The purpose of this study is to explore the diagnostic accuracy of CT measurements in predicting syndesmosis instability of injured ankle, with correlation to operative findings. From July 2006 to June 2013, 123 patients presented to a single tertiary hospital who received pre-operative CT for ankle fractures were retrospectively reviewed. All patients underwent open reduction and internal fixation for fractures and intra-operative syndesmosis integrity tests. The morphology of incisura fibularis was categorized as deep or shallow. The tibiofibular distance (TFD) between the medial border of the fibula and the nearest point of the lateral border of tibia were measured at anterior (aTFD), middle (mTFD), posterior (pTFD), and maximal (maxTFD) portions across the syndesmosis on axial CT images at 10 mm proximal to the tibial plafond. Statistical analysis was performed with independent samples t test and ROC curve analysis. Intraobserver reproducibility and inter-observers agreement were also evaluated. Of the 123 patients, 39 (31.7 %) were operatively diagnosed with syndesmosis instability. No significant difference of incisura fibularis morphology (deep or shallow) and TFDs was demonstrated respective to genders. The axial CT measurements were significantly higher in ankles diagnosed with syndesmosis instability than the group without (maxTFD means 7.2 ± 2.96 mm vs. 4.6 ± 1.4 mm, aTFD mean 4.9 ± 3.7 mm vs. 1.8 ± 1.4 mm, mTFD mean 5.3 ± 2.4 mm vs. 3.2 ± 1.6 mm, pTFD mean 5.3 ± 1.8 mm vs. 4.1 ± 1.3 mm, p < 0.05). Their respective cutoff values with best sensitivity and specificity were calculated; the aTFD (AUC 0.798) and maxTFD (AUC 0.794) achieved the highest diagnostic accuracy. The optimal cutoff levels were aTFD = 4 mm (sensitivity, 56.4 %; specificity, 91.7 %) and maxTFD = 5.65 mm (sensitivity, 74.4 %; specificity, 79.8 %). The inter-observer agreement was good for all aTFD, mTFD, pTFD, and maxTFD measurements (ICC 0.959, 0.799, 0.783, and 0.865). The ICC

  3. Galectin-3: a possible complementary marker to the PSA blood test

    Science.gov (United States)

    Nangia-Makker, Pratima; Kho, Dhonghyo; Bajaj, Madhuri; Smith, Daryn; Heilbrun, Lance; Raz, Avraham; Heath, Elisabeth

    2013-01-01

    The prostate-specific antigen (PSA) test has served as a blood marker of prostate cancer (PCa), and for monitoring recurrence/metastasis in patients after therapeutic intervention. However, the applicability/reliability of the PSA test was recently questioned as it is not without challenges, in particular in men who have PCa without an elevated PSA (false negative), or in men who are disease-free with elevated levels of PSA (false positive). Galectin-3 is a tumor-associated protein; present in the seminal fluid and is a substrate for the PSA enzyme e.g., a chymotrypsin-like serine protease. We hypothesized that the cleavage status and level of galectin-3 in the prostate tissue and sera are associated with PCa. Thus, we compared galectin-3 levels obtained from sera of non-cancer urology patients to those of metastatic PCa patients. The data were confirmed by analyzing PCa tissue arrays. Here, we report that galectin-3 levels in the sera of patients with metastatic PCa were uniformly higher as compared to the non-cancer patient controls. The data suggest that galectin-3 serum level may be a useful serum complementary marker to the PSA blood test to be used for initial and follow-up PSA complimentary diagnostic/prognostic tool for recurrence in PCa patients. PMID:23625538

  4. Neurosyphilis is unlikely in patients with late latent syphilis and a negative blood VDRL-test.

    Science.gov (United States)

    Wöhrl, Stefan; Geusau, Alexandra

    2006-01-01

    Patients with latent syphilis or syphilis of unknown duration should be evaluated for tertiary disease and neurosyphilis. The aim of this retrospective study was to determine relevant serological parameters for the identification of those individuals with syphilis who are most likely to have neurosyphilis and who therefore require lumbar puncture. After excluding repeated estimates and patients whose blood syphilis serology had either been negative or not been determined within 3 months of lumbar puncture, 265 out of 710 cerebrospinal fluids from 1988 to 2004 were analysed. In each of those patients the earliest available pairs of serum and cerebrospinal fluid samples were evaluated. The diagnosis of neurosyphilis was based on criteria according to established guidelines. Forty-three of 265 patients (16.2%; 5 women, 38 men; mean age 47+/-16 years) had neurosyphilis. Seven of 72 (9.7%) of those testing HIV-positive, fulfilled the criteria of neurosyphilis. Not a single patient with neurosyphilis tested Venereal Disease Research Laboratory test (VDRL)-negative in peripheral blood, an effect which was highly significant (p VDRL titre was significantly higher in patients with neurosyphilis than in those without (1:32 vs. 1:0; p VDRL. Therefore, lumbar puncture is not recommended in these patients.

  5. Blood lactate minimum of rats during swimming test using three incremental stages

    Directory of Open Access Journals (Sweden)

    Mariana de Souza Sena

    2015-09-01

    Full Text Available AbstractThe purpose of this study was to determine the lactate minimum intensity (LMI by swimming LACmintest using three incremental stages (LACmintest3 and to evaluate its sensitivity to changes in aerobic fitness (AF. Twenty Wistar rats performed: LACmintest3 (1: induction of hyperlactacidemia and incremental phase (4%, 5% and 6.5% of bw; Constant loads tests on (2 and above (3 the LMI. Half of the animals were subjected to training with the individual LMI and the tests were performed again. The mean exercise load in LACmintest3 was 5.04 ± 0.13% bw at 5.08 ± 0.55 mmol L-1 blood lactate minimum (BLM. There was a stabilize and disproportionate increase of blood lactate in tests 2 and 3, respectively. After the training period, the mean BLM was lower in the trained animals. The LACmintest3 seems to be a good indicator of LMI and responsive to changes in AF in rats subjected to swim training.

  6. Effect of Background Parenchymal Enhancement on Pre-Operative Breast Magnetic Resonance Imaging: How It Affects Interpretation and the Role of Second-Look Ultrasound in Patient Management.

    Science.gov (United States)

    Kim, Soo-Yeon; Lee, Hye Sun; Kim, Eun-Kyung; Kim, Min Jung; Moon, Hee Jung; Yoon, Jung Hyun

    2016-12-01

    Background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) may either obscure or mimic malignancy. We evaluated the impact of BPE on the diagnostic performance of pre-operative MRI in breast cancer patients, and how second-look ultrasound (US) can help in guiding patient management. Two hundred fifty-three breast cancer patients with pre-operative MRI were included. In moderate or marked BPE, abnormal interpretation rate (38.9% vs. 12.2%) and biopsy rate (27.8% vs. 8.3%) were higher, and specificity (64.7% vs. 89.8%) was lower, compared with minimal or mild BPE (all p abnormal interpretation rate, additional biopsy rate and decreased specificity. Second-look US was useful in visualization of MRI-detected additional suspicious lesions, regardless of BPE.

  7. Validation of a new blood-mimicking fluid for use in Doppler flow test objects.

    Science.gov (United States)

    Ramnarine, K V; Nassiri, D K; Hoskins, P R; Lubbers, J

    1998-03-01

    A blood-mimicking fluid (BMF) suitable for use in Doppler flow test objects is described and characterised. The BMF consists of 5 microns diameter nylon scattering particles suspended in a fluid base of water, glycerol, dextran and surfactant. The acoustical properties of various BMF preparations were measured under uniform flow to study the effects of particle size, particle concentration, surfactant concentration, flow rate and stability. The physical properties, (density, viscosity and particle size), and acoustical properties (velocity, backscatter and attenuation) of the BMF are within draft International Electrotechnical Commission requirements.

  8. Forensic application of the luminol reaction as a presumptive test for latent blood detection.

    Science.gov (United States)

    Barni, Filippo; Lewis, Simon W; Berti, Andrea; Miskelly, Gordon M; Lago, Giampietro

    2007-05-15

    The forensic application of the luminol chemiluminescence reaction is reviewed. Luminol has been effectively employed for more than 40 years for the presumptive detection of bloodstains which are hidden from the naked eye at crime scenes and, for this reason, has been considered one of the most important and well-known assays in the field of forensic sciences. This review provides an historical overview of the forensic use of luminol, and the current understanding of the reaction mechanism with particular reference to the catalysis by blood. Operational use of the luminol reaction, including issues with interferences and the effect of the luminol reaction on subsequent serological and DNA testing is also discussed.

  9. The measurement of peripheral blood volume reactions to tilt test by the electrical impedance technique after exercise in athletes

    Science.gov (United States)

    Melnikov, A. A.; Popov, S. G.; Nikolaev, D. V.; Vikulov, A. D.

    2013-04-01

    We have investigated the distribution of peripheral blood volumes in different regions of the body in response to the tilt-test in endurance trained athletes after aerobic exercise. Distribution of peripheral blood volumes (ml/beat) simultaneously in six regions of the body (two legs, two hands, abdomen, neck and ECG) was assessed in response to the tilt-test using the impedance method (the impedance change rate (dZ/dT). Before and after exercise session cardiac stroke (CSV) and blood volumes in legs, arms and neck were higher in athletes both in lying and standing positions. Before exercise the increase of heart rate and the decrease of a neck blood volume in response to tilting was lower (p blood volumes was higher (pblood volumes were similar. Also, the neck blood volumes as percentage of CSV (%/CSV) did not change in the control but increased in athletes (p exercise (mean HR = 156±8 beat/min, duration 30 min) blood volumes in neck and arms in response to the tilting were reduced equally, but abdomen (pblood volumes (p blood flow (%/CSV) did not change in athletes but decreased in control (pexercise. The data demonstrate greater orthostatic tolerance in athletes both before and after exercise during fatigue which is due to effective distribution of blood flows aimed at maintaining cerebral blood flow.

  10. Portable simultaneous multiple analyte whole-blood analyzer for point-of-care testing.

    Science.gov (United States)

    Schembri, C T; Ostoich, V; Lingane, P J; Burd, T L; Buhl, S N

    1992-09-01

    We describe a portable clinical chemistry analyzer for point-of-care measurements of multiple analytes in less than 10 min from approximately 40 microL of whole blood (fingerstick or venous). Whole blood is applied directly to a 7.9-cm-diameter, single-use plastic rotor containing liquid diluent and greater than or equal to 4-12 tests in the form of 1- to 2-mm-diameter dry reagent beads. The reagent/rotor is immediately placed in a portable instrument along with a ticket/label results card. As the instrument spins the rotor, capillary and rotational forces process the blood into diluted plasma, distribute the patient's diluted sample to cuvettes containing the reagent beads, and mix the diluted sample with the reagents. The instrument monitors the chemical reactions optically at nine wavelengths; sample volume and temperature are also measured optically. The calibration data for each reagent are read from a bar code on the periphery of each rotor. The instrument processes all the measurements to calculate, store, print, and communicate the results. Each reagent/rotor contains an enzymatic control that must be within a defined range before the results from that analysis are reported.

  11. Changes in cerebral blood oxygenation induced by active standing test in children with POTS and NMS.

    Science.gov (United States)

    Endo, Ayumi; Fujita, Yukihiko; Fuchigami, Tatsuo; Takahashi, Shori; Mugishima, Hideo; Skatani, Kaoru

    2014-01-01

    Orthostatic dysregulation (OD) has been classified into subtypes by heart rate and blood pressure; however, the hemodynamics of brains have not yet been revealed. Therefore, we investigated changes in cerebral blood flow and oxygenation during an active standing test to clarify the pathophysiology of two subtypes: postural tachycardia syndrome (POTS) and neurally mediated syncope (NMS). We studied 31 children (15 boys, 16 girls; mean age, 14.0 ± 1.7 years) who presented with OD at the Department of Pediatrics and Child Health, Nihon University School of Medicine between 2009 and 2011. OD was diagnosed using the Japanese clinical guidelines for juvenile orthostatic dysregulation. After a 10-min resting period in the supine position, patients were asked to quickly stand up and keep upright for 10 min. Cerebral blood flow and cerebral oxygenation were measured using transcranial Doppler sonography and near-infrared spectroscopy. POTS showed a significant decrease of oxy-Hb and resistance index (RI), suggesting transient ischemia with maintainable cerebral autoregulation. NMS showed a decrease of oxy-Hb and an increase of RI, suggesting ischemia and impairment of autoregulation.

  12. An ancient DNA test of a founder effect in Native American ABO blood group frequencies.

    Science.gov (United States)

    Halverson, Melissa S; Bolnick, Deborah A

    2008-11-01

    Anthropologists have assumed that reduced genetic diversity in extant Native Americans is due to a founder effect that occurred during the initial peopling of the Americas. However, low diversity could also be the result of subsequent historical events, such as the population decline following European contact. In this study, we show that autosomal DNA from ancient Native American skeletal remains can be used to investigate the low level of ABO blood group diversity in the Americas. Extant Native Americans exhibit a high frequency of blood type O, which may reflect a founder effect, genetic drift associated with the historical population decline, or natural selection in response to the smallpox epidemics that occurred following European contact. To help distinguish between these possibilities, we determined the ABO genotypes of 15 precontact individuals from eastern North America. The precontact ABO frequencies were not significantly different from those observed in extant Native Americans from the same region, but they did differ significantly from the ABO frequencies in extant Siberian populations. Studies of other precontact populations are needed to better test the three hypotheses for low ABO blood group diversity in the Americas, but our findings are most consistent with the hypothesis of a founder effect during the initial settlement of this continent.

  13. Pre-operative variables affecting final vision outcome with a critical review of ocular trauma classification for posterior open globe (zone III) injury

    Science.gov (United States)

    Agrawal, Rupesh; Ho, Sue Wei; Teoh, Stephen

    2013-01-01

    Purpose: To identify pre-operative variables affecting the outcome of posterior open globe (zone III) injuries. Secondary objective was to re-look at the definition or landmarks for zone III injury and its clinical significance for predicting visual prognosis following open globe injury. Materials and Methods: Retrospective review of medical records of all hospitalized patients with surgical repair of open globe injury over last 10 years at a tertiary referral eye care center in Singapore. Out of 172 eyes with open globe injury, 28 eyes (16.3%) with zone III injury was identified and reviewed further. Pre-operative visual acuity (VA) and other variables, extent of scleral wound in reference to rectus insertion, relative afferent pupillary defect (RAPD) and final vision outcome were recorded. Results: Median age was 37 years with male predilection (92.9%). Mean follow-up was 12.9 months. Pre-operative VA was no light perception (NLP) in 16 (57.1%) eyes. Final VA remained NLP in 14 eyes (50.0%). The factors contributing to poor post-operative vision based on univariate regression analysis were the presence of RAPD, poor pre-operative VA, blunt trauma, extent of trauma, associated traumatic cataract, hyphema, vitreous loss and associated vitreo-retinal trauma. Further on, zone III injuries with scleral wound limited anterior to rectus insertion (6 eyes) had better vision outcome than those with injuries extending beyond rectus insertion (22 eyes). Conclusion: Initial VA, blunt ocular trauma, visual axis involvement, loss of light perception, presence of RAPD, traumatic cataract, hyphema, vitreous loss were the important determinants for final visual outcome in patients with zone III injury. Wound extending posterior to rectus insertion has poorer outcome as those limited anterior to rectus insertion. We suggest that there may be a need to relook at zone III injuries with reference to rectus insertion for prognostic significance, and further studies are warranted. PMID

  14. Patient-specific positioning guides for total knee arthroplasty: no significant difference between final component alignment and pre-operative digital plan except for tibial rotation

    OpenAIRE

    Boonen, Bert; Schotanus, Martijn G.M.; Kerens, Bart; Hulsmans, Frans-Jan; Tuinebreijer, Wim; Kort, Nanne P.

    2015-01-01

    Purpose To assess whether there is a significant difference between the alignment of the individual femoral and tibial components (in the frontal, sagittal and horizontal planes) as calculated pre-operatively (digital plan) and the actually achieved alignment in vivo obtained with the use of patient-specific positioning guides (PSPGs) for TKA. It was hypothesised that there would be no difference between post-op implant position and pre-op digital plan. Methods Twenty-six patients were includ...

  15. Optimising renal cancer patients for nephron-sparing surgery: a review of pre-operative considerations and peri-operative techniques for partial nephrectomy.

    Science.gov (United States)

    Ertemi, Hani; Khetrapal, Pramit; Pavithran, Nevil M; Mumtaz, Faiz

    2017-02-03

    Nonmodifiable factors including pre-operative renal function and amount of healthy renal tissue preserved are the most important predictive factors that determine renal function after partial nephrectomy. Ischaemia time is an important modifiable risk factor and cold ischaemia time should be used if longer ischaemia time is anticipated. New techniques may have a role in maximising postoperative kidney function, but more robust studies are required to understand their potential benefits and risks.

  16. Pre-operative endostent placement to allow the complete and safe resection of a recurrent tumor that had tightly adhered to the subclavian artery: A case report

    Directory of Open Access Journals (Sweden)

    Takuya Nakayama

    2015-04-01

    Full Text Available Radiation and tumor infiltration confer a high risk of bleeding on surgical removal of tumor. We report on the case of a 42-year-old woman with a recurrent occult subclavian tumor in her right breast. Computed tomography revealed enhanced tumor adhesion to the subclavian artery at the infraclavicular lymph node. No other metastases were detected. We pre-operatively performed stenting of the right subclavian artery, and the tumor was resected completely and safely.

  17. A randomised controlled trial examining the effect of acupuncture at the EX-HN3 (Yintang) point on pre-operative anxiety levels in neurosurgical patients.

    Science.gov (United States)

    Wiles, M D; Mamdani, J; Pullman, M; Andrzejowski, J C

    2017-03-01

    Pre-operative anxiety is an unpleasant state of psychological distress that occurs in up to 87% of patients awaiting neurosurgical procedures. Sedative medication is undesirable in this population due to the need for early postoperative neurological assessment. Acupuncture has previously been shown to reduce pre-operative anxiety, but studies involving neurosurgical patients are lacking. This single-centre, prospective, randomised controlled trial was designed to determine the effect of acupuncture at the EX-HN3 (Yintang point) on pre-operative anxiety levels in neurosurgical patients. The study was prospectively registered before participant recruitment. After measuring baseline anxiety levels, 128 patients were randomly allocated in a 1:1 ratio by a web-based computer program to receive either acupuncture at the EX-HN3 (Yintang) point (acupuncture group) or no intervention (control group). Participants were not blinded, but all analyses were performed by a member of the research team who was unaware of the group allocation. The primary outcome measure was anxiety level after 30 min, as measured by the six-item short form of the State-Trait Anxiety Inventory (possible score range 20-80). Sixty-two patients in each group were subsequently analysed. Median (IQR [range]) anxiety State-Trait Anxiety Inventory score reduced significantly in the acupuncture group (46.7 (36.7-53.3 [23.3-70.0]) to 40.0 (30.0-46.7) [20.0-53.3]), p < 0.001), with no change seen in the control group (41.7 (33.3-53.3 [20.0-76.7]) to 43.3 (36.7-50.0 [20.0-76.7]), p = 0.829). There were no adverse events in either group. Acupuncture at the EX-HN3 point reduces pre-operative anxiety levels in patients awaiting neurosurgery.

  18. The LIPPSMAck POP (Lung Infection Prevention Post Surgery - Major Abdominal - with Pre-Operative Physiotherapy) trial: study protocol for a multi-centre randomised controlled trial

    OpenAIRE

    Boden, Ianthe; Browning, Laura; Elizabeth H Skinner; Reeve, Julie; El-Ansary, Doa; Robertson, Iain K.; Denehy, Linda

    2015-01-01

    Background Post-operative pulmonary complications are a significant problem following open upper abdominal surgery. Preliminary evidence suggests that a single pre-operative physiotherapy education and preparatory lung expansion training session alone may prevent respiratory complications more effectively than supervised post-operative breathing and coughing exercises. However, the evidence is inconclusive due to methodological limitations. No well-designed, adequately powered, randomised con...

  19. Evaluation of the effect of presence of blood in the stomach on endoscopic diagnostic tests for Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    S Mittal

    2011-01-01

    Full Text Available Introduction: Presence of blood in the stomach has been thought to affect the performance of diagnostic tests used in detecting Helicobacter pylori (H. pylori in the stomach. This study evaluated the effect of blood on the efficacy of rapid urease test (RUT and microscopic appearance of the biopsy after staining with Giemsa stain. Materials and Methods: Patients with bleeding oesophageal varices who met the inclusion criteria were tested for H. pylori by RUT and microscopic examination of the biopsy. A repeat endoscopy, RUT and histology were done one month following initial presentation. The performance of the diagnostic tests was evaluated with and without the presence of intraluminal blood. A combined result of the two tests, RUT and histology, carried out in presence or absence of blood for the diagnosis of H. pylori, when considered together was considered as the gold standard. Results: Thirty six patients included in the study were in the ages ranging between 15-60 years (mean age = 44.14 years ±2.1. The combination of tests at both visits showed 20/36 (55.6% patients were positive for H. pylori. The decrease in H. pylori positivity in the presence of blood was significant for RUT (8.3% vs. 38.9%; P=0.005 and combined test (19.4% vs. 47.2%; P=0.02 but the decrease in positivity for histology (11.1% vs 30.6% was not significant (P=0.08. In the presence of blood, the sensitivity of RUT, histology and combined tests were 15%, 20% and 35%, respectively. In the absence of blood, the sensitivity of RUT, histology and combination of tests was 70%, 55% and 85%, respectively. Conclusion: Blood in the stomach significantly decreased the sensitivity of RUT, histology and the combination of both. Negative results of these tests in acute upper gastro intestinal (GI bleeding should therefore be interpreted carefully.

  20. Rapid, whole blood diagnostic test for detecting anti-hantavirus antibody in rats.

    Science.gov (United States)

    Amada, Takako; Yoshimatsu, Kumiko; Yasuda, Shumpei P; Shimizu, Kenta; Koma, Takaaki; Hayashimoto, Nobuhito; Gamage, Chandika D; Nishio, Sanae; Takakura, Akira; Arikawa, Jiro

    2013-10-01

    Hantavirus is a causative agent of rodent-borne viral zoonoses, hemorrhagic fever with renal syndrome (HFRS) and hantavirus pulmonary syndrome. Seoul virus (SEOV) is a causative agent of urban and laboratory rat-associated HFRS worldwide. Surveillance of rodents has been done mainly by serological detection of hantavirus-specific antibodies by enzyme linked immunosorbent assay (ELISA) and immunofluorescent antibody assay (IFA). An immunochromatographic (ICG) test was developed with the N-terminal 103 amino acids of nucleocapsid protein of Hantaan virus expressed by Escherichia coli as an antigen to detect IgG antibody specific to hantavirus in sera from Rattus sp. animals. Antibody-detecting sensitivity of the ICG test was the same as that of ELISA and about 100-times higher than that of IFA. Overall sensitivities and specificities of the ICG test in comparison to ELISA and IFA for sera from 192 urban rats and 123 laboratory rats were 99.3% and 100%, respectively. Diluted whole blood samples without separation could be used for the ICG test. The ICG test enabled detection of antibodies to SEOV, Hantaan, Dobrava/Belgrade, and Thailand viruses, which are causative agents of HFRS throughout Eurasia. The ICG test is a rapid, simple and safe method for diagnosis of SEOV infection in rats.

  1. New Zealand's breath and blood alcohol testing programs: further data analysis and forensic implications.

    Science.gov (United States)

    Stowell, A R; Gainsford, A R; Gullberg, R G

    2008-07-01

    Paired blood and breath alcohol concentrations (BAC, in g/dL, and BrAC, in g/210 L), were determined for 11,837 drivers apprehended by the New Zealand Police. For each driver, duplicate BAC measurements were made using headspace gas chromatography and duplicate BrAC measurements were made with either Intoxilyzer 5000, Seres 679T or Seres 679ENZ Ethylometre infrared analysers. The variability of differences between duplicate results is described in detail, as well as the variability of differences between the paired BrAC and BAC results. The mean delay between breath and blood sampling was 0.73 h, ranging from 0.17 to 3.1 8h. BAC values at the time of breath testing were estimated by adjusting BAC results using an assumed blood alcohol clearance rate. The paired BrAC and time-adjusted BAC results were analysed with the aim of estimating the proportion of false-positive BrAC results, using the time-adjusted BAC results as references. When BAC results were not time-adjusted, the false-positive rate (BrAC>BAC) was 31.3% but after time-adjustment using 0.019 g/dL/h as the blood alcohol clearance rate, the false-positive rate was only 2.8%. However, harmful false-positives (defined as cases where BrAC>0.1 g/210L, while BACtest results were used as the evidential results instead of the means, the harmful false-positive rate dropped to 0.04%.

  2. The value of oblique pinhole images in pre-operative localisation with {sup 99m}Tc-MIBI for primary hyperparathyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Ho Shon, I.A. [Dept. of Nuclear Medicine, Royal North Shore Hospital, Sydney (Australia); Bernard, E.J.; Roach, P.J. [Dept. of Nuclear Medicine, Royal North Shore Hospital, Sydney (Australia); North Shore Radiology and Nuclear Medicine, North Shore Private Hospital, Sydney (Australia); Delbridge, L.W. [Dept. of Surgery, Royal North Shore Hospital, Sydney (Australia)

    2001-06-01

    Technetium-99m labelled 2-methoxyisobutylisonitrile (MIBI) has been extensively utilised for pre-operative localisation of parathyroid adenomas. Imaging techniques have varied widely, with many centres not performing routine oblique images; thus this study aimed to examine the value of routine oblique pinhole imaging. Ninety-two patients underwent pre-operative {sup 99m}Tc-MIBI imaging including early and delayed anterior oblique pinhole images in addition to standard anterior pinhole images and a thyroid study prior to surgery for primary hyperparathyroidism. These studies were reviewed blindly comparing anterior and oblique images and anterior images only in relation to surgical findings. Of the 92 patients, 83 were found to have 86 parathyroid adenomas or parathyroid adenoma/hyperplasia at surgery. When compared to anterior images only, oblique views improved overall sensitivity from 76% to 88% (P<0.05), correctly localised 11 more adenomas than anterior images alone (13%) and improved the confidence of interpretation in 17 patients (20%). In conclusion, routine oblique pinhole views result in greater sensitivity and reporter confidence in pre-operative parathyroid localisation with {sup 99m}Tc-MIBI. (orig.)

  3. Patient satisfaction with total knee replacement cannot be predicted from pre-operative variables alone: A cohort study from the National Joint Registry for England and Wales.

    Science.gov (United States)

    Baker, P N; Rushton, S; Jameson, S S; Reed, M; Gregg, P; Deehan, D J

    2013-10-01

    Pre-operative variables are increasingly being used to determine eligibility for total knee replacement (TKR). This study was undertaken to evaluate the relationships, interactions and predictive capacity of variables available pre- and post-operatively on patient satisfaction following TKR. Using nationally collected patient reported outcome measures and data from the National Joint Registry for England and Wales, we identified 22 798 patients who underwent TKR for osteoarthritis between August 2008 and September 2010. The ability of specific covariates to predict satisfaction was assessed using ordinal logistic regression and structural equational modelling. Only 4959 (22%) of 22 278 patients rated the results of their TKR as 'excellent', despite the majority (71%, n = 15 882) perceiving their knee symptoms to be much improved. The strongest predictors of satisfaction were post-operative variables. Satisfaction was significantly and positively related to the perception of symptom improvement (operative success) and the post-operative EuroQol-5D score. While also significant within the models pre-operative variables were less important and had a minimal influence upon post-operative satisfaction. The most robust predictions of satisfaction occurred only when both pre- and post-operative variables were considered together. These findings question the appropriateness of restricting access to care based on arbitrary pre-operative thresholds as these factors have little bearing on post-operative satisfaction.

  4. Testing for HTLV 1 and HTLV 2 among blood donors in Western Saudi Arabia: prevalence and cost considerations.

    Science.gov (United States)

    Hindawi, S; Badawi, M; Fouda, F; Mallah, B; Mallah, B; Rajab, H; Madani, T A

    2017-06-28

    Screening all blood donors for human T-cell lymphotropic viruses 1 and 2 (HTLV 1 and HTLV 2) is mandatory in Saudi Arabia. The aim of this study is to evaluate the results and costs associated with the current testing policy for HTLV 1 and HTLV 2 in blood donors at King Abdulaziz University Hospital (KAUH), Jeddah. Donor-testing results from Blood Transfusion Services at KAUH were reviewed over a 10-year period, from January 2006 through December 2015. All donors were screened using chemiluminescent microparticle immunoassay. Reactive samples were then tested by Western blot for confirmation. Costs associated with testing were calculated. Data of 107 419 donations in the study period were reviewed. Saudi nationals constituted 51 168 donors (47·6%). Of 107 419 blood donors tested for HTLV 1 and HTLV 2 antibody, and 95 (0·088%) donors were reactive to screening tests. None of the samples found to be reactive to screening tests was positive by Western blot. The average cost of testing was US$ 171 870 per year. No donors were confirmed to have HTLV 1 and HTLV 2 in this cohort exceeding 100 000 donors. We propose changes to the policy mandating universal testing by replacing it with universal leukodepletion coupled with targeted screening to donors coming from endemic area or donors at risk. Such changes are expected to lead to a reduction of testing cost without affecting safety. © 2017 British Blood Transfusion Society.

  5. Immunochemical faecal occult blood tests have superior stability and analytical performance characteristics over guaiac-based tests in a controlled in vitro study.

    LENUS (Irish Health Repository)

    Lee, Chun Seng

    2011-06-01

    The aims of this study were (1) to determine the measurement accuracy of a widely used guaiac faecal occult blood test (gFOBT) compared with an immunochemical faecal occult blood test (iFOBT) during in vitro studies, including their analytical stability over time at ambient temperature and at 4°C; and (2) to compare analytical imprecision and other characteristics between two commercially available iFOBT methods.

  6. An evaluation of the validity of the pre-operative oxygen uptake efficiency slope as an indicator of cardiorespiratory fitness in elderly patients scheduled for major colorectal surgery.

    Science.gov (United States)

    Bongers, B C; Berkel, A E; Klaase, J M; van Meeteren, N L

    2017-10-01

    This study aimed to investigate the validity of the oxygen uptake efficiency slope as an objective and submaximal indicator of cardiorespiratory fitness in elderly patients scheduled for major colorectal surgery. Patients ≥ 60 years of age, with a metabolic equivalent score using the Veterans Activity Questionnaire ≤ 7 and scheduled for major colorectal surgery participated in a pre-operative cardiopulmonary exercise test. The oxygen uptake efficiency slope was calculated up to different exercise intensities, using 100%, 90% and 80% of the exercise data. Data from 71 patients (47 men, mean (SD) age 75.2 (6.7) years) were analysed. The efficiency slope obtained from all the data was statistically significantly different from the values when 90% (p = 0.027) and 80% (p = 0.023) of the data were used. The 90% and 80% values did not differ significantly from each other (p = 0.152). Correlations between the oxygen uptake efficiency slope and the peak oxygen uptake ranged from 0.816 to 0.825 (all p < 0.001), and correlations between oxygen uptake efficiency slope and the ventilatory anaerobic threshold ranged from 0.793 to 0.805 (all p < 0.001). Receiver operating characteristic curves showed that the oxygen uptake efficiency slope is a sensitive and specific predictor of a peak oxygen uptake ≤ 18.2 ml.kg(-1) .min(-1) , with an area under the curve (95%CI) of 0.876 (0.780-0.972, p < 0.001) and a ventilatory anaerobic threshold ≤ 11.1 ml.kg(-1) .min(-1) , with an area under the curve (95%CI) of 0.828 (0.726-0.929, p < 0.001). These correlations suggest that the oxygen uptake efficiency slope provides a valid (sub)maximal measure of cardiorespiratory fitness in these patients, and the predictive ability described indicates that it might help discriminate patients at higher risk of postoperative morbidity. However, future research should investigate the prognostic value of the oxygen uptake efficiency slope for postoperative outcomes. © 2017 The Association of

  7. Toward laboratory blood test-comparable photometric assessments for anemia in veterinary hematology

    Science.gov (United States)

    Kim, Taehoon; Choi, Seung Ho; Lambert-Cheatham, Nathan; Xu, Zhengbin; Kritchevsky, Janice E.; Bertin, Francois-René; Kim, Young L.

    2016-10-01

    Anemia associated with intestinal parasites and malnutrition is the leading cause of morbidity and mortality in small ruminants worldwide. Qualitative scoring of conjunctival redness has been developed so that farmers can gauge anemia in sheep and goats to identify animals that require treatment. For clinically relevant anemia diagnosis, complete blood count-comparable quantitative methods often rely on complicated and expensive optical instruments, requiring detailed spectral information of hemoglobin. We report experimental and numerical results for simple, yet reliable, noninvasive hemoglobin detection that can be correlated with laboratory-based blood hemoglobin testing for anemia diagnosis. In our pilot animal study using calves, we exploit the third eyelid (i.e., palpebral conjunctiva) as an effective sensing site. To further test spectrometer-free (or spectrometerless) hemoglobin assessments, we implement full spectral reconstruction from RGB data and partial least square regression. The unique combination of RGB-based spectral reconstruction and partial least square regression could potentially offer uncomplicated instrumentation and avoid the use of a spectrometer, which is vital for realizing a compact and inexpensive hematology device for quantitative anemia detection in the farm field.

  8. Direct Urease Test and Acridine Orange Staining on Bactec Blood Culture for Rapid Presumptive Diagnosis of Brucellosis

    Directory of Open Access Journals (Sweden)

    P Maleknejad

    2005-08-01

    Full Text Available Brucellosis is one of the most common zoonotic diseases in Iran and human brucellosis is endemic in all parts of the country. Growth of Brucella is slow and blood culture of these bacteria by use of classical methods is time-consuming. Furthermore, in endemic area culture is required for definitive diagnosis. In the present study, direct urease test and acridine orange staining were tried on the BACTEC blood culture broths for early presumptive identification of Brucella growth. Blood cultures were attempted in 102 seropositive patients. In the forty one blood cultures positive for Brucella, coccobacilli were seen in broth smears stained with acridine orange stain, and also were urease test positive, thus providing presumptive identification of Brucella growth. Urease test was negative and bacteria were not seen in the broth smears of the remaining 61 broths negative for Brucella growth. Because of simplicity, reliability and reproducibility, these tests can be routinely incorporated in the laboratory for diagnosis of brucellosis.

  9. Factors Predicting Fecal Occult Blood Testing among Residents of Bushehr, Iran, Based on the Health Belief Model.

    Science.gov (United States)

    Ghobadi Dashdebi, Kamel; Noroozi, Azita; Tahmasebi, Rahim

    2016-01-01

    Colorectal cancer is a major cause of mortality worldwide. Fecal occult blood testing has proven a very effective screening tool for early detection and mortality reduction. The aim of this study was to determine predictors factors related to fecal occult blood testing using the Health Belief Model method among residents of Bushehr, Iran. A cross sectional study was performed on a sample of 600 men and women more than 50 years of age. The sample was selected by a convenience method from patients referred to public and private laboratories throughout the city. Each subject filled out a questionnaire which was designed and developed based on Health Belief Model constructs. Statistical analysis was conducted using ANOVA, T-test, chi-square test, and logistic regression. Fecal occult blood tests were performed on 179 (29.8%) out of 600 subjects, of which 95 patients (58.1%) did a periodic examination test and 84 patients (46.9%) had a doctor's advice for testing. According to the logistic regression model, the perceived barriers (P=0.0, Exp(B)= 0.3), perceived benefits (P occult blood testing among subjects.The results showed that reducing people's perception of barriers to testing, increasing perceived benefits of screening, and reinforcing self efficacy can have major effect in increasing the rate of fecal occult blood screening for colorectal cancer prevention.

  10. Evaluation of canine and feline leishmaniasis by the association of blood culture, immunofluorescent antibody test and polymerase chain reaction

    OpenAIRE

    Campos Braga, Audrey Renno; Langoni, Hélio; Lucheis, Simone Baldini [UNESP

    2014-01-01

    Background: This study aimed to evaluate the occurrence of Leishmania spp. in dogs and cats from Botucatu, Sao Paulo state, and Campo Grande, Mato Grosso do Sul state, Brazil, by the association of three diagnostic tests: blood culture in liver infusion tryptose medium, immunofluorescent antibody test and polymerase chain reaction. Fifty blood samples of dogs and cats from the Center for Zoonosis Control in Campo Grande, an area endemic for canine visceral leishmaniasis, were collected random...

  11. Dried blood spot sampling for hepatitis B virus serology and molecular testing.

    Directory of Open Access Journals (Sweden)

    Sofiane Mohamed

    Full Text Available BACKGROUND AIMS: Dried blood spots (DBS on filter paper have been successfully used to diagnose and monitor several infectious diseases. The aim was to investigate the performance of DBS in hepatitis B virus (HBV diagnosis using commercial tests in comparison to standard methods. METHODS: Paired DBS and plasma samples were collected from 200 patients: 100 patients with HBsAg negative status and 100 patients with HBsAg positive status. In the latter patient, HBeAg reactivity was tested. Ten samples of anti-HBs were collected from people vaccinated against HBV. We also studied 50 patients with positive HBV DNA viral load in plasma and 10 HBV DNA negative patients. HBV genotypes and gene polymerase mutations were determined in 10 randomly selected HBV-infected patients. The DBS sample consisted of 50 µL of whole blood, i.e. a 12-mm paper card. RESULTS: The sensitivity thresholds of HBsAg and anti-HBs antibody were 0.30 ± 0.08 IU/mL and 18.11 ± 6.05 IU/mL, respectively, for DBS with 98% sensitivity and 100% specificity. Sensitivity was 98% and specificity 100% for the detection of HBV DNA on a blotter, considering an HBV DNA threshold of 914.1 ± 157.8 IU/ml. Ten patients had an HBeAg positive status in plasma, all were detected positive using DBS. HBV genotyping and mutation detection were successfully performed on DBS, with full concordance between the 10 paired DBS and plasma samples. CONCLUSION: This study shows DBS is a reliable alternative to plasma specimens for quantifying and detecting HBsAg, anti-HBs, HBeAg and genotyping. DBS may increase the opportunities for HBV testing and treatment follow-up in hard-to-reach individuals.

  12. Evaluation of the Verigene® Blood Culture Nucleic Acid test for rapid identification of gram positive pathogens from positive blood cultures

    Directory of Open Access Journals (Sweden)

    Agnese Cellini

    2015-06-01

    Full Text Available Background. The rapid identification of the etiology and the evaluation of the antimicrobial susceptibility of the bacteria causing bacteremia is of outmost relevance to set up an adequate treatment of sepsis. In this study we evaluated the microarray based method, Verigene Gram-positive blood cultures (BC-GP nucleic acid test (Nanosphere Inc., Northbrook, IL, USA for the identification of Gram positive pathogens from positive blood cultures. The panel BC-GP is capable to identify 13 germs and 3 genes associated with antimicrobial resistance. Materials and Methods. In this study a total of 100 positive, non replicated and monomicrobic blood cultures have been evaluated. For testing on the Verigene platform using the BC-GP assay, 350 L of blood culture media from a positive the blood culture bottle.Results. A total of 100 positive blood cultures were tested by the Verigene BC-GP assay: out of these a total of 100 Gram-positive cocci were identified. The most frequent bacteria identified included staphylococci, streptococci and enterococci. Among staphylococci, Staphylococcus aureus accounted for 25% (15/60, with 38% of S. epidermidis 37% (23/60 and 37% (22/60 other CoNS. All the S. aureus isolates were correctly identified by BC-GP whereas in 2/45 cases (4% BC-GP misidentified CoNS. In the case of enterococci 7/10 were E. faecalis and 3 E. faecium, all of these were correctly identified.Conclusions. The overall agreement with the results obtained by standard procedure is quite elevated (88% and as a consequence the BC-GP panel could be used as a rapid diagnostic tool to give a faster response in the case of bacteremia associated with sepsis.

  13. The Two-Tier Fecal Occult Blood Test: Cost-Effective Screening

    Directory of Open Access Journals (Sweden)

    Andrew J Rae

    1994-01-01

    Full Text Available The two-tier test represents a strategy combining HO Sensa and Hemeselect fecal occult blood tests (FOBTs with the aim of greater specificity and consequent economic advantages. If patients register a positive result on any HO Sensa guaiac test, they are once again tested by a hemoglobin-specific Hemeselect test. This concept was applied to a multicentre study involving persons 40 years or older. One component of the study enrolled 573 high risk patients while the second arm recruited an additional 1301 patients (52% asymptomatic/48% symptomatic stratified according to personal history and symptoms. The two-tier test produced fewer false positives than traditional tests in both groups evaluated in the study. In the high risk group, specificity (88.7% for two-tier versus 80.6% for Hemoccult and 69.5% for HO Sensa was higher and false positive rates were lower (11.3% for two-tier versus 19.5% for Hemoccultand 30.5% for HO Sensa for the two-tier test versus Hemoccult and HO Sensa FOBTs (95% CI for all colorectal cancers [CRCs] and polyps greater than 1 cm, α=0.05 . No significant differences in sensitivity were observed between tests in the same group. Also, in the high risk group, benefits of the two-tier test outweighed the costs. Due to the small number of cancers and polyps in the second arm of the study, presentation of data is meant to be descriptive and representative of trends in a ‘normal’ population. Nevertheless, specificity of the two-tier test was higher (96.8% for two-tier versus 87.2% for Hemoccult and 69.5% for HO Sensa and false positive rate lower (3.2% for two-tier versus 12.8% for Hemoccult and 22.3% for HO Sensa than either the Hemoccult or HO Sensa FOBT (95% CI for all CRCs and polyps greater than 1 cm. This initial study, focusing on the cost-benefit relationship of increased specificity, represents a new way of economically evaluating existing FOBTs.

  14. Determinants of myocardial blood flow response to cold pressor testing and pharmacologic vasodilation in healthy humans

    Energy Technology Data Exchange (ETDEWEB)

    Prior, John O.; Schindler, Thomas H.; Facta, Alvaro D.; Hernandez-Pampaloni, Miguel; Campisi, Roxana; Dahlbom, Magnus; Schelbert, Heinrich R. [David Geffen School of Medicine at UCLA, Department of Molecular and Medical Pharmacology, B2-085J CHS, 10833 Le Conte Ave, Box 956948, Los Angeles, CA (United States)

    2007-01-15

    Response of myocardial blood flow (MBF) to sympathetic stimulation with cold is modulated by endothelium-related factors and is typically altered in the presence of coronary risk factors. Determinants of flow response to cold pressor testing (CPT) in normal volunteers at low risk for CAD remain less well defined, especially relative to baseline conditions such as hemodynamics and MBF, plasma substrate and lipid levels, and total pharmacologically stimulated vasodilator capacity. In 50 normal volunteers (42{+-}13 years; 31 women) without coronary risk factors, insulin resistance, or family history of diabetes/premature CAD, MBF was measured with {sup 13}N-ammonia and PET at baseline, during CPT, and during pharmacologic hyperemia. Sympathetic stimulation with CPT raised heart rate and blood pressure and thus MBF ({delta}MBF=0.23{+-}0.09 ml/min/g). MBF response, defined in absolute flow units as the difference between CPT and baseline, was independent of age, gender, heart rate, and blood pressure and rate-pressure product (RPP) at baseline as well as plasma substrate and lipid levels with the exception of an association with HDL cholesterol ({rho}=0.40, p=0.005) but depended on the change in RPP from rest ({rho}=0.33, p=0.019). Finally, changes in coronary vascular resistance in response to CPT were associated with changes in pharmacologic vasodilation ({rho}=0.56, p<0.0001). MBF response to sympathetic stimulation with cold (NO-mediated endothelium-dependent vasomotion), reflecting the functional state of the coronary endothelium, was independent of gender, age, and resting heart conditions. It was modulated by HDL cholesterol levels, even in healthy volunteers, and also related to pharmacologically stimulated vasodilator capacity at the coronary vascular resistance level. (orig.)

  15. Immunotoxicity and genotoxicity testing of PLGA-PEO nanoparticles in human blood cell model.

    Science.gov (United States)

    Tulinska, Jana; Kazimirova, Alena; Kuricova, Miroslava; Barancokova, Magdalena; Liskova, Aurelia; Neubauerova, Eva; Drlickova, Martina; Ciampor, Fedor; Vavra, Ivo; Bilanicova, Dagmar; Pojana, Giulio; Staruchova, Marta; Horvathova, Mira; Jahnova, Eva; Volkovova, Katarina; Bartusova, Maria; Cagalinec, Michal; Dusinska, Maria

    2015-05-01

    A human blood cell model for immunotoxicity and genotoxicity testing was used to measure the response to polylactic-co-glycolic acid (PLGA-PEO) nanoparticle (NP) (0.12, 3, 15 and 75 μg/cm(2) exposure in fresh peripheral whole blood cultures/isolated peripheral blood mononuclear cell cultures from human volunteers (n = 9-13). PLGA-PEO NPs were not toxic up to dose 3 μg/cm(2); dose of 75 μg/cm(2) displays significant decrease in [(3)H]-thymidine incorporation into DNA of proliferating cells after 4 h (70% of control) and 48 h (84%) exposure to NPs. In non-cytotoxic concentrations, in vitro assessment of the immunotoxic effects displayed moderate but significant suppression of proliferative activity of T-lymphocytes and T-dependent B-cell response in cultures stimulated with PWM > CON A, and no changes in PHA cultures. Decrease in proliferative function was the most significant in T-cells stimulated with CD3 antigen (up to 84%). Cytotoxicity of natural killer cells was suppressed moderately (92%) but significantly in middle-dosed cultures (4 h exposure). On the other hand, in low PLGA-PEO NPs dosed cultures, significant stimulation of phagocytic activity of granulocytes (119%) > monocytes (117%) and respiratory burst of phagocytes (122%) was recorded. Genotoxicity assessment revealed no increase in the number of micronucleated binucleated cells and no induction of SBs or oxidised DNA bases in PLGA-PEO-treated cells. To conclude on immuno- and genotoxicity of PLGA-PEO NPs, more experiments with various particle size, charge and composition need to be done.

  16. Study on Importance of Primary Screening Test of Blood Donors in the Blood Detection in Blood Bank%献血者初筛检验在血站血液检测中重要性的探讨

    Institute of Scientific and Technical Information of China (English)

    刘玲玲

    2016-01-01

    Objective To detect and analyze the blood specimens of different seasons, time, addresses and blood donors and analyze the related influence factors of blood test results thus discussing the suitable primary screening test method. Meth-ods The blood test results of research staff from May 2013 to October 2015 were selected and the blood test results of dif-ferent seasons, time and populations were analyzed, and the microcomputer inquiry was conducted according to the primary screening results of ALT and HBsAg before blood collection and previous blood donors. Results The time and address had an effect on the test results of ALT and HBsAg of blood donors, the use of primary screening test before blood donation could reduce the collection of positive blood or reactive blood to a certain degree, thus reducing the contamination to envi-ronment after blood donation. Conclusion For street blood donation, we should enhance the primary screening test of feasi-ble projects of ALT and HBsAg, and the electronic files are inquired by the microcomputer, and we should enhance the en-quiry of dieting and rest issues when carrying out blood donation in summer and the rapid test can effectively reduce the is-sues of blood resource waste and blood bank environment pollution.%目的:检测分析在不同季节、时间、地点以及不同献血人群的血液标本,分析影响血液检验结果的相关因素,从而探讨出合适的初筛检验方法。方法该次研究挑选在2013—2015年期间5~10月这个时间段采集研究人员血液的检验结果。分析不同季节、时间以及人群的血液检测结果,并根据采血前的丙氨酸氨基转移酶(ALT)以及乙型肝炎病毒表面抗原(HBsAg)的检测项目的初筛检测和既往献血者的结果进行微机查询。结果时间和地点等因素对于献血者的检测结果在丙氨酸氨基转移酶(ALT)以及乙型肝炎病毒表面抗原(HBsAg)等项目上均有影响,利用献血前初筛

  17. A Rapid Screening Test on Dried Blood for the Neonatal Diagnosis of Tyrosinemia Type I

    Directory of Open Access Journals (Sweden)

    Farahnaz Bodaghkhan

    2016-02-01

    Full Text Available Background: Tyrosinemia is an inherited metabolic disorder characterized by elevated levels of tyrosine and its metabolites in plasma. Without treatment, the disease will progress to hepatic and renal failure, so that without liver transplantation will cause death in less than 10 years of age. So, early diagnosis and treatment can be life saving and crucial. It means that with early treatment starting in the neonatal period, the patient can have normal life with very few restrictions in diets containing tyrosine and phenylalanine. Objectives: In this study we wanted to evaluate an easy to perform, rapid and sensitive qualitative test with low cost, as a part of neonatal screening tests to help early diagnosis and treatment of hereditary tyrosinemia. Patients and Methods: In this cross sectional study, during the study period (2013 - 2014, 100 patients were selected. Fifty three (53 of these patients had proven tyrosinemia and the other 47 cases biliary atresia, paucity of intrahepatic bile ducts, cytomegalovirus (CMV hepatitis, galactosemia and storage diseases. Results: There were 2 false negative and 14 false positive cases of hereditary tyrosinemia (HT-1 in the test. Six cases of biliary atresia, 7 cases of paucity of intrahepatic bile ducts and one patient with cytomegalovirus (CMV hepatitis were falsely positive with the test. Sensitivity of the test was 96.23%, specificity 71.43%, positive predictive value (PPV 78.46%, and negative predictive value (NPV 94.59%. Conclusions: This rapid qualitative test on dried blood sample is an easy, cheap, and feasible method for the screening of hereditary tyrosinemia in neonatal period.

  18. POPULATION BASED COLORECTAL CANCER SCREENING: COMPARISON OF TWO FAECAL OCCULT BLOOD TESTS

    Directory of Open Access Journals (Sweden)

    Miren Begoña eZubero

    2014-01-01

    Full Text Available Background: The aim of screening for colorectal cancer is to improve prognosis by the detection of cancer at its early stages. In order to inform the decision on the specific test to be used in the population-based programme in the Basque Autonomous Region (Spain, we compared two immunochemical faecal occult blood quantitative tests (I-FOBT. Methods: Residents of selected study areas, aged 50-69 years, were invited to participate in the screening. Two tests based on latex agglutination (OC-Sensor and FOB Gold were randomly assigned to different study areas. A colonoscopy was offered to patients with a positive test result. The cut-off point used to classify a result as positive, according to manufacturer’s recommendations, was 100 ng/ml for both tests. Results: The invited population included 37,999 individuals. Participation rates were 61.8% (n=11,162 for OC-Sensor and 59.1% (n=11,786 for FOB Gold, (p=0.008. Positive rate for OC-Sensor was 6.6% (n=737 and 8.5% (n=1,002 for FOB Gold, (pConclusions: OC-Sensor test appears to be superior for I-FOBT based CRC screening, given its acceptance, ease of use, associated small number of errors and its screening accuracy. FOB-Gold on the other hand, has higher rate of positive values, with more colonoscopies performed, it shows higher detection incidence rates, but involves more false positives.

  19. USING CAPILLARY WHOLE BLOOD GLUCOSE TEST IN SCREENING FOR GESTATIONAL DIABETES MELLITUS

    Institute of Scientific and Technical Information of China (English)

    WU Qing-kai; LUO Lai-min; GU Jing-hong; LI Ping; HUANG Ya-juan; FENG Jie; ZHANG Rui

    2007-01-01

    Objective To discuss whether the capillary whole blood glucose (CBG) test can be used in glucose screening test (GST) for gestational diabetes mellitus (GDM) compared to the venous plasma glucose (VPG) method, and to determine the cutoff value of CBG. Methods This was a self-control test. The 50-g oral GST was conducted among 1 557 pregnant women between 24-28 weeks. Every woman was measured CBG and VPG at the same time and same arm. Three hundred and forty women underwent 100-g 3-h oral glucose tolerance test (OGTT). Receiver operation curve (ROC) was used to determine the potential cutoff level of CBG and VPG. Diagnose criteria of GDM was based on NDDG criteria. OGTT diagnosed GDM and VPG ≥ 7. 8 mmol/L were used as golden standard for ROC. Results There was good relationship between CBG and VPG ( P < 0.01 ). Correlation coefficient was 0. 86. The value of CBG was lower than VPG. The statistical and high-sensitivity cutoff values were 7. 4 mmol/L in CBG and 7. 8 mmol/L in VPG when GDM was used as golden standard. Cutoff value of CBG was 7. 0 mmol/L when VPG≥ 7. 8 mmol/L was used as golden standard. The pregnant outcomes of positive cases of three thresholds had no significant differences. But it was better in case of the pregnant woman when the CBG value was more than 7. 4 mmol/L. Conclusion CBG can be used in GST, the threshold of CBG was suggested as 7. 4 mmol/L. CBG test was more convenience and effective than VPG test.

  20. Blunted heart rate recovery is associated with exaggerated blood pressure response during exercise testing.

    Science.gov (United States)

    Dogan, Umuttan; Duzenli, Mehmet Akif; Ozdemir, Kurtulus; Gok, Hasan

    2013-11-01

    Increased sympathetic activity and endothelial dysfunction are the proposed mechanisms underlying exaggerated blood pressure response to exercise (EBPR). However, data regarding heart rate behavior in patients with EBPR are lacking. We hypothesized that heart rate recovery (HRR) could be impaired in patients with EBPR. A total of 75 normotensive subjects who were referred for exercise treadmill test examination and experienced EBPR were included to this cross-sectional case-control study. The control group consisted of 75 age- and gender-matched normotensive subjects without EBPR. EBPR was defined as a peak exercise systolic blood pressure (BP) ≥210 mmHg in men and ≥190 mmHg in women. HRR was defined as the difference in HR from peak exercise to 1 min in recovery; abnormal HRR was defined as ≤12 beats/min. These parameters were compared with respect to occurrence of EBPR. Mean values of systolic and diastolic BP at baseline, peak exercise, and the first minute of the recovery were significantly higher in the subjects with EBPR. Mean HRR values were significantly lower (P exercise, a linear correlation existed between the degree of HRR and decrease in systolic BP during the recovery period. However, such a correlation was not found in subjects with EBPR. Our data suggest that mechanisms underlying the blunting of the HRR might be associated with the genesis of EBPR. The association between the extent of HRR and adverse cardiovascular outcomes in patients with EBPR needs to be investigated in detail in future research.

  1. Interactions of hemoglobin in live red blood cells measured by the electrophoresis release test.

    Science.gov (United States)

    Su, Yan; Gao, Lijun; Ma, Qiang; Zhou, Lishe; Qin, Liangyi; Han, Lihong; Qin, Wenbin

    2010-09-01

    To elucidate the protein-protein interactions of hemoglobin (Hb) variants A and A(2), HbA was first shown to bind with HbA(2) in live red blood cells (RBCs) by diagonal electrophoresis and then the interaction between HbA and HbA(2) outside the RBC was shown by cross electrophoresis. The starch-agarose gel electrophoresis of hemolysate, RBCs, freeze-thawed RBCs and the supernatant of freeze-thawed RBCs showed that the interaction between HbA and HbA(2) was affected by membrane integrity. To identify the proteins involved in the interaction, protein components located between HbA and HbA(2) in RBCs (RBC HbA-HbA(2)) and hemolysate (hemolysate HbA-HbA(2)) were isolated from the starch-agarose gel and separated by 5-12% SDS-PAGE. The results showed that there was a ≈22 kDa protein band located in the RBC HbA-HbA(2) but not in hemolysate HbA-HbA(2). Sequencing by LC/MS/MS showed that this band was a protein complex that included mainly thioredoxin peroxidase B, α-globin, δ-globin and β-globin. Thus, using our unique in vivo whole blood cell electrophoresis release test, Hbs were proven for the first time to interact with other proteins in the live RBC.

  2. Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine

    Science.gov (United States)

    Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

    2016-01-01

    Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard – fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline – second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing. PMID:27812301

  3. Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    Science.gov (United States)

    Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

    2016-10-15

    Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing.

  4. Development of an Intervention for implementing Immunochemical Faecal Occult Blood Test in General Practice

    DEFF Research Database (Denmark)

    Juul, Jakob Søgaard; Vedsted, Peter; Bro, Flemming

    2016-01-01

    Denne korte artikel handler om udviklingen af en intervention til implementering af immunochemical faecal occult blood test (iFOBT) i almen praksis. Artiklen gennemgår processen fra de tidlige udviklingsstadier, over pilot-testning og frem til de endelige justeringer før selve implementeringen blev...... iværksat i almen praksis. Erfaringerne fra pilot-testningen betød, at vejledningen til brugen af iFOBT blev ændret – fra en fast og ”rigid” vejledning, som byggede på helt specifikke indikationer, til en mere ”fleksibel” vejledning, som i højere grad byggede på den praktiserende læges egen kliniske...

  5. Determinants of participation in colorectal cancer screening with faecal occult blood testing

    DEFF Research Database (Denmark)

    von Euler-Chelpin, My; Brasso, Klaus; Lynge, Elsebeth

    2009-01-01

    BACKGROUND: Colorectal cancer is one of the most common cancers in men and women. Participation rates in faecal occult blood testing (FOBT) screening activities are, however, relatively low. In terms of lowering the colorectal cancer mortality, high participation rates are essential, and therefore...... it is important to understand the barriers to FOBT screening. METHODS: We undertook a systematic search through PUBMED, Medline, EMBASE and PsycINFO in order to identify studies that provide information on socio-demographic determinants of participation in FOBT screening. RESULTS: FOBT participation varied...... considerably across countries, but they have rarely been above 60%. The use of other health-care services was in most studies a strong determinant for participation in screening with FOBT. There was a tendency to higher participation among women than among men and among married as opposed to not married...

  6. Preliminary indications for antibiotic susceptibility tests in less than six hour in positive blood cultures

    Directory of Open Access Journals (Sweden)

    Vesselina Kroumova

    2010-03-01

    Full Text Available A rapid determination of the antibiotic susceptibility patterns of pathogens responsible for sepsis represents a significant milestone for a timely correct antibiotic therapy.The system HB&L® (ALIFAX allows reduced time in the detection of bacterial growth and consequently is able to detect the growth or absence of certain microorganisms in the presence of a given antibiotic. In this study three system for rapid antibiotic susceptibility tests among bacteria isolated from blood were compared: HB&L® (ALIFAX,VITEK®2 (bioMérieux and essays Etest® (bioMérieux. Present findings indicate that HB&L® (ALIFAX is rapid reliable instrument that may support the clinician for a rapid and appropriate treatment, particularly in the critical patient.

  7. The mathematical analysis of the heart rate and blood lactate curves during incremental exercise testing.

    Science.gov (United States)

    Rosic, Mirko; Ilic, V; Obradovic, Z; Pantovic, S; Rosic, G

    2011-12-01

    This paper describes a new mathematical approach for the analysis of HR (heart rate) and BL (blood lactate) curves during incremental exercise testing using a HR/BL curve and its derivatives, taking into account the native shape of all curves, without any linear approximation. Using this approach the results indicate the appearance of three characteristic points (A, B and C) on the HR/BL curve. The point A on the HR/BL curve which is the value that corresponds to the load (12.73 ± 0.46 km h-1) at which BL starts to increase above the resting levels (0.9 ± 0.06 mM), and is analogous to Lactate Turn Point 1 (LTP1). The point C on the HR/BL curve which corresponds to a BL of approximately 4mM, and is analogous to LTP2. The point B on the HR/BL curve, which corresponds to the load (16.32 ± 0.49 km h-1) at which the moderate increase turns into a more pronounced increase in BL. This point has not been previously recognized in literature. We speculate this point represents attenuation of left ventricular ejection fraction (LVEF) increase, accompanied by the decrease in diastolic time duration during incremental exercise testing. Proposed mathematical approach allows precise determination of lactate turnpoints during incremental exercise testing.

  8. Effects of recovery type after a kickboxing match on blood lactate and performance in anaerobic tests.

    Science.gov (United States)

    Ouergui, Ibrahim; Hammouda, Omar; Chtourou, Hamdi; Gmada, Nabil; Franchini, Emerson

    2014-06-01

    To verify whether active recovery (AR) applied after a kickboxing match resulted in better performance in anaerobic tests when compared to passive recovery (PR). Eighteen kickboxers volunteered to participate on a Kickboxing match preceded and followed by anaerobic tests: squat jump (SJ), the counter movement jump (CMJ) and the upper-body Wingate test. Blood lactate (BL), heart rate (HR) and rate of perceived exertion (RPE) were analyzed before and after rounds. The recovery sessions consisted of 10min at 50% of maximal aerobic speed or PR. BL was measured at 3, 5 and 10 min after the match, while HR, RPE and anaerobic power were assessed after the recovery period. BL, HR and RPE increased significantly (P<0.001) during the match. BL was lower (P<0.001) after AR compared to PR at 5 min and 10 min (e.g. AR: 8.94 ± 0.31 mmol.l(-1), PR: 10.98 ± 0.33 mmol.l(-1)). However, PR resulted in higher (P<0.05) upper-body mean power (4.65 ± 0.5 W.kg(-1)) compared to AR (4.09 ± 0.5 W.kg(-1)), while SJ and CMJ were not affected by the recovery type. The lactate removal was improved with AR when compared with PR, but AR did not improve subsequent performance.

  9. Blood Donation

    Science.gov (United States)

    Tests and Procedures Blood donation By Mayo Clinic Staff Blood donation is a voluntary procedure. You agree to have blood drawn so that it can ... have a disease that requires blood components. Blood donation makes all of this possible. There are several ...

  10. A new model of centrifugal blood pump for cardiopulmonary bypass: design improvement, performance, and hemolysis tests.

    Science.gov (United States)

    Leme, Juliana; Fonseca, Jeison; Bock, Eduardo; da Silva, Cibele; da Silva, Bruno Utiyama; Dos Santos, Alex Eugênio; Dinkhuysen, Jarbas; Andrade, Aron; Biscegli, José F

    2011-05-01

    A new model of blood pump for cardiopulmonary bypass (CPB) application has been developed and evaluated in our laboratories. Inside the pump housing is a spiral impeller that is conically shaped and has threads on its surface. Worm gears provide an axial motion of the blood column. Rotational motion of the conical shape generates a centrifugal pumping effect and improves pumping performance. One annular magnet with six poles is inside the impeller, providing magnetic coupling to a brushless direct current motor. In order to study the pumping performance, a mock loop system was assembled. Mock loop was composed of Tygon tubes (Saint-Gobain Corporation, Courbevoie, France), oxygenator, digital flowmeter, pressure monitor, electronic driver, and adjustable clamp for flow control. Experiments were performed on six prototypes with small differences in their design. Each prototype was tested and flow and pressure data were obtained for rotational speed of 1000, 1500, 2000, 2500, and 3000 rpm. Hemolysis was studied using pumps with different internal gap sizes (1.35, 1.45, 1.55, and 1.7 mm). Hemolysis tests simulated CPB application with flow rate of 5 L/min against total pressure head of 350 mm Hg. The results from six prototypes were satisfactory, compared to the results from the literature. However, prototype #6 showed the best results. Best hemolysis results were observed with a gap of 1.45 mm, and showed a normalized index of hemolysis of 0.013 g/100 L. When combined, axial and centrifugal pumping principles produce better hydrodynamic performance without increasing hemolysis.

  11. Applicability of bacterial endotoxins test to various blood products by the use of endotoxin-specific lysates.

    Science.gov (United States)

    Ochiai, Masaki; Yamamoto, Akihiko; Naito, Seishiro; Maeyama, Jun-Ichi; Masumi, Atsuko; Hamaguchi, Isao; Horiuchi, Yoshinobu; Yamaguchi, Kazunari

    2010-11-01

    Endotoxin contamination is a serious threat to the safety of parenteral drugs, and the rabbit pyrogen test has played a crucial role in controlling this contamination. Although the highly sensitive endotoxin test has replaced the pyrogen test for various pharmaceuticals, the pyrogen test is still implemented as the control test for most blood products in Japan. We examined the applicability of the endotoxin test to blood products for reliable detection and quantification of endotoxin. Nineteen types of blood products were tested for interfering factors based on spike/recovery of endotoxin by using 2 types of endotoxin-specific lysate reagents for photometric techniques. Interfering effects on the endotoxin test by the products could be eliminated by diluting from 1/2 to 1/16, with the exception of antithrombin III. However, conventional lysate reagents that also react with non-pyrogenic substances, such as (1-3)-β-D-glucan, produced results that were not relevant to endotoxin content or pyrogenicity. Our results showed that the endotoxin test would be applicable to most blood products if used with appropriate endotoxin-specific lysate reagents.

  12. Rapid identification and antimicrobial susceptibility testing of positive blood cultures using MALDI-TOF MS and a modification of the standardised disc diffusion test: a pilot study.

    LENUS (Irish Health Repository)

    Fitzgerald, C

    2016-04-27

    In an era when clinical microbiology laboratories are under increasing financial pressure, there is a need for inexpensive, yet effective, rapid microbiology tests. The aim of this study was to evaluate a novel modification of standard methodology for the identification and antimicrobial susceptibility testing (AST) of pathogens in positive blood cultures, reducing the turnaround time of laboratory results by 24 h.

  13. Effect of pre-operative octenidine nasal ointment and showering on surgical site infections in patients undergoing cardiac surgery.

    Science.gov (United States)

    Reiser, M; Scherag, A; Forstner, C; Brunkhorst, F M; Harbarth, S; Doenst, T; Pletz, M W; Hagel, S

    2017-02-01

    To evaluate the effect of pre-operative octenidine (OCT) decolonization on surgical site infection (SSI) rates. Before-and-after cohort study. Patients undergoing an elective isolated coronary artery bypass graft (CABG) procedure: control group (1(st) January to 31(st) December 2013), N=475; intervention group (1(st) January to 31(st) December 2014), N=428. The intervention consisted of nasal application of OCT ointment three times daily, beginning on the day before surgery, and showering the night before and on the day of surgery with OCT soap. A median sternotomy was performed in 805 (89.1%) patients and a minimally invasive direct coronary artery bypass procedure was performed in 98 (10.9%) patients. Overall, there was no difference in SSI rates between the control and intervention groups (15.4% vs 13.3%, P=0.39). The rate of harvest site SSIs was significantly lower in patients in the intervention group (2.5% vs 0.5%, P=0.01). Patients who had undergone a median sternotomy in the intervention group had a significantly lower rate of organ/space sternal SSIs (1.9% vs 0.3%, P=0.04). However, there was a trend towards an increased rate of deep incisional sternal SSIs (1.2% vs 2.9%, P=0.08). Multi-variate analysis did not identify a significant protective effect of the intervention (odds ratio 0.79, 95% confidence interval 0.53-1.15, P=0.27). Pre-operative decolonization with OCT did not reduce overall SSI rates in patients undergoing an elective isolated CABG procedure, but significantly decreased harvest site and organ/space sternal SSIs. Randomized controlled trials, including controlled patient adherence to the intervention, are required to confirm these observations and to determine the clinical utility of OCT in pre-operative decolonization. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  14. Eletrocardiografia pré-operatória em 474 cães Pre-operative electrocardiography evaluation in 474 dogs

    Directory of Open Access Journals (Sweden)

    C.F. Carvalho

    2009-06-01

    Full Text Available Foram realizadas avaliações eletrocardiográficas pré-operatórias em 474 cães, machos e fêmeas, com o objetivo de analisar a frequência de alterações eletrocardiográficas e sua relação com indicação cirúrgica, sexo, idade, raça, peso, escore corporal (obesidade, histórico e sinais físicos de doenças cardíacas. As alterações eletrocardiográficas foram observadas em 220 animais (46%, sendo mais frequentes nos machos (n=116; 52,7%. O aumento na duração do QRS foi a alteração mais observada (n=54; 24,5%. Sugere-se o exame eletrocardiográfico de rotina na avaliação pré-cirúrgica, independentemente de idade, peso, histórico ou sinais físicos de cardiopatia.Pre-operative electrocardiographic evaluations were done in 474 male and female dogs to analyze the frequency of electrocardiographic alterations and its relation with the surgical indication according to age, breed, weight, body score (obesity, and history and physical signs of cardiac diseases. The electrocardiographic alterations occurred in 220 (46% animals, being more frequent in males (n=116; 52.7%. The increase in QRS duration was the most observed alteration (n=54; 24.5%. The electrocardiographic alterations in the pre-operative are common, which suggests that the performing of electrocardiographic exam in the pre-operative is independent of the age, weight, surgical problem, or signs of cardiopathy on clinical exam.

  15. The utility of MRI for pre-operative T and N staging of gastric carcinoma: a systematic review and meta-analysis.

    Science.gov (United States)

    Huang, Z; Xie, D H; Guo, L; Hu, C H; Fang, X; Meng, Q; Ping, X X; Lu, Z W

    2015-06-01

    To perform a meta-analysis and literature review regarding the diagnostic accuracy of MRI for pre-operative tumour depth invasion (T) and regional lymph node invasion (N) staging of gastric carcinoma (GC). Articles were identified through systematic search of Medline, PubMed, Cochrane Library, Web of Science, Springerlink and several Chinese databases. The study quality was assessed by the quality assessment for studies of diagnostic accuracy. 2 reviewers independently extracted and assessed the data from 11 eligible studies. A meta-analysis was then carried out. Subgroup and sensitivity analyses were also performed. 11 studies (439 patients) were finally included in the current review. Among these studies, the significant evidence of heterogeneity was only discovered for specificity in T4 stage (I(2) = 59.8%). Pooled sensitivity and specificity of MRI to diagnose T stage tumour (T3-4 vs T1-2) were 0.93 [95% confidence interval (CI), 0.89-0.96] and 0.91 (95% CI, 0.87-0.95), respectively. Pooled estimates of sensitivity and specificity of MRI to diagnose N stage tumour (N0 vs N+) were 0.86 (95% CI, 0.80-0.92) and 0.67 (95% CI, 0.54-0.79), respectively. Subgroup analyses showed that diffusion-weighted imaging was more helpful for T staging. The present systematic review suggests that MRI has a good diagnostic accuracy for pre-operative T staging of GC and should be widely used in clinical work. However, the ability for N staging is relatively poor on MRI. In the pre-operative staging of GC, MRI was a useful tool and may enhance accuracy for the T staging of advanced GC.

  16. PRE - OPERATIVE PREDICTORS OF DIFFICUL T LAPAROSCOPIC CHOLECYSTECTOMY; COMPARIS ONS OF TWO SCORING SYSTEMS. A SINGLE CENTER PROSPECTIVE STUDY”

    Directory of Open Access Journals (Sweden)

    Hari Gopal

    2013-10-01

    Full Text Available ABSTRACT: INTRODUCTION: Laparoscopic Cholecystectomy has evolved as the standard of care for the treatment of Gall Stone disease over the past decade. Several patient and procedure related factors have been impli cated in setting of failure to complete the procedure by minimal invasive method and various scores have been developed to precisely predict a Difficult Laparoscopic Cholecystectomy. AIMS: The present study was conducted to ascertain various patient relate d pre - operative risk factors for conversion of l apar o scopic Cholecystectomy to open method and to validate the Risk Score for conversion . SETTINGS & DESIGN: A total of 100 patients with diagnosis of Gall Stone Disease admitted to our surgical Unit between October 2011 and April 2013 were assessed for various pre - determined risk factors and were accordingly categorized into three levels of anticipated difficulty according to RSCLO and our new scoring system. The patients were then subjected to Laparoscopic C holecystectomy by the same surgical team and the procedure was then graded as difficult or not according to the pre - defined criteria. The findings were analysed by appropriate statistical analysis. RESULTS: Presence of factors like Male sex, history of att acks of acute cholecystitis, increased GB wall thickness, presence of supra - umbilical abdominal scar, obesity and a contracted GB were associated with a significantly higher rate of conversion to open method. RSCLO was found to correlate better with the ou tcome in this setting than our New Scoring System. CONCLUSION: Several patient related factors may be helpful in predicting a Difficult Laparoscopic Cholecystectomy pre - operatively. RSCLO Scoring system may be useful as a pre - operative tool to predict intr a - operative difficulty during LC.

  17. Effect of pre-operative rectal diclofenac suppository on post-operative analgesic requirement in cleft palate repair: A randomised clinical trial

    Directory of Open Access Journals (Sweden)

    E S Adarsh

    2012-01-01

    Full Text Available Background: Opioid analgesics used for analgesia are associated with sedation, respiratory depression and post-operative nausea and vomiting. Non-steroidal anti-inflammatory drugs such as diclofenac are a safe and effective alternative with opioid-sparing effect. Objective: To evaluate the effectiveness of pre-operative rectal diclofenac suppository (1 mg/kg in cleft palate repair for post-operative analgesia and reduction in post-operative opioid requirements. Study Design: A randomized clinical trial. Methods: After obtaining approval from the institutional ethical committee, 60 children were allocated by a computer-generated randomisation into two groups of 30 each; group D (Diclofenac group and group C (Conventional group. Children in group D and group C were similar in all aspects except for the fact that group D children received 1 mg/kg diclofenac suppository after induction. Pain was evaluated using modification of the objective pain scale by Hannallah and colleagues for 6 h post-operatively by an anaesthesiology resident or nursing staff who was blinded to the group. If the pain score was more than 3, rescue analgesic I.V. fentanyl 0.5 μgm/kg was administered. The pain scores at different intervals, number of doses and quantity of rescue analgesic required were noted. Results: We observed that pre-operative rectal diclofenac provided effective analgesia in the immediate post-operative period, as evidenced by reduced pain scores and reduced opioid requirement (P=0.00002. There was no evidence of any increased perioperative bleeding in the diclofenac group. Conclusion: Pre-operative rectal diclofenac reduces opioid consumption and provides good post-operative analgesia.

  18. Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction.

    Science.gov (United States)

    Liu, Jia-Ming; Shen, Jian-Xiong; Zhang, Jian-Guo; Zhao, Hong; Li, Shu-Gang; Zhao, Yu; Qiu, Giu-Xing

    2012-01-01

    It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis. Arterial blood gas tests have also been used to evaluate pulmonary function before scoliotic surgery. However, few studies have been reported. The aim of this study was to investigate the roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction. This study involved scoliotic patients with moderate or severe pulmonary dysfunction (forced vital capacity arterial blood gas tests and pulmonary function tests before surgery. The arterial blood gas tests included five parameters: partial pressure of arterial oxygen, partial pressure of arterial carbon dioxide, alveolar-arterial oxygen tension gradient, pH, and standard bases excess. The pulmonary function tests included three parameters: forced expiratory volume in 1 second ratio, forced vital capacity ratio, and peak expiratory flow ratio. All five parameters of the arterial blood gas tests were compared between the two groups with or without postoperative pulmonary complications by variance analysis. Similarly, all three parameters of the pulmonary function tests were compared. The average coronal Cobb angle before surgery was 97.42° (range, 50° - 180°). A total of 15 (20.5%) patients had postoperative pulmonary complications, including hypoxemia in 5 cases (33.3%), increased requirement for postoperative ventilatory support in 4 (26.7%), pneumonia in 2 (13.3%), atelectasis in 2 (13.3%), pneumothorax in 1 (6.7%), and hydrothorax in 1 (6.7%). No significant differences in demographic characteristics or perioperative factors (P > 0.05) existed between the two groups with or without postoperative pulmonary complications. According to the variance analysis, there were no statistically significant differences in any parameter of the arterial blood gas tests between the two groups. No significant correlation between

  19. Role of pre-operative imaging using {sup 99m}Tc-MIBI and neck ultrasound in patients with secondary hyperparathyroidism who are candidates for subtotal parathyroidectomy

    Energy Technology Data Exchange (ETDEWEB)

    Fuster, David; Ortin, Jaime; Setoain, Xavier; Paredes, Pilar; Duch, Joan; Pons, Francesca [Hospital Clinic, Nuclear Medicine Department, Barcelona (Spain); Ybarra, Juan; Torregrosa, Jose-Vicente [Hospital Clinic, Renal Transplant Unit, Barcelona (Spain); Gilabert, Rosa [Hospital Clinic, Radiology Department, Barcelona (Spain)

    2006-04-15

    The purpose of this study was to assess whether pre-operative {sup 99m}Tc-methoxyisobutylisonitrile (MIBI) scintigraphy and neck ultrasound (US) are of value in improving the outcome of subtotal parathyroidectomy in patients with secondary hyperparathyroidism. Forty-eight consecutive haemodialysis patients with severe secondary hyperparathyroidism prospectively underwent ''blinded'' subtotal parathyroid surgery, with 1-year follow-up to establish cure or relapse of their secondary hyperparathyroidism. Double-phase {sup 99m}Tc-MIBI scintigraphy and neck US were performed pre-operatively in all patients. When the preserved gland showed {sup 99m}Tc-MIBI uptake or an abnormal size on US, it was considered that ''{sup 99m}Tc-MIBI advice'' and ''US advice'', respectively, had not been followed. Pre-operative and follow-up parathyroid hormone (PTH) levels were obtained in all patients. All data were evaluated on a patient by patient basis. Four parathyroid glands were identified in each patient at primary surgery, resulting in an operative success rate of 100%. Their weight ranged from 15 to 7,300 mg (mean 1,120{+-}900 mg). Nine of the 48 patients (19%) showed a recurrence of their secondary hyperparathyroidism. The recurrence rate was 2% (1/48) and 10% (5/48), respectively, when {sup 99m}Tc-MIBI and US advice was followed. The sensitivity, specificity, NPV and PPV for pre-operative imaging were 72%, 95%, 97% and 80% respectively for {sup 99m}Tc-MIBI, and 55%, 67%, 87% and 28% for US. {sup 99m}Tc-MIBI scintigraphy is a reliable non-invasive exploratory tool and its preoperative use results in a significant reduction in the number of recurrences in haemodialysis patients with secondary hyperparathyroidism who are candidates for subtotal parathyroidectomy. The use of neck US did not significantly improve the results obtained with {sup 99m}Tc-MIBI alone. (orig.)

  20. Pre-operative renal artery embolization and suprarenal IVC filter placement for prevention of fat embolization in renal angiomyolipoma with venous extension.

    Science.gov (United States)

    Cornman-Homonoff, Joshua; Li, David; Schiffman, Marc

    2017-01-26

    Though generally considered benign, angiomyolipomas can invade through the renal vein into the inferior vena cava, putting patients at risk of catastrophic pulmonary fat embolization. Venous invasion is thus an indication for surgical resection but is thought to increase the risk of adverse operative outcomes including intraoperative hemorrhage and embolization of fat and/or tumor thrombus. We report a novel approach to mitigating these complications illustrated in the case of a 43-year-old woman with IVC-invasive renal AML who underwent successful radical nephrectomy after concurrent pre-operative renal artery embolization and placement of a retrievable suprarenal IVC filter.

  1. Accuracy of 3 T versus 1.5 T breast MRI for pre-operative assessment of extent of disease in newly diagnosed DCIS

    Energy Technology Data Exchange (ETDEWEB)

    Rahbar, Habib, E-mail: hrahbar@uw.edu; DeMartini, Wendy B.; Lee, Amie Y.; Partridge, Savannah C.; Peacock, Sue; Lehman, Constance D.

    2015-04-15

    Highlights: •We compared sizes of known ductal carcinoma in situ (DCIS) on pre-operative breast MRI at 3 T and 1.5 T with final pathology sizes. •DCIS sizes on 3 T MRI correlated better with pathologic sizes than 1.5 T MRI. •Imaging features of DCIS, including morphology and kinetics, were similar at 3 T and 1.5 T MRI. -- Abstract: Objectives: While 3 T breast magnetic resonance imaging has increased in use over the past decade, there is little data comparing its use for assessing ductal carcinoma in situ (DCIS) versus 1.5 T. We sought to compare the accuracies of DCIS extent of disease measures on pre-operative 3 T versus 1.5 T MRI. Methods: This institutional review board-approved prospective study included 20 patients with ductal carcinoma in situ diagnosed by core needle biopsy (CNB) who underwent pre-operative breast MRI at both 3 T (resolution = 0.5 mm × 0.5 mm × 1.3 mm) and 1.5 T (0.85 mm × 0.85 mm × 1.6 mm). All patients provided informed consent, and the study was HIPPA compliant. Lesion sizes and imaging characteristics (morphologic and kinetic enhancement) were recorded for the 3 T and 1.5 T examinations. Lesion size measures at both field strengths were correlated to final pathology, and imaging characteristics also were compared. Results: Of the initial cohort of 20 patients with CNB-diagnosed DCIS, 19 underwent definitive surgery. Median DCIS sizes of these 19 patients were 6 mm (range: 0–67 mm) on 3 T, 13 mm (0–60 mm) on 1.5 T, and 6 mm (0–55 mm) on surgical pathology. Size correlation between MRI and pathology was higher for 3 T (Spearman's ρ = 0.66, p = 0.002) than 1.5 T (ρ = 0.36, p = 0.13). In 10 women in which a residual area of suspicious enhancement was identified on both field strengths, there was agreement of morphologic description (NME vs. mass) in nine, and no significant difference in dynamic contrast enhanced kinetics at 3 T compared to 1.5 T. Conclusions: Pre-operative breast MRI at 3 T provided higher

  2. Analysis of Hypodermic Needles and Syringes for the Presence of Blood and Polydimethylsiloxane (Silicone) Utilizing Microchemical Tests and Infrared Spectroscopy.

    Science.gov (United States)

    Crowe, John B; Lanzarotta, Adam; Witkowski, Mark R; Andria, Sara E

    2015-07-01

    Suspect hypodermic needles and syringes were seized from an unlicensed individual who was allegedly injecting patients with silicone (polydimethylsiloxane [PDMS]) for cosmetic enhancement. Since control syringe barrels and needles often contain an interfering PDMS lubricant, a risk for false positives of foreign PDMS exists. The focus of this report was to minimize this risk and determine a quick and reliable test for the presence of blood in PDMS matrices. Using ATR-FT-IR spectroscopy, the risk for false-positive identification of foreign PDMS was reduced by (i) overfilling the sampling aperture to prevent spectral distortions and (ii) sampling a region of the suspect syringe/needle assembly where manufacturer-applied PDMS is not typically located. Analysis for blood indicated that the Teichman microchemical test was effective for detecting blood in the presence of PDMS. Overall, detecting PDMS established intent and detecting blood established that the needle containing the PDMS had been used for injection.

  3. One-day workflow scheme for bacterial pathogen detection and antimicrobial resistance testing from blood cultures.

    Science.gov (United States)

    Hansen, Wendy L J; Beuving, Judith; Verbon, Annelies; Wolffs, Petra F G

    2012-07-09

    Bloodstream infections are associated with high mortality rates because of the probable manifestation of sepsis, severe sepsis and septic shock(1). Therefore, rapid administration of adequate antibiotic therapy is of foremost importance in the treatment of bloodstream infections. The critical element in this process is timing, heavily dependent on the results of bacterial identification and antibiotic susceptibility testing. Both of these parameters are routinely obtained by culture-based testing, which is time-consuming and takes on average 24-48 hours(2, 4). The aim of the study was to develop DNA-based assays for rapid identification of bloodstream infections, as well as rapid antimicrobial susceptibility testing. The first assay is a eubacterial 16S rDNA-based real-time PCR assay complemented with species- or genus-specific probes(5). Using these probes, Gram-negative bacteria including Pseudomonas spp., Pseudomonas aeruginosa and Escherichia coli as well as Gram-positive bacteria including Staphylococcus spp., Staphylococcus aureus, Enterococcus spp., Streptococcus spp., and Streptococcus pneumoniae could be distinguished. Using this multiprobe assay, a first identification of the causative micro-organism was given after 2 h. Secondly, we developed a semi-molecular assay for antibiotic susceptibility testing of S. aureus, Enterococcus spp. and (facultative) aerobe Gram-negative rods(6). This assay was based on a study in which PCR was used to measure the growth of bacteria(7). Bacteria harvested directly from blood cultures are incubated for 6 h with a selection of antibiotics, and following a Sybr Green-based real-time PCR assay determines inhibition of growth. The combination of these two methods could direct the choice of a suitable antibiotic therapy on the same day (Figure 1). In conclusion, molecular analysis of both identification and antibiotic susceptibility offers a faster alternative for pathogen detection and could improve the diagnosis of

  4. The Psychological Impact of a Colorectal Cancer Diagnosis Following a Negative Fecal Occult Blood Test Result.

    Science.gov (United States)

    Miles, Anne; McClements, Paula L; Steele, Robert J C; Redeker, Claudia; Sevdalis, Nick; Wardle, Jane

    2015-07-01

    Screening using fecal occult blood testing (FOBt) reduces colorectal cancer mortality, but the test has low sensitivity. A "missed" cancer may cause psychologic harms in the screened population that partially counteract the benefits of early detection. Three hundred and eleven people diagnosed with colorectal cancer (i) after a negative FOBt result (interval cancer), (ii) a positive result (screen-detected cancer), or (iii) in regions where screening was not offered, completed questions on quality of life (FACT-C), depression (CES-D), perceived diagnostic delay, and trust in the results of FOBt screening. Fifteen withheld consent to data matching with medical records, leaving a sample size of 296. Controlling for demographic and clinical variables, patients with an interval cancer reported poorer quality of life (difference in means = 6.16, P = 0.03) and more diagnostic delay (OR, 0.37; P = 0.02) than patients with screen-detected disease, with no differences in depression. No differences were observed between the interval cancer group and the group not offered screening on these measures. Patients with an interval cancer reported the lowest levels of trust in FOBt. An interval cancer has adverse effects on trust in FOBt, but does not result in worse psychologic outcomes compared with people diagnosed in areas with no screening program. People with an interval cancer report poorer quality of life than people with screen-detected disease. Improvements in test sensitivity could improve quality of life among people who complete an FOB test over and above any benefits already conferred by earlier detection. ©2015 American Association for Cancer Research.

  5. Development and testing of a new disposable sterile device for labelling white blood cells

    NARCIS (Netherlands)

    Signore, A.; Glaudemans, A. W. J. M.; Malviya, G.; Lazzeri, E.; Prandini, N.; Viglietti, A. L.; De Vries, E. F. J.; Dierckx, R. A. J. O.

    2012-01-01

    Aim. White blood cell (WBC) labelling requires isolation of cells from patient's blood under sterile conditions using sterile materials, buffers and disposables under good manufacturing practice (GMP) conditions. Till now, this limited the use of white blood cell scintigraphy (WBC-S) only to well eq

  6. Development and testing of a new disposable sterile device for labelling white blood cells

    NARCIS (Netherlands)

    Signore, A.; Glaudemans, A. W. J. M.; Malviya, G.; Lazzeri, E.; Prandini, N.; Viglietti, A. L.; De Vries, E. F. J.; Dierckx, R. A. J. O.

    Aim. White blood cell (WBC) labelling requires isolation of cells from patient's blood under sterile conditions using sterile materials, buffers and disposables under good manufacturing practice (GMP) conditions. Till now, this limited the use of white blood cell scintigraphy (WBC-S) only to well

  7. A STUDY OF PRE OPERATION NURSING VISIT ABOUT THE NURSES’ VIEW FROM THE SURGERY ROOM OF A UNIVERSITY HOSPITAL.

    Directory of Open Access Journals (Sweden)

    Izilda Esmenia Muglia Araújo

    2004-08-01

    Full Text Available This study to do an analysis of the PONV`s importance, by nurses from the Daily’s SurgeryRoom of an University Hospital, through forms distributed to them and to apply the written communicationinstrument on the PONV,proposed by NORONHA & ARAÚJO (1995. The results this research were: 92,9% ofthe nurses from the Daily’s Surgery Room think that it is important the performance of the PONV to the patientand Nursing aid, and 85,7% think the PONV is important for the nurse who works in a Surgery Room. Thewritten communication instrument on the PONV was applied with success, being really easy to fill it in with clearquestions , showing so to be a lot of viable but some items of the instrument like blood group and FATOR RHcouldn’t be filled even after the records check. In this way, I think it is worth the suggestion o9f sitting the writtencommunication instrument proposed by ARAÚJO AND NORONHA (1995 at this State University, proposinghowever, inclusion on the patients’ records data about blood group and FATOR RH.

  8. Evaluation of a new, rapid test for detecting HCV infection, suitable for use with blood or oral fluid.

    Science.gov (United States)

    Lee, Stephen R; Kardos, Keith W; Schiff, Eugene; Berne, Cheryl A; Mounzer, Karam; Banks, Alpha T; Tatum, Harvey A; Friel, Timothy J; Demicco, Michael P; Lee, William M; Eder, Scott E; Monto, Alexander; Yearwood, Graham D; Guillon, Geraldine B; Kurtz, Lisa A; Fischl, Mark; Unangst, Jay Lynn; Kriebel, Laura; Feiss, Gary; Roehler, Michele

    2011-03-01

    The availability of a highly accurate, rapid, point-of-care test for hepatitis C virus (HCV) may be useful in addressing the problem of under-diagnosis of HCV, by increasing opportunities for testing outside of traditional clinical settings. A new HCV rapid test device (OraQuick® HCV Rapid Antibody Test), approved recently in Europe for use with venous blood, fingerstick blood, serum, plasma, or oral fluid was evaluated in a multi-center study and performance compared to established laboratory-based tests for detection of HCV. The HCV rapid test was evaluated in prospective testing of subjects with signs and/or symptoms of hepatitis, or who were at risk for hepatitis C using all 5 specimen types. Performance was assessed relative to HCV serostatus established by laboratory methods (EIA, RIBA and PCR) approved in Europe for diagnosis of hepatitis C infection. Sensitivity to antibody in early infection was also compared to EIA in 27 seroconversion panels. In addition, the reliability of the oral fluid sample for accurate detection of anti-HCV was assessed by studying the impact of various potentially interfering conditions of oral health, use of oral care products and consumption of food and drink. In this large study of at-risk and symptomatic persons, the overall specificities of the OraQuick® HCV Rapid Antibody Test were equivalent (99.6-99.9%) for all 5 specimen types and the 95% CIs substantially overlapped. Overall sensitivities were virtually identical for venous blood, fingerstick blood, serum and plasma (99.7-99.9%). Observed sensitivity was slightly lower for oral fluid at 98.1% though the upper CI (99.0%) was equal to the lower CI for venous blood and fingerstick blood. Most of the HCV positive subjects which gave nonreactive results in oral fluid had serological and virological results consistent with resolved infection. Sensitivity for anti-HCV in early seroconversion was virtually identical between the HCV rapid test and EIA. Detection of anti-HCV in

  9. Bayesian estimation of sensitivity and specificity of Coxiella burnetii antibody ELISA tests in bovine blood and milk

    DEFF Research Database (Denmark)

    Paul, Suman; Toft, Nils; Agerholm, Jørgen S.;

    2013-01-01

    Serological tests for Coxiella burnetii (the causative agent of Q fever) antibodies are usually based on enzyme linked immunosorbent assay (ELISA) although this method is not thoroughly evaluated. The objective of this study was to determine the sensitivity and specificity of an ELISA for detection...... of the ELISA methods on milk and blood were equal at 0.99. No conditional dependence was observed between the specificity estimates of the two test methods. However, the sensitivity estimates of both tests were significantly reduced when conditional covariances ≥40 were used. Collection of milk samples from...... to positive (S/P) cut-off of 40 for both blood and milk ELISAs. At this cut-off, sensitivity of milk ELISA was 0.86 (95% posterior credibility interval [PCI] [0.76; 0.96]). This was slightly but insignificantly higher than sensitivity of blood ELISA (0.84; 95% PCI [0.75; 0.93]). The specificity estimates...

  10. Comparison of MR and fluoroscopic mucous fistulography in the pre-operative evaluation of infants with anorectal malformation: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Alves, Jose C.G.; Lotz, Jan W.; Pitcher, Richard D. [Stellenbosch University, Division of Radiodiagnosis, Department of Medical Imaging and Clinical Oncology, Tygerberg Academic Hospital, Cape Town (South Africa); Sidler, Daniel [Stellenbosch University, Division of Pediatric Surgery, Department of Surgical Sciences, Tygerberg Academic Hospital, Cape Town (South Africa)

    2013-08-15

    Anorectal malformations are often associated with rectal pouch fistulas. Surgical correction requires accurate evaluation of the presence and position of such fistulas. Fluoroscopy is currently the chosen modality for the detection of fistulas. The role of MRI is unexplored. To compare the diagnostic accuracy of MR versus fluoroscopic fistulography in the pre-operative evaluation of infants with anorectal malformation. We conducted a pilot study of infants requiring defunctioning colostomy for initial management of anorectal malformation. Dynamic sagittal steady-state free-precession MRI of the pelvis was acquired during introduction of saline into the mucous fistulas. Findings were compared among MR fistulography, fluoroscopic fistulography and intraoperative inspection. Eight children were included. Median age at fistulography was 15 weeks, inter-quartile range 13-20 weeks; all were boys. There was full agreement among MR fistulography, fluoroscopic fistulography and surgical findings. The pilot data suggest that MR fistulography is promising in the pre-operative evaluation of children with anorectal malformation. (orig.)

  11. Nonresponse to pre-operative chemotherapy does not preclude long-term survival after liver resection in patients with colorectal liver metastases.

    Science.gov (United States)

    Neumann, Ulf P; Thelen, Armin; Röcken, Christoph; Seehofer, Daniel; Bahra, Marcus; Riess, Hanno; Jonas, Sven; Schmeding, Maximilian; Pratschke, Johann; Bova, Roberta; Neuhaus, Peter

    2009-07-01

    Liver resection is the only curative treatment offering a chance of long-term survival in patients with colorectal liver metastases (CRM). Recent data indicated that liver resection in patients with tumor progression while receiving chemotherapy was associated with poor outcome. The aim of the study was to identify risk factors for poor outcome in patients with pre-operative chemotherapy of CRM. We analyzed 160 patients after liver resection for CRM with preoperative systemic. chemotherapy. Three groups of patients were identified: 44 patients (27.5%) had a tumor response, 20 (12.5%) showed stable disease, and 96 (60%) patients had tumor progression while on chemotherapy. Median follow-up was 2.4 years (range, 6 days-11.1 years). All available clinicopathologic variables possibly associated with outcome were evaluated. Survival was 88%, 53%, and 37% at 1, 3, and 5 years. Noncurative resection, carcinoembryonic antigen levels >200 ng/ml, tumor grading, size of the largest tumor >5 cm, and number of metastases were associated with poor patient outcome. In the multivariate analysis, tumor free margin and tumor grading correlated with the outcome. Tumor progression while on chemotherapy had no influence on the long-term survival. Liver resection offers a long-term survival benefit for patients with CRM, even when tumor growth proceeds during pre-operative chemotherapy.

  12. Optimism measured pre-operatively is associated with reduced pain intensity and physical symptom reporting after coronary artery bypass graft surgery

    Science.gov (United States)

    Ronaldson, Amy; Poole, Lydia; Kidd, Tara; Leigh, Elizabeth; Jahangiri, Marjan; Steptoe, Andrew

    2014-01-01

    Objective Optimism is thought to be associated with long-term favourable outcomes for patients undergoing coronary artery bypass graft (CABG) surgery. Our objective was to examine the association between optimism and post-operative pain and physical symptoms in CABG patients. Methods We assessed optimism pre-operatively in 197 adults undergoing CABG surgery, and then followed them up 6–8 weeks after the procedure to measure affective pain, pain intensity, and physical symptom reporting directly pertaining to CABG surgery. Results Greater optimism measured pre-operatively was significantly associated with lower pain intensity (β = − 0.150, CI = − 0.196 to − 0.004, p = .042) and fewer physical symptoms following surgery (β = − 0.287, CI = − 0.537 to − 0.036, p = .025), but not with affective pain, after controlling for demographic, clinical and behavioural covariates, including negative affectivity. Conclusions Optimism is a modest, yet significant, predictor of pain intensity and physical symptom reporting after CABG surgery. Having positive expectations may promote better recovery. PMID:25129850

  13. Evaluation of canine and feline leishmaniasis by the association of blood culture, immunofluorescent antibody test and polymerase chain reaction.

    Science.gov (United States)

    Braga, Audrey Rennó Campos; Langoni, Hélio; Lucheis, Simone Baldini

    2014-02-24

    This study aimed to evaluate the occurrence of Leishmania spp. in dogs and cats from Botucatu, São Paulo state, and Campo Grande, Mato Grosso do Sul state, Brazil, by the association of three diagnostic tests: blood culture in liver infusion tryptose medium, immunofluorescent antibody test and polymerase chain reaction. Fifty blood samples of dogs and cats from the Center for Zoonosis Control in Campo Grande, an area endemic for canine visceral leishmaniasis, were collected randomly, as well as canine and feline blood samples from the Municipal Kennel and Animal Protection Association in Botucatu, currently considered a transmission-free, non-endemic area. Of the 50 dog blood cultures from Botucatu, three (6%) were positive and of the 50 cats, two (4%) were positive. In Campo Grande, 29 dog blood cultures (58%) were positive and all (100%) cats negative by this test. Polymerase chain reaction detected Leishmania spp. in 100% of dog and cat samples from Botucatu but found all the cats from Campo Grande to be negative. On the other hand, 36 dogs from Campo Grande were positive (72%) by the same technique. Immunofluorescent antibody test in Botucatu found 100% of dogs and cats non-reactive, while in Campo Grande, it detected positivity in 32 dogs (64%) and 15 cats (30%). The results show the importance of not only continuous epidemiological surveillance in areas not endemic for leishmaniasis, but also research for accurate diagnosis of this zoonosis.

  14. Detection of colorectal cancer in symptomatic outpatients without visible rectal bleeding: Validity of the fecal occult blood test

    DEFF Research Database (Denmark)

    Bjerregaard, Niels Christian; Tøttrup, Anders; Sørensen, Henrik Toft

    2009-01-01

    In 2002, a new diagnostic strategy in symptomatic outpatients without known established colorectal cancer risk factors aged 40 years or older was implemented in Denmark. Fecal occult blood test (Hemoccult Sensa®) was a part of that strategy in patients without visible rectal bleeding.......In 2002, a new diagnostic strategy in symptomatic outpatients without known established colorectal cancer risk factors aged 40 years or older was implemented in Denmark. Fecal occult blood test (Hemoccult Sensa®) was a part of that strategy in patients without visible rectal bleeding....

  15. A New Device for Mechanical Testing of Blood Vessels at Cryogenic Temperatures

    Science.gov (United States)

    Jimenez Rios, Jorge L.; Rabin, Yoed

    2008-01-01

    As part of an ongoing program to study the thermo-mechanical effects associated with cryopreservation via vitrification (vitreous in Latin means glassy), the current study focuses on the development of a new device for mechanical testing of blood vessels at cryogenic temperatures. This device is demonstrated on a bovine carotid artery model, permeated with the cryoprotectant cocktail VS55 and a reference solution of 7.05M DMSO, below glass transition. Results are also presented for crystallized specimens, in the absence of cryoprotectants. Results indicate that the elastic modulus of a specimen with no cryoprotectant, at about −140°C (8.6°C and 15.5°C below the glass transition temperature of 7.05M DMSO and VS55, respectively), is 1038.8 ± 25.2 MPa, which is 8% and 3% higher than that of a vitrified specimen permeated with 7.05M DMSO and VS55, respectively. The elastic modulus of a crystallized material at −50°C is lower by ~20% lower from that at −140°C. PMID:18958183

  16. The characterization of NMR signal for blood pressure monitoring system and its testing

    Directory of Open Access Journals (Sweden)

    Bambang Murdaka Eka Jati

    2016-02-01

    Full Text Available ABSTRACT A blood monitoring system based on NMR method has been designed on constructed. This set-up of equipment used magnetic permanent, radio frequency (RF, receiver coil (RC, function generator (FG, amplifier which included the filter, as well as the oscilloscope digital storage. The background of this research was based on the sensitivity of NMR signal. The signal must be separated from signals background. This method was done by adjusting the frequency on FG, which was connected to radio frequency (RF coil, on empty sample. Subsequently, NMR signal was received by RC, and that signal could be shown on oscilloscope at resonance condition. The true frequency on NMR signal was Larmor frequency, and the other was background. The two variables of this experiment were the position of RF coil and the location temperature (20 up to 30oC. In conclusion, the resonance frequency of NMR signal (as Larmor frequency was 4.7 MHz (at static magnetic field of 1,600 gauss and it could be separated from background signals (3.4 and 6.2 MHz, and that signal was almost constant to room temperature. The equipment was used for sample testing. It gave systole/diastole data of 110/70 mmHg (on sphygmomanometer that was similar to 17/9 mV (on NMR signal. ABSTRAK Telah dikembangkan alat pemantauan tekanan darah berdasar prinsip NMR.

  17. Malabsorption Blood Test: Assessing Fat Absorption in Patients with Cystic Fibrosis and Pancreatic Insufficiency

    Science.gov (United States)

    Mascarenhas, Maria R.; Mondick, John; Barrett, Jeffrey S.; Wilson, Martha; Stallings, Virginia A.; Schall, Joan I.

    2015-01-01

    The Malabsorption Blood Test (MBT), consisting of pentadecanoic acid (PA), a free fatty acid and triheptadecanoic acid (THA), a triglyceride that requires pancreatic lipase for absorption of the heptadecanoic acid (HA), was developed to assess fat malabsorption in patients with cystic fibrosis (CF) and pancreatic insufficiency (PI). The objective was to construct a population pharmacokinetic (PK) model to describe PA and HA disposition in healthy subjects and CF subjects. A model was simultaneously fit to PA and HA concentrations, consisting of one compartment disposition and a transit model to describe absorption. PA bioavailability estimates for CF subjects without pancreatic enzyme administration [1.07 (0.827,1.42)] and with enzymes [0.88 (0.72,1.09)] indicated PA absorption comparable to healthy subjects. HA bioavailability in CF without enzyme administration was 0.0292 (0.0192,0.0459), and with enzymes increased to 0.606 (0.482,0.823). In CF, compared to taking enzymes with the MBT, HA bioavailability was further decreased by factors of 0.829 (0.664,0.979) and 0.78 (0.491,1.13) with enzymes taken 30 and 60 minutes after MBT, respectively. The MBT detected differences in fat absorption in subjects with CF with and without enzyme administration and with changes in enzyme timing. Future studies will address application of the MBT in CF and other malabsorption diagnoses. PMID:25689042

  18. Identification of lung cancer with high sensitivity and specificity by blood testing

    Directory of Open Access Journals (Sweden)

    Stephan Bernhard

    2010-02-01

    Full Text Available Abstract Background Lung cancer is a very frequent and lethal tumor with an identifiable risk population. Cytological analysis and chest X-ray failed to reduce mortality, and CT screenings are still controversially discussed. Recent studies provided first evidence for the potential usefulness of autoantigens as markers for lung cancer. Methods We used extended panels of arrayed antigens and determined autoantibody signatures of sera from patients with different kinds of lung cancer, different common non-tumor lung pathologies, and controls without any lung disease by a newly developed computer aided image analysis procedure. The resulting signatures were classified using linear kernel Support Vector Machines and 10-fold cross-validation. Results The novel approach allowed for discriminating lung cancer patients from controls without any lung disease with a specificity of 97.0%, a sensitivity of 97.9%, and an accuracy of 97.6%. The classification of stage IA/IB tumors and controls yielded a specificity of 97.6%, a sensitivity of 75.9%, and an accuracy of 92.9%. The discrimination of lung cancer patients from patients with non-tumor lung pathologies reached an accuracy of 88.5%. Conclusion We were able to separate lung cancer patients from subjects without any lung disease with high accuracy. Furthermore, lung cancer patients could be seprated from patients with other non-tumor lung diseases. These results provide clear evidence that blood-based tests open new avenues for the early diagnosis of lung cancer.

  19. Joint analysis of multiple blood pressure phenotypes in GAW19 data by using a multivariate rare-variant association test.

    Science.gov (United States)

    Sun, Jianping; Bhatnagar, Sahir R; Oualkacha, Karim; Ciampi, Antonio; Greenwood, Celia M T

    2016-01-01

    Large-scale sequencing studies often measure many related phenotypes in addition to the genetic variants. Joint analysis of multiple phenotypes in genetic association studies may increase power to detect disease-associated loci. We apply a recently developed multivariate rare-variant association test to the Genetic Analysis Workshop 19 data in order to test associations between genetic variants and multiple blood pressure phenotypes simultaneously. We also compare this multivariate test with a widely used univariate test that analyzes phenotypes separately. The multivariate test identified 2 genetic variants that have been previously reported as associated with hypertension or coronary artery disease. In addition, our region-based analyses also show that the multivariate test tends to give smaller p values than the univariate test. Hence, the multivariate test has potential to improve test power, especially when multiple phenotypes are correlated.

  20. Evaluation of the Verigene Gram-positive blood culture nucleic acid test for rapid detection of bacteria and resistance determinants.

    Science.gov (United States)

    Wojewoda, Christina M; Sercia, Linda; Navas, Maria; Tuohy, Marion; Wilson, Deborah; Hall, Geraldine S; Procop, Gary W; Richter, Sandra S

    2013-07-01

    Rapid identification of pathogens from blood cultures can decrease lengths of stay and improve patient outcomes. We evaluated the accuracy of the Verigene Gram-positive blood culture (BC-GP) nucleic acid test for investigational use only (Nanosphere, Inc., Northbrook, IL) for the identification of Gram-positive bacteria from blood cultures. The detection of resistance genes (mecA in Staphylococcus aureus and Staphylococcus epidermidis and vanA or vanB in Enterococcus faecium and Enterococcus faecalis) by the BC-GP assay also was assessed. A total of 186 positive blood cultures (in BacT/Alert FA bottles) with Gram-positive cocci observed with Gram staining were analyzed using the BC-GP assay. The BC-GP results were compared with the identification and susceptibility profiles obtained with routine methods in the clinical laboratory. Discordant results were arbitrated with additional biochemical, cefoxitin disk, and repeat BC-GP testing. The initial BC-GP organism identification was concordant with routine method results for 94.6% of the blood cultures. Only 40% of the Streptococcus pneumoniae identifications were correct. The detection of the mecA gene for 69 blood cultures with only S. aureus or S. epidermidis was concordant with susceptibility testing results. For 3 of 6 cultures with multiple Staphylococcus spp., mecA detection was reported but was correlated with oxacillin resistance in a species other than S. aureus or S. epidermidis. The detection of vanA agreed with susceptibility testing results for 45 of 46 cultures with E. faecalis or E. faecium. Comparison of the mean times to results for each organism group showed that BC-GP results were available 31 to 42 h earlier than phenotypic identifications and 41 to 50 h earlier than susceptibility results.

  1. The stability of the reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests on stored horse blood.

    Science.gov (United States)

    Celi, P; Sullivan, M; Evans, D

    2010-02-01

    Increasing interest in the role of oxidative stress (OS) in equine medicine has highlighted the need to develop reliable methods to quantify it. In this study we describe the effect of refrigeration (at 4 degrees C) on the stability of the reactive oxygen metabolites (d-ROMs) and biological antioxidant potential (BAP) tests carried out on 15 healthy horses. Blood samples, collected from the jugular vein, were immediately placed on ice and analysed using both the d-ROMs and BAP tests. Samples were also refrigerated at 4 degrees C and tested after 3, 7 and 24 h. The average results were similar for up to 24 h and minimal variations were found for each horse. The findings suggest that refrigeration is suitable for preserving equine blood samples for these assays and this approach will provide veterinarians with a technically simple, reliable test to measure OS under field conditions.

  2. Comparison of pneumatic tube system with manual transport for routine chemistry, hematology, coagulation and blood gas tests.

    Science.gov (United States)

    Pupek, Alex; Matthewson, Beverly; Whitman, Erin; Fullarton, Rachel; Chen, Yu

    2017-08-28

    The pneumatic tube system (PTS) is commonly used in modern clinical laboratories to provide quick specimen delivery. However, its impact on sample integrity and laboratory testing results are still debatable. In addition, each PTS installation and configuration is unique to its institution. We sought to validate our Swisslog PTS by comparing routine chemistry, hematology, coagulation and blood gas test results and sample integrity indices between duplicate samples transported either manually or by PTS. Duplicate samples were delivered to the core laboratory manually by human courier or via the Swisslog PTS. Head-to-head comparisons of 48 routine chemistry, hematology, coagulation and blood gas laboratory tests, and three sample integrity indices were conducted on 41 healthy volunteers and 61 adult patients. The PTS showed no impact on sample hemolysis, lipemia, or icterus indices (all pgas (in syringe and capillary tube) laboratory tests.

  3. Why do patients want to have their blood tested? : A qualitative study of patient expectations in general practice

    NARCIS (Netherlands)

    Bokhoven, M.A. van; Pleunis-van Empel, M.C.; Koch, H.; Grol, R.P.T.M.; Dinant, G.J.; Weijden, T. van der

    2006-01-01

    BACKGROUND: General practitioners often take their impression of patients' expectations into account in their decision to have blood tests done. It is commonly recommended to involve patients in decision-making during consultations. The study aimed to obtain detailed information on patients' expecta

  4. The impact of high-dose vitamin C on blood glucose testing in ¹⁸F-FDG PET imaging.

    Science.gov (United States)

    Bahr, Rebekah L; Wilson, Don C

    2015-03-01

    Complementary and alternative therapies in addition to standard oncology protocols are commonly sought by cancer patients; however, few patients disclose their complementary treatments to their cancer care team. A lack of communication may result in unforeseen side effects and the potential for some alternative therapies to interfere with or inhibit conventional treatment. High-dose vitamin C therapy, in particular, may lead to an inability to measure a patient's blood glucose level before (18)F-FDG injection for PET/CT scanning. We report a case of a 52-y-old woman referred for (18)F-FDG PET/CT to evaluate the extent of recurrent colorectal cancer. The PET/CT scan immediately followed a single intravenous dose of 25 g of ascorbic acid from her naturopath. A glucometer that applies the glucose oxidase method for measuring fasting blood glucose was used, for which high doses of vitamin C are listed as a contraindication. The high concentration of ascorbic acid in the patient's blood sample interfered with the chemical reaction on the glucose strip, and therefore no blood glucose measurement could be attained. With more patients receiving alternative and complementary cancer therapies, it is important to know what the implications of orthomolecular therapy might be on routine blood glucose testing for (18)F-FDG PET scans. (18)F-FDG is in direct competition with glucose; therefore, elevated blood glucose levels will cause a decrease in (18)F-FDG absorption and may lead to a false-negative scan.

  5. How to encourage non-donors to be more willing to donate blood? Testing of binding communication based interventions.

    Science.gov (United States)

    Fonte, D; Blondé, J; Girandola, F

    2017-06-01

    Our study aims to test the effectiveness of binding communication based interventions (vs classical persuasive communication based ones) inciting non-donors to act in favour of blood donation. The implementation of effective communication interventions represents a major public health issue. Nevertheless, persuasive media campaigns appear to have little effect on behaviours. Even though non-donors hold a positive attitude towards blood donation, they are not inclined to donate. As an alternative to producing behavioural changes, many recent studies have shown the superiority of binding communication over persuasive communication. All participants, non-donors, were randomly assigned to one of four experimental conditions of a 2 (type of communication: persuasive vs binding) × 2 (source credibility: low vs high) factorial design. Then, they were asked to report their intention to donate blood, and their intention to distribute leaflets regarding blood donation. Binding communication is a more effective strategy for increasing intention towards blood donation compared with persuasive communication, especially when combined with high credibility source. Accordingly this study calls for more consideration of knowledge of social psychology to design effective communication interventions and increase the number of donations. © 2016 British Blood Transfusion Society.

  6. Test for antioxidant ability by scavenging long-lived mutagenic radicals in mammalian cells and by blood test with intentional radicals: an application of gallic acid

    Science.gov (United States)

    Kumagai, Jun; Kawaura, Tomoko; Miyazaki, Tetsuo; Prost, Michel; Prost, Emmanuelle; Watanabe, Masami; Quetin-Leclercq, Joëlle

    2003-01-01

    Antioxidant ability of gallic acid (GA) are determined both by electron spin resonance measurement of long-lived radicals produced in γ-ray irradiated Syrian golden hamster embryo cells with GA and by hemolysis measurement with GA when blood cells are submitted to radicals. Scavenging properties of GA are determined by the reaction rate constant with long-lived mutagenic radicals in the cells while the blood test allows to analyze the global effects of this compound: radical scavenger+metal ion chelator+regeneration of intra- and extra-cellular antioxidant.

  7. Same-day identification and antibiotic susceptibility testing on positive blood cultures: a simple and inexpensive procedure.

    Science.gov (United States)

    Maelegheer, K; Nulens, E

    2016-11-26

    Fast diagnostic tools are becoming a hot topic in microbiology, especially in the case of septic patients. Therefore, we attempted to develop a fast, inexpensive, accurate and easy method to identify bacteria and perform an antibiotic susceptibility test directly on positive blood cultures that could be used in a routine laboratory. A procedure based on centrifugation and washing steps was performed on 110 non-duplicated (including nine seeded) positive blood culture bottles. Direct identification (DID) and antimicrobial susceptibility testing (AST) was conducted on the pellet with the MALDI Biotyper and Phoenix, respectively. Identification (ID) to the species level was correct in 44/45 (97%) cases for Gram-negative bacteria and 44/56 (79%) cases for Gram-positive bacteria. In total, 98.9% of the AST results were identical to the routine laboratory result. No very major errors, four major errors and eight minor errors were detected. A reliable identification and a high AST agreement were obtained from blood cultures seeded with multi-resistant bacteria. We simulated the timeline of DID and demonstrated an identification and AST result within 24 h using Escherichia coli- and Staphylococcus aureus-positive blood cultures as examples. We developed an easy, fast and cheap method to generate reliable ID and AST results. Moreover, this method may be used to obtain results within 24 h after incubating the blood culture bottles in the microbiology lab.

  8. Correct Pre-Operative Diagnosis of Breast Cancer by Tru-cut Biopsy: Key Point in Breast Cancer Management and a Part of Patient Right

    Directory of Open Access Journals (Sweden)

    A. Joulaee

    2009-01-01

    Full Text Available The new revolutionary concept in breast cancer diagnosis and management during the last 3 decades significantly decreases invasion against patients while maximizing the accuracy of diagnosis and the effectiveness of treatment."n"n In this new concept team work multidisciplinary approach is the key. The presence of an interventional breast radiologist in this new approach is absolutely necessary. The role of an interventional and a non interventional breast radiologist in this team work is highlighted and must be respected, especially by surgeons. Now the surgeon performs surgery only to treat the patient either for malignant pathology or symptomatic benign masses. No surgery is acceptable for diagnosis or staging. Diagnosis is best done by preoperative Tru-cut biopsy is done by an interventional breast radiologist for non palpable lesions  in the ideal situation. For palpable lesions depending on the situation either a radiologist or a surgeon would carry out office tru-cut biopsy. For non palpable lesions, the interventional radiologist and not the surgeon performs the diagnosis. Depending on the case, either the radiologist or the surgeon can peform Tru-cut biopsy for palpable lesions. The benefits of pre-operative diagnosis are both for the patients and the whole health care system. The patient would profit the most from this new concept: -No surgery would be done for non-cancerous non-symptomatic lesions. -In the case of cancer, diagnosis would be confirmed pre-operatively. Correct pre-operative diagnosis would eliminate unnecessary surgery for benign pathology for many non-palpable and non-symptomatic palpable lesions. The patient would profit from not having surgery for a benign condition and as a result there will be no endangered health. In the same time avoidance of surgery for non-symptomatic benign breast pathology would significantly decrease the overall health care price for breast disease to have more budgets to instruct standard

  9. Demographic, risk factors and motivations among blood donors with reactive serologic tests for syphilis in São Paulo, Brazil.

    Science.gov (United States)

    Ferreira, S C; de Almeida-Neto, C; Nishiya, A S; Oliveira, C D L; Ferreira, J E; Alencar, C S; Levi, J E; Salles, N A; Mendrone, A; Sabino, E C

    2014-06-01

    To identify the demographic characteristics, risk factors and motivations for donating among blood donors with reactive serologic tests for syphilis. Post-donation interviews with syphilis seropositive blood donors improve recruitment and screening strategies. This case-control study compares 75 Venereal Disease Research Laboratory (VDRL) > 8, EIA+ (enzyme immunoassay) and FTA-ABS+ (fluorescent treponemal antibody); 80 VDRL-, EIA+ and FTA-ABS+; and 34 VDRL- and EIA- donors between 2004 and 2009. Donors were assessed by their demographic characteristics, sexual behaviour, history of alcohol and illicit drugs use, and motivations to donate. Donors with VDRL > 8 were more likely to be divorced [AOR = 12·53; 95% confidence interval (CI) 1·30-120·81], to have had more than six sexual partners (AOR=7·1; 95% CI 1·12-44·62) and to report male-male-sex in the past 12 months (AOR=8·18; 95% CI 1·78-37·60). Donors with VDRL-, EIA+ and FTA-ABS+ were less likely to be female (AOR=0·26; 95% CI 0·07-0·96), more likely to be older (AOR=10·2; 95% CI 2·45-42·58 ≥ 39 and VDRL > 8) and 12·5% (VDRL-, EIA+ and FTA-ABS+) of donors reported that they had been at risk for HIV infection (P = 0·004). One-third of donors came to the blood bank to help a friend or a relative who needed blood. Although donors exposed to syphilis reported and recognised some high risk behaviour, most were motivated by direct appeal to donate blood. Monitoring the risk profile of blood donors can benefit public health and improve blood safety. © 2014 The Authors. Transfusion Medicine © 2014 British Blood Transfusion Society.

  10. Prevalence of adjacent segment disc degeneration in patients undergoing anterior cervical discectomy and fusion based on pre-operative MRI findings.

    Science.gov (United States)

    Lundine, Kristopher M; Davis, Gavin; Rogers, Myron; Staples, Margaret; Quan, Gerald

    2014-01-01

    Anterior cervical discectomy and fusion (ACDF) is a widely accepted surgical treatment for symptomatic cervical spondylosis. Some patients develop symptomatic adjacent segment degeneration, occasionally requiring further treatment. The cause and prevalence of adjacent segment degeneration and disease is unclear at present. Proponents for motion preserving surgery such as disc arthroplasty argue that this technique may decrease the "strain" on adjacent discs and thus decrease the incidence of symptomatic adjacent segment degeneration. The purpose of this study was to assess the pre-operative prevalence of adjacent segment degeneration in patients undergoing ACDF. A database review of three surgeons' practice was carried out to identify patients who had undergone a one- or two-level ACDF for degenerative disc disease. Patients were excluded if they were operated on for recent trauma, had an inflammatory arthropathy (for example, rheumatoid arthritis), or had previous spine surgery. The pre-operative MRI of each patient was reviewed and graded using a standardised methodology. One hundred and six patient MRI studies were reviewed. All patients showed some evidence of intervertebral disc degeneration adjacent to the planned operative segment(s). Increased severity of disc degeneration was associated with increased age and operative level, but was not associated with sagittal alignment. Disc degeneration was more common at levels adjacent to the surgical level than at non-adjacent segments, and was more severe at the superior adjacent level compared with the inferior adjacent level. These findings support the theory that adjacent segment degeneration following ACDF is due in part to the natural history of cervical spondylosis.

  11. Comparison of three feline leukaemia virus (FeLV) point-of-care antigen test kits using blood and saliva.

    Science.gov (United States)

    Westman, Mark E; Malik, Richard; Hall, Evelyn; Sheehy, Paul A; Norris, Jacqueline M

    2017-02-01

    Feline leukaemia virus (FeLV) can be a challenging infection to diagnose due to a complex feline host-pathogen relationship and occasionally unreliable test results. This study compared the accuracy of three point-of-care (PoC) FeLV p27 antigen test kits commonly used in Australia and available commercially worldwide (SNAP FIV/FeLV Combo, Witness FeLV/FIV and Anigen Rapid FIV/FeLV), using detection of FeLV provirus by an in-house real-time polymerase chain reaction (qPCR) assay as the diagnostic gold standard. Blood (n=563) and saliva (n=419) specimens were collected from a population of cats determined to include 491 FeLV-uninfected and 72 FeLV-infected individuals (45 progressive infections [p27 and qPCR positive], 27 regressive infections [p27 negative, qPCR positive]). Sensitivity and specificity using whole blood was 63% and 94% for SNAP Combo, 57% and 98% for Witness, and 57% and 98% for Anigen Rapid, respectively. SNAP Combo had a significantly lower specificity using blood compared to the other two kits (P=0.004 compared to Witness, P=0.007 compared to Anigen Rapid). False-positive test results occurred with all three kits using blood, and although using any two kits in parallel increased specificity, no combination of kits completely eliminated the occurrence of false-positive results. We therefore recommend FeLV proviral PCR testing for any cat that tests positive with a PoC FeLV antigen kit, as well as for any cat that has been potentially exposed to FeLV but tests negative with a FeLV antigen kit, before final assignment of FeLV status can be made with confidence. For saliva testing, sensitivity and specificity was 54% and 100%, respectively, for all three test kits. The reduced sensitivity of saliva testing compared to blood testing, although not statistically significant, suggests saliva testing with the current generation of PoC FeLV antigen kits is unsuitable for screening large populations of cats, such as in shelters. Copyright © 2016 Elsevier

  12. Direct blood culturing on solid medium outperforms an automated continuously monitored broth-based blood culture system in terms of time to identification and susceptibility testing.

    Science.gov (United States)

    Idelevich, E A; Grünastel, B; Peters, G; Becker, K

    2016-03-01

    Pathogen identification and antimicrobial susceptibility testing (AST) should be available as soon as possible for patients with bloodstream infections. We investigated whether a lysis-centrifugation (LC) blood culture (BC) method, combined with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) identification and Vitek 2 AST, provides a time advantage in comparison with the currently used automated broth-based BC system. Seven bacterial reference strains were added each to 10 mL human blood in final concentrations of 100, 10 and 1 CFU/mL. Inoculated blood was added to the Isolator 10 tube and centrifuged at 3000 g for 30 min, then 1.5 mL sediment was distributed onto five 150-mm agar plates. Growth was observed hourly and microcolonies were subjected to MALDI-TOF MS and Vitek 2 as soon as possible. For comparison, seeded blood was introduced into an aerobic BC bottle and incubated in the BACTEC 9240 automated BC system. For all species/concentration combinations except one, successful identification and Vitek 2 inoculation were achieved even before growth detection by BACTEC. The fastest identification and inoculation for AST were achieved with Escherichia coli in concentrations of 100 CFU/mL and 10 CFU/mL (after 7 h each, while BACTEC flagged respective samples positive after 9.5 h and 10 h). Use of the LC-BC method allows skipping of incubation in automated BC systems and, used in combination with rapid diagnostics from microcolonies, provides a considerable advantage in time to result. This suggests that the usefulness of direct BC on solid medium should be re-evaluated in the era of rapid microbiology.

  13. A comparative study of Widal test with blood culture in the diagnosis of typhoid fever in febrile patients.

    Science.gov (United States)

    Andualem, Gizachew; Abebe, Tamrat; Kebede, Nigatu; Gebre-Selassie, Solomon; Mihret, Adane; Alemayehu, Haile

    2014-09-17

    Typhoid fever is a major health problem in developing countries and its diagnosis on clinical ground is difficult. Diagnosis in developing countries including Ethiopia is mostly done by Widal test. However, the value of the test has been debated. Hence, evaluating the result of this test is necessary for correct interpretation of the result. The main aim of this study was to compare the result of Widal test and blood culture in the diagnosis of typhoid fever in febrile patients. Blood samples were collected from 270 febrile patients with symptoms clinically similar to typhoid fever and visiting St. Paul's General Specialized Hospitals from mid December 2010 to March 2011. Blood culture was used to isolate S.typhi and S.paratyphi. Slide agglutination test and tube agglutination tests were used for the determination of antibody titer. An antibody titer of ≥1:80 for anti TO and ≥1:160 for anti TH were taken as a cut of value to indicate recent infection of typhoid fever. One hundred and eighty six (68.9%) participants were females and eighty four (31.1%) were males. 7 (2.6%) cases of S. typhi and 4 (1.5%) cases of S. paratyphi were identified with the total prevalence of typhoid fever 4.1%. The total number of patients who have indicative of recent infection by either of O and H antigens Widal test is 88 (32.6%). The sensitivity, specificity, Positive predictive Value and Negative predictive Value of Widal test were 71.4%, 68.44%, 5.7% and 98.9% respectively. Widal test has a low sensitivity, specificity and PPV, but it has good NPV which indicates that negative Widal test result have a good indication for the absence of the disease.

  14. Development and Testing of a Plastic Optical Fiber Grating Biosensor for Detection of Glucose in the Blood

    Science.gov (United States)

    Yunianto, M.; Eka, D.; Permata, A. N.; Ariningrum, D.; Wahyuningsih, S.; Marzuki, A.

    2017-02-01

    The objective of this study is to detect glucose content in human blood serum using optical fiber grating with LED wavelength corresponding to the absorption of glucose content in blood serum. The testing used a UV-Vis spectrometer and Rays spectrometers, in which in the ray spectrometer it was used optical fiber biosensor using optical fiber grating. The result obtained is the typical peak of glucose absorption in UV-Vis at 581 nm wavelength and rays spectrometer on green LED at 514.2 nm wavelength with linear regression result by 0.97 and 0.94, respectively.

  15. Neonatal gut function, measured by the one hour blood D (+) xylose test: influence of gestational age and size.

    OpenAIRE

    Ducker, D A; Hughes, C A; Warren, I.; McNeish, A S

    1980-01-01

    D(+) Xylose absorption, assessed by one hour blood xylose levels, has been measured after intraduodenal infusion of the sugar in 35 infants of differing gestational age and size. The test was performed between the 2nd and 6th days of life. Full-term appropriately grown infants had higher blood xylose levels (1.41+/-0.07 mmol/l) at one hour than pre-term appropriately grown infants (1.17+/-0.07 mmol/l; P less than 0.05), or 'light for dates' infants, both full-term (0.73+/-0.06 mmol/l; P less ...

  16. Mechanically assisted 3D ultrasound for pre-operative assessment and guiding percutaneous treatment of focal liver tumors

    Science.gov (United States)

    Sadeghi Neshat, Hamid; Bax, Jeffery; Barker, Kevin; Gardi, Lori; Chedalavada, Jason; Kakani, Nirmal; Fenster, Aaron

    2014-03-01

    Image-guided percutaneous ablation is the standard treatment for focal liver tumors deemed inoperable and is commonly used to maintain eligibility for patients on transplant waitlists. Radiofrequency (RFA), microwave (MWA) and cryoablation technologies are all delivered via one or a number of needle-shaped probes inserted directly into the tumor. Planning is mostly based on contrast CT/MRI. While intra-procedural CT is commonly used to confirm the intended probe placement, 2D ultrasound (US) remains the main, and in some centers the only imaging modality used for needle guidance. Corresponding intraoperative 2D US with planning and other intra-procedural imaging modalities is essential for accurate needle placement. However, identification of matching features of interest among these images is often challenging given the limited field-of-view (FOV) and low quality of 2D US images. We have developed a passive tracking arm with a motorized scan-head and software tools to improve guiding capabilities of conventional US by large FOV 3D US scans that provides more anatomical landmarks that can facilitate registration of US with both planning and intra-procedural images. The tracker arm is used to scan the whole liver with a high geometrical accuracy that facilitates multi-modality landmark based image registration. Software tools are provided to assist with the segmentation of the ablation probes and tumors, find the 2D view that best shows the probe(s) from a 3D US image, and to identify the corresponding image from planning CT scans. In this paper, evaluation results from laboratory testing and a phase 1 clinical trial for planning and guiding RFA and MWA procedures using the developed system will be presented. Early clinical results show a comparable performance to intra-procedural CT that suggests 3D US as a cost-effective alternative with no side-effects in centers where CT is not available.

  17. Is pain during pediatric dental sedation associated with children’s pre-operative characteristics? An exploratory study

    Directory of Open Access Journals (Sweden)

    Jordanna Guedes Amorim MENDONÇA

    Full Text Available Abstract Introduction Little is known about the factors associated with the pain of children in dental treatment under conscious sedation. Objective To investigate the association between preoperative characteristics and pain during pediatric dental treatment under sedation. Material and method This exploratory study was conducted with 27 children in restorative treatment under sedation. Information on age, sex and experience of the children with previous dental treatment was obtained through interviews with parents. Oral health status, determined from the presence of dental caries, was verified using the dmf-t index. Pain was assessed by analyzing videos of the dental treatments by two previously calibrated examiners, using the items “legs”, “activity” and “crying” of the observational scale “face, legs, activity, consolability and crying” (FLACC. Data were analyzed using bivariate tests. Result Most of the children (n=14, 51.8% had no pain during dental treatment under sedation. Among the other children, lower or moderate pain scores (median 1.1; minimum 0 to 3.8 were observed. The FLACC scores did not vary according to sex (P=0.38, previous experience with dental treatment (P=0.32 and history with local anesthesia (P=0.96. The FLACC scores did not correlate significantly with age (Spearman rho= -0.08, P=0.67 and dmf-t (Spearman rho= -0.04, P=0.84. Conclusion In this group of children, pain during dental treatment under sedation was of low frequency and intensity and did not associate with age, sex, oral condition and previous dental experience.

  18. Roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction

    Institute of Scientific and Technical Information of China (English)

    LIU Jia-ming; SHEN Jian-xiong; ZHANG Jian-guo; ZHAO Hong; LI Shu-gang; ZHAO Yu; QIU Giu-xing

    2012-01-01

    Background It has been stated that preoperative pulmonary function tests are essential to assess the surgical risk in patients with scoliosis.Arterial blood gas tests have also been used to evaluate pulmonary function before scoliotic surgery.However,few studies have been reported.The aim of this study was to investigate the roles of preoperative arterial blood gas tests in the surgical treatment of scoliosis with moderate or severe pulmonary dysfunction.Methods This study involved scoliotic patients with moderate or severe pulmonary dysfunction (forced vital capacity <60%) who underwent surgical treatment between January 2002 and April 2010.A total of 73 scoliotic patients (23 males and 50 females) with moderate or severe pulmonary dysfunction were included.The average age of the patients was 16.53 years (ranged 10-44).The demographic distribution,medical records,and radiographs of all patients were collected.All patients received arterial blood gas tests and pulmonary function tests before surgery.The arterial blood gas tests included five parameters:partial pressure of arterial oxygen,partial pressure of arterial carbon dioxide,alveolar-arterial oxygen tension gradient,pH,and standard bases excess.The pulmonary function tests included three parameters:forced expiratory volume in 1 second ratio,forced vital capacity ratio,and peak expiratory flow ratio.All five parameters of the arterial blood gas tests were compared between the two groups with or without postoperative pulmonary complications by variance analysis.Similarly,all three parameters of the pulmonary function tests were compared.Results The average coronal Cobb angle before surgery was 97.42° (range,50°-180°).A total of 15 (20.5%) patients had postoperative pulmonary complications,including hypoxemia in 5 cases (33.3%),increased requirement for postoperative ventilatory support in 4 (26.7%),pneumonia in 2 (13.3%),atelectasis in 2 (13.3%),pneumothorax in 1 (6.7%),and hydrothorax in 1

  19. Do maximal aerobic power and blood lactate concentration affect Specific Judo Fitness Test performance in female judo athletes?

    Science.gov (United States)

    Garbouj, H; Selmi, M A; Sassi, R Haj; Yahmed, M Haj; Chamari, K; Chaouachi, A

    2016-12-01

    The Special Judo Fitness Test (SJFT) has become the test most widely used by coaches and physical trainers for assessment of competitors' judo-specific physical aptitude and training programme prescription. The aim of this study was to investigate the relationship between the SJFT performance indices and both maximal aerobic power and the level of blood lactate concentrations in female judo athletes. Seventeen female judokas (age: 21.9±1.6 years, body mass: 74.6±27.4 kg, height: 164.5±8.6 cm; BMI: 27.1±8.0 kg · m(-2)) took part in this study. All participants performed the SJFT, 20 m multi-stage shuttle run test (MSRT), and 30 m straight sprint test (SST), from which we calculated both acceleration (10 m) and the maximal anaerobic speed (MAnS: flying 20 m sprint). A blood sample was taken 3 min after the SJFT. The number of throws was significantly correlated with estimated VO2max (r=0.795, p=0.0001) and both acceleration (r=0.63, p =0.006) and MAnS (r=0.76, p=0.0004). Peak blood lactate recorded after the SJFT was 13.90±1.39 mmol · l(-1). No significant correlation was found between blood lactate concentration and the SJFT performance indices. The lack of significant correlation between blood lactate and SJFT performance suggests that lactic anaerobic metabolism has no effect on this type of judo-specific supra-maximal exercise. The observed results can provide coaches and strength and conditioning professionals with relevant information for the interpretation of SJFT performance and the prescription of specific training programmes for female judo athletes.

  20. Half a decade of mini-pool nucleic acid testing: Cost-effective way for improving blood safety in India

    Directory of Open Access Journals (Sweden)

    Shivaram Chandrashekar

    2014-01-01

    Full Text Available Background and Objectives: It is well established that Nucleic acid testing (NAT reduces window phase of transfusion transmissible infections (TTI and helps improve blood safety. NAT testing can be done individually or in pools. The objectives of this study were to determine the utility, feasibility and cost effectiveness of an in-house minipool-NAT(MP-NAT. Materials and Methods: Blood donors were screened by history, tested by ELISA and sero-negative samples were subjected to an in-house NAT by using reverse transcriptase-polymerase chain reaction (RT-PCR. Testing was done in mini-pools of size eight (8. Positive pools were repeated with individual samples. Results: During the study period of Oct 2005-Sept 2010 (5 years all blood donors (n=53729 were screened by ELISA. Of which 469 (0.87% were positive for HIV-1, HBV or HCV. Sero-negative samples (n=53260 were screened by in-house MP-NAT. HIV-NAT yield was 1/53260 (n=1 and HBV NAT yield (n=2 was 1/26630. Conclusion: NAT yield was lower than other India studies possibly due to the lower sero-reactivity amongst our donors. Nevertheless it intercepted 9 lives including the components prepared. The in-house assay met our objective of improving blood safety at nominal cost and showed that it is feasible to set up small molecular biology units in medium-large sized blood banks and deliver blood within 24-48 hours. The utility of NAT (NAT yield will vary based on the donor population, the type of serological test used, the nature of kit employed and the sensitivity of NAT test used. The limitations of our in-house MP-NAT consisted of stringent sample preparation requirements, with labor and time involved. The benefits of our MP-NAT were that it acted as a second level of check for ELISA tests, was relatively inexpensive compared to ID-NAT and did not need sophisticated equipment.

  1. [Impact of a pre-operative mobilisation program using the Viv-Arte training model based on kinesthetic mobilisation on mobility, pain, and post-operation length of stay of patients receiving an elective medial laparotomy: a prospective, randomised, controlled pilot study].

    Science.gov (United States)

    Haasenritter, Jörg; Eisenschink, Anna Maria; Kirchner, Elisabeth; Bauder-Missbach, Heidi; Brach, Michael; Veith, Jessica; Sander, Silvia; Panfil, Eva-Maria

    2009-02-01

    A medial incision is a common surgical technique to obtain access to the abdomen. Thereby, the muscles involved in movement are manipulated, leading to post-operative restrictions in mobility and pain determined by movement. The aim of this pilot study was to assess the impact of a pre-operative training session using the Viv-Arte model, which is based on kinesthetic mobilisation principles. The parameters to be measured were mobility, pain, and length of hospital stay for patients, who were undergoing elective medial laparotomy. In addition, the study tested the research design and to identify possible effect sizes. The method chosen was a prospective, randomised, controlled, and unblinded design. Twenty-seven patients were involved (median=63 years, 19 of the patients were male) who were to have a medial incision for cystectomy. The intervention involved pre-operative training of post-operative mobility techniques. Mobility was tested using the "Mobilitätstest für Patienten im Akutkrankenhaus (MOTPA) (Mobility test for patients in hospital)"; pain intensity was assessed using the visual analogue scale. The intervention and control groups were comparable for all variables. There were no significant differences in the two groups related to the objectives. It is possible that the study groups or the operationalisation were not appropriate for testing the effects of the intervention. It seems important to continue to develop instruments that are appropriate for measuring the effect of mobility-related interventions.

  2. Surrogate testing suggests that chlorine dioxide gas exposure would not inactivate Ebola virus contained in environmental blood contamination.

    Science.gov (United States)

    Lowe, John J; Hewlett, Angela L; Iwen, Peter C; Smith, Philip W; Gibbs, Shawn G

    2015-05-08

    The ability to decontaminate a room potentially containing the Ebola virus is important to healthcare facilities in the United States. Ebola virus remains viable in body fluids, a room that has housed a patient with Ebola virus disease must have all surfaces manually wiped with an approved disinfectant, which increases occupational exposure risk. This study evaluated the efficacy of gaseous chlorine dioxide inactivation of bacterial organisms in blood as Ebola virus surrogates and as the organisms used by the Nebraska Biocontainment Unit to provide the margin of safety for decontamination. Bacillus anthracis, Escherichia coli, Enterococcus faecalis, and Mycobacterium smegmatis blood suspensions that were exposed to ClO2 gas concentrations and exposure limits. The log reduction in Colony Forming Units (CFU) was determined for each bacterial blood suspension. Exposure parameters approximating industry practices for ClO2 environmental decontamination (360ppm concentration to 780 ppm-hrs exposure, 65% relative humidity) as well as parameters exceeding current practice (1116 ppm concentration to 1400 ppm-hrs exposure; 1342ppm concentration to 1487 ppm-hrs exposure) were evaluated. Complete inactivation was not achieved for any of the bacterial blood suspensions tested. Reductions were observed in concentrations of B. anthracis spores (1.3 -3.76 log) and E. faecalis vegetative cells (1.3 log) whereas significant reductions in vegetative cell concentrations for E. coli and M. smegmatis blood suspensions were not achieved. Our results showed that bacteria in the presence of blood were not inactivated using gaseous ClO2 decontamination. ClO2 decontamination alone should not be used for Ebola virus, but decontamination processes should first include manual wiping of potentially contaminated blood; especially for microorganisms as infectious as the Ebola virus.

  3. Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system.

    Science.gov (United States)

    Bazzi, Ali M; Rabaan, Ali A; Fawarah, Mahmoud M; Al-Tawfiq, Jaffar A

    2016-06-13

    Compared to routine isolated colony-based methods, direct testing of bacterial pellets from positive blood cultures reduces turnaround time for reporting of antibiotic susceptibility. The aim of this study was to compare the accuracy, and precision, of a rapid method for direct identification and susceptibility testing of blood cultures with the routine method used in our laboratory, using Vitek 2. A total of 60 isolates were evaluated using the candidate and the routine method. The candidate method had 100% accuracy for the identification of Gram negative bacteria, Staphylococcus and Enterococcus, 50% for Streptococcus and 33.3% for Corynebacterium species. Susceptibility testing of Gram negative isolates yielded 98-100% essential agreement. For Staphylococcus and Enterococcus isolates, essential agreement was 100% for 17 antibiotics except for moxifloxacin. Direct testing of blood culture samples with Vitek 2 produced reliable identification and susceptibility results 18-24h sooner for aerobic/anaerobic facultative Gram-negative bacteria and Gram-positive Staphylococcus and Enterococcus strains.

  4. Microbial identification and automated antibiotic susceptibility testing directly from positive blood cultures using MALDI-TOF MS and VITEK 2.

    Science.gov (United States)

    Wattal, C; Oberoi, J K

    2016-01-01

    The study addresses the utility of Matrix Assisted Laser Desorption/Ionisation Time-Of-Flight mass spectrometry (MALDI-TOF MS) using VITEK MS and the VITEK 2 antimicrobial susceptibility testing (AST) system for direct identification (ID) and timely AST from positive blood culture bottles using a lysis-filtration method (LFM). Between July and December 2014, a total of 140 non-duplicate mono-microbial blood cultures were processed. An aliquot of positive blood culture broth was incubated with lysis buffer before the bacteria were filtered and washed. Micro-organisms recovered from the filter were first identified using VITEK MS and its suspension was used for direct AST by VITEK 2 once the ID was known. Direct ID and AST results were compared with classical methods using solid growth. Out of the 140 bottles tested, VITEK MS resulted in 70.7 % correct identification to the genus and/ or species level. For the 103 bottles where identification was possible, there was agreement in 97 samples (94.17 %) with classical culture. Compared to the routine method, the direct AST resulted in category agreement in 860 (96.5 %) of 891 bacteria-antimicrobial agent combinations tested. The results of direct ID and AST were available 16.1 hours before those of the standard approach on average. The combined use of VITEK MS and VITEK 2 directly on samples from positive blood culture bottles using a LFM technique can result in rapid and reliable ID and AST results in blood stream infections to result in early institution of targeted treatment. The combination of LFM and AST using VITEK 2 was found to expedite AST more reliably.

  5. Blood gases and oximetry: calibration-free new dry-chemistry and optical technology for near-patient testing.

    Science.gov (United States)

    Boalth, N; Wandrup, J; Larsson, L; Frischauf, P A; Lundsgaard, F C; Andersen, W L; Jensen, N; Singer, R; Troldborg, C P; Lunding, G

    2001-05-01

    The first calibration-free Near-Patient-Testing instrument (NPT7) for blood gases, pH and oximetry has been developed. With cartridges of 30 single-use cuvettes, the NPT7 needs no preparation prior to sample aspiration, no manual calibration, and no maintenance apart from paper and cartridge changes and regulatory quality control. Each cuvette measures pCO2, pO2, pH, total hemoglobin (ctHb), oxygen saturation (sO2), fractions of carboxyhemoglobin (FCOHb) and methemoglobin (FMetHb) on 95 microl whole blood with a 110-s measuring cycle. The measurement principles are as follows: pCO2-three-wavelength infrared spectroscopy of dissolved CO2; pO2-measurement of O2-induced changes in the decay time of phosphorescence; pH-the absorbance spectra change of an azo-dye color indicator; and oximetry is performed with a 128-wavelength spectrophotometer. We determined the within and between instrument variations with tonometered whole blood on seven prototype instruments, using between one and five control levels per analyte. The 95% analytical performance limits: +/-(/Bias/ +2 xS(T)) in the NPT7 instrument matched the analytical performance criteria for the measured quantities as defined by AACC guidelines. The application of these optical measuring methods for blood gases, pH and oximetry in single-use devices introduces a new concept into point-of-care testing (POCT), where preanalytical activities otherwise associated with instrument preparation are eliminated.

  6. A comprehensive experimental study of industrial, domestic and environmental interferences with the forensic luminol test for blood.

    Science.gov (United States)

    Creamer, J I; Quickenden, T I; Apanah, M V; Kerr, K A; Robertson, P

    2003-01-01

    This paper presents the fi rst comprehensive and quantitative study of substances that interfere with the forensic luminol test for blood. Two hundred and fifty substances have been selected on the basis of modern lifestyles and of contiguity with crime scenes. The intensity of the chemiluminescence produced by each substance has been measured relative to that of haemoglobin and the peak wavelength shift has also been determined. The following is a short list of nine substances that produce chemiluminescence intensities comparable with that of haemoglobin: turnips, parsnips, horseradishes, commercial bleach (NaClO), copper metal, some furniture polishes, some enamel paints, and some interior fabrics in motor vehicles. Care needs to be taken when the luminol test for blood is used in the presence of these substances.

  7. Blood tests for investigating maternal wellbeing. 4. When nausea and vomiting in pregnancy becomes pathological: hyperemesis gravidarum.

    Science.gov (United States)

    Ballard, Sarah

    2011-01-01

    Nausea and vomiting in pregnancy (NVP) is commonplace, with many midwives frequently counselling women in their care. But how do midwives know when NVP becomes pathological? Although hyperemesis gravidarum (HEG) is less common, midwives must be able to recognise and differentiate between these two conditions, especially as HEG has the potential to have a detrimental effect on maternal and fetal wellbeing. The physiological impact of HEG is well documented but what often goes unacknowledged is the psychological, social, occupational and familial impact it also has on a woman's life. Knowledge about the aetiology of HEG and treatment options available is essential but a timely initial diagnosis is paramount. For this to occur the midwife must be skilled in history taking, clinical examination and utilisation of serum blood tests--specifically electrolytes and urea. An understanding of how electrolyte levels can cause pathology is vital if the midwife wishes to interpret blood tests for women with this condition.

  8. The Assessment of Cytotoxicity and Genotoxicity of Mirtazapine in Human Blood Lymphocytes Using Micronucleus Test

    Directory of Open Access Journals (Sweden)

    M Norizadeh tazehkand

    2015-02-01

    Results: MN formation was not significantly induced at 24- and 48-h treatment periods when compared with control but Nuclear division index (NDI significantly decreased at all concentrations for two treatment periods. Conclusion: Mirtazapine was not genetoxic but was cytotoxic in human peripheral blood lymphocytes. According to this study mirtazapine has cytotoxic effects on human's cells.

  9. Awareness and Knowledge of Cardiovascular Risk through Blood Pressure and Cholesterol Testing in College Freshmen

    Science.gov (United States)

    Melnyk, J. A.; Panza, G.; Zaleski, A.; Taylor, B.

    2015-01-01

    Background: Cardiovascular disease (CVD) is the leading cause of death in the United States, yet knowledge of CVD risk factors is surprisingly low in college students. Purpose: The purpose of this study was to determine the effectiveness of an individualized blood pressure, cholesterol, and CVD education intervention on college freshmen. Methods:…

  10. Awareness and Knowledge of Cardiovascular Risk through Blood Pressure and Cholesterol Testing in College Freshmen

    Science.gov (United States)

    Melnyk, J. A.; Panza, G.; Zaleski, A.; Taylor, B.

    2015-01-01

    Background: Cardiovascular disease (CVD) is the leading cause of death in the United States, yet knowledge of CVD risk factors is surprisingly low in college students. Purpose: The purpose of this study was to determine the effectiveness of an individualized blood pressure, cholesterol, and CVD education intervention on college freshmen. Methods:…

  11. A single dual-emissive nanofluorophore test paper for highly sensitive colorimetry-based quantification of blood glucose.

    Science.gov (United States)

    Huang, Xiaoyan; Zhou, Yujie; Liu, Cui; Zhang, Ruilong; Zhang, Liying; Du, Shuhu; Liu, Bianhua; Han, Ming-Yong; Zhang, Zhongping

    2016-12-15

    Fluorescent test papers are promising for the wide applications in the assays of diagnosis, environments and foods, but unlike classical dye-absorption-based pH test paper, they are usually limited in the qualitative yes/no type of detection by fluorescent brightness, and the colorimetry-based quantification remains a challenging task. Here, we report a single dual-emissive nanofluorophore probe to achieve the consecutive color variations from blue to red for the quantification of blood glucose on its as-prepared test papers. Red quantum dots were embedded into silica nanoparticles as a stable internal standard emission, and blue carbon dots (CDs) were further covalently linked onto the surface of silica, in which the ratiometric fluorescence intensity of blue to red is controlled at 5:1. While the oxidation of glucose induced the formation of Fe(3+) ions, the blue emission of CDs was thus quenched by the electron transfer from CDs to Fe(3+), displaying a serial of consecutive color variations from blue to red with the dosage of glucose. The high-quality test papers printed by the probe ink exhibited a dosage-sensitive allochromatic capability with the clear differentiations of ~5, 7, 9, 11mM glucose in human serum (normal: 3-8mM). The blood glucose determined by the test paper was almost in accordance with that measured by a standard glucometer. The method reported here opens a window to the wide applications of fluorescent test paper in biological assays.

  12. Fish oil-supplementation from 9 to 12 months of age affects infant attention in a free-play test and is related to change in blood pressure

    DEFF Research Database (Denmark)

    Harbild, Helle Liliegren; Harsløf, Laurine Bente Schram; Christensen, J. H.;

    2013-01-01

    This intervention examined whether fish-oil-supplementation in late infancy modifies free-play test scores and if this is related to blood pressure (BP) and mean RR interval.......This intervention examined whether fish-oil-supplementation in late infancy modifies free-play test scores and if this is related to blood pressure (BP) and mean RR interval....

  13. Colorectal cancer screening for the natural population of Beijing with sequential fecal occult blood test: a multicenter study

    Institute of Scientific and Technical Information of China (English)

    李世荣; 聂昭华; 李楠; 李军祥; 章萍; 杨昭徐; 牟善坤; 杜亚萍; 胡继春; 袁申元; 屈汉庭; 张泰昌; 王世鑫; 董恩钰; 漆德芳

    2003-01-01

    Objective To assess the prevalence of colorectal cancer (CRC) in Beijing and the reliability of the sequential fecal occult blood test (SFOBT) for CRC screening. Methods Of the natural population (48 100 persons) in several Beijing communities, we screened 26@!827 persons with age over 30 using the SFOBT screening p rogram, Guaiacum Fecal Occult Blood Test (GFOBT), Immuno Fecal Occult Blood Test (IFOBT), and colonoscopies.Results The screening rate of the population was 74%. The positive rate of SFOBT was 5.6%. The prevalence of CRC in the entire population of Beijing was therefore c alculated to be 36.57/105. Of 12 CRC detected patients, 4 cases were in stage Dukes A (33.33%), 7 cases in stage Dukes B (58.33%), only 1 case (8.34% ) in stage Dukes C.Conclusions The prevalence of CRC in Beijing is one of the highest in China. Individuals at high risk for CRC or those over 50 years of age should be considered as primary candidates for screening. SFOBT screening is a cost-effective and reliable me thod for early detection of CRC.

  14. Derivation of a measure of systolic blood pressure mutability: a novel information theory-based metric from ambulatory blood pressure tests.

    Science.gov (United States)

    Contreras, Danitza J; Vogel, Eugenio E; Saravia, Gonzalo; Stockins, Benjamin

    2016-03-01

    We provide ambulatory blood pressure (BP) exams with tools based on information theory to quantify fluctuations thus increasing the capture of dynamic test components. Data from 515 ambulatory 24-hour BP exams were considered. Average age was 54 years, 54% were women, and 53% were under BP treatment. The average systolic pressure (SP) was 127 ± 8 mm Hg. A data compressor (wlzip) designed to recognize meaningful information is invoked to measure mutability which is a form of dynamical variability. For patients with the same average SP, different mutability values are obtained which reflects the differences in dynamical variability. In unadjusted linear regression models, mutability had low association with the mean systolic BP (R(2) = 0.056; P information toward diagnosis.

  15. For People of African, Mediterranean, or Southeast Asian Heritage: Important Information about Diabetes Blood Tests

    Science.gov (United States)

    ... Biopsy Liver Biopsy Lower GI Series Prostate Tests Sickle Cell Trait & Other Hemoglobinopathies & Diabetes (For Providers) Thyroid Tests Upper ... a carrier. One condition caused by hemoglobin S is sickle cell trait, which occurs most often in people of African ...

  16. Automatic registration between 3D intra-operative ultrasound and pre-operative CT images of the liver based on robust edge matching

    Science.gov (United States)

    Nam, Woo Hyun; Kang, Dong-Goo; Lee, Duhgoon; Lee, Jae Young; Ra, Jong Beom

    2012-01-01

    The registration of a three-dimensional (3D) ultrasound (US) image with a computed tomography (CT) or magnetic resonance image is beneficial in various clinical applications such as diagnosis and image-guided intervention of the liver. However, conventional methods usually require a time-consuming and inconvenient manual process for pre-alignment, and the success of this process strongly depends on the proper selection of initial transformation parameters. In this paper, we present an automatic feature-based affine registration procedure of 3D intra-operative US and pre-operative CT images of the liver. In the registration procedure, we first segment vessel lumens and the liver surface from a 3D B-mode US image. We then automatically estimate an initial registration transformation by using the proposed edge matching algorithm. The algorithm finds the most likely correspondences between the vessel centerlines of both images in a non-iterative manner based on a modified Viterbi algorithm. Finally, the registration is iteratively refined on the basis of the global affine transformation by jointly using the vessel and liver surface information. The proposed registration algorithm is validated on synthesized datasets and 20 clinical datasets, through both qualitative and quantitative evaluations. Experimental results show that automatic registration can be successfully achieved between 3D B-mode US and CT images even with a large initial misalignment.

  17. MR mammography in the pre-operative staging of breast cancer in patients with dense breast tissue: comparison with mammography and ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Van Goethem, M.; Schelfout, K.; Verslegers, I.; Biltjes, I.; De Schepper, A. [Department of Radiology, University Hospital Antwerp, Antwerp (Belgium); Dijckmans, L. [Department of Gynecology, University Hospital Antwerp, Antwerp (Belgium); Van Der Auwera, J.C.; Weyler, J. [Department of Epidemiology and Social Medicine, University Hospital Antwerp, Antwerp (Belgium)

    2004-05-01

    The aim of this study was to determine whether pre-operative MR mammography could predict the extent of breast cancer in patients with dense breasts or whether dense parenchyma will lead to false-positive or inconclusive examinations. Sixty-seven patients with dense breasts with a malignant breast tumor planned for conservative surgery were reviewed. Detection rates of mammography, ultrasound, and MR mammography were studied, and the diameters of the lesions were measured and compared with pathological examination. Pathology revealed breast cancer in 65 patients. Sensitivity for detection of index lesions was 83% for mammography, 70.8% for ultrasound, and 98% for MR mammography. Mammography underestimated tumor extent in 37%, ultrasound in 40%, and MR in 12.5%. Of the 20 patients (31%) with multifocal or multicentric carcinoma, mammography detected the lesions in 35%, ultrasound in 30%, and MR in 100%, with a false-positive rate of 12.5, 14, and 23%. The MR mammography is more accurate in assessing tumor extent and multifocality in patients with dense breasts, but benign changes may lead to false-positive examinations. (orig.)

  18. Comparison between FDG Uptake and Pathologic or Immunohistochemical Parametersin Pre-operative PET/CT Scan of Patient with Primary Colorectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Na, Sae Jung; Chung, Yong An; Maeng, Lee So; Kim, Ki Jun; Sohn, Kyung Myung; Kim, Sung Hoon; Sohn, Hyung Sun; Chung, Soo Kyo [College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2009-12-15

    To evaluate the relationship between F-18 FDG uptake of tumor in PET/CT scan and pathological or immunohistochemial parameters of colorectal cancer. 147 colorectal cancer patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The pathologic results such as site, size, depth of invasion (T stage), growth pattern, differentiation of primary tumor, lymph node metastasis and Dukes-Astler and Coller stage and immunohistochemical markers such as expression of EGFR, MLH1, MSH2 and Ki-67 index were reviewed. 146 out of 147 PET/CT scans with colorectal cancer showed perceptible focal FDG uptake. SUVmax showed mild positive linear correlation with size of primary tumor (r=0.277, p=0.001) and Ki-67 index (r=0.226, p=0.019). No significant difference in F-18 FDG uptake was found according to site, depth of invasion (T stage), growth pattern, differentiation of primary tumor, presence of lymph node metastasis, Dukes-Astler and Coller stage and expression of EGFR. The degree of F-18 FDG uptake in colorectal cancer was associated with the size and the degree of Ki-67 index of primary tumor. It could be thought that FDG uptake of primary tumor has a correlation with macroscopic and microscopic tumor growth.

  19. Effects of pre-operative submucosal dexamethasone injection on the postoperative swelling and trismus following surgical extraction of mandibular third molar.

    Science.gov (United States)

    Ehsan, Afeefa; Ali Bukhari, Syed Gulzar; Ashar; Manzoor, Arslan; Junaid, Muhammad

    2014-07-01

    To determine the effects of pre-operative submucosal dexamethasone injection on postoperative swelling and trismus following surgical extraction of mandibular third molar. Randomized controlled trial. Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry (AFID), Rawalpindi, from October 2009 to March 2010. A total of 100 patients aged 18 - 40 years with good periodontal health and mesioangular impaction were divided in two treatment groups (50 in each group). Group-A received prophylactic 4 mg submucosal dexamethasone intraoral injection and Group-B acted as control group. Facial swelling and trismus were assessed at baseline, 2nd and 7th postoperative days. Data was analyzed using SPSS-10. There were 35 (70%) males and 15 (30%) females in group-A and 34 (68%) males and 16 (32%) females in group-B. Surgical time ranged from 30 - 50 minutes (mean = 40.62 ± 4.886 minutes) for group-A and 33 - 50 minutes (mean = 42.12 ± 4.543 minutes) for group-B. Administration of dexamethasone had statistically significant effect in reduction of swelling and trismus on second postoperative day (p trismus.

  20. [Multiple gastro-intestinal stromal tumors (GIST) in a patient with type I neurofibromatosis revealed by chronic bleeding: pre-operative radiological diagnosis].

    Science.gov (United States)

    Guillaud, Olivier; Dumortier, Jérôme; Bringuier, Pierre-Paul; Saurin, Jean-Christophe; Poncet, Gilles; Boulez, Jean; Henry, Luc; Chayvialle, Jean-Alain; Scoazec, Jean-Yves

    2006-02-01

    Recent studies have pointed out a high incidence of GIST, usually multiple and of small intestinal location, in patients with type I neurofibromatosis. We here report an additional case, revealed by chronic gastro-intestinal bleeding and diagnosed at pre-operative imaging studies. A 56-year-old patient, with known type I neurofibromatosis, was referred to our department for the exploration of chronic gastro-intestinal bleeding during anti-aggregant therapy. Endoscopical examination was negative. Enteroscanner showed the presence of four tumor lesions, 3 in the jejunum and 1 in the ileum. Segmental surgical resections were performed. At histological examination, 2 of among the 3 jejunal lesions were diagnosed as typical GIST, of low risk of malignancy, CD117+, CD34+, whereas the last jejunal and ileal lesions were identified as fibroid tumors. Mutations of c-kit gene and of the gene coding for PDGF-Ralpha were not detected. Post-operative recovery was uneventful; no recurrent bleeding was observed. Our case report underlines the potential role of enteroscanner in the management of patients with type I neurofibromatosis with possible digestive complications. It also emphasizes the importance of an accurate diagnosis of the digestive tumors associated with type I neurofibromatosis: GISTs are frequent in this setting and must not be misdiagnosed as neurofibromas.

  1. The value of high-resolution MRI technique in patients with rectal carcinoma: pre-operative assessment of mesorectal fascia involvement, circumferential resection margin and local staging.

    Science.gov (United States)

    Algebally, Ahmed Mohamed; Mohey, Nesreen; Szmigielski, Wojciech; Yousef, Reda Ramadan Hussein; Kohla, Samah

    2015-01-01

    The purpose of the study was to identify the accuracy of high-resolution MRI in the pre-operative assessment of mesorectal fascia involvement, circumfrential resection margin (CRM) and local staging in patients with rectal carcinoma. The study included 56 patients: 32 male and 24 female. All patients underwent high-resolution MRI and had confirmed histopathological diagnosis of rectal cancer located within 15 cm from the anal verge, followed by surgery. MRI findings were compared with pathological and surgical results. The overall accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of MRI-based T-staging were 92.8, 88.8%, 96.5%, 96%, and 90.3%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based assessment of CRM were 94.6%, 84.6%, 97.6%, 91.4, and 94.6%, respectively. The accuracy, sensitivity, specificity, PPV, and NPV of MRI-based N-staging were 82.1%, 75%, 67.3%, 60%, and 86.1%, respectively. Preoperative high-resolution rectal MRI is accurate in predicting tumor stage and CRM involvement. MRI is a precise diagnostic tool to select patients who may benefit from neo-adjuvant therapy and to avoid overtreatment in those patients who can proceed directly to surgery.

  2. Pre-operative and post-operative effect of a pain management programme prior to total hip replacement: a randomized controlled trial.

    Science.gov (United States)

    Berge, Daniel J; Dolin, Simon J; Williams, Amanda CdeC; Harman, Rachel

    2004-07-01

    Patients may wait some time for total hip replacement with conservative management of pain and disability, but no attempts to rehabilitate them. This study randomised 40 patients accepted for and awaiting total hip replacement to a brief rehabilitative psychologically based pain management programme (PMP) or to a control group with no intervention. Patients were assessed before randomisation, 3 months after the PMP or equivalent waiting time, and again one year later after total hip replacement. Assessments included pain, impact of pain (Arthritis Impact Scale: AIMS), mobility (timed walk), sleep and analgesic consumption. The patients who had learned pain management reported lower pain intensity and pain distress and less sleep disturbance than waiting list controls, but no improvement in function or analgesic consumption. Six patients opted to delay, but this did not differ between groups. Post-hip replacement both groups improved in pain and some aspects of activity (AIMS) with greater improvement in the PMP group for physical activity and total AIMS scores, suggesting that some techniques had continued to be of use post-surgically. Rehabilitative pain management may be useful to patients pre-operatively in managing everyday pain, but not to the extent that they opt to delay surgery; it may also improve their function after hip replacement.

  3. Epi proColon(®) 2.0 CE: A Blood-Based Screening Test for Colorectal Cancer.

    Science.gov (United States)

    Lamb, Yvette N; Dhillon, Sohita

    2017-04-01

    Epi proColon(®) 2.0 CE is a blood-based test designed to aid in the early detection of colorectal cancer. The test comprises a qualitative assay for the polymerase chain reaction (PCR) detection of methylated Septin9 DNA, the presence of which is associated with colorectal cancer: however, positive results should be verified by colonoscopy or sigmoidoscopy. Epi proColon(®) 2.0 CE discriminated between patients with colorectal cancer and healthy controls with high clinical sensitivity and specificity in pivotal case-control studies. The sensitivity of the test did not appear to be affected by the tumour location or by patient age or gender. In addition, limited data suggest that Epi proColon(®) 2.0 CE discriminated between patients with colorectal cancer and healthy controls with higher sensitivity and generally similar specificity to that of the faecal immunochemical test, and with higher sensitivity and specificity to that of the guaiac-based faecal occult blood test (statistical data not available). In an observational study, most patients who refused colonoscopy for screening accepted a non-invasive test option as an alternative, and preferred Epi proColon(®) 2.0 CE over a stool-based test. Large prospective trials of Epi proColon(®) 2.0 CE in a screening setting will be required to further elucidate the cost-effectiveness of the test. Nevertheless, currently available data suggests that Epi proColon(®) 2.0 CE has the potential to be a sensitive and convenient screening option for patients refusing screening by colonoscopy.

  4. Evaluation of a multi-endpoint assay in rats, combining the bone-marrow micronucleus test, the Comet assay and the flow-cytometric peripheral blood micronucleus test.

    Science.gov (United States)

    Bowen, Damian E; Whitwell, James H; Lillford, Lucinda; Henderson, Debbie; Kidd, Darren; Mc Garry, Sarah; Pearce, Gareth; Beevers, Carol; Kirkland, David J

    2011-05-18

    With the publication of revised draft ICH guidelines (Draft ICH S2), there is scope and potential to establish a combined multi-end point in vivo assay to alleviate the need for multiple in vivo assays, thereby reducing time, cost and use of animals. Presented here are the results of an evaluation trial in which the bone-marrow and peripheral blood (via MicroFlow(®) flow cytometry) micronucleus tests (looking at potential chromosome breakage and whole chromosome loss) in developing erythrocytes or young reticulocytes were combined with the Comet assay (measuring DNA strand-breakage), in stomach, liver and blood lymphocytes. This allowed a variety of potential target tissues (site of contact, site of metabolism and peripheral distribution) to be assessed for DNA damage. This combination approach was performed with minimal changes to the standard and regulatory recommended sampling times for the stand-alone assays. A series of eight in vivo genotoxins (2-acetylaminofluorene, benzo[a]pyrene, carbendazim, cyclophosphamide, dimethylnitrosamine, ethyl methanesulfonate, ethyl nitrosourea and mitomycin C), which are known to act via different modes of action (direct- and indirect-acting clastogens, alkylating agents, gene mutagens, cross-linking and aneugenic compounds) were tested. Male rats were dosed at 0, 24 and 45 h, and bone marrow and peripheral blood (micronucleus endpoint), liver, whole blood and stomach (Comet endpoint) were sampled at three hours after the last dose. Comet and micronucleus responses were as expected based on available data for conventional (acute) stand-alone assays. All compounds were detected as genotoxic in at least one of the endpoints. The importance of evaluating both endpoints was highlighted by the uniquely positive responses for certain chemicals (benzo[a]pyrene and 2-acetylaminofluorene) with the Comet endpoint and certain other chemicals (carbendazim and mitomycin C) with the micronucleus endpoint. The data generated from these

  5. Stress and coping in HIV-positive former plasma/blood donors in China: a test of cognitive appraisal theory.

    Science.gov (United States)

    Meade, Christina S; Wang, Jianping; Lin, Xiuyun; Wu, Hao; Poppen, Paul J

    2010-04-01

    Throughout the 1990s, many villagers in rural China were infected with HIV through commercial plasma/blood donation. These former plasma/blood donors (FPDs) experienced many HIV-related stressors. This study tested a cognitive appraisal model of stress and coping in a sample of HIV-positive adult FPDs. Participants (N = 207) from multiple villages completed a battery of questionnaires assessing HIV-related stress, HIV symptoms, cognitive appraisal, coping behaviors, and psychological distress. Participants reported high levels of HIV-related stress, depression, and anxiety. In a structural equation model, greater HIV-related stress, HIV symptoms, and threat appraisal were directly associated with psychological distress. HIV-related stress was also indirectly associated with psychological distress through threat appraisal. In a second model, coping was found to mediate the relationship between challenge appraisal and psychological distress. Results support the utility of cognitive appraisal theory. Stress management interventions targeting HIV-positive FPDs in China are indicated.

  6. Clinical laboratory experience of blood CRIM testing in infantile Pompe disease

    Directory of Open Access Journals (Sweden)

    Deeksha S. Bali

    2015-12-01

    Full Text Available Cross-reactive immunological material (CRIM status is an important prognostic factor in patients with infantile Pompe disease (IPD being treated with enzyme replacement therapy. Western blot analysis of cultured skin fibroblast lysates has been the gold standard for determining CRIM status. Here, we evaluated CRIM status using peripheral blood mononuclear cell (PBMC protein. For 6 of 33 patients (18% CRIM status determination using PBMC was either indeterminate or discordant with GAA genotype or fibroblast CRIM analysis results. While the use of PBMCs for CRIM determination has the advantage of a faster turnaround time, further evaluation is needed to ensure the accuracy of CRIM results.

  7. Focal increase of cerebral blood flow during stereognostic testing in man

    DEFF Research Database (Denmark)

    Roland, E; Larsen, B

    1976-01-01

    An attempt was made to study the regional cerebral blood flow (rCBF) pattern during stereognostic discrimination in man. The rCBF was measured in 18 subjects who had no major neurological defects. The clearance from the hemisphere of xenon 133 injected (133Xe) into the carotid artery was measured...... with a 254-channel dynamic gamma camera. During stereognostic discrimination with hand, mouth, or foot, the rCBF increased focally in the corresponding contralateral sensory-motor region and increased focally in the premotor part of the frontal lobe. The increase in the sensory region was attributed...

  8. Dynamics of changes in the activation of blood coagulation tests at different variants of thromboprophylaxis

    Directory of Open Access Journals (Sweden)

    Олена Миколаївна Клигуненко

    2015-09-01

    Full Text Available Aim: To study an influence of the different variants of thromboprophylaxis on activation of blood coagulation test on the background of surgical aggression. D-dimer concentration in serum is in direct proportion to fibrinolysis activity and to an amount of lysed fibrin. At the same time fibrinolysis activation is followed with an increase of formation of products of fibrin degradation (PFD that interact with fibrin-monomers and increase the number of SFMC.Materials and methods: After informed consent 200 patients were prospectively divided into groups depending on preparation and regimen of thromboprophylaxis. 1 group (n=30 – ungraded heparin (UGH (5000 ОD for 2 hours before surgery 2 times during 7 days after it. 2 group(n=30 nadraparin calcium 9500 anti-Ха МO (0,3 ml for 2 hours before surgery 2500 МО 1 time for a day 7 days after surgery; 3 group(n=48 – endoxaparin sodium(0,2 ml for 2 hours before surgery 1 time a day 7 days; 4 group(n=29 endoxaparin sodium(0,2ml for 8 hours before surgery, 0,2 ml 1 time a day 7 days; 5 group(n=34 – bemiparin sodium(0,2 ml for 2 hours before surgery 0,2 ml 1 time a day 7 days; 6 group(n=29 bemiparin sodium(0,2ml in 6 hours after surgery 1 time a day 7 days. Patients were comparable on sex, concomitant pathology, class АSA (1-2 and type of surgical intervention. There were studied the number of thrombocytes, prothrombin time (PT, INR AFTT, fibrinogen, Х-а factor activity, antithrombin, 111 (AT111, protein C, SFMC, d-dimer before surgery, on 1,5 and 7 day after it.Results and discussions: On the 1 day of postsurgical period the most influence on D-dimer level had presurgical thromboprophylaxis (TPP with UGH and nadroparin calcium. So the D-dimer level exceeded norm respectively by 67 % (р=0,017 and 65,9 % (р<0,05. In patients of 3 and 4 groups D-dimer level was the lowest that formed deficiency by 56 % (р<0,05 and 52,7 % (р<0,05 from the norm respectively. At the same time an analysis of

  9. Effect of stage duration on maximal heart rate and post-exercise blood lactate concentration during incremental treadmill tests.

    Science.gov (United States)

    Machado, Fabiana A; Kravchychyn, Ana Claudia P; Peserico, Cecilia S; da Silva, Danilo F; Mezzaroba, Paulo V

    2013-05-01

    This study compared the responses during maximal incremental treadmill tests of 1-min, 2-min, and 3-min stage durations mainly in terms of maximal heart rate (HRmax) and peak blood lactate concentration (LApeak). Repeated-measures. Thirty-four male, recreational, endurance-trained runners (40±13 years) performed three tests on a motorized treadmill. The tests started at 8kmh(-1) with increments of 1kmh(-1) every 1min for the short-stage protocol, every 2min for the intermediate-stage protocol, and every 3min for the long-stage protocol. LApeak was defined for each subject as the highest value among the lactate concentrations determined at the end of each test and at the third, fifth and seventh minutes after test, during passive recovery. Analysis of variance revealed a significant effect of the stage duration on the HRmax (p=0.003) and LApeak (p=0.001). The HRmax was higher in the intermediate-stage compared to the short-stage protocol (184.8±12.7 vs. 181.8±12.1beatsmin(-1), p0.05). The LApeak was lower in the long-stage compared to the short-stage and intermediate-stage protocols (7.9±2.2 vs. 9.4±2.2 and 9.2±1.9mmolL(-1), respectively, pblood lactate reached peak concentration at the fifth minute after test for all the protocols. Thus, HRmax and LApeak depend on the stage duration of the incremental test, but the moment at which blood lactate reaches peak concentration is independent of the duration. Further, we suggest 2-min stage duration protocols to determine HRmax. Copyright © 2012 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. White Blood Cell Count

    Science.gov (United States)

    ... limited. Home Visit Global Sites Search Help? White Blood Cell Count Share this page: Was this page helpful? ... Count; Leukocyte Count; White Count Formal name: White Blood Cell Count Related tests: Complete Blood Count , Blood Smear , ...

  11. Antimicrobial susceptibility testing of Gram-positive and -negative bacterial isolates directly from spiked blood culture media with Raman spectroscopy.

    Science.gov (United States)

    Dekter, H E; Orelio, C C; Morsink, M C; Tektas, S; Vis, B; Te Witt, R; van Leeuwen, W B

    2017-01-01

    Patients suffering from bacterial bloodstream infections have an increased risk of developing systematic inflammatory response syndrome (SIRS), which can result in rapid deterioration of the patients' health. Diagnostic methods for bacterial identification and antimicrobial susceptibility tests are time-consuming. The aim of this study was to investigate whether Raman spectroscopy would be able to rapidly provide an antimicrobial susceptibility profile from bacteria isolated directly from positive blood cultures. First, bacterial strains (n = 133) were inoculated in tryptic soy broth and incubated in the presence or absence of antibiotics for 5 h. Antimicrobial susceptibility profiles were analyzed by Raman spectroscopy. Subsequently, a selection of strains was isolated from blood cultures and analyzed similarly. VITEK®2 technology and broth dilution were used as the reference methods. Raman spectra from 67 antibiotic-susceptible strains showed discriminatory spectra in the absence or at low concentrations of antibiotics as compared to high antibiotic concentrations. For 66 antibiotic-resistant strains, no antimicrobial effect was observed on the bacterial Raman spectra. Full concordance with VITEK®2 data and broth dilution was obtained for the antibiotic-susceptible strains, 68 % and 98 %, respectively, for the resistant strains. Discriminative antimicrobial susceptibility testing (AST) profiles were obtained for all bacterial strains isolated from blood cultures, resulting in full concordance with the VITEK®2 data. It can be concluded that Raman spectroscopy is able to detect the antimicrobial susceptibility of bacterial species isolated from a positive blood culture bottle within 5 h. Although Raman spectroscopy is cheap and rapid, further optimization is required, to fulfill a great promise for future AST profiling technology development.

  12. Blood glucose testing and primary prevention of diabetes mellitus type 2 - evaluation of the effect of evidence based patient information

    Directory of Open Access Journals (Sweden)

    Giani Guido

    2010-01-01

    Full Text Available Abstract Background Evidence-based patient information (EBPI has been recognised as important tool for informed choice in particular in the matter of preventive options. An objective, on the best scientific evidence-based consumer information about subthreshold elevated blood glucose levels (impaired fasting glucose and impaired glucose tolerance and primary prevention of diabetes, is not available yet. Thus we developed a web-based EBPI and aim to evaluate its effects on informed decision making in people 50 years or older. Methods/Design We conduct a web-based randomised-controlled trial to evaluate the effect of information about elevated blood glucose levels and diabetes primary prevention on five specific outcomes: (i knowledge of elevated blood glucose level-related issues (primary outcome; (ii attitudes to a metabolic testing; (iii intention to undergo a metabolic testing; (iv decision conflict; (v satisfaction with the information. The intervention group receives a specially developed EBPI about subthreshold elevated blood glucose levels and diabetes primary prevention, the control group information about this topic, available in the internet. The study population consists of people between 50 and 69 years of age without known diabetes. Participants will be recruited via the internet page of the cooperating health insurance company, Techniker Krankenkasse (TK, and the internet page of the German Diabetes Centre. Outcomes will be measured through online questionnaires. We expect better informed participants in the intervention group. Discussion The design of this study may be a prototype for other web-based prevention information and their evaluation. Trial registration Current Controlled Trial: ISRCTN22060616.

  13. Shortened Time to Identify Staphylococcus Species from Blood Cultures and Methicillin Resistance Testing Using CHROMAgar

    Directory of Open Access Journals (Sweden)

    Shingo Chihara

    2009-01-01

    Full Text Available The ability to rapidly differentiate coagulase-negative staphylococcus (CoNS from Staphylococcus aureus and to determine methicillin resistance is important as it affects the decision to treat empiric antibiotic selection. The objective of this study was to evaluate CHROMagar S. aureus and CHROMagar MRSA (Becton Dickinson for rapid identification of Staphylococcus spp. directly from blood cultures. Consecutive blood culture bottles (BacT Alert 3D SA and SN, bioMérieux growing gram-positive cocci in clusters were evaluated. An aliquot was plated onto CHROMagar MRSA (C-MRSA and CHROMagar S. aureus (C-SA plates, which were read at 12 to 16 hours. C-SA correctly identified 147/147 S. aureus (100% sensitivity; 2 CoNS were misidentified as S. aureus (98% specificity. C-MRSA correctly identified 74/77 MRSA (96% sensitivity. None of the MSSA isolates grew on C-MRSA (100% specificity. In conclusion, CHROMagar is a rapid and sensitive method to distinguish MRSA, MSSA, and coagulase-negative Staphylococcus and may decrease time of reporting positive results.

  14. Blood serum components and serum protein test of Hybro-PG broilers of different ages

    Directory of Open Access Journals (Sweden)

    PRL Silva

    2007-12-01

    Full Text Available Blood serum samples of HYBRO PG broilers were analyzed, with 30 samples collected from 21-day-old broilers (G1, 30 from 35-day-old birds (G2, and 30 from 42-day-old birds (G3, with the aim of establishing normal values of some blood serum parameters. The activities of the enzymes gamma-glutamyl-transferase (GGT, aspartate aminotransferase (AST, creatine kinase (CK, alkaline phosphatase (ALP, and lactate dehydrogenase (LDH, serum levels of total calcium, calcium ion, phosphorus, sodium, potassium, magnesium, chlorides, creatinine, uric acid, triglycerides, cholesterol, total protein, albumin, total and indirect and direct bilirubin, and electrophoretic profile of serum proteins in acrylamide (SDS-PAGE and agarose gel were determined. There was no influence of age on total bilirubin and albumin levels. All the other evaluated parameters presented differences in at least one age group. Protein electrophoretic profile also changed as a function of age. The obtained results can be considered as normal for the studied ages, and therefore be used as references for the interpretation of laboratory exams of broilers of this genetic line in the evaluated ages.

  15. Advanced contrast nanoagents for photoacoustic molecular imaging, cytometry, blood test and photothermal theranostics.

    Science.gov (United States)

    de la Zerda, Adam; Kim, Jin-Woo; Galanzha, Ekaterina I; Gambhir, Sanjiv S; Zharov, Vladimir P

    2011-01-01

    Various nanoparticles have raised significant interest over the past decades for their unique physical and optical properties and biological utilities. Here we summarize the vast applications of advanced nanoparticles with a focus on carbon nanotube (CNT)-based or CNT-catalyzed contrast agents for photoacoustic (PA) imaging, cytometry and theranostics applications based on the photothermal (PT) effect. We briefly review the safety and potential toxicity of the PA/PT contrast nanoagents, while showing how the physical properties as well as multiple biological coatings change their toxicity profiles and contrasts. We provide general guidelines needed for the validation of a new molecular imaging agent in living subjects, and exemplify these guidelines with single-walled CNTs targeted to α(v) β(3) , an integrin associated with tumor angiogenesis, and golden carbon nanotubes targeted to LYVE-1, endothelial lymphatic receptors. An extensive review of the potential applications of advanced contrast agents is provided, including imaging of static targets such as tumor angiogenesis receptors, in vivo cytometry of dynamic targets such as circulating tumor cells and nanoparticles in blood, lymph, bones and plants, methods to enhance the PA and PT effects with transient and stationary bubble conjugates, PT/PA Raman imaging and multispectral histology. Finally, theranostic applications are reviewed, including the nanophotothermolysis of individual tumor cells and bacteria with clustered nanoparticles, nanothrombolysis of blood clots, detection and purging metastasis in sentinel lymph nodes, spectral hole burning and multiplex therapy with ultrasharp rainbow nanoparticles.

  16. Comparison of the Staphylococcus QuickFISH BC test with the tube coagulase test performed on positive blood cultures for evaluation and application in a clinical routine setting.

    Science.gov (United States)

    Carretto, E; Bardaro, M; Russello, G; Mirra, M; Zuelli, C; Barbarini, D

    2013-01-01

    Many studies demonstrate that delayed proper therapy in bloodstream infections caused by Staphylococcus aureus increases the mortality rate, emphasizing the need to shorten the turnaround time for positive blood cultures. Different techniques are currently available, from phenotypic methods to more complex tests such as matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF), real-time PCR (RT-PCR), and fluorescence in situ hybridization using peptide nucleic acid probes (PNA FISH). This study evaluated the performance of the Staphylococcus QuickFISH BC test (QFT), a novel FISH methodology, compared with the direct tube coagulase test (DTCT) on blood cultures exhibiting Gram-positive cocci in clusters. A total of 173 blood cultures collected from 128 different patients were analyzed using the DTCT, evaluated after both 4 and 24 h, and the QFT. A total of 179 isolates were identified using the Vitek2 system. Thirty-five out of 35 Staphylococcus aureus were correctly identified by the QFT (sensitivity = 100%), with a specificity of 100% (no green fluorescence was detected for strains different from S. aureus). The DTCT was positive after 4 h for 28 out of the 35 samples (sensitivity = 80%) and after 24 h for 31 out of the 35 samples (sensitivity = 88.57%). Among the remaining 144 isolates, one was then identified as Corynebacterium striatum and two as Micrococcus luteus. QFT identified 139 out of the 141 coagulase-negative staphylococci (CoNS) (sensitivity = 98.58%), showing again a specificity of 100% (no fluorescent red signals were detected for strains different from CoNS). We also discuss also the implementation process of this methodology in our setting, with particular emphasis on the workflow and the cost-effectiveness.

  17. Public banking of umbilical cord blood or storage in a private bank: testing social and ethical policy in northeastern Italy

    Directory of Open Access Journals (Sweden)

    Parco S

    2013-04-01

    Full Text Available Sergio Parco, Fulvia Vascotto, Patrizia Visconti Institute for Maternal and Child Health, Trieste, Italy Background: In northeastern Italy, according to Italian legislation, authorized public facilities can accept the donation and preservation of cord blood stem cells (CB-SC. Attitudes and knowledge in pregnant women differs between the local and immigrant (non-European Union [EU] population. In this study we assessed the choices that pregnant women have with respect to the public and private harvesting system and the main reasons driving their decisions. We examined the ethnic origin of the families and compared tests for syphilis screening and leukocyte (WBC counts in the CB-SC bags that are required for validation of the collection. Methods: Out of a population of 3450 pregnant patients at the Institute for Maternal and Child Health of Trieste, northeast Italy, 772 women agreed to cord blood harvesting and the associated lab tests. Of these, 221 women (28.6% were from immigrant families of non-EU countries. Their ethnic affiliation was recorded, and tests were performed for syphilis screening and for nucleated red blood cell (NRBC interference with the WBC count in CB-SC bags to assess cellularity and to determine if storage was appropriate. Results: Of the 772 pregnant women, 648 (84.0% accessed the public collection system, which is free of charge, and 124 (15.0% accessed the private fee-based system. One woman from the non-EU group opted for the private fee-based system. Of the 3450 pregnant women screened for syphilis at the Institute for Maternal and Child Health, the Treponema pallidum hemagglutination (TPHA and Venereal Disease Research Laboratory (VDRL tests were the main tests performed (66.0% of total cases because many gynecologists in the public harvesting system apply the Italian regulations of the 1988 Decree, while the private system requires tests on syphilis and leaves the option to the lab physicians to select the best

  18. Value of tissue markers p27kip1, MIB-1, and CD44s for the pre-operative prediction of tumour features in screen-detected prostate cancer

    NARCIS (Netherlands)

    A.N. Vis (André); B.W. van Rhijn (Bas); M.A. Noordzij (Marinus); F.H. Schröder (Fritz); Th.H. van der Kwast (Theo)

    2002-01-01

    textabstractThe pre-operative prediction of prognostic tumour features in the radical prostatectomy specimen using routine clinicopathological variables remains limited. The present study evaluated the predictive value of the cell-cycle protein p27kip1, the proliferation marker MIB-1, and the cell-a

  19. ERα and ERβ expression in correlation with Ki-67, Bcl-2 and Bak in primary tumors and lymph node metastases of breast cancer: The effect of pre-operative chemotherapy.

    Science.gov (United States)

    Kanczuga-Koda, Luiza; Koda, Mariusz; Tomaszewski, Jakub; Jarzabek, Katarzyna; Lotowska, Joanna; Baltaziak, Marek; Sulkowska, Urszula; Sobaniec-Lotowska, Maria; Sulkowski, Stanisław

    2010-11-01

    This study aimed to assess the pre-operative chemotherapy impact on the relationship between estrogen receptor (ER) expression and markers of proliferation and apoptosis in primary and metastatic breast cancer. Immunohistochemical examinations were conducted on surgically removed ductal invasive breast cancers and their lymph node metastases in 135 patients. A total of 64 patients from this group underwent pre-operative chemotherapy and in 71 cases the surgery was performed without primary chemotherapy. A negative correlation between ERα and Ki-67 was found in primary tumors and lymph node metastases. A positive correlation was observed between ERα and Bcl-2. A positive correlation was also noted between ERβ and Bak, suggesting that the two ERs were involved in the regulation of proteins responsible for the control of the apoptotic process. Assessment of the expression of the proteins conducted separately in primary tumors and lymph node metastases did not reveal a significant effect of pre-operative chemotherapy on the correlations of ERs with Ki-67, Bcl-2 and Bak. However, the analysis of the correlations between the receptor expression in primary tumors and Ki-67, Bcl-2 and Bak in lymph node metastases showed a statistically significant impact of pre-operative chemotherapy on the correlations of ERα and Bcl-2 with ERβ and Bak, confirming involvement of the two ERs in the regulation of apoptosis during breast carcinogenesis.

  20. Fechamento de colostomias: com ou sem estudo do cólon? Colostomy closure: with or without pre-operative colon study

    Directory of Open Access Journals (Sweden)

    Hernán Augusto Centurión Sobral

    2008-09-01

    Full Text Available O estudo pré-operatório do cólon para fechamento de colostomias em alça devido a trauma vem perdendo importância nos últimos anos. A necessidade de se avaliar as alterações anatômicas pós-traumáticas do cólon vai de encontro aos custos, desconforto e morbidade dos exames. OBJETIVO: analisar a real necessidade do estudo prévio do cólon no fechamento de colostomia pós-trauma. MÉTODO: foram analisados, retrospectivamente, 98 prontuários de pacientes, no período de janeiro de 2004 a janeiro de 2006, portadores de colostomia em alça confeccionada após traumatismo e que foram alocados em dois grupos: grupo A, composto de 32 casos com estudo do cólon e o grupo B, 66 casos sem estudo colônico prévio. RESULTADOS: 94,9% dos pacientes eram do sexo masculino e a média de idade foi de 27 anos. O tempo de permanência da colostomia foi, em média, 32,8 meses, sendo o flanco esquerdo a localização mais comum em ambos os grupos. A morbidade geral foi de 7,1%, sendo 3,1% de complicações no grupo A e 9,1% no grupo B (p=0,16 e sem mortalidade. A complicação mais freqüente foi hematoma da parede abdominal em cinco casos (5,1%, e apenas um caso de infecção de ferida operatória (1%, e mais um de deiscência de anastomose (1%. CONCLUSÃO: o estudo pré-operatório do cólon para fechamento de colostomia feita após trauma colorretal é dispensável.The pre-operative study of the colon before loop colostomy closure in trauma patients has been loosing its importance since last few years. The need of evaluating the pos-traumatic anatomic alterations of the colon goes against the costs and morbidity of the examinations. OBJECTIVE: to analyze the real necessity of the colon study before colostomy closure in trauma patients. METHODS: a retrospective study of 98 patients submitted to colostomy closure after trauma, from January of 2004 to January of 2006 was carried out. They were divided in two groups: group A, composed of 32 patients with

  1. Routine blood tests to predict liver fibrosis in chronic hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Yung-Yu Hsieh; Shui-Yi Tung; Kamfai Lee; Cheng-Shyong Wu; Kuo-Liang Wei; Chien-Heng Shen; Te-Sheng Chang; Yi-Hsiung Lin

    2012-01-01

    AIM:To verify the usefulness of FibroQ for predicting fibrosis in patients with chronic hepatitis C,compared with other noninvasive tests.METHODS:This retrospective cohort study included 237 consecutive patients with chronic hepatitis C who had undergone percutaneous liver biopsy before treatment.FibroQ,aspartate aminotransferase (AST)/alanine aminotransferase ratio (AAR),AST to platelet ratio index,cirrhosis discriminant score,age-platelet index (API),Pohl score,FIB-4 index,and Lok's model were calculated and compared.RESULTS:FibroQ,FIB-4,AAR,API and Lok's model results increased significantly as fibrosis advanced (analysis of variance test:P < 0.001).FibroQ trended to be superior in predicting significant fibrosis score in chronic hepatitis C compared with other noninvasive tests.CONCLUSION:FibroQ is a simple and useful test for predicting significant fibrosis in patients with chronic hepatitis C.

  2. Risk factors for false positive and for false negative test results in screening with fecal occult blood testing.

    Science.gov (United States)

    Stegeman, Inge; de Wijkerslooth, Thomas R; Stoop, Esther M; van Leerdam, Monique; van Ballegooijen, M; Kraaijenhagen, Roderik A; Fockens, Paul; Kuipers, Ernst J; Dekker, Evelien; Bossuyt, Patrick M

    2013-11-15

    Differences in the risk of a false negative or a false positive fecal immunochemical test (FIT) across subgroups may affect optimal screening strategies. We evaluate whether subgroups are at increased risk of a false positive or a false negative FIT result, whether such variability in risk is related to differences in FIT sensitivity and specificity or to differences in prior CRC risk. Randomly selected, asymptomatic individuals were invited to undergo colonoscopy. Participants were asked to undergo one sample FIT and to complete a risk questionnaire. We identified patient characteristics associated with a false negative and false positive FIT results using logistic regression. We focused on statistically significant differences as well as on variables influencing the false positive or negative risk for which the odds ratio exceeded 1.25. Of the 1,426 screening participants, 1,112 (78%) completed FIT and the questionnaire; 101 (9.1%) had advanced neoplasia. 102 Individuals were FIT positive, 65 (64%) had a false negative FIT result and 66 (65%) a false positive FIT result. Participants at higher age and smokers had a significantly higher risk of a false negative FIT result. Males were at increased risk of a false positive result, so were smokers and regular NSAID users. FIT sensitivity was lower in females. Specificity was lower for males, smokers and regular NSAID users. FIT sensitivity was lower in women. FIT specificity was lower in males, smokers and regular NSAID users. Our results can be used for further evidence based individualization of screening strategies.

  3. Comparison of breath-alcohol screening test results with venous blood alcohol concentration in suspected drunken drivers.

    Science.gov (United States)

    Kriikku, Pirkko; Wilhelm, Lars; Jenckel, Stefan; Rintatalo, Janne; Hurme, Jukka; Kramer, Jan; Jones, A Wayne; Ojanperä, Ilkka

    2014-06-01

    Hand-held electronic breath-alcohol analyzers are widely used by police authorities in their efforts to detect drunken drivers and to improve road-traffic safety. Over a three month period, the results of roadside breath-alcohol tests of drivers apprehended in Finland were compared with venous blood alcohol concentration (BAC). The mean (median) time between sampling blood and breath was 0.71h (0.58h) with a range from 0 to 6h. Some hand-held instruments gave results as the concentration of alcohol in breath and were converted into BAC assuming a blood-breath alcohol ratio (BBR) of 2260. The mean venous BAC (1.82g/kg) in traffic offenders was higher than the result predicted by the hand-held breath analyzers (1.72g/kg). In 1875 roadside tests, the relationship between venous BAC (x) and BrAC (y) was defined by the regression equation y=0.18+0.85x. The coefficients show both a constant bias (y-intercept 0.18g/kg) and a proportional bias (slope=0.85). The residual standard deviation (SD), an indicator of random variation, was ±0.40g/kg. After BAC results were corrected for the time elapsed between sampling blood and breath, the y-intercept decreased to 0.10g/kg and 0.004g/kg, respectively, when low (0.1g/kg/h) and high (0.25g/kg/h) rates of alcohol elimination were used. The proportional bias of 0.85 shows that the breath-alcohol test result reads lower than the actual BAC by 15% on average. This suggests that the BBR of 2260 used for calibration should be increased by about 15% to give closer agreement between BAC and BrAC. Because of the large random variation (SD±0.40g/kg), there is considerable uncertainty if and when results from the roadside screening test are used to estimate venous BAC. The roadside breath-alcohol screening instruments worked well for the purpose of selecting drivers above the statutory limit of 0.50g/kg.

  4. [An adolescent with autism and a somatic high-risk profile receiving treatment with antipsychotics refuses blood tests].

    Science.gov (United States)

    Harlaar, J; Gelderblom, I L; van der Sijde, A; Bastiaansen, D

    2013-01-01

    An 18-year-old adolescent with an autism spectrum disorder was on antipsychotic medication for anxiety and aggressive behaviour. From a physical examination and the patient’s family medical history there emerged a high-risk profile for the metabolic syndrome. Because the patient refused blood tests the doctors were faced with the dilemma of whether to continue the patient’s medication with the risk of severe side effects or whether to stop medication, which could lead to the recurrence of severe behavioural problems and aggressive behaviour. The dilemma is discussed and some recommendations are given.

  5. A Comparative Study on the Efficacy of Rectal Diazepam and Midazolam for Reduction of Pre-Operative Anxiety in Pediatric Patients

    Directory of Open Access Journals (Sweden)

    Mohammad-Esmaiel Darabi

    2007-05-01

    Full Text Available Objective: Children, due to their great parental dependency, are amongst the cases that should receive preoperatively medication to reduce their fear and anxiety. The objective of this study was to compare the efficacy of rectal diazepam and midazolam for this purpose in pediatric patients scheduled for elective surgery. Material & Methods: 60 children, aged between 1 and 6 years, scheduled for elective surgery, were included in this double blind, randomized controlled trial. Patients were randomly allocated into three equal groups. Patients in midazolam and diazepam groups received the drugs 0.3 mg/kg and 0.5 mg/kg respectively (in normal saline at a final volume of 2.5 ml and placebo group received only 2.5 ml of normal saline 20 min before arriving operation room through rectal applicator. Sedation and anxiety scores at the time of separation from their parents before arriving operating room were recorded for all groups. Findings: There was a significant reduction in anxiety level in midazolam and diazepam groups as compared to placebo group (P<0.001. Sedation rate was 65% for midazolam, 60% for diazepam, and 15% for placebo group (P=0.007. There were no significant changes in hemodynamic parameters in the three study groups. Conclusion: With respect to effective anxiolytic and sedative activity, rectal midazolam (0.3 mg/Kg and diazepam (0.5 mg/Kg can be used as an anesthetic premedicant for children at pre-operative period and their use is safe regarding hemodynamic variables and related side-effects.

  6. [Syphilis detection using ELISA and VDRL tests on blood donors at the blood center of Guarapuava, State of Paraná].

    Science.gov (United States)

    Oliveira, Viviane Matoso de; Verdasca, Izabel Cristina; Monteiro, Marta Chagas

    2008-01-01

    The aim of this study was to evaluate the syphilis seroprevalence among 5,752 blood donors who were attended at the blood center of Guarapuava, State of Paraná, in 2006. The seropositivity rates were 2.1% for enzyme Linked Immuno Sorbent Assay and 0.2% for Veneral Disease Research Laboratory, thus showing low prevalence of syphilis among the individuals who came to this blood bank.

  7. Baseline Systolic Blood Pressure Response to Exercise Stress Test Can Predict Exercise Indices following Cardiac Rehabilitation Program

    Directory of Open Access Journals (Sweden)

    Akram Sardari

    2010-11-01

    Full Text Available Background: Systolic blood pressure recovery (rSBP is of prognostic value for predicting the survival and co-morbidity rate in patients with coronary artery disease (CAD. This study investigated the association between rSBP and exercise indices after complete cardiac rehabilitation program (CR in a population-based sample of patients undergoing coronary artery bypass grafting (CABG.Methods: The sample population consisted of 352 patients who underwent pure CABG. The patients underwent standard symptom-limited exercise testing immediately before and also after the completion of the CR sessions. rSBP was defined as the ratio of the systolic blood pressure at 3 minutes in recovery to the systolic blood pressure at peak exercise.Results: An abnormal baseline rSBP after exercise was a strong predictor of exercise parameters in the last session, including metabolic equivalents (β = -0.617, SE = 0.127, p value < 0.001 and peak O2 consumption (β = -1.950, SE = 0.363, p value < 0.001 measured in the last session adjusted for baseline exercise characteristics, demographics, function class, and left ventricular ejection fraction.Conclusion: The current study strongly emphasizes the predictive role of baseline rSBP after exercise in evaluating exercise parameters following CR. This baseline index can predict abnormal METs value, peak O2 consumption, post-exercise heart rate, and heart rate recovery after a 24-session CR program.

  8. Quantitative analysis of genomic DNA degradation in whole blood under various storage conditions for molecular diagnostic testing.

    Science.gov (United States)

    Permenter, Jessalyn; Ishwar, Arjun; Rounsavall, Angie; Smith, Maddie; Faske, Jennifer; Sailey, Charles J; Alfaro, Maria P

    2015-12-01

    Proper storage of whole blood is crucial for isolating nucleic acids from leukocytes and to ensure adequate performance of downstream assays in the molecular diagnostic laboratory. Short-term and long-term storage recommendations are lacking for successful isolation of genomic DNA (gDNA). Container type (EDTA or heparin), temperature (4 °C and room temperature) and time (1-130 days) were assessed as criterion for sample acceptance policies. The percentage of integrated area (%Ti) between 150 and 10,000 bp from the 2200 TapeStation electropherogram was calculated to measure gDNA degradation. Refrigerated EDTA samples yielded gDNA with low %Ti (high quality). Heparinized samples stored at room temperature yielded gDNA of worst quality. Downstream analysis demonstrated that the quality of the gDNA correlated with the quality of the data; samples with high %Ti generated significantly lower levels of high molecular weight amplicons. Recommendations from these analyses include storing blood samples intended for nucleic acid isolation in EDTA tubes at 4 °C for long term storage (>10 days). gDNA should be extracted within 3 days when blood is stored at room temperature regardless of the container. Finally, refrigerated heparinized samples should not be stored longer than 9 days if expecting high quality gDNA isolates. Laboratories should consider many factors, in addition to the results obtained herein, to update their policies for sample acceptance for gDNA extraction intended for molecular genetic testing.

  9. Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels

    Science.gov (United States)

    Hol, L; Wilschut, J A; van Ballegooijen, M; van Vuuren, A J; van der Valk, H; Reijerink, J C I Y; van der Togt, A C M; Kuipers, E J; Habbema, J D F; van Leerdam, M E

    2009-01-01

    Immunochemical faecal occult blood testing (FIT) provides quantitative test results, which allows optimisation of the cut-off value for follow-up colonoscopy. We conducted a randomised population-based trial to determine test characteristics of FIT (OC-Sensor micro, Eiken, Japan) screening at different cut-off levels and compare these with guaiac-based faecal occult blood test (gFOBT) screening in an average risk population. A representative sample of the Dutch population (n=10 011), aged 50–74 years, was 1 : 1 randomised before invitation to gFOBT and FIT screening. Colonoscopy was offered to screenees with a positive gFOBT or FIT (cut-off 50 ng haemoglobin/ml). When varying the cut-off level between 50 and 200 ng ml−1, the positivity rate of FIT ranged between 8.1% (95% CI: 7.2–9.1%) and 3.5% (95% CI: 2.9–4.2%), the detection rate of advanced neoplasia ranged between 3.2% (95% CI: 2.6–3.9%) and 2.1% (95% CI: 1.6–2.6%), and the specificity ranged between 95.5% (95% CI: 94.5–96.3%) and 98.8% (95% CI: 98.4–99.0%). At a cut-off value of 75 ng ml−1, the detection rate was two times higher than with gFOBT screening (gFOBT: 1.2%; FIT: 2.5%; P<0.001), whereas the number needed to scope (NNscope) to find one screenee with advanced neoplasia was similar (2.2 vs 1.9; P=0.69). Immunochemical faecal occult blood testing is considerably more effective than gFOBT screening within the range of tested cut-off values. From our experience, a cut-off value of 75 ng ml−1 provided an adequate positivity rate and an acceptable trade-off between detection rate and NNscope. PMID:19337257

  10. Rapid testing using the Verigene Gram-negative blood culture nucleic acid test in combination with antimicrobial stewardship intervention against Gram-negative bacteremia.

    Science.gov (United States)

    Bork, Jacqueline T; Leekha, Surbhi; Heil, Emily L; Zhao, LiCheng; Badamas, Rilwan; Johnson, J Kristie

    2015-03-01

    Rapid identification of microorganisms and antimicrobial resistance is paramount for targeted treatment in serious bloodstream infections (BSI). The Verigene Gram-negative blood culture nucleic acid test (BC-GN) is a multiplex, automated molecular diagnostic test for identification of eight Gram-negative (GN) organisms and resistance markers from blood culture with a turnaround time of approximately 2 h. Clinical isolates from adult patients at the University Maryland Medical Center with GN bacteremia from 1 January 2012 to 30 June 2012 were included in this study. Blood culture bottles were spiked with clinical isolates, allowed to incubate, and processed by BC-GN. A diagnostic evaluation was performed. In addition, a theoretical evaluation of time to effective and optimal antibiotic was performed, comparing actual antibiotic administration times from chart review ("control") to theoretical administration times based on BC-GN reporting and antimicrobial stewardship team (AST) review ("intervention"). For organisms detected by the assay, BC-GN correctly identified 95.6% (131/137), with a sensitivity of 97.1% (95% confidence interval [CI], 90.7 to 98.4%) and a specificity of 99.5% (95% CI, 98.8 to 99.8%). CTX-M and OXA resistance determinants were both detected. Allowing 12 h from Gram stain for antibiotic implementation, the intervention group had a significantly shorter duration to both effective (3.3 versus 7.0 h; P < 0.01) and optimal (23.5 versus 41.8 h; P < 0.01) antibiotic therapy. BC-GN with AST intervention can potentially decrease time to both effective and optimal antibiotic therapy in GN BSI.

  11. Blood glucose testing in the hospital: error sources and risk management.

    Science.gov (United States)

    Nichols, James H

    2011-01-01

    Glucose testing in the hospital with point-of-care devices presents multiple opportunities for error. Any device can fail under the right conditions. For glucose monitoring in the hospital, with thousands of operators, hundreds of devices, and dozens of locations involved, there is ample opportunity for errors that can impact the quality of test results. Errors can occur in any phase of the testing process: preanalytic, analytic, or postanalytic. Common sources of meter error include patient or methodology interferences, operator mistakes, environmental exposure, and device malfunction. Early models of glucose meters had few internal checks or capability to warn the operator of meter problems. The latest generation of glucose monitors has a number of internal checks and controls engineered into the testing process to prevent serious errors or warn the operator by suppressing test results. Some of these control processes are built into the software and data management system of the meters, others require the hospital to do something, such as regularly clean the meter or analyze control samples of known glucose concentration, to verify meter performance. Hospitals need to be aware of the potential for errors by understanding weaknesses in the testing process that could lead to erroneous results and take steps to prevent errors from occurring or to minimize the harm to patients when errors do occur. The reliability of a glucose result will depend on the balance of internal control features available from manufacturers in conjunction with the liquid control analysis and other control processes (operator training, device validation, and maintenance) utilized by the hospitals.

  12. Validation of Cobas AmpliPrep/Cobas TaqMan HIV-1 Test on dried blood spots

    Directory of Open Access Journals (Sweden)

    N Ruiz

    2012-11-01

    Full Text Available The plasma specimen is the gold standard for viral load monitoring, the key method to assess the effect of antiviral chemotherapy and to monitor progression of the disease toward AIDS. Nevertheless, several works endorse the use of dried blood spots (DBS on filter paper for the reliable quantification of the levels needed to take therapeutic decisions, detect of treatment failure and monitor the occurrence of drug resistance. The purpose of this study was to validate the use of Cobas AmpliPrep/Cobas TaqMan HIV-1 test version 2.0, with DBS. To evaluate the performance of the above mentioned kit, three stages were involved: 1- Standardization of DBS working conditions, 2- Stability studies at three temperature conditions and 3- Performance evaluation of the kit using this alternative specimen. Additionally, the viral load was quantified in parallel (plasma and DBS to 43 genetically characterized samples, with different levels of viral load. The Pearson correlation coefficient was calculated and the prediction of the value of RNA in plasma starting from the obtained value in DBS was made. Linear regression analysis was performed and coefficients of variation in precision assays were calculated. The best conditions pickups to the work with DBS were: 100 µL of blood (2 spots/50 µl, dried time between 16 and 18 hours at room temperature and, elution of the blood, 2 hours, between 2 and 8°C; in TRIS-EDTA buffer. The samples on DBS proved to be stable during the study periods. A strong correlation was attained between the measurements of viral load in plasma and DBS samples (r=0.96. The detection rate was 90.7 and the coefficient of variation between the values obtained in plasma-DBS sample pairs averaged 3.42%. The CAP/CTM HIV-1 test provided a linear response in DBS, from 330 copies/mL to 420 000 copies/mL. Overall, coefficients of variation in precision tests were below 10%. Cobas AmpliPrep/Cobas TaqMan HIV-1 test version 2.0 had a good

  13. Antioxidant Activity in the Blood and Testes of the Mottled Brown ...

    African Journals Online (AJOL)

    IJAAAR

    Department of Animal Science, University of Ibadan, Ibadan, Nigeria. ... Key words: Reproductive potentials, Mottled brown male quail, Age groups, ... oxygen species (ROS)-generating systems. ... this risk, the testes have developed a ... centrifuge model of BOSCH 90-2) at 4000rpm .... human against oxidant and radical-.

  14. First-trimester contingent screening for trisomy 21 by biomarkers and maternal blood cell-free DNA testing.

    Science.gov (United States)

    Nicolaides, K H; Wright, D; Poon, L C; Syngelaki, A; Gil, M M

    2013-07-01

    To define risk cut-offs with corresponding detection rates (DR) and false-positive rates (FPR) in screening for trisomy 21 using maternal age and combinations of first-trimester biomarkers in order to determine which women should undergo contingent maternal blood cell-free (cf) DNA testing. From singleton pregnancies undergoing screening for aneuploidies at three UK hospitals between March 2006 and May 2012, we analyzed prospectively collected data on the following biomarkers: fetal nuchal translucency thickness (NT) and ductus venosus pulsatility index for veins (DV-PIV) at 11 + 0 to 13 + 6 weeks' gestation and serum free β-human chorionic gonadotropin (β-hCG), pregnancy-associated plasma protein-A (PAPP-A), placental growth factor (PlGF) and alpha-fetoprotein (AFP) at 8 + 0 to 13 + 6 weeks. Estimates of risk cut-offs, DRs and FPRs were derived for combinations of biomarkers and these were used to define the best strategy for contingent cfDNA testing. In contingent screening, detection of 98% of fetuses with trisomy 21 at an overall invasive testing rate 21% and 11% of cases identified by first-line screening using the combined test alone, using the combined test with the addition of serum PlGF and AFP and using the combined test with the addition of PlGF, AFP and DV-PIV, respectively. Effective first-trimester screening for trisomy 21, with DR of 98% and invasive testing rate < 0.5%, can be potentially achieved by contingent screening incorporating biomarkers and cfDNA testing. Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.

  15. Development of a blood-based molecular biomarker test for identification of schizophrenia before disease onset

    Science.gov (United States)

    Chan, M K; Krebs, M-O; Cox, D; Guest, P C; Yolken, R H; Rahmoune, H; Rothermundt, M; Steiner, J; Leweke, F M; van Beveren, N J M; Niebuhr, D W; Weber, N S; Cowan, D N; Suarez-Pinilla, P; Crespo-Facorro, B; Mam-Lam-Fook, C; Bourgin, J; Wenstrup, R J; Kaldate, R R; Cooper, J D; Bahn, S

    2015-01-01

    Recent research efforts have progressively shifted towards preventative psychiatry and prognostic identification of individuals before disease onset. We describe the development of a serum biomarker test for the identification of individuals at risk of developing schizophrenia based on multiplex immunoassay profiling analysis of 957 serum samples. First, we conducted a meta-analysis of five independent cohorts of 127 first-onset drug-naive schizophrenia patients and 204 controls. Using least absolute shrinkage and selection operator regression, we identified an optimal panel of 26 biomarkers that best discriminated patients and controls. Next, we successfully validated this biomarker panel using two independent validation cohorts of 93 patients and 88 controls, which yielded an area under the curve (AUC) of 0.97 (0.95–1.00) for schizophrenia detection. Finally, we tested its predictive performance for identifying patients before onset of psychosis using two cohorts of 445 pre-onset or at-risk individuals. The predictive performance achieved by the panel was excellent for identifying USA military personnel (AUC: 0.90 (0.86–0.95)) and help-seeking prodromal individuals (AUC: 0.82 (0.71–0.93)) who developed schizophrenia up to 2 years after baseline sampling. The performance increased further using the latter cohort following the incorporation of CAARMS (Comprehensive Assessment of At-Risk Mental State) positive subscale symptom scores into the model (AUC: 0.90 (0.82–0.98)). The current findings may represent the first successful step towards a test that could address the clinical need for early intervention in psychiatry. Further developments of a combined molecular/symptom-based test will aid clinicians in the identification of vulnerable patients early in the disease process, allowing more effective therapeutic intervention before overt disease onset. PMID:26171982

  16. Effects of blood contamination of cerebrospinal fluid on results of indirect fluorescent antibody tests for detection of antibodies against Sarcocystis neurona and Neospora hughesi.

    Science.gov (United States)

    Finno, Carrie J; Packham, Andrea E; David Wilson, W; Gardner, Ian A; Conrad, Patricia A; Pusterla, Nicola

    2007-05-01

    The purpose of this study was to determine the effect of blood contamination of cerebrospinal fluid (CSF) on the results of indirect fluorescent antibody tests (IFATs) for Sarcocystis neurona and Neospora hughesi. The in vitro study used antibody-negative CSF collected from non-neurologic horses immediately after euthanasia and blood samples from 40 healthy horses that had a range of IFAT antibody titers against S. neurona and N. hughesi. Serial dilutions of whole blood were made in seronegative CSF to generate blood-contaminated CSF with red blood cell (RBC) concentrations ranging from 10 to 100,000 RBCs/microl. The blood-contaminated CSF samples were then tested for antibodies against both pathogens using IFAT. Blood contamination of CSF had no detectable effect on IFAT results for S. neurona or N. hughesi at any serologic titer when the RBC concentration in CSF was or=5) for S. neurona and N. hughesi were detected only when the corresponding serum titers were >or=160 and >or=80, respectively. The IFAT performed on CSF is reliable for testing horses for equine protozoal myeloencephalitis caused by S. neurona or N. hughesi, even when blood contamination causes the RBC concentration in CSF to be up to 10,000 RBCs/microl.

  17. A systems biology approach to the blood-aluminium problem: the application and testing of a computational model.

    Science.gov (United States)

    Beardmore, James; Rugg, Gordon; Exley, Christopher

    2007-09-01

    Transport and distribution of systemic aluminium are influenced by its interaction with blood. Current understanding is centred upon the role played by the iron transport protein transferrin which has been shown to bind up to 90% of serum total aluminium. We have coined what we have called the blood-aluminium problem which states that the proportion of serum aluminium which, at any one moment in time, is bound by transferrin is more heavily influenced by kinetic constraints than thermodynamic equilibria with the result that the role played by transferrin in the transport and distribution of aluminium is likely to have been over estimated. To begin to solve the blood-aluminium problem and therewith provide a numerical solution to the aforementioned kinetic constraints we have applied and tested a simple computational model of the time-dependency of a putative transferrin ligand (L) binding aluminium to form an Al-L complex with a probability of existence, K(E), between 0% (no complex) and 100% (complex will not dissociate). The model is based upon the principles of a lattice-gas automaton which when ran for K(E) in the range 0.1-98.0% demonstrated the emergence of complex behaviour which could be defined in the terms of a set of parameters (equilibrium value, E(V), equilibrium time, E(T), peak value, P(V), peak time, P(T), area under curve, AUC) the values of which varied in a predictable way with K(E). When K(E) was set to 98% the model predicted that ca. 90% of the total aluminium would be bound by transferrin within ca. 350 simulation timesteps. We have used a systems biology approach to develop a simple model of the time-dependency of the binding of aluminium by transferrin. To use this approach to begin to solve the blood-aluminium problem we shall need to increase the complexity of the model to better reflect the heterogeneity of a biological system such as the blood.

  18. Early detection of extended-spectrum β-lactamase from blood culture positive for an Enterobacteriaceae using βLACTA test