Does routine repeat testing of critical laboratory values improve their accuracy?

Background: Routine repeat testing of critical laboratory values is very common these days to increase their accuracy and to avoid reporting false or infeasible results. We figure that repeat testing of critical laboratory values has any benefits or not. Methods: We examined 2233 repeated critical laboratory values in 13 different hematology and chemistry tests including: hemoglobin, white blood cell, platelet, international normalized ratio, partial thromboplastin time, glucose, potassium, sodium, phosphorus, magnesium, calcium, total bilirubin and direct bilirubin. The absolute difference and the percentage of change between the two tests for each critical value were calculated and then compared with the College of American Pathologists/Clinical Laboratory Improvement Amendments allowable error. Results: Repeat testing yielded results that were within the allowable error on 2213 of 2233 specimens (99.1). There was only one outlier (0.2) in the white blood cell test category, 9 (2.9) in the platelet test category, 5 (4) in the partial thromboplastin time test category, 5 (4.8) in the international normalized ratio test category and none in other test categories. Conclusion: Routine, repeat testing of critical hemoglobin, white blood cell, platelet, international normalized ratio, partial thromboplastin time, glucose, potassium, sodium, phosphorus, magnesium, calcium, total bilirubin and direct bilirubin results does not have any benefits to increase their accuracy

Characterization of Diclofenac Liposomes Formulated with Palm Oil Fractions

Purpose: To characterize diclofenac sodium (DS) liposomes prepared using palm oil fractions.Methods: Reverse-phase evaporation method was used to prepare liposomes containing 10, 20, 30 , 40 or 50% palm oil fractions. The effect of palm oil content on liposome formation, surface morphology, shape, size and zeta potential of the liposomes were studied using scanning electron microscopy (SEM) transmission electron microscopy (TEM) and particle analyzer. Drug loading, entrapment efficiency and in vitro drug release were measured in phosphate-buffered saline (PBS, pH 7.4) by UV spectrophotometry.Results: TEM and SEM images showed formation of liposomes for all formulations, However, increase in the proportion of palm oil in the formulations significantly reduced particle size and increased zeta potential. The effect on drug loading and drug release varied with palm oil fraction. The best release pattern with appropriate entrapment efficiency and stability was obtained with liposomes containing 33 % palm oil fraction. Introduction of 46 and 56 % of palm oil fractions yielded zeta potential of -42.8 and - 50.7 mV, respectively, compared with -31.2 mV for the formulation without palm oil.Conclusion: The results demonstrate the potentials of palm oil fractions in the preparation of suitable DS liposomes with good bioavailability.Keywords: Liposome, Drug delivery, Palm oil, Diclofenac

Osteoclast-like giant-cell tumor of the parotid with salivary duct carcinoma: Case report and cytologic, histologic, and immunohistochemical findings

Primary giant-cell tumor of the salivary gland is a rare lesion with an incompletely characterized histogenesis. To the best of our knowledge, only 16 cases have been previously documented in the English-language literature. We report a new case, which occurred in a 75-year-old man who presented with a parotid mass and cervical lymphadenopathy. The patient underwent a left total parotidectomy and cervical lymph node dissection. As far as we know, ours is the only reported case of a primary giant-cell tumor of the salivary gland in which the patient presented with lymph node metastasis. Because so little is known about giant-cell tumor of the salivary gland, we use the occasion of this case report to describe the cytologic, histologic, and immunohistochemical characteristics that we observed

Predicting the Geothermal Heat Flux in Greenland: A Machine Learning Approach

Geothermal heat flux (GHF) is a crucial boundary condition for making accurate predictions of ice sheet mass loss, yet it is poorly known in Greenland due to inaccessibility of the bedrock. Here we use a machine learning algorithm on a large collection of relevant geologic features and global GHF measurements and produce a GHF map of Greenland that we argue is within ∼15% accuracy. The main features of our predicted GHF map include a large region with high GHF in central‐north Greenland surrounding the NorthGRIP ice core site, and hot spots in the Jakobshavn Isbræ catchment, upstream of Petermann Gletscher, and near the terminus of Nioghalvfjerdsfjorden glacier. Our model also captures the trajectory of Greenland movement over the Icelandic plume by predicting a stripe of elevated GHF in central‐east Greenland. Finally, we show that our model can produce substantially more accurate predictions if additional measurements of GHF in Greenland are provided

On the Efficacy of Isolating Shoulder and Elbow Movements with a Soft, Portable, and Wearable Robotic Device

Treatment intensity has a profound effect on motor recovery following neurological injury. The use of robotics has potential to automate these labor-intensive therapy procedures that are typically performed by physical therapists. Further, the use of wearable robotics offers an aspect of portability that may allow for rehabilitation outside the clinic. The authors have developed a soft, portable, lightweight upper extremity wearable robotic device to provide motor rehabilitation of patients with affected upper limbs due to traumatic brain injury (TBI). A key feature of the device demonstrated in this paper is the isolation of shoulder and elbow movements necessary for effective rehabilitation interventions. Herein is presented a feasibility study with one subject and demonstration of the device's ability to provide safe, comfortable, and controlled upper extremity movements. Moreover, it is shown that by decoupling shoulder and elbow motions, desired isolated joint actuation can be achieved

Polysorbate 80 Inhibition of Pseudomonas aeruginosa Biofilm Formation and Its Cleavage by the Secreted Lipase LipA

Surface-associated bacterial communities known as biofilms are an important source of nosocomial infections. Microorganisms such as Pseudomonas aeruginosa can colonize the abiotic surfaces of medical implants, leading to chronic infections that are difficult to eradicate. Our study demonstrates that polysorbate 80 (PS80), a surfactant commonly added to food and medicines, is able to inhibit biofilm formation by P. aeruginosa on a variety of surfaces, including contact lenses

Blueberry muffin rash in a patient with hemolytic disease of the newborn due to anti-Cw

Blueberry muffin rash is a characteristic multiple bluish skin nodules associated with perinatal infection, severe and chronic anemia, and neoplastic infiltrative diseases. We present an unusually severe case of hemolytic disease of the newborn. He required exchange transfusions for several times. The complete work up led to the diagnosis of anti-Cw. The skin lesion regressed spontaneously within one month

Effect of dietary canola oil level on the growth performance and fatty acid composition of fingerlings of rainbow trout (Oncorhynchus mykiss)

This study evaluated the suitability of canola oil as a source of supplemental dietary lipid for rainbow trout. Triplicate groups of the 30 fingerlings held under identical culture conditions were fed twice daily by iso-nitrogenous, iso-calorific and iso-lipidic diets for eight weeks. Experimental diets consisted of 30.3% protein, 18.7 kJg^-1 energy and 16.7% lipid from fish oil (FO), canola oil (CO) and 1:1 blend of the two oils (FCO). Moisture, ash, protein, lipid, final body weight, condition factor, feed conversion ratio, survival and hepatosomatic indices were not affected by treatments. Specific growth rate and weight gain of fish reared on fish oil diet (FOD) and canola oil diet (COD) were significantly higher than those fed with the fish and canola oils diet (FCOD). Protein efficiency ratio was highest in fish fed with the COD. Whole body fatty acid compositions mirrored those of diet treatments. The highest amounts of HUFAs were detected in fish fed with FOD, which was significantly different from other treatments. In all treatments PUFAs/SFAs and n-6/n-3 ratios were higher than 0.45 and lower than 4, respectively. Our results indicate the fingerlings can be reared on diets in which FO has been replaced with CO, with no significant effects on fish growth performance