Näytekuljetusten lämpötilapoikkeamien vaikutus kokoverenä saapuvien näytteiden analysointikelpoisuuteen

Tämän opinnäytetyön tarkoituksena oli selvittää yleisimpien kokoverinäytteiden säilyvyyttä poikkeavissa näytekuljetuslämpötiloissa. Tavoitteena oli, että tutkimuksen avulla Meilahden sairaalan automaatiopäivystyslaboratorio saisi alustavan toimintamallin siitä, miten näytekuljetuksissa poikkeaville lämpötiloille altistuneiden näytteiden kanssa tulisi toimia. Tutkimuksen pohjalta luotiin laboratorion käyttöön luonnos ohjeesta näytteiden lämpötilatestausta varten, sillä vastaavaa ohjetta ei tällä hetkellä ole. Analyyttien säilyvyyttä tutkittiin kirjallisuuskatsauksen avulla perehtymällä aikaisempiin tieteellisiin tutkimuksiin aiheesta. Tutkimukset rajattiin koskemaan kuuden tunnin säilyvyyttä kokoverenä, sillä suurin osa näytteistä kuljetetaan HUSLABin toimipisteissä erottelematta, ja kuljetukset kestävät pisimmillään kahdesta tunnista kuuteen tuntiin. Kirjallisuuskatsauksen perusteella kalium, glukoosi, laktaattidehydrogenaasi ja epäorgaaninen fosfaatti olivat kaikkein herkimpiä lämpötilamuutoksille. Muut opinnäytetyöhön sisällytetyt analyytit säilyivät verraten hyvin sekä matalissa että korkeissa lämpötiloissa. Suoria johtopäätöksiä näytteiden säilyvyydestä ei voitu tehdä, sillä käytetyt tutkimusmenetelmät, lämpötilat ja ajat sekä tilastolliset menetelmät erosivat toisistaan aikaisemmissa tutkimuksissa. Useimmiten tulokset olivat kuitenkin samansuuntaisia, joten tuloksia voi pitää suuntaa-antavina. Tuloksiin tulee suhtautua kriittisesti, sillä joiltain osin eri tutkimusten välillä oli eriäviä tuloksia. CLSI:n (Clinical and Laboratory Standards Institute) suosituksen mukaisesti tulee varmistua aikaisemman tutkimustiedon soveltuvuudesta yksittäisen laboratorion käyttöön.The purpose of our study was to report the validity of the results of some of the most common whole blood sample analytes exposed to variant temperature conditions. The information we gathered will be utilised by the HUSLAB Automation Laboratory of Meilahti Hospital, Helsinki, Finland, to develop an operational model for the cases of sample temperature deviations during regional transportation. We did a literature review of the studies of the effects of temperature on the results of several common laboratory analyses. The temperatures varied from 3 to 38 degrees Celsius. Our main focus was on the studies that involved sustaining these temperatures from at least two to six hours which were the minimum and maximum durations of the regional transports in the HUS service area. We found out that potassium, glucose, lactate dehydrogenase and inorganic phosphorus were the least stable analytes in prolonged variant temperatures. The other analytes included in our study were relatively stable in all the studied temperatures. The results were merely indicative, though, since as the Clinical and Laboratory Standards Institute recommended the applicability of previous research findings should be verified before deployment. Moreover, the methods used in the studies were not altogether similar and we found some sporadic contradictory results

DIGIDIA-project: Experiences of video-enabled receptions for prevention of type 2 diabetes

The time of the COVID-19 epidemic emphasized the need for the development and implementation of remote receptions and digital services, as preventive work was reduced, and people decreased their in-person visits in health care due to fear of infections. In 2020, the diagnoses of type 2 diabetes (T2D) decreased, despite the fact that diabetes is known to be increasing. DIGIDIA (Promoting Digital Skills in the Low Labour Market-Driven Diabetes Patients) project aimed to respond to this need. The project focused on developing digital health competence, health literacy, and practices that enable preparation for future unforeseen events. The project recruited adults from Tampere who were at risk of T2D, had prediabetes, or recently received a diagnosis of type 2 diabetes (n=60). Participants were provided with a digital learning environment, workshops, and video-enabled receptions. This article presents the use of video reception and user experiences (n=52) in the project. The participants appreciated all organized activities. All but one participant felt that video-enabled reception suited them well. The majority of participants (87%) expressed a desire for using video reception again in health care settings. However, it was pointed out that this form of telemedicine might not be suitable for everyone, and concerns about data security were also raised. As a conclusion, citizens were ready to use video-enabled services in healthcare settings.  The use of video receptions should be increased in the management of type 2 diabetes (T2D)

Clinical practice selectively follows acute appendicitis guidelines

Peer reviewe

Incidence of parastomal and incisional hernia following emergency surgery for Hinchey III-IV diverticulitis:a systematic review

Abstract Purpose: The aim of this systematic review was to evaluate the risk of parastomal (PSH) and incisional hernias (IH) after emergency surgery for Hinchey III–IV diverticulitis, with comparison between the Hartmann procedure and other surgical techniques. Methods: The Cochrane Library, Embase, PubMed (MEDLINE), Web of Science and Scopus databases were systematically searched. The primary endpoint was parastomal hernia incidence. The secondary endpoint was incisional hernia incidence. Results: Five studies (four randomized controlled trials and one retrospective cohort) with a total of 699 patients were eligible for inclusion. The PSH rate was 15%–46% for Hartmann procedure, 0%–85% for primary anastomosis, 4% for resection, and 2% for laparoscopic lavage. The IH rates were 5%–38% for Hartmann procedure, 5%–27% for primary anastomosis, 9%–12% for primary resection, and 3%–11% for laparoscopic lavage. Conclusions: Both the parastomal and incisional hernia incidences are poorly evaluated and reported, and varied greatly between the studies