Laboratory Services Research Articles

Doctors' perceptions of antimicrobial resistance in the Northern West Bank, Palestine: a qualitative study.

In the West Bank, antimicrobial resistance (AMR) is increasingly and alarmingly common. Efforts are being made to introduce antimicrobial stewardship programmes (ASPs). This study explores doctors' perceptions of AMR and context-specific barriers and facilitators to ASPs at a critical point in national ASP development. Semi-structured interviews were conducted with 22 doctors working in primary healthcare, government and non-governmental hospitals in Nablus in 2019. Two researchers thematically analysed the data. Participants recognized antibiotic resistance as a major threat to health. Few felt that doctors were well informed about ASPs; many had not heard of them. However, there was willingness to expand and begin new education programmes. Barriers and facilitators to ASPs included: (i) doctors were perceived to 'misuse' antibiotics, lack awareness, favour short-term outcomes, and externalize blame; (ii) patients reportedly treat antibiotics 'like analgesia' with high expectations of doctors; (iii) resource limitations make ASPs and infection control difficult-a lack of drugs, laboratory services, infectious disease specialists, and research to develop local guidelines; and (iv) top-down policy is recommended to restrict access to antibiotics without a prescription, but should be coupled with support, collaboration and community action. Doctors' appreciation of the severity of the issue, and willingness for the expansion of existing programmes targeted at their own prescribing practices, provides a strong foundation for successful ASPs. A top-down approach to prevent inappropriate antibiotic prescribing is welcomed by participating doctors. If financial and resource limitations could be addressed, a continued multifaceted approach may enable physician, pharmacist and patient behaviours to change.

Enhancing surveillance for dengue fever in Oyo State, Nigeria – a one health approach

BackgroundDengue fever (DF) poses a growing global threat, necessitating a comprehensive one-health approach to address its complex interplay between human, animal, and environmental factors. In Oyo State, Nigeria, the true burden of DF remains unknown due to underdiagnosis and misdiagnosis as malaria, exacerbated by poor health-seeking behavior, weak surveillance systems, and inadequate health infrastructure. Adopting a one-health approach is crucial to understanding the dynamics of DF transmission.MethodsA cross-sectional study was conducted from January 2022 to April 2023 in 10 high-risk LGAs of Oyo State. It involved screening DENV in 289 febrile human blood samples and 1,015 Aedes species mosquitoes. Viral RNA from human and mosquito specimens was extracted and analyzed using RT-qPCR. A one-step lateral flow immunoassay cassette test kit detected DENV-specific IgM and IgG in humans. DENV IgM-positive participants were screened for Lassa Virus (LASV) to rule out coinfection due to an outbreak of Lassa fever. Mosquitoes recovered were morphologically identified and classified using appropriate taxonomical keys. Meteorological data was obtained from the Nigeria Meteorological Agency. Data was abridged as proportions and correlation analysis was performed.ResultThe overall seroprevalence of DENV was 128/289 (44.2%) with 19/289 (6.6%) and 109/289 (37.7%) being IgM and IgG positive respectively. DENV was detected all year round with more cases in the rainy season. LASV and DENV coinfection were detected in a participant. DENV RT-qPCR analysis in febrile patients and mosquitoes was negative. There was a high abundance of Aedes aegypti (79.5%) in all the locations surveyed with Aedes albopictus (12.3%) detected in Ido LGA and Ibadan South-East LGA and Aedes simpsoni (9.1%) in Iwajowa LGA. DF shows moderate to strong positive correlations with Aedes mosquito population, humidity, and rainfall (r = 0.419–0.61, p < 0.05), and a negative correlation with temperature (r =—0.465, p < 0.05).ConclusionThe study reveals a significant burden of DENV in Oyo State. The presence of both IgM and IgG antibodies suggests past exposure and possible recent circulation of the virus. The co-detection of LASV and DENV in one participant highlights the likely potential for co-infection. Although DENV was not detected in febrile patients and mosquitoes through RT-qPCR, the high abundance of Aedes species underscores the risk of transmission. These findings emphasize the need for enhanced surveillance systems, strengthened laboratory services, targeted vector control, and increased awareness.

Analysis of Viral Marketing Impact on Perceived Value through Trust as a Mediator in Satwa Sehat Laboratory Services

Analysis of Viral Marketing Impact on Perceived Value through Trust as a Mediator in Satwa Sehat Laboratory Services

Improvement Plan for the Pre-Analytical Process of the SEMEDICLAB Laboratory Period 2022

Objective: SEMEDIC is a clinical laboratory that performs tests in the areas of hematology, biochemistry, urinalysis, immunology, coprology, and immunochemistry. This work aims to implement a continuous improvement plan for the pre-analytical process of the SEMEDICLAB laboratory in 2022. Theoretical Framework: The research focuses on pre-analytical errors in clinical laboratories and their impact on the quality of results. It is based on the premise that, despite technological advances and automation, the pre-analytical phase remains a weak link in the clinical analysis process. Method: The present study adopts an observational and descriptive methodology, as it allows for the visualization of the environment in which the research is carried out. It should be noted that no population or sample was considered; it was based on the identification, definition, and standardization of sub-processes of the SEMEDICLAB company process. Clause 5.4 of the ISO 15189:2012 checklist was used to identify the gap between the sub-processes currently completed. Results and Discussion: The causes of the problem in the pre-analytical phase of the workers in the SEMEDICLAB laboratory were described, which were caused by non-compliance or omission of the ISO 15189: 2012 standard, related to clauses 5.4.2. "Information for patients and users," 5.4.4.2. "Instructions for pre-analytical activities," and 5.4.6 "Sample reception," where irregularities were observed. Implications of the research: Research on pre-analytical errors has a direct impact on the quality of patient care, the efficiency of clinical laboratories, and the sustainability of health systems. By identifying the causes of these errors and developing strategies to prevent them, it contributes to improving patient safety and the reliability of laboratory results. Originality/Value: The value of this type of research is multifaceted. Firstly, it contributes to improving the quality of patient care by reducing the incidence of erroneous laboratory results, which in turn reduces the risk of misdiagnosis and inappropriate treatment. Secondly, it optimizes processes in clinical laboratories, increasing efficiency and reducing costs associated with the repetition of tests and error management. Thirdly, this research promotes the development of standards and clinical practice guidelines for the prevention and management of pre-analytical errors, which helps to ensure the quality and safety of laboratory services at the national and international level.

Insights into Pneumocystis jirovecii pneumonia in South Africa (2018-2022).

Pneumocystis jirovecii (P. jirovecii) causes P. jirovecii pneumonia (PJP) - a leading opportunistic infection among persons with advanced human immunodeficiency virus (HIV). Furthermore, individuals with underlying conditions such as cancer and transplant recipients are susceptible to PJP. Most data on PJP comes from other countries, with limited knowledge about its prevalence in Africa. The aim was to describe changes in the proportion of positive PJP tests in South Africa from 2018 to 2022. A five-year retrospective study was conducted on patients with suspected P. jirovecii, detected by polymerase chain reaction (PCR). Data were obtained from the National Health Laboratory Service (NHLS), where laboratory diagnostics were done as part of routine patient care. Mann-Whitney test and chi-square tests were used to compare the age, sex, and wards with both the negative and positive results of PJP. From 2018 to 2022, a total of 8110 patients' results were retrieved and 8059 met the inclusion criteria. The positive test proportions of PJP in SA were 32.66%, 29.93%, 34.02%, 24.98%, and 25.78% respectively. The median age was 35 years, with interquartile range (IQR) of 24 to 43 years (p=0.002). Female patients had a higher positive test proportion than males (59.39% vs 38.74%, p<0.001). The proportion of positive PJP tests was higher in general wards (48.54%) and intensive care units (ICU) (18.99%) (p=0.012). The epidemiology of PJP in South Africa is similar to that of other countries in some respects but is influenced by unique factors specific to the country. These findings are crucial for public health planning, emphasizing the need for targeted PJP prevention strategies considering sex- and age-specific vulnerabilities in South Africa.

Rapid response strategies to sanitary and epidemiological emergencies in Russian Federation regions considering particular epidemiological scenarios (in case of cholera outbreaks)

Relevance. Currently, cholera poses a serious external infection risk for the Russia. Any region of Russia is at risk of cholera infestation/importation, while importation events shall be considered as a real threat to the sanitary and epidemiological wellbeing of the population. Every Russian region is characterized by a set of individual factors and conditions affecting cholera infection risks, as well as preparedness of medical and testing lab capacities. In such environment, every region of Russia is in critical need of region-specific stochastic epidemiological forecasting is critically demanded in the case of cholera infestation importation. Ability to select a most efficient rapid response strategy in every forecasted scenario is no less relevant.The study objective is to use the developed epidemiological risk assessment score for cholera infestation/importation in individual regions of Russia to eventually establish the probability for each of the three potential epidemiological scenarios, as well as to guide scenario-specific rapid response strategies.Methodology. Epidemic risk assessment score for cholera infestation/importation in Russia was developed based on region-specific quantitative evaluation of the potential epidemiological risk at public mass events and the overall epidemiological capacity in case of cholera exposure. Modifications included ranking the sets of assessment score indicators by cholera epidemiological risk exposure with a few extra sets of indicators, such as region-specific product output, economic factors, emergency incidence rate and scope of consequences. Stochastic scenarios are based on retrospective data analyzing the links between the initial epidemiological risk factors, preparedness of medical and laboratory services, and real country specific data regarding the development of the epidemiological situation amid cholera outbreaks.Results and discussion. The study develops a region-specific epidemiological risk assessment score for cholera infestation/importation for Russian Federation regions to provide an insight into the impacts of epidemiological risk factors and counter-epidemic preparedness capacities of every region, considering the implementation of each of the three potential epidemiological situation scenarios (negative, limited spreading, and favorable). The paper elaborates strategies and solutions to provide efficient rapid response in case of either scenario.Conclusion. The developed epidemiological risk assessment score for cholera infestation/importation in individual regions of Russia allows to evaluate the probability for each of the three epidemiological scenarios in a particular region depending on the total score, as well as to select most efficient scenario-specific rapid response strategies.

Analysis of Human Resources Assessment in Laboratories of Public Health Organizations Bishkek

This article provides information on the importance of laboratory services for the effective treatment process of patients. At the same time, assessing the human resources potential of laboratory services remains currently an urgent task, the solution of which requires a standardized approach and methodology. To address this issue, documents have been developed that provide guidance for assessing the human resources used to assess the public health laboratory system.

Modern trends in the development of clinical diagnostic laboratory. Innovations and experience of the state budgetary healthcare institution of the Samara region «Syzran central city and district hospital»

The article covers the issues of implementation of the complex process of centralization and optimization of the laboratory service of the State Budgetary Healthcare Institution of the Samara Region «Syzran Central City and District Hospital» and presents the main goals of this process.

First year of in-house forensic neuropathology consultations in Helsinki, Finland.

In July 2023, an in-house forensic neuropathology consultation pilot was established at the Helsinki office of the Forensic Medicine Unit, Finnish Institute for Health and Welfare. This offered an alternative to the previous practice of full outsourcing to a hospital neuropathology department. This paper aims to introduce the first year experiences of the pilot. The in-house consultant team comprised two forensic pathologists with special training in neuropathology. In-house consultations were offered for medico-legal autopsy cases with traumatic brain injury (TBI) and hypoxic-ischaemic encephalopathy. The in-house histology laboratory participated in the pilot, implementing beta-amyloid precursor protein (β-APP) stain at the end of the pilot year. An electronic database was also developed for data collection and reporting. The characteristics, costs, and duration of the first 25 consultation cases were reviewed. The cases involved mostly male decedents (84.0%) with TBI (84.0%). The median total cost of a pilot case was €624, which was substantially lower compared to the previous outsourced practice (€1013 per case + €38/84 for each microscope slide with special/immunohistochemical stain, respectively). After the implementation of β-APP stain into the in-house laboratory service, the median total cost of a pilot case was reduced further to €94. The median duration of an in-house consultation was 2.3 months. Thanks to a favourable in-house atmosphere, the first year experiences are encouraging. While the costs of the in-house consultation practice appear to be markedly lower than those of an external provider, both alternatives should be available for cases where sufficient expertise cannot be found in-house.

Standardising lipid testing and reporting in the United Kingdom; a joint statement by HEART UK and The Association for Laboratory Medicine.

Atherosclerotic cardiovascular disease remains a major cause of premature death in the UK. Lipid testing is a key tool used to assess cardiovascular risk and guide clinical management decisions. There are currently no national guidelines to provide evidence-based recommendations on lipid testing and reporting for UK laboratories and clinicians. Here we present consensus guidance, following a review of published evidence by a multidisciplinary group of UK experts across a range of laboratory and clinical services. Recommendations include: the composition of a standard lipid profile; indications for, and composition of, an enhanced lipid profile including apolipoprotein B and lipoprotein (a); use of the Sampson-NIH calculation for LDL-c estimation; and guidance on when to flag abnormal results. This consensus guidance on lipid testing and reporting in the UK has been endorsed by HEART UK and The Association for Laboratory Medicine.

Quality of hypertension management and health insurance impact: an assessment of insured and uninsured patients with systemic hypertension in a teaching Hospital in Ilorin, Nigeria.

Patient satisfaction is an important indicator used to measure quality of care and the performance of healthcare services. This study assessed patient satisfaction with the quality of hypertension care received by both insured and uninsured patients with systemic hypertension. This comparative cross-sectional study was conducted among insured and uninsured patients with systemic hypertension attending the Medical Outpatient Department clinics of the University of Ilorin Teaching Hospital, Kwara State, Nigeria, from May to July, 2023. Data were collected from 95 patients from each group, selected by systematic random sampling; using an interviewer-administered, anonymous, structured close ended questionnaire. Different aspects of the healthcare services were assessed; these include patient registration process, waiting time, staff attitudes, laboratory services, availability and cost of prescribed drugs etc. Data analysis was done using Statistical Package for the Social Sciences (SPSS) version 27.0 software. The insured patients with systemic hypertension had a higher overall mean satisfaction (74.1±20.8) compared to the uninsured group (69.3±23.2), though this was not statistically significant (p value = 0.417). However, the insured patients with systemic hypertension had significant satisfaction scores compared to uninsured hypertensive group in the domains of waiting time (63.6 ± 24.9 vs 48.0 ± 25.8, p=0.000), drug cost and availability (73.9 ± 24.1 vs 56.2 ± 25.0, p=0.000), and cost of service and care (74.1±24.0 vs 59.8±26.0, p=0.000). This study concluded that both insured and uninsured patients with systemic hypertension had comparable treatment, though the insured group had some better satisfaction scores in some of the assessed healthcare domains. The healthcare policy makers should endeavour to improve health insurance coverage, and utilize identified factors in policy formulation and implementation to encourage utilization of health insurance among patients.

Post COVID-19: Advancing medical laboratory service integration in nigeria and progress towards establishing integration guideline

BackgroundThe Nigerian healthcare system, including medical laboratories, operates in a three-tiered structure across public and private sectors. Lessons from COVID-19 show the urgent need for a guideline to drive medical laboratory service integration. ProblemLack of operational guideline to drive the integration of laboratory services has resulted in siloed operations across different medical laboratories causing duplication of resources, coordination issues, and inefficiencies. AimTo highlight the development processes of medical laboratory service integration guideline and discuss its key provisions. MethodThe Medical Laboratory Services Division (MLSD), Federal Ministry of Health (FMoH) initiated the development of a national guideline for integrating medical laboratory services. Partnering with stakeholders and engaging two consultants, a technical workshop was facilitated in January 2024. The Consultants garnered the initial inputs stakeholders made at the five-day meeting. The inputs were collated and organized to produce the guideline. The guideline was circulated to participants and other stakeholders for review and feedback received was used to finalize the document. The MLSD with support from partners further held a three-day stakeholders’ meeting in May 2024 to validate the document before submitting it to the Health Minister for endorsement. ResultThe guideline sets standards for achieving medical laboratory services and systems integration across different medical laboratories. The contents of the guideline are enumerated and respective recommendations made under each element are highlighted. ConclusionThe implementation of the guideline will help harmonize services, improve access to diagnostics, streamline processes, reduce redundancies, optimize resource utilization, enhance communication, data sharing, and pandemic preparedness.

Veterinarians approach towards antimicrobial stewardship and one health: A survey study.

Antimicrobial resistance (AMR) is one of the top 10 global public health threats. One Health approach is needed to tackle antimicrobial resistance as most antimicrobials used in animals are also used in humans and affect the environment. Although the knowledge and attitudes of personnel in the human healthcare sector are studied more frequently in Gujarat, veterinarians' approaches also play a pivotal role in attaining antimicrobial stewardship. Thus, an online survey was conducted to understand the knowledge, attitudes, and practices of veterinarians regarding AMR and antimicrobial stewardship in Gujarat. A total of 691 respondents included 300 government veterinarians (44%), 258 cooperative veterinarians (37%), 45 private veterinarians (5%), 69 MVD GVK veterinarians (10%), and 19 others (4%). Several veterinarians (77%) believe that farmers' misuse of antimicrobials contributes significantly to AMR. According to 78% of respondents, the inappropriate use of antimicrobials in food-producing animals contributes to AMR, which can be reduced by vaccines, biosecurity measures, and hygiene (79%). As per 86% of the responders, antimicrobial stewardship is important, and 81% educate farmers on the rational use of antimicrobials. Though 92% of veterinarians agreed that culture and antimicrobial sensitivity testing (AST) should be done as frequently as possible to guide antimicrobial usage, only 4% always, and 68% sometimes send samples for AST. However, 31% think it is acceptable to commence antimicrobial therapy without a confirmatory diagnosis. The study findings suggest that AMR awareness among farmers, increased provision of laboratory services, and AST at affordable costs should be developed to combat the development of AMR.

The economic burden of post-endoscopic retrograde cholangiopancreatography (ERCP) procedure infections in Italy.

The infections of multidrug-resistant organisms (MDROs) associated with duodenoscopes during endoscopic retrograde cholangiopancreatography (ERCP) procedure have become a significant cause for concern, especially in fragile patients. While the clinical impacts of these infections are well-documented, their economic implications remain underexplored. This study assesses the incidence and economic burden of post-ERCP infections in Italy using an administrative database. We conducted a retrospective observational study using administrative databases from A.O.U. Città della Salute e della Scienza di Torino. The study included all patients who underwent their first inpatient ERCP between 2018 and 2021. Infections were identified using ICD-9-CM codes for Pseudomonas aeruginosa, Clostridium difficile, Escherichia coli, Klebsiella spp., and Staphylococcus aureus. A 1-year follow-up was defined in order to estimate healthcare resource utilization and related costs, including readmissions, drug prescriptions, and outpatient specialist and laboratory services. The study included 686 inpatient ERCP cases, an overall infection rate of 4.2% was observed. Higher infection rates were observed in women (4.6%), patients over 70 years old (4.6%), emergency admissions (5.1%), and transplant patients (19.1%). The average hospital stay doubled for infected patients (24.3 vs. 11.3 days; p=0.001). Post-ERCP infections led to a 28% increase in average costs (€12,256 vs. €9,561; p=0.048). With an annual volume of 25,000 ERCP procedures, post-ERCP infections in Italy contribute approximately €2.9 million in additional direct costs per year. Post-ERCP infections impose substantial financial burdens on the healthcare system, underscoring the critical importance of implementing cost-effective prevention strategies to mitigate this public health threat in Italy.

HIV-1 Viremia and Cancer Risk in 2.8 Million People: the South African HIV Cancer Match Study

Abstract Background Most research on HIV-1 viremia and cancer risk is from high-income countries. We evaluated the association between HIV-1 viremia and the risk of various cancer types among people with HIV (PWH) in South Africa. Methods We analysed data from the South African HIV Cancer Match study, based on laboratory measurements from the National Health Laboratory Services and cancer records from the National Cancer Registry from 2004-2014. Using Cox proportional hazards models, we estimated hazard ratios (HR) for cancer incidence per unit increase in time-updated Log10 HIV-1 RNA viral load copies/mL. We created partially adjusted (sex, age, calendar year) and fully adjusted models (additionally including time-updated CD4 count). Results We included 2,770,200 PWH with 10,175 incident cancers; most common were cervical cancer (N=2,481), Kaposi sarcoma (N=1,902), breast cancer (N=1,063), and non-Hodgkin lymphoma (N=863). Hazard ratios for the association of HIV-1 viremia and cancer risk changed after partial and full adjustment and were generally attenuated for infection-related cancers but tended to increase for infection-unrelated cancers. In the fully adjusted model, HIV-1 viremia was associated with an increased risk of Kaposi sarcoma (HR per unit increase in Log10 HIV-1 RNA viral load: 1.38, 95% CI 1.35-1.42), leukemia (HR: 1.28, 95% CI 1.13-1.45), non-Hodgkin lymphoma (HR: 1.24, 95% CI 1.19-1.29), conjunctival cancer (HR: 1.19, 95% CI 1.11-1.25), and colorectal cancer (HR: 1.11, 95% CI 1.02-1.21). Associations with other cancer types were weaker or absent. Conclusions Our findings underline the importance of sustained viral suppression for cancer prevention among PWH in South Africa.

Frequency and pattern of utilization of clinical microbiological laboratory services in oral and maxillofacial surgery in a Nigerian tertiary hospital

Background: Oral and maxillofacial infections can be fatal if the services of clinical microbiological laboratory (CML) are underutilized. To the best of our knowledge, it appears that the utilization of CML services have not been properly documented in literature. The objective of this study was to determine the frequency and pattern of utilization of CML services in oral and maxillofacial surgery patients in a Nigerian tertiary hospital. Methodology: This was a retrospective cross-sectional study conducted in the department of clinical microbiology of University of Benin Teaching Hospital from January 2019 to December 2023. Data were obtained from the laboratory register and case notes of patients. Patients with incomplete data were excluded from the study. Data collected include age, gender, type of specimens, microbiological tests and services, Gram stain morphology, microbial culture growth and antimicrobial susceptibility test results. The unit of analysis was patients rather than specimens. Both descriptive and inferential statistics were performed, and p value less than 0.05 was considered significant.Results: Of the total 7,345 patients seen during the study period, specimens of 79 patients were sent to CML for analysis, given a laboratory utilization rate of 1.08%. The age range of the 79 patients was 11-101 years with a mean age of 46.1±17.6 years. More than two-third (75.9%) of the patients were younger than 60 years, and just a little more than half (57.0%) were females. Bacteriology services was the most rendered service to the oral and maxillofacial patients. Male and female equally utilize the services. Also, both young and elderly patients equally utilize the services.Conclusion: The rate of utilization of CML services in OMF surgery is relatively low. The most utilized service was bacteriology. Age and gender were not significantly associated with utilization of CML services by oral and maxillofacial patients.

Assessing the impact of the COVID-19 pandemic on uptake and experiences of gestational diabetes mellitus screening in Ontario: A parallel convergent mixed-methods study.

Gestational diabetes mellitus (GDM) is a common medical complication of pregnancy that leads to adverse outcomes for both infants and pregnant people. Early detection and treatment can mitigate these negative outcomes. The COVID-19 pandemic strained healthcare and laboratory services, including GDM screening programs. Adapted GDM screening guidelines were introduced in many jurisdictions. This study examined changes in uptake, modality, and experiences of GDM screening in Ontario, Canada during the COVID-19 pandemic. This convergent mixed-method study involved a population-based retrospective cohort analysis of Ontario-based health administrative data to describe and compare gestational diabetes screening rates among 85,228 individuals with live, in-hospital births between January 1-March 31 before (2019) and during the COVID-19 pandemic (2021 and 2022). Descriptive analyses were conducted for GDM screening pathways aligning with usual and pandemic-adapted screening guidance. Qualitative descriptive interviews were conducted about experiences and decision-making of GDM screening with 43 Ontario residents who gave birth between May 2020 and December 2021. Data were integrated during the design and interpretation phases. There were small but significant increases in GDM screening during the pandemic; likelihood of screening completion using any modality increased in 2021 and 2022 compared to 2019. Testing modality shifted; the alternate screening strategies introduced during COVID-19 were adopted by clinicians. Interview participants perceived GDM screening to be important and obligatory but accompanied by a degree of stress about potential COVID-19 exposure. Despite health system challenges experienced in Ontario during the COVID-19 pandemic, GDM screening rates increased in the study population, demonstrating the success of adapted GDM screening guidelines. Decisions about screening modalities were driven by clinician expertise, and interview participants were satisfied to provide informed consent to these recommendations.

Comprehensive Analysis of Technology Integration in Nursing, Radiology, and Laboratory Services

The uses of applied technology in nursing, radiology, and laboratory services are discussed in this paper with a special focus on the changes that have enhanced patients’ care, the flow, and the accuracy of diagnosis. Technological advancement in the form of EHRs, HL7s, PACS, and LIMS has changed both the operations of care ’patients’ engagement in their care. Electronic health records have brought a change in the management of patient information, increased errors, and communication gaps among healthcare givers. Omega tools that are related to the use of AI in radiology, especially in the aspect of image analysis, have enriched the accuracy as well as the speed of the interpretations. PACS has almost transformed the medical imaging area by making the ownership, reporting, and distribution of digital images more convenient. In laboratory services, the implementation of automation has greatly improved the speed at which samples can undergo some processes and improved the quality of the results from the tests compared to operations and operations, which may involve operator mistakes. Considering such advances as these technological tools, they bring about outcomes of care and care and efficient operation to remove time and cost factors in delivering services. This paper reviews previous research, investigates how these technologies are applied, and provides an analysis of outcomes that would be helpful to anyone concerned about how technology is changing these vital segments of health care for the better.

Health professionals contacting patients' relatives directly about genetic risk (with patient consent): current clinical practice and perspectives.

Genetic testing can provide risk information to individuals and their blood relatives. Cascade testing uptake by at-risk relatives is <50%, with suboptimal family communication a key barrier to risk notification. The practice of health professionals (HPs) directly contacting relatives (with patient consent) to assist with risk notification has significant international support, but little is known about the practices and views of HPs in Australia. We surveyed Australian clinical genetics and laboratory services (public and private) which offer genetic testing of relevance to relatives, about current practices and views. Of 104 services invited, 78 responded to our online survey (75.0% response rate; clinical n = 59/81; laboratory n = 19/23). Most clinical services (83.3%) agreed it would be beneficial to contact at-risk relatives directly. However, the majority (80.4%) do not routinely contact relatives directly, with inadequate resources (80.0%) and privacy concerns (62.2%) cited as primary reasons. If direct contact methods were used, most clinical services (65.4%) prefer a letter which includes specific information about the genetic condition. Most clinical (86.5%) and laboratory (88.2%) services saw benefit in the development of a national clinical guideline for HPs regarding direct contact. This study confirms that most clinical genetics services would see benefits to being able to assist patients by contacting relatives directly about their potential genetic risk. Our findings highlight the need for a national clinical guideline clarifying HPs' legal and privacy obligations, and provide an opportunity for clinical services to reconsider their allocation of resources to prioritise assisting patients with risk notification.

Demographic and clinicopathological comparison among oral lichen planus, lichenoid lesions and proliferative verrucous leukoplakia: a retrospective study

BackgroundClinicopathological diagnosis and follow-up of oral lichen planus and leukoplakia are necessary due to its potential for malignant transformation and the need to differentiate it from other lichenoid diseases and proliferative verrucous leukoplakia. This study aimed to classify and compare sociodemographic and clinicopathological features among patients with oral lichen planus, oral lichenoid lesions and proliferative verrucous leukoplakia.MethodsA transversal observational study in which oral leukoplakia and oral lichen planus patients were surveyed at the Oral Pathological Anatomy Service and Applied Biotechnology Laboratory was conducted. Sociodemographic and clinicopathological data were compared for the lesions studied with the chi-square test or Fisher’s exact test.ResultsAfter classification, 21 oral lichen planus lesions, 34 oral lichenoid lesions and 12 proliferative verrucous leukoplakia lesions were evaluated. Reticular patterns are more characteristic of oral lichen planus and plaque lesions of proliferative verrucous leukoplakia. The buccal mucosa was the most affected site in oral lichen planus lesions, and it was bilateral in all patients. Epithelial dysplasia was present in almost all patients with proliferative verrucous leukoplakia.ConclusionsCompared with oral lichen planus and proliferative verrucous leukoplakia, oral lichenoid lesions presented intermediate features. This may delay proliferative verrucous leukoplakia diagnosis.