ABSTRACT
BACKGROUND: In Korea, since 1990, in an effort to reduce the transmission of non-A, non-B hepatitis, all blood donations with alanine aminotransferase (ALT) levels above 65 IU/L are discarded. In 2012, 64.8% of the disposed blood units at the Korean Red Cross blood centers were due to high ALT levels. Pre-donation ALT testing might prevent unnecessary blood donation and save related expenses. We evaluated performance of point-of-care test (POCT) devices for pre-donation ALT screening. METHODS: ALT levels by four ALT POCT devices (Mission C100, Acon; Reflotron Plus, Roche; Labgeo PT10, Samsung; and FDC NX500, Fujifilm) were compared with venous blood results using laboratory chemistry analyzers (AU series, Beckman Coulter Inc.). Intraclass correlation coefficients (ICCs), sensitivity (ability to detect ALT > or =65 IU/L), and specificity (ability to detect <65 IU/L) for each method were calculated. RESULTS: Compared with the laboratory analyzers, the ICCs of ALT measurements by Mission C-100, Reflotron Plus, Labgeo PT10, and FDC NX500 were 0.96 (95% confidence interval (CI): 0.95~0.97), 0.99 (95% CI: 0.99~0.99), 0.98 (95% CI: 0.98~0.98), and 0.94 (95% CI: 0.91~0.96), respectively. The sensitivity was 80.95% for Mission C-100, 83.33% for Reflotron Plus, 78.57% for Labgeo PT10, and 97.62% for FDC NX500. The specificity was 99.13% for Mission C-100, 100.00% for Reflotron Plus, 99.78% for Labgeo PT10, and 98.26% for FDC NX500. CONCLUSION: The ALT POCT devices showed almost perfect agreement with the laboratory analyzers and could be useful for pre-donation ALT screening. However, before implementing ALT POCT devices, cost-effectiveness analyses should be performed.
Subject(s)
Humans , Alanine Transaminase , Blood Donors , Chemistry , Hepatitis , Korea , Mass Screening , Religious Missions , Red Cross , Sensitivity and SpecificityABSTRACT
PURPOSE: This study compared the catheter-associated urinary tract infection (CAUTI) rates resulting from the use of four perineal care agents (soap-and-water, skin cleansing foam, 10% povidone-iodine, and normal saline) among patients in intensive care units (ICUs). METHODS: This four-group experimental study was done with 97 adult patients who had urinary catheters over 2 days in three ICUs between April and July 2008. The patients received one of the four types of perineal care. Data collected included the incidence of CAUTI at baseline (prior to perineal care) and 1 week, 2 weeks, and 4 weeks after beginning perineal care. Patients were divided into UTI and non-UTI groups based on the Centers for Disease Control and Prevention/National Healthcare Safety Network UTI definition to calculate incidence rates. The hazard ratio (HR) and 95% confidence intervals were calculated by Cox's proportional hazard analysis. RESULTS: The cumulative incidence of CAUTIs per 100 urinary catheter days were 3.18 episodes during 1 week with urinary catheter, 3.31 during 2 weeks, and 3.04 during 4 weeks. No statistically significant difference in hazard ratios of CAUTIs for each perineal care agent was evident with reference to soap-and-water at 1 week, 2 weeks, and 4 weeks after beginning perineal care after controlling for age, use of antibiotics, fecal incontinence, consciousness level, fever, and diabetes. CONCLUSIONS: The type of perineal care does not influence the incidence of CAUTIs. Further confirmatory studies with a larger patient population should be conducted, as well as determining perineal agent preference.
Subject(s)
Adult , Humans , Anti-Bacterial Agents , Consciousness , Delivery of Health Care , Detergents , Fecal Incontinence , Fever , Incidence , Critical Care , Intensive Care Units , Perineum , Povidone-Iodine , Skin , Urinary Catheterization , Urinary Catheters , Urinary Tract , Urinary Tract InfectionsABSTRACT
A wide variety of malignancies, including carcinoma of the lung, breast, prostate thyroid and kidney, frequently metastasize to bone. Patient suffering pathological fracture secondary to these metastases are frequently referred to the orthopaedic surgeon for care and management. In such cases, operative intervention with rigid fixation and early ambulation offer much in terms of over-all patient management. One case of breast careinoma metastatic to right proximal femur, neck and femoral head of segmental resection and restoration by special segmental femoral prosthesis with Giliberty Bipolar Endoprosthesis was presented. This technique provides an effective means of restoring the structural integrity of proximal femur and of preserving physiologic function of the joint.
Subject(s)
Humans , Breast Neoplasms , Breast , Early Ambulation , Femur , Fractures, Spontaneous , Head , Joints , Kidney , Lung , Neck , Neoplasm Metastasis , Prostate , Prostheses and Implants , Thyroid GlandABSTRACT
The Enchondroma is a benign cartilage forming harmartoma arising chiefly from short tubular bones on hands and feet. If on a long tubular bone or flat bone such as femur or ilium, it is most likely to be a true neoplasm such as chondrosarcoma, not a harmartoma. A case of enchondroma was reported. It occurred over right ischium of 19 years old male and was found incidentally by roentgenogram. The lesion was biopsied and diagnos's was confirmed by histologic examination. It was treated by curretage with filling of cavity with bone chips. Post operative-course was uneventful.