Prevalence of unnecessary laboratory tests and related avoidable costs in intensive care unit

Conclusion: Significant number of unnecessary testing was found, with occurrence pattern on Monday and not dependent on age or length of stay. The data indicate the need to implement guidelines or protocols for ordering laboratory tests in the ICU, which have proven effective in helping the prescribing professional in their clinical practice, and contribute to optimize for health care spending. Introdução: Com o aumento dos recursos diagnósticos, os exames laboratoriais têm se tornado ferramenta indispensável nas elucidações diagnósticas. Observa-se, portanto, um crescimento nas solicitações desses exames. Objetivos: Determinar a prevalência das solicitações de exames laboratoriais da unidade de terapia intensiva (UTI) de um hospital geral e estimar os valores gastos com exames desnecessários, apontando custos evitáveis e visando à racionalização do uso deles. Métodos: Trata-se de um estudo de corte transversal, no qual foi realizado levantamento de dados de prontuário e resultados de exames laboratoriais de internados em UTI, no período de agosto a setembro de 2013. Resultados: A amostra foi composta por 105 pacientes, sendo 58,1% do sexo masculino e 47,6% com faixa etária entre 18-59 anos. Durante o período, foram solicitados 12.217 exames laboratoriais, sendo 49,4% dentro da faixa de normalidade. Os exames mais solic...
Source: Jornal Brasileiro de Patologia e Medicina Laboratorial - Category: Pathology Source Type: research

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Publication date: Available online 10 November 2019Source: Urology Case ReportsAuthor(s): Jonathan Kopel, Pranav Sharma, Irfan WarriachAbstractSolitary fibrous tumors (SFTs) are rare mesenchymal neoplasms found areas lining the pleura. First reported in 1931, there have been a total of 55 cases of SFTs of the kidney worldwide. In most cases, SFTs presents with hematuria, flank pain, and enlarging abdominal mass. In this case, we report a case of a patient who underwent a radical nephrectomy to remove an SFTs of the kidney with compression of the vena cava. This case further expands upon the importance of diagnosing and ass...
Source: Urology Case Reports - Category: Urology & Nephrology Source Type: research
AbstractHyperlipidemia and oxidative stress are indispensable features of chronic kidney disease (CKD) that favor the development of atherogenic plaques and cardiovascular disease (CVD). A number of vasoactive mediators including proprotein convertase subtilisin –kexin type 9 (PCSK9), endothelin-1, nitric oxide, and angiotensin II have fundamental roles in the pathophysiology of atherosclerotic events; moreover, their levels are affected by dyslipidemia and oxidative stress due to renal dysfunction. Therefore, therapeutic measures aimed at correcting dysl ipidemia and alleviating oxidative stress could potentially pr...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
AbstractThe prevalence of asymptomatic HUA is increasing year after year. HUA is a risk factor for the occurrence and development of renal diseases. However, the role of urate-lowering therapy in asymptomatic HUA complicated by renal damage is still controversial. In some experiments, the treatment of asymptomatic HUA complicated by renal damage may delay the progression of kidney damage. In addition, there is increasing evidence, suggesting that elevated serum uric acid is an independent risk factor for kidney disease. However, in other studies, uric acid-lowering therapy did not improve renal function, and uric acid leve...
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsTrimetazidine did not exert significant renal protective effect on preventing CIN and in hosptial  major adverse clinical events in unselected patients undergoing PCI.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsUnmarried men are at higher risk of not benefiting of cytoreductive nephrectomy, metastasectomy, or systemic therapy than their married counterparts. Unmarried women are at higher risk of not benefiting of cytoreductive nephrectomy or systemic therapy. These gender-related differences cumulate in higher CSM in unmarried men, but not in unmarried women.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
We examined the relationship between baseline MetS and renal dysfunction after a 3-year evaluation based on estimated glomerul ar filtration rate (eGFRCKDEPI) using the CKD-EPI equations modified by the Japan coefficient. CKD was defined as dipstick-positive proteinuria (>  or = 1 +) or a low eGFRCKDEPI (
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionsFebuxostat presents a superior effect in delaying renal impairment progression compared with allopurinol in CKD patients complicated with HUA.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
AbstractKidney injury molecule-1 (KIM-1) staining has been shown to be very useful in identifying acute proximal tubular injury, but its sensitivity, specificity and predicting values for the recovery of renal function after injury in renal biopsies have not been well established. In the first study, we randomly selected 184 renal biopsies from a wide age range of patients (children to elderly) with various renal diseases. KIM-1 staining scores were significantly correlated with serum creatinine (sCr) levels (P 
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
ConclusionIn renal cell carcinoma, rapid and successful drug development has resulted in multiple treatment options, requiring careful decision making for individual patients and have emphasized how newly developed therapies work.
Source: International Urology and Nephrology - Category: Urology & Nephrology Source Type: research
Marc Rodwin of Suffolk University Law School reports that the French health system controls drug prices by determining maximum prices based on added therapeutic value and external reference pricing; employing negotiation to set prices and limit price increases; and capping total spending to a global budget.        
Source: The Commonwealth Fund: Publications - Category: International Medicine & Public Health Authors: Source Type: research
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