Laboratory Test Results Of Patients Research Articles

Association between hemogram‑derived indices and culture‑positive infections in intensive care population.

To investigate the relationship between hemogram parameters and bacterial growth in cultures of blood, urine or sputum in intensive care unit patients. This retrospective, observational, cross-sectional study was conducted in a tertiary referral hospital between March 2015 and December 2017. Baseline demographic and clinical characteristics, hemogram parameters and other laboratory test results of patients admitted to intensive care unit were recorded. Patients were divided into two groups as patients who were infected, and those who did not have any infectious agents grown in the culture dish, and then the groups were compared with each other. There were no significant differences between the groups in terms of baseline demographic and clinical characteristics. When the groups were compared in terms of hemogram parameters, the neutrophil‑to‑lymphocyte ratio (p < 0.001), platelet‑to‑lymphocyte ratio (p = 0.013), plateletcrit (p = 0.028) and mean platelet volume (p < 0.001) were significantly higher in infected patients than in non-infected patients. We suggest that neutrophil‑to‑lymphocyte ratio, platelet‑to‑lymphocyte ratio, plateletcrit, and mean platelet volume could be used as infection markers in the intensive care unit population (Tab. 1, Ref. 25).

Verification of reference intervals in routine clinical laboratories: practical challenges and recommendations.

Reference intervals (RIs) are fundamental tools used by healthcare and laboratory professionals to interpret patient laboratory test results, ideally enabling differentiation of healthy and unhealthy individuals. Under optimal conditions, a laboratory should perform its own RI study to establish RIs specific for its method and local population. However, the process of developing RIs is often beyond the capabilities of an individual laboratory due to the complex, expensive and time-consuming process to develop them. Therefore, a laboratory can alternatively verify RIs established by an external source. Common RIs can be established by large, multicenter studies and can subsequently be received by local laboratories using various verification procedures. The standard approach to verify RIs recommended by the Clinical Laboratory Standards Institute (CLSI) EP28-A3c guideline for routine clinical laboratories is to collect and analyze a minimum of 20 samples from healthy subjects from the local population. Alternatively, "data mining" techniques using large amounts of patient test results can be used to verify RIs, considering both the laboratory method and local population. Although procedures for verifying RIs in the literature and guidelines are clear in theory, gaps remain for the implementation of these procedures in routine clinical laboratories. Pediatric and geriatric age-groups also continue to pose additional challenges in respect of acquiring and verifying RIs. In this article, we review the current guidelines/approaches and challenges to RI verification and provide a practical guide for routine implementation in clinical laboratories.

Sentetik kannabinoid kullanımı nedeniyle polikliniğe başvuran hastaların klinik özellikleri ve laboratuvar sonuçları

Clinical characteristics and laboratory test results of patients admitted to outpatient clinic for synthetic cannabinoid usage Objective: Synthetic cannabinoids (SC) are psychoactive substances that have agonistic effects on cannabinoid receptors. The aim of this study was to investigate the sociodemographic variables, SC usage properties, clinical effects and withdrawal symptoms of SC in patients who admitted to Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) in Istanbul for SC usage, while analyzing the urine samples of the patients by an enzyme immunoassay screening test. Methods: One hundred fifty eight patients who admitted to AMATEM outpatient clinic between 28.08.201313.02.2014 and reported that they had been using SC were enrolled in the study. Sociodemographic and clinical data form were applied to patients and their urine samples were investigated by a screening test. Results: One hundred thirty five of the patients (86.0%) reported that they had been using cannabis before they started on SC, while 19 patients reported that the first substance they had used were SC. The reason to use SC was relaxation for 143 (92.3%) of the patients. One hundred eight (70.1%) of the patients had unsuccessful attempts to stop SC usage. One hundred four (86.7%) of the 120 patients whose urine samples could be analyzed, had positive screening test results for SC. Conclusion: Our study is important because it is the first study that investigates the usage properties and clinical effects of SC with the screening test results for SC in Turkey.

Contrast-induced nephropathy in patients undergoing intravenous contrast-enhanced computed tomography in Korea: a multi-institutional study in 101487 patients.

ObjectiveTo evaluate the prevalence of known risk factors for contrast-induced nephropathy (CIN) and their association with the actual occurrence of CIN in patients undergoing intravenous contrast-enhanced computed tomography (CECT) in Korea.Materials and MethodsPatients who underwent CECT in 2008 were identified in the electronic medical records of 16 tertiary hospitals of Korea. Data on demographics, comorbidities, prescriptions and laboratory test results of patients were collected following a standard data extraction protocol. The baseline renal function was assessed using the estimated glomerular filtration rate (eGFR). We identified the prevalence of risk factors along the eGFR strata and evaluated their influence on the incidence of CIN, defined as a 0.5 mg/dL or 25% increase in serum creatinine after CECT.ResultsOf 432425 CECT examinations in 272136 patients, 140838 examinations in 101487 patients met the eligibility criteria for analysis. The mean age of the participants was 57.9 ± 15.5 years; 25.1% of the patients were older than 70 years. The prevalence of diabetes mellitus was 11.9%, of hypertension 13.7%, of gout 0.55% and of heart failure was 1.7%. Preventive measures were used in 40238 CECT examinations (28.6%). The prevalence of risk factors and use of preventive measures increased as the renal function became worse. A CIN was occurred after 3103 (2.2%) CECT examinations, revealing a significant association with decreased eGFR, diabetes mellitus, and congestive heart failure after adjustment.ConclusionRisk factors for CIN are prevalent among the patients undergoing CECT. Preventive measures were seemingly underutilized and a system is needed to improve preventive care.

An Introduction to Reference Intervals (1)—Some Theoretical Considerations

The population-based reference interval is the most widely used tool for interpretation of individual patient laboratory test results. The clinical value of those results depend crucially on the reference intervals with which they are compared, and all efforts directed at ensuring analytically precise and accurate test results are, to a greater or lesser extent, in vain if the relevant reference interval is invalid or deficient in some way. This is the first of two introductory articles focusing on the reference interval. Here we consider the concept of the reference interval as an interpretive tool, define some relevant terms and address some of the theoretical aspects to be considered when constructing and using reference intervals. The second article - An introduction to reference intervals (2) - some practical considerations - which lends heavily on current expert opinion contained in a 2008 report (C28-P3) from the Clinical and Laboratory Standards Institute, describes how to validate reference intervals according to internationally agreed standards. Construction of a reference interval from scratch according to these standards is an enormous undertaking that could not reasonably be expected to be within the remit of most clinical laboratories. By contrast, validation of an existing reference interval is a much less arduous task that can and should be undertaken by all laboratories when introducing an established test to the laboratory repertoire or when making changes to existing test methodology/sampling protocols.

Obtaining patient test results from clinical laboratories: A survey of state law for pharmacists

To identify states with laws that restrict to whom clinical laboratories may release copies of laboratory test results and to describe how these laws may affect pharmacists' ability to obtain patient laboratory test results. Researchers examined state statutes and administrative codes for all 50 states and the District of Columbia at the University of Iowa Law Library between June and July 2007. Researchers also consulted with lawyers, state Clinical Laboratory Improvement Amendments officers, and law librarians. Laws relating to the study objective were analyzed. 34 jurisdictions do not restrict the release of laboratory test results, while 17 states have laws that restrict to whom clinical laboratories can send copies of test results. In these states, pharmacists will have to use alternative sources, such as physician offices, to obtain test results. Pharmacists must consider state law before requesting copies of laboratory test results from clinical laboratories. This may be an issue that state pharmacy associations can address to increase pharmacist access to important patient information.

Severe Hypersensitivity Dermatitis and Liver Dysfunction Induced by Occupational Exposure to Trichloroethylene

Trichloroethylene-induced hypersensitivity dermatitis is one of the serious occupational health events in China, however, little is known about the clinical features and possible mechanism of this disorder. The objective of the present study was to report some typical trichloroethylene-induced dermatitis patients and investigate their occupational exposure as well as the clinical features. We sampled and tested some cleaning agents from the companies where TCE-induced skin disorder occurred, the trichloroethylene concentrations were also monitored in the workplace air. Additionally, the symptoms, signs and laboratory test results of patients were collected. TCE concentrations varied from 10.2% to 91.4% in the cleaning agent by gas chromatography-mass chromatography analysis, and TCE levels in the workplace air ranged between 18 mg/m(3) and 683 mg/m(3), at most sampled sites TCE levels were higher than China national health standard for TCE. The trichloroethylene exposure time of the patients was 5-90 days (average 38.2 d), the patients with headache, dizziness, skin itch, fever were 90.5%, 100%, 100%, and 61.9%, respectively. 85.7% patients had skin erythema, 90.5% with rashes, and 38.1% with blisters. In addition, liver enlargement occurred in 3 patients, the abnormal rate of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (T-Bil) were 90.5%, 85.7% and 76.2%, respectively. 6 out of 15 patients were with abnormal electrocardiogram, and trichloroacetic acid (TCA) elevated in 14 patients (66.7%). Taken together, the major detrimental effect of trichloroethylene was to induce hypersensitivity dermatitis and liver dysfunction, the occurrence of this disorder is likely related to the individual hypersensitivity to trichloroethylene exposure.

Cysteine, Sulfite, and Glutamate Toxicity: A Cause of ALS?

Amyotrophic lateral sclerosis (ALS) of nonmutant superoxide dismutase (SOD) type may be caused by toxicity of the reduced glutathione (GSH) precursors glutamate and cysteine, and sulfite (a metabolite of cysteine), which accumulate when one or more of the enzymes needed for GSH synthesis are defective. A case is examined where the patient exhibited elevated sulfur on a hair mineral analysis, elevated blood cysteine, positive urine sulfite, elevated urine glutamate, and low whole blood GSH. During the time when strict dietary and supplement measures normalized the patient's whole blood GSH, blood cysteine, and urine sulfite, the patient did not experience additional physical decline. The possible causes of abnormalities of the patient's laboratory test results, as well as the nutrition measures used to normalize them, are discussed in relationship to the functions and importance of cysteine, sulfite, and glutamate in glutathione metabolism in ALS. Since elevated plasma cysteine has been reported in other ALS patients, sulfite and cysteine toxicity may be involved in other cases of ALS. Patients with ALS with nonmutant-SOD should be tested for sulfite toxicity, cysteine, glutamate and GSH levels, and whether they have low levels of GSH metabolism enzymes. Since glutamate metabolism appears to be inhibited by sulfite, research on the effect of sulfite on glutamate levels in patients with ALS should be pursued. Life might be prolonged in those patients with ALS with sulfite toxicity by closely monitoring the blood cysteine and urine sulfite levels and minimizing their dietary intake, as well as increasing GSH by using sublingual GSH. A long-term solution might be found through research to determine methods to increase GSH synthesis without using sulfur-containing supplements that may add to the cysteine and sulfite toxicity.

Forma isolada do miocárdio não-compactado

Noncompaction of the myocardium (NCM) is a rare congenital heart defect. It was first described 15 years ago, and few cases are published. The purpose of this study is to describe a NCM case. Clinical findings and imaging test results of a 37-year-old female patient with isolated NCM are presented. The patient complained of palpitations; her physical examination revealed extrasystoles, and her 12-lead electrocardiogram showed ventricular bigeminy. Three-dimensional Doppler echocardiography revealed numerous prominent trabeculations with deep intertrabecular recesses with blood flow which communicated with the ventricular cavity, which were more intense in the septal apical region. Cardiac magnetic resonance imaging corroborated the echocardiographic findings. The clinical presentation and the patients laboratory test results confirmed the diagnosis of isolated NCM. The knowledge of the echocardiographic findings of this disease enables an early diagnosis and a more adequate treatment.