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Drug Safety - Analgesics are among the most widely used drugs worldwide. This study describes the population treated with narcotic analgesics, their therapeutic indications and how the data have...  相似文献   
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In recent years, there has been an increasing focus on routine outcome monitoring (ROM) to provide feedback on patient progress during mental health treatment, with some systems also predicting the expected treatment outcome. The aim of this study was to elicit patients’ and psychologists’ preferences regarding how ROM system-generated feedback reports should display predicted treatment outcomes. In a discrete-choice experiment, participants were asked 12–13 times to choose between two ways of displaying an expected treatment outcome. The choices varied in four different attributes: representation, outcome, predictors, and advice. A conditional logistic regression was used to estimate participants’ preferences. A total of 104 participants (68 patients and 36 psychologists) completed the questionnaire. Participants preferred feedback reports on expected treatment outcome that included: (a) both text and images, (b) a continuous outcome or an outcome that is expressed in terms of a probability, (c) specific predictors, and (d) specific advice. For both patients and psychologists, specific predictors appeared to be most important, specific advice was second most important, a continuous outcome or a probability was third most important, and feedback that includes both text and images was fourth in importance. The ranking in importance of both the attributes and the attribute levels was identical for patients and psychologists. This suggests that, as long as the report is understandable to the patient, psychologists and patients can use the same ROM feedback report, eliminating the need for ROM administrators to develop different versions.

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PurposeTo assess the impact of dose reduction and the use of an advanced modeled iterative reconstruction algorithm (ADMIRE) on image quality in low-energy monochromatic images from a dual-source dual energy computed tomography CT (DSCT) platform.Materials and methodsAcquisitions on an image-quality phantom were performed using DSCT equipment with 100/Sn150 kVp for four dose levels (CTDIvol: 20/11/8/5mGy). Raw data were reconstructed for six energy levels (40/50/60/70/80/100 keV) using filtered back projection and two levels of ADMIRE (A3/A5). Noise power spectrum (NPS) and task-based transfer function (TTF) were calculated on virtual monoenergetic images (VMIs). Detectability index (d′) was computed to model the detection task of two enhanced iodine lesions as function of keV.ResultsNoise-magnitude was significantly reduced between 40 to 70 keV by ?56 ± 0% (SD) (range: ?56%–?55%) with FBP; ?56 ± 0% (SD) (?56%–?56%) with A3; and ?57 ± 1% (SD) (range: ?57%–?56%) with A5. The average spatial frequency of the NPS peaked at 70 keV and decreased as ADMIRE level increased. TTF values at 50% were greatest at 40 keV and shifted towards lower frequencies as the keV increased. The detectability of both lesions increased with increasing dose level and ADMIRE level. For the simulated lesion with iodine at 2 mg/mL, d’ values peaked at 70 keV for all reconstruction types, except for A3 at 20 mGy and A5 at 11 and 20 mGy, where d’ peaked at 60 keV. For the other simulated lesion, d’ values were highest at 40 keV and decreased beyond.ConclusionAt low keV on VMIs, this study confirms that iterative reconstruction reduces the noise magnitude, improves the spatial resolution and increases the detectability of enhanced iodine lesions.  相似文献   
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Background

With the worldwide spread of antibiotic resistance, delivering antibiotic susceptibility test (AST) results in a timely manner represents a major challenge. In cases of sepsis, rapid AST may facilitate early optimization of empiric antibiotic therapy. Disc diffusion is a well-standardized AST method, however 16 to 24?h are required to achieve an overall AST profile according to antimicrobial societies.

Methods

In this prospective pilot study, we evaluated the performance of Mueller-Hinton-Rapid-SIR (MHR-SIR) agar after 6–8?h of incubation in comparison with standard MH agar after 16?h of incubation directly on positive blood cultures caused by Enterobacteriaceae and Staphylococcus aureus from routine clinical microbiology.A total of 133 positive blood samples including 110 Enterobacteriaceae (83%) and 23 Staphylococcus aureus (17%) were tested in parallel by two direct AST methods, each using EUCAST breakpoints. For each combination bacterium and antibiotic, we compared the categorical agreement and the correlation between the diameters obtained by MHR-SIR and by standard MH.

Results

Our results showed 97.7% categorical agreement for Enterobacteriaceae, with 1.4% minor errors, 0.4% major errors and 0.5% very major errors. For S. aureus, we observed 97.8% categorical agreement, 1.9% minor errors, 0.3% major errors and no very major errors.

Conclusion

Our results showed excellent categorical agreement and correlations between diameters for MHR-SIR and standard MH methods. MHRSIR can predict the result of overall AST profile within 6–8?h with reliable results. AST is obtained on the same day the blood culture becomes positive, with a very moderate cost.  相似文献   
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CMV IgG avidity assays are widely used and can be helpful in pregnant women to date the onset of CMV primary infection; however, these tests are not standardized and sometimes give inconclusive results. We evaluated the performances of Mikrogen recomLine CMV IgG and IgG Avidity compared to the VIDAS CMV IgG Avidity. On a first sample set of 89 sequential sera collected from 40 women with precisely determined onset of CMV primary infection, the combination of Mikrogen recomLine CMV IgG and IgG Avidity showed an accurate interpretation in 83.1% (74/89), an incorrect result in 4.5% (4/89), and an inconclusive result in 12.4% (11/89) and showed a better sensitivity to diagnose infections <14?weeks compared to VIDAS (85.9% vs. 76.9%). On a second sample set of 89 sera with an intermediate VIDAS CMV IgG Avidity, the combination of line immunoassays provided additional information on the time of infection in 79% (70/89) of the samples. This combination of line assays is useful as additional confirmatory testing and can help to date more precisely the onset of CMV primary infection.  相似文献   
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