Evaluation of the Sysmex UF-4000i urine analyzer as a screening test to rule out urinary tract infection and reduce urine cultures. / Évaluation de l'analyseur Sysmex UF-4000i comme test de dépistage pour exclusion des infections urinaires et diminution des mises en culture

INTRODUCTION: Urinary tract infection (UTI) diagnosis by urine culture is time- and labor- consuming. In the Ibn Rochd microbiology laboratory, up to 70% of urine culture samples yield no growth or insignificant growth. OBJECTIVE: To evaluate the new generation of Sysmex UF-4000i fluorescence flow cytometry analyzer with a blue semiconducting laser as a method to rule out negative urine samples for UTI, in comparison of urine culture. MATERIAL AND METHODS: Flow cytometry and microbiological analysis were performed on 502 urine samples included in the study. We used ROC analysis to determine cutoff points at which optimal sensitivity and specificity are achieved for clinical use. RESULTS: Our results showed that bacteria count at a cut-off of 100/µL, and/or the leucocytes count ≥ 45/µL are the optimal indicator for positive culture results. At these cut off, bacteria sensitivity (SE), specificity (SP), Positive predictive value (PPV) and negative predictive value (NPV) were 97,3%, 95%, 87,8% and 98,8% respectively. For leucocytes, SE, SP, PPV and NPV were 99,1%, 95,8%, 88,6% and 99,7% respectively. DISCUSSION AND CONCLUSION: The bacterial and leucocytes counts generated by UF-4000i analysis may be useful in our context as a rapid screening to exclude UTI by reducing about 70% of urines cultures and then workload. Nevertheless, further validation is needed for different patient groups especially with urological disease or immunocompromised patients.

HLA-C Genotyping Reveals Haplotype C*07 as a Potential Biomarker of Late Psoriasis Onset in Moroccan Patients.

Psoriasis still has an unknown etiology. Genetic predisposition shows the association between HLA-Cw6 allele and psoriasis. Although biotherapies have been proven effective in psoriasis treatment, methotrexate (MTX) is still used as a first-line systemic therapy due to its efficacy/affordability, but the differential response to MTX is mostly related to interindividual genetic variability and remains an issue. Our study aimed to analyze HLA-C allele frequencies in a sample of Moroccan psoriatic patients and assess the therapeutic response to MTX. Whole blood of 54 Moroccan psoriatic patients was collected and DNA was extracted. Patients' HLA-C locus was genotyped by PCR-SSO. Results were analyzed with Luminex xMAP Technology and Match-it DNA Evolution 3.4. HLA-C typing results of 77 sex- and age-matched unrelated non-psoriatic healthy subjects were included. We observed no difference in the allelic distribution of HLA-C between patients and healthy controls, suggesting that none of the HLA-C alleles were significantly associated with psoriasis. Moreover, the HLA-C*07 allele was associated with a late age at disease onset (>30 years old) (p = 0.007). No statistically significant association was found between HLA-C allele expression and response to MTX, despite a higher frequency of HLA-C*06 in responders compared to non-responders. Thus, HLA-C*07 could be a biomarker of late psoriasis onset in the Moroccan population.

Evaluation of the Sysmex UF-4000i urine analyzer as a screening test to rule out urinary tract infection and reduce urine cultures.

INTRODUCTION: Urinary tract infection (UTI) diagnosis by urine culture is time- and labor- consuming. In the Ibn Rochd microbiology laboratory, up to 70% of urine culture samples yield no growth or insignificant growth. OBJECTIVE: To evaluate the new generation of Sysmex UF-4000i fluorescence flow cytometry analyzer with a blue semiconducting laser as a method to rule out negative urine samples for UTI, in comparison of urine culture. MATERIAL AND METHODS: Flow cytometry and microbiological analysis were performed on 502 urine samples included in the study. We used ROC analysis to determine cutoff points at which optimal sensitivity and specificity are achieved for clinical use. RESULTS: Our results showed that bacteria count at a cut-off of 100/µL, and/or the leucocytes count ≥45/µL are the optimal indicator for positive culture results. At these cut off, bacteria sensitivity (SE), specificity (SP), Positive predictive value (PPV) and negative predictive value (NPV) were 97,3%, 95%, 87,8% and 98,8% respectively. For leucocytes, SE, SP, PPV and NPV were 99,1%, 95,8%, 88,6% and 99,7% respectively. DISCUSSION AND CONCLUSION: The bacterial and leucocytes counts generated by UF-4000i analysis may be useful in our context as a rapid screening to exclude UTI by reducing about 70% of urines cultures and then workload. Nevertheless, further validation is needed for different patient groups especially with urological disease or immunocompromised patients.

Real-Time Monitoring System to Manage Mental Healthcare Emergency Unit.

OBJECTIVES: Real-time relevant information helps guide the healthcare decision-making process in daily clinical practice as well as the management and optimization of healthcare processes. However, proprietary business intelligence suite solutions supporting the production of decision-making information requires investment that is out of reach of small and mediumsized healthcare facilities or those with limited resources, particularly in developing countries. This paper describes our experience in designing and implementing a real-time healthcare monitoring system solution to manage healthcare emergency units. METHODS: Through the use of free Business Intelligence tools and Python data science language we designed a real-time monitoring system, which was implemented to explore the Electronic Medical Records system of a university mental health emergency unit and render an electronic dashboard to support health professional daily practice. RESULTS: Three main dashboards were created to monitor patient waiting time, to access the clinical notes summary for the next waiting patient, and to obtain insights into activity during the last 24 hours. CONCLUSIONS: The designed system could serve as a monitoring support model using free and user-friendly data science tools, which are good alternatives to proprietary business intelligence solutions and drastically reduce cost. Still, the key to success in decision-making systems is based on investment in human resources, business intelligence skills training, the organizational aspect of the decision-making process, and data production quality insurance.

Monitoring Mental Healthcare Services Using Business Analytics.

OBJECTIVES: Monitoring healthcare activities is the first step for health stakeholders and health professionals to improve the quality and performance of healthcare services. However, monitoring remains a challenge for healthcare facilities, especially in developing countries. Fortunately, advances in business analytics address this need. This paper aims to describe the experience of a low-income healthcare facility in a developing country in using business analytics descriptive techniques and to discuss business analytics implementation challenges and opportunities in such an environment. METHODS: Business analytics descriptive techniques were applied on 3 years' electronic medical records of outpatient consultation of the University Psychiatric Centre (CPU) of Casablanca. Statistical analysis was conducted to compare results over years. RESULTS: Over the 3 monitored years, the monthly number of computerized physician order entries increased significantly (p < 0.001). Physicians improved their personal recording over years. Schizophrenia as well as depressive and bipolar disorders were noted at the top of outpatient mental disorders. Antipsychotics are the most prescribed drugs, and a significant annual decrease in outpatient care wait time was noted (p < 0.001). CONCLUSIONS: Business analytics allowed CPU to monitor mental healthcare outpatient activity and to adopt its business processes according to outcomes. However, challenges mainly in the organizational dimension of the decision-making process and the definition of strategic key metrics, data structuration, and the quality of data entry had to be considered for the optimal use of business analytics.

[Occupational exposure to blood among medical students in Casablanca (Morocco): Analysis of knowledge and practices]. / Les accidents d?exposition au sang chez les étudiants en médecine de Casablanca (Maroc) : Analyse des connaissances et pratiques.

Occupational exposure to blood (OEB) is associated with a significant risk of transmission of bloodborne viruses to medical students. The objective of this study was to evaluate the knowledge and practices of Casablanca medical students concerning OEB preventive measures and their behaviour after accidental exposure. A cross-sectional study was carried out at the Ibn Rochd University Hospital in Casablanca using stratified cluster sampling ; data from this study were collected by means of an anonymous self-administered questionnaire. The mean age was 22.38 years (SD = 1.69) with a female predominance (56.0%). About 17.5% of students had experienced at least one OEB, and only 38.3% were familiar with the standard precautions to prevent these accidents. Accidental exposure was significantly associated with needle recapping (p = 0.002) and ignorance of standard precautions (p = 0.028).These results illustrate the insufficient knowledge and poor compliance with preventive measures of occupational exposure to blood, indicating the need for awareness-raising and training activities for medical students.

[Smoking in public middle schools in Casablanca]. / Tabagisme aux collèges publics de Casablanca.

The transition period between elementary and middle school is a high-risk period for smoking initiation. Hence the importance of primary prevention programs in adolescent populations. The development and implementation of appropriate preventive measures requires information on tobacco use among adolescents. The objective of this study was to estimate the prevalence of smoking among middle school students in Casablanca and to describe associated drug use. A cross-sectional study was conducted in 2010 in six collèges (middle schools) in Casablanca. The average age of the students was 16.3 years (SD = 2.1). 55% of the students were female. Overall smoking prevalence was 7.5% (CI 95% = 5.5% - 10.1%) ? 11.4% among boys and 4.6% among girls. 52.5% of the smokers began smoking between the ages of 14 and 18. The reasons for smoking included smoking as a way of escaping from problems (30%), relaxation (16%) and experience (7%). Smoking behavior was associated with drug use in 23.3% of smokers, compared to 0.6% among non-smokers (p < 10?3). These results suggest the need for prevention measures aimed at strengthening tobacco control policies in schools and other gathering places for young people.