Additional technician tasks and turnaround time in the clinical Stat laboratory.

Introduction: Many additional tasks in the Stat laboratory (SL) increase the workload. It is necessary to control them because they can affect the service provided by the laboratory. Our aim is to calculate these tasks, study their evolution over a 10 year period, and compare turnaround times (TAT) in summer period to the rest of the year. Materials and methods: Additional tasks were classified as “additional test request” and “additional sample”. We collected those incidences from the laboratory information system (LIS), and calculated their evolution over time. We also calculated the monthly TAT for troponin for Emergency department (ED) patients, as the difference between the verification and LIS registration time. A median time of 30 minutes was our indicator target. TAT results and tests workload in summer were compared to the rest of the year. Results: Over a 10-year period, the technologists in the SL performed 51,385 additional tasks, a median of 475 per month. The workload was significantly higher during the summer (45,496 tests) than the rest of the year (44,555 tests) (P = 0.019). The troponin TAT did not show this variation between summer and the rest of the year, complying always with our 30 minutes indicator target. Conclusion: The technicians accomplished a significant number of additional tasks, and the workload kept increasing over the period of 10 years. That did not affect the TAT results

Efecto ansiolítico in vivo del extracto etanólico de passiflora salpoense (passifloraceae)

Evaluar el efecto ansiolítico in vivo del extracto etanólico de Passiflora salpoense (passifloraceae). Material y métodos: Se trabajó con 20 ratones Balb/c que aleatoreamente fueron distribuidos en 4 grupos administrándoles por vía oral (VO) de la siguiente forma: G1: Grupo blanco 0,2 ml de solución salina, G2: Grupo diazepam 1mg/kg, G3: Grupo 50 mg/kg de extracto etanólico de P. salpoense y G4: Grupo 100 mg/kg de extracto etanólico de P. salpoense. Luego, a los ratones se indujeron a ansiedad usando la prueba de Murble burying Test o prueba de enterramiento de canicas. Resultados: Los resultados demostraron que los grupos G3 y G4 disminuyeron de manera significativa el número de esferas enterradas con una media 9,60 ± 1,82 y 4,20 ± 1,30, respectivamente a comparación del grupo control blanco (G1) cuya media fue de 17,20 ± 3,03. Asimismo, los grupos G3 y G4, presentó una respuesta similar al grupo G2 cuya media fue de 3 ± 0,71. Conclusiones: Por lo tanto, que se concluyó que las dosis 50 mg/kg y 100 mg/kg del extracto etanólico de Passiflora salpoense (Passifloraceae) disminuyen los niveles de ansiedad de forma significativa (p<0.05).Evaluate in vivo the anxiolytic effect of the ethanolic extract of Passiflora salpoense (Passifloraceae). Material and methods: A prospective, transversal, preclinical in vivo. It was used 20 Balb/c mice that were randomly distributed in 4 groups for administering them orally in the following way: G1: white group 0.2 ml saline solution, G2: group diazepam 1 mg/kg, G3: group 50 mg/kg of ethanolic extract of P. salpoense, and G4: group 100 mg/kg of ethanolic extract of P. salpoense. Then, the mice were induced to anxiety using the Marble burying test. Results: G3 and G4 groups significantly decreased the number of buried spheres with a mean of 9.60 ± 1.82 and 4.20 ± 1.30, respectively compared to the white control group (G1) whose mean was 17.20 ± 3.03. Likewise, the G3 and G4 groups presented a response similar to the G2 group whose mean was 3 ± 0.71. Conclusions: The doses 50 mg/kg and 100 mg/kg of the ethanolic extract of Passiflora salpoense significantly reduce anxiety levels (p < 0..05)Tesi

Big differences in primary care celiac disease serological markers request in Spain

Introduction: Celiac disease (CD) prevalence is increasing but the disorder remains undiagnosed. The study compares CD serology markers requested by General Practitioners (GPs) over time and geographical areas. The aim of the current research is to assess the inter-practice and temporal variability in the request of CD serology markers by GPs in Spain, and the differences between regions. Materials and methods: A cross-sectional study was conducted enrolling Spanish clinical laboratories. Primary care CD serology markers request in 2010, 2012 and 2014 from 15 autonomous communities (AACC), with more participants was reported. Test-utilization rates were calculated (tissue transglutaminase IgA antibodies (tTG-IgA) and deaminated peptide gliadine IgA antibodies (DGP-IgA) per 1000 inhabitants), and also the ratio of both tests request (DGP-IgA /tTG-IgA). Results: The request of tTG-IgA per 1000 inhabitants increased significantly along years (from 3.99 to 5.90 (P < 0.001)). The demand of DGP-IgA per 1000 inhabitants was maintained in 2010 and 2012 (0.68 and 0.6), and decreased in 2014 (0.35) (P = 0.927). DGP-IgA /tTG-IgA diminished over time (from 0.16 to 0.06 (P = 0.548)), and in the 2014 edition, there was a significant regional difference, ranging from 0.01 to 0.57 (P < 0.001). Conclusions: The variability in the request in CD serology markers emphasizes the need of inter-regional cooperation to develop strategies to optimize the use of laboratory test

Automatic laboratory-based strategy to improve the diagnosis of type 2 diabetes in primary care

Introduction: To study the pre-design and success of a strategy based on the addition of hemoglobin A1c (HbA1c) in the blood samples of certain primary care patients to detect new cases of type 2 diabetes. Materials and methods: In a first step, we retrospectively calculated the number of HbA1c that would have been measured in one year if HbA1c would have been processed, according to the guidelines of the American Diabetes Association (ADA). Based on those results we decided to prospectively measure HbA1c in every primary care patient above 45 years, with no HbA1c in the previous 3 years, and glucose concentration between 5.6-6.9 mmol/L, during an 18 months period. We calculated the number of HbA1c that were automatically added by the LIS based on our strategy, we evaluated the medical record of such subjects to confirm whether type 2 diabetes was finally confirmed, and we calculated the cost of our intervention. Results: In a first stage, according to the guidelines, Hb1Ac should have been added to the blood samples of 13,085 patients, resulting in a cost of 14,973€. In the prospective study, the laboratory added Hb1Ac to 2092 patients, leading to an expense of 2393€. 314 patients had an HbA1c value ≥ 6.5% (48 mmol/mol). 82 were finally diagnosed as type 2 diabetes; 28 thanks to our strategy, with an individual cost of 85.4€; and 54 due to the request of HbA1c by the general practitioners (GPs), with a cost of 47.5€. Conclusion: The automatic laboratory-based strategy detected patients with type 2 diabetes in primary care, at a cost of 85.4€ per new case

Factores asociados a la no adherencia del tratamiento antirretroviral de gran actividad en adultos con sindrome de inmunodeficiencia adquirida Hospital Lazarte

Mediante la presente investigación se busca determinar los factores asociados a la no Adherencia del Tratamiento Antirretroviral de Gran Actividad en adultos con Síndrome de Inmunodeficiencia Adquirida en Hospital Víctor Lazarte Echegaray. Para lo cual; se llevó a cabo un estudio de tipo analítico, observacional, retrospectivo, de casos y controles. La población de estudio estuvo constituida por 150 pacientes adultos con Síndrome de Inmunodeficiencia Adquirida según criterios de inclusión y exclusión establecidos; distribuidos en dos grupos: con y sin adherencia del Tratamiento Antirretroviral de Gran Actividad. Teniendo como resultados que el promedio de edad en el grupo no adherente fue 26.4 años y en el grupo adherente fue 31.5 años (p<0.05); El promedio de tiempo de enfermedad en el grupo no adherente fue 4.6 años y en el grupo adherente fue 2.5 años (p<0.05); el tener grado de instrucción analfabeta o primaria condiciona un odds ratio de 4.1 (p<0.05) de no adherencia al TARGA; el tener conducta homosexual condiciona un odds ratio de 2.1 (p<0.05) de no adherencia al TARGA. Concluyendo que el tener menor edad, mayor tiempo de enfermedad, grado de instrucción analfabeta o primaria y tener conducta homosexual es factor asociado a la no adherencia al TARGA en adultos con Síndrome de Inmunodeficiencia Adquirida.The purpose of this research is to determine the factors associated with Nonadherence of Highly Active Antiretroviral Therapy (HAART) in adults with Acquired Immune Deficiency Syndrome (AIDS) in Victor Lazarte Echegaray Hospital. For this purpose, a retrospective, observational and analytical case-control study was made. The study population consisted of 150 adult patients with Acquired Immune Deficiency Syndrome as per inclusion and exclusion criteria; divided them into two groups: with or without adherence of Highly Active Antiretroviral Therapy. As a result of this research, the average age was 26.4 years for the nonadherent group and 31.5 years in tha dherent group (p <0.05); the average time of disease was 4.6 years for the non-adherent group and 2.5 years in the adherent group (p <0.05); an education level of illiterate or elementary determines an odds ratio of 4.1 (p <0.05) of nonadherence to HAART; an homosexual behavior calculates an odds ratio of 2.1 (p <0.05) of non-adherence to HAART. In conclusion, younger age, longer time of the disease and elementary or illiterate education level and homosexual behavior is a factor associated with non-adherence to HAART in adults with Acquired Immunodeficiency Syndrome

Education and communication is the key for the successful management of vitamin D test requesting

Introduction: Pre-preanalytical and post-postanalytical phases are steps where the laboratory professional may play a crucial role. Measuring the serum circulating 25 hydroxyvitamin D level (25(OH)D) is recommended to evaluate vitamin D status in patients at risk for vitamin D deficiency while 1,25 hydroxyvitamin D (1,25(OH)2D) is only recommended to monitor several particular conditions (chronic kidney disease, hereditary phosphate-losing disorders, and some other) clearly defined by the current clinical guidelines of Endocrine Society. Our research hypothesis was that through education and communication through comments in the Laboratory Information System (LIS), we could improve appropriateness in the request vitamin D tests. Materials and methods: A retrospective observational cross-sectional study was conducted from January 2005 to December 2014. Each 1,25(OH)2D request was reviewed individually by a member of the laboratory staff. Starting in November 2011, each inappropriate 1,25(OH)2D request was registered in LIS and 25(OH)D was measured instead of 1,25(OH)2D. We counted the overall number of 1,25(OH)2D requests and the number of inappropriate requests which then were marked with a comment. Results: The request of 25(OH)D increased along years. However, 1,25(OH)2D requests increased until 2012 when demand began to diminish. Conclusions: Education and communication through comments in the LIS, corrected the inappropri-ate request of 1,25(OH)2D and promoted the use of 25(OH)D to study vitamin D deficiency

Perfusion computed tomography relative threshold values in definition of acute stroke lesions

BACKGROUND: Perfusion computed tomography (CT) is a relatively new technique that allows fast evaluation of cerebral hemodynamics by providing perfusion maps and gives confirmation of perfusion deficits in ischemic areas. Some controversies exist regarding accuracy of quantitative detection of tissue viability: penumbra (tissue at risk) or core (necrosis). PURPOSE: To define brain tissue viability grade on the basis of the perfusion CT parameters in acute stroke patients. MATERIAL AND METHODS: A multimodal CT imaging protocol; unenhanced CT of the brain, CT angiography of head and neck blood vessels, followed by brain perfusion CT and 24 h follow-up brain CT was performed. Perfusion deficits were detected first visually, with subsequent manual quantitative and relative measurements in affected and contra-lateral hemisphere in 87 acute stroke patients. RESULTS: Visual perfusion deficit on perfusion CT images was found in 78 cases (38 women, 40 men; mean age, 30-84 years). Penumbra lesions (n = 49) and core lesions (n = 42) were detected by increased mean transit time (MTT) on perfusion CT maps in comparison to contra-lateral hemispheres. Cerebral blood volume (CBV) mean values in the penumbra group were increased in the penumbra group and decreased in the core group. Cerebral blood flow (CBF) values were decreased in penumbra and markedly decreased in core lesion. CONCLUSION: Perfusion CT measurements are reliable in estimation of penumbra and core lesions in acute stroke patients, if relative threshold values are used. The most accurate parameter of hypoperfusion is increased MTT above 190%. Relative threshold values for irreversible lesion are CBFpublishersversionPeer reviewe

Análisis factorial exploratorio de la escala de impacto psicosocial de los desastres en una muestra de personas que vivieron el terremoto y tsunami del 27 de febrero de 2010

110 p.La presente investigación busca validar de manera exploratoria la Escala de Impacto Psicosocial en desastres ("PsychosocialImpactScale of Disasters" o SPSI-D) en personas que han sido expuestas al terremoto y tsunami del 27 de febrero de 2010, después de cinco años de ocurrido, específicamente estudiantes de psicología de Talca, de la facultad de psicología que sufrieron el 27-F cuando eran adolescentes y habitantes de la zona costera (Ciudad de Constitución de la Séptima región del Maule) damnificados por el terremoto y tsunami del 27-F. Para validar la escala se diseñaron 231 ítems que fueron evaluados por 6 jueces mediante Criterio de Acuerdo Interjueces. De estos, quedaron 194 ítems, los cuales fueron evaluados en una muestra de 194 personas (63% de habitantes de Constitución), obteniéndose 5 de 7 dimensiones iniciales correspondientes de Impacto Psicosocial: Protección v/s Desprotección (exposición al evento y apoyo social), Procesamiento (creencias sobre sí mismo, los otros y el mundo, estilos de afrontamiento e historias de eventos traumáticos) y Respuestas negativas versus Respuestas positivas (respuestas negativas y respuestas positivas). A partir de los resultados y su discusión se obtiene como un hallazgo importante que, a través de la validación de constructo del instrumento, el modelo teórico de PSI se observa y ajusta correctamente con sus 3 dimensiones, permitiendo su medición, es decir, que el modelo si es un constructo válido y medible en personas afectadas por el 27-F. Palabras clave: Impacto psicosocial, escala de impacto psicosocial, desastres naturales, análisis factorial exploratorio./ABSTRACT: This research seeks to validate in a exploratory way the "Psychosocial Impact Scale disaster" ("Psychosocial Impact Scale of Disasters" or SPSI-D) in population who have been exposed to the disaster of February 27, 2010, after five years occurred, specifically students from the University of Talca Faculty of psychology who suffered 27-F as teenagers, and residents of the coastal zone (City of Constitution of the Seventh Region of Maule) affected by the earthquake and tsunami 27- F. To validate the scale were designed 231 items, and were evaluated by six judges using criteria interrater agreement (CIA). Of these, were 94 items validated by the judges, which were assessed in a sample of 194 people (63% of population of Constitution town), leaving 5 from the 7 original dimentions corresponding of Psychosocial Impact: Protection v/s protection (exposure to the event and social support) Processing (beliefs about yourself, others and the world, coping styles and stories of traumatic events) and negative responses versus positive responses (negative responses and positive responses).From the results and their discussion is obtained, as an important finding that, through construct validation of the instrument, the theoretical model of PSI is observed and adjusted properly with its 3 dimensions, allowing measurement, in other words, the model itself is a valid and measurable construct in people affected by 27F Keywords: Psychosocial impact, psychosocial impact scale, natural disasters, exploratory factor analysis