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Training and competency strategies for point-of-care testing
No full textThe increased availability and use of POCT are being influenced by many factors, such as; industry trends to move towards patient-centered care and healthcare decentralization, the increasing prevalence of infectious diseases also including the current use of Rapid SARS-CoV-2 Testing, a growing incidence of lifestyle diseases such as diabetes, heart disease, and hypertension, as well as advances in in-vitro diagnostic medical technologies. The use of POCT can increase the efficiency of services and improve outcomes for patients. However, the variability of the testing environment and conditions as well as the competency of staff performing the tests may have a significant impact on the quality and accuracy of POCT results. A majority of the staff who perform POCT are not trained laboratory staff and may not be as knowledgeable about the processes involved in testing, such as patient preparation, sample collection, management of equipment and supplies, instrument calibration and maintenance, the performance of the test, quality control, interpretation of the results, and reporting/documentation of results in each patient’s context. Therefore, staff performing POCT must have the proper training and experience to ensure test results are accurate and reliable. This short communication outlines the specific requirements for staff training based on international standards which need to be considered to ensure the quality of test results and describes competency criteria required for compliance with POCT. © 2021 International Federation of Clinical Chemistry and Laboratory Medicine. All rights reserved
Tracheobronchial stent sizing and deployment practices airway stenting practices around the world: a survey study
No full textWOS: 000583404900028PubMed: 33209383Background: Tracheobronchial stents types, uses, techniques for deployment and extraction have practice variations around the world. Methods: We collected responses by sending an online survey of 8 questions to world interventional bronchology member societies and social media groups. Results: There were 269 respondents from 47 countries. Europe had 97 respondents from 22 countries. There were 8 respondents from Australia, 7 from Africa (3 countries) and 7 from 4 countries in South America (SA). North America (NA) had 72 respondents from 3 countries. Asia had 78 respondents from 14 countries. For stent placements 15% [41] used fiberoptic bronchoscope (FB) only. Rigid bronchoscopy (RB) was solely utilized by 38% [102]. Forty-six percent [123] used a combination of RB and FB (P value <0.00001). For stent extraction 13% [19] used FB alone, 57% [85] used RB, and 36% [54] used a combination of RB and FB (P value <0.00001). Placement of stents were 50.5% [135] only by direct visualization. Twenty-three percent [61] always used fluoroscopic guidance. Twenty-six-point-five percent [71] used fluoroscopy in certain cases (P value <0.00001). Sixty percent [162] decided stent sizing by measurements of stenotic and non-stenotic areas on radiology. Twelve percent [32] respondents used sizing devices. Sixty-five percent [177] used a ruler and bronchoscope to measure stenotic areas. Thirty-eight percent [104] used visual estimation and experience. Seven percent [19] used serial balloon dilatation size. To prevent clogging of stents, 22% [59] prescribed mucolytics. Seventy-three percent [195] nebulized saline, 26% [70] had Mucomyst Nebulization, 24% [65] Nebulized bronchodilators and other methods 11% [30] were advised. Covered self-expandable metal stents (SEMS) 44% was the commonest type of stent used around the world. Silicone stents 37%, Y stents 15%, uncovered SEMS 12%, Montgomery T tube 5% followed. Polyflex stents 3% and custom-made stents 3% were least used. Biodegradable stents were used by 7.5%, and not used by 92.5%. Conclusions: Tracheobronchial stent practice norms have slowly evolved, but its practice variations lack uniformity, and have sparse evidence-based studies for its direction
Does Being A Cancer Patient or Family Caregiver of A Cancer Patient Affect Stem Cell Donation Awareness?
No full textObjective: One of the most difficult challenges regarding hematopoietic stem cell transplantation in Turkey is finding donors for allogeneic transplantation candidates who do not have related donors. This study aims to determine whether there is any difference in the awareness of stem cell donation and transplantation between cancer and noncancer patients and their family caregivers. in addition, this study aims to determine the awareness of stem cell donation and transplantation in the entire study population. Methods: This descriptive study was conducted in Turkey using a data collection form comprising questions about demographics, stem cell transplantations, donations, and medical history. on analyzing the research data, variables were expressed as mean ± standard deviation and as numbers (n) and percentages (%). the Chi-square and Fisher's exact tests were performed to evaluate differences among cancer and noncancer diagnosed patients and their family members. Results: A total of 192 patients and 169 family caregivers participated in the study. in comparison with noncancer patients, cancer patients showed more awareness on what stem cell transplantation is, how lifesaving it is, and how to donate stem cells. Similarly, the family caregivers of cancer patients were more aware of what stem cell transplantation is and how to donate stem cells. Conclusions: the results of this study showed that cancer patients and their families were more aware of stem cell donation and transplantation; however, most of the patients and families did not know enough about the national registry program and how to donate stem cells. © 2020 Wolters Kluwer Medknow Publications. All rights reserved
Lung Cancer Surgery in Patients With a History of Coronary Artery Bypass Graft: A Multicentre Study
No full textBackground: Lung cancer surgery may be required for patients with a history of coronary artery bypass graft (CABG). in this study, we evaluated the general characteristics of patients, the difficulties experienced during and after lung cancer surgery and complications and mortality rates. Method: Patients who were operated on for primary lung cancer between January 2012 and July 2017 in the participating centres were analysed retrospectively (n=7,530). Patients with a history of CABG (n=220) were examined in detail. This special group was analysed and compared with other patients operated on for lung cancer who did not have CABG (n=7,310) in terms of 30-day mortality and revision for haemorrhage. Results: of the 7,530 patients operated on for primary lung cancer, 2.9% were found to have undergone CABG. Surgical revision was required in the early postoperative period for 6.8% of those who had CABG and 3.5% in those who did not have CABG (p=0.009). Thirty-day (30-day) mortality was 4.5% in those who had CABG and 2.9% in those who did not have CABG (p=0.143). Further analysis of patients who had undergone CABG demonstrated that video-assisted thoracoscopic surgery (VATS) resulted in fewer complications (p=0.015). Patients with a left-sided left internal mammary artery (LIMA) graft had a higher number of postoperative complications (p=0.30). Conclusions: Patients who had CABG suffered postoperative haemorrhage requiring a revision twice as often, and a tendency towards higher mortality (non-statistically significant). in patients with a history of CABG, VATS was demonstrated to have fewer complications. Patients with a LIMA graft who had a left-sided resection had more postoperative complications. © 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ
Oxytocin and cabergoline alleviate ovarian hyperstimulation syndrome (OHSS) by suppressing vascular endothelial growth factor (VEGF) in an experimental model
No full textHortu, Ismet/0000-0003-3833-0999WOS: 000584341600001PubMed: 33140116Purpose Ovarian hyperstimulation syndrome (OHSS) is a life-threatening complication of ovarian stimulation in reproductive medicine. Here, we aimed to investigate the role of oxytocin (OT) and cabergoline in the prevention and alleviation of the OHSS in an animal model. Methods Thirty-five female immature Wistar rats were randomly assigned to five groups. the control group (n = 7) received saline only for five consecutive days. Remaining twenty-eight rats received 10 IU of pregnant mare serum gonadotropin (PMSG) followed by 30 IU of human chorionic gonadotropin (hCG) to induce OHSS. Group 2 (n = 7) was managed with no additional intervention after the induction of OHSS. Group 3 (n = 7) received 100 mu g/kg cabergoline 2 h before the PMSG injection for four consecutive days and 2 h before the hCG injection on the fifth day. Group 4 (n = 7) and group 5 (n = 7) received 80 mu g/kg and 160 mu g/kg OT after induction of OHSS, respectively. Oxytocin was administered 2 h before the PMSG injection for four consecutive days and 2 h before the hCG injection on the fifth day. Body and ovary weight, vascular permeability (VP), VEGF expression in the ovaries, and levels of VEGF in the peritoneal fluids were examined in all animals. Results Cabergoline and OT reduced body weight, ovary weight, and VP compared to that of the OHSS group (p < 0.05). VEGF expressions in ovaries and peritoneal VEGF levels were decreased in cabergoline and OT groups compared to that of the OHSS groups (p < 0.001 for cabergoline and OT-80 mu g/kg; p < 0.00001 for OT-160 mu g/kg). However, there was no statistically significant difference in these parameters between the OT and cabergoline groups. Conclusion Both OT and cabergoline were active in the alleviation of OHSS through suppression of VEGF and VP. Overall, we conclude that OT is effective for downregulation for VEGF and improvement in vascular permeability in OHSS
Use of rotational thromboelastometry for a global screening of coagulation profile in patients of myeloproliferative neoplasms
No full textGoren Sahin, Deniz/0000-0002-3189-6810WOS: 000523124200001PubMed: 32245332Chronic myeloproliferative neoplasms (MPN) are clonal disorders of hematopoietic stem/progenitor cell characterized by thrombohemorrhagic complications and a tendency to transform into acute leukemia. the pathogenesis of thrombosis in MPN is complex and results from a multifaceted interplay of clinical and disease-related factors. Rotational thromboelastometry (ROTEM) provides the complete and rapid information about all stages of the coagulation process. Here, we assess ROTEM parameters as a screening of coagulation profile in patients with MPNs. in particular, higher mean maximum clot firmness values were found in Essential thrombocythemia and Polycythemia vera patients when compared to healthy controls. Rotational thromboelastometry may be able to detect MPN patients who are susceptible to thrombotic and/or hemorrhagic complications. the predictive value of ROTEM for thrombosis remains to be established to classify subsets of patients at prominent risk who may benefit from prophylaxis with antithrombotic drugs
PERFORMANCE OF THE EULAR/ACR 2019 CLASSIFICATION CRITERIA FOR SYSTEMIC LUPUS ERYTHEMATOSUS IN EARLY DISEASE, ACROSS SEXES AND ETHNICITIES
No full textAnnual European Congress of Rheumatology (EULAR) -- JUN 03, 2020 -- ELECTR NETWORKWOS: 000555905001115[No abstract available
Miyelofibrozisli olgularda allojenik kök hücre nakil sonuçlarımız: tek merkezli, retrospektif bir analiz
No full textAmaç: Primer miyelofibrozis (PMF), kronik miyeloproliferasyon, atipik megakaryositik hiperplazi vekem k l ğ f broz s le karakter ze klonal b r kök hücre hastalığıdır. Bu hastalarda günümüzde halengöster leb lm ş tek şifa sağlayıcı tedavi seçeneği olan allojenik kök hücre nakli, ülkemiz SağlıkBakanlığı endikasyon listesine göre DIPPS skoru orta-2 veya yüksek riskli birincil veya ikincilmiyelofibrozisli hastalara önerilmektedir. Çalışmamızda miyelofibrozisli hastalarımızın allojenik nakilsonrası takip verilerini paylaşmayı amaçladık.Gereç ve Yöntem: Geriye dönük ve kesitsel bu değerlendirmeye Şişli Florence Nightingale HastanesiHematopoetik Kök Hücre Nakil Merkezinde 2011-2016 yılları arasında allojenik nakil yapılan ve takipteolan toplam dokuz miyelofibrozis tanılı olgu dahil edildi. Olguların tüm demografik özellikleri yanı sıra,DIPPS-plus skorları, engrafman süreleri, graft versus host hastalığı (GVHH) görülme sıklıkları gibiparametreler ve sağ kalım verileri kaydedildi.Bulgular: Olguların ortalama yaşları 49,7 (34-63) yıl idi. Tanı ile transplant arası geçen süre ortalama30,2 ay (1,7-65,2) idi. Tam uyumlu kardeş nakil altı olguda ve akraba dışı nakil üç olguda yapıldı. Tamuyumlu kardeş nakilde, nötrofil engraftman süresinin akraba dışı nakile göre anlamlı kısa iken,trombosit engraftman sürelerinin ise tam uyumlu kardeş nakilde kısa olma eğilimi ile birlikte istatistikselanlamlı farklılık göstermediği izlenmiştir. Toplam dokuz hastanın takibinde üç olguda (%33,4) akut, altıolguda (%66,6) kronik GVHH geliştiği izlenmiştir. Kümülatif sağ kalım beş yıllık %70’dir.Sonuç: Merkezimizde miyelofibrozisli olguların değerlendirmelerinde, özellikle toplam sağ kalım oranıliteratürdeki birçok seriye göre yüksek görünmektedir. Hasta sayısının az oluşu önemli bir sınırlamaolmakla birlikte hem yaş hem de verici çeşitliliği mevcuttur. Ayrıca yüksek GVHH oranlarına karşın sağkalımın yüksek kalmasının, hasta takibinin ve komplikasyonların iyi yönetiminin önemini vurguladığınıdüşünüyoruz
Aşırı Ağırlıklı ve Şişman Ergenlerde Depresyon ve Kardiyometabolik Risk Etmenlerinin İlişkisi
No full textObjective: The aim of this study was to examine whether the presence of depression in overweight or obese adolescents increases the likelihood of cardiometabolic risk factors. Method: We performed a retrospective cross-sectional analysis of the data obtained from overweight or obese, adolescents aged 11-18 years, who were evaluated in our clinic from January 2012 to December 2015. Depression was evaluated by “Children’s Depression Inventory”. Hypertension, dyslipidemia, hyperinsulinemia, hyperglycemia and insulin resistance were defined as cardiometabolic risk factors. The degree of obesity was calculated as the body mass index standard deviation score. Results: Among 283 adolescents who were included in the study, 75 (26.5%) were overweight, and 208 (73.5%) were obese. The mean age was 14.02±1.67 years and 168 (59.4%) subjects were girls. The mean body mass index standard deviation score was 2.36±0.62, The mean Children’s Depression Inventory score was 12.72±6.5, and 47 (16.6%) of the participants were in depression. Depression was more frequently detected in females than in males (p=0.047). Body mass index standard deviation score was in positive correlation with Children’s Depression Inventory scores (r=0.123, p= 0.038). In univariate analyses, hyperinsulinemia was found to be 2.3 times more frequent in depressed group than in nondepressed group (p=0.026). In logistic regression analysis this relation disappeared. Conclusion: We showed that severity of depression increased, as the degree of obesity increased, but we could not find any clear relationship between depression and cardiometabolic risk factors in overweight or obese adolescents.Amaç: Bu çalışmanın amacı aşırı ağırlıklı ya da şişman ergenlerde depresyon varlığının kardiyometabolik risk etmenlerini artırıp artırmadığını incelemektir. Yöntem: Ocak 2012 - Aralık 2015 tarihleri arasında kliniğimizde değerlendirilen, 11-18 yaş arası aşırı ağırlıklı ya da şişmanergenlerin verilerinin geriye dönük kesitsel çözümlemesi yapıldı. Depresyon, “Çocuklar için Depresyon Ölçeği” ile değerlendirildi. Hipertansiyon, dislipidemi, hiperinsülinemi, hiperglisemi ve insülin direnci kardiyometabolik risk etmenleri olarak tanımlandı. Şişmanlık derecesi, beden kitle indeksi standart sapma skoru olarak hesaplandı. Bulgular: Çalışmaya alınan 283 ergenden 75'i (% 26.5) aşırı ağırlıklı, 208'i (% 73.5) şişmandı. Olguların yaş ortalaması 14.02 ± 1.67 yıldı ve 168'i (% 59.4) kızdı. Beden kitle indeksi standart sapma skoru ortalama değeri 2.36 ± 0.62, Çocuklar için Depresyon Ölçeği ortalama puanı 12.72 ± 6.5 idi ve katılımcıların 47'sinde (% 16.6) depresyon saptandı. Depresyon sıklığı kızlarda erkeklerden daha yüksek saptandı (p = 0.047). Beden kitle indeksi standart sapma skoru ile Çocuklar için Depresyon Ölçeği puanları arasında aynı yönlü anlamlı ilişki saptandı (r=0.123, p = 0.038). Tek değişkenli çözümlemelerde depresyonu olanlarda hiperinsülinemi, depresyonu olmayanlara gören 2.3 kat daha sık bulundu (p = 0.026). Lojistik regresyon çözümlemesinde bu ilişki kayboldu. Sonuç: Şişmanlığın derecesi arttıkça depresyonun şiddetinin arttığını gösterdik, ancak aşırı ağırlıklı ya da şişman ergenlerde depresyon ve kardiyometabolik risk etmenleri arasında bir ilişki bulamadı
RELATIONSHIP BETWEEN MIGRAINE WITH VISUAL AURA AND MIGRANEOUS INFARCTIONS: REPORT OF TWO CASES
No full textWOS:000587365203330[No Abstract Available]0264