The prevalence of bacterial contamination in donated blood in Dar es salaam, Tanzania

Blood transfusion services are required to provide blood and components which are safe in cost effective way for transfusion into patients who require the blood products. This study aims to determine the prevalence of bacterial contamination and the antimicrobial resistance pattern in collected blood in Eastern zone blood transfusion centre. A cross-sectional study was conducted at Eastern Zone Blood Transfusion Services located at Mchikichini, Ilala District, in Dar es Salaam. Stored whole blood bags were selected from the refrigerator containing 500 blood bags using a simple random sampling technique. About 384 blood bags were randomly picked for study, each blood bag was given an ID number (1-500), and a table of random numbers was used to select the 384 donated blood bags. Culture was done on different media; isolates were identified using standard biochemical and bacteriological methods. Kirby- Bauer disk diffusion method was used for antimicrobial susceptibility testing according to existing guidelines of CLSI. Data entry and analysis were performed using EpiInfo 3.5.1. About 11 (2.8%) were found to have bacterial contamination, of which 9 (2.3%) were gram positive cocci and 2 (0.5%) gram positive rods. The bacterial isolates were about 7 (63.6%) coagulase negative staphylococci identified as Staphylococcus epidermidis and 2 (18.2%) were micro cocci identified as M.luteus and bacilli species identified as Corynebacterium diphtheroids. Sensitivity among the organisms were varied; as all the 11 (100%) of the organisms isolated were sensitive to amikacin, of which 7 (100%) Staphylococcus epidermidis were sensitive to ciprofloxacin, gentamycine, cefriaxone, erythromycin and co-trimoxazole. Gram positive rods were tested against erythromycin and Gentamycine; where 100% were sensitive to Gentamycine and (60.5%) were sensitive to erythromycin. M.luteus were tested against ceftriaxone and gentamycin had (98%) and (97.5%) sensitivity to these antibiotics respectively. Gram positive rods showed (100%) resistant to ampicilin, cotrimoxazole and tetracycline The isolates obtained in the donated blood are skin associated organisms and are considered as contaminants related to procedure during donor bleeding or taking sample for culture

A review of evidence on non-invasive prenatal diagnosis (NIPD) : tests for fetal RHD genotype

This report concentrates on three main areas. First and foremost, we set the background context for RhD NIPD in prenatal care. While the methodology chapter describes how the literature review was carried out and how additional information was collected, the second chapter provides an overview of the key issues associated with pregnancy of RhD negative women. We present background information based on publications from 1997 to 2006 which describe the genetic condition and its prevalence (RhD negativity) in populations, as well as the frequency of cases of sensitisation and HDN (haemolytic disease of the newborn). We also discuss current service provision for RhD negative women in a number of European countries and look at how the NIPD test might be set within current service contexts

Causes of prehospital misinterpretations of ST elevation myocardial infarction

Objectives: To determine the causes of software misinterpretation of ST elevation myocardial infarction (STEMI) compared to clinically identified STEMI to identify opportunities to improve prehospital STEMI identification. Methods: We compared ECGs acquired from July 2011 through June 2012 using the LIFEPAK 15 on adult patients transported by the Los Angeles Fire Department. Cases included patients ≥18 years who received a prehospital ECG. Software interpretation of the ECG (STEMI or not) was compared with data in the regional EMS registry to classify the interpretation as true positive (TP), true negative (TN), false positive (FP), or false negative (FN). For cases where classification was not possible using registry data, 3 blinded cardiologists interpreted the ECG. Each discordance was subsequently reviewed to determine the likely cause of misclassification. The cardiologists independently reviewed a sample of these discordant ECGs and the causes of misclassification were updated in an iterative fashion. Results: Of 44,611 cases, 50% were male (median age 65; inter-quartile range 52–80). Cases were classified as 482 (1.1%) TP, 711 (1.6%) FP, 43371 (97.2%) TN, and 47 (0.11%) FN. Of the 711 classified as FP, 126 (18%) were considered appropriate for, though did not undergo, emergent coronary angiography, because the ECG showed definite (52 cases) or borderline (65 cases) ischemic ST elevation, a STEMI equivalent (5 cases) or ST-elevation due to vasospasm (4 cases). The sensitivity was 92.8% [95% CI 90.6, 94.7%] and the specificity 98.7% [95% CI 98.6, 98.8%]. The leading causes of FP were ECG artifact (20%), early repolarization (16%), probable pericarditis/myocarditis (13%), indeterminate (12%), left ventricular hypertrophy (8%), and right bundle branch block (5%). There were 18 additional reasons for FP interpretation (<4% each). The leading causes of FN were borderline ST-segment elevations less than the algorithm threshold (40%) and tall T waves reducing the ST/T ratio below threshold (15%). There were 11 additional reasons for FN interpretation occurring ≤3 times each. Conclusion: The leading causes of FP automated interpretation of STEMI were ECG artifact and non-ischemic causes of ST-segment elevation. FN were rare and were related to ST-segment elevation or ST/T ratio that did not meet the software algorithm threshold

Advancing Physician Performance Measurement: Using Administrative Data to Assess Physician Quality and Efficiency

Summarizes national initiatives to advance the practice of standardized measurement and outlines goals for developing a method for tracking efficiency and quality that will reward physicians and enable patients to make informed healthcare choices

Technology applications

A summary of NASA Technology Utilization programs for the period of 1 December 1971 through 31 May 1972 is presented. An abbreviated description of the overall Technology Utilization Applications Program is provided as a background for the specific applications examples. Subjects discussed are in the broad headings of: (1) cancer, (2) cardiovascular disease, (2) medical instrumentation, (4) urinary system disorders, (5) rehabilitation medicine, (6) air and water pollution, (7) housing and urban construction, (8) fire safety, (9) law enforcement and criminalistics, (10) transportation, and (11) mine safety

A (digital) finger on the pulse

Complex Event Processing (CEP) is a computer-based technique used to track, analyse and process data in real-time (as an event happens). It establishes correlations between streams of information and matches to defined behaviour

HER2 testing in breast cancer: Opportunities and challenges

Human epidermal growth factor receptor 2 (HER2) is overexpressed in 15-25% of breast cancers, usually as a result of HER2 gene amplification. Positive HER2 status is considered to be an adverse prognostic factor. Recognition of the role of HER2 in breast cancer growth has led to the development of anti-HER2 directed therapy, with the humanized monoclonal antibody trastuzumab (Herceptin (R)) having been approved for the therapy of HER2-positive metastatic breast cancer. Clinical studies have further suggested that HER2 status can provide important information regarding success or failure of certain hormonal therapies or chemotherapies. As a result of these developments, there has been increasing demand to perform HER2 testing on current and archived breast cancer specimens. This article reviews the molecular background of HER2 function, activation and inhibition as well as current opinions concerning its role in chemosensitivity and interaction with estrogen receptor biology. The different tissue-based assays used to detect HER2 amplification and overexpression are discussed with respect to their advantages and disadvantages, when to test (at initial diagnosis or pre-treatment), where to test (locally or centralized) and the need for quality assurance to ensure accurate and valid testing results

Knowledge-based best of breed approach for automated detection of clinical events based on German free text digital hospital discharge letters

OBJECTIVES: The secondary use of medical data contained in electronic medical records, such as hospital discharge letters, is a valuable resource for the improvement of clinical care (e.g. in terms of medication safety) or for research purposes. However, the automated processing and analysis of medical free text still poses a huge challenge to available natural language processing (NLP) systems. The aim of this study was to implement a knowledge-based best of breed approach, combining a terminology server with integrated ontology, a NLP pipeline and a rules engine. METHODS: We tested the performance of this approach in a use case. The clinical event of interest was the particular drug-disease interaction "proton-pump inhibitor [PPI] use and osteoporosis". Cases were to be identified based on free text digital discharge letters as source of information. Automated detection was validated against a gold standard. RESULTS: Precision of recognition of osteoporosis was 94.19%, and recall was 97.45%. PPIs were detected with 100% precision and 97.97% recall. The F-score for the detection of the given drug-disease-interaction was 96,13%. CONCLUSION: We could show that our approach of combining a NLP pipeline, a terminology server, and a rules engine for the purpose of automated detection of clinical events such as drug-disease interactions from free text digital hospital discharge letters was effective. There is huge potential for the implementation in clinical and research contexts, as this approach enables analyses of very high numbers of medical free text documents within a short time period

Applications of aerospace technology in the public sector

Current activities of the program to accelerate specific applications of space related technology in major public sector problem areas are summarized for the period 1 June 1971 through 30 November 1971. An overview of NASA technology, technology applications, and supporting activities are presented. Specific technology applications in biomedicine are reported including cancer detection, treatment and research; cardiovascular diseases, diagnosis, and treatment; medical instrumentation; kidney function disorders, treatment, and research; and rehabilitation medicine