Reducing Diagnostic Errors Worldwide Through Diagnostic Management Teams

Roberto Verna,Adriana Berumen Velazquez,,Michael Laposata, 대한진단검사의학회 2019 Annals of Laboratory Medicine Vol.39 No.2

A major challenge facing most countries is the growing cost of healthcare. Laboratory testing costs constitute approximately 3% of all clinical costs, while waste of funds due to inappropriate admissions to clinical departments is reported to be as high as 15%. A frequently used approach to save money in healthcare is random reduction of laboratory budgets, focusing on decreasing the number of unnecessary laboratory tests. The World Health Assembly has approached this problem by publishing a list of essential in vitro diagnostic tests, to achieve a global rationalization of the problem. A much more thoughtful strategy to reducing healthcare expenditure is to improve the efficiency of the diagnostic process. Decreasing the time to a correct diagnosis provides considerable financial and clinical benefits. Additionally, reducing both overutilization and underutilization of laboratory tests while achieving the correct diagnosis is of great benefit to challenged healthcare budgets. Examining the situation in the United States and Italy, this review presents an opportunity for reducing diagnostic error and increasing the efficiency of diagnostic testing worldwide. One approach taken to achieve major savings in healthcare in the United States, which can be applied in Italy and other countries, is the creation of “diagnostic management teams,” comprising experts in specialty areas of medicine, primarily based in the clinical laboratory, who can advise physicians on the selection of necessary tests and the interpretation of complex test results

Elevated Neutrophil to Lymphocyte Ratio in Older Adults with Cocaine Use Disorder as a Marker of Chronic Inflammation

Heather E. Soder,Amber M. Berumen,Kira E. Gomez,Charles E. Green,Robert Suchting,Margaret C. Wardle,Jessica Vincent,Antonio L. Teixeira,Joy M. Schmitz,Scott D. Lane 대한정신약물학회 2020 CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE Vol.18 No.1

Objective: The neutrophil to lymphocyte ratio (NLR) is a non-specific, easy-to-obtain marker of inflammation associated with morbidity and mortality in systemic, psychiatric, and age-related inflammatory conditions. Given the growing trend of substance use disorder (SUD) in older adults, and the relationship between inflammation and SUD elevated NLR may serve as a useful inflammatory biomarker of the combined burden of aging and SUD. The present study focused on cocaine use disorder (CUD) to examine if cocaine adds further inflammatory burden among older adults, by comparing NLR values between older adults with CUD and a non-cocaine using, aged-matched, nationally representative sample. Methods: The dataset included 107 (86% male) participants (aged 50−65 years) with cocaine use disorder. NLR was derived from complete blood count tests by dividing the absolute value of peripheral neutrophil concentration by lymphocyte concentration. For comparison, we extracted data from age-matched adults without CUD using the National Health and Nutrition Examination Survey. Individuals with immunocompromising conditions were excluded (e.g., rheumatoid arthritis and sexually transmitted infections such as HIV). A doubly-robust inverse probability-weighted regression adjustment (IPWRA) propensity score method was used to estimate group differences on NLR while controlling for potential confounding variables (age, gender, race, income, nicotine, marijuana and alcohol use). Results: The IPWRA model revealed that the CUD sample had significantly elevated NLR in comparison to non-cocaine users, with a moderate effect size ( weight = 0.67). Conclusion: Although non-specific, NLR represents a readily obtainable inflammatory marker for SUD research. CUD may add further inflammatory burden to aging cocaine users.

Molecular signatures of transgenerational response to ocean acidification in a species of reef fish

Schunter, Celia,Welch, Megan ,J.,Ryu, Taewoo,Zhang, Huoming,Berumen, Michael ,L.,Nilsson, Gö,ran ,E.,Munday, Philip ,L.,Ravasi, Timothy Nature Publishing Group, a division of Macmillan P 2016 Nature climate change Vol.6 No.11

<P>The impact of ocean acidification on marine ecosystems will depend on species capacity to adapt(1,2). Recent studies show that the behaviour of reef fishes is impaired at projected CO2 levels(3,4); however, individual variation exists that might promote adaptation. Here, we show a clear signature of parental sensitivity to high CO2 in the brain molecular phenotype of juvenile spiny damselfish, Acanthochromis polyacanthus, primarily driven by circadian rhythm genes. Offspring of CO2-tolerant and CO2-sensitive parents were reared at near-future CO2 (754 mu atm) or present-day control levels (414 mu atm). By integrating 33 brain transcriptomes and proteomes with a de novo assembled genome we investigate the molecular responses of the fish brain to increased CO2 and the expression of parental tolerance to high CO2 in the offspring molecular phenotype. Exposure to high CO2 resulted in differential regulation of 173 and 62 genes and 109 and 68 proteins in the tolerant and sensitive groups, respectively. Importantly, the majority of differences between offspring of tolerant and sensitive parents occurred in high CO2 conditions. This transgenerational molecular signature suggests that individual variation in CO2 sensitivity could facilitate adaptation of fish populations to ocean acidification.</P>

Assessment of Beneficial and Possible Toxic Effects of Two New Alfalfa-Derived Shelf Products

Maria G. Soto-Zarazua,Moustapha Bah,Maria G. Garcia-Alcocer,Laura C. Berumen,Carla Sofia Costa,Maria Joao Bessa,Francisca Rodrigues,Joao Paulo Teixeira,Maria Beatriz P.P. Oliveira 한국식품영양과학회 2016 Journal of medicinal food Vol.19 No.10

Aerial parts of Medicago sativa L. have been used as food and its consumption has been associated with health benefits, one among the most important being menopausal symptoms control. This work was aimed to explore possible pharmacological effects of two new alfalfa-derived products that have recently emerged as daily beverage preparations. In exploring their potential estrogenic effects, they produced no relevant alteration in the uterus. However, lowering glucose levels until normal values without causing further hypoglycemic effect were observed, when rats were treated with 1.5 g/kg/day samples. In vivo acute toxicity was not found when the alfalfa products were tested up to 3 g/kg rat weight. Furthermore, in vitro studies were conducted to assess their possible toxic effects. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) and lactate dehydrogenase tests were carried out on the Caco-2 cell model to determine cell viability and membrane integrity. A concentration-dependent effect was observed, with a significant decrease in cell viability after exposure to concentrations of alfalfa product up to 100 mg/mL (after 3 h of incubation) and 50 mg/mL (after 24 h of treatment). Although in vitro level, the decrease in cell viability at these still low doses may underlie some toxicity, making necessary additional studies before any recommendation of a sustained consumption of these products by humans.

Production of Platinum Nanoparticles and Nanoaggregates Using Neurospora crassa

( E. Castro Longoria ),( S. D. Moreno Velasquez ),( A. R. Vilchis Nestor ),( E. Arenas Berumen ),( M. Avalos Borja ) 한국미생물 · 생명공학회 2012 Journal of microbiology and biotechnology Vol.22 No.7

Fungal biomass and fungal extract of the nonpathogenic fungus Neurospora crassa were successfully used as reducing agents for the biosynthesis of platinum nanoparticles (PtNPs). The experiment was carried out by exposing the fungal biomass or the fungal extract to a 0.001 M precursor solution of hexachloroplatinic(IV) acid (H2PtCl6). A change of color of the biomass from pale yellow to dark brown was the first indication of possible formation of PtNPs by the fungus. Subsequent analyses confirmed the intracellular biosynthesis of single PtNPs (4-35 nm in diameter) and spherical nanoaggregates (20-110 nm in diameter). Using the fungal extract, similar results were obtained, producing rounded nanoaggregates of Pt single crystals in the range of 17-76 nm.