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This study was carried out to determine the level of patient satisfaction with the services rendered by the Malasakit Center in Amang Rodriguez Memorial Medical Center. It aimed to identify the service frequently requested by the patient and/or their representative and its frequency, as well as the level of satisfaction. This study employed descriptive research to describe the nature of the situation that existed in the study together with a survey questionnaire as the research instrument tool. The 125 respondents were selected through convenience sampling. The findings of this study revealed that most of the patients and their representatives' access Malasakit centers with the query on the document requirement. Eight other services were also sought from the Malasakit Center such as medical help/aid, follow up and status of the documents submitted. These services were rated with a high level of satisfaction with a weighted mean rating of 3.84. The study concluded that various services were accessed by the patients and/or patients' representatives. The patients' and/or patients' representatives' degree of satisfaction with the service of the Malasakit Center at the Amang Rodriguez Memorial Medical Center is extremely high or highly satisfactory. The health practitioners will be educated and equipped to handle the services provided by the Malasakit Center as a result of these measures. [ABSTRACT FROM AUTHOR]

Cardiac disease is the major cause of death in patients with end-stage renal disease (ESRD), accounting for about 45% of all deaths. In dialysis patients about 20% of cardiac deaths are attributed to acute myocardial infarction (AMI). The survival of dialysis patients after AMI is poor, with nearly three-quarters of patients dead at 2 years after AMI. The definition of AMI is based on symptoms, electrocardiography, and cardiac biomarkers. In the non-ESRD population, it has been recognized that sensitive markers of myocardial injury (cardiac troponin I and troponin T) define a group of patients who are increased risk for adverse cardiac outcomes and who are more likely to benefit from treatment. Elevated cardiac troponin levels in nonhospitalized ESRD patients without other evidence of ongoing myocardial ischemia may also prospectively identify a subgroup of ESRD patients at increased risk for death. This editorial is an overview of cardiac biomarkers (specifically troponin I and troponin T) in the management of acute coronary syndromes in ESRD patients. A potential role of cardiac troponin testing for risk stratification in the outpatient dialysis unit is also presented. [ABSTRACT FROM AUTHOR]

Serum cardiac troponin I measurement is preferred to creatine kinase-MB mass for the diagnosis of acute myocardial infarction in patients with renal insufficiency. Unexplained increases in cardiac troponin I in this population requires further evaluation and close follow-up. [ABSTRACT FROM AUTHOR]

Objective: We sought to validate the clinical performance of a rapid assessment pathway incorporating the Siemens Atellica IM high sensitivity cardiac troponin I (hs-cTnI) assay in patients presenting to the emergency department (ED) with suspected acute myocardial infarction (AMI)., Methods: This was a multicentre prospective observational study of adult ED patients presenting to five Australian hospitals between November 2020 and September 2021. Participants included those with symptoms of suspected AMI (without ST-segment elevation MI on presentation ECG). The Siemen's Atellica IM hs-cTnI laboratory-based assay was used to measure troponin concentrations at admission and after 2-3 hours and cardiologists adjudicated final diagnoses. The HighSTEACS diagnostic algorithm was evaluated, incorporating hs-cTnI concentrations at presentation and absolute changes within the first 2 to 3 hours. The primary outcome was index AMI, including type 1 or 2 non-ST segment elevation MI (NSTEMI) or ST-elevation MI (STEMI) following presentation. 30-day major adverse cardiac outcomes (including AMI, urgent revascularisation or cardiac death) were also reported. The trial was registered with the Australian and New Zealand Clinical Trials Registry., Results: 1994 patients were included. The average age was 56.2 years (SD = 15.6), and 44.9% were women. 118 (5.9%) patients had confirmed index AMI. The 2-hour algorithm defined 61.3% of patients as low risk. Sensitivity was 99.1% (94.0%-99.9%) and negative predictive value was 99.9% (99.3%-100%). 24.4% of patients were deemed intermediate risk. When applying the parameters for high risk, 252 (14.3%) were identified, with a specificity of 91.5% (88.7%-93.6%) and a PPV of 42.0% (35.6-48.7%)., Conclusions: A 2-hour algorithm based on the HighSTEACS strategy using the Siemens Atellica IM hs-cTnI laboratory-based assay enables safe and efficient risk assessment of emergency patients with suspected AMI., Trial Registration Number: ACTRN12621000053820., Competing Interests: Competing interests: LC has received institutional grants from Siemens, Beckman Coulter, Abbott Diagnostics, Roche, and Radiometer Pacific. She has received consulting fees from Siemens Healthineers, Abbott Diagnostics and Beckman Coulter. JHG received a fellowship from Advance Queensland. WP has received institutional grants from Siemens, Beckman Coulter, Abbott Diagnostics, Roche and Radiometer Pacific. He has received consulting fees from Pfizer, Abbott Diagnostics and institutional consultancy fees from Siemens Healthineers. MT has received funding for clinical research from Abbott, Alere, Beckman, Radiometer and Roche. Payment for speaking from Abbott, Alere and Roche, Consulting fees from Abbott, Roche and Siemens. Participation in Advisory boards of Abbott, Radiometer, Roche, and Siemens. Funding for education from Abbott, Alere and Beckman. FA: Board of Directors for HyTest Ltd; Associate Editor for Clinical Chemistry; Advisory Boards: Instrumentation Laboratory, Siemens Healthineers, Osler Diagnostics, Qorvo; Honorarium for Speaking at Industry Conferences: Siemens Healthineers, Abbott Diagnostics; principal investigator on Industry Funded Grants (non-salaried) on cardiac biomarkers through Hennepin Healthcare Research Institute: Abbott Diagnostics, Abbott POC, BD, Beckman Coulter, Ortho-Clinical Diagnostics, Roche Diagnostics, Siemens Healthcare, ET Healthcare, Qorvo., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Objectives: Patients presenting with symptoms suggestive of acute coronary syndrome (ACS) contribute to a high workload and overcrowding in the Emergency Department (ED). Accelerated diagnostic protocols for non-ST-elevation myocardial infarction have proved challenging to implement. One obstacle is the turnaround time for analyzing high-sensitivity cardiac troponin (hs-cTn). In the WESTCOR-POC study (Clinical Trials number NCT05354804) we aim to evaluate safety and efficiency of a 0/1 h hs-cTn algorithm utilizing a hs-cTnI point of care (POC) instrument in comparison to central laboratory hs-cTnT measurements., Design: This is a prospective single-center randomized clinical trial aiming to include 1500 patients admitted to the ED with symptoms suggestive of ACS. Patients will receive standard investigations following the European Society of Cardiology 0/1h protocols for centralized hs-cTnT measurements or the intervention using a 0/1h POC hs-cTnI algorithm. Primary end-points are 1) Safety; death, myocardial infarction or acute revascularization within 30 days 2) Efficiency; length of stay in the ED, 3) Cost- effectiveness; total episode cost, 4) Patient satisfaction, 5) Patient symptom burden and 6) Patients quality of life. Secondary outcomes are 12-months death, myocardial infarction or acute revascularization, percentage discharged after 3 and 6 h, total length of hospital stay and all costs related to hospital contact within 12 months., Conclusion: Results from this study may facilitate implementation of POC hs-cTn testing assays and accelerated diagnostic protocols in EDs, and may serve as a valuable resource for guiding future investigations for the use of POC high sensitivity troponin assays in outpatient clinics and prehospital settings.

Importance: Most healthcare institutions require employees to be vaccinated against SARS-CoV-2 and many also require at least one booster., Objective: We determine the impact of vaccine type, demographics, and health conditions on COVID-19 vaccine side effects in healthcare professionals., Design: A COVID-19 immunity study was performed at the 2021 American Association for Clinical Chemistry Annual Scientific meeting. As part of this study, a REDCap survey with cascading questions was administered from September 9, 2021 to October 20, 2021. General questions included participant demographics, past and present health conditions, smoking, exercise, and medications. COVID-19 specific questions asked about SARS-CoV-2 vaccine status and type, vaccine-associated side effects after each dose including any boosters, previous infection with COVID-19, diagnostic testing performed, and type and severity symptoms of COVID-19., Results: There were 975 participants (47.1% male, median age of 50 years) who completed the survey. Pfizer was the most commonly administered vaccine (56.4%) followed by Moderna (32.0%) and Johnson & Johnson (7.1%). There were no significant differences in vaccine type received by age, health conditions, smoking, exercise, or type or number of prescription medications. Side effects were reported more frequently after second dose (e.g., Moderna or Pfizer) (54.1%) or single/only dose of Johnson & Johnson (47.8%). Males were significantly more likely to report no side effects ( p < 0.001), while females were significantly more likely to report injection site reactions ( p < 0.001), fatigue ( p < 0.001), headache ( p < 0.001), muscle pain ( p < 0.001), chills ( p = 0.001), fever ( p = 0.007), and nausea ( p < 0.001). There was a significant upward trend in participants reporting no side effects with increasing age ( p < 0.001). There were no significant trends in side effects among different races, ethnicities, health conditions, medications, smoking status or exercise. In multivariate logistic regressions analyses, the second dose of Moderna was associated with a significantly higher risk of side effects than both the second dose of Pfizer and the single dose of Johnson & Johnson., Conclusions and Relevance: Younger people, females, and those receiving the second dose of Moderna had more COVID-19 vaccine side effects that per self-report led to moderate to severe limitations. As reported in other studies, the increase in side effects from Moderna may be explained by higher viral mRNA concentrations but be associated with additional protective immunity., Competing Interests: Author YZ is a consultant for Thermo Fisher. Author JW is Co-PI on a US and International patent. Specificity enhancing reagents for COVID-19 Antibody Testing. Author ZZ has sponsored research supported by Novartis, Waters, Siemens, Polymedco, Waters, Roche and ET Healthcare and has received consulting/speaker fee from Siemens, Roche and ET Healthcare. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Melanson, Zhao, Kumanovics, Love, Meng, Wu, Apple, Ondracek, Schulz, Wiencek, Koch, Christenson and Zhang.)

Risk scores including the Thrombolysis in Myocardial Infarction (TIMI) score; History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) score; and Simplified Emergency Department Assessment of Chest Pain Score (sEDACS) have been used to evaluate patients with symptoms suggestive of acute myocardial infarct (AMI). This study assessed prognostic utility of cardiac risk stratification scores when augmented with a high-sensitivity cardiac troponin-I assay (hs-cTnI)., Methods: This study enrolled 2,505 suspected AMI patients at 29 hospitals in the United States from April 2015 to April 2016. Blood samples were tested for hs-cTnI on the Atellica IM TnIH Assay (Siemens Healthineers). Patients were considered low risk for death/AMI with a TIMI score = 0, HEART ≤3, sEDACS ≤15, and hs-cTnI <45 ng/L (99th percentile) at time 0 and 2-3 hours., Results: There were 2,336 patients included after exclusions for ST-segment elevation myocardial infarction or incomplete data. At 30 days, 283 patients (12.1%) had been diagnosed with AMI, and there were 24 (1.0%) deaths and 213 (9.1%) revascularizations. Of 298 patients with death or AMI, 258 (86.6%) had elevated hs-cTnI. The HEART score and sEDACS identified 34.5% and 36.6% of patients as low risk, respectively. This was significantly more than the 12.1% identified by the TIMI score (P < .01)., Conclusions: The TIMI, HEART, and sEDACS scores all identify low-risk patients when combined with hs-cTnI measurements. The HEART score and sEDACS identified more low-risk patients compared to the TIMI score. These patients could be considered for discharge from the emergency department without further testing., (Copyright © 2020 Elsevier Inc. All rights reserved.)