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Objective To compare the financial and time cost of breast cancer biomarker analysis by immunohistochemistry with that by the Xpert® STRAT4 assay. Methods We estimated costs (personnel, location, consumables and indirect) and time involved in breast cancer diagnosis at the Butaro Cancer Centre of Excellence, Rwanda, using time-driven activity-based costing. We performed a cost-minimization analysis to compare the cost of biomarker analysis for estrogen receptor, progesterone receptor and human epidermal growth factor receptor-2 status with immunohistochemistry versus STRAT4. We performed sensitivity analyses by altering laboratory-specific parameters for the two methods. Findings We estimated that breast cancer diagnosis in Rwanda costs 138.29 United States dollars (US$) per patient when conducting biomarker analysis by immunohistochemistry. At a realistic immunohistochemistry antibody utilization efficiency of 70%, biomarker analysis comprises 48.7% (US$ 67.33) of diagnostic costs and takes 33 min. We determined that biomarker analysis with STRAT4 yields a reduction in diagnosis cost of US$ 7.33 (10.9%; 7.33/67.33), and in pathologist and technician time of 20 min (60.6%; 20/33), per patient. Our sensitivity analysis revealed that no cost savings would be made in laboratories with antibody utilization efficiencies over 90%, or where only estrogen and/or progesterone receptor status are assessed; however, such operational efficiencies are unlikely, and more laboratories are pursuing human epidermal growth factor receptor-2 analysis as targeted therapies become increasingly available. Conclusion Breast cancer biomarker analysis with STRAT4 has the potential to reduce the required human and capital resources in subSaharan African laboratories, leading to improved treatment selection and better clinical outcomes.
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Humans , Male , Female , Breast Neoplasms , Immunohistochemistry , Biomarkers, Tumor , Diagnosis , RNA, Messenger , Estrogens , Pathology, Molecular , GeneticsABSTRACT
Enterobacteriaceae are the most common causes of community-acquired and nosocomial infections. They are usually treated with beta-lactam antibiotics, i.e., penicillins, broad-spectrum cephalosporins, and carbapenems (Imipenem, meropenem, ertapenem). In order to evaluate the resistance profile of Escherichia coli (E. coli) to beta-lactam antibiotics, a 3-year retrospective study was carried out in the medical biology laboratory of the Laquintinie Hospital in Douala. The aim was to compare the behavior of Escherichia coli bacteria to penicillins, carbapenems, and cephalosporins. In order to achieve this objective, we used the results obtained from E. coli strains isolated from urine, cervico-vaginal fluid, puncture fluid, pleural fluid and pus samples. Identification was confirmed using the API 20 E Enterobacteriaceae system of biochemical testing and the VITEK 2 system. The VITEK 2 system was used to perform the antibiogram. Statistical analyses obtained from GraphPad Prim V 5.0 software allowed us to perform tests such as ANOVA, Kruskal-Wallis test, and Spearman correlations. Preliminary results show that E. coli bacteria are highly resistant to penicillins and significantly susceptible to cephalosporins of all generations if they are not ESBL (extended-spectrum beta-lactamases). Data on carbapenem behavior show less resistance and moderate susceptibility.
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Objective:To explore the effect of improving oral care based on cluster management in ventilator-associated pneumonia (VAP).Methods:Totally 126 VAP patients from February 2019 to February 2020 in our hospital were selected. The patients admitted from February 2019 to August 2019 were the control group, and the patients from September 2019 to February 2020 were the observation group, 63 cases in each group. The control group was treated with cluster nursing, and the observation group was treated with cluster nursing with improved oral care. The EICU hospitalization time, mechanical ventilation time, plaque index, pathogen infection, oral cleaning score, oral bleeding ulcer and aspiration were compared between the two groups.Results:After nursing, the EICU hospitalization time and mechanical ventilation time in the observation group were (18.34±4.15), (8.56±2.14) days, which were shorter than (23.56±4.82), (12.04±3.10) days in the control group ( t value was -6.514, -7.333, P<0.05). During the nursing process, the incidence of bleeding ulcer and aspiration in the observation group were 12.70% (8/63), 6.35% (4/63), which were lower than 30.16% (19/63), 20.63% (13/63) in the control group ( χ 2 values were 5.704, 5.508, P<0.05). After nursing, the plaque index of the two groups was lower than that before nursing ( t values were 12.516, 6.654, P<0.05), and the plaque index of the observation group was lower than that of the control group ( t value was -6.860, P<0.05). During the nursing process, the incidence of pathogenic bacteria infection in the observation group was 28.57% (18/63), which was lower than 49.21% (31/63) in the control group ( χ 2 value was 5.644, P<0.05). After nursing, the oral cleaning score of the two groups was lower than that before nursing ( t values were 11.118, 6.240, P<0.05), and the score of the observation group was (14.38±3.60) points, which was lower than (18.20±4.11) points of the control group ( t value was -5.549, P<0.05). Conclusion:Auricular pressure therapy can effectively improve the constipation symptoms, shorten the time required to take effect for the main symptoms, and improve the quality of life of schizophrenic patients.
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No abstract available.
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Glycoproteins , Oligodendroglia , Rubella virus , RubellaABSTRACT
BACKGROUND AND PURPOSE: Electroencephalography (EEG) is often used as a screening tool for selecting pilots despite controversy regarding its contribution to aviation safety. We investigated EEG abnormalities in Korean commercial pilot applicants in order to identify the usefulness of EEG screening in this population. METHODS: We retrospectively analyzed the EEG results of 740 unselected pilot applicants who underwent waking EEG at Inha University Hospital from January 2013 to May 2017. EEG recording was performed for 30 minutes, which included 3 minutes of hyperventilation and intermittent photic stimulation. RESULTS: The pilot applicants were predominantly male (95.3%) and had a mean age of 27.8 years (range: 16–40 years). Nine of them (1.2%) exhibited EEG abnormalities; the most common abnormality (six applicants) was a small amount of generalized irregular slow activities, while the other three applicants (0.4%) exhibited epileptiform discharges, with two showing generalized spike-and-wave complexes and one showing a few spike-and-wave complexes in the left frontotemporal area. The two applicants with generalized spike-and-wave complexes were found to have experienced clinical seizures by a neurologist during detailed history-taking. CONCLUSIONS: This study found that 2 of 740 pilot applicants (0.3%) were diagnosed with epilepsy by routine EEG screening in an unselected population. Considering the low predictive value of EEG without the relevant clinical history in an unselected healthy young population, our findings raise questions regarding the cost-effectiveness of the current EEG screening protocol applied to pilot applicants. We suggest that a more-targeted and standardized EEG screening approach be applied to pilot applicants with epilepsy risk factors or a seizure history as determined by thorough medical history-taking.
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Humans , Male , Aviation , Electroencephalography , Epilepsy , Hyperventilation , Korea , Mass Screening , Photic Stimulation , Retrospective Studies , Risk Factors , SeizuresABSTRACT
Hemichorea after cortical infarction has rarely been reported. We report a female patient in which hemichorea of the right extremities developed following a left temporo-parietal infarction. An acute infarction in the territory of the inferior division of the left middle cerebral artery was evident in diffusion-weighted imaging, but the basal ganglia, thalamus, and brainstem appeared normal. Her choreic movement gradually improved after administering haloperidol, and the hemichorea disappeared after 4 days.
Subject(s)
Female , Humans , Basal Ganglia , Brain Stem , Chorea , Extremities , Haloperidol , Infarction , Middle Cerebral Artery , ThalamusABSTRACT
The present study was to evaluate effects of vitamin E on intravenous administration of lidocaine-induced antinociception. Experiments were carried out using male Sprague-Dawley rats. Orofacial formalin-induced nociceptive behavioral responses were used as the orofacial animal pain model. Subcutaneous injection of formalin produced significant nociceptive scratching behavior. Intraperitoneal injection of 5 and 10 mg/kg of lidocaine attenuated formalin-induced nociceptive behavior in the 2nd phase, compared to the vehicle-treated group. Intraperitoneal injection of 1 g/kg of vitamin E also attenuated the formalin-induced nociceptive behavior in the 2nd phase, compared to the vehicle-treated group. However, low dose of vitamin E (0.5 g/kg) did not affect the nociceptive behavioral responses produced by subcutaneous injection of formalin. The present study also investigated effects of intraperitoneal injection of both vitamin E and lidocaine on orofacial formalin-induced behavioral responses. Vehicle treatment affected neither formalin-induced behavioral responses nor lidocaine-induced antinociceptive effects. However, intraperitoneal injection of 0.5 g/kg of vitamin E enhanced the lidocaine-induced antinociceptive effects in the 2nd phase compared to the vehicle-treated group. Intraperitoneal injection of naloxone, an opioid receptor antagonist, did not affect antinociception produced by intraperitoneal injections of both vitamin E and lidocaine. These results suggest that treatment with vitamin E enhances the systemic treatment with lidocaine-induced antinociception and reduces side effects when systemically treated with lidocaine. Therefore, the combined treatment with vitamin E and lidocaine is a potential therapeutic for chronic orofacial pain.
Subject(s)
Animals , Humans , Male , Rats , Administration, Intravenous , Facial Pain , Formaldehyde , Injections, Intraperitoneal , Injections, Subcutaneous , Lidocaine , Naloxone , Rats, Sprague-Dawley , Receptors, Opioid , Vitamin E , VitaminsABSTRACT
Higher Secondary School students and their teachers were studied to assess the knowledge about AIDS and attitude towards AIDS patients. Only 13.5% senior school students and 16.2% teachers had clear knowledge regarding AIDS--its general aspects, transmission and prevention. Girls had higher and clear knowledge than boys. 45.8% of girls, 38.8% of boys students and 20.3% of teachers had positive attitudes towards nursing an AIDS case. It is suggested that schools have to device ways to open up more effective communication with students in relation to education on sex and AIDS. Training on AIDS should be emphasized on school teachers who on their turn can teach the students in a correct way about AIDS.