Category 1 external quality assessment program for serum creatinine.

Background: The Commission of Analytical Quality and the Committee of External Quality Programs of Spanish Society of Laboratory Medicine (SEQC) in collaboration with the Dutch Foundation for the Quality organized the first national category 1 External Quality Assessment Programs (EQAP) pilot study. The aim is to evaluate the standardization of serum creatinine measurements in the Spanish laboratories through a category 1 external quality assurance program with commutable material and reference method assigned values.

Methods: A total of 87 Spanish laboratories were involved in this program in 2015.

Microscopic observation drug-susceptibility assay vs. Xpert MTB/RIF for the diagnosis of tuberculosis in a rural African setting: a cost-utility analysis.

Objective: To compare the cost-utility of microscopic observation drug-susceptibility assay (MODS) and Xpert MTB/RIF implementation for tuberculosis (TB) diagnosis in rural northern Mozambique.

Methods: Stochastic transmission compartmental TB model from the healthcare provider perspective with parameter input from direct measurements, systematic literature reviews and expert opinion. MODS and Xpert MTB/RIF were evaluated as replacement test of smear microscopy (SM) or as an add-on test after a negative SM.

Pain underreporting associated with profound intellectual disability in emergency departments.

Background: Little information is available regarding the visits made by persons with profound intellectual disability (PID) to general hospital emergency departments (ED). This study aims to know whether persons with PID who attend ED are given the same type of diagnoses as people with no such disability.

Methods: Over a period of 18 months, we gathered data from all non-scheduled visits to an ED by persons with PID to identify the reason for consultation (according to the classification used by the Spanish Society for Emergency Nursing) and the final diagnosis upon discharge.

Criteria for initiation of invasive ventilation in septic shock: An international survey.

Purpose: The objective of this study is to record intensivists' beliefs on indications and modalities of ventilatory support in critically ill patients with septic shock.

Methods: The instrument is a 23-items questionnaire, sent to all members of the Systemic Inflammation and Sepsis section of the European Society of Intensive Care Medicine.

Results: A total of 186 intensivists from 30 countries completed the survey.

Microscopic observation drug susceptibility assay for the diagnosis of TB and MDR-TB in HIV-infected patients: a systematic review and meta-analysis.

The objective of the present study was to assess the diagnostic accuracy of the microscopic observation drug susceptibility (MODS) assay for tuberculosis (TB) diagnosis in HIV-infected patients. MEDLINE, EMBASE, LILACS, the Cochrane Central Register of Controlled Trials, African Index Medicus, ResearchGate, SciELO, and the abstracts of the main conferences on infectious diseases and tropical medicine were searched, and other sources investigated. Only studies including HIV-infected patients evaluating MODS for the diagnosis of TB and using culture-based diagnostic tests as a gold standard were analysed.

Empiric antibiotic treatment reduces mortality in severe sepsis and septic shock from the first hour: results from a guideline-based performance improvement program.

Objectives: Compelling evidence has shown that aggressive resuscitation bundles, adequate source control, appropriate antibiotic therapy, and organ support are cornerstone for the success in the treatment of patients with sepsis. Delay in the initiation of appropriate antibiotic therapy has been recognized as a risk factor for mortality. To perform a retrospective analysis on the Surviving Sepsis Campaign database to evaluate the relationship between timing of antibiotic administration and mortality.

Effectiveness of long-acting injectable antipsychotics in delusional disorders with nonprominent hallucinations and without hallucinations.

The presence of nonprominent hallucinations in delusional disorder (DD) has been accepted by the current Diagnostic and Statistical Manual of Mental Disorders, 5th ed. A recent meta-analysis revealed that patients with schizophrenia treated with long-acting atypical antipsychotics showed a significant improvement in psychotic symptoms. However, little research has been conducted on DD.

Future options for (economically) sustainable research in sepsis.

The relentless increase in healthcare costs and the global economic crisis require us to rethink the way research is done. The heterogeneity of patients is a major challenge in designing and coordinating high-quality studies about sepsis. Studies on new treatments and devices, such as polymyxin B hemoperfusion, must be optimized not only for potential benefits for a specific population (i.

Extended cervical mediastinoscopy.

Surgical exploration of subaortic and para-aortic lymph nodes has traditionally required the combination of standard cervical mediastinoscopy and left anterior mediastinotomy. Video-assisted thoracoscopic surgery is another technique that allows the exploration of these nodal stations. Extended cervical mediastinoscopy is a useful and safe technique for the assessment of para-aortic and subaortic nodal stations through the same incision of the standard cervical mediastinoscopy.

Appropriate antibiotic dosing in severe sepsis and acute renal failure: factors to consider.

Severe sepsis and septic shock cause considerable morbidity and mortality. Early appropriate empiric broad-spectrum antibiotics and advanced resuscitation therapy are the cornerstones of treatment for these conditions. In prescribing an antibiotic regimen in septic patients with acute renal failure treated with continuous renal replacement therapy, several factors should be considered: pharmacokinetics, weight, residual renal function, hepatic function, mode of renal replacement therapy (membrane and surface area, sieving coefficient, effluent and dialysate rate, and blood flow rate), severity of illness, microorganism, minimum inhibitory concentration, and others.

Tridimensional sonographic anatomical changes on pelvic floor muscle according to the type of delivery.

Introduction And Hypothesis: The aim of the study was to evaluate the association of avulsion and postnatal hiatal dimensions with delivery mode. These anatomical changes on pelvic floor muscle may be assessed by 3-4D ultrasonography.

Methods: This is a prospective observational study that included 164 women: 20 nulliparous, 20 primigravid, and 124 postpartum women (62 at 1 month, 62 at 9 months postpartum).