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Preanalytic Error Rates for the Central Laboratory of a Large-scale Public Hospital in Turkey

Journal of Pharmacy and Pharmacology 2016年第7期4卷 318-321页

作者： Kemal TOrker ULUTAS Metin CELIK Beril AKCIMEN Esin Damla Z. KARACOR Fatma KARAZiNDiYANOGLU Antakya state Hospital Department of Medical Biochemistry Antakya 31000 Hatay TURKEY osmaniye state hospitals Central Clinical Laboratory Osmaniye 80000 Osmaniye TURKEY Kadirli state Hospital Central Biochemistry Laboratory Kadirli 80750 Hatay TURKEY

Abstract： The pre and post analytical phase in a testing cycle contributes up to 93% of total laboratory errors. However, pre-analytical phase is primarily responsible for errors. Hence, it is of precise importance for the laboratory to study error occurrence rates during the testing cycle and implement a quality improvement plan to release an accurate result. The present study was conducted during the period Jan-Nov 2014 in the Central Clinical Lab in osmaniye state Hospital, Turkey. During period of 11 months, 626897 samples were monitored for major preanalytical problems at the receiving counter of the Central Clinical Laboratory. Among all preanalytic laboratory errors, 35.4% of the errors were associated with clotted sample, 25.5% errors with inadequate sample, and 25.3% errors with hemolysed sample in the laboratory. Assessment considering the departments showed that emergency unit had the highest error rates （hemolysis： 52.5%, lipemic： 42.9%, damaged： 34.6%, clotted： 34.2%, inadequate： 26.8%, wrong material： 17.6%, wrong barcode： 16.7%）. There was significant difference among the departments in terms of preanalytic errors （p 〈 0.001）. Based on these observations, major preanalytic errors are of great concern and needs corrective approach via proper educational programs to related personals. If this area is ignored, that can lead to negative patient outcome. However, a better specimen quality and patient satisfaction are achieved with the high quality personal-based education regarding pre-analytical errors.

关键词： Pre-analytical errors biochemistry laboratory hemolysis.

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New parameter in diagnosis of acute appendicitis:Platelet distribution width

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World Journal of Gastroenterology 2015年第6期21卷 1821-1826页

作者： Bulent Dinc Alten Oskay Selcan Enver Dinc Bilge Bas Sabri Tekin Department of General Surgery Ataturk State Hospital Department of Emergency Denizli State Hospital Department of Emergency Isparta State Hospital Department of Gastroenterology Ataturk State Hospital Department of Surgery Medical Park Hospitals

AIM:To investigate the diagnostic accuracy of the mean platelet volume and platelet distribution width in acute ***:This retrospective,case-controlled study compared 295 patients with acute appendicitis(Group?Ⅰ),100 patients with other intra-abdominal infections(GroupⅡ),and 100 healthy individuals(GroupⅢ)between January 2012 and January *** age,gender,and white blood cell count,neutrophil percentage,mean platelet volume,and platelet distribution width values from blood samples were compared among the *** analyses were performed using SPSS for Windows 21.0 *** addition,the sensitivity,specificity,positive and negative predictive values and likelihood ratios,and diagnostic accuracy were ***:The mean ages of patients were 29.9±12.0years for Group?Ⅰ,31.5±14.0 years for GroupⅡ,and30.4±13.0 years for GroupⅢ.Demographic features such as age and gender were not significantly different among the *** blood cell count,neutrophil percentage and platelet distribution width were significantly higher in Group?Ⅰ?compared to groupsⅡandⅢ(P<0.05).Diagnostically,the sensitivity,specificity and diagnostic accuracy were 73.1%,94.0%,and 78%for white blood cell count,70.0%,96.0%,and 76.0%for neutrophil percentage,29.5%,49.0%,and 34.0%for mean platelet volume,and 97.1%,93.0%,and 96.0%for platelet distribution width,*** highest diagnostic accuracy detected was for platelet distribution width between Group?Ⅰ?and GroupⅢ(P<0.01).CONCLUSION:Platelet distribution width analysis can be used for diagnosis of acute appendicitis without requiring additional tests,thus reducing the cost and loss of time.

关键词： Appendicitis Diagnosis Platelet function test Plat

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Advances in transcatheter aortic valve replacement

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Journal of Geriatric Cardiology 2019年第9期16卷 724-732页

作者： Tomo Ando Alexandros Briasoulis Sidakpal Panaich Wayne state University/Detroit Medical Center Detroit Michigan United States University of Iowa Hospitals and Clinics Iowa Iowa United States

Evidence in transcatheter aortic valve replacement(TAVR) has accumulated rapidly over the last few years and its application to clinical decision making are becoming more important. In this review, we discuss the adva... 详细信息

关键词： Aortic stenosis Periprocedural complications Surgical risk Transcatheter aortic valve replacement

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Perioperative mortality in children in a tertiary teaching hospital in Nigeria: a prospective study

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World Journal of Pediatric Surgery 2021年第1期4卷 25-31页

作者： Ademola Olusegun Talabi Olugbenga Olalekan Ojo Olurotimi Idowu Aaron Oludayo Adedapo Sowande Folayemi Aramide Faponle Olusanya Adejuyigbe Department of Surgery Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals ComplexIle-lfeOsun StateNigeria Department of Anaesthesia Obafemi Awolowo University/Obafemi Awolowo University Teaching Hospitals ComplexIle-lfeOsun StateNigeria

Background Perioperative mortality is one of the tools that can help to assess the adequacy of healthcare delivery in a *** audit was conducted to determine the 24-hour,7-day and 30-day perioperative mortality rates and the predictors of mortality in a pediatric surgical *** This was a prospective study of children whose ages ranged from a few hours to 15 years and who were operated on between May 2019 and April *** primary outcome was to determine the incidence of in-hospital perioperative *** A total of 530 procedures were done in 502 *** ages ranged from a few hours to 15 years with a median of 36 *** 24-hour,7-day and 30-day mortality rates were 113.2 per 10000 procedures[95%confidence interval(CI)=40 to 210],207.6 per 10000 procedures(95%CI=110 to 320)and 320.8 per 10000 procedures(95%CI=190 to 470),*** anomalies complicated by postoperative sepsis contributed to death in the majority of *** predictors of mortality were neonatal age group[adjusted odds ratio(AOR)=19.92,95%CI=2.32 to 170.37,p=0.006],higher American Society of Anesthesiologists Physical Status III and above(AOR=21.6,95%CI=3.05 to 152.91,p=0.002),emergency surgery(AOR=17.1,95%CI=5.21 to 60.27,p=0.001),congenital anomalies(AOR=12.7,95%CI=3.37 to 47.52,p=0.001),and multiple surgical procedures(AOR=9.7,95%CI=2.79 to 33.54,p=0.001).Conclusion Perioperative mortality remains high in our institution.

关键词： mortality prospective children

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Postoperative pain assessment and management among nurses in selected hospitals in Benin City,Edo state,Nigeria

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Journal of Integrative Nursing 2023年第3期5卷 203-209页

作者： Timothy Aghogho EHWARIEME Uzezi JOSIAH Oluwaseun Oluwafunmilayo ABIODUN Department of Nursing Science School of Basic Medical SciencesUniversity of BeninBenin CityEdo StateNigeria Department of Nursing Science Delta State UniversityAbrakaDelta StateNigeria Department of Nursing Science Achievers UniversityOwoOndo StateNigeria

Objective:This study was designed to determine the nurse assessment of postoperative pain and its management in selected hospitals,Benin City,Edo state,*** and Methods:A descriptive cross-sectional survey was *** target population consist of 222 purposely nurses who are in the cadre of nursing officer II to chief nursing officer who works in the various surgical wards/units of the selected health *** data were collected from the participants using the pretested structured questionnaire developed by the ***:Results showed that 66.2%of nurses had a poor level of knowledge on postoperative pain *** McGill Pain Questionnaire was the most used pain assessment tool with a mean score of 2.84 whereas the Dallas Pain Questionnaire was the least used with a mean score of 1.90.“Providing clean,calm,and well-ventilated ward environment”(3.69±0.61)was the most used nonpharmacological method for postoperative pain management,followed by“distraction,relaxation,and guided imagery”(3.52±0.50),“dressing,bandage,splint,and reinforce wound sites postoperatively”(3.39±0.54),and“early ambulation/exercise”(3.20±0.62).The most used pharmacological interventions were“acetaminophen”(3.63±0.55),“topical anesthetic”(2.92±0.62),“nonselective nonsteroidal anti-inflammatory drugs”(2.87±0.43),and“mixed opioid agonist-antagonist”(2.56±0.56).Conclusion:There is a poor level of knowledge on postoperative pain assessment among nurses in this study *** is,therefore,pertinent for hospitals to organize continuous in-service training for postoperative pain assessment and management,especially on nonpharmacological approaches among nurses.

关键词： Knowledge nurses postoperative pain assessment postoperative pain assessment tool postoperative pain management

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Reality of evidence-based practice in palliative care

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Cancer Biology & Medicine 2015年第3期12卷 193-200页

作者： Claire Visser Gina Hadley Bee Wee Harris Manchester College University of Oxford Sir Michael Sobell House Oxford University Hospitals NHS Trust

There has been a paradigm shift in medicine away from tradition, anecdote and theoretical reasoning from the basic sciences towards evidence-based medicine(EBM). In palliative care however, statistically significant benefits may be marginal and may not be related to clinical meaningfulness. The typical treatment vs. placebo comparison necessitated by ‘gold standard' randomised controlled trials(RCTs) is not necessarily applicable. The complex multimorbidity of end of life care involves considerations of the patient's physical, psychological, social and spiritual needs. In addition, the field of palliative care covers a heterogeneous group of chronic and incurable diseases no longer limited to cancer. Adequate sample sizes can be difficult to achieve, reducing the power of studies and high attrition rates can result in inadequate follow up periods. This review uses examples of the management of cancer-related fatigue and death rattle(noisy breathing) to demonstrate the current state of EBM in palliative care. The future of EBM in palliative care needs to be as diverse as the patients who ultimately derive benefit. Non-RCT methodologies of equivalent quality, validity and size conducted by collaborative research networks using a ‘mixed methods approach' are likely to pose the correct clinical questions and derive evidencebased yet clinically relevant outcomes.

关键词： Palliative care evidence-based medicine (EBM) multimorbidity clinical meaningfulness

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Utilization of access to colorectal cancer screening modalities in low-income populations after medicaid expansion

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World Journal of Gastrointestinal Oncology 2023年第9期15卷 1653-1661页

作者： Gerald Fletcher Joan Culpepper-Morgan Alvaro Genao Eric Alatevi Department of Gastroenterology NYC Health+Hospitals/HarlemNew YorkNY 10037United States Department of Gastroenterology NYC Health+Hospitals/Harlem506 Lenox AveNew YorkNY 10037United States

BACKGROUND Colorectal cancer(CRC)remains a relevant public health *** research suggests that racial,economic and geographic disparities impact *** the expansion of Medicaid eligibility as a key component of the Affordable Care Act(ACA),there is a dearth of information on the utilization of newly gained access to CRC screening by low-income *** study investigates the impact of the ACA’s Medicaid expansion on utilization of the various CRC screening modalities by low-income *** working hypothesis is that Medicaid expansion will increase access and utilization of CRC screening by low-income *** To investigate the impact of the Affordable Care Act and in particular the effect of Medicaid expansion on access and utilization of CRC screening modalities by Medicaid state expansion status across the United *** This was a quasi-experimental study design using data from the Behavioral Risk Factor Surveillance System,a large health system survey for participants across the United states and with over 2.8 million *** period of the study was from 2011 to 2016 which was dichotomized as pre-ACA Medicaid expansion(2011-2013)and post-ACA Medicaid expansion(2014-2016).The change in utilization of access to CRC screening strategies between the expansion periods were analyzed as the dependent *** analyses included stratification of the access by ethnicity/race,income,and education *** A greater increase in utilization of access to CRC screening was observed in Medicaid expansion states than in nonexpansion states[+2.9%;95%confidence interval(95%CI):2.12,3.69].Low-income participants showed a+4.02%(95%CI:2.96,5.07)change between the expansion periods compared with higher income groups+3.19%(1.70,4.67).Non-Hispanic Whites and Hispanics[+3.01%(95%CI:2.16,3.85)vs+5.51%(95%CI:2.81,8.20)]showed a statistically significant increase in utilization of access but not in Non-Hispanic Blac

关键词： Medicaid expansion Colorectal cancer screening Low-income Disparities Minorities Affordable care act

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Journal of Integrative Nursing 2024年第3期6卷 169-177页

作者： Oluwaseyi Abiodun AKPOR Ishaq Ajibola AFOLAYAN Funmilayo Abimbola IBITOBA Oghenerobor Benjamin AKPOR Olubukola Esther ABIODUN-OJO Department of Nursing Science Afe Babalola UniversityAdo-ekitiEkiti StateNigeria Afe Babalola University Ado-ekitiEkiti StateNigeria

Objective:The study assessed the quality of life(QoL)and coping strategies of patients on hemodialysis in selected hospitals in Ilorin,Kwara ***:The study was a descriptive cross-sectional design using a quantitative strategy.A multistage sampling technique was adopted to select 80 *** data were collected using an adapted questionnaire including four sections:sociodemographic characteristics,hemodialysis stressor scale consisting of four stressors,Jaloweic Coping Scale consisting of eight coping strategies,and QoL consisting of four *** data were analyzed using SPSS version ***:Findings from the study revealed that 50%of the participants were between the ages of 18 and 39 years,40%of the participants have been on hemodialysis for 1-2 years,whereas 52.5%had hypertension as a comorbidity.A total of 12.5%,63.8%,and 23.8%of the respondents were categorized as experiencing low,moderate,and high stress due to hemodialysis,*** of the respondents revealed that 49.4%had no problem in self-care *** monthly income(χ^(2)=16.36,P=0.04)was observed to be significantly associated with coping strategies,whereas religion(χ^(2)=11.14,P=0.03)and frequency of hemodialysis(χ^(2)=10.26,P=0.04)were significantly associated with coping ***:All participants experienced stress at varying *** results in marked changes in the quality of patients’life,since it includes a number of modifications and restrictions,which affects patients’health *** study revealed a wide range of information on the psychological and physiological stressors of people under hemodialysis.

关键词： Chronic renal failure coping strategies health-related quality of life hemodialysis

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Oligodendrocyte pathology in fetal alcohol spectrum disorders

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Neural Regeneration Research 2022年第3期17卷 497-502页

作者： Nune Darbinian Michael E.Selzer Center for Neural Repair and Rehabilitation(Shriners hospitals Pediatric Research Center) Lewis Katz School of Medicine at Temple UniversityPhiladelphiaPAUSA

The pathology of fetal alcohol syndrome and the less severe fetal alcohol spectrum disorders includes brain *** studies have shed light on the molecular mechanisms underlying these white matter *** models of fetal alcohol syndrome and human studies have shown suppressed oligodendrocyte differentiation and apoptosis of oligodendrocyte precursor *** exposure led to reduced expression of myelin basic protein and delayed myelin basic protein expression in rat and mouse models of fetal alcohol syndrome and in human histopathological *** studies have reported increased expression of many chemokines in dysmyelinating disorders in central nervous system,including multiple sclerosis and fetal alcohol *** ethanol exposure reduced levels of the neuroprotective insulin-like growth factor-1 in fetal and maternal sheep and in human fetal brain tissues,while ethanol increased the expression of tumor necrosis factor α in mouse and human *** matter lesions have been induced in the developing sheep brain by alcohol exposure in early *** fetal alcohol syndrome models have shown reduced axon diameters,with thinner myelin sheaths,as well as reduced numbers of oligodendrocytes,which were also morphologically aberrant *** of markers for mature myelination,including myelin basic protein,also were *** accumulating knowledge concerning the mechanisms of ethanol-induced dysmyelination could lead to the development of strategies to prevent dysmyelination in children exposed to ethanol during fetal *** studies using fetal oligodendrocyte-and oligodendrocyte precursor cell-derived exosomes isolated from the mother's blood may identify biomarkers for fetal alcohol syndrome and even implicate epigenetic changes in early development that affect oligodendrocyte precursor cell and oligodendrocyte function in *** combining various imaging modalities with mo

关键词： alcohol development dysmyelination ethanol fetal alcohol syndrome fetal brain myelin basic protein neurodegeneration oligodendrocyte injury oligodendrocyte precursor cells

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Pathological and Physiological High-frequency Oscillations on Electroencephalography in Patients with Epilepsy

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Neuroscience Bulletin 2024年第5期40卷 609-620页

作者： Hongyi Ye Cong Chen Shennan A.Weiss Shuang Wang Department of Neurology Epilepsy CenterSecond Affiliated HospitalSchool of MedicineZhejiang UniversityHangzhou310009China Department of Neurology State University of New York DownstateBrooklynNY11203USA Department of Physiology and Pharmacology State University of New York DownstateBrooklynNY11203USA Department of Neurology New York City Health+Hospitals/Kings CountyBrooklynNY11203USA

High-frequency oscillations(HFOs)encompass ripples(80 Hz–200 Hz)and fast ripples(200 Hz–600 Hz),serving as a promising biomarker for localizing the epileptogenic zone in *** fast ripples are always pathological,while ripples may be physiological or *** physiological from pathological ripples is important not only for designating epileptogenic brain regions,but also for investigations that study ripples in the context of memory encoding,consolidation,and recall in patients with *** studies have sought to identify distinguishing features between pathological and physiological ripples over the past two *** and pathological ripples differ with respect to their spatial location,cellular mechanisms,morphology,and coupling with background electroencephalographic *** studies have demonstrated that differentiating between pathological and physiological ripples can improve surgical outcome *** this review,we summarize the characteristics,differences,and applications of pathological and physiological HFOs and discuss strategies for their clinical translation.

关键词： Ripples Epilepsy Memory Sleep Surgical outcome

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