Comparative in silico design and validation of GPS™ CoVID-19 dtec-RT-qPCR test.

AIMS: Providing a ready-to-use reverse transcriptase qPCR (RT-qPCR) method fully validated to detect the SARS-CoV-2 with a higher exclusivity than this shown by early published RT-qPCR designs. METHODS AND RESULTS: The specificity of the GPS™ CoVID-19 dtec-RT-qPCR test by analysis of sequence alignments was approached and compared with other RT-qPCR designs. The GPS™ CoVID-19 dtec-RT-qPCR test was validated following criteria of UNE/EN ISO 17025:2005 and ISO/IEC 15189:2012. Diagnostic validation was achieved by two independent reference laboratories, the Instituto de Salud Carlos III, (Madrid, Spain), the Public Health England (Colindale, London, UK), and received the label CE-IVD. The GPS design showed the highest exclusivity and passed all parameters of validation with strict acceptance criteria. Results from reference laboratories 100% correlated with these obtained by using reference methods and showed 100% of diagnostic sensitivity and specificity. CONCLUSIONS: The CE-IVD GPS™ CoVID-19 dtec-RT-qPCR test, available worldwide with full analytical and diagnostic validation, is the more exclusive for SARS-CoV-2 by far. SIGNIFICANCE AND IMPACT OF THE STUDY: Considering the CoVID-19 pandemic status, the exclusivity of RT-qPCR tests is crucial to avoid false positives due to related coronaviruses. This work provides of a highly specific and validated RT-qPCR method for detection of SARS-CoV-2, which represents a case of efficient transfer of technology successfully used since the pandemic was declared.

¿Pueden influir las variables epidemiológicas el resultado a los 2 años de una cirugía por enfermedad lumbar degenerativa en términos de calidad de vida, discapacidad y dolor postoperatorio? / Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?

Objetivo: Evaluar si los factores epidemiológicos afectan a los resultados de la cirugía por enfermedad lumbar degenerativa en términos de calidad de vida, discapacidad y dolor crónico. Material y método: Doscientos sesenta y tres pacientes intervenidos por afección lumbar degenerativa fueron incluidos en el estudio (2005-2008). Variables epidemiológicas: edad, género, situación laboral y comorbilidad. Se completaron en el preoperatorio y 2 años tras la cirugía el Medical Outcomes Study Short Form-36 version 2, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI) y EVA para dolor lumbar y ciático. En el análisis de los datos, se evaluó la correlación entre variables epidemiológicas y el cambio en los resultados de los cuestionarios, así como, la existencia de factores pronósticos independientes. Resultados: Edad media 54,00 años (22-86); 131 mujeres (49,8%); 42 pérdidas de seguimiento (16%). Se observaron correlaciones significativas (p < 0,05) entre la edad, el género, la comorbilidad, la incapacidad laboral permanente y el dolor preoperatorio con el cambio del ODI, el COMI, los componentes de salud física y mental y las EVA de lumbar y ciático. El análisis de regresión lineal muestra a las ILP y la edad como variables predictoras del cambio de la discapacidad (β = 14,146; IC del 95%, 9,09-29,58; p < 0,01, y β = 0,334; IC del 95%, 0,40-0,98, p < 0,05, respectivamente) y de la calidad de vida (β = −8,568; IC del 95%, −14,88, −2,26; p < 0,01 y β = −0,228, IC del 95%, −0,40, −0,06, p < 0,05, respectivamente). Conclusión: Según nuestros resultados, hemos de considerar al aumento de la edad y la incapacidad laboral permanente como factores epidemiológicos predictores negativos de los resultados tras cirugía por patología lumbar degenerativa (AU)

Purpose: To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. Material and method: A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. Results: The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P < 0.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (β = 14.146; 95% CI : 9.09-29.58; P < 0.01 and β = 0.334; 95% CI: 0.40-0.98, P < 0.05, respectively), and change in quality of life (β = −8.568; 95% CI: −14.88 to −2.26; P < 0.01 and β = −0.228, 95% CI: −0.40 to −0.06, P < 0.05, respectively). Conclusion: Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery (AU)

[Can epidemiological factors affect the 2-year outcomes after surgery for degenerative lumbar disease in terms of quality of life, disability and post-surgical pain?]. / Pueden influir las variables epidemiológicas el resultado a los 2 años de una cirugía por enfermedad lumbar degenerativa en términos de calidad de vida, discapacidad y dolor postoperatorio?

PURPOSE: To evaluate the influence of epidemiological factors on the outcomes of surgery for degenerative lumbar disease in terms of quality of life, disability and chronic pain. MATERIAL AND METHOD: A total of 263 patients who received surgery for degenerative lumbar disease (2005-2008) were included in the study. The epidemiological data collected were age, gender, employment status, and co-morbidity. The SF-36, Oswestry Disability Index (ODI), Core Outcomes Measures Index (COMI), and VAS score for lumbar and sciatic pain were measure before and 2 years after surgery. The correlation between epidemiological data and questionnaire results, as well as any independent prognostic factors, were assessed in the data analysis. RESULTS: The mean age of the patients was 54.0 years (22-86), and 131 were female (49.8%). There were 42 (16%) lost to follow-up. Statistically significant correlations (P<.05) were observed between age, gender, co-morbidity, permanent sick leave, and pre-operative pain with changes in the ODI, COMI, physical and SF-36 mental scales, and lumbar and sciatic VAS. Linear regression analysis showed permanent sick leave and age as predictive factors of disability (ß=14.146; 95% CI: 9.09 - 29.58; P<.01 and ß=0.334; 95% CI: 0.40 - 0.98, P<.05, respectively), and change in quality of life (ß=-8.568; 95% CI: -14.88 - -2.26; p<.01 and ß=-0.228, IC 95% CI: -0.40 - -0.06, P<.05, respectively). CONCLUSION: Based on our findings, age and permanent sick leave have to be considered as negative epidemiologic predictive factors of the outcome of degenerative lumbar disease surgery.

Routine determination of morphine, morphine 3-beta-D-glucuronide and morphine 6-beta-D-glucuronide in human serum by liquid chromatography coupled to electrospray mass spectrometry.

A robust liquid chromatographic mass spectrometric method capable of quantifying morphine, morphine 3-beta-D-glucuronide and morphine 6-beta-D-glucuronide down to 1.0 ng/ml, 5.0 ng/ml and 2.0 ng/ml respectively in human serum is presented. The method was validated over linear ranges of 1.0 to 20.0 ng/ml for morphine, 5.0 to 500.0 ng/ml for morphine 3-beta-D-glucuronide and 2.0 to 100.0 ng/ml for morphine 6-beta-D-glucuronide using deuterated morphine as internal standard. In tandem mass spectrometry conditions, the product ions of morphine-3-glucuronide and morphine-6-glucuronide were the ion m/z corresponding to the morphine moiety. By contrast morphine which presented numerous product ions after collision did not allowed a tandem methodology. Compounds were extracted on 100 mg C18 columns and analysed on the PE Sciex API 300 system equipped with a C18 column and electrospray ionisation interface. The interrun precision of quality controls (1.0, 2.0, 10.0, 20.0 ng/ml for morphine, 5.0, 10.0, 250.0, 500.0 ng/ml for morphine 3-beta-D-glucuronide and 2.0, 4.0, 50.0, 100.0 ng/ml for morphine 6-beta-D-glucuronide) was < or =9.3% and accuracy was between 97.9 and 109.8% for each analyte. Sample stabilities in biological matrix were also investigated. This method has been applied to pharmacokinetic analysis of morphine, morphine 3-beta-D-glucuronide and morphine 6-beta-D-glucuronide in human serum.

Parental visitation in the post-anesthesia care unit: a means to lessen anxiety.

Programs that assist parents and children with coping during hospitalization may minimize the emotional trauma of hospitalization and improve both child and family well-being. The purpose of this study was to determine the effect of parental visitation in the Post-Anesthesia Care Unit (PACU) on pre- and postoperative anxiety levels of pediatric patients and parents. Sixty-eight patient-parent pairs were enrolled in the study: 20 before implementing parental visitation and 48 following implementation. Although no differences were found in children's anxiety levels pre- to postoperatively, the anxiety levels of parents who visited their children in the PACU were significantly lower postoperatively.

Using the revised APON standards of practice.

In 1988, the Association of Pediatric Oncology Nurses published its first Scope of Practice Statement. At that time the Standards of Practice were revised in the process outcome format. Six standards refer to direct care of the child and family and a final standard refers to the nurse's professional responsibility to maintain expertise as a specialist or competency as a generalist. The development of these two documents and how they are used by the practitioner and the educator is discussed.

Using and documenting nursing diagnosis in an ambulatory setting.

Documentation and the use of nursing diagnosis have proved to be important in increasing the efficiency of communication and the clarification of nursing services provided. This has led to better utilization of nursing resources. The increased emphasis on ambulatory care has shifted our focus to nurses' roles in clinic and day hospital settings. How do nurses document the care they provide in an ambulatory setting? Can nursing diagnosis be used as effectively in the outpatient department as it has been in the acute or chronic inpatient hospital setting? This article describes how one agency developed a unique documentation tool for ambulatory care which allows for and encourages the use of nursing diagnosis by staff nurses, IV nurses and nurses in expanded roles, and facilitates communication among all nursing personnel.

Unit-based research forums: a model for the clinical nurse specialist to promote clinical research.

Although nurse researchers have generated research findings, practitioners in clinical practice have not consistently utilized them. Evaluation and modification of clinical practice through research is a key component of the role of the clinical nurse specialist (CNS). In this paper, an innovative model is described in which the Clinical Nurse Specialist coordinates specialty-based clinical research through the use of unit-based research forums, an outgrowth of unit-based quality assurance. Such a model allows staff at the unit level to engage in problem-solving dialogues, resulting in increased use of research findings and generation of original research.