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Background: In recent decades, the analytical quality of clinical laboratory results has substantially increased because of collaborative efforts. To effectively utilize laboratory results in applications, such as machine learning through big data, understanding the level of harmonization for each test would be beneficial. We aimed to develop a quantitative harmonization index that reflects the harmonization status of real-world laboratory tests. Methods: We collected 2021–2022 external quality assessment (EQA) results for eight tests (HbA1c, creatinine, total cholesterol, HDL-cholesterol, triglyceride, alpha-fetoprotein [AFP], carcinoembryonic antigen [CEA], and prostate-specific antigen [PSA]). This EQA was conducted by the Korean Association of External Quality Assessment Service, using commutable materials. The total analytical error of each test was determined according to the bias% and CV% within peer groups. The values were divided by the total allowable error from biological variation (minimum, desirable, and optimal) to establish a real-world harmonization index (RWHI) at each level (minimum, desirable, and optimal). Good harmonization was arbitrarily defined as an RWHI value ≤1 for the three levels. Results: Total cholesterol, triglyceride, and CEA had an optimal RWHI of ≤1, indicating an optimal harmonization level. Tests with a desirable harmonization level included HDL-cholesterol, AFP, and PSA. Creatinine had a minimum harmonization level, and HbA1c did not reach the minimum harmonization level. Conclusions: We developed a quantitative RWHI using regional EQA data. This index may help reflect the actual harmonization level of laboratory tests in the field. [ABSTRACT FROM AUTHOR]

ChatGPT is an artificial intelligence (AI) chatbot application. In this study, we explore the creation and use of a customized version of ChatGPT designed specifically for patient education, called "Lab Explainer." Lab Explainer aims to simplify and clarify the results of complex laboratory tests for patients, using the sophisticated capabilities of AI in natural language processing; it analyses various laboratory test data and provides clear explanations and contextual information. The approach involved adapting OpenAI's ChatGPT model specifically to analyze laboratory test data. The results suggest that Lab Explainer has the potential to improve understanding by providing an interpretation of laboratory tests to the patient. In conclusion, the Lab Explainer can assist patient education by providing intelligible interpretations of laboratory tests. [ABSTRACT FROM AUTHOR]

To perform its function of providing health services, the clinical laboratory faces several challenges, especially in the speediness and accuracy of result delivery. Some issues frequently arise during the execution. An approach to overcoming obstacles and improving service quality is to use online applications delivered via the Android system to distribute the laboratory results. This study assessed internal customer satisfaction with the use of this online application. This study employs a quantitative approach with a cross-sectional approach. The customer was given a questionnaire with 15 questions covering five aspects of service quality (tangibility, reliability, responsiveness, assurance and empathy). The questionnaire's validity and reliability were evaluated, and the Cartesian diagram analysis was used to determine the service improvement strategy. The empathy dimension has the highest satisfaction figure, with an average of 95.39%, while the assurance dimension has the lowest, with an average of 84.62%. The majority of the quality subdimensions are found in quadrants II and III of the Cartesian diagram (five parameters each). Most subdimension quality is found in quadrant II, with as many as five subdimension quality, indicating a high level of importance and satisfaction. [ABSTRACT FROM AUTHOR]

Laboratory medical reports are often not intuitively comprehensible to non-medical professionals. Given their recent advancements, easier accessibility and remarkable performance on medical licensing exams, patients are therefore likely to turn to artificial intelligence-based chatbots to understand their laboratory results. However, empirical studies assessing the efficacy of these chatbots in responding to real-life patient queries regarding laboratory medicine are scarce.Thus, this investigation included 100 patient inquiries from an online health forum, specifically addressing Complete Blood Count interpretation. The aim was to evaluate the proficiency of three artificial intelligence-based chatbots (ChatGPT, Gemini and Le Chat) against the online responses from certified physicians.The findings revealed that the chatbots’ interpretations of laboratory results were inferior to those from online medical professionals. While the chatbots exhibited a higher degree of empathetic communication, they frequently produced erroneous or overly generalized responses to complex patient questions. The appropriateness of chatbot responses ranged from 51 to 64 %, with 22 to 33 % of responses overestimating patient conditions. A notable positive aspect was the chatbots’ consistent inclusion of disclaimers regarding its non-medical nature and recommendations to seek professional medical advice.The chatbots’ interpretations of laboratory results from real patient queries highlight a dangerous dichotomy – a perceived trustworthiness potentially obscuring factual inaccuracies. Given the growing inclination towards self-diagnosis using AI platforms, further research and improvement of these chatbots is imperative to increase patients’ awareness and avoid future burdens on the healthcare system. [ABSTRACT FROM AUTHOR]

Peloidotherapy and aromatherapy have been used for years in the treatment of numerous inflammatory conditions, including rheumatoid arthritis (RA). The exact mechanism of their action in RA is unclear. The goal of our research is to determine the effect of peloidotherapy and aromatherapy on inflammation parameters in RA patients. Our study included 20 patients of both sexes, with confirmed diagnosis of RA, older than 18 years. Patients were treated during 28 days with combination of peloidotherapy and aromatherapy. Serum samples for detection of levels of inflammation parameters were taken at two intervals: before the start of therapy and at the end of treatment. The results of our study show that there were no significant changes in the parameters of the complete blood count. Nevertheless, a statistically significant decrease in the serum concentration of two markers of inflammation—interleukin-6 (IL-6) and nitrogen-oxide (NO)—was detected. Correlation analyses results say that there is a synchronized drop in the serum concentrations of CRP and the sedimentation rate, and the serum concentrations of fibrinogen and IL-6 are in the same relationship as well as serum levels of IL-6 and NO. Bearing in mind the importance of IL-6 and NO in the pathogenesis of inflammation in RA, we conclude that the application of our therapeutic protocol can be a significant add-on treatment to classic immunomodulators. Due to the small number of study participants, the lack of a control group, and the short follow-up time of patients, additional research is needed. [ABSTRACT FROM AUTHOR]

This study explores how patient’s laboratory result are accessed in pediatric emergency departments. The rapid turnaround of laboratory results and their timely access by the medical team are crucial for effective patient management and care decision-making. This study revealed a systematic access prioritization to the Electronic Health Record, led by physicians, followed by nurses, and then other healthcare staff Despite efforts to streamline access through computerized laboratory results, optimized laboratory turnaround time and integration of final results into the electronic health record remain key challenges. Delays in accessing analysis results issued by the central hospital laboratory are consistently experienced across various laboratory types, indicating broader systemic workflow issues rather than inefficiencies specific to individual laboratories. [ABSTRACT FROM AUTHOR]

Research in medicinal and aromatic science laboratories often involves isolation, identification, and characterization of bioactive compounds from natural sources, particularly those with potential applications in medicine and healthcare. A wide range of analytical techniques, including chromatography, spectroscopy, in vitro – in vivo bioassays, and also toxicity tests to investigate the chemical and biological properties with the safeties of these compounds, and to understand how they interact with biological systems at the molecular level. However, many different species, and different test results creates a great challenge to keep track of results even within one research laboratory. In this study, we introduce a practical offline database and software program for recording medicinal and aromatic science experimental results in laboratories. The program uses a familiar input file, (Microsoft Excel), so users do not need to learn a new software. By implementing a standardized data recording system and evidence file for each plant, even if the same plant has different synonyms, different parts, and originates from different regions, all data can be collected and accessed through a single platform. This system allows for the integration of experimental results, including chromatograms, spectra, images, etc., and facilitates data management and analysis. The presented database provides a significant advantage by allowing immediate access to pertinent information regarding laboratory experimental results during collaborative efforts with diverse research groups and departments. It's always-on data archiving features will prevent any experiment replications and also eliminates the potential loss of time during the data evaluation process. [Display omitted] • We introduce a database and software program for recording experimental results fascilitating efficient management. • The software works with a familiar input file, eliminating the need for users to learn a new software interface. • The recommended system allows integration of experimental results, including chromatograms, spectra, and pertinent data. • It enables collaborative efforts and fosters interdisciplinary cooperation and knowledge exchange. [ABSTRACT FROM AUTHOR]

This quality improvement project focuses on decreasing laboratory result retrieval times within a 6-month period at a rural home health setting. Prior to implementation, 73% of all laboratory results were not received within 24 hours (72 hours for cultures). Interventions included Lean Six Sigma methodologies (process mapping and process redesign) and Plan-Do-Study-Act to reduce laboratory result retrieval times. Data analysis included descriptive statistics including means, averages, and percentages for the primary outcome of laboratory result retrieval time. 119 participants included all patients who had laboratory specimens collected by home health staff during the project timeline. Laboratory result delays ≥24/72 hours decreased from 73% (29/40) to 14% (11/79). Furthermore, 25% (10/40) of labs were delayed ≥5 days pre-implementation and 0% post-implementation. Abnormal laboratory results with delayed treatment decreased from 28% (11/40) to 5% (4/79). Provider notification within 24 hours of an abnormal laboratory result increased from 0% (0/13) to 75% (6/8). Hospitalization rates within 30 days of an abnormal result was 15% (6/40) pre-implementation and decreased to 5% (4/79) post-implementation. [ABSTRACT FROM AUTHOR]

Incidental finding (IF) follow-up is of critical importance for patient safety and is a source of malpractice risk. Laboratory, imaging, or other types of IFs are often uncovered incidentally and are missed, not addressed, or only result after hospital discharge. Despite a growing IF notification literature, a need remains to study cost-effective non–electronic health record (EHR)–specific solutions that can be used across different types of IFs and EHRs. The objective of this study was to evaluate the utility and cost-effectiveness of an EHR-independent emergency medicine–based quality assurance (QA) follow-up program in which an experienced nurse reviewed laboratory and imaging studies and ensured appropriate follow-up of results. A QA nurse reviewed preceding-day abnormal studies from a tertiary care hospital, a community hospital, and an urgent care center. Laboratory values outside preset parameters or radiology over-reads resulting in clinically actionable changes triggered contact with an on-call emergency physician to determine an appropriate intervention and its implementation. Of 104,125 visits with 1,351,212 laboratory studies and 95,000 imaging studies, 6530 visits had IFs, including 2659 laboratory and 4004 imaging results. The most common intervention was contacting a primary care physician (5783 cases [88.6%]). Twenty-one cases resulted in a patient returning to the ED, at an average cost of $28,000 per potential life-/limb-saving intervention. Although abnormalities in laboratory results and imaging are often incidental to patient care, a dedicated emergency department QA follow-up program resulted in the identification and communication of numerous laboratory and imaging abnormalities and may result in changes to patients' subsequent clinical course, potentially increasing patient safety. [ABSTRACT FROM AUTHOR]

This article discusses the use of large language models (LLMs), specifically Chat Generative Pre-trained Transformer (ChatGPT), in healthcare. While LLMs like ChatGPT have shown promise in various applications, their use in healthcare is controversial due to the potential for generating erroneous interpretations or incorrect information. The study focuses on using ChatGPT to interpret laboratory results for hemoglobinopathies. The results show that ChatGPT v4.0 achieved a 76% accuracy for predicting hemoglobinopathies, but its accuracy for negative cases was only slightly better than chance. The study highlights the importance of considering the benefits and risks of using LLMs in healthcare and emphasizes that they should only be considered as support tools, not replacements for physicians and laboratory specialists. [Extracted from the article]

Sudden sensorineural hearing loss (SSNHL) is defined as an abrupt hearing loss of more than 30 dB in three contiguous frequencies within 72 h. It is an emergency disease requiring immediate diagnosis and treatment. The incidence of SSNHL in Western countries' population is estimated between 5 and 20 per 1,00,000 inhabitants. The etiology of SSNHL remains unknown. Due to the uncertainty of the cause of SSNHL, at present, no specific treatment targets the cause of SSNHL, resulting in poor efficacy. Previous studies have reported that some comorbidities are risk factors for SSNHL, and some laboratory results may provide some clues for the etiology of SSNHL. Atherosclerosis, microthrombosis, inflammation, and the immune system may be the main etiological factors for SSNHL. This study confirms that SSNHL is a multifactorial disease. Some comorbidities, such as virus infections, are suggested to be the causes of SSNHL. In summary, by analyzing the etiology of SSNHL, more targeting treatments should be used to achieve a better effect. [ABSTRACT FROM AUTHOR]

We aimed to determine the pattern of delay and its effect on the short-term outcomes of total gastrectomy before and during the coronavirus disease 2019 (COVID-19) pandemic. Overlaid line graphs were used to visualize the dynamic changes in the severity of the pandemic, number of gastric cancer patients, and waiting time for a total gastrectomy. We observed a slightly longer waiting time during the pandemic (median: 28.00 days, interquartile range: 22.00–34.75) than before the pandemic (median: 25.00 days, interquartile range: 18.00– 34.00; p = 0.0071). Moreover, we study the effect of delayed surgery (waiting time > 30 days) on short-term outcomes using postoperative complications, extreme value of laboratory results, and postoperative stay. In patients who had longer waiting times, we did not observe worse short-term complication rates (grade II–IV: 15% vs. 19%, p = 0.27; grade III–IV: 7.3% vs. 9.2%, p = 0.51, the short waiting group vs. the prolonged waiting group) or a higher risk of a longer POD (univariable: OR 1.09, 95% CI 0.80–1.49, p = 0.59; multivariable: OR 1.10, 95% CI 0.78–1.55, p = 0.59). Patients in the short waiting group, rather than in the delayed surgery group, had an increased risk of bleeding in analyses of laboratory results (plasma prothrombin activity, hemoglobin, and hematocrit). A slightly prolonged preoperative waiting time during COVID-19 pandemic might not influence the short-term outcomes of patients who underwent total gastrectomy. [ABSTRACT FROM AUTHOR]

A research study was carried out to collect data on the quality and quantity of petroleum and nonpetroleum industrial wastewater from different sources in Kuwait over a period of 1 y as well as developing a database of such characteristics and attributes using geographic information system (GIS) technique. During the field visits, a specially designed field surveys were submitted to the owners of industrial facilities in three industrial areas in Kuwait, namely, Sabhan, Kuwait City, and Shuaiba industrial areas. In this study, wastewater samples were collected and analysed on monthly and biweekly basis from 14 non-petroleum factories of Sabhan industrial areas. This paper was targeting assessment of total petroleum hydrocarbon (TPH) in the raw wastewater for factories of Sabhan industrial area. The field wastewater data indicated presence slightly acid to slightly alkaline (4.9-10.8), reduced to oxidized environment (-410 mv-538 mv) and freshwater to brackish water (120-8,673 µS/cm). The laboratory results revealed that total petroleum hydrocarbon concentrations for wastewater of 14 factories ranged between 0.3 and 19 mg/L. The mean values of total petroleum hydrocarbon concentrations for wastewater of 14 factories were meeting the maximum limit (5 mg/L) set by KEPA for irrigation water purposes except those values of TPH (>5 mg/L) for three factories. The mean value of quantities of wastewater generated from 14 factories was found 55,894 m3/week. The large quantities of raw wastewater generated from these factories can be used safely as irrigation water for landscaping and greenery with respect to total petroleum hydrocarbon concentrations. [ABSTRACT FROM AUTHOR]

Abstract Background The novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019. The disease rapidly expanded and led to an epidemic throughout China, followed by the rising number of cases worldwide. Given the high prevalence of COVID-19, rapid and accurate diagnostic methods are immediately needed to identify, isolate and treat the patients as soon as possible, decreasing mortality rates and the risk of public contamination by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2). Methods This case-control study was conducted in two hospitals in Alborz Province in Iran. All recruited cases in this study were symptomatic adults hospitalized as COVID-19 patients with compatible Computed tomographic (CT) scan findings and available rRT-PCR results. The patients were recruited in this study. The patients were categorized into positive and negative rRT-PCR groups and evaluated for symptoms, initial vital signs, comorbidity, clinical and laboratory findings. Finally, the results were assessed by SPSS software. Results Between March 5 to April 5, 2020, 164 symptomatic COVID-19 patients were studied. In total, there were 111 rRT-PCR positive (67.6%) and 53 rRT-PCR negative patients (32.4%). In terms of statistics, the frequency of symptoms revealed no difference, except for cough (P.V:0.008), dizziness (PV: 0.048), and weakness (P.V:0.022). Among initial vital signs, PR (P.V:0.041) and O2 Saturation (PV: 0.014) were statistically different between the two groups. Evaluation of comorbidities revealed no difference except for hyperlipidemia (P.V:0.024). In the comparison of laboratory findings, only WBC count (PV: 0.001), lymphocyte count (PV: 0.001), and Hb (P.V:0.008) were statistically different between the two groups. Conclusion In case of the negative rRT-PCR result, it is necessary to take a logical approach, and we recommended that the physician decides according to clinical manifestations, laboratory findings, and positive CT results.

Transgender individuals experience discordance between their gender identity and sex assigned at birth. To relieve the disconnection between their identity and their biological state, some may take hormonal therapy, which leads to notable changes in several laboratory results. As reference intervals in the clinical laboratory reports are mainly gender specific for biological male and female, the transgender population on hormonal therapy may end up with misinterpretation of their test results, which could lead to misdiagnosis or inappropriate medical decisions. The aim of this review is to highlight the challenges experienced by clinicians in this regard and some strategies used to interpret these results. Establishing reference intervals for transgender individuals will assist in correct interpretation of patients' results and their management. This will also maximise their overall health, psychological well-being and self-actualisation. [ABSTRACT FROM AUTHOR]

There is currently limited clinical ability to identify COVID-19 patients at risk for severe outcomes. To unbiasedly identify metrics associated with severe outcomes in COVID-19 patients, we conducted a retrospective study of 835 COVID-19 positive patients at a single academic medical center between March 10, 2020 and October 13, 2020. As of December 1, 2020, 656 (79%) patients required hospitalization and 149 (18%) died. Unbiased comparisons of all clinical characteristics and mortality revealed that abnormal pH (OR 8.54, 95% CI 5.34–13.6), abnormal creatinine (OR 6.94, 95% CI 4.22–11.4), and abnormal PTT (OR 4.78, 95% CI 3.11–7.33) were most significantly associated with mortality. Correlation with ordinal severity scores confirmed these associations, in addition to associations between respiratory rate (Spearman's rho = −0.56), absolute neutrophil count (Spearman's rho = −0.5), and C-reactive protein (Spearman's rho = 0.59) with disease severity. Unsupervised principal component analysis and machine learning model classification of patient demographics, laboratory results, medications, comorbidities, signs and symptoms, and vitals are capable of separating patients on the basis of COVID-19 mortality (AUC 0.82). This retrospective analysis identifies laboratory and clinical metrics most relevant to predict COVID-19 severity. [ABSTRACT FROM AUTHOR]

Background: In recent decades, the analytical quality of clinical laboratory results has substantially increased because of collaborative efforts. To effectively utilize laboratory results in applications, such as machine learning through big data, understanding the level of harmonization for each test would be beneficial. We aimed to develop a quantitative harmonization index that reflects the harmonization status of real-world laboratory tests., Methods: We collected 2021-2022 external quality assessment (EQA) results for eight tests (HbA1c, creatinine, total cholesterol, HDL-cholesterol, triglyceride, alpha-fetoprotein [AFP], carcinoembryonic antigen [CEA], and prostate-specific antigen [PSA]). This EQA was conducted by the Korean Association of External Quality Assessment Service, using commutable materials. The total analytical error of each test was determined according to the bias% and CV% within peer groups. The values were divided by the total allowable error from biological variation (minimum, desirable, and optimal) to establish a real-world harmonization index (RWHI) at each level (minimum, desirable, and optimal). Good harmonization was arbitrarily defined as an RWHI value ≤ 1 for the three levels., Results: Total cholesterol, triglyceride, and CEA had an optimal RWHI of ≤ 1, indicating an optimal harmonization level. Tests with a desirable harmonization level included HDL-cholesterol, AFP, and PSA. Creatinine had a minimum harmonization level, and HbA1c did not reach the minimum harmonization level., Conclusions: We developed a quantitative RWHI using regional EQA data. This index may help reflect the actual harmonization level of laboratory tests in the field.

In recent years, many people have experienced different problems and challenges in using the national Danish health portal sundhed.dk, as they find it difficult to obtain desired information about their own laboratory test results and treatment plans. Therefore, the aim of this study is to find solutions, to make patients laboratory results easily accessible and understandable for the users. To achieve this aim there will be used two participatory design methods, video observation and questionnaires. The results shows that only 43.5% normally understand their test results, whereas the remaining participants need help to understand their results. [ABSTRACT FROM AUTHOR]

Aim: To investigate the frequency of fatigue and musculoskeletal symptoms and their correlation with laboratory data in patients with COVID-19.Methods: This study included 80 patients hospitalised and treated for COVID-19 in the infectious diseases clinic between March 2020 and May 2020. Data analysis was performed retrospectively from the hospital medical charts. Demographic data, clinical symptoms, and laboratory findings were noted. Clinical symptoms and correlations with laboratory results were assessed. Besides, an analysis of patients with and without chronic disease was performed for clinical symptoms and laboratory findings.Results: The frequencies of myalgia and fatigue were 46.1% and 50%, respectively. In the laboratory data, there was a significant increase in creatinine kinase (CK) level and lymphocyte count in the patients with myalgia symptoms (P < .05). There were no other significant results in the laboratory data. Of the patients with chronic disease, it has been shown that hemoglobin levels were significantly decreased (P < .05), while D-dimer was markedly increased (P < .05).Conclusion: The laboratory findings of COVID-19-related myalgia suggested that patients might have a risk of progressive muscle injury. Therefore, these patients should also be followed up in terms of the myopathic process. [ABSTRACT FROM AUTHOR]

People are increasingly able to access their laboratory (lab) results using patient-facing portals. However, lab reports for citizens are often identical to those for clinicians; without specialized training they can be near impossible to interpret. In this study, we inspected a mobile health application (app) that converts traditional lab results into a citizen-centred format. We used the Health Literacy Online (HLO) checklist to inspect the app. Our inspection revealed that most of the app's strengths were related to its Organization of Content and Simple Navigation and most of its weaknesses were related to Engage Users. We also identified several usability and user experience (UX) issues that were beyond the purview of the HLO checklist. Although this app represents an important step towards making lab results universally accessible, we identified several opportunities for improvements that could increase its value to citizens. [ABSTRACT FROM AUTHOR]

Abstract Background Cerebrospinal fluid (CSF) can be collected into ethylenediaminetetraacetic acid (EDTA) or plain tubes. The EDTA content presumably contributes to a better cell preservation. EDTA, however, is reported to cause a false elevation in the total protein concentration and to dilute the CSF sample, thereby affecting the diagnostic interpretation. To the authors’ knowledge, no validated studies support this view. The aim of this study was therefore to determine if the choice of tube (EDTA or plain) influences the results of the standard CSF analysis. Results Thirty-two paired EDTA stabilised and plain CSF samples were included. There was no statistically significant difference in the semi-quantitative protein concentrations when comparing CSF samples from EDTA and plain plastic tubes (P > 0.99). The total nucleated cell count did not differ significantly between EDTA and plain tube samples (P = 0.85). There were no significant differences in the differential cell counts between the two tubes when evaluating polymorphonuclear cells (P = 0.90), lymphocytes (P = 0.84) and monocytes/macrophages (P = 0.86). Also, there was no significant difference in the preservation of cell morphology when evaluating cytological preparations from EDTA stabilised and plain tube samples (P = 0.45). Conclusions The collection of CSF into EDTA tubes does not influence the result of the standard CSF analysis. However, a presumed positive effect of EDTA on cell preservation could not be shown in the present study.

Background: We investigated the effects of anthropometric, laboratory, and lifestyle factors on the development of non-alcoholic fatty liver disease (NAFLD) in a nationwide, population-based, 4-year retrospective cohort.Methods: The propensity score-matched study and control groups contained 1,474 subjects who had data in the Korean National Health Insurance Service-National Sample Cohort in 2009, 2011, and 2013. NAFLD was defined using medical records of a diagnosis confirmed by primary clinicians and meeting two previously validated fatty liver prediction models. Chronological changes in anthropometric variables, laboratory results, and lifestyle factors during two periods were compared between patient and control groups in order to find out parameters with consistent dynamics in pre-NAFLD stage which was defined as period just before the NAFLD development.Results: Among the 5 anthropometric, 10 laboratory, and 3 lifestyle factors, prominent chronological decremental changes in serum triglycerides were consistently observed during the pre-NAFLD stage, although the degrees of changes were more predominant in men (−9.46 mg/dL) than women (−5.98 mg/dL). Furthermore, weight and waist circumference changes during the pre-NAFLD stage were noticeable only in women (+0.36 kg and +0.9 cm for weight and waist circumference, respectively), which suggest gender difference in NAFLD.Conclusion: Early screening strategies for people with abrupt chronological changes in serum triglycerides to predict NAFLD development before the progression is recommended.

Background: The novel coronavirus disease 2019 (COVID-19) was emergency turned into global public health after the first patients were detected in Wuhan, China, in December 2019. The disease rapidly expanded and led to an epidemic throughout China, followed by the rising number of cases worldwide. Given the high prevalence of COVID-19, rapid and accurate diagnostic methods are immediately needed to identify, isolate and treat the patients as soon as possible, decreasing mortality rates and the risk of public contamination by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods: This case-control study was conducted in two hospitals in Alborz Province in Iran. All recruited cases in this study were symptomatic adults hospitalized as COVID-19 patients with compatible Computed tomographic (CT) scan findings and available rRT-PCR results. The patients were recruited in this study. The patients were categorized into positive and negative rRT-PCR groups and evaluated for symptoms, initial vital signs, comorbidity, clinical and laboratory findings. Finally, the results were assessed by SPSS software.Results: Between March 5 to April 5, 2020, 164 symptomatic COVID-19 patients were studied. In total, there were 111 rRT-PCR positive (67.6%) and 53 rRT-PCR negative patients (32.4%). In terms of statistics, the frequency of symptoms revealed no difference, except for cough (P.V:0.008), dizziness (PV: 0.048), and weakness (P.V:0.022). Among initial vital signs, PR (P.V:0.041) and O2 Saturation (PV: 0.014) were statistically different between the two groups. Evaluation of comorbidities revealed no difference except for hyperlipidemia (P.V:0.024). In the comparison of laboratory findings, only WBC count (PV: 0.001), lymphocyte count (PV: 0.001), and Hb (P.V:0.008) were statistically different between the two groups.Conclusion: In case of the negative rRT-PCR result, it is necessary to take a logical approach, and we recommended that the physician decides according to clinical manifestations, laboratory findings, and positive CT results. [ABSTRACT FROM AUTHOR]

Introduction: SARS-CoV-2 infection is spreading around the world, including countries from Southeastern Europe. The purpose of the study was to present the clinical manifestations of COVID-19 patients admitted to the Military Medical Academy, Sofia, Bulgaria. Materials and Methods: A retrospective study was conducted for a period of 3 months from March 2020 to June 2020 on this infection in our hospital. All participants were laboratory confirmed cases of COVID-19. RTPCR was performed for etiological diagnosis. The hospitalized patients were divided into two groups on admission, that is, nonsevere and severe. Results: One hundred thirty-eight COVID-19 patients were hospitalized and analyzed during the study period. The mean age was 52.9 years. Male was the dominant sex (sex ratio: male/female = 1/0.6). The leading clinical signs were fever, fatigue, cough, and headache. On comparative analysis of both groups (nonsevere and severe) was measured significant elevation of white blood cells (odds ratio [OR] = 1.238; p value = 0.006), C-reactive protein (OR = 1.021; p < 0.001), creatinine (OR = 1.037; p < 0.001), aspartate aminotransferase (OR = 1.014; p = 0.040), lactate dehydrogenase (OR = 1.004; p < 0.001), ferritin (OR = 1.002; p < 0.001), fibrinogen (OR = 2.028; p < 0.001), and d-dimer (OR = 2.162; p = 0.002) in severe group than in nonsevere group. Interleukin 6 was tested in 17.4% of patients and high value was found--38.6 pg/mL (95% confidence interval: 16.5-60.7). Conclusion: The first Bulgarian retrospective study of COVID-19 hospitalized patients was presented. Older age, male sex, comorbidity, and signs of dyspnea and nausea were estimated as higher risk factors for severe form. Abnormality in inflammatory markers was associated with poor progression of the illness. [ABSTRACT FROM AUTHOR]

Purpose: Identification of clinical predictors of acute and surgical pathologies on abdominal CT in patients with non-traumatic abdominal pain (NTAP). Methods: Retrospective chart review cohort study of adults who had abdominal CT scans for investigation of NTAP in the Emergency Department in a tertiary care center in Lebanon. Multivariate analyses were performed to identify predictors of pathologies on CT scan. Results: This study included 147 patients who had abdominal CT scans for NTAP. Mean age was 39.8 ± 15.1 years and 58.5 % of patients were females. Less than half (44.9 %) had normal scans. Women had significantly higher rates of normal scans compared to males. Right lower quadrant (RLQ) tenderness was associated with significantly higher odds of having acute abnormalities on CT and of having surgical diagnoses, while epigastric tenderness was negatively associated with these two outcomes. Right and left upper quadrants and diffuse abdominal tenderness, and an abnormal neutrophil count were found to be associated with surgical diagnoses on CT. Conclusions: Women are less likely to have acute and surgical pathologies on CT ordered for non traumatic abdominal pain. Epigastric tenderness is negatively associated with abnormal and surgical CT results while RLQ tenderness is associated with an abnormal CT that is likely surgical in nature. These findings should help improve diagnostic accuracy of ordering providers and improve resource utilization.

Objectives: The aim of this meta-analysis was to assess association between a composite clinical outcome (severe infection/required ICU admission/death) of COVID-19 pneumonia and demographic, clinical, laboratory and radiological findings of these patients. Methods: A literature search was conducted using the databases PubMed, Medline, Scopus and Web of Science till July. Relative risk (RRs), standardized mean difference (SMDs) and 95% confidence intervals (CIs) were pooled using random-effects models. We described overall estimates of relevant data of clinical importance from 116,260 COVID-19 pneumonia patients including 19,628 with composite end points from 40 observational studies of 5 countries. Results: The result showed that male gender (RR=1.24, p <.001), older age (SMD= 3.19, P<.001) especially > 64 years (RR=2.52, P <.001) followed aggravated course. Delayed hospitalization (SMD=.75, p= 0.005), presence of comorbidity (RR= 1.76, p<.001) and multiple co-morbidities (RR=1.50, p<.001) were associated with higher risk of fatal course. Pooled data reported significantly high neutrophil-lymphocyte ratio (SMD=10.79, p<.001), low lymphocyte-to-C-reactive protein ratio (SMD=-3.89, p<.001), low platelet count (SMD=-1.622, p<.001), prolonged prothrombin time (SMD=0.98, p<.001), high lactate dehydrogenase (SMD=6.260, p<.001), D-dimer (SMD=1.92, p<.001), creatine kinase (SMD=1.68, p= 0.001) and interleukin-6 level (SMD=2.84, P=.001) in patients with fatal outcome. Funnel plots and Egger's tests did not reveal any significant publication bias. Conclusions: Features like older age, male gender, presence of co-morbidities and delayed hospitalization along with the laboratory findings consistent with infection, immune system activation, coagulation disorder and tissue damage could help clinicians to identify COVID-19 patients with poor prognosis at an early stage. [ABSTRACT FROM AUTHOR]

In this study, we investigated whether hypereosinophilia (peripheral eosinophil ≥ 1500/mm3) at diagnosis could estimate the increased current activity and predict the poor prognosis during follow-up in patients with eosinophilic granulomatosis with polyangiitis (EGPA). We retrospectively reviewed the medical records of 42 patients with EGPA and finally included 30 systemic immunosuppressive drug-naïve patients. We obtained clinical and laboratory data including clinical manifestations, Birmingham vasculitis activity score (BVAS), five-factor score (FFS) (2009), and routine laboratory results. Hypereosinophilia was defined as peripheral eosinophil ≥ 1500/mm3. We divided EGPA patients based on hypereosinophilia and compared variables between the two groups. The cumulative relapse-free survival rates were compared by the Kaplan–Meier survival analysis. Patients with hypereosinophilia more commonly exhibited cutaneous manifestation than those without (50.0% vs. 14.3%, P = 0.038), but there were no significant differences in BVAS and FFS (2009) at diagnosis. Patients with hypereosinophilia showed the higher median WBC (14,200.0/mm3 vs. 7940.0/mm3) and CRP (17.6 mg/L vs. 2.0 mg/L) at diagnosis than those without. During follow-up, patients with hypereosinophilia at diagnosis exhibited the similar cumulative relapse-free survival rate to those without (P = 0.393). Whereas, patients with FFS (2009) at diagnosis ≥ 2, which was a well-known predictor of the poor prognosis of EGPA, exhibited the lower cumulative relapse-free survival rate than those with FFS (2009) < 2 (P = 0.030). Hypereosinophilia at diagnosis could neither estimate the current activity nor predict relapse in systemic immunosuppressive drug-naïve patients with EGPA unlike theoretical assumption. [ABSTRACT FROM AUTHOR]

Health literacy has been defined and studied as an important component of a patient's ability to understand and obtain appropriate healthcare. However, a laboratory component of health literacy, as it pertains to the understanding of laboratory tests and their results, has not been previously defined. An analysis of readily available health literacy tools was conducted to determine laboratory testing-specific content representation. One hundred and four health literacy tools from a publicly available database were analyzed. Many of the health literacy tools were found to be lacking items related to laboratory testing. Of the health literacy tools that did contain a laboratory component, they were categorized pertaining to the laboratory test/testing content. Emerging from this process, eight competencies were identified that encompassed the entire range of laboratory-related aspects of health literacy. We propose that these eight competencies form the basis of a set of competencies needed for one to access, interpret, and act on laboratory results-a capacity we are referring to as "laboratory literacy.", (© 2023 The Authors.)

Objective: Since the anesthesiologist and surgeon have different observation angles in the intraoperative period, their predictions based on clinical observation vary greatly. Whether these predictions accurately reflect actual blood loss is still a matter of debate. The aim of this study was to compare the clinical observations of anesthesiologists and surgeons on perioperative blood loss and transfusion requirements with laboratory results. Methods: Sixty patients who were scheduled for major orthopedic surgery were included in the study. Same anesthesiologist and the same surgeon were asked to estimate the amount of blood loss , and whether blood transfusion was needed during the perioperative period. The amount of blood loss was calculated synchronously using the perioperative hemoglobin value and the total blood volume. The blood loss estimates of the anesthesiologist and the surgeon were compared, with blood loss calculated in the laboratory. Results: The anesthesiologist’s and the surgeon’s estimates of perioperative mean blood loss volume were found to be lower than the blood volume calculated in the laboratory (p=0.01). When the estimated blood loss was less than 600 mL, it was considered as overestimation, and when it was more than 600 mL then it was interpreted as 20% underestimation (p=0.01). According to our findings, the rate of error in the perioperative blood loss estimates was 28.72%. When the blood loss was more than 1000 mL, the error rate of predictions was 34.03%; when it was less than 1000 mL, the error rate of predictions was 25.18%. Conclusion: We believe that when blood loss is more than 1000 mL in major orthopedic surgeries, the error in the estimation is increased, the amount of blood loss is difficult to predict, and the anesthesiologist makes a better prediction than the surgeon. [ABSTRACT FROM AUTHOR]

Objective The aim of the research paper was to assess selected laboratory results in children with fever without seizures and febrile seizure. Materials and Methods The paper presents an analysis of a group of 306 children aged 6 months - 5 years who were admitted with diagnosed fever without seizures and febrile seizures in Specialized Health Care Centre for Mother and Child in Poznan between 1st January 2008 and 31st December 2009. Out of the diagnostics procedures performed in children the following ones were taken into consideration: BCC and CRP. Results Of the analyzed group of 306 children, 59.48% were boys and 40.52% were girls. In the studied group 61.93% were boys and control group 56.15% were boys. Mean age of admitted children was 22 months. In the study group mean body temperature was 39.0°C and in the control group 38.6°C. A statistically significant difference was found between body temperature of study and control group ( p = .005). The mean C-reactive protein level in the study group was 15.73 mg/L and in the control group 58.20 mg/L. There was a statistically significant difference ( p < .001). There was a statistically significant difference between the number of lymphocytes and neutrophils ( p < .001). There was also a statistically significant difference between the number of hemoglobin, hematocrit and platelets. Conclusions The study showed that children with FS, had statistically significant higher neutrophils level compared to those with fever without seizures. The number of lymphocytes was lower in children with FS than in children with fever without seizures. [ABSTRACT FROM AUTHOR]

Summary: Fracture liaison services often perform laboratory testing, but these results may be altered by surgery. In 40 hip arthroplasty patients, many laboratory parameters of bone health relevance were reduced by 8-22% on the first post-operative day. Laboratory results obtained in the immediate post-surgery interval do not reliably ascertain baseline status. Introduction: As secondary causes of osteoporosis are common, fracture liaison services often perform laboratory testing in the immediate post-fracture interval. We hypothesized that laboratory results obtained shortly after surgery may not accurately ascertain baseline status. If true, such alterations might confound subsequent fracture prevention efforts. Methods: Patients undergoing elective total hip arthroplasty were studied as a surrogate for hip fracture patients. Blood and urine were obtained 2 weeks before surgery, before anesthetic induction, on post-operative day one, and 6 weeks after surgery. Serum total and free 25-hydroxyvitamin D (25(OH)D), vitamin D-binding protein (DBP), calcium, creatinine, albumin (Alb), alkaline phosphatase (ALP), plasma hemoglobin (Hgb) and urinary DBP/creatinine ratio (UDBP/Cr) were measured. Results: Forty volunteers (28 women; 12 men) with mean age of 65.7 [8.7] years were studied. Laboratory results were stable from 2 weeks before to the day of surgery. On the first day after surgery, total 25(OH)D, DBP, calcium, creatinine, ALP, and Alb declined 8-22% ( p < 0.0001); free 25(OH)D and Hgb declined by 8 and 15% ( p < 0.01), respectively; and UDBP/Cr increased 32% ( p < 0.01). Using a 25(OH)D <30 ng/mL threshold, vitamin D inadequacy prevalence increased from 38% before surgery to 68% the day after ( p < 0.001). All laboratory values returned to baseline at 6 weeks after surgery. Conclusions: Laboratory values are reduced immediately following elective total hip arthroplasty. Testing at that time does not accurately ascertain baseline status and may lead to elevated estimates of vitamin D inadequacy, incorrect interventions, and misallocation of healthcare resources. [ABSTRACT FROM AUTHOR]

Background: With regard to the German E-Health Law of 2016, the DGKL has been invited to develop a standard procedure for the storage and transmission of laboratory results. We suggest the commonly used z-transformation. Methods: This method evaluates by how many standard deviations a given result deviates from the mean of the respective reference population. We confirm with real data that laboratory results of healthy individuals can be adjusted to a normal distribution by logarithmic transformation. Results: Thus, knowing the lower and upper reference limits LL and UL, one can transform any result x into a zlog value using the following equation: The result can easily be interpreted, since its reference interval is -1.96 to +1.96 by default, and very low or high results yield zlog values around -5 and +5, respectively. For intuitive data presentation, the zlog values may be transformed into a continuous colour scale, e.g. from blue via white to orange. Using the inverse function, any zlog value can then be translated into the theoretical result of an analytical method with another reference interval: Conclusions: Our standardization proposal can easily be put into practice and may effectively contribute to data quality and patient safety in the frame of the German E-health law. We suggest for the future that laboratories should provide the zlog value in addition to the original result, and that the data transmission protocols (e.g. HL7, LDT) should contain a special field for this additional value. [ABSTRACT FROM AUTHOR]

Background: Delays in reviewing issued laboratory results in emergency departments (EDs) can adversely affect efficiency and quality of care. One opportunity to improve therapeutic turnaround time could be to provide real-time access to laboratory results on mobile devices available to every caregiver. We developed a mobile app named "Patients In My Pocket in my Hospital" (PIMPmyHospital) to help ED caregivers automatically obtain and share relevant information about the patients they care for including laboratory results., Objective: This pre- and posttest study aims to explore whether the implementation of the PIMPmyHospital app impacts the timeliness with which ED physicians and nurses remotely access laboratory results while actively working in their real-world environment, including ED length of stay, technology acceptance and usability among users, and how specific in-app alerts impact on its effectiveness., Methods: This single-center study of nonequivalent pre- and posttest comparison group design will be conducted before and after the implementation of the app in a tertiary pediatric ED in Switzerland. The retrospective period will cover the previous 12 months, and the prospective period will cover the following 6 months. Participants will be postgraduate residents pursuing a ≤6-year residency in pediatrics, pediatric emergency medicine fellows, and registered nurses from the pediatric ED. The primary outcome will be the mean elapsed time in minutes from delivery of laboratory results to caregivers' consideration by accessing them either through the hospital's electronic medical records or through the app before and after the implementation of the app, respectively. As secondary outcomes, participants will be queried about the acceptance and usability of the app using the Unified Theory of Acceptance and Use of Technology model and the System Usability Scale. ED length of stay will be compared before and after the implementation of the app for patients with laboratory results. The impact of specific alerts on the app, such as a flashing icon or sound for reported pathological values, will be reported., Results: Retrospective data collection gathered from the institutional data set will span a 12-month period from October 2021 to October 2022, while the 6-month prospective collection will begin with the implementation of the app in November 2022 and is expected to cease at the end of April 2023. We expect the results of the study to be published in a peer-reviewed journal in late 2023., Conclusions: This study will show the potential reach, effectiveness, acceptance, and use of the PIMPmyHospital app among ED caregivers. The findings of this study will serve as the basis for future research on the app and any further development to improve its effectiveness. Trial Registration: ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331., Trial Registration: ClinicalTrials.gov NCT05557331; https://clinicaltrials.gov/ct2/show/NCT05557331., International Registered Report Identifier (irrid): PRR1-10.2196/43695., (©Frederic Ehrler, Carlotta Tuor, Robin Rey, Rémy Trompier, Antoine Berger, Michael Ramusi, Delphine S Courvoisier, Johan N Siebert. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 03.05.2023.)