The Experts below are selected from a list of 156 Experts worldwide ranked by ideXlab platform
Jeffrey M Goldberg - One of the best experts on this subject based on the ideXlab platform.
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Heterophile antibody Blocking Agent to confirm false positive serum human chorionic gonadotropin assay.
Obstetrics and gynecology, 2003Co-Authors: Navid Esfandiari, Jeffrey M GoldbergAbstract:Persistently false positive human chorionic gonadotropin (hCG) test results in the absence of an intrauterine pregnancy may lead to a diagnosis of ectopic pregnancy or gestational trophoblastic neoplasia and unnecessary testing and therapy. A 38-year-old woman on oral contraceptives and a 53-year-old perimenopausal woman presented with persistently elevated serum beta-hCG levels from 30 to 225 mIU/mL. Both women had a history of working with mice. Urine hCG testing was negative. Serum beta-hCG levels for both patients were negative after pretreatment of their serum with a heterophile antibody Blocking Agent. These cases illustrate that serum heterophile antibodies can interfere with the hCG enzyme immunoassay and result in false positive values. The addition of heterophile Blocking Agent to the serum can exclude false positives, thereby preventing unnecessary evaluation and treatment.
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Heterophile antibody Blocking Agent to confirm false positive serum human chorionic gonadotropin assay.
Obstetrics & Gynecology, 2003Co-Authors: Navid Esfandiari, Jeffrey M GoldbergAbstract:Abstract background Persistently false positive human chorionic gonadotropin (hCG) test results in the absence of an intrauterine pregnancy may lead to a diagnosis of ectopic pregnancy or gestational trophoblastic neoplasia and unnecessary testing and therapy. Cases A 38-year-old woman on oral contraceptives and a 53-year-old perimenopausal woman presented with persistently elevated serum β-hCG levels from 30 to 225 mIU/mL. Both women had a history of working with mice. Urine hCG testing was negative. Serum β-hCG levels for both patients were negative after pretreatment of their serum with a heterophile antibody Blocking Agent. Conclusion These cases illustrate that serum heterophile antibodies can interfere with the hCG enzyme immunoassay and result in false positive values. The addition of heterophile Blocking Agent to the serum can exclude false positives, thereby preventing unnecessary evaluation and treatment.
Matthias Eikermann - One of the best experts on this subject based on the ideXlab platform.
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optimal sedation in patients who receive neuromuscular Blocking Agent infusions for treatment of acute respiratory distress syndrome a retrospective cohort study from a new england health care network
Critical Care Medicine, 2021Co-Authors: Karuna Wongtangman, Stephanie D Grabitz, Maximilian Hammer, Luca J Wachtendorf, Maximilian S Schaefer, Philipp Fassbender, Peter Santer, Elias Baedorf Kassis, Daniel Talmor, Matthias EikermannAbstract:OBJECTIVES Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular Blocking Agent infusions in patients with acute respiratory distress syndrome (acute respiratory distress syndrome). The sedation regimen differed between these trials and also within the ROSE trial between treatment and control groups. We hypothesized that the proportion of deeper sedation is a mediator of the effect of neuromuscular Blocking Agent infusions on mortality. DESIGN Retrospective cohort study. SETTING Seven ICUs in an academic hospital network, Beth Israel Deaconess Medical Center (Boston, MA). PATIENTS Intubated and mechanically ventilated ICU patients with acute respiratory distress syndrome (Berlin definition) admitted between January 2008 until June 2019. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The proportion of deeper sedation was defined as days with nonlight sedation as a fraction of mechanical ventilation days in the ICU after acute respiratory distress syndrome diagnosis. Using clinical data obtained from a hospital network registry, 3,419 patients with acute respiratory distress syndrome were included, of whom 577 (16.9%) were treated with neuromuscular Blocking Agent infusions, for a mean (SD) duration of 1.8 (±1.9) days. The duration of deeper sedation was prolonged in patients receiving neuromuscular Blocking Agent infusions (4.6 ± 2.2 d) compared with patients without neuromuscular Blocking Agent infusions (2.4 ± 2.2 d; p < 0.001). The proportion of deeper sedation completely mediated the negative effect of neuromuscular Blocking Agent infusions on in-hospital mortality (p < 0.001). Exploratory analysis in patients who received deeper sedation revealed a beneficial effect of neuromuscular Blocking Agent infusions on mortality (49% vs 51%; adjusted odds ratio, 0.80; 95% CI, 0.63-0.99, adjusted absolute risk difference, -0.05; p = 0.048). CONCLUSIONS In acute respiratory distress syndrome patients who receive neuromuscular Blocking Agent infusions, a prolonged, high proportion of deeper sedation is associated with increased mortality. Our data support the view that clinicians should minimize the duration of deeper sedation after recovery from neuromuscular Blocking Agent infusion.
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association between intraoperative non depolarising neuromuscular Blocking Agent dose and 30 day readmission after abdominal surgery
BJA: British Journal of Anaesthesia, 2017Co-Authors: Tharusan Thevathasan, Stephanie D Grabitz, Matthias Eikermann, Shirley L Shih, Kyan Safavi, D L Berger, Sara M Burns, R S Glidden, Ross Zafonte, Jeffrey C SchneiderAbstract:Abstract Background We hypothesised that intraoperative non-depolarising neuromuscular Blocking Agent (NMBA) dose is associated with 30-day hospital readmission. Methods Data from 13,122 adult patients who underwent abdominal surgery under general anaesthesia at a tertiary care hospital were analysed by multivariable regression, to examine the effects of intraoperatively administered NMBA dose on 30-day readmission (primary endpoint), hospital length of stay, and hospital costs. Results Clinicians used cisatracurium (mean dose [ SD ] 0.19 mg kg−1 [0.12]), rocuronium (0.83 mg kg−1 [0.53]) and vecuronium (0.14 mg kg−1 [0.07]). Intraoperative administration of NMBAs was dose-dependently associated with higher risk of 30-day hospital readmission (adjusted odds ratio 1.89 [95% Confidence Interval (CI) 1.26–2.84] for 5th quintile vs 1st quintile; P for trend: P Conclusions In a retrospective analysis, high doses of NMBAs given during abdominal surgery was associated with an increased risk of 30-day readmission, particularly in patients undergoing ambulatory surgery.
Navid Esfandiari - One of the best experts on this subject based on the ideXlab platform.
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Heterophile antibody Blocking Agent to confirm false positive serum human chorionic gonadotropin assay.
Obstetrics and gynecology, 2003Co-Authors: Navid Esfandiari, Jeffrey M GoldbergAbstract:Persistently false positive human chorionic gonadotropin (hCG) test results in the absence of an intrauterine pregnancy may lead to a diagnosis of ectopic pregnancy or gestational trophoblastic neoplasia and unnecessary testing and therapy. A 38-year-old woman on oral contraceptives and a 53-year-old perimenopausal woman presented with persistently elevated serum beta-hCG levels from 30 to 225 mIU/mL. Both women had a history of working with mice. Urine hCG testing was negative. Serum beta-hCG levels for both patients were negative after pretreatment of their serum with a heterophile antibody Blocking Agent. These cases illustrate that serum heterophile antibodies can interfere with the hCG enzyme immunoassay and result in false positive values. The addition of heterophile Blocking Agent to the serum can exclude false positives, thereby preventing unnecessary evaluation and treatment.
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Heterophile antibody Blocking Agent to confirm false positive serum human chorionic gonadotropin assay.
Obstetrics & Gynecology, 2003Co-Authors: Navid Esfandiari, Jeffrey M GoldbergAbstract:Abstract background Persistently false positive human chorionic gonadotropin (hCG) test results in the absence of an intrauterine pregnancy may lead to a diagnosis of ectopic pregnancy or gestational trophoblastic neoplasia and unnecessary testing and therapy. Cases A 38-year-old woman on oral contraceptives and a 53-year-old perimenopausal woman presented with persistently elevated serum β-hCG levels from 30 to 225 mIU/mL. Both women had a history of working with mice. Urine hCG testing was negative. Serum β-hCG levels for both patients were negative after pretreatment of their serum with a heterophile antibody Blocking Agent. Conclusion These cases illustrate that serum heterophile antibodies can interfere with the hCG enzyme immunoassay and result in false positive values. The addition of heterophile Blocking Agent to the serum can exclude false positives, thereby preventing unnecessary evaluation and treatment.
Stephanie D Grabitz - One of the best experts on this subject based on the ideXlab platform.
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optimal sedation in patients who receive neuromuscular Blocking Agent infusions for treatment of acute respiratory distress syndrome a retrospective cohort study from a new england health care network
Critical Care Medicine, 2021Co-Authors: Karuna Wongtangman, Stephanie D Grabitz, Maximilian Hammer, Luca J Wachtendorf, Maximilian S Schaefer, Philipp Fassbender, Peter Santer, Elias Baedorf Kassis, Daniel Talmor, Matthias EikermannAbstract:OBJECTIVES Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular Blocking Agent infusions in patients with acute respiratory distress syndrome (acute respiratory distress syndrome). The sedation regimen differed between these trials and also within the ROSE trial between treatment and control groups. We hypothesized that the proportion of deeper sedation is a mediator of the effect of neuromuscular Blocking Agent infusions on mortality. DESIGN Retrospective cohort study. SETTING Seven ICUs in an academic hospital network, Beth Israel Deaconess Medical Center (Boston, MA). PATIENTS Intubated and mechanically ventilated ICU patients with acute respiratory distress syndrome (Berlin definition) admitted between January 2008 until June 2019. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The proportion of deeper sedation was defined as days with nonlight sedation as a fraction of mechanical ventilation days in the ICU after acute respiratory distress syndrome diagnosis. Using clinical data obtained from a hospital network registry, 3,419 patients with acute respiratory distress syndrome were included, of whom 577 (16.9%) were treated with neuromuscular Blocking Agent infusions, for a mean (SD) duration of 1.8 (±1.9) days. The duration of deeper sedation was prolonged in patients receiving neuromuscular Blocking Agent infusions (4.6 ± 2.2 d) compared with patients without neuromuscular Blocking Agent infusions (2.4 ± 2.2 d; p < 0.001). The proportion of deeper sedation completely mediated the negative effect of neuromuscular Blocking Agent infusions on in-hospital mortality (p < 0.001). Exploratory analysis in patients who received deeper sedation revealed a beneficial effect of neuromuscular Blocking Agent infusions on mortality (49% vs 51%; adjusted odds ratio, 0.80; 95% CI, 0.63-0.99, adjusted absolute risk difference, -0.05; p = 0.048). CONCLUSIONS In acute respiratory distress syndrome patients who receive neuromuscular Blocking Agent infusions, a prolonged, high proportion of deeper sedation is associated with increased mortality. Our data support the view that clinicians should minimize the duration of deeper sedation after recovery from neuromuscular Blocking Agent infusion.
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association between intraoperative non depolarising neuromuscular Blocking Agent dose and 30 day readmission after abdominal surgery
BJA: British Journal of Anaesthesia, 2017Co-Authors: Tharusan Thevathasan, Stephanie D Grabitz, Matthias Eikermann, Shirley L Shih, Kyan Safavi, D L Berger, Sara M Burns, R S Glidden, Ross Zafonte, Jeffrey C SchneiderAbstract:Abstract Background We hypothesised that intraoperative non-depolarising neuromuscular Blocking Agent (NMBA) dose is associated with 30-day hospital readmission. Methods Data from 13,122 adult patients who underwent abdominal surgery under general anaesthesia at a tertiary care hospital were analysed by multivariable regression, to examine the effects of intraoperatively administered NMBA dose on 30-day readmission (primary endpoint), hospital length of stay, and hospital costs. Results Clinicians used cisatracurium (mean dose [ SD ] 0.19 mg kg−1 [0.12]), rocuronium (0.83 mg kg−1 [0.53]) and vecuronium (0.14 mg kg−1 [0.07]). Intraoperative administration of NMBAs was dose-dependently associated with higher risk of 30-day hospital readmission (adjusted odds ratio 1.89 [95% Confidence Interval (CI) 1.26–2.84] for 5th quintile vs 1st quintile; P for trend: P Conclusions In a retrospective analysis, high doses of NMBAs given during abdominal surgery was associated with an increased risk of 30-day readmission, particularly in patients undergoing ambulatory surgery.
Karuna Wongtangman - One of the best experts on this subject based on the ideXlab platform.
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optimal sedation in patients who receive neuromuscular Blocking Agent infusions for treatment of acute respiratory distress syndrome a retrospective cohort study from a new england health care network
Critical Care Medicine, 2021Co-Authors: Karuna Wongtangman, Stephanie D Grabitz, Maximilian Hammer, Luca J Wachtendorf, Maximilian S Schaefer, Philipp Fassbender, Peter Santer, Elias Baedorf Kassis, Daniel Talmor, Matthias EikermannAbstract:OBJECTIVES Two previously published trials (ARDS et Curarisation Systematique [ACURASYS] and Reevaluation of Systemic Early Neuromuscular Blockade [ROSE]) presented equivocal evidence on the effect of neuromuscular Blocking Agent infusions in patients with acute respiratory distress syndrome (acute respiratory distress syndrome). The sedation regimen differed between these trials and also within the ROSE trial between treatment and control groups. We hypothesized that the proportion of deeper sedation is a mediator of the effect of neuromuscular Blocking Agent infusions on mortality. DESIGN Retrospective cohort study. SETTING Seven ICUs in an academic hospital network, Beth Israel Deaconess Medical Center (Boston, MA). PATIENTS Intubated and mechanically ventilated ICU patients with acute respiratory distress syndrome (Berlin definition) admitted between January 2008 until June 2019. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The proportion of deeper sedation was defined as days with nonlight sedation as a fraction of mechanical ventilation days in the ICU after acute respiratory distress syndrome diagnosis. Using clinical data obtained from a hospital network registry, 3,419 patients with acute respiratory distress syndrome were included, of whom 577 (16.9%) were treated with neuromuscular Blocking Agent infusions, for a mean (SD) duration of 1.8 (±1.9) days. The duration of deeper sedation was prolonged in patients receiving neuromuscular Blocking Agent infusions (4.6 ± 2.2 d) compared with patients without neuromuscular Blocking Agent infusions (2.4 ± 2.2 d; p < 0.001). The proportion of deeper sedation completely mediated the negative effect of neuromuscular Blocking Agent infusions on in-hospital mortality (p < 0.001). Exploratory analysis in patients who received deeper sedation revealed a beneficial effect of neuromuscular Blocking Agent infusions on mortality (49% vs 51%; adjusted odds ratio, 0.80; 95% CI, 0.63-0.99, adjusted absolute risk difference, -0.05; p = 0.048). CONCLUSIONS In acute respiratory distress syndrome patients who receive neuromuscular Blocking Agent infusions, a prolonged, high proportion of deeper sedation is associated with increased mortality. Our data support the view that clinicians should minimize the duration of deeper sedation after recovery from neuromuscular Blocking Agent infusion.