WorldWideScience

Sample records for blood-based laboratory test

  1. Hair sheep blood, citrated or defibrinated, fulfills all requirements of blood agar for diagnostic microbiology laboratory tests.

    Science.gov (United States)

    Yeh, Ellen; Pinsky, Benjamin A; Banaei, Niaz; Baron, Ellen Jo

    2009-07-03

    Blood agar is used for the identification and antibiotic susceptibility testing of many bacterial pathogens. In the developing world, microbiologists use human blood agar because of the high cost and inhospitable conditions for raising wool sheep or horses to supply blood. Many pathogens either fail to grow entirely or exhibit morphologies and hemolytic patterns on human blood agar that confound colony recognition. Furthermore, human blood can be hazardous to handle due to HIV and hepatitis. This study investigated whether blood from hair sheep, a hardy, low-maintenance variety of sheep adapted for hot climates, was suitable for routine clinical microbiology studies. Hair sheep blood obtained by jugular venipuncture was anticoagulated by either manual defibrination or collection in human blood bank bags containing citrate-phosphate-dextrose. Trypticase soy 5% blood agar was made from both forms of hair sheep blood and commercial defibrinated wool sheep blood. Growth characteristics, colony morphologies, and hemolytic patterns of selected human pathogens, including several streptococcal species, were evaluated. Specialized identification tests, including CAMP test, reverse CAMP test, and satellite colony formation with Haemophilus influenzae and Abiotrophia defectiva were also performed. Mueller-Hinton blood agar plates prepared from the three blood types were compared in antibiotic susceptibility tests by disk diffusion and E-test. The results of all studies showed that blood agar prepared from citrated hair sheep blood is suitable for microbiological tests used in routine identification and susceptibility profiling of human pathogens. The validation of citrated hair sheep blood eliminates the labor-intensive and equipment-requiring process of manual defibrination. Use of hair sheep blood, in lieu of human blood currently used by many developing world laboratories and as an alternative to cost-prohibitive commercial sheep blood, offers the opportunity to

  2. Hair sheep blood, citrated or defibrinated, fulfills all requirements of blood agar for diagnostic microbiology laboratory tests.

    Directory of Open Access Journals (Sweden)

    Ellen Yeh

    Full Text Available BACKGROUND: Blood agar is used for the identification and antibiotic susceptibility testing of many bacterial pathogens. In the developing world, microbiologists use human blood agar because of the high cost and inhospitable conditions for raising wool sheep or horses to supply blood. Many pathogens either fail to grow entirely or exhibit morphologies and hemolytic patterns on human blood agar that confound colony recognition. Furthermore, human blood can be hazardous to handle due to HIV and hepatitis. This study investigated whether blood from hair sheep, a hardy, low-maintenance variety of sheep adapted for hot climates, was suitable for routine clinical microbiology studies. METHODS AND FINDINGS: Hair sheep blood obtained by jugular venipuncture was anticoagulated by either manual defibrination or collection in human blood bank bags containing citrate-phosphate-dextrose. Trypticase soy 5% blood agar was made from both forms of hair sheep blood and commercial defibrinated wool sheep blood. Growth characteristics, colony morphologies, and hemolytic patterns of selected human pathogens, including several streptococcal species, were evaluated. Specialized identification tests, including CAMP test, reverse CAMP test, and satellite colony formation with Haemophilus influenzae and Abiotrophia defectiva were also performed. Mueller-Hinton blood agar plates prepared from the three blood types were compared in antibiotic susceptibility tests by disk diffusion and E-test. CONCLUSIONS: The results of all studies showed that blood agar prepared from citrated hair sheep blood is suitable for microbiological tests used in routine identification and susceptibility profiling of human pathogens. The validation of citrated hair sheep blood eliminates the labor-intensive and equipment-requiring process of manual defibrination. Use of hair sheep blood, in lieu of human blood currently used by many developing world laboratories and as an alternative to cost

  3. Laboratory Tests

    Science.gov (United States)

    ... Medical Devices Radiation-Emitting Products Vaccines, Blood & Biologics Animal & ... What are lab tests? Laboratory tests are medical devices that are intended for use on samples of blood, urine, or other tissues ...

  4. Blood gas testing and related measurements: National recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    Science.gov (United States)

    Dukić, Lora; Kopčinović, Lara Milevoj; Dorotić, Adrijana; Baršić, Ivana

    2016-10-15

    Blood gas analysis (BGA) is exposed to risks of errors caused by improper sampling, transport and storage conditions. The Clinical and Laboratory Standards Institute (CLSI) generated documents with recommendations for avoidance of potential errors caused by sample mishandling. Two main documents related to BGA issued by the CLSI are GP43-A4 (former H11-A4) Procedures for the collection of arterial blood specimens; approved standard - fourth edition, and C46-A2 Blood gas and pH analysis and related measurements; approved guideline - second edition. Practices related to processing of blood gas samples are not standardized in the Republic of Croatia. Each institution has its own protocol for ordering, collection and analysis of blood gases. Although many laboratories use state of the art analyzers, still many preanalytical procedures remain unchanged. The objective of the Croatian Society of Medical Biochemistry and Laboratory Medicine (CSMBLM) is to standardize the procedures for BGA based on CLSI recommendations. The Working Group for Blood Gas Testing as part of the Committee for the Scientific Professional Development of the CSMBLM prepared a set of recommended protocols for sampling, transport, storage and processing of blood gas samples based on relevant CLSI documents, relevant literature search and on the results of Croatian survey study on practices and policies in acid-base testing. Recommendations are intended for laboratory professionals and all healthcare workers involved in blood gas processing.

  5. [Blood volume for biochemistry determinations--laboratory needs and everyday practice].

    Science.gov (United States)

    Sztefko, Krystyna; Mamica, Katarzyna; Bugajska, Jolanta; Maziarz, Barbara; Tomasik, Przemysław

    2014-01-01

    Blood loss due to diagnostic phlebotomy jest a very serious problem, especially for newborn, infants and critically ill patients on intensive care units. Although single blood loss can be easily tolerated in adults, in small babies and in patients who are frequently monitored based on laboratory tests iatrogenic anaemia can occur. To evaluate the blood volume drawn for routine biochemistry tests in relation to patient age and the number of parameters requested. Blood volume drawn for routine biochemistry measurements from patients hospitalized in University Children's Hospital (N = 2980, children age from one day to 18 years) and in University Hospital (N = 859, adults, aged > 1.8 years) in Cracow has been analyzed. Blood volume was calculated based on regular tube diameter and blood heights in the tube. In case of microvettes the blood volume was 0.2 ml. Statistical analysis has been performed by using PRISM 5.0. The statistical significance was set at p nurses and doctors should include the information about current laboratory automation and methods miniaturization; 2) The amount of blood volume needed by laboratory for the requested number of tests should always be taken into account when diagnostic phlebotomy is necessary.

  6. Toward laboratory blood test-comparable photometric assessments for anemia in veterinary hematology

    Science.gov (United States)

    Kim, Taehoon; Choi, Seung Ho; Lambert-Cheatham, Nathan; Xu, Zhengbin; Kritchevsky, Janice E.; Bertin, Francois-René; Kim, Young L.

    2016-10-01

    Anemia associated with intestinal parasites and malnutrition is the leading cause of morbidity and mortality in small ruminants worldwide. Qualitative scoring of conjunctival redness has been developed so that farmers can gauge anemia in sheep and goats to identify animals that require treatment. For clinically relevant anemia diagnosis, complete blood count-comparable quantitative methods often rely on complicated and expensive optical instruments, requiring detailed spectral information of hemoglobin. We report experimental and numerical results for simple, yet reliable, noninvasive hemoglobin detection that can be correlated with laboratory-based blood hemoglobin testing for anemia diagnosis. In our pilot animal study using calves, we exploit the third eyelid (i.e., palpebral conjunctiva) as an effective sensing site. To further test spectrometer-free (or spectrometerless) hemoglobin assessments, we implement full spectral reconstruction from RGB data and partial least square regression. The unique combination of RGB-based spectral reconstruction and partial least square regression could potentially offer uncomplicated instrumentation and avoid the use of a spectrometer, which is vital for realizing a compact and inexpensive hematology device for quantitative anemia detection in the farm field.

  7. Factors affecting the labor efficiency of hospital-based blood bank laboratories.

    Science.gov (United States)

    Lam, H C; Kominski, G F; Petz, L D; Sofaer, S

    1994-09-01

    A variety of financing mechanisms and managerial innovations have been developed in the past decade to control hospital costs. Some evidence suggests that those changes have not produced substantial improvements in labor efficiency among employees in the hospital's technical level, such as in the blood bank laboratories. This study measured labor efficiency in 40 hospital-based blood bank laboratories in Southern California during the year from July 1989 to June 1990 and explored the impact of financial, managerial, and operational factors on labor efficiency. With standardized output measures used in all blood bank laboratories, a wide variation of labor efficiency was found. Multivariate analyses indicate that the labor efficiency of blood bank employees was not influenced by organizational financial incentives, but was affected by the managerial styles of blood bank managers. Interpretation of the findings suggests that labor efficiency is affected by operational designs intended to improve responses to variable workloads and reduce slack time.

  8. Going beyond audit and feedback: towards behaviour-based interventions to change physician laboratory test ordering behaviour.

    Science.gov (United States)

    Meidani, Z; Mousavi, G A; Kheirkhah, D; Benar, N; Maleki, M R; Sharifi, M; Farrokhian, A

    2017-12-01

    Studies indicate there are a variety of contributing factors affecting physician test ordering behaviour. Identifying these behaviours allows development of behaviour-based interventions. Methods Through a pilot study, the list of contributing factors in laboratory tests ordering, and the most ordered tests, were identified, and given to 50 medical students, interns, residents and paediatricians in questionnaire form. The results showed routine tests and peer or supervisor pressure as the most influential factors affecting physician ordering behaviour. An audit and feedback mechanism was selected as an appropriate intervention to improve physician ordering behaviour. The intervention was carried out at two intervals over a three-month period. Findings There was a large reduction in the number of laboratory tests ordered; from 908 before intervention to 389 and 361 after first and second intervention, respectively. There was a significant relationship between audit and feedback and the meaningful reduction of 7 out of 15 laboratory tests including complete blood count (p = 0.002), erythrocyte sedimentation rate (p = 0.01), C-reactive protein (p = 0.01), venous blood gas (p = 0.016), urine analysis (p = 0.005), blood culture (p = 0.045) and stool examination (p = 0.001). Conclusion The audit and feedback intervention, even in short duration, affects physician ordering behaviour. It should be designed in terms of behaviour-based intervention and diagnosis of the contributing factors in physicians' behaviour. Further studies are required to substantiate the effectiveness of such behaviour-based intervention strategies in changing physician behaviour.

  9. Pyruvate kinase blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003357.htm Pyruvate kinase blood test To use the sharing features on this page, ... energy when oxygen levels are low. How the Test is Performed A blood sample is needed. In the laboratory, white blood ...

  10. Comparison of a New Cobinamide-Based Method to a Standard Laboratory Method for Measuring Cyanide in Human Blood

    Science.gov (United States)

    Swezey, Robert; Shinn, Walter; Green, Carol; Drover, David R.; Hammer, Gregory B.; Schulman, Scott R.; Zajicek, Anne; Jett, David A.; Boss, Gerry R.

    2013-01-01

    Most hospital laboratories do not measure blood cyanide concentrations, and samples must be sent to reference laboratories. A simple method is needed for measuring cyanide in hospitals. The authors previously developed a method to quantify cyanide based on the high binding affinity of the vitamin B12 analog, cobinamide, for cyanide and a major spectral change observed for cyanide-bound cobinamide. This method is now validated in human blood, and the findings include a mean inter-assay accuracy of 99.1%, precision of 8.75% and a lower limit of quantification of 3.27 µM cyanide. The method was applied to blood samples from children treated with sodium nitroprusside and it yielded measurable results in 88 of 172 samples (51%), whereas the reference laboratory yielded results in only 19 samples (11%). In all 19 samples, the cobinamide-based method also yielded measurable results. The two methods showed reasonable agreement when analyzed by linear regression, but not when analyzed by a standard error of the estimate or paired t-test. Differences in results between the two methods may be because samples were assayed at different times on different sample types. The cobinamide-based method is applicable to human blood, and can be used in hospital laboratories and emergency rooms. PMID:23653045

  11. Overuse of preoperative laboratory coagulation testing and ABO blood typing: a French national study.

    Science.gov (United States)

    Beloeil, H; Ruchard, D; Drewniak, N; Molliex, S

    2017-12-01

    Following publication of guidelines on routine preoperative tests, the French Society of Anaesthesiology and Intensive Care (SFAR), in association with French national public health insurance, conducted a survey to evaluate adherence to guidelines and the economic consequences. Using the French Hospital Discharge Database and National Health Insurance Information system, tests performed during the 30 days before surgery were analysed for two situations: (1) standard laboratory coagulation tests and ABO blood typing in children able to walk and scheduled for tonsillectomy/adenoidectomy; and (2) ABO blood typing in adults before laparoscopic cholecystectomy, thyroidectomy, lumbar discectomy or breast surgery. Guidelines do not recommend any preoperative tests in these settings. Between 2013 and 2015, a coagulation test was performed in 49% of the 241 017 children who underwent tonsillectomy and 39% of the 133 790 children who underwent adenoidectomy. A similar pattern was observed for ABO blood typing although re-operation rates for bleeding on the first postoperative day were very low (0.12-0.31% for tonsillectomy and 0.01-0.02% for adenoidectomy). Between 2012 and 2015, ABO blood typing was performed in 32-45% of the 1 114 082 patients who underwent one of the four selected procedures. The transfusion rate was very low (0.02-0.31%). The mean cost for the four procedures over the 4 yr period was €5 310 000 (sd €325 000). Standard laboratory coagulation tests and ABO blood typing are still routinely prescribed before surgery and anaesthesia despite current guidelines. This over-prescription represents a high and unnecessary cost, and should therefore be addressed. © The Author 2017. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com

  12. Test Cost and Test Accuracy in Clinical Laboratories in Kampala, Uganda.

    Science.gov (United States)

    Amukele, Timothy K; Jones, Robert; Elbireer, Ali

    2018-04-25

    To assess the accuracy and costs of laboratory tests in Kampala, Uganda. A random selection of 78 laboratories tested external quality assurance samples at market rates. There were 40 moderate- to high-complexity and 38 low-complexity laboratories. Four percent (3/78) of these laboratories were accredited and 94% (73/78) were private. The 40 moderate- to high-complexity laboratories performed malaria blood smear, urine human chorionic gonadotropin (hCG), human immunodeficiency virus (HIV), syphilis, glucose, and three-panel tests: CBC, liver function tests, and kidney function tests. The 38 low-complexity laboratories performed malaria blood smear, urine hCG, and syphilis testing only. Hematology, HIV, syphilis, and malarial proficiency testing samples were prepared by accredited laboratories in Kampala. All other samples were provided by the Royal College of Pathologists of Australia. 77.1% of all results were accurate (met target values). It varied widely by laboratory (50%-100%), test identity (malaria blood smear, 96%; serum urea nitrogen, 38%), and test type (quantitative: 66% [31%-89%], qualitative: 91% [68%-97%]). Test prices varied by up to 3,600%, and there was no correlation between test cost and accuracy (r2 = 0.02). There were large differences in accuracy and price across laboratories in Kampala. Price was not associated with quality.

  13. Inappropriate emergency laboratory test ordering: defensive or peer evidence shared based medicine?

    Directory of Open Access Journals (Sweden)

    C. Descovich

    2013-05-01

    Full Text Available BACKGROUND The laboratory overuse is widely prevalent in hospital practice, mostly in the emergency care. Reasons for excessive and inappropriate test-ordering include defensive behaviour and fear or uncertainty, lack of experience, the misuse of protocols and guidelines, “routine” and local attitudes, inadequate educational feedback and clinician’s unawareness about the cost of examinations and their related implications. AIM OF THE STUDY AND METHODS The primary target of our working group was to reduce inappropriate ordering on a urgent basis test, implementing further examinations not yet previewed in the hospital panel of the available urgencies, according to the evidence based diagnosis concept. The secondary goal was to indicate strategies of re-engineering of the processes, improving turnaround time in the laboratory management of emergencies. After evaluating, as first intervention, the more reliable sources for practice guidelines, systematic reviews and RCTs, the committee further discussed main topics with in-hospital stakeholders, selected from Emergency, Internal Medicine and Surgery Depts. The working group, in many subsequent audits, tried to obtain a systematic feed back with all involved professionals. RESULTS After reviewing literature’s evidence, the board constrained testing options by defining the basic emergency laboratory panel tests (blood type, hemogram, blood urea nitrogen, plasma creatinine, glucose, sodium, potassium, chloride, osmolarity, CRP, bicarbonate, CPK, creatine phosphokinase-MB, myoglobin, troponin, BNP and NT-proBNP, PT-INR, PTT, D-dimer, beta- HCG, biochemical urinalysis etc.. As final result, the proposed tests reduced the overall number of inappropriate investigations and increased, with newer and updated tests, the available panel for critical patients. DISCUSSION A collegiate review of data reporting, in-hospital deepening of problems and the inter- professional discussion of the evidences

  14. Capillary blood sampling: national recommendations on behalf of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    Science.gov (United States)

    Krleza, Jasna Lenicek; Dorotic, Adrijana; Grzunov, Ana; Maradin, Miljenka

    2015-01-01

    Capillary blood sampling is a medical procedure aimed at assisting in patient diagnosis, management and treatment, and is increasingly used worldwide, in part because of the increasing availability of point-of-care testing. It is also frequently used to obtain small blood volumes for laboratory testing because it minimizes pain. The capillary blood sampling procedure can influence the quality of the sample as well as the accuracy of test results, highlighting the need for immediate, widespread standardization. A recent nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia has shown that capillary sampling procedures are not standardized and that only a small proportion of Croatian laboratories comply with guidelines from the Clinical Laboratory Standards Institute (CLSI) or the World Health Organization (WHO). The aim of this document is to provide recommendations for capillary blood sampling. This document has been produced by the Working Group for Capillary Blood Sampling within the Croatian Society of Medical Biochemistry and Laboratory Medicine. Our recommendations are based on existing available standards and recommendations (WHO Best Practices in Phlebotomy, CLSI GP42-A6 and CLSI C46-A2), which have been modified based on local logistical, cultural, legal and regulatory requirements. We hope that these recommendations will be a useful contribution to the standardization of capillary blood sampling in Croatia.

  15. Comparison of Rapid Malaria Test and Laboratory Microscopy ...

    African Journals Online (AJOL)

    Michael Horsfall

    ABSTRACT: Blood samples collected from 272 volunteers in two communities of Bayelsa State in the Niger. Delta area were investigated for falciparum malaria parasite using the rapid test based on the detection of soluble antigen and laboratory microscopy test. The data showed that out of the 272 samples collected, ...

  16. Advantages and Limitations of Anticipating Laboratory Test Results from Regression- and Tree-Based Rules Derived from Electronic Health-Record Data

    OpenAIRE

    Mohammad, Fahim; Theisen-Toupal, Jesse C.; Arnaout, Ramy

    2014-01-01

    Laboratory testing is the single highest-volume medical activity, making it useful to ask how well one can anticipate whether a given test result will be high, low, or within the reference interval ("normal"). We analyzed 10 years of electronic health records--a total of 69.4 million blood tests--to see how well standard rule-mining techniques can anticipate test results based on patient age and gender, recent diagnoses, and recent laboratory test results. We evaluated rules according to thei...

  17. Advantages and limitations of anticipating laboratory test results from regression- and tree-based rules derived from electronic health-record data.

    Directory of Open Access Journals (Sweden)

    Fahim Mohammad

    Full Text Available Laboratory testing is the single highest-volume medical activity, making it useful to ask how well one can anticipate whether a given test result will be high, low, or within the reference interval ("normal". We analyzed 10 years of electronic health records--a total of 69.4 million blood tests--to see how well standard rule-mining techniques can anticipate test results based on patient age and gender, recent diagnoses, and recent laboratory test results. We evaluated rules according to their positive and negative predictive value (PPV and NPV and area under the receiver-operator characteristic curve (ROC AUCs. Using a stringent cutoff of PPV and/or NPV≥0.95, standard techniques yield few rules for sendout tests but several for in-house tests, mostly for repeat laboratory tests that are part of the complete blood count and basic metabolic panel. Most rules were clinically and pathophysiologically plausible, and several seemed clinically useful for informing pre-test probability of a given result. But overall, rules were unlikely to be able to function as a general substitute for actually ordering a test. Improving laboratory utilization will likely require different input data and/or alternative methods.

  18. Advantages and limitations of anticipating laboratory test results from regression- and tree-based rules derived from electronic health-record data.

    Science.gov (United States)

    Mohammad, Fahim; Theisen-Toupal, Jesse C; Arnaout, Ramy

    2014-01-01

    Laboratory testing is the single highest-volume medical activity, making it useful to ask how well one can anticipate whether a given test result will be high, low, or within the reference interval ("normal"). We analyzed 10 years of electronic health records--a total of 69.4 million blood tests--to see how well standard rule-mining techniques can anticipate test results based on patient age and gender, recent diagnoses, and recent laboratory test results. We evaluated rules according to their positive and negative predictive value (PPV and NPV) and area under the receiver-operator characteristic curve (ROC AUCs). Using a stringent cutoff of PPV and/or NPV≥0.95, standard techniques yield few rules for sendout tests but several for in-house tests, mostly for repeat laboratory tests that are part of the complete blood count and basic metabolic panel. Most rules were clinically and pathophysiologically plausible, and several seemed clinically useful for informing pre-test probability of a given result. But overall, rules were unlikely to be able to function as a general substitute for actually ordering a test. Improving laboratory utilization will likely require different input data and/or alternative methods.

  19. Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia.

    Science.gov (United States)

    Krleza, Jasna Lenicek

    2014-01-01

    Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear. All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about the laboratory's parent institution, patient population, types and frequencies of laboratory tests based on capillary blood samples, choice of reference intervals, and policies and procedures specifically related to capillary sampling. Sampling practices were compared with guidelines from the Clinical and Laboratory Standards Institute (CLSI) and the World Health Organization (WHO). Of the 204 laboratories surveyed, 174 (85%) responded with complete questionnaires. Among the 174 respondents, 155 (89%) reported that they routinely perform capillary sampling, which is carried out by laboratory staff in 118 laboratories (76%). Nearly half of respondent laboratories (48%) do not have a written protocol including order of draw for multiple sampling. A single puncture site is used to provide capillary blood for up to two samples at 43% of laboratories that occasionally or regularly perform such sampling. Most respondents (88%) never perform arterialisation prior to capillary blood sampling. Capillary blood sampling is highly prevalent in Croatia across different types of clinical facilities and patient populations. Capillary sampling procedures are not standardised in the country, and the rate of laboratory compliance with CLSI and WHO guidelines is low.

  20. Point-of-Care Test Equipment for Flexible Laboratory Automation.

    Science.gov (United States)

    You, Won Suk; Park, Jae Jun; Jin, Sung Moon; Ryew, Sung Moo; Choi, Hyouk Ryeol

    2014-08-01

    Blood tests are some of the core clinical laboratory tests for diagnosing patients. In hospitals, an automated process called total laboratory automation, which relies on a set of sophisticated equipment, is normally adopted for blood tests. Noting that the total laboratory automation system typically requires a large footprint and significant amount of power, slim and easy-to-move blood test equipment is necessary for specific demands such as emergency departments or small-size local clinics. In this article, we present a point-of-care test system that can provide flexibility and portability with low cost. First, the system components, including a reagent tray, dispensing module, microfluidic disk rotor, and photometry scanner, and their functions are explained. Then, a scheduler algorithm to provide a point-of-care test platform with an efficient test schedule to reduce test time is introduced. Finally, the results of diagnostic tests are presented to evaluate the system. © 2014 Society for Laboratory Automation and Screening.

  1. Blood Count Tests: MedlinePlus Health Topic

    Science.gov (United States)

    ... Spanish WBC count (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Blood Count Tests ... WBC count Show More Show Less Related Health Topics Bleeding Disorders Blood Laboratory Tests National Institutes of ...

  2. Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia

    Science.gov (United States)

    Krleza, Jasna Lenicek

    2014-01-01

    Introduction: Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear. Materials and methods: All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about the laboratory’s parent institution, patient population, types and frequencies of laboratory tests based on capillary blood samples, choice of reference intervals, and policies and procedures specifically related to capillary sampling. Sampling practices were compared with guidelines from the Clinical and Laboratory Standards Institute (CLSI) and the World Health Organization (WHO). Results: Of the 204 laboratories surveyed, 174 (85%) responded with complete questionnaires. Among the 174 respondents, 155 (89%) reported that they routinely perform capillary sampling, which is carried out by laboratory staff in 118 laboratories (76%). Nearly half of respondent laboratories (48%) do not have a written protocol including order of draw for multiple sampling. A single puncture site is used to provide capillary blood for up to two samples at 43% of laboratories that occasionally or regularly perform such sampling. Most respondents (88%) never perform arterialisation prior to capillary blood sampling. Conclusions: Capillary blood sampling is highly prevalent in Croatia across different types of clinical facilities and patient populations. Capillary sampling procedures are not standardised in the country, and the rate of laboratory compliance with CLSI and WHO guidelines is low. PMID:25351353

  3. Comparison of a commercial blood cross-matching kit to the standard laboratory method for establishing blood transfusion compatibility in dogs.

    Science.gov (United States)

    Guzman, Leo Roa; Streeter, Elizabeth; Malandra, Allison

    2016-01-01

    To evaluate the accuracy of a commercial blood transfusion cross-match kit when compared to the standard laboratory method for establishing blood transfusion compatibility. A prospective observational in intro study performed from July 2009 to July 2013. Private referral veterinary center. Ten healthy dogs, 11 anemic dogs, and 24 previously transfused dogs. None. Forty-five dogs were enrolled in a prospective study in order to compare the standard blood transfusion cross-match technique to a commercial blood transfusion cross-matching kit. These dogs were divided into 3 different groups that included 10 healthy dogs (control group), 11 anemic dogs in need of a blood transfusion, and 24 sick dogs that were previously transfused. Thirty-five dogs diagnosed with anemia secondary to multiple disease processes were cross-matched using both techniques. All dogs cross-matched via the kit had a compatible major and minor result, whereas 16 dogs out of 45 (35%) had an incompatible cross-match result when the standard laboratory technique was performed. The average time to perform the commercial kit was 15 minutes and this was 3 times shorter than the manual cross-match laboratory technique that averaged 45-50 minutes to complete. While the gel-based cross-match kit is quicker and less technically demanding than standard laboratory cross-match procedures, microagglutination and low-grade hemolysis are difficult to identify by using the gel-based kits. This could result in transfusion reactions if the gel-based kits are used as the sole determinant of blood compatibility prior to transfusion. Based on our results, the standard manual cross-match technique remains the gold standard test to determine blood transfusion compatibility. © Veterinary Emergency and Critical Care Society 2016.

  4. Influence of diet on the results of laboratory tests

    Directory of Open Access Journals (Sweden)

    Kinga Lis

    2013-12-01

    Full Text Available Blood and urine laboratory tests are necessary to diagnose the state of the patient. These tests are also helpful in the assessment of diet and nutritional status of the organism. It is recommended that both blood and urine for laboratory tests be collected in the morning, from fasting patients after an overnight rest. These conditions are defined as the standard conditions for collection of material for laboratory testing. Before testing, patients should follow their natural diet and avoid physical exertion, night work, long-distance travel, as well as consumption of alcohol and drugs. They should also reduce the consumption of synthetic vitamins and herbal remedies and other dietary supplements. Medications should be limited to those that are absolutely necessary. All of these factors can affect the results of laboratory tests.

  5. Laboratory Workflow Analysis of Culture of Periprosthetic Tissues in Blood Culture Bottles.

    Science.gov (United States)

    Peel, Trisha N; Sedarski, John A; Dylla, Brenda L; Shannon, Samantha K; Amirahmadi, Fazlollaah; Hughes, John G; Cheng, Allen C; Patel, Robin

    2017-09-01

    Culture of periprosthetic tissue specimens in blood culture bottles is more sensitive than conventional techniques, but the impact on laboratory workflow has yet to be addressed. Herein, we examined the impact of culture of periprosthetic tissues in blood culture bottles on laboratory workflow and cost. The workflow was process mapped, decision tree models were constructed using probabilities of positive and negative cultures drawn from our published study (T. N. Peel, B. L. Dylla, J. G. Hughes, D. T. Lynch, K. E. Greenwood-Quaintance, A. C. Cheng, J. N. Mandrekar, and R. Patel, mBio 7:e01776-15, 2016, https://doi.org/10.1128/mBio.01776-15), and the processing times and resource costs from the laboratory staff time viewpoint were used to compare periprosthetic tissues culture processes using conventional techniques with culture in blood culture bottles. Sensitivity analysis was performed using various rates of positive cultures. Annualized labor savings were estimated based on salary costs from the U.S. Labor Bureau for Laboratory staff. The model demonstrated a 60.1% reduction in mean total staff time with the adoption of tissue inoculation into blood culture bottles compared to conventional techniques (mean ± standard deviation, 30.7 ± 27.6 versus 77.0 ± 35.3 h per month, respectively; P < 0.001). The estimated annualized labor cost savings of culture using blood culture bottles was $10,876.83 (±$337.16). Sensitivity analysis was performed using various rates of culture positivity (5 to 50%). Culture in blood culture bottles was cost-effective, based on the estimated labor cost savings of $2,132.71 for each percent increase in test accuracy. In conclusion, culture of periprosthetic tissue in blood culture bottles is not only more accurate than but is also cost-saving compared to conventional culture methods. Copyright © 2017 American Society for Microbiology.

  6. Laboratory test of an APS-based sun sensor prototype

    Science.gov (United States)

    Rufino, Giancarlo; Perrotta, Alessandro; Grassi, Michele

    2017-11-01

    This paper deals with design and prototype development of an Active Pixel Sensor - based miniature sun sensor and a laboratory facility for its indoor test and calibration. The miniature sun sensor is described and the laboratory test facility is presented in detail. The major focus of the paper is on tests and calibration of the sensor. Two different calibration functions have been adopted. They are based, respectively, on a geometrical model, which has required least-squares optimisation of system physical parameters estimates, and on neural networks. Calibration results are presented for the above solutions, showing that accuracy in the order of 0.01° has been achieved. Neural calibration functions have attained better performance thanks to their intrinsic auto-adaptive structure.

  7. Clinical Laboratory Tests in Some Acute Exogenous Poisonings.

    Science.gov (United States)

    Tufkova, Stoilka G; Yankov, Ivan V; Paskaleva, Diana A

    2017-09-01

    There is no specific toxicological screening of clinical laboratory parameters in clinical toxicology when it comes to acute exogenous poisoning. To determine routine clinical laboratory parameters and indicators for assessment of vital functions in patients with acute intoxications. One hundred and fifty-three patients were included in the present study. They were hospitalized in the Department of Clinical Toxicology at St. George University Hospital, Plovdiv for cerebral toxicity inducing medication (n = 45), alcohol (n = 40), heroin abuse (n = 33). The controls were 35. The laboratory tests were conducted in compliance with the standards of the clinical laboratory. We used the following statistical analyses: analysis of variance (the ucriterion of normal distribution, the Student's t-test, dispersion analysis based on ANOVA) and non-parametric analysis. Based on the routine hematological parameters with statistically significant changes in three groups of poisoning are: red blood cells, hematocrit, hemoglobin (except alcohol intoxication) and leukocytes. We found statistically significant changes in serum total protein, sodium and bilirubin. The highest statistical significance is the increased activity of AST and ALT. We present a model for selection of clinical laboratory tests for severe acute poisoning with modern equipment under standardized conditions. The results of the study suggest that the clinical laboratory constellation we used can be used as a mandatory element in the diagnosis of moderate and severe intoxication with the mentioned toxic substances.

  8. [Results of Training for Personnel Involved in Blood-Transfusion Testing Outside of Regular Work Hours at Saga University Hospital].

    Science.gov (United States)

    Yamada, Marie; Yamada, Naotomo; Higashitani, Takanori; Ohta, Shoichiro; Sueoka, Eisaburo

    2015-11-01

    Laboratory testing prior to blood transfusion outside of regular hours in many hospitals and clinics is frequently conducted by technicians without sufficient experience in such testing work. To obtain consistent test results regardless of the degree of laboratory experience with blood transfusion testing, the number of facilities introducing automated equipment for testing prior to blood transfusion is increasing. Our hospital's blood transfusion department introduced fully automated test equipment in October of 2010 for use when blood transfusions are conducted outside of regular hours. However, excessive dependence on automated testing can lead to an inability to do manual blood typing or cross-match testing when necessitated by breakdowns in the automated test equipment, in the case of abnormal specimen reactions, or other such case. In addition, even outside of normal working hours there are more than a few instances in which transfusion must take place based on urgent communications from clinical staff, with the need for prompt and flexible timing of blood transfusion test and delivery of blood products. To address this situation, in 2010 we began training after-hours laboratory personnel in blood transfusion testing to provide practice using test tubes manually and to achieve greater understanding of blood transfusion test work (especially in cases of critical blood loss). Results of the training and difficulties in its implementation for such after-hours laboratory personnel at our hospital are presented and discussed in this paper. [Original

  9. Blood-alcohol proficiency test program

    Science.gov (United States)

    1975-01-01

    A preliminary survey has been performed to ascertain the validity of the blood alcohol analysis performed by a number of laboratories on a voluntary basis. Values of accuracy and precision of the tests are presented. /Abstract from report summary pag...

  10. Comparision between bed side testing of blood glucose by glucometer vs centralized testing in a tertiary care hospital.

    Science.gov (United States)

    Baig, Ayaz; Siddiqui, Imran; Jabbar, Abdul; Azam, Syed Iqbal; Sabir, Salman; Alam, Shahryar; Ghani, Farooq

    2007-01-01

    To determine the accuracy, turnaround time and cost effectiveness of bedside monitoring of blood glucose levels by non-laboratory health care workers and centralized testing of blood glucose by automated analyzer in a tertiary care hospital. The study was conducted in Section of Chemical Pathology, Department of Pathology and Microbiology and Section of Endocrinology Department of Medicine, Aga Khan University and Hospital Karachi, from April 2005 to March 2006. One hundred and ten patients were included in the study. The blood glucose levels were analyzed on glucometer (Precision Abbott) by finger stick, using Biosensor Technology. At the same time venous blood was obtained to analyze glucose in clinical laboratory on automated analyzer (SYNCHRON CX7) by glucose oxidase method. We observed good correlation between bed side glucometer and laboratory automated analyzer for glucose values between 3.3 mmol/L (60 mg/dl) and 16.7 (300 mg/dl). A significant difference was observed for glucose values less than 3.3 mmol/L (p = 0.002) and glucose values more than 16.67 mmol/l (p = 0.049). Mean Turnaround time for glucometer and automated analyzer were 0.08 hours and 2.49 hours respectively. The cost of glucose testing with glucometer was 48.8% lower than centralized lab based testing. Bedside glucometer testing, though less expensive does not have good accuracy in acutely ill patient with either very high or very low blood glucose levels.

  11. Correlation of same-visit HbA1c test with laboratory-based measurements: A MetroNet study

    Directory of Open Access Journals (Sweden)

    West Patricia A

    2005-07-01

    Full Text Available Abstract Background Glycated hemoglobin (HbA1c results vary by analytical method. Use of same-visit HbA1c testing methodology holds the promise of more efficient patient care, and improved diabetes management. Our objective was to test the feasibility of introducing a same-visit HbA1c methodology into busy family practice centers (FPC and to calculate the correlation between the same-visit HbA1c test and the laboratory method that the clinical site was currently using for HbA1c testing. Methods Consecutive diabetic patients 18 years of age and older having blood samples drawn for routine laboratory analysis of HbA1c were asked to provide a capillary blood sample for same-visit testing with the BIO-RAD Micromat II. We compared the results of the same-visit test to three different laboratory methods (one FPC used two different laboratories. Results 147 paired samples were available for analysis (73 from one FPC; 74 from the other. The Pearson correlation of Micromat II and ion-exchange HPLC was 0.713 (p Conclusion For each of the laboratory methods, the correlation coefficient was lower than the 0.96 reported by the manufacturer. This might be due to variability introduced by the multiple users of the Micromat II machine. The mean HbA1c results were also consistently lower than those obtained from laboratory analysis. Additionally, the amount of dedicated time required to perform the assay may limit its usefulness in a busy clinical practice. Before introducing a same-visit HbA1c methodology, clinicians should compare the rapid results to their current method of analysis.

  12. On the improvement of blood sample collection at clinical laboratories.

    Science.gov (United States)

    Grasas, Alex; Ramalhinho, Helena; Pessoa, Luciana S; Resende, Mauricio G C; Caballé, Imma; Barba, Nuria

    2014-01-09

    Blood samples are usually collected daily from different collection points, such hospitals and health centers, and transported to a core laboratory for testing. This paper presents a project to improve the collection routes of two of the largest clinical laboratories in Spain. These routes must be designed in a cost-efficient manner while satisfying two important constraints: (i) two-hour time windows between collection and delivery, and (ii) vehicle capacity. A heuristic method based on a genetic algorithm has been designed to solve the problem of blood sample collection. The user enters the following information for each collection point: postal address, average collecting time, and average demand (in thermal containers). After implementing the algorithm using C programming, this is run and, in few seconds, it obtains optimal (or near-optimal) collection routes that specify the collection sequence for each vehicle. Different scenarios using various types of vehicles have been considered. Unless new collection points are added or problem parameters are changed substantially, routes need to be designed only once. The two laboratories in this study previously planned routes manually for 43 and 74 collection points, respectively. These routes were covered by an external carrier company. With the implementation of this algorithm, the number of routes could be reduced from ten to seven in one laboratory and from twelve to nine in the other, which represents significant annual savings in transportation costs. The algorithm presented can be easily implemented in other laboratories that face this type of problem, and it is particularly interesting and useful as the number of collection points increases. The method designs blood collection routes with reduced costs that meet the time and capacity constraints of the problem.

  13. [Measures to prevent patient identification errors in blood collection/physiological function testing utilizing a laboratory information system].

    Science.gov (United States)

    Shimazu, Chisato; Hoshino, Satoshi; Furukawa, Taiji

    2013-08-01

    We constructed an integrated personal identification workflow chart using both bar code reading and an all in-one laboratory information system. The information system not only handles test data but also the information needed for patient guidance in the laboratory department. The reception terminals at the entrance, displays for patient guidance and patient identification tools at blood-sampling booths are all controlled by the information system. The number of patient identification errors was greatly reduced by the system. However, identification errors have not been abolished in the ultrasound department. After re-evaluation of the patient identification process in this department, we recognized that the major reason for the errors came from excessive identification workflow. Ordinarily, an ultrasound test requires patient identification 3 times, because 3 different systems are required during the entire test process, i.e. ultrasound modality system, laboratory information system and a system for producing reports. We are trying to connect the 3 different systems to develop a one-time identification workflow, but it is not a simple task and has not been completed yet. Utilization of the laboratory information system is effective, but is not yet perfect for patient identification. The most fundamental procedure for patient identification is to ask a person's name even today. Everyday checks in the ordinary workflow and everyone's participation in safety-management activity are important for the prevention of patient identification errors.

  14. Use of standard laboratory methods to obviate routine dithiothreitol treatment of blood samples with daratumumab interference.

    Science.gov (United States)

    Lintel, Nicholas J; Brown, Debra K; Schafer, Diane T; Tsimba-Chitsva, Farai M; Koepsell, Scott A; Shunkwiler, Sara M

    2017-01-01

    Daratumumab is an antibody currently used in the treatment of patients with refractory multiple myeloma. Blood samples from patients being treated with daratumumab may show panreactivity during pre-transfusion testing. To facilitate the provision of blood components for such patients, it is recommended that a baseline phenotype or genotype be established prior to starting treatment with daratumumab. If patient red blood cells (RBCs) require phenotyping after the start of daratumumab treatment, dithiothreitol (DTT) treatment of the patient's RBCs should be performed. The medical charts of four patients treated with daratumumab were reviewed. The individual number of doses ranged from 1 to 14; patient age ranged from 55 to 78 years; two men and two women were included in the review. Type and screen data were obtained from samples collected over 33 encounters with a range of 1 to 13 encounters per patient. All samples were tested initially by automated solid-phase testing. Any reactivity with solid phase led to tube testing with either low-ionic-strength saline, polyethylene glycol, or both. If incubation failed to eliminate the reactivity, the sample was sent to a reference laboratory for DTT treatment and phenotyping. Of the 33 samples tested, 23 (69.7%) samples had reactivity in solid-phase testing. In 8 of the 10 samples that did not react in solid-phase, testing was conducted more than four half-lives after the last dose of daratumumab. Of the 23 that had reactivity in solid-phase, 16 (69.6%) samples demonstrated loss of reactivity using common laboratory methods. For the seven patients whose sample reactivity was not initially eliminated, six were provided with phenotypically matched blood based on prior molecular testing. Only one sample was sent out for DTT treatment. These results suggest that daratumumab interference with pre-transfusion testing can be addressed using common laboratory methods. This finding could save time and money for laboratories that do

  15. [Laboratory accreditation and proficiency testing].

    Science.gov (United States)

    Kuwa, Katsuhiko

    2003-05-01

    ISO/TC 212 covering clinical laboratory testing and in vitro diagnostic test systems will issue the international standard for medical laboratory quality and competence requirements, ISO 15189. This standard is based on the ISO/IEC 17025, general requirements for competence of testing and calibration laboratories and ISO 9001, quality management systems-requirements. Clinical laboratory services are essential to patient care and therefore should be available to meet the needs of all patients and clinical personnel responsible for human health care. If a laboratory seeks accreditation, it should select an accreditation body that operates according to this international standard and in a manner which takes into account the particular requirements of clinical laboratories. Proficiency testing should be available to evaluate the calibration laboratories and reference measurement laboratories in clinical medicine. Reference measurement procedures should be of precise and the analytical principle of measurement applied should ensure reliability. We should be prepared to establish a quality management system and proficiency testing in clinical laboratories.

  16. Comparison of blood glucose test strips in the detection of neonatal hypoglycaemia

    OpenAIRE

    Wilkins, B H; Kalra, D

    1982-01-01

    Blood glucose levels were estimated in 101 neonatal blood samples using three glucose test strip methods and the results compared with those from a laboratory. BM-test-glycemie 20-800 test strips and Reflotest-hypoglycemie test strips gave a rapid and reliable estimate of blood glucose level in the range 0-8 mmol/l (0-140 mg/100 ml). Dextrostix test strips tended to overestimate all blood glucose levels.

  17. Institutional practices and policies in acid-base testing: a self reported Croatian survey study on behalf of the Croatian society of medical biochemistry and laboratory medicine Working Group for acid-base balance.

    Science.gov (United States)

    Dukić, Lora; Simundić, Ana-Maria

    2014-01-01

    The aim of this survey study was to assess the current practices and policies in use related to the various steps in the blood gas testing process, across hospital laboratories in Croatia. First questionnaire was sent by email to all medical biochemistry laboratories (N = 104) within general, specialized and clinical hospitals and university hospital centres to identify laboratories which perform blood gas analysis. Second questionnaire with detailed questions about sample collection, analysis and quality control procedures, was sent only to 47 laboratories identified by the first survey. Questionnaire was designed as combination of questions and statements with Likert scale. Third questionnaire was sent to all participating laboratories (N=47) for additional clarification for either indeterminate or unclear answers. Blood gas analysis is performed in 47/104 hospital laboratories in Croatia. In 25/41 (0.61) of the laboratories capillary blood gas sampling is the preferred sample type for adult patient population, whereas arterial blood sample is preferentially used in only 5/44 laboratories (0.11). Blood sampling and sample processing for capillary samples is done almost always by laboratory technicians (36/41 and 37/44, respectively), whereas arterial blood sampling is almost always done by the physician (24/29) and only rarely by a nurse (5/28). Sample acceptance criteria and sample analysis are in accordance with international recommendations for majority of laboratories. 43/44 laboratories participate in the national EQA program. POCT analyzers are installed outside of the laboratory in 20/47 (0.43) institutions. Laboratory staff is responsible for education and training of ward personnel, quality control and instrument maintenance in only 12/22, 11/20 and 9/20 institutions, respectively. Practices related to collection and analysis for blood gases in Croatia are not standardised and vary substantially between laboratories. POCT analyzers are not under the

  18. [Development of a laboratory test on dried blood spots for facilitating early diagnosis of alpha-1-antitrypsin deficiency].

    Science.gov (United States)

    Balduyck, Malika; Chapuis Cellier, Colette; Roche, Denis; Odou, Marie-Françoise; Joly, Philippe; Madelain, Vincent; Vergne, Anita; Nouadje, Georges; Lafitte, Jean-Jacques; Porchet, Nicole; Beaune, Philippe; Zerimech, Farid

    2014-01-01

    Alpha- 1-antitrypsin (A1AT) deficiency is a hereditary autosomal codominant genetic disorder resulting in low circulating levels of A1AT and leading to lung and/or liver disease. It remains underdiagnosed and only 5 to 10% of PIZZ patients, the most common form of severe A1AT deficiency, would be actually identified in France. Facilitating early diagnosis of A1AT deficiency would allow a better management of this disease; therefore we have developed and standardized in three laboratories involved in this study, a diagnostic test on dried blood spots (DBS) including quantitative A1AT measurement, phenotyping by IEF electrophoresis and, if necessary, genotyping by SERPINA1 gene sequencing. We performed a quantitative assay on 90 DBS samples by immunoturbidimetric or immunonephelometric methods. We demonstrated that both methods were suitable for this type of sampling and the results obtained were highly correlated (R(2)>0.9) between the three laboratories: for a target value of 1.00 g/L, the results obtained from the three laboratories were between 1.00 and 1.02 g/L. Phenotyping and genotyping were performed under redefined operating conditions and adapted to the analysis of DBS samples. The results were comparable with those obtained for venous blood samples. Following this work, it becomes possible to provide pulmonologists with a reliable kit to perform a capillary blood sampling on filter paper which would allow a large-scale screening of A1AT deficiency in the population particularly affected by this genetic condition.

  19. Reliability on intra-laboratory and inter-laboratory data of hair mineral analysis comparing with blood analysis.

    Science.gov (United States)

    Namkoong, Sun; Hong, Seung Phil; Kim, Myung Hwa; Park, Byung Cheol

    2013-02-01

    Nowadays, although its clinical value remains controversial institutions utilize hair mineral analysis. Arguments about the reliability of hair mineral analysis persist, and there have been evaluations of commercial laboratories performing hair mineral analysis. The objective of this study was to assess the reliability of intra-laboratory and inter-laboratory data at three commercial laboratories conducting hair mineral analysis, compared to serum mineral analysis. Two divided hair samples taken from near the scalp were submitted for analysis at the same time, to all laboratories, from one healthy volunteer. Each laboratory sent a report consisting of quantitative results and their interpretation of health implications. Differences among intra-laboratory and interlaboratory data were analyzed using SPSS version 12.0 (SPSS Inc., USA). All the laboratories used identical methods for quantitative analysis, and they generated consistent numerical results according to Friedman analysis of variance. However, the normal reference ranges of each laboratory varied. As such, each laboratory interpreted the patient's health differently. On intra-laboratory data, Wilcoxon analysis suggested they generated relatively coherent data, but laboratory B could not in one element, so its reliability was doubtful. In comparison with the blood test, laboratory C generated identical results, but not laboratory A and B. Hair mineral analysis has its limitations, considering the reliability of inter and intra laboratory analysis comparing with blood analysis. As such, clinicians should be cautious when applying hair mineral analysis as an ancillary tool. Each laboratory included in this study requires continuous refinement from now on for inducing standardized normal reference levels.

  20. Croatian Society of Medical Biochemistry and Laboratory Medicine: national recommendations for venous blood sampling.

    Science.gov (United States)

    Nikolac, Nora; Supak-Smolcić, Vesna; Simundić, Ana-Maria; Celap, Ivana

    2013-01-01

    Phlebotomy is one of the most complex medical procedures in the diagnosis, management and treatment of patients in healthcare. Since laboratory test results are the basis for a large proportion (60-80%) of medical decisions, any error in the phlebotomy process could have serious consequences. In order to minimize the possibility of errors, phlebotomy procedures should be standardised, well-documented and written instructions should be available at every workstation. Croatia is one of the few European countries that have national guidelines for phlebotomy, besides the universally used CLSI (Clinical Laboratory Standards Institute) H3-A6 Procedures for the Collection of Diagnostic Blood Specimens by Venipuncture; approved Standard-Sixth Edition (CLSI, 2007) and WHO (World Health Organization) guidelines on drawing blood: best practices in phlebotomy (WHO, 2010). However, the growing body of evidence in importance of preanalytical phase management resulted in a need for evidence based revision and expansion of existing recommendations. The Croatian Society for Medical Biochemistry and Laboratory Medicine, Working Group for the Preanalytical Phase issued this recommendation. This document is based on the CLSI guideline H3-A6, with significant differences and additional information.

  1. Activity-based costing methodology as tool for costing in hematopathology laboratory.

    Science.gov (United States)

    Gujral, Sumeet; Dongre, Kanchan; Bhindare, Sonal; Subramanian, P G; Narayan, Hkv; Mahajan, Asim; Batura, Rekha; Hingnekar, Chitra; Chabbria, Meenu; Nair, C N

    2010-01-01

    Cost analysis in laboratories represents a necessary phase in their scientific progression. To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL). Activity-based costing (ABC) method is used to calculate per cost test of the hematopathology laboratory. Information is collected from registers, purchase orders, annual maintenance contracts (AMCs), payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC), bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

  2. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds

    Directory of Open Access Journals (Sweden)

    Jared A. Frank

    2016-08-01

    Full Text Available Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability.

  3. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds.

    Science.gov (United States)

    Frank, Jared A; Brill, Anthony; Kapila, Vikram

    2016-08-20

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability.

  4. Automated blood-sample handling in the clinical laboratory.

    Science.gov (United States)

    Godolphin, W; Bodtker, K; Uyeno, D; Goh, L O

    1990-09-01

    The only significant advances in blood-taking in 25 years have been the disposable needle and evacuated blood-drawing tube. With the exception of a few isolated barcode experiments, most sample-tracking is performed through handwritten or computer-printed labels. Attempts to reduce the hazards of centrifugation have resulted in air-tight lids or chambers, the use of which is time-consuming and cumbersome. Most commonly used clinical analyzers require serum or plasma, distributed into specialized containers, unique to that analyzer. Aliquots for different tests are prepared by handpouring or pipetting. Moderate to large clinical laboratories perform so many different tests that even multi-analyzers performing multiple analyses on a single sample may account for only a portion of all tests ordered for a patient. Thus several aliquots of each specimen are usually required. We have developed a proprietary serial centrifuge and blood-collection tube suitable for incorporation into an automated or robotic sample-handling system. The system we propose is (a) safe--avoids or prevents biological danger to the many "handlers" of blood; (b) small--minimizes the amount of sample taken and space required to adapt to the needs of satellite and mobile testing, and direct interfacing with analyzers; (c) serial--permits each sample to be treated according to its own "merits," optimizes throughput, and facilitates flexible automation; and (d) smart--ensures quality results through monitoring and intelligent control of patient identification, sample characteristics, and separation process.

  5. [Guidelines for blood transfusion teaching to medical laboratory technology students].

    Science.gov (United States)

    Moncharmont, P; Tourlourat, M; Fourcade, C; Julien, E; Peyrard, T; Cabaud, J-J

    2012-02-01

    The new French law about clinical laboratory medicine, the requirements of the ISO/CEI 15189 standard, the numerous abilities expected from the medical laboratory technologists and their involvement in blood bank management has led the working group "Recherche et démarche qualité" of the French Society of Blood Transfusion to initiate an inventory of blood transfusion teaching syllabus for medical laboratory technology students and to propose transfusion medicine teaching guidelines. Seven worksheets have been established for that purpose including red blood cell antigen typing and antibody screening, blood sampling in immunohaematology, automation, clinical practices, blood products, blood delivery and haemovigilance. These guidelines aim at contributing to the harmonization of transfusion medicine teaching and at providing objective elements to the medical laboratory managers regarding the practical and theoretical skills of theirs collaborators. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  6. Activity-based costing methodology as tool for costing in hematopathology laboratory

    Directory of Open Access Journals (Sweden)

    Gujral Sumeet

    2010-01-01

    Full Text Available Background: Cost analysis in laboratories represents a necessary phase in their scientific progression. Aim: To calculate indirect cost and thus total cost per sample of various tests at Hematopathology laboratory (HPL Settings and Design: Activity-based costing (ABC method is used to calculate per cost test of the hematopathology laboratory. Material and Methods: Information is collected from registers, purchase orders, annual maintenance contracts (AMCs, payrolls, account books, hospital bills and registers along with informal interviews with hospital staff. Results: Cost per test decreases as total number of samples increases. Maximum annual expense at the HPL is on reagents and consumables followed by manpower. Cost per test is higher for specialized tests which interpret morphological or flow data and are done by a pathologist. Conclusions: Despite several limitations and assumptions, this was an attempt to understand how the resources are consumed in a large size government-run laboratory. The rate structure needs to be revised for most of the tests, mainly for complete blood counts (CBC, bone marrow examination, coagulation tests and Immunophenotyping. This costing exercise is laboratory specific and each laboratory needs to do its own costing. Such an exercise may help a laboratory redesign its costing structure or at least understand the economics involved in the laboratory management.

  7. Nationwide survey of policies and practices related to capillary blood sampling in medical laboratories in Croatia

    OpenAIRE

    Lenicek Krleza, Jasna

    2014-01-01

    Introduction: Capillary sampling is increasingly used to obtain blood for laboratory tests in volumes as small as necessary and as non-invasively as possible. Whether capillary blood sampling is also frequent in Croatia, and whether it is performed according to international laboratory standards is unclear. Materials and methods: All medical laboratories that participate in the Croatian National External Quality Assessment Program (N = 204) were surveyed on-line to collect information about t...

  8. Blood sugar test

    Science.gov (United States)

    ... sugar; Blood sugar level; Fasting blood sugar; Glucose test; Diabetic screening - blood sugar test; Diabetes - blood sugar test ... The test may be done in the following ways: After you have not eaten anything for at least 8 ...

  9. Analysis of bias in measurements of potassium, sodium and hemoglobin by an emergency department-based blood gas analyzer relative to hospital laboratory autoanalyzer results.

    Directory of Open Access Journals (Sweden)

    Jian Bo Zhang

    Full Text Available The emergency departments (EDs of Chinese hospitals are gradually being equipped with blood gas machines. These machines, along with the measurement of biochemical markers by the hospital laboratory, facilitate the care of patients with severe conditions who present to the ED. However, discrepancies have been noted between the Arterial Blood Gas (ABG analyzers in the ED and the hospital laboratory autoanalyzer in relation to electrolyte and hemoglobin measurements. The present study was performed to determine whether the ABG and laboratory measurements of potassium, sodium, and hemoglobin levels are equivalent, and whether ABG analyzer results can be used to guide clinical care before the laboratory results become available.Study power analyses revealed that 200 consecutive patients who presented to our ED would allow this prospective single-center cohort study to detect significant differences between ABG- and laboratory-measured potassium, sodium, and hemoglobin levels. Paired arterial and venous blood samples were collected within 30 minutes. Arterial blood samples were measured in the ED by an ABL 90 FLEX blood gas analyzer. The biochemistry and blood cell counts of the venous samples were measured in the hospital laboratory. The potassium, sodium, and hemoglobin concentrations obtained by both methods were compared by using paired Student's t-test, Spearman's correlation, Bland-Altman plots, and Deming regression.The mean ABG and laboratory potassium values were 3.77±0.44 and 4.2±0.55, respectively (P<0.0001. The mean ABG and laboratory sodium values were 137.89±5.44 and 140.93±5.50, respectively (P<0.0001. The mean ABG and laboratory Hemoglobin values were 12.28±2.62 and 12.35±2.60, respectively (P = 0.24.Although there are the statistical difference and acceptable biases between ABG- and laboratory-measured potassium and sodium, the biases do not exceed USCLIA-determined limits. In parallel, there are no statistical differences and

  10. Interference by pralidoxime (PAM) salts in clinical laboratory tests.

    Science.gov (United States)

    Nagase, Sumika; Kohguchi, Katsunori; Tohyama, Kaoru; Watanabe, Mikio; Iwatani, Yoshinori

    2013-02-01

    Drugs sometimes alter the results of clinical laboratory tests. We examined the effects of pralidoxime (PAM) salts, a medicine used to treat organophosphorus poisoning, on clinical laboratory test results for the first time. The effects of PAM salts on glucose (GLU) measurements were examined using a point-of-care testing (POCT) meter, four self-monitoring of blood glucose (SMBG) meters, and two biochemical autoanalyzers. The effects of PAM salts on other clinical tests were also evaluated. The addition of PAM iodide or potassium iodide, but not of PAM chloride or potassium chloride, to blood samples increased the GLU values measured by one POCT meter and 4 SMBG meters using the enzyme electrode (hydrogen peroxidase or oxygen electrode) method. On the other hand, PAM iodide or PAM chloride, but not KI or KCl, affected the values measured at 340 nm by an autoanalyzer using absorption spectrophotometry in 8 of 14 clinical laboratory tests. The absorption spectrum of PAM changed from 294 to 338 nm due to the reaction between PAM and the alkaline buffer, a component of the measuring reagents. PAM iodide increases the GLU values measured by the enzyme electrode method, and PAM salts affected the values measured at 340 nm by absorption spectrophotometry in many other clinical test items. Copyright © 2012 Elsevier B.V. All rights reserved.

  11. Porphyrins - blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003372.htm Porphyrins blood test To use the sharing features on this page, ... blood or the urine . This article discusses the blood test. How the Test is Performed A blood sample ...

  12. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds †

    Science.gov (United States)

    Frank, Jared A.; Brill, Anthony; Kapila, Vikram

    2016-01-01

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their embedded hardware and software in the measurement and control of the test-beds. This approach is a first step towards replacing laboratory-grade peripherals with more compact and affordable smartphone-based platforms, whose interactive user interfaces can engender wider participation and engagement from learners. Demonstrative cases are presented in which the sensing, computation, control, and user interaction with three motor-based test-beds are handled by a mounted smartphone. Results of experiments and simulations are used to validate the feasibility of mounted smartphones as measurement and feedback control platforms for motor-based laboratory test-beds, report the measurement precision and closed-loop performance achieved with such platforms, and address challenges in the development of platforms to maintain system stability. PMID:27556464

  13. Myoglobin blood test

    Science.gov (United States)

    Serum myoglobin; Heart attack - myoglobin blood test; Myositis - myoglobin blood test; Rhabdomyolysis - myoglobin blood test ... too high, it can damage the kidneys. This test is ordered when your health care provider suspects ...

  14. Potential over request in anemia laboratory tests in primary care in Spain.

    Science.gov (United States)

    Salinas, María; López-Garrigós, Maite; Flores, Emilio; Uris, Joaquín; Leiva-Salinas, Carlos

    2015-07-01

    The aim was to study the inter-practice variability in anemia laboratory tests requested by general practitioners in Spain, to evaluate for a potential requesting inappropriateness. Laboratories from diverse Spanish regions filled out the number of cell blood count, ferritin, folate, iron, transferrin, and vitamin B12 requested by general practitioners during 2012. The number of test requests per 1000 inhabitants and ratios of related tests requests were calculated. The results obtained in hospitals from different areas (urban, rural, or urban-rural), type of management (public or private), and geographic regions were compared. There was a high variability in the number of test requests and ratios of related tests. Cell blood count was over requested in rural areas and in hospitals with private management. Andalucía was the community with the lowest number of iron requests and the lowest folate/vitamin B12 indicator value. Iron and transferrin seemed over requested in some areas; as were folate and ferritin when compared to vitamin B12 and cell blood count, respectively. The differences observed between areas indicate that other factors besides clinical reasons could be behind that variability and emphasize the need to accomplish interventions to improve the appropriate use of anemia laboratory tests.

  15. Catecholamine blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003561.htm Catecholamine blood test To use the sharing features on this page, ... measured with a urine test than with a blood test. How the Test is Performed A blood sample ...

  16. Ketones blood test

    Science.gov (United States)

    Acetone bodies; Ketones - serum; Nitroprusside test; Ketone bodies - serum; Ketones - blood; Ketoacidosis - ketones blood test ... fat cells break down in the blood. This test is used to diagnose ketoacidosis . This is a ...

  17. Relocation of blood gas laboratory to the emergency department helps decrease lactic acid values.

    Science.gov (United States)

    Brazg, Jared; Huang, Phyllis; Weiner, Corey; Singh, Guneet; Likourezos, Antonios; Salem, Linda; Dickman, Eitan; Marshall, John

    2018-03-12

    Emergency Physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016. The study was exempt from institutional review board approval. Samples were separated into two groups: those which were drawn prior to and after relocation of the blood gas laboratory to the ED. The data, including patient demographic characteristics, acute illness severity indices, and blood gas results were compared within and between each group using t-test for continuous variables and chi-square test for categorical variables. The primary outcome was the mean lactate value measured in the SL group in 2015 compared to the ED group in 2016. Potassium and creatinine values were measured between the two groups as secondary outcomes. Of the 21,595 consecutive samples drawn, 10,363 samples were from the SL group and 11,232 from the ED group. The SL group included 5458 (52.7%) women; mean (SD) age was 61.8 (21.0). The ED group contained 5860 (52.2%) women; mean (SD) age was 61.7 (20.5). Mean Emergency Severity Index (ESI) were the same in each group at 2.31 and rates of Systemic Inflammatory Response Syndrome (SIRS) were also equivalent in each group at 22.2%. Significant differences were found between LA values in the SL group (mean 2.21mmol/L) and in the ED group (mean 1.99mmol/L) with a p value of values in the SL group (mean 3.98meq/L) compared to the ED Group (mean 3.96meq/L) with a p value of 0.022. No significant difference was found between the creatinine values. These results suggest that mean lactate values decreased when measured in an ED blood gas laboratory and may provide more

  18. Relocation of blood gas laboratory to the emergency department helps decrease lactic acid values.

    Science.gov (United States)

    Brazg, Jared; Huang, Phyllis; Weiner, Corey; Singh, Guneet; Likourezos, Antonios; Salem, Linda; Dickman, Eitan; Marshall, John

    2018-03-20

    Emergency physicians often rely on Lactic Acid (LA) values to make important clinical decisions. Accuracy of LA values improve when blood gas analysis is performed in the emergency department (ED) as opposed to a satellite laboratory (SL). To investigate an association between blood gas laboratory location and accuracy of ED lactic acid samples. The study team evaluated lactic acid values from venous and arterial blood gas samples drawn between June 1, 2015 and September 30, 2016. The study was exempt from institutional review board approval. Samples were separated into two groups: those which were drawn prior to and after relocation of the blood gas laboratory to the ED. The data, including patient demographic characteristics, acute illness severity indices, and blood gas results were compared within and between each group using t-test for continuous variables and chi-square test for categorical variables. The primary outcome was the mean lactate value measured in the SL group in 2015 compared to the ED group in 2016. Potassium and creatinine values were measured between the two groups as secondary outcomes. Of the 21,595 consecutive samples drawn, 10,363 samples were from the SL group and 11,232 from the ED group. The SL group included 5458 (52.7%) women; mean (SD) age was 61.8 (21.0). The ED group contained 5860 (52.2%) women; mean (SD) age was 61.7 (20.5). Mean Emergency Severity Index (ESI) were the same in each group at 2.31 and rates of Systemic Inflammatory Response Syndrome (SIRS) were also equivalent in each group at 22.2%. Significant differences were found between LA values in the SL group (mean 2.21mmol/L) and in the ED group (mean 1.99mmol/L) with a p value of values in the SL group (mean 3.98meq/L) compared to the ED Group (mean 3.96meq/L) with a p value of 0.022. No significant difference was found between the creatinine values. These results suggest that mean lactate values decreased when measured in an ED blood gas laboratory and may provide more

  19. Renin blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003698.htm Renin blood test To use the sharing features on this page, ... renin test measures the level of renin in blood. How the Test is Performed A blood sample is needed . How ...

  20. Prolactin blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003718.htm Prolactin blood test To use the sharing features on this page, ... test measures the amount of prolactin in the blood. How the Test is Performed A blood sample is needed . How ...

  1. BloodLink: Computer-based Decision Support for Blood Test Ordering; Assessment of the effect on physicians' test-ordering behavior

    NARCIS (Netherlands)

    M.A.M. van Wijk (Marc)

    2000-01-01

    textabstractRequesting blood tests is an important aspect of the health care delivered by the general practitioner in The Netherlands. About three to four percent of the patients encounters with Dutch general practitioners result in the physician requesting blood tests, which is lower than in many

  2. Validation of capillary blood analysis and capillary testing mode on the epoc Point of Care system.

    Science.gov (United States)

    Cao, Jing; Edwards, Rachel; Chairez, Janette; Devaraj, Sridevi

    2017-12-01

    Laboratory test in transport is a critical component of patient care, and capillary blood is a preferred sample type particularly in children. This study evaluated the performance of capillary blood testing on the epoc Point of Care Blood Analysis System (Alere Inc). Ten fresh venous blood samples was tested on the epoc system under the capillary mode. Correlation with GEM 4000 (Instrumentation Laboratory) was examined for Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pO2, pCO2, and pH, and correlation with serum tested on Vitros 5600 (Ortho Clinical Diagnostics) was examined for creatinine. Eight paired capillary and venous blood was tested on epoc and ABL800 (Radiometer) for the correlation of Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pCO2, and pH. Capillary blood from 23 apparently healthy volunteers was tested on the epoc system to assess the concordance to reference ranges used locally. Deming regression correlation coefficients for all the comparisons were above 0.65 except for ionized Ca2+. Accordance of greater than 85% to the local reference ranges were found in all assays with the exception of pO2 and Cl-. Data from this study indicates that capillary blood tests on the epoc system provide comparable results to reference method for these assays, Na+, K+, glucose, lactate, hematocrit, hemoglobin, pCO2, and pH. Further validation in critically ill patients is needed to implement the epoc system in patient transport. This study demonstrated that capillary blood tests on the epoc Point of Care Blood Analysis System give comparable results to other chemistry analyzers for major blood gas and critical tests. The results are informative to institutions where pre-hospital and inter-hospital laboratory testing on capillary blood is a critical component of patient point of care testing.

  3. HIT or miss? A comprehensive contemporary investigation of laboratory tests for heparin induced thrombocytopenia.

    Science.gov (United States)

    Favaloro, Emmanuel J; McCaughan, Georgia; Mohammed, Soma; Lau, Kun Kan Edwin; Gemmell, Rosalie; Cavanaugh, Lauren; Donikian, Dea; Kondo, Mayuko; Brighton, Timothy; Pasalic, Leonardo

    2018-04-17

    Heparin induced thrombocytopenia (HIT) is a rare but potentially fatal complication of heparin therapy, which in a proportion of patients causes platelet activation and thrombosis. Initial clinical assessment of the likelihood of HIT is facilitated by laboratory testing to confirm or exclude HIT. This prospective investigation was performed over an 18-month period, and has involved testing of over 300 test samples from over 100 consecutive patients. Clinical assessment by 4T score was supplemented by laboratory tests that comprised both immunological [lateral flow ('STiC'), chemiluminescence (AcuStar; HIT-IgG (PF4-H) ), ELISA (Asserachrom HPIA IgG)] and functional assays [SRA, platelet aggregation using whole blood ('Multiplate') and platelet rich plasma ('LTA')]. We observed both false positive and false negative test findings with most assays. Overall, the whole blood aggregation method provided a reasonable alternative to SRA for identifying functional HIT. STiC, AcuStar and ELISA procedures were fairly comparable in terms of screening for HIT, although STiC and AcuStar both yielded false negatives, albeit also resulting in fewer false positives than ELISA. The 4T score had less utility in our patient cohort than we were expecting, although there was an association with the likelihood of HIT. Nevertheless, we accept that our observations are based on limited test numbers. In conclusion, no single approach (clinical or laboratory) was associated with optimal sensitivity or specificity of HIT exclusion or identification, and thus, a combination of clinical evaluation and laboratory testing will best ensure the accuracy of diagnosis. Crown Copyright © 2018. Published by Elsevier B.V. All rights reserved.

  4. Whiteboard Icons to Support the Blood-Test Process in an Emergency Department

    DEFF Research Database (Denmark)

    Torkilsheyggi, Arnvør Martinsdottir á; Hertzum, Morten; From, Gustav

    2013-01-01

    The competent treatment of emergency department (ED) patients requires an effective and efficient process for handling laboratory tests such as blood tests. This study investigates how ED clinicians go about the process, from ordering blood tests to acknowledging their results and, specifically......, assesses the use of whiteboard icons to support this process. On the basis of observation and interviews we find that the blood-test process is intertwined with multiple other temporal patterns in ED work. The whiteboard icons, which indicate four temporally distinct steps in the blood-test process......, support the nurses in maintaining the flow of patients through the ED and the physicians in assessing test results at timeouts. The main results of this study are, however, that the blood-test process is temporally and collaboratively complex, that the whiteboard icons pass by most of this complexity...

  5. Phosphorus blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003478.htm Phosphorus blood test To use the sharing features on this page, please enable JavaScript. The phosphorus blood test measures the amount of phosphate in the blood. ...

  6. Calcium blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003477.htm Calcium blood test To use the sharing features on this page, please enable JavaScript. The calcium blood test measures the level of calcium in the blood. ...

  7. PCR identification of bacteria in blood culture does not fit the daily workflow of a routine microbiology laboratory.

    Science.gov (United States)

    Karumaa, Santra; Kärpänoja, Pauliina; Sarkkinen, Hannu

    2012-03-01

    We have evaluated the GenoType blood culture assay (Hain Lifescience, Nehren, Germany) for the identification of bacteria in 233 positive blood cultures and assessed its suitability in the workflow of a routine microbiology laboratory. In 68/233 (29.2%) samples, the culture result could not be confirmed by the GenoType assay due to a lack of primers in the test, multiple organisms in the sample, or inconsistency with respect to the identification by culture. Although the GenoType blood culture assay gives satisfactory results for bacteria for which primers are available, there are difficulties in applying the test in the routine microbiology laboratory.

  8. Gastrin blood test

    Science.gov (United States)

    Peptic ulcer - gastrin blood test ... A blood sample is needed . ... in the stomach, gastrin is released into the blood. As the acid ... provider may order this test if you have signs or symptoms of a ...

  9. Inquiry-based laboratory investigations and student performance on standardized tests in biological science

    Science.gov (United States)

    Patke, Usha

    Achievement data from the 3rd International Mathematics and Sciences Study and Program for International Student Assessment in science have indicated that Black students from economically disadvantaged families underachieve at alarming rates in comparison to White and economically advantaged peer groups. The study site was a predominately Black, urban school district experiencing underachievement. The purpose of this correlational study was to examine the relationship between students' use of inquiry-based laboratory investigations and their performance on the Biology End of Course Test, as well as to examine the relationship while partialling out the effects of student gender. Constructivist theory formed the theoretical foundation of the study. Students' perceived levels of experience with inquiry-based laboratory investigations were measured using the Laboratory Program Variable Inventory (LPVI) survey. LPVI scores of 256 students were correlated with test scores and were examined by student gender. The Pearson correlation coefficient revealed a small direct correlation between students' experience in inquiry-based laboratory investigation classes and standardized test scores on the Biology EOCT. A partial correlational analysis indicated that the correlation remained after controlling for gender. This study may prompt a change from teacher-centered to student-centered pedagogy at the local site in order to increase academic achievement for all students. The results of this study may also influence administrators and policy makers to initiate local, state, or nationwide curricular development. A change in curriculum may promote social change as students become more competent, and more able, to succeed in life beyond secondary school.

  10. Ammonia blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003506.htm Ammonia blood test To use the sharing features on this page, ... Encephalopathy - ammonia; Cirrhosis - ammonia; Liver failure - ammonia Images Blood test References Chernecky CC, Berger BJ. Ammonia (NH3) - blood ...

  11. Validation of capillary blood analysis and capillary testing mode on the epoc Point of Care system

    Directory of Open Access Journals (Sweden)

    Jing Cao

    2017-12-01

    Full Text Available Background: Laboratory test in transport is a critical component of patient care, and capillary blood is a preferred sample type particularly in children. This study evaluated the performance of capillary blood testing on the epoc Point of Care Blood Analysis System (Alere Inc. Methods: Ten fresh venous blood samples was tested on the epoc system under the capillary mode. Correlation with GEM 4000 (Instrumentation Laboratory was examined for Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pO2, pCO2, and pH, and correlation with serum tested on Vitros 5600 (Ortho Clinical Diagnostics was examined for creatinine. Eight paired capillary and venous blood was tested on epoc and ABL800 (Radiometer for the correlation of Na+, K+, Cl-, Ca2+, glucose, lactate, hematocrit, hemoglobin, pCO2, and pH. Capillary blood from 23 apparently healthy volunteers was tested on the epoc system to assess the concordance to reference ranges used locally. Results: Deming regression correlation coefficients for all the comparisons were above 0.65 except for ionized Ca2+. Accordance of greater than 85% to the local reference ranges were found in all assays with the exception of pO2 and Cl-. Conclusion: Data from this study indicates that capillary blood tests on the epoc system provide comparable results to reference method for these assays, Na+, K+, glucose, lactate, hematocrit, hemoglobin, pCO2, and pH. Further validation in critically ill patients is needed to implement the epoc system in patient transport. Impact of the study: This study demonstrated that capillary blood tests on the epoc Point of Care Blood Analysis System give comparable results to other chemistry analyzers for major blood gas and critical tests. The results are informative to institutions where pre-hospital and inter-hospital laboratory testing on capillary blood is a critical component of patient point of care testing. Keywords: Epoc, Capillary, Transport, Blood gas, Point of care

  12. Blood Test: Bilirubin

    Science.gov (United States)

    ... Videos for Educators Search English Español Blood Test: Bilirubin KidsHealth / For Parents / Blood Test: Bilirubin What's in ... liver or kidneys) is working. What Is a Bilirubin Test? A bilirubin test measures how much bilirubin ...

  13. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

    Directory of Open Access Journals (Sweden)

    Jane Y. Carter

    2012-10-01

    Setting: Six rural health centres in Kenya. Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya. Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health centres were compared before and after basic laboratory testing. Essential clinical diagnostic equipment and laboratory tests were established at each health centre. Clinical officers and laboratory technicians received on-site refresher training in good diagnostic practices and laboratory procedures before the study began. Results: Laboratory tests were ordered on 704 (62.1% patients. Diagnosis and treatment were changed in 45% of tested patients who returned with laboratory results (21% of all patients attending the clinics. 166 (23.5% patients did not return to the clinician for a final diagnosis and management decision after laboratory testing. Blood slide examination for malaria parasites, wet preparations, urine microscopy and stool microscopy resulted in most changes to diagnosis. There was no significant change in drug costs after laboratory testing. The greatest changes in numbers of recorded diseases following laboratory testing was for intestinal worms (53% and malaria (21%. Conclusion: Effective use of basic laboratory tests at primary health care level significantly improves diagnosis and patient treatment. Use of laboratory testing can be readily incorporated into routine clinical practice. On-site refresher training is an effective means of improving the quality of patient care and communication between clinical and laboratory staff.

  14. The laboratory information float, time-based competition, and point-of-care testing.

    Science.gov (United States)

    Friedman, B A

    1994-01-01

    A new term, the laboratory information float, should be substituted for turnaround-time when evaluating the performance of the clinical laboratory because it includes the time necessary to make test results both available (ready to use) and accessible (easy to use) to clinicians ordering tests. The laboratory information float can be greatly reduced simply by telescoping the analytic phase of laboratory testing into the preanalytic phase. Significant costs are incurred by such a change, some of which can be reduced by developing a mobile clinical laboratory (sometimes referred to as a "lab-on-a-slab" or "rolling thunder") to transport the analytic devices directly to patient care units. The mobile clinical laboratory should be equipped with an integrated personal computer that can communicate continuously with the host laboratory information system and achieve some semblance of continuous flow processing despite test performance in point-of-care venues. Equipping clinicians with palmtop computers will allow the mobile clinician to access test results and order tests on the run. Such devices can be easily configured to operate in a passive mode, accessing relevant information automatically instead of forcing clinicians to query the laboratory information system periodically for the test results necessary to render care to their patients. The laboratory information float of the year 2,000 will surely be measured in minutes through the judicious deployment of relevant technology such as mobile clinical laboratories and palmtop computers.

  15. Comparison of the performance of laboratory tests in the diagnosis of feline infectious peritonitis.

    Science.gov (United States)

    Stranieri, Angelica; Giordano, Alessia; Paltrinieri, Saverio; Giudice, Chiara; Cannito, Valentina; Lauzi, Stefania

    2018-05-01

    We compared the performance of clinicopathologic and molecular tests used in the antemortem diagnosis of feline infectious peritonitis (FIP). From 16 FIP and 14 non-FIP cats, we evaluated retrospectively the sensitivity, specificity, and likelihood ratios (LRs) of serum protein electrophoresis, α 1 -acid glycoprotein (AGP) on peripheral blood, screening reverse-transcription nested PCR (RT-nPCR) on the 3'-untranslated region (3'-UTR), and spike (S) gene sequencing on peripheral blood, body cavity effusions, and tissue, as well as body cavity cytology and delta total nucleated cell count (ΔTNC). Any of these tests on blood, and especially the molecular tests, may support or confirm a clinical diagnosis of FIP. A negative result does not exclude the disease except for AGP. Cytology, 3'-UTR PCR, and ΔTNC may confirm a clinical diagnosis on effusions; cytology or 3'-UTR PCR may exclude FIP. Conversely, S gene sequencing is not recommended based on the LRs. On tissues, S gene sequencing is preferable when histology is highly consistent with FIP, and 3'-UTR PCR when FIP is unlikely. Combining one test with high LR+ with one with low LR- (e.g., molecular tests and AGP on blood, ΔTNC and cytology in effusions) may improve the diagnostic power of the most used laboratory tests.

  16. Quality management in European screening laboratories in blood establishments: A view of current approaches and trends.

    Science.gov (United States)

    Pereira, Paulo; Westgard, James O; Encarnação, Pedro; Seghatchian, Jerard; de Sousa, Gracinda

    2015-04-01

    The screening laboratory has a critical role in the post-transfusion safety. The success of its targets and efficiency depends on the management system used. Even though the European Union directive 2002/98/EC requires a quality management system in blood establishments, its requirements for screening laboratories are generic. Complementary approaches are needed to implement a quality management system focused on screening laboratories. This article briefly discusses the current good manufacturing practices and good laboratory practices, as well as the trends in quality management system standards. ISO 9001 is widely accepted in some European Union blood establishments as the quality management standard, however this is not synonymous of its successful application. The ISO "risk-based thinking" is interrelated with the quality risk-management process of the EuBIS "Standards and criteria for the inspection of blood establishments". ISO 15189 should be the next step on the quality assurance of a screening laboratory, since it is focused on medical laboratory. To standardize the quality management systems in blood establishments' screening laboratories, new national and European claims focused on technical requirements following ISO 15189 is needed. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. A centrifuge-less plasma separation method from whole blood anticoagulated with EDTA-2K for the use of clinical laboratory tests.

    Science.gov (United States)

    Tatsumi, N; Tsuda, I; Fukumori, T; Hino, M; Takubo, T; Kondo, H

    2001-12-01

    In the modern medical laboratory system, simple and rapid processing of specimens are required. In the current system with the transportation line, its centrifugation part would disturb smooth flow of the testing because it needs much time for the centrifugation. To solve the problems, a serum separation method was tried for the whole blood specimen using poly-L-lysine, concanavalin A and phyto-hemoagglutinin. Ploy-L-lysine with molecular weight 130,000 to 210,000 in a final concentration of 0.1% could accelerate blood sedimentation, although its supernatant contaminated platelets. Concanavalin and phytohemoagulutinin could accelerate the sedimentation and obtained plasma, but the method could yield enough amount of supernatant by 1 hour standing. As the purpose of this study is to develop a centrifugeless method, a sieve method using a steel mesh and a magnet was applied to the mixture of EDTA blood, red-cell adhesives and thrombin. The method was unique to separate plasma, but the yield was not so high and chemistry data were not fitted with serum data in some of tests. Thus, the trial would be a new technology, but it was judged that some further improvement will be needed technically.

  18. Blood Test: Testosterone

    Science.gov (United States)

    ... Test: Estradiol Precocious Puberty Understanding Puberty Endocrine System Male Reproductive System Getting a Blood Test (Video) All About Puberty Blood Test (Video) Male Reproductive System View more About Us Contact Us Partners Editorial ...

  19. AUDILAB: a knowledge-based quality audit simulator for testing laboratories.

    Science.gov (United States)

    Brai, A; Garnerin, P

    1997-05-01

    In order to obtain an accreditation, a laboratory must be prepared to provide a point-by-point check of various activities against the chosen reference standard, both from a general point of view and in relation to details of application. This paper describes AUDILAB, a computerized simulator accessible by network, able to provide testing laboratories with realistic quality audits performed in a customized way. AUDILAB establishes a detailed list of strengths (compliance with corresponding requirements of established standards) and weaknesses (improvements needed for laboratory's accreditation). The standard used by AUDILAB is the EN 45001 "General criteria for the operation of testing laboratories". A preliminary validation has already been completed. AUDILAB became operational in September 1993.

  20. BUN - blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003474.htm BUN - blood test To use the sharing features on this page, ... for the Test Many medicines can interfere with blood test results. Your health care provider will tell you ...

  1. Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories.

    Science.gov (United States)

    Wallin, Olof; Söderberg, Johan; Van Guelpen, Bethany; Stenlund, Hans; Grankvist, Kjell; Brulin, Christine

    2010-09-01

    Scand J Caring Sci; 2010; 24; 581-591 
 Blood sample collection and patient identification demand improvement: a questionnaire study of preanalytical practices in hospital wards and laboratories   Most errors in venous blood testing result from human mistakes occurring before the sample reach the laboratory.   To survey venous blood sampling (VBS) practices in hospital wards and to compare practices with hospital laboratories.   Staff in two hospitals (all wards) and two hospital laboratories (314 respondents, response rate 94%), completed a questionnaire addressing issues relevant to the collection of venous blood samples for clinical chemistry testing.   The findings suggest that instructions for patient identification and the collection of venous blood samples were not always followed. For example, 79% of the respondents reported the undesirable practice (UDP) of not always using wristbands for patient identification. Similarly, 87% of the respondents noted the UDP of removing venous stasis after the sampling is finished. Compared with the ward staff, a significantly higher proportion of the laboratory staff reported desirable practices regarding the collection of venous blood samples. Neither education nor the existence of established sampling routines was clearly associated with VBS practices among the ward staff.   The results of this study, the first of its kind, suggest that a clinically important risk of error is associated with VBS in the surveyed wards. Most important is the risk of misidentification of patients. Quality improvement of blood sample collection is clearly needed, particularly in hospital wards. © 2009 The Authors. Journal compilation © 2009 Nordic College of Caring Science.

  2. Analytical and pre-analytical performance characteristics of a novel cartridge-type blood gas analyzer for point-of-care and laboratory testing.

    Science.gov (United States)

    Oyaert, Matthijs; Van Maerken, Tom; Bridts, Silke; Van Loon, Silvi; Laverge, Heleen; Stove, Veronique

    2018-03-01

    Point-of-care blood gas test results may benefit therapeutic decision making by their immediate impact on patient care. We evaluated the (pre-)analytical performance of a novel cartridge-type blood gas analyzer, the GEM Premier 5000 (Werfen), for the determination of pH, partial carbon dioxide pressure (pCO 2 ), partial oxygen pressure (pO 2 ), sodium (Na + ), potassium (K + ), chloride (Cl - ), ionized calcium ( i Ca 2+ ), glucose, lactate, and total hemoglobin (tHb). Total imprecision was estimated according to the CLSI EP5-A2 protocol. The estimated total error was calculated based on the mean of the range claimed by the manufacturer. Based on the CLSI EP9-A2 evaluation protocol, a method comparison with the Siemens RapidPoint 500 and Abbott i-STAT CG8+ was performed. Obtained data were compared against preset quality specifications. Interference of potential pre-analytical confounders on co-oximetry and electrolyte concentrations were studied. The analytical performance was acceptable for all parameters tested. Method comparison demonstrated good agreement to the RapidPoint 500 and i-STAT CG8+, except for some parameters (RapidPoint 500: pCO 2 , K + , lactate and tHb; i-STAT CG8+: pO 2 , Na + , i Ca 2+ and tHb) for which significant differences between analyzers were recorded. No interference of lipemia or methylene blue on CO-oximetry results was found. On the contrary, significant interference for benzalkonium and hemolysis on electrolyte measurements were found, for which the user is notified by an interferent specific flag. Identification of sample errors from pre-analytical sources, such as interferences and automatic corrective actions, along with the analytical performance, ease of use and low maintenance time of the instrument, makes the evaluated instrument a suitable blood gas analyzer for both POCT and laboratory use. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  3. Comparison of the peripheral blood eosinophil count using near-patient testing and standard automated laboratory measurement in healthy, asthmatic and COPD subjects

    Directory of Open Access Journals (Sweden)

    Hambleton K

    2017-09-01

    Full Text Available Kirsty Hambleton, Clare M Connolly, Catherine Borg, Joanne H Davies, Helen P Jeffers, Richard EK Russell, Mona Bafadhel Respiratory Medicine Unit, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK Abstract: Near-patient testing (NPT allows clinical decisions to be made in a rapid and convenient manner and is often cost effective. In COPD the peripheral blood eosinophil count has been demonstrated to have utility in providing prognostic information and predicting response to treatment during an acute exacerbation. For this potential to be achieved having a reliable NPT of blood eosinophil count would be extremely useful. Therefore, we investigated the use of the HemoCue® WBC Diff System and evaluated its sensitivity and specificity in healthy, asthmatic and COPD subjects. This method requires a simple skin prick of blood and was compared to standard venepuncture laboratory analysis. The HemoCue® WBC Diff System measured the peripheral blood eosinophil count in healthy, asthma and COPD subjects with very close correlation to the eosinophil count as measured by standard venepuncture. The correlations were unaffected by disease status. This method for the measurement of the peripheral blood eosinophil count has the potential to provide rapid near-patient results and thus influence the speed of management decisions in the treatment of airway diseases. Keywords: asthma, chronic obstructive pulmonary disease, eosinophils, near-patient testing

  4. Proficiency testing materials for pH and blood gases. The California Thoracic Society experience.

    Science.gov (United States)

    Hansen, J E; Clausen, J L; Levy, S E; Mohler, J G; Van Kessel, A L

    1986-02-01

    The California Thoracic Society Blood Gas Proficiency Testing Program distributed ampules from three separate lots of quality control products every three months as unknowns to participating clinical (survey) laboratories and ten selected reference laboratories. For eight quarters, aqueous buffers were distributed. For each lot, PCO2 and pH measurements varied within narrow ranges between laboratories. Concurrently, the PO2 measurements varied widely between reference laboratories as well as survey laboratories, but varied minimally when repeatedly assessed on each reference laboratory machine. Change to a fluorocarbon-containing emulsion as a testing medium resulted in a significant reduction in within model and overall variability for PO2. We attribute this reduction in variability to the higher O2 content and decreased temperature sensitivity for PO2 of the fluorocarbon-containing emulsion. Because we have no evidence that the magnitude of the interinstrument differences in PO2 found with these materials would be found with fresh human blood we recommend that regulatory agencies use the results of proficiency testing for PO2 cautiously.

  5. Internet-Based Contingency Management to Improve Adherence with Blood Glucose Testing Recommendations for Teens with Type 1 Diabetes

    Science.gov (United States)

    Raiff, Bethany R.; Dallery, Jesse

    2010-01-01

    The current study used Internet-based contingency management (CM) to increase adherence with blood glucose testing to at least 4 times daily. Four teens diagnosed with Type 1 diabetes earned vouchers for submitting blood glucose testing videos over a Web site. Participants submitted a mean of 1.7 and 3.1 blood glucose tests per day during the 2…

  6. Design of a tablet computer app for facilitation of a molecular blood culture test in clinical microbiology and preliminary usability evaluation

    DEFF Research Database (Denmark)

    Samson, Lasse L.; Pape-Haugaard, Louise; Meltzer, Michelle C.

    2016-01-01

    through specialized applications (apps) while supporting the mobility of the users. The use of apps for mobile phones and tablet computers may support workflow of complex tasks, for example, molecular-based diagnostic tests in clinical microbiology. Multiplex Blood Culture Test (MuxBCT) is a molecular......-based diagnostic test used for rapid identification of pathogens in positive blood cultures. To facilitate the workflow of the MuxBCT, a specialized tablet computer app was developed as an accessory to the diagnostic test. The app aims to reduce the complexity of the test by step-by-step guidance of microscopy...... and to assist users in reaching an exact bacterial or fungal diagnosis based on blood specimen observations and controls. Additionally, the app allows for entry of test results, and communication thereof to the laboratory information system (LIS). OBJECTIVE: The objective of the study was to describe the design...

  7. [Development and evaluation of a pyrogen test based on human whole blood

    Science.gov (United States)

    Hartung, Thomas; Fennrich, Stefan; Fischer, Matthias; Montag-Lessing, Thomas; Wendel, Albrecht

    1998-01-01

    When cells of the immune system, especially blood monocytes and macrophages, come into contact with pyrogenic (fever-inducing) contaminations, they secrete messenger molecules which initiate an hyperthermic reaction in the organism. Of this group of endogenous pyrogens, most is known about interleukin-1 (IL-1). A new pyrogen test makes use of this reaction as a system for detection: The substances which are to be screened are incubated with a small volume of blood from a healthy donor. Any pyrogens present induce the production of IL-1 which can be detected by ELISA. This test has a higher sensitivity and is more economical than the conventional pyrogen test in rabbits and furthermore reflects the reaction of the relevant species. In contrast to the customary alternative method, the Limulus amoebocyte lysate test (LAL), this test is not restricted to endotoxins from Gram-negative bacteria and is also not hindered by substances which bind endotoxins, such as blood proteins, to the same extent. Consequently, more than 50 non-endotoxin pyrogens have already been traced by this test. The whole blood test is even superior to the LAL in regard to the detection of endotoxins: in a comparison of about 60 endotoxins, there was a correlation of the potency of the individual endotoxins between the whole blood test and the pyrogen test in rabbits, but neither test correlated with the LAL test. In some cases, endotoxins with equal effects in the LAL test differed in potency in the human blood model by a factor of 10 000. A method has been developed by which cryopreserved blood can be put to use in the test. In this way, blood donations from a donor can be pre-tested so that uniform material may be employed in the test. This test opens up entirely new perspectives on pyrogen testing for Gram-positive or fungal pyrogens as well as in medicinal products. In addition, it could fill the dangerous security gap which might result from the limitations of testing medications and blood

  8. Estradiol blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003711.htm Estradiol blood test To use the sharing features on this page, ... of estrogens. How the Test is Performed A blood sample is needed . How to Prepare for the Test Your health care provider may tell you to ...

  9. Home blood sugar testing

    Science.gov (United States)

    Diabetes - home glucose testing; Diabetes - home blood sugar testing ... Usual times to test your blood sugar are before meals and at bedtime. Your provider may ask you to check your blood sugar 2 hours after a meal or ...

  10. TBG - blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003374.htm TBG - blood test To use the sharing features on this page, please enable JavaScript. The TBG blood test measures the level of a protein that moves ...

  11. Calcitonin blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003699.htm Calcitonin blood test To use the sharing features on this page, please enable JavaScript. The calcitonin blood test measures the level of the hormone calcitonin in ...

  12. Glucagon blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003716.htm Glucagon blood test To use the sharing features on this page, please enable JavaScript. A glucagon blood test measures the amount of a hormone called glucagon ...

  13. Haptoglobin blood test

    Science.gov (United States)

    The haptoglobin blood test measures the level of haptoglobin in your blood. Haptoglobin is a protein produced by the liver. It attaches to a certain type of hemoglobin in the blood. Hemoglobin is a blood cell that carries oxygen.

  14. ACE blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003567.htm ACE blood test To use the sharing features on this page, ... Alternative Names Serum angiotensin-converting enzyme; SACE Images Blood test References Carty RP, Pincus MR, Sarafraz-Yazdi E. ...

  15. CEA blood test

    Science.gov (United States)

    Carcinoembryonic antigen blood test ... doing so for a short time before the test. ... When the needle is inserted to draw blood, some people feel ... may be some throbbing or a slight bruise. This soon goes away.

  16. Aldolase blood test

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003566.htm Aldolase blood test To use the sharing features on this page, ... risk any time the skin is broken) Images Blood test References Berridge BR, Van Vleet JF, Herman E. ...

  17. Quality assurance of laboratory work and clinical use of laboratory tests in general practice in norway: a survey.

    Science.gov (United States)

    Thue, Geir; Jevnaker, Marianne; Gulstad, Guri Andersen; Sandberg, Sverre

    2011-09-01

    Virtually all the general practices in Norway participate in the Norwegian Quality Improvement of Laboratory Services in Primary Care, NOKLUS. In order to assess and develop NOKLUS's services, it was decided to carry out an investigation in the largest participating group, general practices. In autumn 2008 a questionnaire was sent to all Norwegian general practices asking for feedback on different aspects of NOKLUS's main services: contact with medical laboratory technologists, sending of control materials, use and maintenance of practice-specific laboratory binders, courses, and testing of laboratory equipment. In addition, attitudes were elicited towards possible new services directed at assessing other technical equipment and clinical use of tests. Responses were received from 1290 of 1552 practices (83%). The great majority thought that the frequency of sending out control material should continue as at present, and they were pleased with the feedback reports and follow-up by the laboratory technologists in the counties. Even after many years of practical experience, there is still a need to update laboratory knowledge through visits to practices, courses, and written information. Practices also wanted quality assurance of blood pressure meters and spirometers, and many doctors wanted feedback on their use of laboratory tests. Services regarding quality assurance of point-of-care tests, guidance, and courses should be continued. Quality assurance of other technical equipment and of the doctor's clinical use of laboratory tests should be established as part of comprehensive quality assurance.

  18. Automated cognitive testing of monkeys in social groups yields results comparable to individual laboratory-based testing.

    Science.gov (United States)

    Gazes, Regina Paxton; Brown, Emily Kathryn; Basile, Benjamin M; Hampton, Robert R

    2013-05-01

    Cognitive abilities likely evolved in response to specific environmental and social challenges and are therefore expected to be specialized for the life history of each species. Specialized cognitive abilities may be most readily engaged under conditions that approximate the natural environment of the species being studied. While naturalistic environments might therefore have advantages over laboratory settings for cognitive research, it is difficult to conduct certain types of cognitive tests in these settings. We implemented methods for automated cognitive testing of monkeys (Macaca mulatta) in large social groups (Field station) and compared the performance to that of laboratory-housed monkeys (Laboratory). The Field station animals shared access to four touch-screen computers in a large naturalistic social group. Each Field station subject had an RFID chip implanted in each arm for computerized identification and individualized assignment of cognitive tests. The Laboratory group was housed and tested in a typical laboratory setting, with individual access to testing computers in their home cages. Monkeys in both groups voluntarily participated at their own pace for food rewards. We evaluated performance in two visual psychophysics tests, a perceptual classification test, a transitive inference test, and a delayed matching-to-sample memory test. Despite the differences in housing, social environment, age, and sex, monkeys in the two groups performed similarly in all tests. Semi-free ranging monkeys living in complex social environments are therefore viable subjects for cognitive testing designed to take advantage of the unique affordances of naturalistic testing environments.

  19. Design of a Tablet Computer App for Facilitation of a Molecular Blood Culture Test in Clinical Microbiology and Preliminary Usability Evaluation.

    Science.gov (United States)

    Samson, Lasse L; Pape-Haugaard, Louise; Meltzer, Michelle C; Fuchs, Martin; Schønheyder, Henrik C; Hejlesen, Ole

    2016-03-18

    User mobility is an important aspect of the development of clinical information systems for health care professionals. Mobile phones and tablet computers have obtained widespread use by health care professionals, offering an opportunity for supporting the access to patient information through specialized applications (apps) while supporting the mobility of the users. The use of apps for mobile phones and tablet computers may support workflow of complex tasks, for example, molecular-based diagnostic tests in clinical microbiology. Multiplex Blood Culture Test (MuxBCT) is a molecular-based diagnostic test used for rapid identification of pathogens in positive blood cultures. To facilitate the workflow of the MuxBCT, a specialized tablet computer app was developed as an accessory to the diagnostic test. The app aims to reduce the complexity of the test by step-by-step guidance of microscopy and to assist users in reaching an exact bacterial or fungal diagnosis based on blood specimen observations and controls. Additionally, the app allows for entry of test results, and communication thereof to the laboratory information system (LIS). The objective of the study was to describe the design considerations of the MuxBCT app and the results of a preliminary usability evaluation. The MuxBCT tablet app was developed and set up for use in a clinical microbiology laboratory. A near-live simulation study was conducted in the clinical microbiology laboratory to evaluate the usability of the MuxBCT app. The study was designed to achieve a high degree of realism as participants carried out a scenario representing the context of use for the MuxBCT app. As the MuxBCT was under development, the scenario involved the use of molecular blood culture tests similar to the MuxBCT for identification of microorganisms from positive blood culture samples. The study participants were observed, and their interactions with the app were recorded. After the study, the participants were debriefed to

  20. Blood Test: Lead (For Parents)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Blood Test: Lead KidsHealth / For Parents / Blood Test: Lead What's ... español Análisis de sangre: plomo What Is a Blood Test? A blood test is when a sample of ...

  1. Antithrombin III blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003661.htm Antithrombin III blood test To use the sharing features on this page, ... a protein that helps control blood clotting. A blood test can determine the amount of AT III present ...

  2. New, small, fast acting blood glucose meters--an analytical laboratory evaluation.

    Science.gov (United States)

    Weitgasser, Raimund; Hofmann, Manuela; Gappmayer, Brigitta; Garstenauer, Christa

    2007-09-22

    Patients and medical personnel are eager to use blood glucose meters that are easy to handle and fast acting. We questioned whether accuracy and precision of these new, small and light weight devices would meet analytical laboratory standards and tested four meters with the above mentioned conditions. Approximately 300 capillary blood samples were collected and tested using two devices of each brand and two different types of glucose test strips. Blood from the same samples was used for comparison. Results were evaluated using maximum deviation of 5% and 10% from the comparative method, the error grid analysis, the overall deviation of the devices, the linear regression analysis as well as the CVs for measurement in series. Of all 1196 measurements a deviation of less than 5% resp. 10% from the reference method was found for the FreeStyle (FS) meter in 69.5% and 96%, the Glucocard X Meter (GX) in 44% and 75%, the One Touch Ultra (OT) in 29% and 60%, the Wellion True Track (WT) in 28.5% and 58%. The error grid analysis gave 99.7% for FS, 99% for GX, 98% for OT and 97% for WT in zone A. The remainder of the values lay within zone B. Linear regression analysis resembled these results. CVs for measurement in series showed higher deviations for OT and WT compared to FS and GX. The four new, small and fast acting glucose meters fulfil clinically relevant analytical laboratory requirements making them appropriate for use by medical personnel. However, with regard to the tight and restrictive limits of the ADA recommendations, the devices are still in need of improvement. This should be taken into account when the devices are used by primarily inexperienced persons and is relevant for further industrial development of such devices.

  3. Fibrinopeptide A blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003373.htm Fibrinopeptide A blood test To use the sharing features on this page, ... measure the level of this substance in your blood. How the Test is Performed A blood sample is needed. How ...

  4. Luteinizing hormone (LH) blood test

    Science.gov (United States)

    ICSH - blood test; Luteinizing hormone - blood test; Interstitial cell stimulating hormone - blood test ... to temporarily stop medicines that may affect the test results. Be sure to tell your provider about ...

  5. Laboratory- and field-based testing as predictors of skating performance in competitive-level female ice hockey.

    Science.gov (United States)

    Henriksson, Tommy; Vescovi, Jason D; Fjellman-Wiklund, Anncristine; Gilenstam, Kajsa

    2016-01-01

    The purpose of this study was to examine whether field-based and/or laboratory-based assessments are valid tools for predicting key performance characteristics of skating in competitive-level female hockey players. Cross-sectional study. Twenty-three female ice hockey players aged 15-25 years (body mass: 66.1±6.3 kg; height: 169.5±5.5 cm), with 10.6±3.2 years playing experience volunteered to participate in the study. The field-based assessments included 20 m sprint, squat jump, countermovement jump, 30-second repeated jump test, standing long jump, single-leg standing long jump, 20 m shuttle run test, isometric leg pull, one-repetition maximum bench press, and one-repetition maximum squats. The laboratory-based assessments included body composition (dual energy X-ray absorptiometry), maximal aerobic power, and isokinetic strength (Biodex). The on-ice tests included agility cornering s-turn, cone agility skate, transition agility skate, and modified repeat skate sprint. Data were analyzed using stepwise multivariate linear regression analysis. Linear regression analysis was used to establish the relationship between key performance characteristics of skating and the predictor variables. Regression models (adj R (2)) for the on-ice variables ranged from 0.244 to 0.663 for the field-based assessments and from 0.136 to 0.420 for the laboratory-based assessments. Single-leg tests were the strongest predictors for key performance characteristics of skating. Single leg standing long jump alone explained 57.1%, 38.1%, and 29.1% of the variance in skating time during transition agility skate, agility cornering s-turn, and modified repeat skate sprint, respectively. Isokinetic peak torque in the quadriceps at 90° explained 42.0% and 32.2% of the variance in skating time during agility cornering s-turn and modified repeat skate sprint, respectively. Field-based assessments, particularly single-leg tests, are an adequate substitute to more expensive and time

  6. FOOD SAFETY TESTING LABORATORY

    Data.gov (United States)

    Federal Laboratory Consortium — This laboratory develops screening assays, tests and modifies biosensor equipment, and optimizes food safety testing protocols for the military and civilian sector...

  7. Laboratory informatics based evaluation of methylene tetrahydrofolate reductase C677T genetic test overutilization

    Directory of Open Access Journals (Sweden)

    David A Cohen

    2013-01-01

    Full Text Available Background: Laboratory data can provide a wide range of information to estimate adherence to guidelines and proper utilization of genetic testing. The methylene tetrahydrofolate reductase (MTHFR C677T variant has been demonstrated to have negligible utility in patient management. However, the testing of this variant remains pervasive. The purpose of this study was to develop methods to analyze concordance of clinician ordering practices with national guidelines. Methods: We used laboratory data to extract specific data elements including patient demographics, timestamps, physician ordering logs and temporal relationship to chemistry requests to examine 245 consecutive MTHFR tests ordered in 2011 at an academic tertiary center. A comprehensive chart review was used to identify indications for testing. These results were correlated with a retrospective analysis of 4,226 tests drawn at a range of hospitals requesting testing from a national reference laboratory over a 2-year period. MTHFR ordering practices drawn from 17 institutions were examined longitudinally from 2002 to 2011. Results: Indications for testing included cerebrovascular events (40.0% and venous thrombosis (39.1%. Family history prompted testing in eight cases. Based on acceptable hypercoagulability guidelines recommending MTHFR C677T testing only in the presence of elevated serum homocysteine, 10.6% (22/207 of adult patients met an indicated threshold at an academic tertiary center. Among 77 institutions, 14.5% (613/4226 of MTHFR testing met recommendations. Conclusion: We demonstrate an effective method to examine discreet elements of a molecular diagnostics laboratory information system at a tertiary care institution and to correlate these findings at a national level. Retrospective examination of clinicians′ request of MTHFR C677T genetic testing strongly suggests that clinicians have failed to adjust their ordering practices in light of evolving scientific and professional

  8. Chloride Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/chloridebloodtest.html Chloride Blood Test To use the sharing features on this page, please enable JavaScript. What is a Chloride Blood Test? A chloride blood test measures the ...

  9. Bilirubin Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/bilirubinbloodtest.html Bilirubin Blood Test To use the sharing features on this page, please enable JavaScript. What is a Bilirubin Blood Test? A bilirubin blood test measures the ...

  10. Recommended procedures for performance testing of radiobioassay laboratories: Volume 3, In vivo test phantoms

    International Nuclear Information System (INIS)

    MacLellan, J.A.; Traub, R.J.

    1988-11-01

    Draft American National Standards Institute (ANSI) Standard N13.30 (Performance Criteria for Radiobioassay) was developed for the US Department of Energy and the US Nuclear Regulatory Commission to help ensure that bioassay laboratories provide accurate and consistent results. The draft standard describes the procedures necessary to establish a bioassay performance-testing laboratory and program. The bioassay performance-testing laboratory will conduct tests to evaluate the performance of service laboratories. Pacific Northwest Laboratory helped develop testing procedures as part of an effort to evaluate the draft ANSI N13.30 performance criteria by testing the existing measurement capabilities of various bioassay laboratories. This report recommends guidelines for the preparation, handling, storage, distribution, shipping, and documentation of test phantoms used for calibration of measurement systems for direct bioassay. The data base and recommended records system for documenting radiobioassay performance at the service laboratories are also presented

  11. Iodine based radiopacity of experimental blood clots for testing of mechanical thrombectomy devices

    International Nuclear Information System (INIS)

    Luo, Zhong Hua; Chung, Alex; Choi, Gibok; Lin, Yih Huie; Pang, Huajin; Uchida, Barry T.; Pavcnik, Dusan; Jeromel, Miran; Keller, Frederick S.; Rösch, Josef

    2013-01-01

    Barium sulfate powder used for radiopacity of experimental blood clots (EBCs) for testing mechanical thrombectomy devices (MTD) has negative effects on EBCs mechanical properties. In vitro and in vivo exploration was performed to determine if the iodine based contrast medium will have less negative effects on the EBCs than barium. Fresh blood from 2 swine was used to create fibrinogen enhanced and thrombin initiated EBC in tubes. Iodine radiopacity was achieved by mixing the blood with 65% Iohexol or by soaking the EBCs for 2 or 24 hours in Iohexol. The EBCs opacified with barium served as controls. In vitro study: The EBCs were subjected to four tests, manual elongation, catheter injection, radiopacity and contrast wash out tests. In vivo study: The common carotid arteries of 2 swine were embolized by either barium EBC or EBC soaked for 24 hours in Iohexol. The duration of radiopacity of the different EBCs was compared. The EBCs opacified with Iohexol initially had higher radiopacity than the barium opacified EBCs. However, their opacity rapidly decreased with saline soaking and, particularly, after they were embolized in live animals. The mechanical properties of Iohexol opacified EBCs were inferior to barium opacified EBCs. The Iohexol mixed EBCs were less firm and elastic and half of them fragmented during catheter injection. The Iohexol soaked EBCs exhibited decreased tensile strength and elasticity compared to the barium EBCs. Compared to barium, iodine based contrast medium does not offer any advantage for opacifying EBCs

  12. Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) - does it leverage any advantage in clinical decision making?

    Science.gov (United States)

    Florkowski, Christopher; Don-Wauchope, Andrew; Gimenez, Nuria; Rodriguez-Capote, Karina; Wils, Julien; Zemlin, Annalise

    Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870. The justification for POCT depends upon being able to demonstrate that a more timely result (shorter turnaround times (TATs)) is able to leverage a clinically important advantage in decision making compared with the central laboratory (CL). In the four decades since POCT was adapted for the self-monitoring of blood glucose levels by subjects with diabetes, numerous new POCT methodologies have become available, enabling the clinician to receive results and initiate treatment more rapidly. However, these instruments are often operated by staff not trained in laboratory medicine and hence are prone to errors in the analytical phase (as opposed to laboratory testing where the analytical phase has the least errors). In some environments, particularly remote rural settings, the CL may be at a considerable distance and timely availability of cardiac troponins and other analytes can triage referrals to the main centers, thus avoiding expensive unnecessary patient transportation costs. However, in the Emergency Department, availability of more rapid results with POCT does not always translate into shorter stays due to other barriers to implementation of care. In this review, we apply the principles of evidence-based

  13. Impact of Laboratory Test Use Strategies in a Turkish Hospital.

    Directory of Open Access Journals (Sweden)

    Fatma Meriç Yılmaz

    Full Text Available Eliminating unnecessary laboratory tests is a good way to reduce costs while maintain patient safety. The aim of this study was to define and process strategies to rationalize laboratory use in Ankara Numune Training and Research Hospital (ANH and calculate potential savings in costs.A collaborative plan was defined by hospital managers; joint meetings with ANHTA and laboratory professors were set; the joint committee invited relevant staff for input, and a laboratory efficiency committee was created. Literature was reviewed systematically to identify strategies used to improve laboratory efficiency. Strategies that would be applicable in local settings were identified for implementation, processed, and the impact on clinical use and costs assessed for 12 months.Laboratory use in ANH differed enormously among clinics. Major use was identified in internal medicine. The mean number of tests per patient was 15.8. Unnecessary testing for chloride, folic acid, free prostate specific antigen, hepatitis and HIV testing were observed. Test panel use was pinpointed as the main cause of overuse of the laboratory and the Hospital Information System test ordering page was reorganized. A significant decrease (between 12.6-85.0% was observed for the tests that were taken to an alternative page on the computer screen. The one year study saving was equivalent to 371,183 US dollars.Hospital-based committees including laboratory professionals and clinicians can define hospital based problems and led to a standardized approach to test use that can help clinicians reduce laboratory costs through appropriate use of laboratory tests.

  14. Microscopic or occult hematuria, when reflex testing is not good laboratory practice.

    Science.gov (United States)

    Froom, Paul; Barak, Mira

    2010-01-01

    Consensus opinion suggests that hematuria found by dipstick and not confirmed on microscopic examination (<2 erythrocytes per high power field) signifies a false-positive reagent strip test result. Standard practice is to repeat the dipstick test several days later and if still positive to confirm by microscopic examination. If discordant results are obtained, experts recommend reflex testing for urinary myoglobin and hemoglobin concentrations. The question is whether or not this approach represents good laboratory practice. These recommendations are not evidence based. We conclude that the reference range for red blood cells on the reagent strip should be increased to 25x10(6) cells/L for young men, and 50x10(6) cells/L for the rest of the adult population, ranges consistent with flow cytometry reports. Confirmation reflex testing using tests that have inferior sensitivity, precision and probably accuracy is not recommended.

  15. Comparative evaluation of blood and serum samples in rapid immunochromatographic tests for visceral leishmaniasis.

    Science.gov (United States)

    Kumar, Dinesh; Khanal, Basudha; Tiwary, Puja; Mudavath, Shyam Lal; Tiwary, Narendra K; Singh, Rupa; Koirala, Kanika; Boelaert, Marleen; Rijal, Suman; Sundar, Shyam

    2013-12-01

    Rapid diagnostic tests (RDTs) based on the detection of specific antibodies in serum are commonly used for the diagnosis of visceral leishmaniasis (VL). Several commercial kits are available, and some of them allow the use of whole-blood samples instead of serum. An RDT is much more user-friendly for blood samples than for serum samples. In this study, we examined the sensitivities and specificities of six different commercially available immunochromatographic tests for their accuracy in detecting Leishmania infection in whole blood and serum of parasitologically confirmed VL cases. This study was performed in areas of India and Nepal where VL is endemic. A total of 177 confirmed VL cases, 208 healthy controls from areas of endemicity (EHCs), 26 malaria patients (MP), and 37 tuberculosis (TB) patients were enrolled. The reproducibilities of the blood and serum results and between-reader and between-laboratory results were tested. In India, the sensitivities of all the RDTs ranged between 94.7 and 100.0%, with no significant differences between whole blood and serum. The specificities ranged between 92.4 and 100.0%, except for the specificity of the Onsite Leishmania Ab RevB kit, which was lower (33.6 to 42.0%). No differences in specificities were observed for blood and serum. In Nepal, the sensitivities of all the test kits, for whole-blood as well as serum samples, ranged between 96.3 and 100.0%, and the specificities ranged between 90.1 and 96.1%, again with the exception of that of the Onsite Leishmania Ab RevB test, which was markedly lower (48.7 to 49.3%). The diagnostic accuracies of all the tests, except for one brand, were excellent for the whole-blood and serum samples. We conclude that whole blood is an adequate alternative for serum in RDTs for VL, with sensitivities and specificities comparable to those obtained in serum samples, provided that the test kit is of overall good quality.

  16. Blood tests and prognosis in bladder carcinomas treated with definitive radiotherapy

    International Nuclear Information System (INIS)

    Hannisdal, E.; Fossa, S.D.; Host, H.

    1993-01-01

    The value of some commonly recorded blood tests as prognostic factors in patients with bladder carcinomas treated with definitive radiotherapy has been assessed. This study included 202 consecutive patients (T2, n=46; T3, n=82 and T4, n=74) treated during the period 1980-1987. The median total dose received was 56 Gy [50-67] and the median cumulative radiation effect was 1750 reu (radiation effect unit) (1515-1823). The blood tests examined in survival analyses were erythrocyte sedimentation rate (ESR), hemoglobin (Hb), leucocyte and thrombocyte count, alkaline phosphatase (ALP), γ-glutamyltransferase (GT), lactate dehydrogenase (LD), creatinine and albumin. In the univariate survival analyses six blood tests were significant prognostic factors (ESR, albumin, creatinine, Hb, ALP and GT). In the multivariate analysis of all 202 patients, the following five variables were significantly associated with shorter survival: T4 tumors, ESR > 30 mm/h, albumin 400 U/I and age >75 years. Our conclusion is that several commonly recorded blood tests are powerful prognostic factors in bladder cancer treated with definitive radiotherapy. These tests can replace other more expensive laboratory investigations used for prognostication. (author). figs. tabs

  17. Laboratory performance testing of an extruded bitumen containing a surrogate, sodium nitrate-based, low-level aqueous waste

    International Nuclear Information System (INIS)

    Mattus, A.J.; Kaczmarsky, M.M.

    1986-01-01

    Laboratory results of a comprehensive, regulatory performance test program, utilizing an extruded bitumen and a surrogate, sodium nitrate-based waste, have been compiled at the Oak Ridge National Laboratory (ORNL). Using a 53 millimeter, Werner and Pfleiderer extruder, operated by personnel of WasteChem Corporation of Paramus, New Jersey, laboratory-scale, molded samples of type three, air blown bitumen were prepared for laboratory performance testing. A surrogate, low-level, mixed liquid waste, formulated to represent an actual on-site waste at ORNL, containing about 30 wt % sodium nitrate, in addition to eight heavy metals, cold cesium and strontium was utilized. Samples tested contained three levels of waste loading: that is, forty, fifty and sixty wt % salt. Performance test results include the ninety day ANS 16.1 leach test, with leach indices reported for all cations and anions, in addition to the EP Toxicity test, at all levels of waste loading. Additionally, test results presented also include the unconfined compressive strength and surface morphology utilizing scanning electron microscopy. Data presented include correlations between waste form loading and test results, in addition to their relationship to regulatory performance requirements

  18. Platelet antibodies blood test

    Science.gov (United States)

    This blood test shows if you have antibodies against platelets in your blood. Platelets are a part of the blood ... Chernecky CC, Berger BJ. Platelet antibody - blood. In: Chernecky ... caused by platelet destruction, hypersplenism, or hemodilution. ...

  19. Antidiuretic hormone blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003702.htm Antidiuretic hormone blood test To use the sharing features on this page, please enable JavaScript. Antidiuretic blood test measures the level of antidiuretic hormone (ADH) in ...

  20. Evaluation of rapid HIV test kits on whole blood and development of rapid testing algorithm for voluntary testing and counseling centers in Ethiopia.

    Science.gov (United States)

    Tegbaru, Belete; Messele, Tsehaynesh; Wolday, Dawit; Meles, PhD Hailu; Tesema, Desalegn; Birhanu, Hiwot; Tesfaye, Girma; Bond, Kyle B; Martin, Robert; Rayfield, Mark A; Wuhib, Tadesse; Fekadu, Makonnen

    2004-10-01

    Five simple and rapid HIV antibody detection assays viz. Determine, Capillus, Oraquick, Unigold and Hemastrip were evaluated to examine their performance and to develop an alternative rapid test based testing algorithm for voluntary counseling and testing (VCT) in Ethiopia. All the kits were tested on whole blood, plasma and serum. The evaluation had three phases: Primary lab review, piloting at point of service and implementation. This report includes the results of the first two phases. A total of 2,693 specimens (both whole blood and plasma) were included in the evaluation. Results were compared to double Enzyme Linked Immuno-Sorbent Assay (ELISA) system. Discordant EIA results were resolved using Western Blot. The assays had very good sensitivities and specificities, 99-100%, at the two different phases of the evaluation. A 98-100% result agreement was obtained from those tested at VCT centers and National Referral Laboratory for AIDS (NRLA), in the quality control phase of the evaluation. A testing strategy yielding 100% [95% CI; 98.9-100.0] sensitivity was achieved by the sequential use of the three rapid test kits. Direct cost comparison showed serial testing algorithm reduces the cost of testing by over 30% compared to parallel testing in the current situation. Determine, Capillus/Oraquick (presence/absence of frefrigeration) and Unigold were recommended as screening, confirmation and tiebreaker tests, respectively.

  1. Ethylene glycol blood test

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/article/003564.htm Ethylene glycol blood test To use the sharing features ... enable JavaScript. This test measures the level of ethylene glycol in the blood. Ethylene glycol is a ...

  2. Methylmalonic acid blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003565.htm Methylmalonic acid blood test To use the sharing features on this page, please enable JavaScript. The methylmalonic acid blood test measures the amount of methylmalonic acid in the ...

  3. Flushable reagent stool blood test

    Science.gov (United States)

    Stool occult blood test - flushable home test; Fecal occult blood test - flushable home test ... This test is performed at home with disposable pads. You can buy the pads at the drug store without ...

  4. HCG blood test - qualitative

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003509.htm HCG blood test - qualitative To use the sharing features on this page, please enable JavaScript. A qualitative HCG blood test checks if there is a hormone called human ...

  5. LDH isoenzyme blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003499.htm LDH isoenzyme blood test To use the sharing features on this page, ... Names LD; LDH; Lactic (lactate) dehydrogenase isoenzymes Images Blood test References Carty RP, Pincus MR, Sarafraz-Yazdi E. ...

  6. Leucine aminopeptidase blood test

    Science.gov (United States)

    ... medlineplus.gov/ency/article/003559.htm Leucine aminopeptidase blood test To use the sharing features on this page, ... Alternative Names Serum leucine aminopeptidase; LAP - serum Images Blood test References Chernecky CC, Berger BJ. Leucine aminopeptidase (LAP) - ...

  7. Laboratory testing in hyperthyroidism.

    Science.gov (United States)

    Grebe, Stefan K G; Kahaly, George J

    2012-09-01

    The clinical diagnosis of hypo- or hyperthyroidism is difficult (full text available online: http://education.amjmed.com/pp1/272). Clinical symptoms and signs are often non-specific, and there is incomplete correlation between structural and functional thyroid gland changes. Laboratory testing is therefore indispensible in establishing the diagnosis of thyrotoxicosis. Similar considerations apply to treatment monitoring. Laboratory testing also plays a crucial role in establishing the most likely cause for a patient's hyperthyroidism. Finally, during pregnancy, when isotopic scanning is relatively contraindicated and ultrasound is more difficult to interpret, laboratory testing becomes even more important. Copyright © 2012. Published by Elsevier Inc.

  8. Operational feasibility of using whole blood in the rapid HIV testing algorithm of a resource-limited settings like Bangladesh.

    Science.gov (United States)

    Munshi, Saif U; Oyewale, Tajudeen O; Begum, Shahnaz; Uddin, Ziya; Tabassum, Shahina

    2016-03-01

    Serum-based rapid HIV testing algorithm in Bangladesh constitutes operational challenge to scaleup HIV testing and counselling (HTC) in the country. This study explored the operational feasibility of using whole blood as alternative to serum for rapid HIV testing in Bangladesh. Whole blood specimens were collected from two study groups. The groups included HIV-positive patients (n = 200) and HIV-negative individuals (n = 200) presenting at the reference laboratory in Dhaka, Bangladesh. The specimens were subjected to rapid HIV tests using the national algorithm with A1 = Alere Determine (United States), A2 = Uni-Gold (Ireland), and A3 = First Response (India). The sensitivity and specificity of the test results, and the operational cost were compared with current serum-based testing. The sensitivities [95% of confidence interval (CI)] for A1, A2, and A3 tests using whole blood were 100% (CI: 99.1-100%), 100% (CI: 99.1-100%), and 97% (CI: 96.4-98.2%), respectively, and specificities of all test kits were 100% (CI: 99.1-100%). Significant (P < 0.05) reduction in the cost of establishing HTC centre and consumables by 94 and 61%, respectively, were observed. The cost of administration and external quality assurance reduced by 39 and 43%, respectively. Overall, there was a 36% cost reduction in total operational cost of rapid HIV testing with blood when compared with serum. Considering the similar sensitivity and specificity of the two specimens, and significant cost reduction, rapid HIV testing with whole blood is feasible. A review of the national HIV rapid testing algorithm with whole blood will contribute toward improving HTC coverage in Bangladesh.

  9. Do sediment type and test durations affect results of laboratory-based, accelerated testing studies of permeable pavement clogging?

    Science.gov (United States)

    Nichols, Peter W B; White, Richard; Lucke, Terry

    2015-04-01

    Previous studies have attempted to quantify the clogging processes of Permeable Interlocking Concrete Pavers (PICPs) using accelerated testing methods. However, the results have been variable. This study investigated the effects that three different sediment types (natural and silica), and different simulated rainfall intensities, and testing durations had on the observed clogging processes (and measured surface infiltration rates) of laboratory-based, accelerated PICP testing studies. Results showed that accelerated simulated laboratory testing results are highly dependent on the type, and size of sediment used in the experiments. For example, when using real stormwater sediment up to 1.18 mm in size, the results showed that neither testing duration, nor stormwater application rate had any significant effect on PICP clogging. However, the study clearly showed that shorter testing durations generally increased clogging and reduced the surface infiltration rates of the models when artificial silica sediment was used. Longer testing durations also generally increased clogging of the models when using fine sediment (<300 μm). Results from this study will help researchers and designers better anticipate when and why PICPs are susceptible to clogging, reduce maintenance and extend the useful life of these increasingly common stormwater best management practices. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Heavy Metal Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/heavymetalbloodtest.html Heavy Metal Blood Test To use the sharing features ... this page, please enable JavaScript. What is a Heavy Metal Blood Test? A heavy metal blood test ...

  11. [On-site laboratory monitoring on the intensive care unit. Blood gas, electrolyte, glucose, hemoglobin and lactate determination with the CIBA Corning 865 Analysis System].

    Science.gov (United States)

    Gödje, O; Fuchs, A; Dewald, O; Fischlein, T; Reichart, B

    1997-09-01

    For decision-making in the ICU, rapid and accurate analysis of vital laboratory parameters is essential. The industry provides devices which analyse these parameters on a decentralised setting and which are designed for use by non-laboratory personnel. We investigated whether accuracy and handling of a new analyser (Ciba-Corning 865, Chiron Diagnostics, Medfield, USA) are good enough for basing clinical decisions on the measured parameters. The Ciba-Corning 865 allows measurement of blood gases, electrolytes, haemoglobin, glucose and lactate by use of photometric, ion-selective, enzymatic and electrochemical sensors in less than 18 microliters of whole blood. In a cardiac surgical intensive-care unit the accuracy of the device was tested by comparison to 61 measurements of quality control reagents, 48 tonometered blood samples and 536 parallel measurements in the clinical laboratory. Besides a 10-minute instruction, the participating personnel had no formal training with the device. The differences between measurements in quality control reagents and tonometered blood and the expected value were lower than 5%. The comparison with clinical laboratory measurements showed correlation coefficients from 0.94 (sodium) to 0.99 (glucose, lactate). The biases in Bland-Altman analyses were below 5%, the limits of agreement were found to be in a clinically acceptable range for all parameters. During the test period no technical problems occurred with the analyser and good acceptance by the personnel was found. The measured parameters were accurate enough to be used for therapeutic decisions in acute care medicine. Although it should not be a complete alternative to the clinical laboratory, because of rapid analyses, small sample volumes and easy handling the use of the Ciba-Corning 865 is advantageous for patients and users.

  12. Anion Gap Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... https://medlineplus.gov/labtests/aniongapbloodtest.html Anion Gap Blood Test To use the sharing features on this page, please enable JavaScript. What is an Anion Gap Blood Test? An anion gap blood test is a way ...

  13. 222-S LABORATORY FUME HOOD TESTING STUDY

    International Nuclear Information System (INIS)

    RUELAS, B.H.

    2007-01-01

    The 222-S Laboratory contains 155 active fume hoods that are used to support analytical work with radioactive and/or toxic materials. The performance of a fume hood was brought into question after employees detected odors in the work area while mixing chemicals within the subject fume hood. Following the event, testing of the fume hood was conducted to assess the performance of the fume hood. Based on observations from the testing, it was deemed appropriate to conduct performance evaluations of other fume hoods within the laboratory

  14. The Cost-Effective Laboratory: Implementation of Economic Evaluation of Laboratory Testing

    Directory of Open Access Journals (Sweden)

    Bogavac-Stanojevic Natasa

    2017-09-01

    Full Text Available Laboratory testing as a part of laboratory in vitro diagnostic (IVD has become required tool in clinical practice for diagnosing, monitoring and prognosis of diseases, as well as for prediction of treatment response. The number of IVD tests available in laboratory practice has increased over the past decades and is likely to further increase in the future. Consequently, there is growing concern about the overutilization of laboratory tests and rising costs for laboratory testing. It is estimated that IVD accounts for between 1.4 and 2.3% of total healthcare expenditure and less than 5% of total hospital cost (Lewin Group report. These costs are rather low when compared to pharmaceuticals and medical aids which account for 15 and 5%, respectively. On the other hand, IVD tests play an important role in clinical practice, as they influence from 60% to 70% of clinical decision-making. Unfortunately, constant increases in healthcare spending are not directly related to healthcare benefit. Since healthcare resources are limited, health payers are interested whether the benefits of IVD tests are actually worth their cost. Many articles have introduced frameworks to assess the economic value of IVD tests. The most appropriate tool for quantitative assessment of their economic value is cost-effectiveness (CEA and cost-utility (CUA analysis. The both analysis determine cost in terms of effectiveness or utilities (combine quantity and quality of life of new laboratory test against its alternative. On the other hand, some investigators recommended calculation of laboratory test value as product of two ratios: Laboratory test value = (Technical accuracy/Turnaround time × (Utility/Costs. Recently, some researches used multicriteria decision analysis which allows comparison of diagnostic strategies in terms of benefits, opportunities, costs and risks. All analyses are constructed to identify laboratory test that produce the greatest healthcare benefit with

  15. Blood Test: Comprehensive Metabolic Panel (CMP)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Blood Test: Comprehensive Metabolic Panel (CMP) KidsHealth / For Parents / Blood ... de sangre: panel metabólico ampliado What Is a Blood Test? A blood test is when a sample of ...

  16. Development of a Whole Blood Paper-Based Device for Phenylalanine Detection in the Context of PKU Therapy Monitoring

    Directory of Open Access Journals (Sweden)

    Robert Robinson

    2016-02-01

    Full Text Available Laboratory-based testing does not allow for the sufficiently rapid return of data to enable optimal therapeutic monitoring of patients with metabolic diseases such as phenylketonuria (PKU. The typical turn-around time of several days for current laboratory-based testing is too slow to be practically useful for effective monitoring or optimizing therapy. This report describes the development of a rapid, paper-based, point-of-care device for phenylalanine detection using a small volume (40 μL of whole blood. The quantitative resolution and reproducibility of this device with instrumented readout are described, together with the potential use of this device for point-of-care monitoring by PKU patients.

  17. Laboratory development and testing of spacecraft diagnostics

    Science.gov (United States)

    Amatucci, William; Tejero, Erik; Blackwell, Dave; Walker, Dave; Gatling, George; Enloe, Lon; Gillman, Eric

    2017-10-01

    The Naval Research Laboratory's Space Chamber experiment is a large-scale laboratory device dedicated to the creation of large-volume plasmas with parameters scaled to realistic space plasmas. Such devices make valuable contributions to the investigation of space plasma phenomena under controlled, reproducible conditions, allowing for the validation of theoretical models being applied to space data. However, in addition to investigations such as plasma wave and instability studies, such devices can also make valuable contributions to the development and testing of space plasma diagnostics. One example is the plasma impedance probe developed at NRL. Originally developed as a laboratory diagnostic, the sensor has now been flown on a sounding rocket, is included on a CubeSat experiment, and will be included on the DoD Space Test Program's STP-H6 experiment on the International Space Station. In this talk, we will describe how the laboratory simulation of space plasmas made this development path possible. Work sponsored by the US Naval Research Laboratory Base Program.

  18. Parathyroid hormone (PTH) blood test

    Science.gov (United States)

    ... PTH) intact molecule; Intact PTH; Hyperparathyroidism - PTH blood test; Hypoparathyroidism - PTH blood test ... drinking for some period of time before the test. Most often, you will not need to fast ...

  19. LABORATORY EXAMINATION IN NERVE AGENT INTOXICATION

    Directory of Open Access Journals (Sweden)

    Jiří Bajgar

    2013-01-01

    Full Text Available Diagnosis of nerve agent intoxication is based on anamnestic data, clinical signs and laboratory examination. For acute poisoning, cholinesterase activity in the blood (erythrocyte AChE, plasma/serum BuChE is sensitive, simple and most frequent laboratory examination performed in biochemical laboratories. Specialized examinations to precise treatment (reactivation test or to make retrospective diagnosis (fluoride induced reactivation etc. can be conducted. Other sophisticated methods are available, too.

  20. Fibrin degradation products blood test

    Science.gov (United States)

    ... behind when clots dissolve in the blood. A blood test can be done to measure these products. ... Certain medicines can change blood test results. Tell your health care provider about all the medicines you take. Your provider will tell you if you need ...

  1. Intra-laboratory validation of a human cell based in vitro angiogenesis assay for testing angiogenesis modulators

    Directory of Open Access Journals (Sweden)

    Jertta-Riina Sarkanen

    2011-01-01

    Full Text Available The developed standardized human cell based in vitro angiogenesis assay was intra-laboratory validated to verify that the method is reliable and relevant for routine testing of modulators of angiogenesis e.g. pharmaceuticals and industrial chemicals. This assay is based on the earlier published method but it was improved and shown to be more sensitive and rapid than the previous assay. The performance of the assay was assessed by using 6 reference chemicals, which are widely used pharmaceuticals that inhibit angiogenesis: acetyl salicylic acid, erlotinib, 2-methoxyestradiol, levamisole, thalidomide, and anti-vascular endothelial growth factor. In the intra-laboratory validation, the sensitivity of the assay (upper and lower limits of detection and linearity of response in tubule formation, batch to batch variation in tubule formation between different Master cell bank batches, and precision as well as the reliability of the assay (reproducibility and repeatability were tested. The pre-set acceptance criteria for the intra-laboratory validation study were met. The relevance of the assay in man was investigated by comparing the effects of reference chemicals and their concentrations to the published human data. The comparison showed a good concordance, which indicates that this human cell based angiogenesis model predicts well the effects in man and has the potential to be used to supplement and/or replace of animal tests.

  2. [Costs of Chagas' disease screening test in blood donors in two Colombian blood banks, 2015].

    Science.gov (United States)

    Alvis, Nelson José; Díaz, Diana Patricia; Castillo, Liliana; Alvis, Nelson Rafael; Bermúdez, María Isabel; Berrío, Olga Maritza; Beltrán, Mauricio; Castañeda-Orjuela, Carlos Andrés

    2018-03-15

    Transfusion is a mechanism of transmission of Chagas' disease. There are no studies on the costs of the screening test in Colombian blood banks. To estimate the costs of the screening test for Chagas' disease among blood donors in two Colombian blood banks, 2015. We conducted a micro-costing study from the perspective of the health care provider to estimate the cost of Chagas' disease testing in two blood banks, Banco de Sangre de la Cruz Roja, Seccional Bolívar, and Banco de Sangre del Hospital de Yopal, Casanare, taking into account four cost categories: 1) Administrative costs: public services and insurance costs were calculated based on the blood bank area in square meters; 2) capital costs: building and equipment costs that were annualized using a 3% discount rate and a lifespan of 20 years for building and five for equipment; 3) costs of Chagas' disease test materials and reagents adjusted by blood bank production level, and 4) costs of staff in charge of Chagas' disease test processing. The costs of transfusion bagsand immunohematology tests are also reported. The cost of Chagas' disease test in the blood bank of Seccional Bolívar was COP$ 37,804 (USD$ 12), and the blood bag and immunohematology test costs were COP$ 25,941 (USD$ 8.2) and COP$ 6,800 (USD$ 2.2), respectively. In the blood bank of Yopal, Casanare, the costs were COP$ 77,384 (USD$ 24.6), COP$ 30,141 (USD$ 9.6) and COP$ 12,627 (USD$ 4), respectively. Personnel cost accounted for the highest percentage of the total cost for both blood banks (47.5% in Seccional Bolívar, and 55.7% in Yopal, Casanare). Our results are an important input for the planning of services and cost-effectiveness studies for screening tests for Chagas' disease in Colombian blood banks.

  3. Laboratory- and field-based testing as predictors of skating performance in competitive-level female ice hockey

    Directory of Open Access Journals (Sweden)

    Henriksson T

    2016-08-01

    Full Text Available Tommy Henriksson,1,2 Jason D Vescovi,3 Anncristine Fjellman-Wiklund,4 Kajsa Gilenstam1 1Sport Medicine Unit, Department of Community Medicine and Rehabilitation, 2The National Graduate School of Gender Studies, Umeå University, Umeå, Sweden; 3Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; 4Physiotherapy Unit, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden Objectives: The purpose of this study was to examine whether field-based and/or laboratory-based assessments are valid tools for predicting key performance characteristics of skating in competitive-level female hockey players.Design: Cross-sectional study.Methods: Twenty-three female ice hockey players aged 15–25 years (body mass: 66.1±6.3 kg; height: 169.5±5.5 cm, with 10.6±3.2 years playing experience volunteered to participate in the study. The field-based assessments included 20 m sprint, squat jump, countermovement jump, 30-second repeated jump test, standing long jump, single-leg standing long jump, 20 m shuttle run test, isometric leg pull, one-repetition maximum bench press, and one-repetition maximum squats. The laboratory-based assessments included body composition (dual energy X-ray absorptiometry, maximal aerobic power, and isokinetic strength (Biodex. The on-ice tests included agility cornering s-turn, cone agility skate, transition agility skate, and modified repeat skate sprint. Data were analyzed using stepwise multivariate linear regression analysis. Linear regression analysis was used to establish the relationship between key performance characteristics of skating and the predictor variables.Results: Regression models (adj R2 for the on-ice variables ranged from 0.244 to 0.663 for the field-based assessments and from 0.136 to 0.420 for the laboratory-based assessments. Single-leg tests were the strongest predictors for key performance characteristics of skating. Single leg standing

  4. Comparison of 2 electronic cowside tests to detect subclinical ketosis in dairy cows and the influence of the temperature and type of blood sample on the test results.

    Science.gov (United States)

    Iwersen, M; Klein-Jöbstl, D; Pichler, M; Roland, L; Fidlschuster, B; Schwendenwein, I; Drillich, M

    2013-01-01

    The objective of this study was to determine the suitability of 2 electronic hand-held devices [FreeStyle Precision (FSP), Abbott GmbH & Co. KG, Wiesbaden, Germany and GlucoMen LX Plus (GLX), A. Menarini GmbH, Vienna, Austria] for measuring β-hydroxybutyrate (BHBA) in dairy cows. Three experiments were conducted to evaluate (1) the diagnostic performance of the devices, (2) the effect of the type of blood sample, and (3) the influence of the ambient temperature on the determined results. A total of 415 blood samples from lactating Holstein and Simmental cows were collected and analyzed with both devices (whole blood) and in a laboratory (serum). Correlation coefficients between whole-blood and serum BHBA concentrations were highly significant, with 94% for the FSP and 80% for the GLX device. Based on thresholds for subclinical ketosis of 1.2 and 1.4 mmol of BHBA/L, results obtained with the hand-held devices were evaluated by receiver operating characteristics analyses. This resulted in adjusted thresholds of 1.2 and 1.4 mmol/L for the FSP and 1.1 and 1.3 mmol/L for the GLX device. Applying these thresholds, sensitivities were 98 and 100% for the FSP and 80 and 86% for the GLX device, respectively. Corresponding specificities were 90 and 97% for the FSP and 87 and 96% for the GLX device, respectively. Additionally, concentrations of BHBA were tested with both devices in whole blood, EDTA-added whole blood, and in their resulting serum and plasma, collected from 65 animals. Determined BHBA concentrations were similar within each device for whole and EDTA-added blood, and in serum and plasma, but differed between whole blood and serum and between EDTA-added blood and plasma. Blood samples with low (0.4 mmol/L), medium (1.1 mmol/L), and high (1.6 mmol/L) BHBA concentrations were stored between +5 to +32°C and analyzed repeatedly at temperature levels differing by 4°C. Additionally, devices and test strips were stored at equal conditions and used for measurement

  5. Post-test probability for neonatal hyperbilirubinemia based on umbilical cord blood bilirubin, direct antiglobulin test, and ABO compatibility results.

    Science.gov (United States)

    Peeters, Bart; Geerts, Inge; Van Mullem, Mia; Micalessi, Isabel; Saegeman, Veroniek; Moerman, Jan

    2016-05-01

    Many hospitals opt for early postnatal discharge of newborns with a potential risk of readmission for neonatal hyperbilirubinemia. Assays/algorithms with the possibility to improve prediction of significant neonatal hyperbilirubinemia are needed to optimize screening protocols and safe discharge of neonates. This study investigated the predictive value of umbilical cord blood (UCB) testing for significant hyperbilirubinemia. Neonatal UCB bilirubin, UCB direct antiglobulin test (DAT), and blood group were determined, as well as the maternal blood group and the red blood cell antibody status. Moreover, in newborns with clinically apparent jaundice after visual assessment, plasma total bilirubin (TB) was measured. Clinical factors positively associated with UCB bilirubin were ABO incompatibility, positive DAT, presence of maternal red cell antibodies, alarming visual assessment and significant hyperbilirubinemia in the first 6 days of life. UCB bilirubin performed clinically well with an area under the receiver-operating characteristic curve (AUC) of 0.82 (95 % CI 0.80-0.84). The combined UCB bilirubin, DAT, and blood group analysis outperformed results of these parameters considered separately to detect significant hyperbilirubinemia and correlated exponentially with hyperbilirubinemia post-test probability. Post-test probabilities for neonatal hyperbilirubinemia can be calculated using exponential functions defined by UCB bilirubin, DAT, and ABO compatibility results. • The diagnostic value of the triad umbilical cord blood bilirubin measurement, direct antiglobulin testing and blood group analysis for neonatal hyperbilirubinemia remains unclear in literature. • Currently no guideline recommends screening for hyperbilirubinemia using umbilical cord blood. What is New: • Post-test probability for hyperbilirubinemia correlated exponentially with umbilical cord blood bilirubin in different risk groups defined by direct antiglobulin test and ABO blood group

  6. Reduction in unnecessary red blood cell folate testing by restricting computerized physician order entry in the electronic health record.

    Science.gov (United States)

    MacMillan, Thomas E; Gudgeon, Patrick; Yip, Paul M; Cavalcanti, Rodrigo B

    2018-05-02

    Red blood cell folate is a laboratory test with limited clinical utility. Previous attempts to reduce physician ordering of unnecessary laboratory tests, including folate, have resulted in only modest success. The objective of this study was to assess the effectiveness and impacts of restricting red blood cell folate ordering in the electronic health record. This was a retrospective observational study from January 2010 to December 2016 at a large academic healthcare network in Toronto, Canada. All inpatients and outpatients who underwent at least 1 red blood cell folate or vitamin B12 test during the study period were included. Red blood cell folate ordering was restricted to clincians in gastroenterology and hematology and was removed from other physicians' computerized order entry screen in the electronic health record in June 2013. Red blood cell folate testing decreased by 94.4% during the study, from a mean of 493.0 (SD 48.0) tests/month before intervention to 27.6 (SD 10.3) tests/month after intervention (P<.001). Restricting red blood cell folate ordering in the electronic health record resulted in a large and sustained reduction in red blood cell folate testing. Significant cost savings estimated at over a quarter-million dollars (CAD) over three years were achieved. There was no significant clinical impact of the intervention on the diagnosis of folate deficiency. Copyright © 2018. Published by Elsevier Inc.

  7. The quality of veterinary in-clinic and reference laboratory biochemical testing.

    Science.gov (United States)

    Rishniw, Mark; Pion, Paul D; Maher, Tammy

    2012-03-01

    Although evaluation of biochemical analytes in blood is common in veterinary practice, studies assessing the global quality of veterinary in-clinic and reference laboratory testing have not been reported. The aim of this study was to assess the quality of biochemical testing in veterinary laboratories using results obtained from analyses of 3 levels of assayed quality control materials over 5 days. Quality was assessed by comparison of calculated total error with quality requirements, determination of sigma metrics, use of a quality goal index to determine factors contributing to poor performance, and agreement between in-clinic and reference laboratory mean results. The suitability of in-clinic and reference laboratory instruments for statistical quality control was determined using adaptations from the computerized program, EZRules3. Reference laboratories were able to achieve desirable quality requirements more frequently than in-clinic laboratories. Across all 3 materials, > 50% of in-clinic analyzers achieved a sigma metric ≥ 6.0 for measurement of 2 analytes, whereas > 50% of reference laboratory analyzers achieved a sigma metric ≥ 6.0 for measurement of 6 analytes. Expanded uncertainty of measurement and ± total allowable error resulted in the highest mean percentages of analytes demonstrating agreement between in-clinic and reference laboratories. Owing to marked variation in bias and coefficient of variation between analyzers of the same and different types, the percentages of analytes suitable for statistical quality control varied widely. These findings reflect the current state-of-the-art with regard to in-clinic and reference laboratory analyzer performance and provide a baseline for future evaluations of the quality of veterinary laboratory testing. © 2012 American Society for Veterinary Clinical Pathology.

  8. Understanding Laboratory Tests

    Science.gov (United States)

    ... and Drug Administration (FDA) regulates the development and marketing of all laboratory tests that use test kits ... Cancer.gov en español Multimedia Publications Site Map Digital Standards for NCI Websites POLICIES Accessibility Comment Policy ...

  9. Metallurgical Laboratory and Components Testing

    Data.gov (United States)

    Federal Laboratory Consortium — In the field of metallurgy, TTC is equipped to run laboratory tests on track and rolling stock components and materials. The testing lab contains scanning-electron,...

  10. Evaluation of the agreement among three handheld blood glucose meters and a laboratory blood analyzer for measurement of blood glucose concentration in Hispaniolan Amazon parrots (Amazona ventralis).

    Science.gov (United States)

    Acierno, Mark J; Mitchell, Mark A; Schuster, Patricia J; Freeman, Diana; Sanchez-Migallon Guzman, David; Tully, Thomas N

    2009-02-01

    To determine the degree of agreement between 3 commercially available point-of-care blood glucose meters and a laboratory analyzer for measurement of blood glucose concentrations in Hispaniolan Amazon parrots (Amazona ventralis). 20 healthy adult Hispaniolan Amazon parrots. A 26-gauge needle and 3-mL syringe were used to obtain a blood sample (approx 0.5 mL) from a jugular vein of each parrot. Small volumes of blood (0.6 to 1.5 microL) were used to operate each of the blood glucose meters, and the remainder was placed into lithium heparin microtubes and centrifuged. Plasma was harvested and frozen at -30 degrees C. Within 5 days after collection, plasma samples were thawed and plasma glucose concentrations were measured by means of the laboratory analyzer. Agreement between pairs of blood glucose meters and between each blood glucose meter and the laboratory analyzer was evaluated by means of the Bland-Altman method, and limits of agreement (LOA) were calculated. None of the results of the 3 blood glucose meters agreed with results of the laboratory analyzer. Each point-of-care blood glucose meter underestimated the blood glucose concentration, and the degree of negative bias was not consistent (meter A bias, -94.9 mg/dL [LOA, -148.0 to -41.7 mg/dL]; meter B bias, -52 mg/dL [LOA, -107.5 to 3.5 mg/dL]; and meter C bias, -78.9 mg/dL [LOA, -137.2 to -20.6 mg/dL]). On the basis of these results, use of handheld blood glucose meters in the diagnosis or treatment of Hispaniolan Amazon parrots and other psittacines cannot be recommended.

  11. Transfusions of blood and blood products and viral infections

    Directory of Open Access Journals (Sweden)

    Marta Wróblewska

    2002-06-01

    Full Text Available Transfusions of blood and blood products are commonly used in medicine, but being biological materials they carry a risk of transmitting infections--viral, bacterial, parasitic, as well as prions. Laboratory tests used for screening of donated blood for viral infections at present cannot detect all infectious units. Criteria for selection of blood donors therefore must be very strict, while methods of inactivation of viruses and laboratory assays for detection of their presence must be improved. Indications for blood transfusion should be restricted.

  12. Laboratory diagnostics of malaria

    Science.gov (United States)

    Siahaan, L.

    2018-03-01

    Even now, malaria treatment should only be administered after laboratory confirmation. There are several principal methods for diagnosing malaria. All these methods have their disadvantages.Presumptive treatment of malaria is widely practiced where laboratory tests are not readily available. Microscopy of Giemsa-stained thick and thin blood films remains the gold standard for the diagnosis of malaria infection. The technique of slide preparation, staining and reading are well known and standardized, and so is the estimate of the parasite density and parasite stages. Microscopy is not always available or feasible at primary health services in limited resource settings due to cost, lack of skilled manpower, accessories and reagents required. Rapid diagnostic tests (RDTs) are potential tools for parasite-based diagnosis since the tests are accurate in detecting malaria infections and are easy to use. The test is based on the capture of parasite antigen that released from parasitized red blood cells using monoclonal antibodies prepared against malaria antigen target. Polymerase Chain Reaction (PCR), depend on DNA amplification approaches and have higher sensitivity than microscopy. PCR it is not widely used due to the lack of a standardized methodology, high costs, and the need for highly-trained staff.

  13. Sensitivity and Specificity of Clinical and Laboratory Otolith Function Tests.

    Science.gov (United States)

    Kumar, Lokesh; Thakar, Alok; Thakur, Bhaskar; Sikka, Kapil

    2017-10-01

    To evaluate clinic based and laboratory tests of otolith function for their sensitivity and specificity in demarcating unilateral compensated complete vestibular deficit from normal. Prospective cross-sectional study. Tertiary care hospital vestibular physiology laboratory. Control group-30 healthy adults, 20-45 years age; Case group-15 subjects post vestibular shwannoma excision or post-labyrinthectomy with compensated unilateral complete audio-vestibular loss. Otolith function evaluation by precise clinical testing (head tilt test-HTT; subjective visual vertical-SVV) and laboratory testing (headroll-eye counterroll-HR-ECR; vesibular evoked myogenic potentials-cVEMP). Sensitivity and specificity of clinical and laboratory tests in differentiating case and control subjects. Measurable test results were universally obtained with clinical otolith tests (SVV; HTT) but not with laboratory tests. The HR-ECR test did not indicate any definitive wave forms in 10% controls and 26% cases. cVEMP responses were absent in 10% controls.HTT test with normative cutoff at 2 degrees deviations from vertical noted as 93.33% sensitive and 100% specific. SVV test with normative cutoff at 1.3 degrees noted as 100% sensitive and 100% specific. Laboratory tests demonstrated poorer specificities owing primarily to significant unresponsiveness in normal controls. Clinical otolith function tests, if conducted with precision, demonstrate greater ability than laboratory testing in discriminating normal controls from cases with unilateral complete compensated vestibular dysfunction.

  14. Total laboratory automation: Do stat tests still matter?

    Science.gov (United States)

    Dolci, Alberto; Giavarina, Davide; Pasqualetti, Sara; Szőke, Dominika; Panteghini, Mauro

    2017-07-01

    During the past decades the healthcare systems have rapidly changed and today hospital care is primarily advocated for critical patients and acute treatments, for which laboratory test results are crucial and need to be always reported in predictably short turnaround time (TAT). Laboratories in the hospital setting can face this challenge by changing their organization from a compartmentalized laboratory department toward a decision making-based laboratory department. This requires the implementation of a core laboratory, that exploits total laboratory automation (TLA) using technological innovation in analytical platforms, track systems and information technology, including middleware, and a number of satellite specialized laboratory sections cooperating with care teams for specific medical conditions. In this laboratory department model, the short TAT for all first-line tests performed by TLA in the core laboratory represents the key paradigm, where no more stat testing is required because all samples are handled in real-time and (auto)validated results dispatched in a time that fulfills clinical needs. To optimally reach this goal, laboratories should be actively involved in managing all the steps covering the total examination process, speeding up also extra-laboratory phases, such sample delivery. Furthermore, to warrant effectiveness and not only efficiency, all the processes, e.g. specimen integrity check, should be managed by middleware through a predefined set of rules defined in light of the clinical governance. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  15. Tularemia blood test

    Science.gov (United States)

    Tularemia test; Serology for Francisella tularensis ... This blood test is done when tularemia is suspected. ... Elsevier; 2017:chap 44. Chernecky CC, Berger BJ. Tularemia agglutinins - serum. In: Chernecky CC, Berger BJ, eds. ...

  16. Investigation of laboratory test procedures for assessing the structural capacity of geogrid-reinforced aggregate base materials.

    Science.gov (United States)

    2015-04-01

    The objective of this research was to identify a laboratory test method that can be used to quantify improvements in structural capacity of aggregate base materials reinforced with geogrid. For this research, National Cooperative Highway Research Pro...

  17. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis

    DEFF Research Database (Denmark)

    Dessau, Ram B; van Dam, Alje P; Fingerle, Volker

    2018-01-01

    rational use of laboratory testing in patients with clinically suspected Lyme borreliosis. SOURCES: This is a narrative review combining various aspects of the clinical and laboratory diagnosis with an educational purpose. The literature search was based on existing systematic reviews, national...... and international guidelines and supplemented with specific citations. IMPLICATIONS: The main recommendations according to current European case definitions for Lyme borreliosis are as follows: Typical erythema migrans should be diagnosed clinically and does not require laboratory testing, the diagnosis of Lyme...

  18. Allergy Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/allergybloodtest.html Allergy Blood Test To use the sharing features on this page, please enable JavaScript. What is an Allergy Blood Test? Allergies are a common and chronic ...

  19. Direct identification and susceptibility testing of positive blood cultures using high speed cold centrifugation and Vitek II system.

    Science.gov (United States)

    Bazzi, Ali M; Rabaan, Ali A; Fawarah, Mahmoud M; Al-Tawfiq, Jaffar A

    Compared to routine isolated colony-based methods, direct testing of bacterial pellets from positive blood cultures reduces turnaround time for reporting of antibiotic susceptibility. The aim of this study was to compare the accuracy, and precision, of a rapid method for direct identification and susceptibility testing of blood cultures with the routine method used in our laboratory, using Vitek 2. A total of 60 isolates were evaluated using the candidate and the routine method. The candidate method had 100% accuracy for the identification of Gram negative bacteria, Staphylococcus and Enterococcus, 50% for Streptococcus and 33.3% for Corynebacterium species. Susceptibility testing of Gram negative isolates yielded 98-100% essential agreement. For Staphylococcus and Enterococcus isolates, essential agreement was 100% for 17 antibiotics except for moxifloxacin. Direct testing of blood culture samples with Vitek 2 produced reliable identification and susceptibility results 18-24h sooner for aerobic/anaerobic facultative Gram-negative bacteria and Gram-positive Staphylococcus and Enterococcus strains. Copyright © 2016 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

  20. POPULATION BASED COLORECTAL CANCER SCREENING: COMPARISON OF TWO FAECAL OCCULT BLOOD TESTS

    Directory of Open Access Journals (Sweden)

    Miren Begoña eZubero

    2014-01-01

    Full Text Available Background: The aim of screening for colorectal cancer is to improve prognosis by the detection of cancer at its early stages. In order to inform the decision on the specific test to be used in the population-based programme in the Basque Autonomous Region (Spain, we compared two immunochemical faecal occult blood quantitative tests (I-FOBT. Methods: Residents of selected study areas, aged 50-69 years, were invited to participate in the screening. Two tests based on latex agglutination (OC-Sensor and FOB Gold were randomly assigned to different study areas. A colonoscopy was offered to patients with a positive test result. The cut-off point used to classify a result as positive, according to manufacturer’s recommendations, was 100 ng/ml for both tests. Results: The invited population included 37,999 individuals. Participation rates were 61.8% (n=11,162 for OC-Sensor and 59.1% (n=11,786 for FOB Gold, (p=0.008. Positive rate for OC-Sensor was 6.6% (n=737 and 8.5% (n=1,002 for FOB Gold, (pConclusions: OC-Sensor test appears to be superior for I-FOBT based CRC screening, given its acceptance, ease of use, associated small number of errors and its screening accuracy. FOB-Gold on the other hand, has higher rate of positive values, with more colonoscopies performed, it shows higher detection incidence rates, but involves more false positives.

  1. Abnormalities of laboratory coagulation tests versus clinically evident coagulopathic bleeding

    DEFF Research Database (Denmark)

    Chang, Ronald; Fox, Erin E; Greene, Thomas J

    2018-01-01

    BACKGROUND: Laboratory-based evidence of coagulopathy (LC) is observed in 25-35% of trauma patients, but clinically-evident coagulopathy (CC) is not well described. METHODS: Prospective observational study of adult trauma patients transported by helicopter from the scene to nine Level 1 trauma...... centers in 2015. Patients meeting predefined highest-risk criteria were divided into CC+ (predefined as surgeon-confirmed bleeding from uninjured sites or injured sites not controllable by sutures) or CC-. We used a mixed-effects, Poisson regression with robust error variance to test the hypothesis...... that abnormalities on rapid thrombelastography (r-TEG) and international normalized ratio (INR) were independently associated with CC+. RESULTS: Of 1,019 highest-risk patients, CC+ (n=41, 4%) were more severely injured (median ISS 32 vs 17), had evidence of LC on r-TEG and INR, received more transfused blood...

  2. Lipoprotein (a) Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... this page: https://medlineplus.gov/labtests/lipoproteinabloodtest.html Lipoprotein (a) Blood Test To use the sharing features ... this page, please enable JavaScript. What is a Lipoprotein (a) Blood Test? A lipoprotein (a) test measures ...

  3. Medical Laboratory Technician--Hematology, Serology, Blood Banking, and Immunohematology (AFSC 90470).

    Science.gov (United States)

    Thompson, Joselyn H.

    This three-volume student text is designed for use by Air Force personnel enrolled in a self-study extension course for medical laboratory technicians. Covered in the individual volumes are hematology (the physiology of blood, complete blood counts and related studies, erythrocyte studies, leukocyte and thrombocyte maturation, and blood…

  4. Stochastic optimization of laboratory test workflow at metallurgical testing centers

    Directory of Open Access Journals (Sweden)

    F. Tošenovský

    2016-10-01

    Full Text Available The objective of the paper is to present a way to shorten the time required to perform laboratory tests of materials in metallurgy. The paper finds a relation between the time to perform a test of materials and the number of technicians carrying out the test. The relation can be used to optimize the number of technicians. The approach is based on probability theory, as the amount of material to be tested is unknown in advance, and uses powerful modelling techniques involving the generalized estimating equations.

  5. Aspartate aminotransferase (AST) blood test

    Science.gov (United States)

    ... gov/ency/article/003472.htm Aspartate aminotransferase (AST) blood test To use the sharing features on this page, please enable JavaScript. The aspartate aminotransferase (AST) blood test measures the level of the enzyme AST in ...

  6. Alanine transaminase (ALT) blood test

    Science.gov (United States)

    ... gov/ency/article/003473.htm Alanine transaminase (ALT) blood test To use the sharing features on this page, please enable JavaScript. The alanine transaminase (ALT) blood test measures the level of the enzyme ALT in ...

  7. 21 CFR 640.23 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... this chapter and § 640.5 (a), (b), and (c). (b) The tests shall be performed on a sample of blood... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.23 Section 640.23 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Platelets § 640.23 Testing the blood. (a) Blood from...

  8. Rapid identification and antimicrobial susceptibility testing of positive blood cultures using MALDI-TOF MS and a modification of the standardised disc diffusion test: a pilot study.

    LENUS (Irish Health Repository)

    Fitzgerald, C

    2016-04-27

    In an era when clinical microbiology laboratories are under increasing financial pressure, there is a need for inexpensive, yet effective, rapid microbiology tests. The aim of this study was to evaluate a novel modification of standard methodology for the identification and antimicrobial susceptibility testing (AST) of pathogens in positive blood cultures, reducing the turnaround time of laboratory results by 24 h.

  9. Validation of a Blood-Based Laboratory Test to Aid in the Confirmation of a Diagnosis of Schizophrenia

    NARCIS (Netherlands)

    E. Schwartz (Emanuel); R. Izmailov (Rauf); M. Spain (Michael); A. Barnes (Anthony); J.P. Mapes (James); P.C. Guest (Paul); H. Rahmoune (Hassan); S. Pietsch (Sandra); F.M. Leweke (Marcus); M. Rothermundt (Matthias); J. Steiner (Johann); D. Koethe (Dagmar); L. Kranaster (Laura); P. Ohrmann (Patricia); T. Suslow (Thomas); Y. Levin (Yishai); B. Bogerts (Bernhard); N.J.M. van Beveren (Nico); G. McAllister (George); N. Weber (Natalya); D. Niebuhr (David); D. Cowan (David); R.H. Yolken (Robert); S. Bahn (Sabine)

    2010-01-01

    textabstractAbstract: We describe the validation of a serum-based test developed by Rules-Based Medicine which can be used to help confirm the diagnosis of schizophrenia. In preliminary studies using multiplex immunoassay profiling technology, we identified a disease signature comprised of 51

  10. Laboratory Medicine Best Practice Guideline: Vitamins A, E and the Carotenoids in Blood

    Science.gov (United States)

    Greaves, Ronda F; Woollard, Gerald A; Hoad, Kirsten E; Walmsley, Trevor A; Johnson, Lambro A; Briscoe, Scott; Koetsier, Sabrina; Harrower, Tamantha; Gill, Janice P

    2014-01-01

    Despite apparent method similarities between laboratories there appear to be confounding factors inhibiting uniform reporting and standardisation of vitamin assays. The Australasian Association of Clinical Biochemists (AACB) Vitamins Working Party, in conjunction with The Royal College of Pathologists of Australasia Quality Assurance Programs, has formulated a guideline to improve performance, reproducibility and accuracy of fat-soluble vitamin results. The aim of the guideline is to identify critical pre-analytical, analytical and post-analytical components of the analysis of vitamins A, E and carotenoids in blood to promote best practice and harmonisation. This best practice guideline has been developed with reference to the Centers for Disease Control and Prevention (CDC) “Laboratory Medicine Best Practices: Developing an Evidence-Based Review and Evaluation Process”. The CDC document cites an evaluation framework for generating best practice recommendations that are specific to laboratory medicine. These 50 recommendations proposed herein, were generated from a comprehensive literature search and the extensive combined experience of the AACB Vitamins Working Party members. They were formulated based on comparison between an impact assessment rating and strength of evidence and were classified as either: (1) strongly recommend, (2) recommend, (3) no recommendation for or against, or (4) recommend against. These best practice recommendations represent the consensus views, in association with peer reviewed evidence of the AACB Vitamins Working Party, towards best practice for the collection, analysis and interpretation of vitamins A, E and carotenoids in blood. PMID:25210208

  11. Follicle-stimulating hormone (FSH) blood test

    Science.gov (United States)

    ... ency/article/003710.htm Follicle-stimulating hormone (FSH) blood test To use the sharing features on this page, please enable JavaScript. The follicle stimulating hormone (FSH) blood test measures the level of FSH in blood. FSH ...

  12. Laboratory procedures for waste form testing

    International Nuclear Information System (INIS)

    Mast, E.S.

    1994-01-01

    The 100 and 300 areas of the Hanford Site are included on the US Environmental Protection Agencies (EPA) National Priorities List under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Soil washing is a treatment process that is being considered for the remediation of the soil in these areas. Contaminated soil washing fines can be mixed or blended with cementations materials to produce stable waste forms that can be used for beneficial purposes in mixed or low-level waste landfills, burial trenches, environmental restoration sites, and other applications. This process has been termed co-disposal. The Co-Disposal Treatability Study Test Plan is designed to identify a range of cement-based formulations that could be used in disposal efforts in Hanford in co-disposal applications. The purpose of this document is to provide explicit procedural information for the testing of co-disposal formulations. This plan also provides a discussion of laboratory safety and quality assurance necessary to ensure safe, reproducible testing in the laboratory

  13. Laboratory procedures for waste form testing

    Energy Technology Data Exchange (ETDEWEB)

    Mast, E.S.

    1994-09-19

    The 100 and 300 areas of the Hanford Site are included on the US Environmental Protection Agencies (EPA) National Priorities List under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA). Soil washing is a treatment process that is being considered for the remediation of the soil in these areas. Contaminated soil washing fines can be mixed or blended with cementations materials to produce stable waste forms that can be used for beneficial purposes in mixed or low-level waste landfills, burial trenches, environmental restoration sites, and other applications. This process has been termed co-disposal. The Co-Disposal Treatability Study Test Plan is designed to identify a range of cement-based formulations that could be used in disposal efforts in Hanford in co-disposal applications. The purpose of this document is to provide explicit procedural information for the testing of co-disposal formulations. This plan also provides a discussion of laboratory safety and quality assurance necessary to ensure safe, reproducible testing in the laboratory.

  14. Utility of repeat testing of critical values: a Q-probes analysis of 86 clinical laboratories.

    Science.gov (United States)

    Lehman, Christopher M; Howanitz, Peter J; Souers, Rhona; Karcher, Donald S

    2014-06-01

    A common laboratory practice is to repeat critical values before reporting the test results to the clinical care provider. This may be an unnecessary step that delays the reporting of critical test results without adding value to the accuracy of the test result. To determine the proportions of repeated chemistry and hematology critical values that differ significantly from the original value as defined by the participating laboratory, to determine the threshold differences defined by the laboratory as clinically significant, and to determine the additional time required to analyze the repeat test. Participants prospectively reviewed critical test results for 4 laboratory tests: glucose, potassium, white blood cell count, and platelet count. Participants reported the following information: initial and repeated test result; time initial and repeat results were first known to laboratory staff; critical result notification time; if the repeat result was still a critical result; if the repeat result was significantly different from the initial result, as judged by the laboratory professional or policy; significant difference threshold, as defined by the laboratory; the make and model of the instrument used for primary and repeat testing. Routine, repeat analysis of critical values is a common practice. Most laboratories did not formally define a significant difference between repeat results. Repeated results were rarely considered significantly different. Median repeated times were at least 17 to 21 minutes for 10% of laboratories. Twenty percent of laboratories reported at least 1 incident in the last calendar year of delayed result reporting that clinicians indicated had adversely affected patient care. Routine repeat analysis of automated chemistry and hematology critical values is unlikely to be clinically useful and may adversely affect patient care.

  15. Performance of a new test strip for freestyle blood glucose monitoring systems.

    Science.gov (United States)

    Lock, John Paul; Brazg, Ronald; Bernstein, Robert M; Taylor, Elizabeth; Patel, Mona; Ward, Jeanne; Alva, Shridhara; Chen, Ting; Welsh, Zoë; Amor, Walter; Bhogal, Claire; Ng, Ronald

    2011-01-01

    a new strip, designed to enhance the ease of use and minimize interference of non-glucose sugars, has been developed to replace the current FreeStyle (Abbott Diabetes Care, Alameda, CA) blood glucose test strip. We evaluated the performance of this new strip. laboratory evaluation included precision, linearity, dynamic range, effects of operating temperature, humidity, altitude, hematocrit, interferents, and blood reapplication. System accuracy, lay user performance, and ease of use for finger capillary blood testing and accuracy for venous blood testing were evaluated at clinics. Lay users also compared the speed and ease of use between the new strip and the current FreeStyle strip. for glucose concentrations blood glucose results obtained by lay users fell within ± 5, 10, and 15 mg/dL, respectively, of the reference. For glucose concentrations ≥75 mg/dL, 68%, 95%, 99%, and 99% of the lay user results fell within  ±  5%, 10%, 15%, and 20%, respectively, of the reference. Comparable accuracy was obtained in the venous blood study. Lay users found the new test strip easy to use and faster and easier to use than the current FreeStyle strip. The new strip maintained accuracy under various challenging conditions, including high concentrations of various interferents, sample reapplication up to 60 s, and extremes in hematocrit, altitude, and operating temperature and humidity. our results demonstrated excellent accuracy of the new FreeStyle test strip and validated the improvements in minimizing interference and enhancing ease of use.

  16. 21 CFR 640.53 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Testing the blood. 640.53 Section 640.53 Food and... ADDITIONAL STANDARDS FOR HUMAN BLOOD AND BLOOD PRODUCTS Cryoprecipitate § 640.53 Testing the blood. (a) Blood... prescribed in § 610.40 of this chapter and § 640.5 (a), (b), and (c). (b) The tests shall be performed on a...

  17. ALP - blood test

    Science.gov (United States)

    ... Tissues with higher amounts of ALP include the liver, bile ducts, and bone. A blood test can be done ... and the A.D.A.M. Editorial team. Bile Duct Diseases Read more Bone Diseases Read more Liver Function Tests Read more A.D.A.M., ...

  18. A survey on blood group determination

    Science.gov (United States)

    Radhika, K.; Sowjanya, S. J.; Ramya, T.

    2018-04-01

    Detection of blood group is an essential factor in critical conditions before performing blood transfer. At presently tests are conducted by lab technicians manually in the laboratory. When the test is done by technicians with large samples it becomes monotonous to do and sometimes it leads to incorrect results and even its time consuming to get the result. The research survey proposal is to reduce the physical work to identify the blood group with a paper-based device. The paper is having a long thermometer with two ends. By using this we can detect the blood type by changing the color of the paper. Chemical reactions between dye, Bromo creosol green, and blood serum proteins, were performed to test the blood sample. The paper becomes teal or brown color, depending on whether the association of antibodies and antigens are present. It gives the result within 30 seconds, which is quicker than traditional detection system. The tested blood sample had a good accuracy rate.

  19. Parathyroid hormone-related protein blood test

    Science.gov (United States)

    ... ency/article/003691.htm Parathyroid hormone-related protein blood test To use the sharing features on this page, ... measures the level of a hormone in the blood, called parathyroid hormone-related protein. How the Test is Performed A blood sample is needed . How ...

  20. Smartphone-based assessment of blood alteration severity

    Science.gov (United States)

    Li, Xianglin; Xue, Jiaxin; Li, Wei; Li, Ting

    2018-02-01

    Blood quality and safety management is a critical issue for cold chain transportation of blood or blood-based biological reagent. The conventional methods of blood alteration severity assessment mainly rely on kit test or blood-gas analysis required opening the blood package to get samples, which cause possible blood pollution and are complicate, timeconsuming, and expensive. Here we proposed to develop a portable, real-time, safety, easy-operated and low cost method aimed at assessing blood alteration severity. Color images of the blood in transparent blood bags were collected with a smartphone and the alteration severity of the blood was assessed by the smartphone app offered analysis of RGB color values of the blood. The algorithm is based on a large number sample of RGB values of blood at different alteration degree. The blood quality results evaluated by the smartphone are in accordance with the actual data. This study indicates the potential of smart phone in real time, convenient, and reliable blood quality assessment.

  1. [Blood Test Patterns for Blood Donors after Nucleic Acid Detection in the Blood Center].

    Science.gov (United States)

    Men, Shou-Shan; Lv, Lian-Zhi; Chen, Yuan-Feng; Han, Chun-Hua; Liu, Hong-Yu; Yan, Yan

    2017-12-01

    To investigate the blood test patterns for blood donors after nucleic acid detection in blood center. The collected blood samples after voluntary blood donors first were detected by conventional ELISA, then 31981 negative samples were detected via HBV/HCV/HIV combined nucleic acid test of 6 mixed samples(22716 cases) or single samples(9265 cases) by means of Roche cobas s201 instrument. The combined detection method as follows: the blood samples were assayed by conventional nucleic acid test of 6 mixed samples, at same time, 6 mixed samples were treated with polyethylene glycol precipitation method to concentrate the virus, then the nucleic acid test of blood samples was performed; the single detection method as follows: firstly the conventional nucleic acid test of single sample was performed, then the positive reactive samples after re-examination were 6-fold diluted to simulate the nucleic acid test of 6-mixed samples. The positive rate of positive samples detected by combined nucleic acid test, positive samples detected by nucleic acid test of mixed virus concentration and positive samples detected by single nucleic acid test was statistically analyzed. In addition, for HBV + persons the serological test yet should be performed. In 22 716 samples detected by nucleic acid test of 6 mixed samples (MP-6-NAT) , 9 cases were HBV + (0.40‰, 9/22716); at same time, the detection of same samples by nucleic acid test of mixed sample virus concentration showed 29 cases of HBV + (1.28‰, 29/22716). In 9265 samples detected by single nucleic acid test(ID-NAT) 12 cases showed HBV + (1.30‰, 12/9265), meanwhile the detection of these 12 samples with HBV + by 6-fold dilution for virus concentration found only 4 samples with HBV + . In serological qualified samples, ID-NAT unqualified rate was 1.28‰, which was higher than that of MP-6-NAT(0.4‰) (χ 2 =8.11, P0.05). In 41 samples with HBsAg - HBV DNA + detected by ELISA, 36 samples were confirmed to be occult HBV

  2. CO2 blood test

    Science.gov (United States)

    Bicarbonate test; HCO3-; Carbon dioxide test; TCO2; Total CO2; CO2 test - serum; Acidosis - CO2; Alkalosis - CO2 ... Many medicines can interfere with blood test results. Your health ... need to stop taking any medicines before you have this test. DO ...

  3. Exploration of task performance tests in a physics laboratory

    Science.gov (United States)

    Liu, Dan; El Turkey, Houssein

    2017-11-01

    In this article, we investigate the implementation of task performance tests in an undergraduate physics laboratory. Two performance tests were carried out over two semesters using the task of building a DC circuit. The first implementation in Spring 2014 had certain concerns such as the privacy of students’ testing and their ‘trial and error’ attempts. These concerns were addressed in Fall 2015 through implementing a second performance test. The second implementation was administered differently but the content of the two tests was the same. We discuss the validity of both implementations and present the correlation (or lack of) between the time that students needed to complete the tests and their grades from a paper-based laboratory assessment method.

  4. [Quality Management and Quality Specifications of Laboratory Tests in Clinical Studies--Challenges in Pre-Analytical Processes in Clinical Laboratories].

    Science.gov (United States)

    Ishibashi, Midori

    2015-01-01

    The cost, speed, and quality are the three important factors recently indicated by the Ministry of Health, Labour and Welfare (MHLW) for the purpose of accelerating clinical studies. Based on this background, the importance of laboratory tests is increasing, especially in the evaluation of clinical study participants' entry and safety, and drug efficacy. To assure the quality of laboratory tests, providing high-quality laboratory tests is mandatory. For providing adequate quality assurance in laboratory tests, quality control in the three fields of pre-analytical, analytical, and post-analytical processes is extremely important. There are, however, no detailed written requirements concerning specimen collection, handling, preparation, storage, and shipping. Most laboratory tests for clinical studies are performed onsite in a local laboratory; however, a part of laboratory tests is done in offsite central laboratories after specimen shipping. As factors affecting laboratory tests, individual and inter-individual variations are well-known. Besides these factors, standardizing the factors of specimen collection, handling, preparation, storage, and shipping, may improve and maintain the high quality of clinical studies in general. Furthermore, the analytical method, units, and reference interval are also important factors. It is concluded that, to overcome the problems derived from pre-analytical processes, it is necessary to standardize specimen handling in a broad sense.

  5. Audit of clinical-laboratory practices in haematology and blood ...

    African Journals Online (AJOL)

    In Tanzania, there is paucity of data for monitoring laboratory medicine including haematology. This therefore calls for audits of practices in haematology and blood transfusion in order to provide appraise practice and devise strategies that would result in improved quality of health care services. This descriptive ...

  6. National survey on intra-laboratory turnaround time for some most common routine and stat laboratory analyses in 479 laboratories in China.

    Science.gov (United States)

    Fei, Yang; Zeng, Rong; Wang, Wei; He, Falin; Zhong, Kun; Wang, Zhiguo

    2015-01-01

    To investigate the state of the art of intra-laboratory turnaround time (intra-TAT), provide suggestions and find out whether laboratories accredited by International Organization for Standardization (ISO) 15189 or College of American Pathologists (CAP) will show better performance on intra-TAT than non-accredited ones. 479 Chinese clinical laboratories participating in the external quality assessment programs of chemistry, blood gas, and haematology tests organized by the National Centre for Clinical Laboratories in China were included in our study. General information and the median of intra-TAT of routine and stat tests in last one week were asked in the questionnaires. The response rate of clinical biochemistry, blood gas, and haematology testing were 36% (479/1307), 38% (228/598), and 36% (449/1250), respectively. More than 50% of laboratories indicated that they had set up intra-TAT median goals and almost 60% of laboratories declared they had monitored intra-TAT generally for every analyte they performed. Among all analytes we investigated, the intra-TAT of haematology analytes was shorter than biochemistry while the intra-TAT of blood gas analytes was the shortest. There were significant differences between median intra-TAT on different days of the week for routine tests. However, there were no significant differences in median intra-TAT reported by accredited laboratories and non-accredited laboratories. Many laboratories in China are aware of intra-TAT control and are making effort to reach the target. There is still space for improvement. Accredited laboratories have better status on intra-TAT monitoring and target setting than the non-accredited, but there are no significant differences in median intra-TAT reported by them.

  7. Laboratory hemostasis: milestones in Clinical Chemistry and Laboratory Medicine.

    Science.gov (United States)

    Lippi, Giuseppe; Favaloro, Emmanuel J

    2013-01-01

    Hemostasis is a delicate, dynamic and intricate system, in which pro- and anti-coagulant forces cooperate for either maintaining blood fluidity under normal conditions, or else will prompt blood clot generation to limit the bleeding when the integrity of blood vessels is jeopardized. Excessive prevalence of anticoagulant forces leads to hemorrhage, whereas excessive activation of procoagulant forces triggers excessive coagulation and thrombosis. The hemostasis laboratory performs a variety of first, second and third line tests, and plays a pivotal role in diagnostic and monitoring of most hemostasis disturbances. Since the leading targets of Clinical Chemistry and Laboratory Medicine include promotion of progress in fundamental and applied research, along with publication of guidelines and recommendations in laboratory diagnostics, this journal is an ideal source of information on current developments in the laboratory technology of hemostasis, and this article is aimed to celebrate some of the most important and popular articles ever published by the journal in the filed of laboratory hemostasis.

  8. Anthropomorphic Test Drive (ATD) Certification Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The ATD Certification Laboratory consists of several test fixtures to ensure ATDs are functioning correctly and within specifications prior to use in any OP testing....

  9. Quality assurance in the HIV/AIDS laboratory network of China.

    Science.gov (United States)

    Jiang, Yan; Qiu, Maofeng; Zhang, Guiyun; Xing, Wenge; Xiao, Yao; Pan, Pinliang; Yao, Jun; Ou, Chin-Yih; Su, Xueli

    2010-12-01

    In 2009, there were 8273 local screening laboratories, 254 confirmatory laboratories, 35 provincial confirmatory central laboratories and 1 National AIDS Reference Laboratory (NARL) in China. These laboratories were located in Center for Disease Control and Prevention (CDC) facilities, hospitals, blood donation clinics, maternal and child health (MCH) hospitals and border health quarantine health-care facilities. The NARL and provincial laboratories provide quality assurance through technical, bio-safety and managerial training; periodic proficiency testing; on-site supervisory inspections; and commercial serologic kit evaluations. From 2002 to 2009, more than 220 million HIV antibody tests were performed at screening laboratories, and all reactive and indeterminate samples were confirmed at confirmatory laboratories. The use of highly technically complex tests, including CD4 cell enumeration, viral load, dried blood spot (DBS)-based early infant diagnosis (EID), drug resistance (DR) genotyping, HIV-1 subtyping and incidence assays, have increased in recent years and their performance quality is closely monitored. China has made significant progress in establishing a well-coordinated HIV laboratory network and QA systems. However, the coverage and intensity of HIV testing and quality assurance programmes need to be strengthened so as to ensure that more infected persons are diagnosed and that they receive timely prevention and treatment services.

  10. Blood histamine release: A new allergy blood test

    International Nuclear Information System (INIS)

    Faraj, B.A.; Gottlieb, G.R.; Camp, V.M.; Lollies, P.

    1985-01-01

    Allergen-mediated histamine release from human leukocytes represents an important model for in vitro studies of allergic reactions. The purpose of this study was to determine whether the measurement of histamine released in allergic patients (pts) by radioenzymatic assay following mixing of their blood with common allergens represents a reliable index for diagnosis of atopic allergy. Three categories of allergies were used: (1) housedust and mite; (2) cat and dog dander; (3) trees and grasses and ragweed mixture. The presence of allergy was established by intradermal skin testing in the study group of 82 pts. Significant atopy was defined as ≥ 3+ (overall range 0-4 +, negative to maximum) on skin testing. The test was carried out in tubes with 0.5 ml heparinized blood, 0.5 ml tris albumin buffer, and one of the allergens (60-100 PNU/ml). In 20 controls without allergy, there always was ≤ 4% histamine release (normal response). A significant allergen-mediated histamine release, ranging from 12 to 30% of the total blood histamine content, was observed in 96% of the pts with skin test sensitivity of ≥ 3+. There was good agreement between skin testing and histamine release in terms of the allergen causing the response. Thus, measurement of histamine release in blood in response to allergen challenge represents a clinically useful in vitro test for the diagnosis of atopic allergy. Because data can be obtained from a single sample and are highly quantitative, this new method should have application to the longitudinal study of allergic pts and to the assessment of interventions

  11. Sodium blood test

    Science.gov (United States)

    ... medicines that may affect the test. These include: Antibiotics Antidepressants Some high blood pressure medicines Lithium Nonsteroidal anti-inflammatory drugs (NSAIDs) Water pills (diuretics) DO NOT stop ...

  12. Influence of a prolonged fasting and mild activity on routine laboratory tests.

    Science.gov (United States)

    Šupak-Smolčić, Vesna; Antončić, Dragana; Ožanić, Doris; Vladilo, Ivana; Bilić-Zulle, Lidija

    2015-01-01

    Despite the standardization of the phlebotomy procedure, blood analysis is occasionally requested after recommended hours with the excuse that the patient is still fasting. We aimed to examine the influence of prolonged fasting and mild physical activity on routine laboratory tests. The study was conducted on 30 volunteers (27 female) median age 40y (20-59). Blood samples were taken in the morning (7:00-8:00a.m.) and early afternoon (1:00-2:00p.m.) after prolonged fasting and usual daily activities. Serum glucose (GLU), urea, creatinine, triglyceride, uric acid (UA), iron and electrolytes were analyzed on Roche cobas 6000 c501 and complete blood count on Siemens ADVIA 2120i. Statistical significance between the two measurements was tested using paired t-test or Wilcoxon test according to data distribution. Clinical significance was judged against calculated reference change values (RCV). A statistically significant decrease was found for red blood cell count, hemoglobin, hematocrit, mean corpuscular volume (MCV), GLU, urea, creatinine, triglycerides and electrolytes, whereas white blood cell count and iron were significantly increased. Judging against desirable bias derived from biological variation, a significant change was found for all the analytes except MCV, platelet count, UA and triglycerides. A clinically significant change was not found for any of the tested analytes when compared to RCV. Prolonged fasting and mild activity will not influence the medical decision for healthy subjects with normal results. Despite the present statistically significant change, the clinically significant change was not shown. However, the study did not include pathological results which have to be interpreted more carefully. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  13. Closing the brain-to-brain loop in laboratory testing.

    Science.gov (United States)

    Plebani, Mario; Lippi, Giuseppe

    2011-07-01

    Abstract The delivery of laboratory services has been described 40 years ago and defined with the foremost concept of "brain-to-brain turnaround time loop". This concept consists of several processes, including the final step which is the action undertaken on the patient based on laboratory information. Unfortunately, the need for systematic feedback to improve the value of laboratory services has been poorly understood and, even more risky, poorly applied in daily laboratory practice. Currently, major problems arise from the unavailability of consensually accepted quality specifications for the extra-analytical phase of laboratory testing. This, in turn, does not allow clinical laboratories to calculate a budget for the "patient-related total error". The definition and use of the term "total error" refers only to the analytical phase, and should be better defined as "total analytical error" to avoid any confusion and misinterpretation. According to the hierarchical approach to classify strategies to set analytical quality specifications, the "assessment of the effect of analytical performance on specific clinical decision-making" is comprehensively at the top and therefore should be applied as much as possible to address analytical efforts towards effective goals. In addition, an increasing number of laboratories worldwide are adopting risk management strategies such as FMEA, FRACAS, LEAN and Six Sigma since these techniques allow the identification of the most critical steps in the total testing process, and to reduce the patient-related risk of error. As a matter of fact, an increasing number of laboratory professionals recognize the importance of understanding and monitoring any step in the total testing process, including the appropriateness of the test request as well as the appropriate interpretation and utilization of test results.

  14. Good agreement of conventional and gel-based direct agglutination test in immune-mediated haemolytic anaemia

    Directory of Open Access Journals (Sweden)

    Piek Christine J

    2012-02-01

    Full Text Available Abstract Background The aim of this study was to compare a gel-based test with the traditional direct agglutination test (DAT for the diagnosis of immune-mediated haemolytic anaemia (IMHA. Methods Canine (n = 247 and feline (n = 74 blood samples were submitted for DAT testing to two laboratories. A subset of canine samples was categorized as having idiopathic IMHA, secondary IMHA, or no IMHA. Results The kappa values for agreement between the tests were in one laboratory 0.86 for canine and 0.58 for feline samples, and in the other 0.48 for canine samples. The lower agreement in the second laboratory was caused by a high number of positive canine DATs for which the gel test was negative. This group included significantly more dogs with secondary IMHA. Conclusions The gel test might be used as a screening test for idiopathic IMHA and is less often positive in secondary IMHA than the DAT.

  15. Field and laboratory tests on acute toxicity of cadmium to freshwater crayfish

    Energy Technology Data Exchange (ETDEWEB)

    1986-09-01

    Environmental regulatory standards for cadmium (EPA 1980), like those for most pollutants, are based on acute, laboratory toxicity tests of single species. Such tests can be conducted rapidly and inexpensively in comparison to acute or chronic field studies, but their validity has often been questioned. Laboratory-based criteria are subject to two criticisms: (1) chemical and physical conditions differ greatly in degree and variability from laboratory to field, and (2) species are not isolated, but live in an ecosystem of interacting taxa and biofeedback. To investigate the validity of basing field toxicity standards on laboratory data, the authors subjected the freshwater crayfish Orconectes immunis for 96 h to various levels of cadmium in laboratory aquaria and experimental ponds. The study was designed to evaluate in part the first criticism of lab-based criteria. The studies were conducted concurrently with similar short-term experiments on the fathead minnow, Pimephales promelas, and coincided with studies of chronic cadmium stress on fathead minnows in experimental ponds.

  16. Electromedical devices test laboratories accreditation

    International Nuclear Information System (INIS)

    Murad, C; Rubio, D; Ponce, S; Alvarez Abri, A; Terron, A; Vicencio, D; Fascioli, E

    2007-01-01

    In the last years, the technology and equipment at hospitals have been increase in a great way as the risks of their implementation. Safety in medical equipment must be considered an important issue to protect patients and their users. For this reason, test and calibrations laboratories must verify the correct performance of this kind of devices under national and international standards. Is an essential mission for laboratories to develop their measurement activities taking into account a quality management system. In this article, we intend to transmit our experience working to achieve an accredited Test Laboratories for medical devices in National technological University

  17. Web-Based Virtual Laboratory for Food Analysis Course

    Science.gov (United States)

    Handayani, M. N.; Khoerunnisa, I.; Sugiarti, Y.

    2018-02-01

    Implementation of learning on food analysis course in Program Study of Agro-industrial Technology Education faced problems. These problems include the availability of space and tools in the laboratory that is not comparable with the number of students also lack of interactive learning tools. On the other hand, the information technology literacy of students is quite high as well the internet network is quite easily accessible on campus. This is a challenge as well as opportunities in the development of learning media that can help optimize learning in the laboratory. This study aims to develop web-based virtual laboratory as one of the alternative learning media in food analysis course. This research is R & D (research and development) which refers to Borg & Gall model. The results showed that assessment’s expert of web-based virtual labs developed, in terms of software engineering aspects; visual communication; material relevance; usefulness and language used, is feasible as learning media. The results of the scaled test and wide-scale test show that students strongly agree with the development of web based virtual laboratory. The response of student to this virtual laboratory was positive. Suggestions from students provided further opportunities for improvement web based virtual laboratory and should be considered for further research.

  18. Lawrence Livermore National Laboratory underground coal gasification data base. [US DOE-supported field tests; data

    Energy Technology Data Exchange (ETDEWEB)

    Cena, R. J.; Thorsness, C. B.

    1981-08-21

    The Department of Energy has sponsored a number of field projects to determine the feasibility of converting the nation's vast coal reserves into a clean efficient energy source via underground coal gasification (UCG). Due to these tests, a significant data base of process information has developed covering a range of coal seams (flat subbituminous, deep flat bituminous and steeply dipping subbituminous) and processing techniques. A summary of all DOE-sponsored tests to data is shown. The development of UCG on a commercial scale requires involvement from both the public and private sectors. However, without detailed process information, accurate assessments of the commercial viability of UCG cannot be determined. To help overcome this problem the DOE has directed the Lawrence Livermore National Laboratory (LLNL) to develop a UCG data base containing raw and reduced process data from all DOE-sponsored field tests. It is our intent to make the data base available upon request to interested parties, to help them assess the true potential of UCG.

  19. Laboratory evaluation of three dual rapid diagnostic tests for HIV and syphilis in China and Nigeria.

    Science.gov (United States)

    Yin, Yue-Ping; Ngige, Evelyn; Anyaike, Chukwuma; Ijaodola, Gbenga; Oyelade, Taiwo A; Vaz, Rui Gama; Newman, Lori M; Chen, Xiang-Sheng

    2015-06-01

    To determine the laboratory-based performance and operational characteristics of three dual rapid diagnostic tests (RDTs) for testing HIV and syphilis. Three dual RDTs (SD Bioline, Chembio, and MedMira) were evaluated using 1514 serum specimens archived at laboratories or collected from clinics in China and Nigeria to determine sensitivity and specificity, with 95% confidence intervals. Concordance of testing results read by two technicians, stability of testing results read at two time points, and test operation characteristics were also assessed. All three of the evaluated RDTs gave excellent performance with a combined sensitivity ranging from 99.0%-99.6% for HIV and 98.3%-99.0% for syphilis, and a combined specificity ranging from 97.9%-99.0% for HIV and 97.2%-99.6% for syphilis. Concordance of testing results between two technicians and stability of testing results read within and one hour past the recommended reading period showed excellent agreement, with Kappa greater than or equal to 0.98. All the tests were found to be very or fairly easy to use and easy to interpret the results. Further evaluations of these dual RDTs with whole blood in field settings, and more studies on the implication of introduction of these tests in HIV and syphilis control programs are needed. Copyright © 2015. Published by Elsevier Ireland Ltd.

  20. A Laboratory Exercise to Determine Human ABO Blood Type by Noninvasive Methods

    Science.gov (United States)

    Martin, Michael P.; Detzel, Stephen M.

    2008-01-01

    Analysis of single-nucleotide polymorphisms and their association with diseases and nondisease phenotypes is of growing importance in human biology studies. In this laboratory exercise, students determine the genetic basis for their ABO blood type; however, no blood is drawn. Students isolate genomic DNA from buccal mucosa cells that are present…

  1. Relocation of cryopreserved umbilical cord blood samples using a high-capacity dry shipper to a new laboratory: a cord blood banking experience.

    Science.gov (United States)

    Thiagarajah, Kalaivani; Wong, Chee-Yin; Vijayan, Vickneswary Veera; Ooi, Ghee-Chien; Ng, Mei-Theng; Cheong, Soon-Keng; Then, Kong-Yong

    2015-05-01

    Processed umbilical cord blood (UCB) must be stored at cryogenic temperature at all times to maintain the quality and viability of the cells. However, a challenge is presented in the form of moving a large number of cryopreserved UCB samples to a new location. In this report, we share our experience on relocating more than 100,000 units of cryopreserved UCB samples stored in 12 liquid nitrogen freezers (LNFs) to our new laboratory. For quality control purposes, 2 weeks before relocation, donor UCB samples were processed, cryopreserved, and stored in each LNF. On relocation day, half of the samples were retrieved to determine total nucleated cell count, percentage of CD34+ cells, and cell viability as controls for later comparison. UCB samples were transferred into dry shippers before being relocated to the new laboratory. Upon arrival, LNFs were serviced before transferring UCB samples back into its original location within the LNF. The remaining donor UCB samples were retrieved and analyzed for the same tests mentioned. We found no significant differences in pre- and postrelocation values of the tests performed. All UCB samples were successfully relocated into the new laboratory without affecting the quality. © 2014 AABB.

  2. Recommended procedures for performance testing of radiobioassay laboratories: Volume 1, Quality assurance

    International Nuclear Information System (INIS)

    Fenrick, H.W.; MacLellan, J.A.

    1988-11-01

    Draft American National Standards Institute (ANSI) Standard N13.30 (Performance Criteria for Radiobioassay) was developed in response to a concern expressed by the US Department of Energy and US Nuclear Regulatory Commission to help ensure that bioassay laboratories provide accurate and consistent results. The draft standard specifies the criteria for defining the procedures necessary to establish a bioassay performance-testing laboratory and program. The testing laboratory will conduct tests to evaluate the performance of service laboratories. Pacific Northwest Laboratory helped define responsibilities and develop procedures as part of an effort to evaluate the draft ANSI N13.30 performance criteria for quality assurance at bioassay laboratories. This report recommends elements of quality assurance and quality control responsibilities for the bioassay performance-testing laboratory program, including the qualification and performance of personnel and the calibration, certification, and performance of equipment. The data base and recommended records system for documenting radiobioassay performance at the service laboratories are also presented. 15 refs

  3. Comparison of PCR-Based Diagnosis with Centrifuged-Based Enrichment Method for Detection of Borrelia persica in Animal Blood Samples.

    Science.gov (United States)

    Naddaf, S R; Kishdehi, M; Siavashi, Mr

    2011-01-01

    The mainstay of diagnosis of relapsing fever (RF) is demonstration of the spirochetes in Giemsa-stained thick blood smears, but during non fever periods the bacteria are very scanty and rarely detected in blood smears by microscopy. This study is aimed to evaluate the sensitivity of different methods developed for detection of low-grade spirochetemia. Animal blood samples with low degrees of spirochetemia were tested with two PCRs and a nested PCR targeting flaB, GlpQ, and rrs genes. Also, a centrifuged-based enrichment method and Giemsa staining were performed on blood samples with various degrees of spirochetemia. The flaB-PCR and nested rrs-PCR turned positive with various degrees of spirochetemia including the blood samples that turned negative with dark-field microscopy. The GlpQ-PCR was positive as far as at least one spirochete was seen in 5-10 microscopic fields. The sensitivity of GlpQ-PCR increased when DNA from Buffy Coat Layer (BCL) was used as template. The centrifuged-based enrichment method turned positive with as low concentration as 50 bacteria/ml blood, while Giemsa thick staining detected bacteria with concentrations ≥ 25000 bacteria/ml. Centrifuged-based enrichment method appeared as much as 500-fold more sensitive than thick smears, which makes it even superior to some PCR assays. Due to simplicity and minimal laboratory requirements, this method can be considered a valuable tool for diagnosis of RF in rural health centers.

  4. Relay testing at Brookhaven National Laboratory

    International Nuclear Information System (INIS)

    Bandyopadhyay, K.; Hofmayer, C.

    1989-01-01

    Brookhaven National Laboratory (BNL) is conducting a seismic test program on relays. The purpose of the test program is to investigate the influence of various designs, electrical and vibration parameters on the seismic capacity levels. The first series of testing has been completed and performed at Wyle Laboratories. The major part of the test program consisted of single axis, single frequency sine dwell tests. Random multiaxis, multifrequency tests were also performed. Highlights of the test results as well as a description of the testing methods are presented in this paper. 10 figs

  5. Validation of a Blood-Based Laboratory Test to Aid in the Confirmation of a Diagnosis of Schizophrenia

    Directory of Open Access Journals (Sweden)

    Emanuel Schwarz

    2010-05-01

    Full Text Available We describe the validation of a serum-based test developed by Rules-Based Medicine which can be used to help confirm the diagnosis of schizophrenia. In preliminary studies using multiplex immunoassay profiling technology, we identified a disease signature comprised of 51 analytes which could distinguish schizophrenia (n = 250 from control (n = 230 subjects. In the next stage, these analytes were developed as a refined 51-plex immunoassay panel for validation using a large independent cohort of schizophrenia (n = 577 and control (n = 229 subjects. The resulting test yielded an overall sensitivity of 83% and specificity of 83% with a receiver operating characteristic area under the curve (ROC-AUC of 89%. These 51 immunoassays and the associated decision rule delivered a sensitive and specific prediction for the presence of schizophrenia in patients compared to matched healthy controls.

  6. Recommended procedures for performance testing of radiobioassay laboratories: Volume 2, In vitro samples

    International Nuclear Information System (INIS)

    Fenrick, H.W.; MacLellan, J.A.

    1988-11-01

    Draft American National Standards Institute (ANSI) Standard N13.30 (Performance Criteria for Radiobioassay) was developed for the US Department of Energy and the US Nuclear Regulatory Commission to help ensure that bioassay laboratories provide accurate and consistent results. The draft standard specifies the criteria for defining the procedures necessary to establish a bioassay performance-testing laboratory and program. The bioassay testing laboratory will conduct tests to evaluate the performance of service laboratories. Pacific Northwest Laboratory helped develop testing procedures as part of an effort to evaluate the performance criteria by testing the existing measurement capabilities of various bioassay laboratories. This report recommends guidelines for the preparation, handling, storage, distribution, shipping, and documentation of in vitro test samples (artificial urine and fecal matter) for indirect bioassay. The data base and recommended records system for documenting radiobioassay performance at the service laboratories are also presented. 8 refs., 3 tabs

  7. The Classroom-Friendly ABO Blood Types Kit: Blood Agglutination Simulation

    Science.gov (United States)

    Arnold, Savittree Rochanasmita; Kruatong, Tussatrin; Dahsah, Chanyah; Suwanjinda, Duongdearn

    2012-01-01

    The classroom-friendly ABO blood type kit was developed by combining advantages of modelling and a simulation laboratory to teach the topics of ABO blood types and blood transfusion. Teachers can easily simulate the agglutination reaction on a blood type testing plate in the classroom, and show the students how this reaction occurs by using the…

  8. Laboratory testing of hemolytic properties of materials that come in contact with blood: Comparative application testing method’s two variants according to the standard ASTM F756 in accordance with ISO 10993-4

    Directory of Open Access Journals (Sweden)

    Pavlović Katarina B.

    2010-01-01

    Full Text Available The presence of hemolytic material in contact with blood may produce increased levels of blood cell lysis and increased levels of plasma hemoglobin. This may induce toxic effects or other effects which may stress the kidneys or other organs. In this paper two variants of in vitro method and obtained results’ comparison were presented for testing of hemolytic properties of six raw materials (Polipropylene Moplen EP 540 P, Policarbonate colorless 164 R-112, Policarbonate brown 164 R-51918, Polietylene NG 3026 K, Polietylene NG - Purell GB 7250, Polietylene VG - Hiplex 5502 for medical device manufacturing and one raw material (Polietylen NG granulate used for infusion solutions’s plastic bottles manufacturing. One of method’s variants relies on raw material direct contact with swine blood and the other on extract of the material contact with swine blood. Both method’s variants imply reading of the absorbance of the supernatant after tubes were incubated and centrifuged. According to values obtained and using the standard curve free hemoglobin concentration is determined and based on this percentage hemolysis of raw material. Positive and negative controls were used in both variants where water for injection (WFI was used as positive control in which partial or complete hemolysis of erythrocytes occurs due to osmotic shock and phosphate buffer saline was used as negative control with no hemolytic property. In this paper comparison of results obtained by both method’s variants for testing of seven raw materials was presented, while these conclusions can not be used neither for all materials, nor for all applications without preliminary testing using both variants and then choosing more sensitive and more reliable one. It was shown and stated in the paper as well that incubation time being 3, 15 or 24 h, had no impact on the variant’s with direct contact sensitivity. This comparative approach was used for drawing conclusions in terms of

  9. Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.

    Science.gov (United States)

    Schroeder, Scott R; Salomon, Meghan M; Galanter, William L; Schiff, Gordon D; Vaida, Allen J; Gaunt, Michael J; Bryson, Michelle L; Rash, Christine; Falck, Suzanne; Lambert, Bruce L

    2017-05-01

    Drug name confusion is a common type of medication error and a persistent threat to patient safety. In the USA, roughly one per thousand prescriptions results in the wrong drug being filled, and most of these errors involve drug names that look or sound alike. Prior to approval, drug names undergo a variety of tests to assess their potential for confusability, but none of these preapproval tests has been shown to predict real-world error rates. We conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. Eighty participants, comprising doctors, nurses, pharmacists, technicians and lay people, completed a battery of laboratory tests assessing visual perception, auditory perception and short-term memory of look-alike and sound-alike drug name pairs (eg, hydroxyzine/hydralazine). Laboratory test error rates (and other metrics) significantly predicted real-world error rates obtained from a large, outpatient pharmacy chain, with the best-fitting model accounting for 37% of the variance in real-world error rates. Cross-validation analyses confirmed these results, showing that the laboratory tests also predicted errors from a second pharmacy chain, with 45% of the variance being explained by the laboratory test data. Across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception. Regulators and drug companies seeking a validated preapproval method for identifying confusing drug names ought to consider using these simple tests. By using a standard battery of memory and perception tests, it should be possible to reduce the number of confusing look-alike and sound-alike drug name pairs that reach the market, which will help protect patients from potentially harmful medication errors. Published by the BMJ

  10. [How do hospital clinical laboratories and laboratory testing companies cooperate and build reciprocal relations?].

    Science.gov (United States)

    Kawano, Seiji

    2014-12-01

    As the 2nd Joint Symposium of the Japanese Society of Laboratory Medicine and the Japanese Association of Laboratory Pathologists, the symposium on clinical test out-sourcing and branch laboratories was held at the 60th General Meeting of the Japanese Society of Laboratory Medicine on November 2nd, 2013 in Kobe. For the symposium, we conducted a questionnaire survey on the usage of clinical test out-sourcing and the introduction of branch laboratories to clinical laboratories of Japanese university hospitals, both private and public, between July 25th and August 20th, 2013. Seventy-two hospitals responded to the questionnaire survey, consisting of 41 public medical school hospitals and 31 private ones. According to the survey, the selection of each clinical test for out-sourcing was mainly determined by the capacities of hospital clinical laboratories and their equipment, as well as the profitability of each test. The main concerns of clinical laboratory members of university hospitals involved the continuity of measurement principles, traceability, and standardization of reference values for each test. They strongly requested the interchangeability and computerization of test data between laboratory testing companies. A branch laboratory was introduced to six hospitals, all of which were private medical college hospitals, out of 72 university hospitals, and eight of the other hospitals were open to its introduction. The merits and demerits of introducing a branch laboratory were also discussed. (Review).

  11. Potassium Blood Test

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Potassium, Serum; 426–27 p. Lab ...

  12. Clinical evaluation of a 51Cr-labeled red blood cell survival test for in vivo blood compatibility testing

    International Nuclear Information System (INIS)

    Pineda, A.A.; Dharkar, D.D.; Wahner, H.W.

    1984-01-01

    Modified red blood cell survival studies with use of 51Cr were performed in three groups of subjects. Group 1 consisted of normal subjects who were given labeled autologous blood, group 2 were subjects in need of blood transfusions and given labeled ABO and Rh crossmatch-compatible blood, and group 3 were patients in need of blood transfusion but in whom problems arose in finding compatible blood. The results of the studies suggest that for patients with blood compatibility problems, normal red blood cell survival values at 1 hour do not exclude the possibility of severe hemolysis 24 hours later. Thus, if a 1-hour test result is normal, the procedure should be extended routinely to 24 hours. Moreover, the test can be used to evaluate the clinical importance of antibodies. We showed that anti-Yka and anti-Lan were clinically significant, but high-titer, low-avidity antibodies, anti-Kna, anti-I, and anti-HI were clinically insignificant in the cases studied. This finding emphasizes the importance of an in vivo test for the final compatibility evaluation in complicated blood replacement problems

  13. How to encourage non-donors to be more willing to donate blood? Testing of binding communication based interventions.

    Science.gov (United States)

    Fonte, D; Blondé, J; Girandola, F

    2017-06-01

    Our study aims to test the effectiveness of binding communication based interventions (vs classical persuasive communication based ones) inciting non-donors to act in favour of blood donation. The implementation of effective communication interventions represents a major public health issue. Nevertheless, persuasive media campaigns appear to have little effect on behaviours. Even though non-donors hold a positive attitude towards blood donation, they are not inclined to donate. As an alternative to producing behavioural changes, many recent studies have shown the superiority of binding communication over persuasive communication. All participants, non-donors, were randomly assigned to one of four experimental conditions of a 2 (type of communication: persuasive vs binding) × 2 (source credibility: low vs high) factorial design. Then, they were asked to report their intention to donate blood, and their intention to distribute leaflets regarding blood donation. Binding communication is a more effective strategy for increasing intention towards blood donation compared with persuasive communication, especially when combined with high credibility source. Accordingly this study calls for more consideration of knowledge of social psychology to design effective communication interventions and increase the number of donations. © 2016 British Blood Transfusion Society.

  14. The Computerized Laboratory Notebook concept for genetic toxicology experimentation and testing.

    Science.gov (United States)

    Strauss, G H; Stanford, W L; Berkowitz, S J

    1989-03-01

    We describe a microcomputer system utilizing the Computerized Laboratory Notebook (CLN) concept developed in our laboratory for the purpose of automating the Battery of Leukocyte Tests (BLT). The BLT was designed to evaluate blood specimens for toxic, immunotoxic, and genotoxic effects after in vivo exposure to putative mutagens. A system was developed with the advantages of low cost, limited spatial requirements, ease of use for personnel inexperienced with computers, and applicability to specific testing yet flexibility for experimentation. This system eliminates cumbersome record keeping and repetitive analysis inherent in genetic toxicology bioassays. Statistical analysis of the vast quantity of data produced by the BLT would not be feasible without a central database. Our central database is maintained by an integrated package which we have adapted to develop the CLN. The clonal assay of lymphocyte mutagenesis (CALM) section of the CLN is demonstrated. PC-Slaves expand the microcomputer to multiple workstations so that our computerized notebook can be used next to a hood while other work is done in an office and instrument room simultaneously. Communication with peripheral instruments is an indispensable part of many laboratory operations, and we present a representative program, written to acquire and analyze CALM data, for communicating with both a liquid scintillation counter and an ELISA plate reader. In conclusion we discuss how our computer system could easily be adapted to the needs of other laboratories.

  15. Laboratory for filter testing

    Energy Technology Data Exchange (ETDEWEB)

    Paluch, W.

    1987-07-01

    Filters used for mine draining in brown coal surface mines are tested by the Mine Draining Department of Poltegor. Laboratory tests of new types of filters developed by Poltegor are analyzed. Two types of tests are used: tests of scale filter models and tests of experimental units of new filters. Design and operation of the test stands used for testing mechanical properties and hydraulic properties of filters for coal mines are described: dimensions, pressure fluctuations, hydraulic equipment. Examples of testing large-diameter filters for brown coal mines are discussed.

  16. Development and validation of an app-based cell counter for use in the clinical laboratory setting

    Directory of Open Access Journals (Sweden)

    Alexander C Thurman

    2015-01-01

    Full Text Available Introduction: For decades cellular differentials have been generated exclusively on analog tabletop cell counters. With the advent of tablet computers, digital cell counters - in the form of mobile applications ("apps" - now represent an alternative to analog devices. However, app-based counters have not been widely adopted by clinical laboratories, perhaps owing to a presumed decrease in count accuracy related to the lack of tactile feedback inherent in a touchscreen interface. We herein provide the first systematic evidence that digital cell counters function similarly to standard tabletop units. Methods: We developed an app-based cell counter optimized for use in the clinical laboratory setting. Paired counts of 188 peripheral blood smears and 62 bone marrow aspirate smears were performed using our app-based counter and a standard analog device. Differences between paired data sets were analyzed using the correlation coefficient, Student′s t-test for paired samples and Bland-Altman plots. Results: All counts showed excellent agreement across all users and touch screen devices. With the exception of peripheral blood basophils (r = 0.684, differentials generated for the measured cell categories within the paired data sets were highly correlated (all r ≥ 0.899. Results of paired t-tests did not reach statistical significance for any cell type (all P > 0.05, and Bland-Altman plots showed a narrow spread of the difference about the mean without evidence of significant outliers. Conclusions: Our analysis suggests that no systematic differences exist between cellular differentials obtained via app-based or tabletop counters and that agreement between these two methods is excellent.

  17. A single dual-emissive nanofluorophore test paper for highly sensitive colorimetry-based quantification of blood glucose.

    Science.gov (United States)

    Huang, Xiaoyan; Zhou, Yujie; Liu, Cui; Zhang, Ruilong; Zhang, Liying; Du, Shuhu; Liu, Bianhua; Han, Ming-Yong; Zhang, Zhongping

    2016-12-15

    Fluorescent test papers are promising for the wide applications in the assays of diagnosis, environments and foods, but unlike classical dye-absorption-based pH test paper, they are usually limited in the qualitative yes/no type of detection by fluorescent brightness, and the colorimetry-based quantification remains a challenging task. Here, we report a single dual-emissive nanofluorophore probe to achieve the consecutive color variations from blue to red for the quantification of blood glucose on its as-prepared test papers. Red quantum dots were embedded into silica nanoparticles as a stable internal standard emission, and blue carbon dots (CDs) were further covalently linked onto the surface of silica, in which the ratiometric fluorescence intensity of blue to red is controlled at 5:1. While the oxidation of glucose induced the formation of Fe(3+) ions, the blue emission of CDs was thus quenched by the electron transfer from CDs to Fe(3+), displaying a serial of consecutive color variations from blue to red with the dosage of glucose. The high-quality test papers printed by the probe ink exhibited a dosage-sensitive allochromatic capability with the clear differentiations of ~5, 7, 9, 11mM glucose in human serum (normal: 3-8mM). The blood glucose determined by the test paper was almost in accordance with that measured by a standard glucometer. The method reported here opens a window to the wide applications of fluorescent test paper in biological assays. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Laboratory Diagnosis and Susceptibility Testing for Mycobacterium tuberculosis.

    Science.gov (United States)

    Procop, Gary W

    2016-12-01

    The laboratory, which utilizes some of the most sophisticated and rapidly changing technologies, plays a critical role in the diagnosis of tuberculosis. Some of these tools are being employed in resource-challenged countries for the rapid detection and characterization of Mycobacterium tuberculosis. Foremost, the laboratory defines appropriate specimen criteria for optimal test performance. The direct detection of mycobacteria in the clinical specimen, predominantly done by acid-fast staining, may eventually be replaced by rapid-cycle PCR. The widespread use of the Xpert MTB/RIF (Cepheid) assay, which detects both M. tuberculosis and key genetic determinants of rifampin resistance, is important for the early detection of multidrug-resistant strains. Culture, using both broth and solid media, remains the standard for establishing the laboratory-based diagnosis of tuberculosis. Cultured isolates are identified far less commonly by traditional biochemical profiling and more commonly by molecular methods, such as DNA probes and broad-range PCR with DNA sequencing. Non-nucleic acid-based methods of identification, such as high-performance liquid chromatography and, more recently, matrix-assisted laser desorption/ionization-time of flight mass spectrometry, may also be used for identification. Cultured isolates of M. tuberculosis should be submitted for susceptibility testing according to standard guidelines. The use of broth-based susceptibility testing is recommended to significantly decrease the time to result. Cultured isolates may also be submitted for strain typing for epidemiologic purposes. The use of massive parallel sequencing, also known as next-generation sequencing, promises to continue to this molecular revolution in mycobacteriology, as whole-genome sequencing provides identification, susceptibility, and typing information simultaneously.

  19. Evolution of a Computer-Based Testing Laboratory

    Science.gov (United States)

    Moskal, Patrick; Caldwell, Richard; Ellis, Taylor

    2009-01-01

    In 2003, faced with increasing growth in technology-based and large-enrollment courses, the College of Business Administration at the University of Central Florida opened a computer-based testing lab to facilitate administration of course examinations. Patrick Moskal, Richard Caldwell, and Taylor Ellis describe the development and evolution of the…

  20. Predicting blood transfusion using automated analysis of pulse oximetry signals and laboratory values.

    Science.gov (United States)

    Shackelford, Stacy; Yang, Shiming; Hu, Peter; Miller, Catriona; Anazodo, Amechi; Galvagno, Samuel; Wang, Yulei; Hartsky, Lauren; Fang, Raymond; Mackenzie, Colin

    2015-10-01

    Identification of hemorrhaging trauma patients and prediction of blood transfusion needs in near real time will expedite care of the critically injured. We hypothesized that automated analysis of pulse oximetry signals in combination with laboratory values and vital signs obtained at the time of triage would predict the need for blood transfusion with accuracy greater than that of triage vital signs or pulse oximetry analysis alone. Continuous pulse oximetry signals were recorded for directly admitted trauma patients with abnormal prehospital shock index (heart rate [HR] / systolic blood pressure) of 0.62 or greater. Predictions of blood transfusion within 24 hours were compared using Delong's method for area under the receiver operating characteristic (AUROC) curves to determine the optimal combination of triage vital signs (prehospital HR + systolic blood pressure), pulse oximetry features (40 waveform features, O2 saturation, HR), and laboratory values (hematocrit, electrolytes, bicarbonate, prothrombin time, international normalization ratio, lactate) in multivariate logistic regression models. We enrolled 1,191 patients; 339 were excluded because of incomplete data; 40 received blood within 3 hours; and 14 received massive transfusion. Triage vital signs predicted need for transfusion within 3 hours (AUROC, 0.59) and massive transfusion (AUROC, 0.70). Pulse oximetry for 15 minutes predicted transfusion more accurately than triage vital signs for both time frames (3-hour AUROC, 0.74; p = 0.004) (massive transfusion AUROC, 0.88; p transfusion prediction (3-hour AUROC, 0.84; p transfusion AUROC, 0.91; p blood transfusion during trauma resuscitation more accurately than triage vital signs or pulse oximetry analysis alone. Results suggest automated calculations from a noninvasive vital sign monitor interfaced with a point-of-care laboratory device may support clinical decisions by recognizing patients with hemorrhage sufficient to need transfusion. Epidemiologic

  1. Evaluation of Blood-Based Antibody Rapid Testing for HIV Early Therapy: A Meta-Analysis of the Evidence

    Directory of Open Access Journals (Sweden)

    Xiaojie Huang

    2018-06-01

    Full Text Available BackgroundWestern blot (WB assay is considered the gold standard test for HIV infection confirmation. However, it requires technical expertise and is quite time-consuming. WHO recommends blood-based rapid diagnosis to achieve same-day test and treatment. However, this rapid testing strategy has not been promoted worldwide due to inadequate research evaluating the effectiveness of rapid tests (RTs as an alternative confirmatory HIV test for WB. This study aims to compare the diagnostic performance of rapid HIV tests compared with WB.MethodsPubMed and Web of Science were searched for publications on rapid HIV tests using blood specimen. A meta-analysis was performed to quantitatively evaluate the diagnostic performance of rapid HIV tests compared with the WB assay in terms of pooled sensitivity, specificity, area under summary receiver operating characteristic (SROC curve, and diagnostic odds ratio (DOR.ResultsTwenty articles involving 27,343 fresh specimens for rapid HIV tests were included in the meta-analysis. Regarding Capillus HIV-1/HIV-2, the pooled sensitivity, specificity, area under SROC curve, and DOR derived from six studies were 0.999 (95% CI, 0.956–1.000, 0.999 (95% CI, 0.991–1.00, 1.00 (95% CI, 0.99–1.00, and 1.0 × 106 (95% CI, 2.6 × 104–3.9 × 107 compared with the WB assay, respectively. With respect to Determine HIV-1/2, the pooled sensitivity, specificity area under SROC, and DOR derived from eight studies were 1.00 (95% CI, 0.789–1.000, 0.992 (95% CI, 0.985–0.996, 1.00 (95% CI, 0.99–1.00, and 1.8 × 106 (95% CI 406.049–7.8 × 109 compared with the WB assay, respectively. Regarding two-step serial RTs, the pooled sensitivity, specificity area under SROC, and DOR derived from eight studies were 0.998 (95% CI, 0.991–1.000, 0.998 (95% CI, 0.994–0.999, and 1.00 (95% CI 0.99–1.00 compared with the WB assay, respectively.ConclusionOur meta-analysis results may provide evidenced-based support

  2. Measuring the level of agreement between a veterinary and a human point-of-care glucometer and a laboratory blood analyzer in Hispaniolan Amazon parrots (Amazona ventralis).

    Science.gov (United States)

    Acierno, Mark J; Schnellbacher, Rodney; Tully, Thomas N

    2012-12-01

    Although abnormalities in blood glucose concentrations in avian species are not as common as they are in mammals, the inability to provide point-of-care glucose measurement likely results in underreporting and missed treatment opportunities. A veterinary glucometer that uses different optimization codes for specific groups of animals has been produced. To obtain data for a psittacine bird-specific optimization code, as well as to calculate agreement between the veterinary glucometer, a standard human glucometer, and a laboratory analyzer, blood samples were obtained from 25 Hispaniolan Amazon parrots (Amazona ventralis) in a 2-phase study. In the initial phase, blood samples were obtained from 20 parrots twice at a 2-week interval. For each sample, the packed cell volume was determined, and the blood glucose concentration was measured by the veterinary glucometer. The rest of each sample was placed into a lithium heparin microtainer tube and centrifuged, and plasma was removed and frozen at -30 degrees C. Within 5 days, tubes were thawed, and blood glucose concentrations were measured with a laboratory analyzer. The data from both procedures were used to develop a psittacine bird-specific code. For the second phase of the study, the same procedure was repeated twice at a 2-week interval in 25 birds to determine agreement between the veterinary glucometer, a standard human glucometer, and a laboratory analyzer. Neither glucometer was in good agreement with the laboratory analyzer (veterinary glucometer bias, 9.0; level of agreement, -38.1 to 56.2; standard glucometer bias, 69.4; level of agreement -17.8 to 156.7). Based on these results, the use of handheld glucometers in the diagnostic testing of Hispaniolan Amazon parrots and other psittacine birds cannot be recommended.

  3. Good laboratory practices for biochemical genetic testing and newborn screening for inherited metabolic disorders.

    Science.gov (United States)

    2012-04-06

    Biochemical genetic testing and newborn screening are essential laboratory services for the screening, detection, diagnosis, and monitoring of inborn errors of metabolism or inherited metabolic disorders. Under the Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations, laboratory testing is categorized on the basis of the level of testing complexity as either waived (i.e., from routine regulatory oversight) or nonwaived testing (which includes tests of moderate and high complexity). Laboratories that perform biochemical genetic testing are required by CLIA regulations to meet the general quality systems requirements for nonwaived testing and the personnel requirements for high-complexity testing. Laboratories that perform public health newborn screening are subject to the same CLIA regulations and applicable state requirements. As the number of inherited metabolic diseases that are included in state-based newborn screening programs continues to increase, ensuring the quality of performance and delivery of testing services remains a continuous challenge not only for public health laboratories and other newborn screening facilities but also for biochemical genetic testing laboratories. To help ensure the quality of laboratory testing, CDC collaborated with the Centers for Medicare & Medicaid Services, the Food and Drug Administration, the Health Resources and Services Administration, and the National Institutes of Health to develop guidelines for laboratories to meet CLIA requirements and apply additional quality assurance measures for these areas of genetic testing. This report provides recommendations for good laboratory practices that were developed based on recommendations from the Clinical Laboratory Improvement Advisory Committee, with additional input from the Secretary's Advisory Committee on Genetics, Health, and Society; the Secretary's Advisory Committee on Heritable Disorders in Newborns and Children; and representatives of newborn

  4. Decay in blood loss estimation skills after web-based didactic training.

    Science.gov (United States)

    Toledo, Paloma; Eosakul, Stanley T; Goetz, Kristopher; Wong, Cynthia A; Grobman, William A

    2012-02-01

    Accuracy in blood loss estimation has been shown to improve immediately after didactic training. The objective of this study was to evaluate retention of blood loss estimation skills 9 months after a didactic web-based training. Forty-four participants were recruited from a cohort that had undergone web-based training and testing in blood loss estimation. The web-based posttraining test, consisting of pictures of simulated blood loss, was repeated 9 months after the initial training and testing. The primary outcome was the difference in accuracy of estimated blood loss (percent error) at 9 months compared with immediately posttraining. At the 9-month follow-up, the median error in estimation worsened to -34.6%. Although better than the pretraining error of -47.8% (P = 0.003), the 9-month error was significantly less accurate than the immediate posttraining error of -13.5% (P = 0.01). Decay in blood loss estimation skills occurs by 9 months after didactic training.

  5. Hip Resurfacing Arthroplasty and Perioperative Blood Testing

    Directory of Open Access Journals (Sweden)

    Andrew Cook

    2014-01-01

    Full Text Available It is standard practice in many institutions to routinely perform preoperative and postoperative haemoglobin level testing in association with hip joint arthroplasty procedures. It is our observation, however, that blood transfusion after uncomplicated primary hip arthroplasty in healthy patients is uncommon and that the decision to proceed with blood transfusion is typically made on clinical grounds. We therefore question the necessity and clinical value of routine perioperative blood testing about the time of hip resurfacing arthroplasty. We present analysis of perioperative blood tests and transfusion rates in 107 patients undertaking unilateral hybrid hip resurfacing arthroplasty by the senior author at a single institution over a three-year period. We conclude that routine perioperative testing of haemoglobin levels for hip resurfacing arthroplasty procedures does not assist in clinical management. We recommend that postoperative blood testing only be considered should the patient demonstrate clinical signs of symptomatic anaemia or if particular clinical circumstances necessitate.

  6. Hemagglutination detection for blood typing based on waveguide-mode sensors

    Directory of Open Access Journals (Sweden)

    Hiroki Ashiba

    2015-03-01

    Full Text Available ABO and Rh(D blood typing is one of the most important tests performed prior to blood transfusion. Although on-site blood testing is desirable for expedient blood transfusion procedure, most conventional methods and instruments lack the required usability or portability. Here, we describe a novel method, based on the detection of hemagglutination using an optical waveguide-mode sensor, for on-site use. The reflectance spectrum of blood alone and that of blood mixed with antibody reagents was measured using the waveguide-mode sensor. Differences in reflectance by agglutinated and non-agglutinated blood samples were observed at the bottom of the spectral dips; due to differences in the manner in which red blood cells interacted with the surface of the sensor chip. Following the addition of the antibody, blood types A, B, O, and AB were clearly distinguishable and Rh(D typing was also possible using the waveguide-mode sensor. Furthermore, the waveguide-mode-based measurement exhibited the potential to detect weak agglutination, which is difficult for human eyes to distinguish. Thus, this method holds great promise for application in novel on-site test instruments.

  7. Sand characterization by combined centrifuge and laboratory tests

    OpenAIRE

    GAUDIN, C; SCHNAID, F; GARNIER, J

    2005-01-01

    The purpose of this paper is to evaluate new methods of interpretation of in situ tests in sand from correlations established from centrifuge and laboratory data. Emphasis is given to methods that are based on the combination of measurements from independent tests, such as the ratio of the elastic stiffness to ultimate strenght and the ratio of cone resistance and limit pressure. For that purpose, a series of centrifuge tests using a cone penetrometer and a cone pressuremeter was carried out ...

  8. 21 CFR 862.1120 - Blood gases (PCO2, PO2) and blood pH test system.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Blood gases (PCO2, PO2) and blood pH test system... Test Systems § 862.1120 Blood gases (PCO2, PO2) and blood pH test system. (a) Identification. A blood gases (PCO2, PO2) and blood pH test system is a device intended to measure certain gases in blood, serum...

  9. Identification of clinical biomarkers for pre-analytical quality control of blood samples.

    Science.gov (United States)

    Kang, Hyun Ju; Jeon, Soon Young; Park, Jae-Sun; Yun, Ji Young; Kil, Han Na; Hong, Won Kyung; Lee, Mee-Hee; Kim, Jun-Woo; Jeon, Jae-Pil; Han, Bok Ghee

    2013-04-01

    Pre-analytical conditions are key factors in maintaining the high quality of biospecimens. They are necessary for accurate reproducibility of experiments in the field of biomarker discovery as well as achieving optimal specificity of laboratory tests for clinical diagnosis. In research at the National Biobank of Korea, we evaluated the impact of pre-analytical conditions on the stability of biobanked blood samples by measuring biochemical analytes commonly used in clinical laboratory tests. We measured 10 routine laboratory analytes in serum and plasma samples from healthy donors (n = 50) with a chemistry autoanalyzer (Hitachi 7600-110). The analyte measurements were made at different time courses based on delay of blood fractionation, freezing delay of fractionated serum and plasma samples, and at different cycles (0, 1, 3, 6, 9) of freeze-thawing. Statistically significant changes from the reference sample mean were determined using the repeated-measures ANOVA and the significant change limit (SCL). The serum levels of GGT and LDH were changed significantly depending on both the time interval between blood collection and fractionation and the time interval between fractionation and freezing of serum and plasma samples. The glucose level was most sensitive only to the elapsed time between blood collection and centrifugation for blood fractionation. Based on these findings, a simple formula (glucose decrease by 1.387 mg/dL per hour) was derived to estimate the length of time delay after blood collection. In addition, AST, BUN, GGT, and LDH showed sensitive responses to repeated freeze-thaw cycles of serum and plasma samples. These results suggest that GGT and LDH measurements can be used as quality control markers for certain pre-analytical conditions (eg, delayed processing or repeated freeze-thawing) of blood samples which are either directly used in the laboratory tests or stored for future research in the biobank.

  10. Evaluation of a simple polytetrafluoroethylene (PTFE)-based membrane for blood-feeding of malaria and dengue fever vectors in the laboratory.

    Science.gov (United States)

    Siria, Doreen J; Batista, Elis P A; Opiyo, Mercy A; Melo, Elizangela F; Sumaye, Robert D; Ngowo, Halfan S; Eiras, Alvaro E; Okumu, Fredros O

    2018-04-11

    Controlled blood-feeding is essential for maintaining laboratory colonies of disease-transmitting mosquitoes and investigating pathogen transmission. We evaluated a low-cost artificial feeding (AF) method, as an alternative to direct human feeding (DHF), commonly used in mosquito laboratories. We applied thinly-stretched pieces of polytetrafluoroethylene (PTFE) membranes cut from locally available seal tape (i.e. plumbers tape, commonly used for sealing pipe threads in gasworks or waterworks). Approximately 4 ml of bovine blood was placed on the bottom surfaces of inverted Styrofoam cups and then the PTFE membranes were thinly stretched over the surfaces. The cups were filled with boiled water to keep the blood warm (~37 °C), and held over netting cages containing 3-4 day-old inseminated adults of female Aedes aegypti, Anopheles gambiae (s.s.) or Anopheles arabiensis. Blood-feeding success, fecundity and survival of mosquitoes maintained by this system were compared against DHF. Aedes aegypti achieved 100% feeding success on both AF and DHF, and also similar fecundity rates (13.1 ± 1.7 and 12.8 ± 1.0 eggs/mosquito respectively; P > 0.05). An. arabiensis had slightly lower feeding success on AF (85.83 ± 16.28%) than DHF (98.83 ± 2.29%) though these were not statistically different (P > 0.05), and also comparable fecundity between AF (8.82 ± 7.02) and DHF (8.02 ± 5.81). Similarly, for An. gambiae (s.s.), we observed a marginal difference in feeding success between AF (86.00 ± 10.86%) and DHF (98.92 ± 2.65%), but similar fecundity by either method. Compared to DHF, mosquitoes fed using AF survived a similar number of days [Hazard Ratios (HR) for Ae. aegypti = 0.99 (0.75-1.34), P > 0.05; An. arabiensis = 0.96 (0.75-1.22), P > 0.05; and An. gambiae (s.s.) = 1.03 (0.79-1.35), P > 0.05]. Mosquitoes fed via this simple AF method had similar feeding success, fecundity and longevity. The method could potentially be used for laboratory colonization of mosquitoes

  11. DETERMINATION OF AMMONIA IN EAR-LOBE CAPILLARY BLOOD IS AN ALTERNATIVE TO ARTERIAL BLOOD AMMONIA

    NARCIS (Netherlands)

    HUIZENGA, [No Value; GIPS, CH; CONN, HO; JANSEN, PLM

    1995-01-01

    Blood ammonia determination is a laboratory test to diagnose hepatic encephalopathy. Arterial blood is superior to peripheral venous blood ammonia because of ammonia metabolism in muscle. We have compared capillary with arterial whole blood ammonia as capillary sampling is an attractive alternative.

  12. Determination of ammonia in ear-lobe capillary blood is an alternative to arterial blood ammonia

    NARCIS (Netherlands)

    Huizenga, J. R.; Gips, C. H.; Conn, H. O.; Jansen, P. L.

    1995-01-01

    Blood ammonia determination is a laboratory test to diagnose hepatic encephalopathy. Arterial blood is superior to peripheral venous blood ammonia because of ammonia metabolism in muscle. We have compared capillary with arterial whole blood ammonia as capillary sampling is an attractive alternative.

  13. A versatile electrophoresis-based self-test platform.

    Science.gov (United States)

    Staal, Steven; Ungerer, Mathijn; Floris, Arjan; Ten Brinke, Hans-Willem; Helmhout, Roy; Tellegen, Marian; Janssen, Kjeld; Karstens, Erik; van Arragon, Charlotte; Lenk, Stefan; Staijen, Erik; Bartholomew, Jody; Krabbe, Hans; Movig, Kris; Dubský, Pavel; van den Berg, Albert; Eijkel, Jan

    2015-03-01

    This paper reports on recent research creating a family of electrophoresis-based point of care devices for the determination of a wide range of ionic analytes in various sample matrices. These devices are based on a first version for the point-of-care measurement of Li(+), reported in 2010 by Floris et al. (Lab Chip 2010, 10, 1799-1806). With respect to this device, significant improvements in accuracy, precision, detection limit, and reliability have been obtained especially by the use of multiple injections of one sample on a single chip and integrated data analysis. Internal and external validation by clinical laboratories for the determination of analytes in real patients by a self-test is reported. For Li(+) in blood better precision than the standard clinical determination for Li(+) was achieved. For Na(+) in human urine the method was found to be within the clinical acceptability limits. In a veterinary application, Ca(2+) and Mg(2+) were determined in bovine blood by means of the same chip, but using a different platform. Finally, promising preliminary results are reported with the Medimate platform for the determination of creatinine in whole blood and quantification of both cations and anions through replicate measurements on the same sample with the same chip. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. [Quality use of commercial laboratory for clinical testing services - considering laboratory's role].

    Science.gov (United States)

    Ogawa, Shinji

    2014-12-01

    The number of commercial laboratories for clinical testing in Japan run privately has decreased to about 30 companies, and their business is getting tougher. Branch Lab. and FMS businesses have not expanded recently due to the new reimbursement system which adds an additional sample management fee, becoming effective in 2010. This presentation gives an outline of each role for hospital and commercial laboratories, and their pros & cons considering the current medical situation. Commercial laboratories have investigated how to utilize ICT systems for sharing test information between hospitals and our facilities. It would be very helpful to clarify issues for each hospital. We will develop and create new values for clinical laboratory testing services and forge mutually beneficial relationships with medical institutions. (Review).

  15. Microfluidic-Based Bacteria Isolation from Whole Blood for Diagnostics of Blood Stream Infection.

    Science.gov (United States)

    Zelenin, Sergey; Ramachandraiah, Harisha; Faridi, Asim; Russom, Aman

    2017-01-01

    Bacterial blood stream infection (BSI) potentially leads to life-threatening clinical conditions and medical emergencies such as severe sepsis, septic shock, and multi organ failure syndrome. Blood culturing is currently the gold standard for the identification of microorganisms and, although it has been automated over the decade, the process still requires 24-72 h to complete. This long turnaround time, especially for the identification of antimicrobial resistance, is driving the development of rapid molecular diagnostic methods. Rapid detection of microbial pathogens in blood related to bloodstream infections will allow the clinician to decide on or adjust the antimicrobial therapy potentially reducing the morbidity, mortality, and economic burden associated with BSI. For molecular-based methods, there is a lot to gain from an improved and straightforward method for isolation of bacteria from whole blood for downstream processing.We describe a microfluidic-based sample-preparation approach that rapidly and selectively lyses all blood cells while it extracts intact bacteria for downstream analysis. Whole blood is exposed to a mild detergent, which lyses most blood cells, and then to osmotic shock using deionized water, which eliminates the remaining white blood cells. The recovered bacteria are 100 % viable, which opens up possibilities for performing drug susceptibility tests and for nucleic-acid-based molecular identification.

  16. Routine preoperative blood group and save testing is unnecessary for elective laparoscopic cholecystectomy

    International Nuclear Information System (INIS)

    Tandon, A.; Shahzad, K.; Nunes, Q.; Shrotri, M.; Lunevicius, R.

    2017-01-01

    Background: Although the practice of preoperative testing of ABO group and Rh (D) type for elective cholecystectomy has deep historical roots, it is not evidence-based. We aimed to assess the preoperative blood group and save testing practice for a cohort of patients subjected to elective laparoscopic cholecystectomy for symptomatic cholecystolithiasis between January 2010 and October 2014. Methods: National Health Service (NHS) hospital based, surgical procedure-specific, retrospective study was conducted. A final group consisted of 2,079 adult patients. We estimated the incidence of perioperative blood transfusion attributable to laparoscopic cholecystectomy. The results of eight other studies are presented. Results: A preoperative blood group and save test was performed in 907 patients (43.6%), whereas cross-matching was documented in 28 patients (3.1%). None required an intraoperative blood transfusion. Twelve patients (0.58%) underwent blood transfusion postoperatively following laparoscopic cholecystectomy, of which ten were transfused due to severe intra-abdominal bleeding (0.48%). There were no deaths. Conclusions: The likelihood of blood transfusion attributable to elective laparoscopic cholecystectomy is 1:200. A routine preoperative blood group and save testing is unnecessary. It neither alters the management of severe hypovolemia, secondary to perioperative bleeding, nor does it lead to better outcomes. (author)

  17. Evaluation of a clinic-based cholinesterase test kit for the Washington State Cholinesterase Monitoring Program.

    Science.gov (United States)

    Hofmann, Jonathan N; Carden, Angela; Fenske, Richard A; Ruark, Harold E; Keifer, Matthew C

    2008-07-01

    The Washington State Cholinesterase Monitoring Program for pesticide handlers requires blood draws at local clinics, with samples tested at a central laboratory. At present, workers with inhibited cholinesterase activity may be re-exposed before they can be removed from work. In this study we explored the option of on-site testing at local clinics using the EQM Test-mate Kittrade mark, a portable cholinesterase test kit. Test kit cholinesterase activity measurements were performed on 50 blood samples by our research staff, and compared to measurements on the same samples by the Washington State Public Health Laboratory. Another set of samples was also analyzed with the test kit by medical staff at an eastern Washington clinic. Triplicate measurements with the test kit had a 3.3% average coefficient of variation (CV) for plasma cholinesterase (PChE), and a 3.5% average CV for erythrocyte cholinesterase (AChE) measurements. The kit's PChE measurements were similar to PHL measurements (average ratio of 0.98) when performed in the laboratory, but had a tendency to underestimate activity when used in the clinic setting (average ratio of 0.87). The kit systematically overestimated AChE activity by 42-48% relative to the PHL measurements, regardless of where the samples were analyzed. This easy-to-use test kit appeared to be a viable method for clinic-based PChE measurements, but was less consistent for AChE measurements performed in the clinic. Absolute measurements with the kit need to be evaluated carefully relative to standardized methods. (c) 2008 Wiley-Liss, Inc.

  18. Lactate point-of-care testing for acidosis: Cross-comparison of two devices with routine laboratory results

    Directory of Open Access Journals (Sweden)

    Remco van Horssen

    2016-04-01

    Full Text Available Objectives: Lactate is a major parameter in medical decision making. During labor, it is an indicator for fetal acidosis and immediate intervention. In the Emergency Department (ED, rapid analysis of lactate/blood gas is crucial for optimal patient care. Our objectives were to cross-compare-for the first time-two point-of-care testing (POCT lactate devices with routine laboratory results using novel tight precision targets and evaluate different lactate cut-off concentrations to predict metabolic acidosis. Design and methods: Blood samples from the delivery room (n=66 and from the ED (n=85 were analyzed on two POCT devices, the StatStrip-Lactate (Nova Biomedical and the iSTAT-1 (CG4+ cassettes, Abbott, and compared to the routine laboratory analyzer (ABL-735, Radiometer. Lactate concentrations were cross-compared between these analyzers. Results: The StatStrip correlated well with the ABL-735 (R=0.9737 and with the iSTAT-1 (R=0.9774 for lactate in umbilical cord blood. Lactate concentrations in ED samples measured on the iSTAT-1 and ABL-735 showed a correlation coefficient of R=0.9953. Analytical imprecision was excellent for lactate and pH, while for pO2 and pCO2 the coefficient of variation was relatively high using the iSTAT-1. Conclusion: Both POCT devices showed adequate analytical performance to measure lactate. The StatStrip can indicate metabolic acidosis in 1 μl blood and will be implemented at the delivery room. Keywords: Lactate, Point-of-care testing, Blood gas, Fetal acidosis

  19. Basic Blood Tests (For Parents)

    Science.gov (United States)

    ... Other medical conditions and some medicines also can cause high blood glucose. Reviewed by: Rupal Christine Gupta, ... (CMP) Urine Test: Creatinine Urine Test: Microalbumin-to-Creatinine Ratio Getting a ...

  20. Proficiency testing schemes as a quality rating in industrial hygiene laboratories

    Directory of Open Access Journals (Sweden)

    Marek Dobecki

    2016-04-01

    Full Text Available This publication presents the principles of organization, implementation, assessment and exploitation of proficiency testing results in the work environmental laboratory based on basic requirements included in standard PN-EN ISO/IEC 17043 and ISO 13528. The basis for the proper functioning of the laboratory is to use and observe the basic requirements for the competence to carry out the tests and the guidelines on ensuring reliable and accurate results, specified e.g., according to the guidelines described in the standard PN-EN ISO/IEC 17043. The confirmation of the laboratory competence is the obtained accreditation. To obtain this certificate several conditions, including proficiency testing (PT should be met. The main aspects of this paper is to show the role of proficiency testing in the process of assuring a properly functioning quality system in the laboratory. The accreditation requirements, the types of proficiency testing schemes, methods of statistical analysis and interpretation of results are also discussed by the authors. Med Pr 2016;67(2:267–283

  1. Blood glucose meters employing dynamic electrochemistry are stable against hematocrit interference in a laboratory setting.

    Science.gov (United States)

    Pfützner, Andreas; Musholt, Petra B; Schipper, Christina; Demircik, Filiz; Hengesbach, Carina; Flacke, Frank; Sieber, Jochen; Forst, Thomas

    2013-11-01

    Hematocrit (HCT) is known to be a confounding factor that interferes with many blood glucose (BG) measurement technologies, resulting in wrong readings. Dynamic electrochemistry has been identified as one possible way to correct for these potential deviations. The purpose of this laboratory investigation was to assess the HCT stability of four BG meters known to employ dynamic electrochemistry (BGStar and iBGStar, Sanofi; Wavesense Jazz, AgaMatrix; Wellion Linus, MedTrust) in comparison with three other devices (GlucoDock, Medisana; OneTouch Verio Pro, LifeScan; FreeStyle Freedom InsuLinx, Abbott-Medisense). Venous heparinized blood was immediately aliquoted after draw and manipulated to contain three different BG concentrations (60-90, 130-160, and 280-320 mg/dl) and five different HCT levels (25%, 35%, 45%, 55%, and 60%). After careful oxygenation to normal blood oxygen pressure, each of the resulting 15 different samples was measured six times with three devices and three strip lots of each meter. The YSI Stat 2300 served as laboratory reference method. Stability to HCT influence was assumed when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT concentrations [hematocrit interference factor (HIF)]. Five of the investigated self-test meters showed a stable performance with the different HCT levels tested in this investigation: BGStar (HIF 4.6%), iBGStar (6.6%), Wavesense Jazz (4.1%), Wellion Linus (8.5%), and OneTouch Verio Pro (6.2%). The two other meters were influenced by HCT (FreeStyle InsuLinx 17.8%; GlucoDock 46.5%). In this study, meters employing dynamic electrochemistry, as used in the BGStar and iBGStar devices, were shown to correct for potential HCT influence on the meter results. Dynamic electrochemistry appears to be an effective way to handle this interfering condition. © 2013 Diabetes Technology Society.

  2. Blood Glucose Meters Employing Dynamic Electrochemistry Are Stable against Hematocrit Interference in a Laboratory Setting

    Science.gov (United States)

    Pfützner, Andreas; Musholt, Petra B.; Schipper, Christina; Demircik, Filiz; Hengesbach, Carina; Flacke, Frank; Sieber, Jochen; Forst, Thomas

    2013-01-01

    Background Hematocrit (HCT) is known to be a confounding factor that interferes with many blood glucose (BG) measurement technologies, resulting in wrong readings. Dynamic electrochemistry has been identified as one possible way to correct for these potential deviations. The purpose of this laboratory investigation was to assess the HCT stability of four BG meters known to employ dynamic electrochemistry (BGStar and iBGStar, Sanofi; Wavesense Jazz, AgaMatrix; Wellion Linus, MedTrust) in comparison with three other devices (GlucoDock, Medisana; OneTouch Verio Pro, LifeScan; FreeStyle Freedom InsuLinx, Abbott-Medisense). Methods Venous heparinized blood was immediately aliquoted after draw and manipulated to contain three different BG concentrations (60–90, 130–160, and 280–320 mg/dl) and five different HCT levels (25%, 35%, 45%, 55%, and 60%). After careful oxygenation to normal blood oxygen pressure, each of the resulting 15 different samples was measured six times with three devices and three strip lots of each meter. The YSI Stat 2300 served as laboratory reference method. Stability to HCT influence was assumed when less than 10% difference occurred between the highest and lowest mean glucose deviations in relation to HCT concentrations [hematocrit interference factor (HIF)]. Results Five of the investigated self-test meters showed a stable performance with the different HCT levels tested in this investigation: BGStar (HIF 4.6%), iBGStar (6.6%), Wavesense Jazz (4.1%), Wellion Linus (8.5%), and OneTouch Verio Pro (6.2%). The two other meters were influenced by HCT (FreeStyle InsuLinx 17.8%; GlucoDock 46.5%). Conclusions In this study, meters employing dynamic electrochemistry, as used in the BGStar and iBGStar devices, were shown to correct for potential HCT influence on the meter results. Dynamic electrochemistry appears to be an effective way to handle this interfering condition. PMID:24351179

  3. Ferritin Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Ferritin, Serum; 296 p. Lab Tests ...

  4. Correlation between arterial blood gas analysis and peripheral blood gas analysis in acid-base unbalance state

    Directory of Open Access Journals (Sweden)

    Hyun Lee Kim

    2012-06-01

    Full Text Available Acid-base unbalance is most common problem in severe ill patient, especially in condition of abnormal renal function state. Acid-base unbalances are respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis. Metabolic acidosis is frequently appeared in clinical state. Arterial blood gas analysis is considered as a basic test to the intensive care unit patient and emergency state. Recently some researches were done, comparing with arterial blood gas analysis and venous blood gas analysis. Because of venous blood sampling is safer than arterial blood gas analysis, and beside not so different among them for detecting pH, pCO2, HCO3, except pO2 measuring. This research was done in emergency room, and for explaining no different between arterial blood gas analysis and peripheral blood gas analysis result in acid-base unbalance state patient. Especially in kidney functions decreased state. : The study was done from March, 2010 to January, 2011. The object was 89 peoples who came to emergency room for treating internal medicine problem. (Women 53, average age: 66.7±12.1 Then compare between arterial blood gas analysis and peripheral blood gas analysis. Result: The mean arterial minus venous difference for pH, pCO2, and bicarbonate was −0.0170, 2.6528, and 0.6124. Bland-Altman plot was done for predicting agreement of two groups, and the scale was pH −2.95 to 4.17, pCO2 −4.45 to 9.76, bicarbonate −2.95 to 4.16, in 95% relative. Conclusion: The peripheral blood gas pH, pCO2, bicarbonate level is almost same as arterial blood gas analysis results. And enough to measuring acid-base unbalance state, in absent of arterial blood testing.

  5. A Laboratory-Based Evaluation of Four Rapid Point-of-Care Tests for Syphilis

    Science.gov (United States)

    Causer, Louise M.; Kaldor, John M.; Fairley, Christopher K.; Donovan, Basil; Karapanagiotidis, Theo; Leslie, David E.; Robertson, Peter W.; McNulty, Anna M.; Anderson, David; Wand, Handan; Conway, Damian P.; Denham, Ian; Ryan, Claire; Guy, Rebecca J.

    2014-01-01

    Background Syphilis point-of-care tests may reduce morbidity and ongoing transmission by increasing the proportion of people rapidly treated. Syphilis stage and co-infection with HIV may influence test performance. We evaluated four commercially available syphilis point-of-care devices in a head-to-head comparison using sera from laboratories in Australia. Methods Point-of-care tests were evaluated using sera stored at Sydney and Melbourne laboratories. Sensitivity and specificity were calculated by standard methods, comparing point-of-care results to treponemal immunoassay (IA) reference test results. Additional analyses by clinical syphilis stage, HIV status, and non-treponemal antibody titre were performed. Non-overlapping 95% confidence intervals (CI) were considered statistically significant differences in estimates. Results In total 1203 specimens were tested (736 IA-reactive, 467 IA-nonreactive). Point-of-care test sensitivities were: Determine 97.3%(95%CI:95.8–98.3), Onsite 92.5%(90.3–94.3), DPP 89.8%(87.3–91.9) and Bioline 87.8%(85.1–90.0). Specificities were: Determine 96.4%(94.1–97.8), Onsite 92.5%(90.3–94.3), DPP 98.3%(96.5–99.2), and Bioline 98.5%(96.8–99.3). Sensitivity of the Determine test was 100% for primary and 100% for secondary syphilis. The three other tests had reduced sensitivity among primary (80.4–90.2%) compared to secondary syphilis (94.3–98.6%). No significant differences in sensitivity were observed by HIV status. Test sensitivities were significantly higher among high-RPR titre (RPR≥8) (range: 94.6–99.5%) than RPR non-reactive infections (range: 76.3–92.9%). Conclusions The Determine test had the highest sensitivity overall. All tests were most sensitive among high-RPR titre infections. Point-of-care tests have a role in syphilis control programs however in developed countries with established laboratory infrastructures, the lower sensitivities of some tests observed in primary syphilis suggest these would

  6. [Investigation of reference intervals of blood gas and acid-base analysis assays in China].

    Science.gov (United States)

    Zhang, Lu; Wang, Wei; Wang, Zhiguo

    2015-10-01

    To investigate and analyze the upper and lower limits and their sources of reference intervals in blood gas and acid-base analysis assays. The data of reference intervals were collected, which come from the first run of 2014 External Quality Assessment (EQA) program in blood gas and acid-base analysis assays performed by National Center for Clinical Laboratories (NCCL). All the abnormal values and errors were eliminated. Data statistics was performed by SPSS 13.0 and Excel 2007 referring to upper and lower limits of reference intervals and sources of 7 blood gas and acid-base analysis assays, i.e. pH value, partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2), Na+, K+, Ca2+ and Cl-. Values were further grouped based on instrument system and the difference between each group were analyzed. There were 225 laboratories submitting the information on the reference intervals they had been using. The three main sources of reference intervals were National Guide to Clinical Laboratory Procedures [37.07% (400/1 079)], instructions of instrument manufactures [31.23% (337/1 079)] and instructions of reagent manufactures [23.26% (251/1 079)]. Approximately 35.1% (79/225) of the laboratories had validated the reference intervals they used. The difference of upper and lower limits in most assays among 7 laboratories was moderate, both minimum and maximum (i.e. the upper limits of pH value was 7.00-7.45, the lower limits of Na+ was 130.00-156.00 mmol/L), and mean and median (i.e. the upper limits of K+ was 5.04 mmol/L and 5.10 mmol/L, the upper limits of PCO2 was 45.65 mmHg and 45.00 mmHg, 1 mmHg = 0.133 kPa), as well as the difference in P2.5 and P97.5 between each instrument system group. It was shown by Kruskal-Wallis method that the P values of upper and lower limits of all the parameters were lower than 0.001, expecting the lower limits of Na+ with P value 0.029. It was shown by Mann-Whitney that the statistic differences were found among instrument

  7. Project-Based Laboratory Experiences in Mechanical Engineering

    Directory of Open Access Journals (Sweden)

    Narendra Sharma

    2011-12-01

    Full Text Available In this paper we describe project-based laboratories in Mechanical Engineering designed to provide semester-long team experiences which mimic the real life industrial processes of design, development, testing and optimization. The labs are focused on courses at the sophomore level and thus require special attention to constraints of student backgrounds and experience. This paper describes laboratory projects in Dynamics and Fluid Mechanics.

  8. Self-driven filter-based blood plasma separator microfluidic chip for point-of-care testing

    International Nuclear Information System (INIS)

    Madadi, Hojjat; Casals-Terré, Jasmina; Mohammadi, Mahdi

    2015-01-01

    There is currently a growing need for lab-on-a-chip devices for use in clinical analysis and diagnostics, especially in the area of patient care. The first step in most blood assays is plasma extraction from whole blood. This paper presents a novel, self-driven blood plasma separation microfluidic chip, which can extract more than 0.1 μl plasma from a single droplet of undiluted fresh human blood (∼5 μl). This volume of blood plasma is extracted from whole blood with high purity (more than 98%) in a reasonable time frame (3 to 5 min), and without the need for any external force. This would be the first step towards the realization of a single-use, self-blood test that does not require any external force or power source to deliver and analyze a fresh whole-blood sample, in contrast to the existing time-consuming conventional blood analysis. The prototypes are manufactured in polydimethylsiloxane that has been modified with a strong nonionic surfactant (Silwet L-77) to achieve hydrophilic behavior. The main advantage of this microfluidic chip design is the clogging delay in the filtration area, which results in an increased amount of extracted plasma (0.1 μl). Moreover, the plasma can be collected in one or more 10 μm-deep channels to facilitate the detection and readout of multiple blood assays. This high volume of extracted plasma is achieved thanks to a novel design that combines maximum pumping efficiency without disturbing the red blood cells’ trajectory through the use of different hydrodynamic principles, such as a constriction effect and a symmetrical filtration mode. To demonstrate the microfluidic chip’s functionality, we designed and fabricated a novel hybrid microdevice that exhibits the benefits of both microfluidics and lateral flow immunochromatographic tests. The performance of the presented hybrid microdevice is validated using rapid detection of thyroid stimulating hormone within a single droplet of whole blood. (paper)

  9. Analysis and optimization of blood-testing procedures.

    NARCIS (Netherlands)

    Bar-Lev, S.K.; Boxma, O.J.; Perry, D.; Vastazos, L.P.

    2017-01-01

    This paper is devoted to the performance analysis and optimization of blood testing procedures. We present a queueing model of two queues in series, representing the two stages of a blood-testing procedure. Service (testing) in stage 1 is performed in batches, whereas it is done individually in

  10. Fuel Cell Development and Test Laboratory | Energy Systems Integration

    Science.gov (United States)

    Facility | NREL Fuel Cell Development and Test Laboratory Fuel Cell Development and Test Laboratory The Energy System Integration Facility's Fuel Cell Development and Test Laboratory supports fuel cell research and development projects through in-situ fuel cell testing. Photo of a researcher running

  11. Energy Systems High-Pressure Test Laboratory | Energy Systems Integration

    Science.gov (United States)

    Facility | NREL Energy Systems High-Pressure Test Laboratory Energy Systems High-Pressure Test Laboratory In the Energy Systems Integration Facility's High-Pressure Test Laboratory, researchers can safely test high-pressure hydrogen components. Photo of researchers running an experiment with a hydrogen fuel

  12. Performance testing of UK personal dosimetry laboratories

    CERN Document Server

    Marshall, T O

    1985-01-01

    The proposed Ionising Radiations Regulations will require all UK personal dosimetry laboratories that monitor classified personnel to be approved for personal dosimetry by the Health and Safety Executive. It is suggested that these approvals should be based on general and supplementary criteria published by the British Calibration Service (BCS) for laboratory approval for the provision of personal dosimetry services. These criteria specify certain qualitative requirements and also indicate the need for regular tests of performance to be carried out to ensure constancy of dosimetric standards. This report concerns the latter. The status of the BCS criteria is discussed and the need for additional documents to cover new techniques and some modifications to existing documents is indicated. A means is described by which the technical performance of laboratories, concerned with personal monitoring for external radiations, can be assessed, both initially and ongoing. The costs to establish the scheme and operate it...

  13. Comparison of PCR-Based Diagnosis with Centrifuged-Based Enrichment Method for Detection of Borrelia Persica in Animal Blood Samples

    Directory of Open Access Journals (Sweden)

    SR Naddaf

    2011-06-01

    Full Text Available Background: The mainstay of diagnosis of relapsing fever (RF is demonstration of the spirochetes in Giemsa-stained thick blood smears, but during non fever periods the bacteria are very scanty and rarely detected in blood smears by mi­cros­copy. This study is aimed to evaluate the sensitivity of different methods developed for detection of low-grade spi­ro­chetemia. Methods: Animal blood samples with low degrees of spirochetemia were tested with two PCRs and a nested PCR tar­get­ing flaB, GlpQ, and rrs genes. Also, a centrifuged-based enrichment method and Giemsa staining were per­formed on blood samples with various degrees of spirochetemia. Results: The flaB-PCR and nested rrs-PCR turned positive with various degrees of spirochetemia including the blood samples that turned negative with dark-field microscopy. The GlpQ-PCR was positive as far as at least one spi­ro­chete was seen in 5-10 microscopic fields. The sensitivity of GlpQ-PCR increased when DNA from Buffy Coat Layer (BCL was used as template. The centrifuged-based enrichment method turned positive with as low concentra­tion as 50 bacteria/ml blood, while Giemsa thick staining detected bacteria with concentrations ≥ 25000 bacteria/ml. Conclusion: Centrifuged-based enrichment method appeared as much as 500-fold more sensitive than thick smears, which makes it even superior to some PCR assays. Due to simplicity and minimal laboratory requirements, this method can be considered a valuable tool for diagnosis of RF in rural health centers.

  14. Comparison of PCR-Based Diagnosis with Centrifuged-Based Enrichment Method for Detection of Borrelia persica in Animal Blood Samples

    Directory of Open Access Journals (Sweden)

    SR Naddaf

    2011-06-01

    Background: The mainstay of diagnosis of relapsing fever (RF is demonstration of the spirochetes in Giemsa-stained thick blood smears, but during non fever periods the bacteria are very scanty and rarely detected in blood smears by mi­cros­copy. This study is aimed to evaluate the sensitivity of different methods developed for detection of low-grade spi­ro­chetemia. Methods: Animal blood samples with low degrees of spirochetemia were tested with two PCRs and a nested PCR tar­get­ing flaB, GlpQ, and rrs genes. Also, a centrifuged-based enrichment method and Giemsa staining were per­formed on blood samples with various degrees of spirochetemia. Results: The flaB-PCR and nested rrs-PCR turned positive with various degrees of spirochetemia including the blood samples that turned negative with dark-field microscopy. The GlpQ-PCR was positive as far as at least one spi­ro­chete was seen in 5-10 microscopic fields. The sensitivity of GlpQ-PCR increased when DNA from Buffy Coat Layer (BCL was used as template. The centrifuged-based enrichment method turned positive with as low concentra­tion as 50 bacteria/ml blood, while Giemsa thick staining detected bacteria with concentrations ≥ 25000 bacteria/ml.  Conclusion: Centrifuged-based enrichment method appeared as much as 500-fold more sensitive than thick smears, which makes it even superior to some PCR assays. Due to simplicity and minimal laboratory requirements, this method can be considered a valuable tool for diagnosis of RF in rural health centers.  

  15. Evaluation of Mycology Laboratory Proficiency Testing

    Science.gov (United States)

    Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

    1999-01-01

    Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient testing. This study addresses this issue by evaluating medical mycology OPT and comparing its fungal specimen identification error rates to those obtained in a covert (blinded) proficiency testing (CPT) program. Identifications from 188 laboratories participating in the New York State mycology OPT from 1982 to 1994 were compared with the identifications of the same fungi recovered from patient specimens in 1989 and 1994 as part of the routine procedures of 88 of these laboratories. The consistency in the identification of OPT specimens was sufficient to make accurate predictions of OPT error rates. However, while the error rates in OPT and CPT were similar for Candida albicans, significantly higher error rates were found in CPT for Candida tropicalis, Candida glabrata, and other common pathogenic fungi. These differences may, in part, be due to OPT’s use of ideal organism representatives cultured under optimum growth conditions. This difference, as well as the organism-dependent error rate differences, reflects the limitations of OPT as a means of assessing the quality of routine laboratory performance in medical mycology. PMID:10364601

  16. Evaluation of Mycology Laboratory Proficiency Testing

    OpenAIRE

    Reilly, Andrew A.; Salkin, Ira F.; McGinnis, Michael R.; Gromadzki, Sally; Pasarell, Lester; Kemna, Maggi; Higgins, Nancy; Salfinger, Max

    1999-01-01

    Changes over the last decade in overt proficiency testing (OPT) regulations have been ostensibly directed at improving laboratory performance on patient samples. However, the overt (unblinded) format of the tests and regulatory penalties associated with incorrect values allow and encourage laboratorians to take extra precautions with OPT analytes. As a result OPT may measure optimal laboratory performance instead of the intended target of typical performance attained during routine patient te...

  17. How-to-Do-It: A Simulation of the Blood Type Test.

    Science.gov (United States)

    Sharp, John D., Sr.; Smailes, Deborah L.

    1989-01-01

    Explains an activity that allows students to visualize antigen-antibody type reactions and learn about antibodies and antigens without performing blood typing tests. Provides directions for students and a comparison chart of a blood typing simulation with procedure which is based on the reactions of certain ionic solutions when mixed. (RT)

  18. Antimicrobial susceptibility testing by Australian veterinary diagnostic laboratories.

    Science.gov (United States)

    Hardefeldt, L Y; Marenda, M; Crabb, H; Stevenson, M A; Gilkerson, J R; Billman-Jacobe, H; Browning, G F

    2018-04-01

    The national strategy for tackling antimicrobial resistance highlights the need for antimicrobial stewardship in veterinary practice and for surveillance of antimicrobial susceptibility in veterinary pathogens. Diagnostic laboratories have an important role in facilitating both of these processes, but it is unclear whether data from veterinary diagnostic laboratories are similar enough to allow for compilation and if there is consistent promotion of appropriate antimicrobial use embedded in the approaches of different laboratories to susceptibility testing. A cross-sectional study of antimicrobial susceptibility testing and reporting procedures by Australian veterinary diagnostic laboratories was conducted in 2017 using an online questionnaire. All 18 veterinary diagnostic laboratories in Australia completed the questionnaire. Kirby-Bauer disc diffusion was the method predominantly used for antimicrobial susceptibility testing and was used to evaluate 86% of all isolates, although two different protocols were used across the 18 laboratories (CLSI 15/18, CDS 3/18). Minimum inhibitory concentrations were never reported by 61% of laboratories. Common isolates were consistently reported on across all species, except for gram-negative isolates in pigs, for which there was some variation in the approach to reporting. There was considerable diversity in the panels of antimicrobials used for susceptibility testing on common isolates and no consistency was apparent between laboratories for any bacterial species. We recommend that nationally agreed and consistent antimicrobial panels for routine susceptibility testing should be developed and a uniform set of guidelines should be adopted by veterinary diagnostic laboratories in Australia. © 2018 Australian Veterinary Association.

  19. Mounted Smartphones as Measurement and Control Platforms for Motor-Based Laboratory Test-Beds

    OpenAIRE

    Jared A. Frank; Anthony Brill; Vikram Kapila

    2016-01-01

    Laboratory education in science and engineering often entails the use of test-beds equipped with costly peripherals for sensing, acquisition, storage, processing, and control of physical behavior. However, costly peripherals are no longer necessary to obtain precise measurements and achieve stable feedback control of test-beds. With smartphones performing diverse sensing and processing tasks, this study examines the feasibility of mounting smartphones directly to test-beds to exploit their em...

  20. Laboratory test differences associated with HTLV-I and HTLV-II infection

    NARCIS (Netherlands)

    Murphy, EL; Glynn, S; Watanabe, K; Fridey, J; Sacher, R; Schreiber, G; Luban, N

    1998-01-01

    Reports of laboratory abnormalities associated with HTLV-I and HTLV-II infection are inconsistent. We assessed complete blood counts and selected serum chemistry measures at enrollment in a cohort of 153 HTLV-I-seropositive, 386 HTLV-II-seropositive, and 795 HTLV-seronegative blood donors. Linear

  1. Testing activities at the National Battery Test Laboratory

    Science.gov (United States)

    Hornstra, F.; Deluca, W. H.; Mulcahey, T. P.

    The National Battery Test Laboratory (NBTL) is an Argonne National Laboratory facility for testing, evaluating, and studying advanced electric storage batteries. The facility tests batteries developed under Department of Energy programs and from private industry. These include batteries intended for future electric vehicle (EV) propulsion, electric utility load leveling (LL), and solar energy storage. Since becoming operational, the NBTL has evaluated well over 1400 cells (generally in the form of three- to six-cell modules, but up to 140-cell batteries) of various technologies. Performance characterization assessments are conducted under a series of charge/discharge cycles with constant current, constant power, peak power, and computer simulated dynamic load profile conditions. Flexible charging algorithms are provided to accommodate the specific needs of each battery under test. Special studies are conducted to explore and optimize charge procedures, to investigate the impact of unique load demands on battery performance, and to analyze the thermal management requirements of battery systems.

  2. Performance testing of UK personal dosimetry laboratories

    International Nuclear Information System (INIS)

    Marshall, T.O.

    1985-01-01

    The proposed Ionising Radiations Regulations will require all UK personal dosimetry laboratories that monitor classified personnel to be approved for personal dosimetry by the Health and Safety Executive. It is suggested that these approvals should be based on general and supplementary criteria published by the British Calibration Service (BCS) for laboratory approval for the provision of personal dosimetry services. These criteria specify certain qualitative requirements and also indicate the need for regular tests of performance to be carried out to ensure constancy of dosimetric standards. This report concerns the latter. The status of the BCS criteria is discussed and the need for additional documents to cover new techniques and some modifications to existing documents is indicated. A means is described by which the technical performance of laboratories, concerned with personal monitoring for external radiations, can be assessed, both initially and ongoing. The costs to establish the scheme and operate it are also estimated. (author)

  3. In situ vitrification laboratory-scale test work plan

    International Nuclear Information System (INIS)

    Nagata, P.K.; Smith, N.L.

    1991-05-01

    The Buried Waste Program was established in October 1987 to accelerate the studies needed to develop a long-term management plan for the buried mixed waste at the Radioactive Waste Management Complex at Idaho Engineering Laboratory. The In Situ Vitrification Project is being conducted in a Comprehensive Environmental Response, Compensation, and Liability Act feasibility study format to identify methods for the long-term management of mixed buried waste. To support the overall feasibility study, the situ vitrification treatability investigations are proceeding along the three parallel paths: laboratory-scale tests, intermediate field tests, and field tests. Laboratory-scale tests are being performed to provide data to mathematical modeling efforts, which, in turn, will support design of the field tests and to the health and safety risk assessment. This laboratory-scale test work plan provides overall testing program direction to meet the current goals and objectives of the in situ vitrification treatability investigation. 12 refs., 1 fig., 7 tabs

  4. 9 CFR 55.8 - Official CWD tests and approval of laboratories to conduct official CWD tests.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Official CWD tests and approval of laboratories to conduct official CWD tests. 55.8 Section 55.8 Animals and Animal Products ANIMAL AND PLANT... on live or dead animals, and will base the approval or disapproval of a test on the evaluation by...

  5. Acknowledging the results of blood tests

    DEFF Research Database (Denmark)

    Torkilsheyggi, Arnvør Martinsdottir á; Hertzum, Morten

    At the studied hospital, physicians from the Medical and Surgical Departments work some of their shifts in the Emergency Department (ED). Though icons showing the blood-test process were introduced on electronic whiteboards in the ED, these icons did not lead to increased attention to test acknow...... acknowledgement. Rather, the physicians, trans-ferred work practices from their own departments, which did not have electronic white-boards, to the ED. This finding suggests a challenge to the cross-disciplinary work and norms for how to follow up on blood-test results in the ED....

  6. Interference of medical contrast media on laboratory testing.

    Science.gov (United States)

    Lippi, Giuseppe; Daves, Massimo; Mattiuzzi, Camilla

    2014-01-01

    The use of contrast media such as organic iodine molecules and gadolinium contrast agents is commonplace in diagnostic imaging. Although there is widespread perception that side effects and drug interactions may be the leading problems caused by these compounds, various degrees of interference with some laboratory tests have been clearly demonstrated. Overall, the described interference for iodinate contrast media include inappropriate gel barrier formation in blood tubes, the appearance of abnormal peaks in capillary zone electrophoresis of serum proteins, and a positive bias in assessment of cardiac troponin I with one immunoassay. The interference for gadolinium contrast agents include negative bias in calcium assessment with ortho-cresolphthalein colorimetric assays and occasional positive bias using some Arsenazo reagents, negative bias in measurement of angiotensin converting enzyme (ACE) and zinc (colorimetric assay), as well as positive bias in creatinine (Jaffe reaction), total iron binding capacity (TIBC, ferrozine method), magnesium (calmagite reagent) and selenium (mass spectrometry) measurement. Interference has also been reported in assessment of serum indices, pulse oximetry and methaemoglobin in samples of patients receiving Patent Blue V. Under several circumstances the interference was absent from manufacturer-supplied information and limited to certain type of reagents and/or analytes, so that local verification may be advisable to establish whether or not the test in use may be biased. Since the elimination half-life of these compounds is typically lower than 2 h, blood collection after this period may be a safer alternative in patients who have received contrast media for diagnostic purposes.

  7. A Window Into Clinical Next-Generation Sequencing-Based Oncology Testing Practices.

    Science.gov (United States)

    Nagarajan, Rakesh; Bartley, Angela N; Bridge, Julia A; Jennings, Lawrence J; Kamel-Reid, Suzanne; Kim, Annette; Lazar, Alexander J; Lindeman, Neal I; Moncur, Joel; Rai, Alex J; Routbort, Mark J; Vasalos, Patricia; Merker, Jason D

    2017-12-01

    - Detection of acquired variants in cancer is a paradigm of precision medicine, yet little has been reported about clinical laboratory practices across a broad range of laboratories. - To use College of American Pathologists proficiency testing survey results to report on the results from surveys on next-generation sequencing-based oncology testing practices. - College of American Pathologists proficiency testing survey results from more than 250 laboratories currently performing molecular oncology testing were used to determine laboratory trends in next-generation sequencing-based oncology testing. - These presented data provide key information about the number of laboratories that currently offer or are planning to offer next-generation sequencing-based oncology testing. Furthermore, we present data from 60 laboratories performing next-generation sequencing-based oncology testing regarding specimen requirements and assay characteristics. The findings indicate that most laboratories are performing tumor-only targeted sequencing to detect single-nucleotide variants and small insertions and deletions, using desktop sequencers and predesigned commercial kits. Despite these trends, a diversity of approaches to testing exists. - This information should be useful to further inform a variety of topics, including national discussions involving clinical laboratory quality systems, regulation and oversight of next-generation sequencing-based oncology testing, and precision oncology efforts in a data-driven manner.

  8. Valid methods: the quality assurance of test method development, validation, approval, and transfer for veterinary testing laboratories.

    Science.gov (United States)

    Wiegers, Ann L

    2003-07-01

    Third-party accreditation is a valuable tool to demonstrate a laboratory's competence to conduct testing. Accreditation, internationally and in the United States, has been discussed previously. However, accreditation is only I part of establishing data credibility. A validated test method is the first component of a valid measurement system. Validation is defined as confirmation by examination and the provision of objective evidence that the particular requirements for a specific intended use are fulfilled. The international and national standard ISO/IEC 17025 recognizes the importance of validated methods and requires that laboratory-developed methods or methods adopted by the laboratory be appropriate for the intended use. Validated methods are therefore required and their use agreed to by the client (i.e., end users of the test results such as veterinarians, animal health programs, and owners). ISO/IEC 17025 also requires that the introduction of methods developed by the laboratory for its own use be a planned activity conducted by qualified personnel with adequate resources. This article discusses considerations and recommendations for the conduct of veterinary diagnostic test method development, validation, evaluation, approval, and transfer to the user laboratory in the ISO/IEC 17025 environment. These recommendations are based on those of nationally and internationally accepted standards and guidelines, as well as those of reputable and experienced technical bodies. They are also based on the author's experience in the evaluation of method development and transfer projects, validation data, and the implementation of quality management systems in the area of method development.

  9. 21 CFR 864.6550 - Occult blood test.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Occult blood test. 864.6550 Section 864.6550 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES HEMATOLOGY AND PATHOLOGY DEVICES Manual Hematology Devices § 864.6550 Occult blood test. (a...

  10. Evaluation of the BioFire® FilmArray® Blood Culture Identification Panel on positive blood cultures in a regional hospital laboratory in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    Mokshanand Fhooblall

    2016-09-01

    Full Text Available Background: There are presently many non-culture-based methods commercially available to identify organisms and antimicrobial susceptibility from blood culture bottles. Each platform has its benefits and limitations. However, there is a need for an improved system with minimal hands-on requirements and short run times. Objectives: In this study, the performance characteristics of the FilmArray® BCID Panel kit were evaluated to assess the efficiency of the kit against an existing system used for identification and antimicrobial susceptibility of organisms from blood cultures. Methods: Positive blood cultures that had initially been received from hospitalised patients of a large quaternary referral hospital in Durban, South Africa were processed as per routine protocol at its Medical Microbiology Laboratory. Positive blood cultures were processed on the FilmArray BCID Panel kit in parallel with the routine sample processing. Inferences were then drawn from results obtained. Results: Organism detection by the FilmArray BCID panel was accurate at 92.6% when organisms that were on the repertoire of the kit were considered, compared to the combination methods (reference method used in the study laboratory. Detection of the antimicrobial resistance markers provided by the panel and reference method demonstrated 100% consistency. Blood cultures with a single organism were accurately identified at 93.8% by FilmArray, while blood cultures with more than one organism were identified at 85.7%. Conclusion: The FilmArray BCID Panel kit is valuable for detection of organisms and markers of antibiotic resistance for an extensive range of organisms.

  11. Automated nucleic acid amplification testing in blood banks: An additional layer of blood safety

    Directory of Open Access Journals (Sweden)

    Pragati Chigurupati

    2015-01-01

    Full Text Available Context: A total of 30 million blood components are transfused each year in India. Blood safety thus becomes a top priority, especially with a population of around 1.23 billion and a high prevalence rate of human immunodeficiency virus (HIV, hepatitis B virus (HBV and hepatitis C virus (HCV in general population. Nucleic acid amplification testing (NAT in blood donor screening has been implemented in many developed countries to reduce the risk of transfusion-transmitted viral infections (TTIs. NAT takes care of the dynamics of window period of viruses and offers the safest blood pack for donation. Aims: The aim of this study is to show the value of NAT in blood screening. Settings and Design: Dhanavantari Blood Bank, Rajahmundry, Andhra Pradesh, India. Subjects and Methods: Over a period of 1 year from January 2012 to December 2012, a total number of 15,000 blood donor samples were subjected to tests for HIV, HBV, and HCV by enzyme-linked immunosorbent assay (ELISA method and 8000 ELISA nonreactive samples were subjected for NAT using multiplex polymerase chain reaction technology. Results: Of the 15,000 donors tested, 525 were seroreactive. In 8000 ELISA negative blood samples subjected to NAT, 4 donor samples were reactive for HBV. The NAT yield was 1 in 2000. Conclusions: NAT could detect HIV, HBV, and HCV cases in blood donor samples those were undetected by serological tests. NAT could interdict 2500 infectious donations among our approximate 5 million annual blood donations.

  12. ELISA and some biochemical tests of heterophyidae infection in laboratory animals.

    Science.gov (United States)

    El-Seify, Mahmoud A; El-Bahy, Nasr M; Desouky, Abdelrazek Y; Bazh, Eman K

    2012-02-01

    Heterophyiasis is an important food-borne parasitic zoonosis in Egypt, among the inhabitants living around brackish-water lakes especially fishermen, and it is a common human parasite in the Nile Delta. The experiment was done on two laboratory animals (rats and dogs), and the time of sample collection was done periodically at 6, 9, 15, 21, and 28 days post-infection to evaluate different tests required. Whole blood was collected with heparin or ethylenediamine tetra-acetic acid as anticoagulant to help in the hematological studies such as red blood cells count (RBCs), white blood cells count, packed cell volume (PCV), and hemoglobin (Hb). Only marked increase in the total leuckocytic count was recorded while RBCs, PCV, and Hb were decreased in most of the results obtained. Total protein and globulin decreased while albumin and A/G ratio increased. Liver enzymes showing marked increase in aspartate aminotransferase and increase in alanine aminotransferase in dogs and rats denoting that liver has a role in the response to that infection. Kidney-function tests, urea, and creatinine showed slight increase at 6 days post-infection (d.p.i.). After preparation of different Ag (antigen) from different collected helminthes, the protein content of each was determined. The sera of infected animals were collected to find antibodies in their blood against the parasite using enzyme-linked immunosorbent assay and using crude heterophyid antigen collected from their intestines after scarification. The worms washed, homogenized, and then centrifuged to collect supernatant fluid as antigens. The results indicated that antibody starts to appear at 9 d.p.i. and increases till 21 and 28 d.p.i. and detection depends on antigen concentration.

  13. Prealbumin Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... enough nutrition if you are in the hospital. Nutrition plays an important role in recovery and healing. Help diagnose certain infections and chronic diseases Why do I need a prealbumin blood test? Your health care provider ... test to keep track of your nutrition if you are in the hospital. You may ...

  14. Laboratory tests on dark energy

    International Nuclear Information System (INIS)

    Beck, Christian

    2006-01-01

    The physical nature of the currently observed dark energy in the universe is completely unclear, and many different theoretical models co-exist. Nevertheless, if dark energy is produced by vacuum fluctuations then there is a chance to probe some of its properties by simple laboratory tests based on Josephson junctions. These electronic devices can be used to perform 'vacuum fluctuation spectroscopy', by directly measuring a noise spectrum induced by vacuum fluctuations. One would expect to see a cutoff near 1.7 THz in the measured power spectrum, provided the new physics underlying dark energy couples to electric charge. The effect exploited by the Josephson junction is a subtile nonlinear mixing effect and has nothing to do with the Casimir effect or other effects based on van der Waals forces. A Josephson experiment of the suggested type will now be built, and we should know the result within the next 3 years

  15. Point-Counterpoint: The FDA Has a Role in Regulation of Laboratory-Developed Tests.

    Science.gov (United States)

    Caliendo, Angela M; Hanson, Kimberly E

    2016-04-01

    Since the Food and Drug Administration (FDA) released its draft guidance on the regulation of laboratory-developed tests (LDTs) in October 2014, there has been a flurry of responses from commercial and hospital-based laboratory directors, clinicians, professional organizations, and diagnostic companies. The FDA defines an LDT as an "in vitrodiagnostic device that is intended for clinical use and is designed, manufactured, and used within a single laboratory." The draft guidance outlines a risk-based approach, with oversight of high-risk and moderate-risk tests being phased in over 9 years. High-risk tests would be regulated first and require premarket approval. Subsequently, moderate-risk tests would require a 510(k) premarket submission to the FDA and low-risk tests would need only to be registered. Oversight discretion would be exercised for LDTs focused on rare diseases (defined as fewer than 4,000 tests, not cases, per year nationally) and unmet clinical needs (defined as those tests for which there is no alternative FDA-cleared or -approved test). There was an open comment period followed by a public hearing in early January of 2015, and we are currently awaiting the final decision regarding the regulation of LDTs. Given that LDTs have been developed by many laboratories and are essential for the diagnosis and monitoring of an array of infectious diseases, changes in their regulation will have far-reaching implications for clinical microbiology laboratories. In this Point-Counterpoint, Angela Caliendo discusses the potential benefits of the FDA guidance for LDTs whereas Kim Hanson discusses the concerns associated with implementing the guidance and why these regulations may not improve clinical care. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  16. What Happens to Donated Blood?

    Science.gov (United States)

    ... database. Most whole blood donations are spun in centrifuges to separate it into transfusable components: red cells, ... 2, your test tubes arrive at a testing laboratory. A dozen tests are performed, to establish the ...

  17. STANDARDIZATION OF GLYCOHEMOGLOBIN RESULTS AND REFERENCE VALUES IN WHOLE-BLOOD STUDIED IN 103 LABORATORIES USING 20 METHODS

    NARCIS (Netherlands)

    WEYKAMP, CW; PENDERS, TJ; MUSKIET, FAJ; VANDERSLIK, W

    We investigated the effect of calibration with lyophilized calibrators on whole-blood glycohemoglobin (glyHb) results. One hundred three laboratories, using 20 different methods, determined glyHb in two lyophilized calibrators and two whole-blood samples. For whole-blood samples with low (5%) and

  18. Sandia Laboratories technical capabilities: testing

    International Nuclear Information System (INIS)

    Lundergan, C.D.

    1975-12-01

    The testing capabilities at Sandia Laboratories are characterized. Selected applications of these capabilities are presented to illustrate the extent to which they can be applied in research and development programs

  19. Computer-based nuclear radiation detection and instrumentation teaching laboratory system

    International Nuclear Information System (INIS)

    Ellis, W.H.; He, Q.

    1993-01-01

    The integration of computers into the University of Florida's Nuclear Engineering Sciences teaching laboratories is based on the innovative use of MacIntosh 2 microcomputers, IEEE-488 (GPIB) communication and control bus system and protocol, compatible modular nuclear instrumentation (NIM) and test equipment, LabVIEW graphics and applications software, with locally prepared, interactive, menu-driven, HyperCard based multi-exercise laboratory instruction sets and procedures. Results thus far have been highly successful with the majority of the laboratory exercises having been implemented

  20. Do recommended doses of glyphosate-based herbicides affect soil invertebrates? Field and laboratory screening tests to risk assessment.

    Science.gov (United States)

    Niemeyer, Júlia Carina; de Santo, Fernanda Benedet; Guerra, Naiara; Ricardo Filho, Altair Maçaneiro; Pech, Tatiani Maria

    2018-05-01

    Despite glyphosate-based herbicides are widely used in agriculture, forestry and gardens, little is known about its effects on non-target organisms. The present work evaluated the ecotoxicity of four formulated products (Roundup ® Original, Trop ® , Zapp ® Qi 620 and Crucial ® ) on soil invertebrates. Screening ecotoxicity tests were carried out with soil and oat straw collected in a field experiment, besides laboratory-spiked soils. Screening tests included avoidance behaviour of earthworms (Eisenia andrei), collembolans (Folsomia candida) and isopods (Porcellio dilatatus) in single and multispecies tests; reproduction of collembolans (F. candida), and bait lamina in field. Non-avoidance behaviour was observed in standard tests (earthworms) in soil, neither in multispecies tests (earthworm + isopods) using oat straw, while for collembolans it occurred for the product Zapp ® Qi 620 even at the recommended dose. Reproduction of F. candida was not impaired even at high doses in laboratory-spiked soils. Feeding activity on bait lamina test was impaired in treatment corresponding to the red label product, Crucial ® . Results showed the relevance of bait lamina test on screening the impact of herbicides in the field. The findings highlight the importance of considering different formulations for the same active ingredient in risk assessment of pesticides. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Accuracy of self-reports of fecal occult blood tests and test results among individuals in the carpentry trade.

    Science.gov (United States)

    Lipkus, Isaac M; Samsa, Gregory P; Dement, John; Skinner, Celette Sugg; Green, La Sonya G; Pompeii, Lisa; Ransohoff, David F

    2003-11-01

    Inaccuracy in self-reports of colorectal cancer (CRC) screening procedures (e.g., over- or underreporting) may interfere with individuals adhering to appropriate screening intervals, and can blur the true effects of physician recommendations to screen and the effects of interventions designed to promote screening. We assessed accuracy of self-report of having a fecal occult blood test (FOBT) within a 1-year window based on receipt of FOBT kits among individuals aged 50 and older in the carpentry trade (N = 658) who were off-schedule for having had a FOBT. Indices of evaluating accuracy of self-reports (concordance, specificity, false-positive and false-negative rates) were calculated relative to receipt of a mailed FOBT. Among those who mailed a completed FOBT, we assessed accuracy of reporting the test result. Participants underestimated having performed a FOBT (false-negative rate of 44%). Accuracy was unrelated to perceptions of getting or worrying about CRC or family history. Self-reports of having a negative FOBT result more consistently matched the laboratory result (specificity 98%) than having a positive test result (sensitivity 63%). Contrary to other findings, participants under- rather than over reported FOBT screening. Results suggest greater efforts are needed to enhance accurate recall of FOBT screening.

  2. Pending laboratory tests and the hospital discharge summary in patients discharged to sub-acute care.

    Science.gov (United States)

    Walz, Stacy E; Smith, Maureen; Cox, Elizabeth; Sattin, Justin; Kind, Amy J H

    2011-04-01

    Previous studies have noted a high (41%) prevalence and poor discharge summary communication of pending laboratory (lab) tests at the time of hospital discharge for general medical patients. However, the prevalence and communication of pending labs within a high-risk population, specifically those patients discharged to sub-acute care (i.e., skilled nursing, rehabilitation, long-term care), remains unknown. To determine the prevalence and nature of lab tests pending at hospital discharge and their inclusion within hospital discharge summaries, for common sub-acute care populations. Retrospective cohort study. Stroke, hip fracture, and cancer patients discharged from a single large academic medical center to sub-acute care, 2003-2005 (N = 564) Pending lab tests were abstracted from the laboratory information system (LIS) and from each patient's discharge summary, then grouped into 14 categories and compared. Microbiology tests were sub-divided by culture type and number of days pending prior to discharge. Of sub-acute care patients, 32% (181/564) were discharged with pending lab tests per the LIS; however, only 11% (20/181) of discharge summaries documented these. Patients most often left the hospital with pending microbiology tests (83% [150/181]), particularly blood and urine cultures, and reference lab tests (17% [30/181]). However, 82% (61/74) of patients' pending urine cultures did not have 24-hour preliminary results, and 19% (13/70) of patients' pending blood cultures did not have 48-hour preliminary results available at the time of hospital discharge. Approximately one-third of the sub-acute care patients in this study had labs pending at discharge, but few were documented within hospital discharge summaries. Even after considering the availability of preliminary microbiology results, these omissions remain common. Future studies should focus on improving the communication of pending lab tests at discharge and evaluating the impact that this improved

  3. Fecal occult blood test for colorectal cancer screening: an evidence-based analysis.

    Science.gov (United States)

    2009-01-01

    The colorectal cancer (CRC) screening project was undertaken by the Medical Advisory Secretariat (MAS) in collaboration with the Cancer Care Ontario (CCO).In November 2007, the Ontario Health Technology Advisory Committee (OHTAC) MAS to conduct an evidence-based analysis of the available data with respect to colorectal cancer diagnosis and prevention. The general purpose of the project was to investigate the effectiveness, cost effectiveness, and safety of the various methods and techniques used for colorectal cancer screening in average risk people, 50 years of age and older.The options currently offered for colorectal cancer screening were reviewed and five technologies were selected for review:Computed tomographic (CT) colonographyMagnetic resonance (MR) colonographyWireless capsule endoscopy (PillCam Colon)Fecal occult blood test (FOBT)Flexible sigmoidoscopyIn this review, colonoscopy was considered as the "gold standard" technique by which the effectiveness of all other modalities could be evaluated. An economic analysis was also conducted to determine cost-effectiveness of different screening modalities.Evidence-based analyses have been prepared for each of these technologies, as well as summary document that includes an economic analysis, all of which are presented at the MAS Web site: http://www.health.gov.on.ca/english/providers/program/mas/tech/techmn.html The objective of this evidence review is to examine the effectiveness and cost-effectiveness of fecal occult blood testing (FOBT), including guaiac FOBT (gFOBT) and immunochemical FOBT (iFOBT), for use in colorectal cancer (CRC) screening in asymptomatic, average-risk adults. Specifically: Is the use of gFOBT or iFOBT associated with a reduction in CRC and overall mortality?What are the sensitivity and specificity of gFOBT and iFOBT for the detection of 1) CRC and 2) large polyps (≥ 1 cm)? CRC is the most common cause of non-tobacco related cancer death in Canada. It has been estimated that in 2007, 7

  4. The Livermore Free-Electron Laser Program Magnet Test Laboratory

    International Nuclear Information System (INIS)

    Burns, M.J.; Kulke, B.; Deis, G.A.; Frye, R.W.; Kallman, J.S.; Ollis, C.W.; Tyler, G.C.; Van Maren, R.D.; Weiss, W.C.

    1987-01-01

    The Lawrence Livermore National Laboratory (LLNL) Free-Electron Laser Program Magnet Test Laboratory supports the ongoing development of the Induction Linac Free Electron Laser (IFEL) and uses magnetic field measurement systems that are useful in the testing of long periodic magnetic structures, electron-beam transport magnets, and spectrometer magnets. The major systems described include two computer-controlled, three-axis Hall probe-and-search coil transports with computer-controlled data acquisition; a unique, automated-search coil system used to detect very small inaccuracies in wiggler fields; a nuclear magnetic resonance (NMR)-based Hall probe-calibration facility; and a high-current DC ion source using heavy ions of variable momentum to model the transport of high-energy electrons. Additionally, a high-precision electron-beam-position monitor for use within long wigglers that has a positional resolution of less than 100 μm is under development in the laboratory and will be discussed briefly. Data transfer to LLNL's central computing facility and on-line graphics enable us to analyze large data sets quickly. 3 refs

  5. Analysis of Macular Drusen and Blood Test Results in 945 Macaca fascicularis.

    Directory of Open Access Journals (Sweden)

    Koji M Nishiguchi

    Full Text Available Age-dependent formation of macular drusen caused by the focal accumulation of extracellular deposits beneath the retinal pigment epithelium precede the development of age-related macular degeneration (AMD, one of the leading causes of blindness worldwide. It is established that inflammation contributes to the pathogenesis of drusen and AMD. However, development of a preemptive therapeutic strategy targeting macular drusen and AMD has been impeded by the lack of relevant animal models because most laboratory animals lack macula, an anatomic feature present only in humans and a subset of monkeys. Reportedly, macular drusen and macular degeneration develop in monkeys in an age-dependent manner. In this study, we analyzed blood test results from 945 Macaca fascicularis, 317 with and 628 without drusen. First, a trend test for drusen frequency (the Cochran-Armitage test was applied to the quartile data for each parameter. We selected variables with an increasing or decreasing trend with higher quartiles at P < 0.05, to which multivariate logistic regression analysis was applied. This revealed a positive association of age (odds ratio [OR]: 1.10 per year, 95% confidence interval [CI]: 1.07-1.12 and white blood cell count (OR: 1.01 per 1 × 103/μl, 95% CI: 1.00-1.01 with drusen. When the monkeys were divided by age, the association between drusen and white blood cell count was only evident in younger monkeys (OR: 1.01 per 1 × 103/μl, 95% CI: 1.00-1.02. In conclusion, age and white blood cell count may be associated with drusen development in M. fascicularis. Systemic inflammation may contribute to drusen formation in monkeys.

  6. Beta-carotene blood test

    Science.gov (United States)

    The normal range is 50 to 300 mcg/dL or 0.93 to 5.59 micromol/L. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about ...

  7. Immunochemical faecal occult blood tests have superior stability and analytical performance characteristics over guaiac-based tests in a controlled in vitro study.

    LENUS (Irish Health Repository)

    Lee, Chun Seng

    2011-06-01

    The aims of this study were (1) to determine the measurement accuracy of a widely used guaiac faecal occult blood test (gFOBT) compared with an immunochemical faecal occult blood test (iFOBT) during in vitro studies, including their analytical stability over time at ambient temperature and at 4°C; and (2) to compare analytical imprecision and other characteristics between two commercially available iFOBT methods.

  8. Iowa Central Quality Fuel Testing Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    Heach, Don; Bidieman, Julaine

    2013-09-30

    The objective of this project is to finalize the creation of an independent quality fuel testing laboratory on the campus of Iowa Central Community College in Fort Dodge, Iowa that shall provide the exploding biofuels industry a timely and cost-effective centrally located laboratory to complete all state and federal fuel and related tests that are required. The recipient shall work with various state regulatory agencies, biofuel companies and state and national industry associations to ensure that training and testing needs of their members and American consumers are met. The recipient shall work with the Iowa Department of Ag and Land Stewardship on the development of an Iowa Biofuel Quality Standard along with the Development of a standard that can be used throughout industry.

  9. VDRL test

    Science.gov (United States)

    ... confirmed with another blood test to make the diagnosis of syphilis. Normal value ranges may vary slightly among different ... broken) Alternative Names Venereal disease research ... laboratory test (VDRL) – serum. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures . 6th ed. St Louis, MO: Elsevier Saunders; ...

  10. SPIDIA-RNA: second external quality assessment for the pre-analytical phase of blood samples used for RNA based analyses.

    Directory of Open Access Journals (Sweden)

    Francesca Malentacchi

    Full Text Available One purpose of the EC funded project, SPIDIA, is to develop evidence-based quality guidelines for the pre-analytical handling of blood samples for RNA molecular testing. To this end, two pan-European External Quality Assessments (EQAs were implemented. Here we report the results of the second SPIDIA-RNA EQA. This second study included modifications in the protocol related to the blood collection process, the shipping conditions and pre-analytical specimen handling for participants. Participating laboratories received two identical proficiency blood specimens collected in tubes with or without an RNA stabilizer. For pre-defined specimen storage times and temperatures, laboratories were asked to perform RNA extraction from whole blood according to their usual procedure and to return extracted RNA to the SPIDIA facility for further analysis. These RNA samples were evaluated for purity, yield, integrity, stability, presence of interfering substances, and gene expression levels for the validated markers of RNA stability: FOS, IL1B, IL8, GAPDH, FOSB and TNFRSF10c. Analysis of the gene expression results of FOS, IL8, FOSB, and TNFRSF10c, however, indicated that the levels of these transcripts were significantly affected by blood collection tube type and storage temperature. These results demonstrated that only blood collection tubes containing a cellular RNA stabilizer allowed reliable gene expression analysis within 48 h from blood collection for all the genes investigated. The results of these two EQAs have been proposed for use in the development of a Technical Specification by the European Committee for Standardization.

  11. ALT Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Alanine Aminotransferase (ALT); p. 31. Lab ...

  12. Calcium Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Calcium, Serum; Calcium and Phosphates, Urine; ...

  13. Blood Glucose Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Glucose Monitoring; 317 p. National Cancer ...

  14. MPV Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Platelet Count; p. 419. Important Physician ...

  15. Albumin Blood Test: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Albumin; 32 p. Johns Hopkins Medicine [ ...

  16. Utility of laboratory testing for the diagnosis of Hymenoptera venom allergy.

    Science.gov (United States)

    Vachová, Martina; Panzner, Petr; Malkusová, Ivana; Hanzlíková, Jana; Vlas, Tomáš

    2016-05-01

    A diagnosis of Hymenoptera venom allergy is based on clinical history and the results of skin tests and/or laboratory methods. To analyze the utility of available laboratory tests in diagnosing Hymenoptera venom allergy. Ninety-five patients with Hymenoptera venom allergy with a history of bee (35) or wasp (60) anaphylactic sting reaction and positive skin test with bee or wasp venom were included in this analysis. Specific immunoglobulin E (to bee venom extract, wasp venom extract, available recombinant molecules, and a basophil activation test with venom extracts were assessed in all the patients. Test sensitivity and specificity were calculated by using standard threshold values; then, receiver operating characteristic curve analysis was performed to compute optimal threshold values. Also, statistical analysis of the utility of different combinations of laboratory tests was performed. The optimal threshold values were revealed to be the following: 1.0 kIU/L for bee venom extract (sensitivity, 97.14%; specificity, 100%), 0.35 kIU/L for rApi m 1 (sensitivity, 68.57%; specificity, 100%), 1.22 kIU/L for wasp venom extract (sensitivity, 88.33%; specificity, 95.45%), 0.7 kIU/L for rVes v 5 (sensitivity, 86.67%; specificity, 95.45%), 1.0 kIU/L for rVes v 1 (sensitivity, 56.67%; specificity, 95.45%), 6.5% for basophil activation test with bee venom extract (sensitivity, 80%; specificity, 95.45%), and 4.5% for basophil activation test with wasp venom extract (sensitivity, 91.53%; specificity, 95.45%). The best test combinations were found to be the following: bee venom extract plus rApi m 1 (sensitivity, 97.14%; specificity, 95.45%) in bee and either wasp venom extract plus rVes v 5, or rVes v 5 plus rVes v 1 (both sensitivity, 98.33%; specificity, 95.45%) in patients with wasp venom allergy. Our analysis confirmed that currently used laboratory tests represent effective tools in diagnosing Hymenoptera venom allergy. Moreover, our probabilistic approach offered another

  17. Test plan for ISV laboratory-pyrolysis testing

    Energy Technology Data Exchange (ETDEWEB)

    McAtee, R.E.

    1991-09-01

    The objective of the laboratory-pyrolysis studies is to obtain information on the high temperature (< 1200{degree}C) degradation and alteration of organic chemicals and materials similar to those found in the Radioactive Waste Management Complex, Pit 9. This test plan describes experimental procedures, sampling and analysis strategy, sampling procedures, sample control, and document management. It addresses safety issues in the experimental apparatus and procedures, personal training, and hazardous waste disposal. Finally, it describes the data quality objectives using the EPA tiered approach to treatability studies to define where research/scoping tests fit into these studies and the EPA analytical levels required for the tests.

  18. Cost-price estimation of clinical laboratory services based on activity-based costing: A case study from a developing country.

    Science.gov (United States)

    Mouseli, Ali; Barouni, Mohsen; Amiresmaili, Mohammadreza; Samiee, Siamak Mirab; Vali, Leila

    2017-04-01

    It is believed that laboratory tariffs in Iran don't reflect the real costs. This might expose private laboratories at financial hardship. Activity Based Costing is widely used as a cost measurement instrument to more closely approximate the true cost of operations. This study aimed to determine the real price of different clinical tests of a selected private clinical laboratory. This study was a cross sectional study carried out in 2015. The study setting was the private laboratories in the city of Kerman, Iran. Of 629 tests in the tariff book of the laboratory (relative value), 188 tests were conducted in the laboratory that used Activity Based Costing (ABC) methodology to estimate cost-price. Analyzing and cost-price estimating of laboratory services were performed by MY ABCM software Version 5.0. In 2015, the total costs were $641,645. Direct and indirect costs were 78.3% and 21.7% respectively. Laboratory consumable costs by 37% and personnel costs by 36.3% had the largest share of the costing. Also, group of hormone tests cost the most $147,741 (23.03%), and other tests group cost the least $3,611 (0.56%). Also after calculating the cost of laboratory services, a comparison was made between the calculated price and the private sector's tariffs in 2015. This study showed that there was a difference between costs and tariffs in the private laboratory. One way to overcome this problem is to increase the number of laboratory tests with regard to capacity of the laboratories.

  19. Manual on laboratory testing for uranium ore processing

    International Nuclear Information System (INIS)

    1990-01-01

    Laboratory testing of uranium ores is an essential step in the economic evaluation of uranium occurrences and in the development of a project for the production of uranium concentrates. Although these tests represent only a small proportion of the total cost of a project, their proper planning, execution and interpretation are of crucial importance. The main purposes of this manual are to discuss the objectives of metallurgical laboratory ore testing, to show the specific role of these tests in the development of a project, and to provide practical instructions for performing the tests and for interpreting their results. Guidelines on the design of a metallurgical laboratory, on the equipment required to perform the tests and on laboratory safety are also given. This manual is part of a series of Technical Reports on uranium ore processing being prepared by the IAEA's Division of Nuclear Fuel Cycle and Waste Management. A report on the Significance of Mineralogy in the Development of Flowsheets for Processing Uranium Ores (Technical Reports Series No. 196, 1980) and an instruction manual on Methods for the Estimation of Uranium Ore Reserves (No. 255, 1985) have already been published. 17 refs, 40 figs, 17 tabs

  20. Continuous Analytical Performances Monitoring at the On-Site Laboratory through Proficiency, Inter-Laboratory Testing and Inter-Comparison Analytical Methods

    International Nuclear Information System (INIS)

    Duhamel, G.; Decaillon, J.-G.; Dashdondog, S.; Kim, C.-K.; Toervenyi, A.; Hara, S.; Kato, S.; Kawaguchi, T.; Matsuzawa, K.

    2015-01-01

    Since 2008, as one measure to strengthen its quality management system, the On-Site Laboratory for nuclear safeguards at the Rokkasho Reprocessing Plant, has increased its participation in domestic and international proficiency and inter-laboratory testing for the purpose of determining analytical method accuracy, precision and robustness but also to support method development and improvement. This paper provides a description of the testing and its scheduling. It presents the way the testing was optimized to cover most of the analytical methods at the OSL. The paper presents the methodology used for the evaluation of the obtained results based on Analysis of variance (ANOVA). Results are discussed with respect to random, systematic and long term systematic error. (author)

  1. Relevance of laboratory testing for the diagnosis of primary immunodeficiencies: a review of case-based examples of selected immunodeficiencies

    Directory of Open Access Journals (Sweden)

    Abraham Roshini S

    2011-04-01

    Full Text Available Abstract The field of primary immunodeficiencies (PIDs is one of several in the area of clinical immunology that has not been static, but rather has shown exponential growth due to enhanced physician, scientist and patient education and awareness, leading to identification of new diseases, new molecular diagnoses of existing clinical phenotypes, broadening of the spectrum of clinical and phenotypic presentations associated with a single or related gene defects, increased bioinformatics resources, and utilization of advanced diagnostic technology and methodology for disease diagnosis and management resulting in improved outcomes and survival. There are currently over 200 PIDs with at least 170 associated genetic defects identified, with several of these being reported in recent years. The enormous clinical and immunological heterogeneity in the PIDs makes diagnosis challenging, but there is no doubt that early and accurate diagnosis facilitates prompt intervention leading to decreased morbidity and mortality. Diagnosis of PIDs often requires correlation of data obtained from clinical and radiological findings with laboratory immunological analyses and genetic testing. The field of laboratory diagnostic immunology is also rapidly burgeoning, both in terms of novel technologies and applications, and knowledge of human immunology. Over the years, the classification of PIDs has been primarily based on the immunological defect(s ("immunophenotype" with the relatively recent addition of genotype, though there are clinical classifications as well. There can be substantial overlap in terms of the broad immunophenotype and clinical features between PIDs, and therefore, it is relevant to refine, at a cellular and molecular level, unique immunological defects that allow for a specific and accurate diagnosis. The diagnostic testing armamentarium for PID includes flow cytometry - phenotyping and functional, cellular and molecular assays, protein analysis, and

  2. A Rapid Blood Test To Determine the Active Status and Duration of Acute Viral Infection.

    Science.gov (United States)

    Zheng, Tianyu; Finn, Caroline; Parrett, Christopher J; Dhume, Kunal; Hwang, Ji Hae; Sidhom, David; Strutt, Tara M; Li Sip, Yuen Yee; McKinstry, Karl K; Huo, Qun

    2017-11-10

    The ability to rapidly detect and diagnose acute viral infections is crucial for infectious disease control and management. Serology testing for the presence of virus-elicited antibodies in blood is one of the methods used commonly for clinical diagnosis of viral infections. However, standard serology-based tests have a significant limitation: they cannot easily distinguish active from past, historical infections. As a result, it is difficult to determine whether a patient is currently infected with a virus or not, and on an optimal course of action, based off of positive serology testing responses. Here, we report a nanoparticle-enabled blood test that can help overcome this major challenge. The new test is based on the analysis of virus-elicited immunoglobulin G (IgG) antibody present in the protein corona of a gold nanoparticle surface upon mixing the gold nanoparticles with blood sera. Studies conducted on mouse models of influenza A virus infection show that the test gives positive responses only in the presence of a recent acute viral infection, approximately between day 14 and day 21 following the infection, and becomes negative thereafter. When used together with the traditional serology testing, the nanoparticle test can determine clearly whether a positive serology response is due to a recent or historical viral infection. This new blood test can provide critical clinical information needed to optimize further treatment and/or to determine if further quarantining should be continued.

  3. The appropriateness of preoperative blood testing: A retrospective ...

    African Journals Online (AJOL)

    Background. Inappropriate preoperative blood testing can negatively contribute to healthcare costs. Objective. To determine the extent and cost implications of inappropriate preoperative blood testing in adult patients booked for orthopaedic, general or trauma surgical procedures at a regional hospital in KwaZulu-Natal ...

  4. Centrifugal contractors for laboratory-scale solvent extraction tests

    International Nuclear Information System (INIS)

    Leonard, R.A.; Chamberlain, D.B.; Conner, C.

    1995-01-01

    A 2-cm contactor (minicontactor) was developed and used at Argonne National Laboratory for laboratory-scale testing of solvent extraction flowsheets. This new contactor requires only 1 L of simulated waste feed, which is significantly less than the 10 L required for the 4-cm unit that had previously been used. In addition, the volume requirements for the other aqueous and organic feeds are reduced correspondingly. This paper (1) discusses the design of the minicontactor, (2) describes results from having applied the minicontactor to testing various solvent extraction flowsheets, and (3) compares the minicontactor with the 4-cm contactor as a device for testing solvent extraction flowsheets on a laboratory scale

  5. 19 CFR 151.54 - Testing by Customs laboratory.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 2 2010-04-01 2010-04-01 false Testing by Customs laboratory. 151.54 Section 151.54 Customs Duties U.S. CUSTOMS AND BORDER PROTECTION, DEPARTMENT OF HOMELAND SECURITY; DEPARTMENT OF... Other Metal-Bearing Materials § 151.54 Testing by Customs laboratory. Samples taken in accordance with...

  6. The Medical Service teams up with an external laboratory

    CERN Multimedia

    2015-01-01

    Since January, the CERN Medical Service has been collaborating with Proxilis, a medical testing laboratory in Meyrin, to carry out blood tests.   Sylvie Leprat, a nurse from the Proxilis laboratory, comes to the CERN Medical Service (Building 57, first floor) at 8 a.m. every morning to take blood samples. These samples are then taken from CERN to the Proxilis laboratory, where they are analysed by machines, lab technicians or the team's biologist. The results are first conveyed to CERN doctors over the telephone. Then, at the end of the day, they are incorporated into the patient's medical file for validation and possible comments by CERN doctors, before being e-mailed to the patient. People at CERN who are having blood tests done outside the context of their regular medical check-up receive an e-mail inviting them to choose a day and time for the blood samples to be taken. This provides a flexible service that allows appointments to be arranged according to their availability a...

  7. Blood Urea Nitrogen Test

    Science.gov (United States)

    ... to affect the kidneys, such as diabetes or high blood pressure , then creatinine and BUN tests may be used to monitor ... the diet. High-protein diets may cause abnormally high BUN levels while very low-protein diets can cause an abnormally low BUN. A wide variety ... a health practitioner will look at ...

  8. The sensitivity of laboratory tests assessing driving related skills to dose-related impairment of alcohol: A literature review.

    Science.gov (United States)

    Jongen, S; Vuurman, E F P M; Ramaekers, J G; Vermeeren, A

    2016-04-01

    Laboratory tests assessing driving related skills can be useful as initial screening tools to assess potential drug induced impairment as part of a standardized behavioural assessment. Unfortunately, consensus about which laboratory tests should be included to reliably assess drug induced impairment has not yet been reached. The aim of the present review was to evaluate the sensitivity of laboratory tests to the dose dependent effects of alcohol, as a benchmark, on performance parameters. In total, 179 experimental studies were included. Results show that a cued go/no-go task and a divided attention test with primary tracking and secondary visual search were consistently sensitive to the impairing effects at medium and high blood alcohol concentrations. Driving performance assessed in a simulator was less sensitive to the effects of alcohol as compared to naturalistic, on-the-road driving. In conclusion, replicating results of several potentially useful tests and their predictive validity of actual driving impairment should deserve further research. In addition, driving simulators should be validated and compared head to head to naturalistic driving in order to increase construct validity. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  9. Fecal Occult Blood Test (FOBT): MedlinePlus Lab Test Information

    Science.gov (United States)

    ... caused by a variety of conditions, including: Polyps Hemorrhoids Diverticulosis Ulcers Colitis , a type of inflammatory bowel ... on a fecal occult blood test include ulcers, hemorrhoids, polyps, and benign tumors. If your test results ...

  10. Automation software for a materials testing laboratory

    Science.gov (United States)

    Mcgaw, Michael A.; Bonacuse, Peter J.

    1990-01-01

    The software environment in use at the NASA-Lewis Research Center's High Temperature Fatigue and Structures Laboratory is reviewed. This software environment is aimed at supporting the tasks involved in performing materials behavior research. The features and capabilities of the approach to specifying a materials test include static and dynamic control mode switching, enabling multimode test control; dynamic alteration of the control waveform based upon events occurring in the response variables; precise control over the nature of both command waveform generation and data acquisition; and the nesting of waveform/data acquisition strategies so that material history dependencies may be explored. To eliminate repetitive tasks in the coventional research process, a communications network software system is established which provides file interchange and remote console capabilities.

  11. [Generalized neonatal screening based on laboratory tests].

    Science.gov (United States)

    Ardaillou, Raymond; Le Gall, Jean-Yves

    2006-11-01

    diseases in a single run. In addition to issues of cost and organization, any increase in the number of screened diseases will raise ethical problems, such as how to inform parents of an incurable disease, a late-onset disease, or an entirely asymptomatic disorder. It is unanimously agreed that only Mendelian diseases should be screened for (excluding genetic polymorphisms). Analysis of the present situation suggests the following changes:--guidelines for choosing new diseases for neonatal screening should be updated;--all new screening programs should be tested locally before nationwide implementation;--an evaluation committee of paediatricians and epidemiologists should be created, and the children's long-term outcome should be studied;--the conditions in which heterozygous carriers are informed after familial investigations need to be precisely defined;--blood samples should be banked for epidemiological studies.

  12. Guidelines on the management of abnormal liver blood tests

    Science.gov (United States)

    Cramb, Rob; Davison, Suzanne M; Dillon, John F; Foulerton, Mark; Godfrey, Edmund M; Hall, Richard; Harrower, Ulrike; Hudson, Mark; Langford, Andrew; Mackie, Anne; Mitchell-Thain, Robert; Sennett, Karen; Sheron, Nicholas C; Verne, Julia; Walmsley, Martine; Yeoman, Andrew

    2018-01-01

    These updated guidelines on the management of abnormal liver blood tests have been commissioned by the Clinical Services and Standards Committee (CSSC) of the British Society of Gastroenterology (BSG) under the auspices of the liver section of the BSG. The original guidelines, which this document supersedes, were written in 2000 and have undergone extensive revision by members of the Guidelines Development Group (GDG). The GDG comprises representatives from patient/carer groups (British Liver Trust, Liver4life, PBC Foundation and PSC Support), elected members of the BSG liver section (including representatives from Scotland and Wales), British Association for the Study of the Liver (BASL), Specialist Advisory Committee in Clinical Biochemistry/Royal College of Pathology and Association for Clinical Biochemistry, British Society of Paediatric Gastroenterology, Hepatology and Nutrition (BSPGHAN), Public Health England (implementation and screening), Royal College of General Practice, British Society of Gastrointestinal and Abdominal Radiologists (BSGAR) and Society of Acute Medicine. The quality of evidence and grading of recommendations was appraised using the AGREE II tool. These guidelines deal specifically with the management of abnormal liver blood tests in children and adults in both primary and secondary care under the following subheadings: (1) What constitutes an abnormal liver blood test? (2) What constitutes a standard liver blood test panel? (3) When should liver blood tests be checked? (4) Does the extent and duration of abnormal liver blood tests determine subsequent investigation? (5) Response to abnormal liver blood tests. They are not designed to deal with the management of the underlying liver disease. PMID:29122851

  13. Laboratory-based performance evaluation of PIMA CD4+ T-lymphocyte count point-of-care by lay-counselors in Kenya.

    Science.gov (United States)

    Zeh, Clement; Rose, Charles E; Inzaule, Seth; Desai, Mitesh A; Otieno, Fredrick; Humwa, Felix; Akoth, Benta; Omolo, Paul; Chen, Robert T; Kebede, Yenew; Samandari, Taraz

    2017-09-01

    CD4+ T-lymphocyte count testing at the point-of-care (POC) may improve linkage to care of persons diagnosed with HIV-1 infection, but the accuracy of POC devices when operated by lay-counselors in the era of task-shifting is unknown. We examined the accuracy of Alere's Pima™ POC device on both capillary and venous blood when performed by lay-counselors and laboratory technicians. In Phase I, we compared the perfomance of POC against FACSCalibur™ for 280 venous specimens by laboratory technicians. In Phase II we compared POC performance by lay-counselors versus laboratory technicians using 147 paired capillary and venous specimens, and compared these to FACSCalibur™. Statistical analyses included Bland-Altman analyses, concordance correlation coefficient, sensitivity, and specificity at treatment eligibility thresholds of 200, 350, and 500cells/μl. Phase I: POC sensitivity and specificity were 93.0% and 84.1% at 500cells/μl, respectively. Phase II: Good agreement was observed for venous POC results from both lay-counselors (concordance correlation coefficient (CCC)=0.873, bias -86.4cells/μl) and laboratory technicians (CCC=0.920, bias -65.7cells/μl). Capillary POC had good correlation: lay-counselors (CCC=0.902, bias -71.2cells/μl), laboratory technicians (CCC=0.918, bias -63.0cells/μl). Misclassification at the 500 cells/μl threshold for venous blood was 13.6% and 10.2% for lay-counselors and laboratory technicians and 12.2% for capillary blood in both groups. POC tended to under-classify the CD4 values with increasingly negative bias at higher CD4 values. Pima™ results were comparable to FACSCalibur™ for both venous and capillary specimens when operated by lay-counselors. POC CD4 testing has the potential to improve linkage to HIV care without burdening laboratory technicians in resource-limited settings. Published by Elsevier B.V.

  14. Gingival crevicular blood for screening of blood glucose level in patients with & without diabetes: a chair-side test.

    Science.gov (United States)

    Bhavsar, M V; Brahmbhatt, N A; Sahayata, V; Bhavsar, N V

    2016-05-01

    Diabetes is a pandemic disease with increasing prevalence and serious complications. Periodontitis being one of its presentation and is its sixth recognized complication. This study compares blood glucose levels in gingival crevicular blood of patients with and without diabetes elicited during routine periodontal probing and venous blood sample. Seventy patients with moderate gingivitis and periodontitis positive for bleeding on probing were chosen. All the subjects were divided in two groups, group I consisted of 35 diabetic and group II of 35 non-diabetic subjects. Blood from the gingiva of the most inflamed site was collected with the test strip of a glucose self-monitoring device, and the blood glucose levels were measured. At the same time, intravenous blood was collected for measurement in a laboratory glucose analyzer. Gingival index and probing pocket depth were evaluated for each subject at same time. The mean GCB levels and VB derived from all samples were 156.07 ± 49.23 mg dl(-1) and 156 ± 49.89 mg dl(-1) , respectively, for diabetic group and 90.80 ± 11.07 and 93.41 ± 9.30 for non-diabetic group. In both the groups, the difference between GCB and VB glucose levels was non-significant (P > 0.005). Highly significant correlation between GCB and VB (r = 0.972 for diabetic and r = 0.721 for non-diabetic) in both the groups was found. The data from this study show that GCB collected during diagnostic periodontal examination can be an excellent source for estimation of blood sugar or glucometric analysis. This technique is also suitable for routine screening of diabetic and early diagnosis of unknown diabetic cases. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. The impact of meningococcal polymerase chain reaction testing on laboratory confirmation of invasive meningococcal disease.

    LENUS (Irish Health Repository)

    Drew, Richard J

    2012-03-01

    Laboratory methods of diagnosis were examined for 266 children with invasive meningococcal disease. Seventy-five (36%) of 207 cases with bloodstream infection had both positive blood culture and blood meningococcal polymerase chain reaction (PCR), 130 (63%) negative blood culture and positive blood PCR, and 2 (1%) had positive blood culture and negative blood PCR. Sixty-three percent of cases were diagnosed by PCR alone.

  16. Mean Blood Pressure Difference among Adolescents Based on Dyssomnia Types.

    Science.gov (United States)

    Sembiring, Krisnarta; Ramayani, Oke Rina; Lubis, Munar

    2018-02-15

    Dyssomnia is the most frequent sleep disturbance and associated with increased blood pressure. There has been no study determining the difference in mean blood pressure based on dyssomnia types among adolescents. To determine the difference in mean blood pressure among adolescents based on dyssomnia types. Cross-sectional study was conducted in SMP Negeri 1 Muara Batang Gadis in April 2016. Samples were students having sleep disturbance based on Sleep Disturbance Scale for Children (SDSC) questionnaire. Stature and blood pressure data were collected along with demographic data and sleep disorder questionnaire. Analyses were done with Kruskal-Wallis test and logistic regression. P - value blood pressure (DBP) was 111.1 (SD 16.46) mmHg and 70.3 (SD 11.98) mmHg respectively. Mean SDSC score was 49.7 (SD 8.96), and the most frequent dyssomnia type was disorders of initiating and maintaining sleep. Age and sex were not the risk factors of hypertension in dyssomnia. There was a significant difference in mean SBP (P = 0.006) and DBP (P = 0.022) based on dyssomnia types. Combination dyssomnia type had the highest mean blood pressure among dyssomnia types. There is a significant difference in mean blood pressure among adolescents based on dyssomnia types.

  17. Evaluation of the performance of the OneTouch Select Plus blood glucose test system against ISO 15197:2013.

    Science.gov (United States)

    Setford, Steven; Smith, Antony; McColl, David; Grady, Mike; Koria, Krisna; Cameron, Hilary

    2015-01-01

    Assess laboratory and in-clinic performance of the OneTouch Select(®) Plus test system against ISO 15197:2013 standard for measurement of blood glucose. System performance assessed in laboratory against key patient, environmental and pharmacologic factors. User performance was assessed in clinic by system-naïve lay-users. Healthcare professionals assessed system accuracy on diabetes subjects in clinic. The system demonstrated high levels of performance, meeting ISO 15197:2013 requirements in laboratory testing (precision, linearity, hematocrit, temperature, humidity and altitude). System performance was tested against 28 interferents, with an adverse interfering effect only being recorded for pralidoxime iodide. Clinic user performance results fulfilled ISO 15197:2013 accuracy criteria. Subjects agreed that the color range indicator clearly showed if they were low, in-range or high and helped them better understand glucose results. The system evaluated is accurate and meets all ISO 15197:2013 requirements as per the tests described. The color range indicator helped subjects understand glucose results and supports patients in following healthcare professional recommendations on glucose targets.

  18. Nanoscale Test Strips for Multiplexed Blood Analysis

    Science.gov (United States)

    Chan, Eugene

    2015-01-01

    A critical component of the DNA Medicine Institute's Reusable Handheld Electrolyte and Lab Technology for Humans (rHEALTH) sensor are nanoscale test strips, or nanostrips, that enable multiplexed blood analysis. Nanostrips are conceptually similar to the standard urinalysis test strip, but the strips are shrunk down a billionfold to the microscale. Each nanostrip can have several sensor pads that fluoresce in response to different targets in a sample. The strips carry identification tags that permit differentiation of a specific panel from hundreds of other nanostrip panels during a single measurement session. In Phase I of the project, the company fabricated, tested, and demonstrated functional parathyroid hormone and vitamin D nanostrips for bone metabolism, and thrombin aptamer and immunoglobulin G antibody nanostrips. In Phase II, numerous nanostrips were developed to address key space flight-based medical needs: assessment of bone metabolism, immune response, cardiac status, liver metabolism, and lipid profiles. This unique approach holds genuine promise for space-based portable biodiagnostics and for point-of-care (POC) health monitoring and diagnostics here on Earth.

  19. Do children without a known bleeding tendency undergoing PICC placement require coagulation laboratory testing?

    Science.gov (United States)

    Woodley-Cook, Joel; Amaral, Joao; Connolly, Bairbre; Brandão, Leonardo R

    2015-04-01

    Obtaining basic hemostatic laboratory investigations prior to peripherally inserted central catheter (PICC) insertion remains controversial, even if the procedure is converted to a tunneled central venous line (CVL) placement. To determine the value of pre-procedural blood screening (hemoglobin level, platelet count, aPTT/INR) in hospitalized children without a known bleeding diathesis. This retrospective review included pediatric patients undergoing PICC insertion who had both laboratory screening and post-PICC hemoglobin level. Two cohorts (A: 0-3 months; B: >3 months-18 years) were analyzed for procedural major/minor bleeding. Of 1,441 consecutive children identified during a 3-year period, 832 patients (226 in cohort A, 606 in cohort B) fulfilled the inclusion criteria. Overall, 36% (300/832) of the patients had at least one abnormal laboratory result. Only 0.2% (3/1,441) of patients required conversion to a central venous line. In cohort A no major bleeding occurred; the minor bleeding frequency was 30% (68/226). Neither abnormal laboratory results nor correction of abnormal laboratory results was associated with minor bleeding complications. The positive and negative predictive values (PPV/NPV) of having abnormal laboratory screening were 0.22 and 0.68, respectively. In cohort B the major bleeding frequency was 1% (6/606) but no patient required any blood transfusion; minor bleeding occurred in 29% (174/606). Neither abnormal laboratory results nor correction of abnormal laboratory results was associated with minor bleeding complications. The PPV and NPV of abnormal laboratory screening results were 0.24 and 0.72, respectively. Pre-procedural blood screening did not predict bleeding in hospitalized children without a known bleeding diathesis undergoing PICC insertion. The rarity of major bleeding complications and need for conversion to a central venous line did not support a need for laboratory screening.

  20. 7 CFR 58.523 - Laboratory and quality control tests.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Laboratory and quality control tests. 58.523 Section... Service 1 Operations and Operating Procedures § 58.523 Laboratory and quality control tests. (a) Quality control tests shall be made on samples as often as necessary to determine the shelf-life and stability of...

  1. Evaluation of cardiovascular risk-lowering health benefits accruing from laboratory-based, community-based and exercise-referral exercise programmes.

    Science.gov (United States)

    Webb, R; Thompson, J E S; Ruffino, J-S; Davies, N A; Watkeys, L; Hooper, S; Jones, P M; Walters, G; Clayton, D; Thomas, A W; Morris, K; Llewellyn, D H; Ward, M; Wyatt-Williams, J; McDonnell, B J

    2016-01-01

    To evaluate the ability of community-based exercise programmes to facilitate public participation in exercise and hence improved cardiovascular health, we assessed the respective impacts of: a continuously monitored exercise programme based within our university (study 1); a Valleys Regional Park-facilitated community-based outdoor exercise programme (study 2); a Wales National Exercise Referral Scheme-delivered exercise-referral programme (study 3). Biomolecular (monocytic PPARγ target gene expression), vascular haemodynamic (central/peripheral blood pressure, arterial stiffness), clinical (insulin sensitivity, blood lipids) and anthropometric (body mass index, waist circumference, heart rate) parameters were investigated using RT-PCR, applanation tonometry, chemical analysis and standard anthropometric techniques. In studies 1-3, 22/28, 32/65 and 11/14 participants adhered to their respective exercise programmes, and underwent significant increases in physical activity levels. Importantly, beneficial effects similar to those seen in our previous studies (eg, modulations in expression of monocytic PPARγ target genes, decreases in blood pressure/arterial stiffness, improvements in blood lipids/insulin sensitivity) were observed (albeit to slightly differing extents) only in participants who adhered to their respective exercise programmes. While study 1 achieved more intense exercise and more pronounced beneficial effects, significant cardiovascular risk-lowering health benefits related to biomolecular markers, blood pressure, arterial stiffness and blood lipids were achieved via community/referral-based delivery modes in studies 2 and 3. Because cardiovascular health benefits were observed in all 3 studies, we conclude that the majority of benefits previously reported in laboratory-based studies can also be achieved in community-based/exercise-referral settings. These findings may be of use in guiding policymakers with regard to introduction and/or continued

  2. Artificial Neural Network Approach in Laboratory Test Reporting:  Learning Algorithms.

    Science.gov (United States)

    Demirci, Ferhat; Akan, Pinar; Kume, Tuncay; Sisman, Ali Riza; Erbayraktar, Zubeyde; Sevinc, Suleyman

    2016-08-01

    In the field of laboratory medicine, minimizing errors and establishing standardization is only possible by predefined processes. The aim of this study was to build an experimental decision algorithm model open to improvement that would efficiently and rapidly evaluate the results of biochemical tests with critical values by evaluating multiple factors concurrently. The experimental model was built by Weka software (Weka, Waikato, New Zealand) based on the artificial neural network method. Data were received from Dokuz Eylül University Central Laboratory. "Training sets" were developed for our experimental model to teach the evaluation criteria. After training the system, "test sets" developed for different conditions were used to statistically assess the validity of the model. After developing the decision algorithm with three iterations of training, no result was verified that was refused by the laboratory specialist. The sensitivity of the model was 91% and specificity was 100%. The estimated κ score was 0.950. This is the first study based on an artificial neural network to build an experimental assessment and decision algorithm model. By integrating our trained algorithm model into a laboratory information system, it may be possible to reduce employees' workload without compromising patient safety. © American Society for Clinical Pathology, 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Performance specifications for the extra-analytical phases of laboratory testing: Why and how.

    Science.gov (United States)

    Plebani, Mario

    2017-07-01

    An important priority in the current healthcare scenario should be to address errors in laboratory testing, which account for a significant proportion of diagnostic errors. Efforts made in laboratory medicine to enhance the diagnostic process have been directed toward improving technology, greater volumes and more accurate laboratory tests being achieved, but data collected in the last few years highlight the need to re-evaluate the total testing process (TTP) as the unique framework for improving quality and patient safety. Valuable quality indicators (QIs) and extra-analytical performance specifications are required for guidance in improving all TTP steps. Yet in literature no data are available on extra-analytical performance specifications based on outcomes, and nor is it possible to set any specification using calculations involving biological variability. The collection of data representing the state-of-the-art based on quality indicators is, therefore, underway. The adoption of a harmonized set of QIs, a common data collection and standardised reporting method is mandatory as it will not only allow the accreditation of clinical laboratories according to the International Standard, but also assure guidance for promoting improvement processes and guaranteeing quality care to patients. Copyright © 2017 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  4. A Metabolic Murder Mystery: A Case-Based Experiment for the Undergraduate Biochemistry Laboratory

    Science.gov (United States)

    Childs-Disney, Jessica L.; Kauffmann, Andrew D.; Poplawski, Shane G.; Lysiak, Daniel R.; Stewart, Robert J.; Arcadi, Jane K.; Dinan, Frank J.

    2010-01-01

    In 1990, a woman was wrongly convicted of poisoning her infant son and was sentenced to life in prison. Her conviction was based on laboratory work that wrongly identified ethylene glycol as present in her son's blood and in the formula he drank prior to his death. The actual cause of the infant's death, a metabolic disease, was eventually…

  5. Review of progresses on clinical applications of ion selective electrodes for electrolytic ion tests: from conventional ISEs to graphene-based ISEs

    Directory of Open Access Journals (Sweden)

    Rongguo Yan

    2016-10-01

    Full Text Available There exist several positively and negatively charged electrolytes or ions in human blood, urine, and other body fluids. Tests that measure the concentration of these ions in clinics are performed using a more affordable, portable, and disposable potentiometric sensing method with few sample volumes, which requires the use of ion-selective electrodes (ISEs and reference electrodes. This review summarily descriptively presents progressive developments and applications of ion selective electrodes in medical laboratory electrolytic ion tests, from conventional ISEs, solid-contact ISEs, carbon nanotube based ISEs, to graphene-based ISEs.

  6. The efficacy of unsupervised home-based exercise regimens in comparison to supervised laboratory-based exercise training upon cardio-respiratory health facets.

    Science.gov (United States)

    Blackwell, James; Atherton, Philip J; Smith, Kenneth; Doleman, Brett; Williams, John P; Lund, Jonathan N; Phillips, Bethan E

    2017-09-01

    Supervised high-intensity interval training (HIIT) can rapidly improve cardiorespiratory fitness (CRF). However, the effectiveness of time-efficient unsupervised home-based interventions is unknown. Eighteen volunteers completed either: laboratory-HIIT (L-HIIT); home-HIIT (H-HIIT) or home-isometric hand-grip training (H-IHGT). CRF improved significantly in L-HIIT and H-HIIT groups, with blood pressure improvements in the H-IHGT group only. H-HIIT offers a practical, time-efficient exercise mode to improve CRF, away from the laboratory environment. H-IHGT potentially provides a viable alternative to modify blood pressure in those unable to participate in whole-body exercise. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

  7. 21 CFR 640.5 - Testing the blood.

    Science.gov (United States)

    2010-04-01

    ... be negative to a serological test for syphilis. (b) Determination of blood group. Each container of... sample. The label shall indicate the extent of typing and the results of all tests performed. If the test... test is negative, the results shall be confirmed by further testing which shall include tests for the...

  8. Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C.

    Science.gov (United States)

    Halfon, Philippe; Bacq, Yannick; De Muret, Anne; Penaranda, Guillaume; Bourliere, Marc; Ouzan, Denis; Tran, Albert; Botta, Danielle; Renou, Christophe; Bréchot, Marie-Claude; Degott, Claude; Paradis, Valérie

    2007-03-01

    We evaluated the test performance profile (TPP) of blood tests of liver fibrosis. Three hundred and fifty-six patients with C chronic hepatitis were included in two centers. Metavir staging of liver specimens by two independent pathologists and the following tests were evaluated: Fibrotest (FT), APRI, FibroMeter (FM), and Hepascore (HS). Metavir stages were: F0: 4%, F1: 55%, F2: 26%, F3: 11%, and F4: 4%. The AUROCs were not significantly different, respectively, FT, FM, APRI, HS: >or=F2: 0.79, 0.78, 0.76, >or=0.76; F3: 0.81, 0.85, 0.81, 0.81; and F4: 0.86, 0.94, 0.92, 0.89. The TPP relies on the paired comparison of blood-test misclassification based on liver specimen, e.g. FT vs FM, respectively: F0+1: 18 vs 28% (p=0.0003), >or=F2: 43 vs 31% (p=0.004). There was no center effect. In those populations, the four blood tests had a similar performance for significant fibrosis (F>or=2), lying in the lower range of published results which is attributable to a low >or=F2 prevalence, and for >or=F3 and F4. However, FM and FT had performance profiles significantly different as a function of fibrosis stages or diagnostic target (fibrosis cut-off). This has to be considered during the interpretation process. Moreover, the performance should be reported with different diagnostic targets.

  9. Uptake of a colorectal cancer screening blood test in people with elevated risk for cancer who cannot or will not complete a faecal occult blood test.

    Science.gov (United States)

    Symonds, Erin L; Cock, Charles; Meng, Rosie; Cole, Stephen R; Fraser, Robert J L; Young, Graeme P

    2017-03-31

    Participation rates in colorectal cancer (CRC) screening programmes using faecal occult blood tests (FOBTs) are low. Nonparticipation is commonly attributed to psychosocial factors, but some medical conditions also prevent screening. These barriers might be partially overcome if a blood test for CRC screening was available. This study determined whether people who had always declined screening by FOBT would participate if offered a blood test. An audit of registrants within a personalized CRC screening programme was undertaken to determine the reasons for regular nonparticipation in FOBT. Consistent nonparticipants (n=240) were randomly selected and invited for CRC screening with a blood test. Demographic characteristics and the reasons for prior FOBT nonparticipation were collected by means of a questionnaire. Nonparticipation in the screening programme could be classified as either behavioural (8.6%), with consistent noncompliance, or due to medical contraindications (8.5%), which included chronic rectal bleeding, being deemed unsuitable by a health professional, and needing personal assistance. Blood test uptake was 25%, with participation in the medical contraindications group greater than that in the behavioural group (43 vs. 12%, Pprocrastination and dislike of the test, but these were not associated with blood test uptake (P>0.05). There is a subgroup of the community who have medical reasons for nonparticipation in CRC screening with FOBT but will participate if offered a blood test. The option of a blood test does not, however, improve uptake in those who admit to behavioural reasons for noncompliance with screening.

  10. Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

    Science.gov (United States)

    Arnold, Mark; Bakris, George L.; Bruns, David E.; Horvath, Andrea Rita; Kirkman, M. Sue; Lernmark, Ake; Metzger, Boyd E.; Nathan, David M.

    2011-01-01

    BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence-Based Laboratory Medicine Committee of the American Association for Clinical Chemistry jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (HbA1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of HbA1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended. PMID:21617108

  11. Laboratory Exercise: Study of Digestive and Regulatory Processes through the Exploration of Fasted and Postprandial Blood Glucose

    Science.gov (United States)

    Hopper, Mari K.; Maurer, Luke W.

    2013-01-01

    Digestive physiology laboratory exercises often explore the regulation of enzyme action rather than systems physiology. This laboratory exercise provides a systems approach to digestive and regulatory processes through the exploration of postprandial blood glucose levels. In the present exercise, students enrolled in an undergraduate animal…

  12. Blood: Tests Used to Assess the Physiological and Immunological Properties of Blood

    Science.gov (United States)

    Quinn, J. G.; Tansey, E. A.; Johnson, C. D.; Roe, S. M.; Montgomery, L. E. A.

    2016-01-01

    The properties of blood and the relative ease of access to which it can be retrieved make it an ideal source to gauge different aspects of homeostasis within an individual, form an accurate diagnosis, and formulate an appropriate treatment regime. Tests used to determine blood parameters such as the erythrocyte sedimentation rate, hemoglobin…

  13. Child Abuse, Resting Blood Pressure, and Blood Pressure Reactivity to Psychosocial Stress.

    Science.gov (United States)

    Gooding, Holly C; Milliren, Carly E; Austin, S Bryn; Sheridan, Margaret A; McLaughlin, Katie A

    2016-01-01

    Childhood trauma is associated with hypertension in adults. It is unknown whether childhood trauma predicts elevated blood pressure earlier in development. We investigated whether the trauma of child abuse was associated with blood pressure in adolescents. The sample included 145 adolescents aged 13-17 years, 40% with exposure to child abuse. The mean age of participants was 14.93 years (SD = 1.33); 58% were female. The majority self-identified as non-Hispanic White (43%), with the remainder identifying as non-Hispanic Black (17%), Hispanic (17%), or other/mixed race (23%). We used established age/sex/height-specific cutoffs to determine the prevalence of prehypertension and hypertension in the sample. We used two-sample t tests to examine associations of abuse with resting systolic blood pressure (SBP) and diastolic blood pressure (DBP) and blood pressure reactivity to the Trier Social Stress Test and a frustration task. We used linear regression to adjust for potential confounders including sociodemographic variables, body mass index, smoking, and psychopathology. Mean resting SBP and DBP were 114.07 mmHg and 61.35 mmHg in those with a history of abuse and 111.39 mmHg and 56.89 mmHg in those without a history of abuse. This difference was significant for DBP only. Twelve percent of participants met criteria for prehypertension or hypertension based on resting blood pressure values; this did not differ between those with and without an abuse history. Child abuse was associated with lower DBP and SBP reactivity to laboratory stress tasks and reduced DBP reactivity to frustration. These associations were robust to adjustment for potential confounders. Child abuse is associated with higher resting DBP and blunted DBP and SBP reactivity to laboratory stress in adolescence. These findings suggest a potential pathway by which child abuse leads to hypertension. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All

  14. Pediatric blood transfusion practices at a regional referral hospital in Kenya.

    Science.gov (United States)

    Nabwera, Helen M; Fegan, Greg; Shavadia, Jay; Denje, Douglas; Mandaliya, Kishor; Bates, Imelda; Maitland, Kathryn; Hassall, Oliver W

    2016-11-01

    Severe anemia in children is a major public health problem in sub-Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya. This was an observational study where over a 2-year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year. There were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6-6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4-12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2-9.1 g/dL). Ninety-four percent (186) were transfused "appropriately" while 52% (120) were transfused "inappropriately." There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p blood transfusions but only 41% (106) of these had a positive blood film. In this setting, clinicians often order blood based on the clinical impression of "severe anemia." This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice. © 2016 The Authors. Transfusion published by Wiley Periodicals, Inc. on behalf of AABB.

  15. Accuracy in HIV Rapid Testing among Laboratory and Non-laboratory Personnel in Zambia: Observations from the National HIV Proficiency Testing System.

    Directory of Open Access Journals (Sweden)

    Sheila Mwangala

    Full Text Available Despite rapid task-shifting and scale-up of HIV testing services in high HIV prevalence countries, studies evaluating accuracy remain limited. This study aimed to assess overall accuracy level and factors associated with accuracy in HIV rapid testing in Zambia.Accuracy was investigated among rural and urban HIV testing sites participating in two annual national HIV proficiency testing (PT exercises conducted in 2009 (n = 282 sites and 2010 (n = 488 sites. Testers included lay counselors, nurses, laboratory personnel and others. PT panels of five dry tube specimens (DTS were issued to testing sites by the national reference laboratory (NRL. Site accuracy level was assessed by comparison of reported results to the expected results. Non-parametric rank tests and multiple linear regression models were used to assess variation in accuracy between PT cycles and between tester groups, and to examine factors associated with accuracy respectively.Overall accuracy level was 93.1% (95% CI: 91.2-94.9 in 2009 and 96.9% (95% CI: 96.1-97.8 in 2010. Differences in accuracy were seen between the tester groups in 2009 with laboratory personnel being more accurate than non-laboratory personnel, while in 2010 no differences were seen. In both PT exercises, lay counselors and nurses had more difficulties interpreting results, with more occurrences of false-negative, false-positive and indeterminate results. Having received the standard HIV rapid testing training and adherence to the national HIV testing algorithm were positively associated with accuracy.The study showed an improvement in tester group and overall accuracy from the first PT exercise to the next. Average number of incorrect test results per 1000 tests performed was reduced from 69 to 31. Further improvement is needed, however, and the national HIV proficiency testing system seems to be an important tool in this regard, which should be continued and needs to be urgently strengthened.

  16. Evaluating laboratory request forms submitted to haematology and blood transfusion departments at a hospital in Northwest Nigeria

    Directory of Open Access Journals (Sweden)

    Feyisayo Jegede

    2016-05-01

    Objective: We assessed routinely-submitted LRFs to determine the degree of correctness, completeness and consistency. Methods: LRFs submitted to the Department of Haematology (DH and Blood Transfusion Services (BTS of Aminu Kano Teaching Hospital in Kano, Nigeria, between October 2014 and December 2014, were evaluated for completion of all items on the forms. Performance in four quality indicator domains, including patient identifiers, test request details, laboratory details and physician details, was derived as a composite percentage. Results: Of the 2084 LRFs evaluated, 999 were from DH and 1085 from BTS. Overall, LRF completeness was 89.5% for DH and 81.2% for BTS. Information on patient name, patient location and laboratory number were 100% complete for DH, whereas only patient name was 100% complete for BTS. Incomplete information was mostly encountered on BTS forms for physician’s signature (60.8% and signature of laboratory receiver (63.5%. None of the DH and only 9.4% of BTS LRFs met all quality indicator indices. Conclusion: The level of completion of LRFs from these two departments was suboptimal. This underscores the need to review and redesign the LRF, improve on training and communication between laboratory and clinical staff and review specimen rejection practices.

  17. Use of laboratory test results in patient management by clinicians in Malawi.

    Science.gov (United States)

    Moyo, Kundai; Porter, Carol; Chilima, Ben; Mwenda, Reuben; Kabue, Mark; Zungu, Lutho; Sarr, Abdoulaye

    2015-11-18

    Malawi has a high burden of infectious disease. The expansion of programmes targeting these diseases requires a strong laboratory infrastructure to support both diagnosis and treatment. To assess the use of laboratory test results in patient management and to determine the requirements for improving laboratory services. A cross-sectional study was conducted in 2012 to survey practising clinicians. Two hospitals were purposively selected for observations of clinicians ordering laboratory tests. Twelve management-level key informants were interviewed. Descriptive statistics were conducted. A total of 242 clinicians were identified and 216 (89%) were interviewed. Of these, 189 (87%) reported doubting laboratory test results at some point. Clinicians most often doubted the quality of haematology (67%), followed by malaria (53%) and CD4 (22%) test results. A total of 151 (70%) clinicians reported using laboratory tests results in patient management. Use of laboratory test results at all times in patient management varied by the type of health facility ( P management. Key informants reported that the quality of laboratory services was good and useful, but that services were often unavailable. Gaps in the public laboratory system were evident. Key recommendations to enhance the use of laboratory test results in patient management were to strengthen the supply chain, reduce turn-around times, improve the test menu and improve the laboratory infrastructure.

  18. Establishing benchmarks and metrics for disruptive technologies, inappropriate and obsolete tests in the clinical laboratory.

    Science.gov (United States)

    Kiechle, Frederick L; Arcenas, Rodney C; Rogers, Linda C

    2014-01-01

    Benchmarks and metrics related to laboratory test utilization are based on evidence-based medical literature that may suffer from a positive publication bias. Guidelines are only as good as the data reviewed to create them. Disruptive technologies require time for appropriate use to be established before utilization review will be meaningful. Metrics include monitoring the use of obsolete tests and the inappropriate use of lab tests. Test utilization by clients in a hospital outreach program can be used to monitor the impact of new clients on lab workload. A multi-disciplinary laboratory utilization committee is the most effective tool for modifying bad habits, and reviewing and approving new tests for the lab formulary or by sending them out to a reference lab. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. 7 CFR 58.442 - Laboratory and quality control tests.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 3 2010-01-01 2010-01-01 false Laboratory and quality control tests. 58.442 Section... Service 1 Operations and Operating Procedures § 58.442 Laboratory and quality control tests. (a) Chemical... Methods or by other methods giving equivalent results. (b) Weight or volume control. Representative...

  20. Inadequate Information in Laboratory Test Requisition in a Tertiary ...

    African Journals Online (AJOL)

    Objectives: This study examined the pattern of deficiencies in the laboratory test requisition by doctors at the University of Benin Teaching Hospital, Benin City, Nigeria, with a view to suggesting strategies of reducing error rates in laboratory test requisition. Materials and Method: The study generated data through ...

  1. BUN (Blood Urea Nitrogen): MedlinePlus Lab Test Information

    Science.gov (United States)

    ... https://medlineplus.gov/labtests/bunbloodureanitrogen.html BUN (Blood Urea Nitrogen) To use the sharing features on this ... please enable JavaScript. What is a BUN (Blood Urea Nitrogen) Test? A BUN, or blood urea nitrogen ...

  2. Laboratory survival and blood feeding response of wild-caught Culicoides obsoletus Complex (Diptera: Ceratopogonidae) through natural and artificial membranes.

    Science.gov (United States)

    Goffredo, M; Romeo, G; Monaco, F; Di Gennaro, A; Savini, G

    2004-01-01

    In late summer 2002, live wild-caught midges of the Obsoletus Complex were collected using blacklight traps placed at a horse stable in Teramo (Abruzzo, Italy). For the survival study under laboratory conditions, 1,500 Obsoletus Complex midges were kept at 17 degrees C-25 degrees C and provided only with a sucrose solution. Of these, 150 (10%) survived for at least 40 days and 3 midges were still alive after 92 days. In addition, 10 midges survived 10 days at 4 degrees C. For the feeding trials, 40 blood-meals (9,440 midges) were administered, 27 of which were successful (67.5%); the feeding rate ranged from 0.3% to 16.7%, with a total of 592 engorged midges. Similar feeding rates (U Mann-Whitney test=129.5 p>0.05) were obtained when natural (day-old chicken skin) and artificial (stretched parafilm) membranes were used. To infect the insects, a field strain of bluetongue (BT) virus (BTV) serotype 2 isolated from the spleen of a sheep during the 2000 Italian outbreak was added to the blood-meal. Two different viral solutions, with titres of 10(6)TCID(50)/ml and 10(7)TCID(50)/ml, were prepared. Uninfected blood was significantly more appetising (U Mann-Whitney test=88.5 pdays. During the incubation period, the dead insects were collected daily and analysed for evidence of virus infection. Of the 251 engorged midges, 54 (21.5%) died in the feeding chambers or during sorting on the chill table, 136 died within the first 10 days and 61 survived longer. BTV was isolated only from those which died just after feeding (52.6%; 10/19) or 24 h later (47.8%; 11/23). Considering the small number of midges tested after 10 days of incubation, the prevalence of infection detected in this study (95% probability) would have been higher than 4.74%. These preliminary results appear very promising as this is the first time that midges of the Obsoletus Complex have been successfully fed under laboratory conditions.

  3. Comparison of nine blood tests and transient elastography for liver fibrosis in chronic hepatitis C: the ANRS HCEP-23 study.

    Science.gov (United States)

    Zarski, Jean-Pierre; Sturm, Nathalie; Guechot, Jérôme; Paris, Adeline; Zafrani, Elie-Serge; Asselah, Tarik; Boisson, Renée-Claude; Bosson, Jean-Luc; Guyader, Dominique; Renversez, Jean-Charles; Bronowicki, Jean-Pierre; Gelineau, Marie-Christine; Tran, Albert; Trocme, Candice; De Ledinghen, Victor; Lasnier, Elisabeth; Poujol-Robert, Armelle; Ziegler, Frédéric; Bourliere, Marc; Voitot, Hélène; Larrey, Dominique; Rosenthal-Allieri, Maria Alessandra; Fouchard Hubert, Isabelle; Bailly, François; Vaubourdolle, Michel

    2012-01-01

    Blood tests and transient elastography (Fibroscan™) have been developed as alternatives to liver biopsy. This ANRS HCEP-23 study compared the diagnostic accuracy of nine blood tests and transient elastography (Fibroscan™) to assess liver fibrosis, vs. liver biopsy, in untreated patients with chronic hepatitis C (CHC). This was a multicentre prospective independent study in 19 French University hospitals of consecutive adult patients having simultaneous liver biopsy, biochemical blood tests (performed in a centralized laboratory) and Fibroscan™. Two experienced pathologists independently reviewed the liver biopsies (mean length=25±8.4 mm). Performance was assessed using ROC curves corrected by Obuchowski's method. Fibroscan™ was not interpretable in 113 (22%) patients. In the 382 patients having both blood tests and interpretable Fibroscan™, Fibroscan™ performed similarly to the best blood tests for the diagnosis of significant fibrosis and cirrhosis. Obuchowski's measure showed Fibrometer® (0.86), Fibrotest® (0.84), Hepascore® (0.84), and interpretable Fibroscan™ (0.84) to be the most accurate tests. The combination of Fibrotest®, Fibrometer®, or Hepascore® with Fibroscan™ or Apri increases the percentage of well classified patients from 70-73% to 80-83% for significant fibrosis, but for cirrhosis a combination offers no improvement. For the 436 patients having all the blood tests, AUROC's ranged from 0.82 (Fibrometer®) to 0.75 (Hyaluronate) for significant fibrosis, and from 0.89 (Fibrometer® and Hepascore®) to 0.83 (FIB-4) for cirrhosis. Contrarily to blood tests, performance of Fibroscan™ was reduced due to uninterpretable results. Fibrotest®, interpretable Fibroscan™, Fibrometer®, and Hepascore® perform best and similarly for diagnosis of significant fibrosis and cirrhosis. Copyright © 2011 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

  4. Determination of Trimethoprim-Sulfamethoxazole Resistance in Streptococcus pneumoniae by Using the E Test with Mueller-Hinton Agar Supplemented with Sheep or Horse Blood May Be Unreliable

    Science.gov (United States)

    Lovgren, M.; Dell’Acqua, L.; Palacio, R.; Echániz-Aviles, G.; Soto-Noguerón, A.; Castañeda, E.; Agudelo, C. I.; Heitmann, I.; Brandileone, M. C.; Zanella, R. C.; Rossi, A.; Pace, J.; Talbot, J. A.

    1999-01-01

    An international, multicenter study compared trimethoprim-sulfamethoxazole MICs for 743 Streptococcus pneumoniae isolates (107 to 244 isolates per country) by E test, using Mueller-Hinton agar supplemented with 5% defibrinated horse blood or 5% defibrinated sheep blood, with MICs determined by the National Committee for Clinical Laboratory Standards broth microdilution reference method. Agreement within 1 log2 dilution and minor error rates were 69.3 and 15.5%, respectively, on sheep blood-supplemented agar and 76.9 and 13.6%, respectively, with horse blood as the supplement. Significant interlaboratory variability was observed. E test may not be a reliable method for determining the resistance of pneumococci to trimethoprim-sulfamethoxazole. PMID:9854095

  5. Blood Pressure Test

    Science.gov (United States)

    ... pressure monitors may have some limitations. Tracking your blood pressure readings It can be helpful in diagnosing or ... more Stage 2 high blood pressure (hypertension) Elevated blood pressure and stages 1 and 2 high blood pressure ( ...

  6. Proficiency testing for HIV, tuberculosis and malaria diagnosis in clinical laboratories in Nigeria

    Science.gov (United States)

    Onubogu, Catherine C.; Okoye, Rosemary N.; Nwokoye, Nkiru N.; Onwuamah, Chika K.; Musa, Adesola Z.; Raheem, Toyosi Y.; Aniedobe, Maureen N.; Nduaga, Samuel J.; Essien, Ini-Obong; Idigbe, Emmanuel O.

    2014-01-01

    Background Proficiency testing (PT) is a means of verifying the reliability of laboratory results, but such programmes are not readily available to laboratories in developing countries. This project provided PT to laboratories in Nigeria. Objectives To assess the proficiency of laboratories in the diagnosis of HIV, tuberculosis and malaria. Methods This was a prospective study carried out between 2009 and 2011. A structured questionnaire was administered to 106 randomly-selected laboratories. Forty-four indicated their interest in participation and were enrolled. Four rounds of pre-characterised plasma panels for HIV, sputum films for tuberculosis and blood films for malaria were distributed quarterly by courier over the course of one year. The results were returned within two weeks and scores of ≥ 80% were reported as satisfactory. Mentoring was offered after the first and second PT rounds. Results Average HIV PT scores increased from 74% to 95% from the first round to the third round, but decreased in the fourth round. For diagnosis of tuberculosis, average scores increased from 42% in the first round to 78% in the second round; but a decrease to 34% was observed in the fourth round. Malaria PT performance was 2% at first, but average scores increased between the second and fourth rounds, culminating in a fourth-round score of 39%. Many participants requested training and mentoring. Conclusions There were gross deficiencies in the quality of laboratory services rendered across Nigeria. In-country PT programmes, implemented in conjunction with mentoring, will improve coverage and diagnosis of HIV, tuberculosis and malaria. PMID:29043176

  7. Specimen rejection in laboratory medicine: Necessary for patient safety?

    Science.gov (United States)

    Dikmen, Zeliha Gunnur; Pinar, Asli; Akbiyik, Filiz

    2015-01-01

    The emergency laboratory in Hacettepe University Hospitals receives specimens from emergency departments (EDs), inpatient services and intensive care units (ICUs). The samples are accepted according to the rejection criteria of the laboratory. In this study, we aimed to evaluate the sample rejection ratios according to the types of pre-preanalytical errors and collection areas. The samples sent to the emergency laboratory were recorded during 12 months between January to December, 2013 in which 453,171 samples were received and 27,067 specimens were rejected. Rejection ratios was 2.5% for biochemistry tests, 3.2% for complete blood count (CBC), 9.8% for blood gases, 9.2% for urine analysis, 13.3% for coagulation tests, 12.8% for therapeutic drug monitoring, 3.5% for cardiac markers and 12% for hormone tests. The most frequent rejection reasons were fibrin clots (28%) and inadequate volume (9%) for biochemical tests. Clotted samples (35%) and inadequate volume (13%) were the major causes for coagulation tests, blood gas analyses and CBC. The ratio of rejected specimens was higher in the EDs (40%) compared to ICUs (30%) and inpatient services (28%). The highest rejection ratio was observed in neurology ICU (14%) among the ICUs and internal medicine inpatient service (10%) within inpatient clinics. We detected an overall specimen rejection rate of 6% in emergency laboratory. By documentation of rejected samples and periodic training of healthcare personnel, we expect to decrease sample rejection ratios below 2%, improve total quality management of the emergency laboratory and promote patient safety.

  8. Canadian Public Health Laboratory Network Laboratory Guidelines for the Use of Direct Tests to Detect Syphilis in Canada

    Directory of Open Access Journals (Sweden)

    Raymond SW Tsang

    2015-01-01

    Full Text Available Treponema pallidum subsp. pallidum and/or its nucleic acid can be detected by various methods such as microscopy, rabbit infectivity test or polymerase chain reaction (PCR tests. The rabbit infectivity test for T. pallidum, although very sensitive, has been discontinued from most laboratories due to ethical issues related to the need for animal inoculation with live T. pallidum, the technically demanding procedure and long turnaround time for results, thus making it impractical for routine diagnostic use. Dark-field and phase-contrast microscopy are still useful at clinic- or hospital-based laboratories for near-bedside detection of T. pallidum in genital, skin or mucous lesions although their availability is decreasing. The lack of reliable and specific anti-T. pallidum antibodies and its inferior sensitivity to PCR may explain why the direct fluorescent antibody test for T. pallidum is not widely available for clinical use. Immunohistochemical staining for T. pallidum also depends on the availability of specific antibodies, and the method is only applicable for histopathological examination of biopsy and autopsy specimens necessitating an invasive specimen collection approach. With recent advances in molecular diagnostics, PCR is considered to be the most reliable, versatile and practical for laboratories to implement. In addition to being an objective and sensitive test for direct detection of Treponema pallidum subsp. pallidum DNA in skin and mucous membrane lesions, the resulting PCR amplicons from selected gene targets can be further characterized for antimicrobial (macrolide susceptibility testing, strain typing and identification of T. pallidum subspecies.

  9. 21 CFR 864.9175 - Automated blood grouping and antibody test system.

    Science.gov (United States)

    2010-04-01

    ...) Identification. An automated blood grouping and antibody test system is a device used to group erythrocytes (red blood cells) and to detect antibodies to blood group antigens. (b) Classification. Class II (performance... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Automated blood grouping and antibody test system...

  10. The quality and scope of information provided by medical laboratories to patients before laboratory testing: Survey of the Working Group for Patient Preparation of the Croatian Society of Medical Biochemistry and Laboratory Medicine.

    Science.gov (United States)

    Nikolac, Nora; Simundic, Ana-Maria; Kackov, Sanja; Serdar, Tihana; Dorotic, Adrijana; Fumic, Ksenija; Gudasic-Vrdoljak, Jelena; Klenkar, Kornelija; Sambunjak, Jadranka; Vidranski, Valentina

    2015-10-23

    The aim of this work was to evaluate to what extent the scope and content of information provided to patients is standardized across medical biochemistry laboratories in Croatia. Two on-line self-report surveys were sent out: Survey A regarding attitudes on importance of patient preparation and Survey B on the contents of patient preparation instructions. 13/118 laboratories (11%) do not provide written instructions to patients on how to prepare for laboratory testing, and 36 (40%) do not include information about water intake in their instructions. Only half of laboratories provide instructions for prostate-specific antigen (53.8%), female sex hormones (53.7%) and therapeutic drug monitoring (TDM) (52.5%). Inadequate information about fasting status (55.0%) and 24 hour urine collection (77.9%) were frequent errors with high severity and were associated with the greatest potential to cause patient harm. Laboratory professionals in Croatia have a positive attitude towards the importance of patient preparation for laboratory testing. However, the information for laboratory testing is not standardized and frequently lacks guidance for tests related to TDM, coagulation and endocrinology. This study highlights the need for standardized, updated and evidence-based recommendations for patient preparation in order to minimize the risk for patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Which is more useful in predicting hospital mortality--dichotomised blood test results or actual test values? A retrospective study in two hospitals.

    Science.gov (United States)

    Mohammed, Mohammed A; Rudge, Gavin; Wood, Gordon; Smith, Gary; Nangalia, Vishal; Prytherch, David; Holder, Roger; Briggs, Jim

    2012-01-01

    Routine blood tests are an integral part of clinical medicine and in interpreting blood test results clinicians have two broad options. (1) Dichotomise the blood tests into normal/abnormal or (2) use the actual values and overlook the reference values. We refer to these as the "binary" and the "non-binary" strategy respectively. We investigate which strategy is better at predicting the risk of death in hospital based on seven routinely undertaken blood tests (albumin, creatinine, haemoglobin, potassium, sodium, urea, and white blood cell count) using tree models to implement the two strategies. A retrospective database study of emergency admissions to an acute hospital during April 2009 to March 2010, involving 10,050 emergency admissions with routine blood tests undertaken within 24 hours of admission. We compared the area under the Receiver Operating Characteristics (ROC) curve for predicting in-hospital mortality using the binary and non-binary strategy. The mortality rate was 6.98% (701/10050). The mean predicted risk of death in those who died was significantly (p-value non-binary strategy (risk = 0.222 95%CI: 0.194 to 0.251), representing a risk difference of 28.74 deaths in the deceased patients (n = 701). The binary strategy had a significantly (p-value non-binary strategy (0.853 95% CI: 0.840 to 0.867). Similar results were obtained using data from another hospital. Dichotomising routine blood test results is less accurate in predicting in-hospital mortality than using actual test values because it underestimates the risk of death in patients who died. Further research into the use of actual blood test values in clinical decision making is required especially as the infrastructure to implement this potentially promising strategy already exists in most hospitals.

  12. Which Is More Useful in Predicting Hospital Mortality -Dichotomised Blood Test Results or Actual Test Values? A Retrospective Study in Two Hospitals

    Science.gov (United States)

    Mohammed, Mohammed A.; Rudge, Gavin; Wood, Gordon; Smith, Gary; Nangalia, Vishal; Prytherch, David; Holder, Roger; Briggs, Jim

    2012-01-01

    Background Routine blood tests are an integral part of clinical medicine and in interpreting blood test results clinicians have two broad options. (1) Dichotomise the blood tests into normal/abnormal or (2) use the actual values and overlook the reference values. We refer to these as the “binary” and the “non-binary” strategy respectively. We investigate which strategy is better at predicting the risk of death in hospital based on seven routinely undertaken blood tests (albumin, creatinine, haemoglobin, potassium, sodium, urea, and white blood cell count) using tree models to implement the two strategies. Methodology A retrospective database study of emergency admissions to an acute hospital during April 2009 to March 2010, involving 10,050 emergency admissions with routine blood tests undertaken within 24 hours of admission. We compared the area under the Receiver Operating Characteristics (ROC) curve for predicting in-hospital mortality using the binary and non-binary strategy. Results The mortality rate was 6.98% (701/10050). The mean predicted risk of death in those who died was significantly (p-value non-binary strategy (risk = 0.222 95%CI: 0.194 to 0.251), representing a risk difference of 28.74 deaths in the deceased patients (n = 701). The binary strategy had a significantly (p-value non-binary strategy (0.853 95% CI: 0.840 to 0.867). Similar results were obtained using data from another hospital. Conclusions Dichotomising routine blood test results is less accurate in predicting in-hospital mortality than using actual test values because it underestimates the risk of death in patients who died. Further research into the use of actual blood test values in clinical decision making is required especially as the infrastructure to implement this potentially promising strategy already exists in most hospitals. PMID:23077528

  13. Impact of providing fee data on laboratory test ordering: a controlled clinical trial.

    Science.gov (United States)

    Feldman, Leonard S; Shihab, Hasan M; Thiemann, David; Yeh, Hsin-Chieh; Ardolino, Margaret; Mandell, Steven; Brotman, Daniel J

    2013-05-27

    Inpatient care providers often order laboratory tests without any appreciation for the costs of the tests. To determine whether we could decrease the number of laboratory tests ordered by presenting providers with test fees at the time of order entry in a tertiary care hospital, without adding extra steps to the ordering process. Controlled clinical trial. Tertiary care hospital. All providers, including physicians and nonphysicians, who ordered laboratory tests through the computerized provider order entry system at The Johns Hopkins Hospital. We randomly assigned 61 diagnostic laboratory tests to an "active" arm (fee displayed) or to a control arm (fee not displayed). During a 6-month baseline period (November 10, 2008, through May 9, 2009), we did not display any fee data. During a 6-month intervention period 1 year later (November 10, 2009, through May 9, 2010), we displayed fees, based on the Medicare allowable fee, for active tests only. We examined changes in the total number of orders placed, the frequency of ordered tests (per patient-day), and total charges associated with the orders according to the time period (baseline vs intervention period) and by study group (active test vs control). For the active arm tests, rates of test ordering were reduced from 3.72 tests per patient-day in the baseline period to 3.40 tests per patient-day in the intervention period (8.59% decrease; 95% CI, -8.99% to -8.19%). For control arm tests, ordering increased from 1.15 to 1.22 tests per patient-day from the baseline period to the intervention period (5.64% increase; 95% CI, 4.90% to 6.39%) (P fee data to providers at the time of order entry resulted in a modest decrease in test ordering. Adoption of this intervention may reduce the number of inappropriately ordered diagnostic tests.

  14. The Pathology Laboratory Act 2007 explained.

    Science.gov (United States)

    Looi, Lai-Meng

    2008-06-01

    The past century has seen tremendous changes in the scope and practice of pathology laboratories in tandem with the development of the medical services in Malaysia. Major progress was made in the areas of training and specialization of pathologists and laboratory technical staff. Today the pathology laboratory services have entered the International arena, and are propelled along the wave of globalization. Many new challenges have emerged as have new players in the field. Landmark developments over the past decade include the establishment of national quality assurance programmes, the mushrooming of private pathology laboratories, the establishment of a National Accreditation Standard for medical testing laboratories based on ISO 15189, and the passing of the Pathology Laboratory Act in Parliament in mid-2007. The Pathology Laboratory Act 2007 seeks to ensure that the pathology laboratory is accountable to the public, meets required standards of practice, participates in Quality Assurance programmes, is run by qualified staff, complies with safety requirements and is subject to continuous audit. The Act is applicable to all private laboratories (stand alone or hospital) and laboratories in statutory bodies (Universities, foundations). It is not applicable to public laboratories (established and operated by the government) and side-room laboratories established in clinics of registered medical or dental practitioners for their own patients (tests as in the First and Second Schedules respectively). Tests of the Third Schedule (home test blood glucose, urine glucose, urine pregnancy test) are also exempted. The Act has 13 Parts and provides for control of the pathology laboratory through approval (to establish and maintain) and licensing (to operate or provide). The approval or license may only be issued to a sole proprietor, partnership or body corporate, and then only if the entity includes a registered medical practitioner. Details of personnel qualifications and

  15. Assessment of the genotoxic potential of contaminated estuarine sediments in fish peripheral blood: Laboratory versus in situ studies

    International Nuclear Information System (INIS)

    Costa, Pedro M.; Neuparth, Teresa S.; Caeiro, Sandra; Lobo, Jorge; Martins, Marta; Ferreira, Ana M.; Caetano, Miguel; Vale, Carlos; Angel DelValls, T.; Costa, Maria H.

    2011-01-01

    Juvenile Senegalese soles (Solea senegalensis) were exposed to estuarine sediments through 28-day laboratory and in situ (field) bioassays. The sediments, collected from three distinct sites (a reference plus two contaminated) of the Sado Estuary (W Portugal) were characterized for total organic matter, redox potential, fine fraction and for the levels of metals, polycyclic aromatic hydrocarbons (PAHs) and organochlorines, namely polychlorinated biphenyls (PCBs) and dichloro diphenyl tricholoethane plus its main metabolites (DDTs). Genotoxicity was determined in whole peripheral blood by the single-cell gel electrophoresis (SCGE or 'comet') assay and by scoring erythrocytic nuclear abnormalities (ENA). Analysis was complemented with the determination of lipid peroxidation in blood plasma by the thiobarbituric acid reactive substances (TBARS) protocol and cell type sorting. The results showed that exposure to contaminated sediments induced DNA fragmentation and clastogenesis. Still, laboratory exposure to the most contaminated sediment revealed a possible antagonistic effect between metallic and organic contaminants that might have been enhanced by increased bioavailability. The laboratory assay caused a more pronounced increase in ENA whereas a very significant increase in DNA fragmentation was observed in field-tested fish exposed to the reference sediment, which is likely linked to increased lipid peroxidation that probably occurred due to impaired access to food. Influence of natural pathogens was ruled out by unaltered leukocyte counts. The statistical integration of data correlated lipid peroxidation with biological variables such as fish length and weight, whereas the genotoxicity biomarkers were more correlated to sediment contamination. It was demonstrated that laboratory and field bioassays for the risk assessment of sediment contamination may yield different genotoxicity profiles although both provided results that are in overall accordance with sediment

  16. Assessment of the genotoxic potential of contaminated estuarine sediments in fish peripheral blood: Laboratory versus in situ studies

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Pedro M., E-mail: pmcosta@fct.unl.pt [IMAR-Instituto do Mar, Departamento de Ciencias e Engenharia do Ambiente, Faculdade de Ciencias e Tecnologia da Universidade Nova de Lisboa, 2829-516 Caparica (Portugal); Neuparth, Teresa S. [CIIMAR-Centro Interdisciplinar de Investigacao Marinha e Ambiental, Laboratorio de Toxicologia Ambiental, Universidade do Porto, Rua dos Bragas 289, 4050-123 Porto (Portugal); Caeiro, Sandra [IMAR-Instituto do Mar, Departamento de Ciencias e Engenharia do Ambiente, Faculdade de Ciencias e Tecnologia da Universidade Nova de Lisboa, 2829-516 Caparica (Portugal); Departamento de Ciencias e Tecnologia, Universidade Aberta, Rua da Escola Politecnica, 141, 1269-001 Lisboa (Portugal); Lobo, Jorge [IMAR-Instituto do Mar, Departamento de Ciencias e Engenharia do Ambiente, Faculdade de Ciencias e Tecnologia da Universidade Nova de Lisboa, 2829-516 Caparica (Portugal); Martins, Marta; Ferreira, Ana M.; Caetano, Miguel; Vale, Carlos [IPIMAR-INRB, Instituto Nacional dos Recursos Biologicos, Avenida de Brasilia, 1449-006 Lisboa (Portugal); Angel DelValls, T. [UNESCO/UNITWIN/WiCop Chair-Departamento de Quimica Fisica, Facultad de Ciencias del Mar y Ambientales, Universidad de Cadiz, Poligono rio San Pedro s/n, 11510 Puerto Real, Cadiz (Spain); Costa, Maria H. [IMAR-Instituto do Mar, Departamento de Ciencias e Engenharia do Ambiente, Faculdade de Ciencias e Tecnologia da Universidade Nova de Lisboa, 2829-516 Caparica (Portugal)

    2011-01-15

    Juvenile Senegalese soles (Solea senegalensis) were exposed to estuarine sediments through 28-day laboratory and in situ (field) bioassays. The sediments, collected from three distinct sites (a reference plus two contaminated) of the Sado Estuary (W Portugal) were characterized for total organic matter, redox potential, fine fraction and for the levels of metals, polycyclic aromatic hydrocarbons (PAHs) and organochlorines, namely polychlorinated biphenyls (PCBs) and dichloro diphenyl tricholoethane plus its main metabolites (DDTs). Genotoxicity was determined in whole peripheral blood by the single-cell gel electrophoresis (SCGE or 'comet') assay and by scoring erythrocytic nuclear abnormalities (ENA). Analysis was complemented with the determination of lipid peroxidation in blood plasma by the thiobarbituric acid reactive substances (TBARS) protocol and cell type sorting. The results showed that exposure to contaminated sediments induced DNA fragmentation and clastogenesis. Still, laboratory exposure to the most contaminated sediment revealed a possible antagonistic effect between metallic and organic contaminants that might have been enhanced by increased bioavailability. The laboratory assay caused a more pronounced increase in ENA whereas a very significant increase in DNA fragmentation was observed in field-tested fish exposed to the reference sediment, which is likely linked to increased lipid peroxidation that probably occurred due to impaired access to food. Influence of natural pathogens was ruled out by unaltered leukocyte counts. The statistical integration of data correlated lipid peroxidation with biological variables such as fish length and weight, whereas the genotoxicity biomarkers were more correlated to sediment contamination. It was demonstrated that laboratory and field bioassays for the risk assessment of sediment contamination may yield different genotoxicity profiles although both provided results that are in overall accordance with

  17. Simple Sample Preparation Method for Direct Microbial Identification and Susceptibility Testing From Positive Blood Cultures.

    Science.gov (United States)

    Pan, Hong-Wei; Li, Wei; Li, Rong-Guo; Li, Yong; Zhang, Yi; Sun, En-Hua

    2018-01-01

    Rapid identification and determination of the antibiotic susceptibility profiles of the infectious agents in patients with bloodstream infections are critical steps in choosing an effective targeted antibiotic for treatment. However, there has been minimal effort focused on developing combined methods for the simultaneous direct identification and antibiotic susceptibility determination of bacteria in positive blood cultures. In this study, we constructed a lysis-centrifugation-wash procedure to prepare a bacterial pellet from positive blood cultures, which can be used directly for identification by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) and antibiotic susceptibility testing by the Vitek 2 system. The method was evaluated using a total of 129 clinical bacteria-positive blood cultures. The whole sample preparation process could be completed in identification was 96.49% for gram-negative bacteria and 97.22% for gram-positive bacteria. Vitek 2 antimicrobial susceptibility testing of gram-negative bacteria showed an agreement rate of antimicrobial categories of 96.89% with a minor error, major error, and very major error rate of 2.63, 0.24, and 0.24%, respectively. Category agreement of antimicrobials against gram-positive bacteria was 92.81%, with a minor error, major error, and very major error rate of 4.51, 1.22, and 1.46%, respectively. These results indicated that our direct antibiotic susceptibility analysis method worked well compared to the conventional culture-dependent laboratory method. Overall, this fast, easy, and accurate method can facilitate the direct identification and antibiotic susceptibility testing of bacteria in positive blood cultures.

  18. Using standard serology blood tests to diagnose latent syphilis

    Directory of Open Access Journals (Sweden)

    G. L. Katunin

    2016-01-01

    Full Text Available Goal. To conduct a comparative assessment of the results of regulated serological tests obtained as a result of blood tests in patients suffering from latent syphilis. Materials and methods. The authors examined 187 patient medical records with newly diagnosed latent syphilis in FGBU GNTsDK (State Research Center for Dermatology, Venereology and Cosmetology, Health Ministry of the Russian Federation, in 2006-2015. The results of patient blood tests were analyzed with the use of non-treponemal (microprecipitation test/RPR and treponemal (passive hemagglutination test, immune-enzyme assay (IgA, IgM, IgG, IFabs, immunofluorescence test and Treponema pallidum immobilization test serology tests. Results. According to the results of blood tests of latent syphilis patients, the largest number of positive results was obtained as a result of treponemal serology tests such as immune-enzyme assay (100%, passive hemagglutination test (100% and IFabs (100%. The greatest number of negative results was observed in non-treponemal (microprecipitation test/RPR serology tests: in 136 (72.7% patients; evidently positive results (4+ test results were obtained in 8 (4.3% patients only. According to the results of a comparative analysis of blood tests in patients suffering from latent syphilis obtained with the use of treponemal serology tests, the greatest number of evidently positive results (4+ was noted for the passive hemagglutination test (67.9%. Negative treponemal test results were obtained with the use of the immunofluorescence test and Treponema pallidum immobilization test (21.9% and 11.8% of cases, respectively. Moreover, weakly positive results prevailed for the immunofluorescence test: in 65 (34.7% patients. Conclusion. These data confirm that the following treponemal tests belong to the most reliable ones for revealing patients suffering from latent syphilis: immune-enzyme assay, passive hemagglutination test and IFabs.

  19. Are laboratory tests always needed? Frequency and causes of laboratory overuse in a hospital setting.

    Science.gov (United States)

    Cadamuro, Janne; Gaksch, Martin; Wiedemann, Helmut; Lippi, Giuseppe; von Meyer, Alexander; Pertersmann, Astrid; Auer, Simon; Mrazek, Cornelia; Kipman, Ulrike; Felder, Thomas K; Oberkofler, Hannes; Haschke-Becher, Elisabeth

    2018-04-01

    Inappropriate utilization of laboratory resources is an increasing concern especially in high-throughput facilities. Until now, no reliable information has been published addressing to which extent laboratory results are actually used for clinical decision-making. Therefore, we aimed to close this gap using a novel retrospective approach including a survey of clinicians and nurses. We retrospectively evaluated the number of re-orders for potassium (K), lactate dehydrogenase (LD), aspartate-aminotransferase (AST), activated partial thromboplastin-time (APTT) and prothrombin-time/INR (PT/INR), after the initial order had to be cancelled due to preanalytical non-conformities. We analyzed subgroups regarding time to re-order, ward and sample priority (urgent vs. routine). Subsequently, we surveyed clinicians and nurses, asking for their estimate of the amount of failed re-orders as well as for possible reasons. From initially cancelled tests, only ~20% of K, LD, AST and ~30% of APTT and PT/INR tests were re-ordered within 24 h. 70% of the investigated clinical chemistry and 60% of coagulation tests were re-ordered one week after cancellation or not at all. Survey participants quite accurately estimated these numbers. Routine laboratory panels, short stay of out-patients, obsolete test results and avoiding additional phlebotomies were the main reasons for not re-ordering cancelled tests. Overall, 60-70% of test results in the investigated assays ordered in a high throughput laboratory are potentially inappropriate or of doubtful clinically importance. Although clinicians and nurses are aware of this situation, it is the duty of laboratory specialists to overcome overutilization in close collaboration with all involved healthcare workers. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  20. Assessment of the quality of test results from selected civil engineering material testing laboratories in Tanzania

    CSIR Research Space (South Africa)

    Mbawala, SJ

    2017-12-01

    Full Text Available Civil and geotechnical engineering material testing laboratories are expected to produce accurate and reliable test results. However, the ability of laboratories to produce accurate and reliable test results depends on many factors, among others...

  1. Technical performance of cementitious grouting materials for ONKALO. Laboratory tests 2006

    International Nuclear Information System (INIS)

    Raivio, P.; Hansen, J.

    2007-09-01

    During 2006 the development of high and low-pH cementitious grouts for fractures > 100 μm designed for the ONKALO rock was continued within the LPHTEK/IMAproject. The main focus in laboratory was to study high pH micro cement grouts. The low pH (≥ 11.0) of the cementitious grout material is required in deep repository as natural pH plume deriving from pure cement paste is very high and moves via ground water circulation in bedrock. This may be deleterious to the protective covers of nuclear waste. The objective to study high pH grouts in laboratory was to optimise their composition and to get preliminary test results. Low pH grouts based on Portland cement + micro silica were also studied further in laboratory to understand their behaviour more thoroughly in different conditions and due to quality changes in materials and to compare the laboratory results with the field results. Alternative fine-grained glass material was briefly studied to replace silica in low pH grout. Low and high pH rock bolt mortars were also developed and tested to get the preliminary test results. The results of the 2006 laboratory work are presented in this report. The high pH micro cement mix U1 with no silica, mix 5/5 with moderate silica and low pH mix P308B rich in silica show generally good properties at fresh and hardening stage at +12 deg C. Lower temperature gives weaker strength build-up with all the mixes and weakens especially the Marsh fluidity and penetration ability of the mixes 5/5 and P308B as bulk density rises a little at lower temperature. Cement quality variation and insufficient mixing may also weaken the properties of all mixes. Deformation of the hardened mixes was observed in laboratory tests. This may weaken their durability if cracks are formed in the grouts at later ages and need to be studied more thoroughly. (orig.)

  2. Towards a rational antimicrobial testing policy in the laboratory.

    Science.gov (United States)

    Banaji, N; Oommen, S

    2011-01-01

    Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital's antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

  3. Inter-laboratory proficiency tests to detect viral fish diseases

    DEFF Research Database (Denmark)

    Kahns, Søren; Nicolajsen, Nicole; Skall, Helle Frank

    An inter-laboratory proficiency test has ben provided by the European Community Laboratory (CRL) for Fish Diseases every year since 1996. The test is provided to all European National Reference Laboratories (NRLs) that are obliged to participate and to a limited number of non-European NRLs, making......) but also to assess their ability to differentiate other fish viruses as spring viraemia of carp virus, infectious pancreatic necrosis virus, perch rhabdovirus etc. Five coded ampoules are provided to participants containing lyophilised supernatant from infected cell cultures. The CRL collect the data...

  4. Tale of two sites: capillary versus arterial blood glucose testing in the operating room.

    Science.gov (United States)

    Akinbami, Felix; Segal, Scott; Schnipper, Jeffrey L; Stopfkuchen-Evans, Matthias; Mills, Jonathan; Rogers, Selwyn O

    2012-04-01

    strong positive correlation of .91 between capillary glucose values and arterial values (P Glucose monitoring in the operating room can be safely performed by collecting capillary samples for POCT. However, clinicians should still be cautious when interpreting glucose levels that are high, either by repeating the blood glucose test or by having samples sent to the laboratory. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Pediatric blood transfusion practices at a regional referral hospital in Kenya

    Science.gov (United States)

    Fegan, Greg; Shavadia, Jay; Denje, Douglas; Mandaliya, Kishor; Bates, Imelda; Maitland, Kathryn; Hassall, Oliver W.

    2016-01-01

    BACKGROUND Severe anemia in children is a major public health problem in sub‐Saharan Africa. In this study we describe clinical and operational aspects of blood transfusion in children admitted to Coast Provincial General Hospital, Kenya. STUDY DESIGN AND METHODS This was an observational study where over a 2‐year period, demographic and laboratory data were collected on all children for whom the hospital blood bank received a transfusion request. Clinical data were obtained by retrospective review of case notes over the first year. RESULTS There were 2789 requests for blood for children (median age, 1.8 years; interquartile range [IQR], 0.6‐6.6 years); 70% (1950) of the samples were crossmatched with 85% (1663/1950) issued. Ninety percent (1505/1663) were presumed transfused. Median time from laboratory receipt of request to collection of blood was 3.6 hours (IQR, 1.4‐12.8 hr). Case notes of 590 children were reviewed and median pretransfusion hemoglobin level was 6.0 g/dL (IQR, 4.2‐9.1 g/dL). Ninety‐four percent (186) were transfused “appropriately” while 52% (120) were transfused “inappropriately.” There was significant disagreement between the clinical and laboratory diagnosis of severe anemia (exact McNemar's test; p blood transfusions but only 41% (106) of these had a positive blood film. CONCLUSION In this setting, clinicians often order blood based on the clinical impression of “severe anemia.” This has implications for laboratory workload and the blood supply itself. However, the majority of children with severe anemia were appropriately transfused. The use of antimalarials with blood transfusions irrespective of blood film results is common practice. PMID:27611471

  6. Laboratory tests of hydraulic fracturing and swell healing

    DEFF Research Database (Denmark)

    Thunbo, Christensen Claes; Foged, Christensen Helle; Foged, Niels

    1998-01-01

    New laboratory test set-ups and test procedures are described - for testing the formation of hydraulically induced fractures as well as the potential for subsequent fracture closurefrom the relase of a swelling potential. The main purpose with the tests is to provide information on fracturing str...

  7. Radioactive material package testing capabilities at Sandia National Laboratories

    International Nuclear Information System (INIS)

    Uncapher, W.L.; Hohnstreiter, G.F.

    1995-01-01

    Evaluation and certification of radioactive and hazardous material transport packages can be accomplished by subjecting these packages to normal transport and hypothetical accident test conditions. The regulations allow package designers to certify packages using analysis, testing, or a combination of analysis and testing. Testing can be used to substantiate assumptions used in analytical models and to demonstrate package structural and thermal response. Regulatory test conditions include impact, puncture, crush, penetration, water spray, immersion, and thermal environments. Testing facilities are used to simulate the required test conditions and provide measurement response data. Over the past four decades, comprehensive testing facilities have been developed at Sandia National Laboratories to perform a broad range of verification and certification tests on hazardous and radioactive material packages or component sections. Sandia's facilities provide an experience base that has been established during the development and certification of many package designs. These unique facilities, along with innovative instrumentation data collection capabilities and techniques, simulate a broad range of testing environments. In certain package designs, package testing can be an economical alternative to complex analysis to resolve regulatory questions or concerns

  8. Polymerase chain reaction and blood culture in blood donors screened by ELISA test for Chagas' disease

    Directory of Open Access Journals (Sweden)

    Andréa Tieko Kinoshita-Yanaga

    2011-03-01

    Full Text Available The objective of this study was to evaluate, through blood culture and PCR, the results of the ELISA for Chagas' disease in the screening of blood donors in the public blood-supply network of the state of Paraná, Brazil, and to map the epidemiological profile of the donors with respect to their risk of infection by Trypanosoma cruzi. The negative and positive results of the ELISA were confirmed by blood culture and PCR for 190/191 individuals (99.5%. For one individual (0.5%, the ELISA was inconclusive, blood culture and IIF were negative, and IHA and PCR positive. Three individuals (1.6% were positive for T. cruzi on all the tests. Donors were predominantly female, and natives of Paraná, of rural origin, had observed or been informed of the presence of the vector in the municipalities where they resided, had never received a blood transfusion, had donated blood 1 to 4 times, and reported no cases of Chagas' disease in their families. We concluded that PCR and blood culturing have excellent potential for confirming the results of the ELISA, and that candidate blood donors with negative or positive tests have a similar risk of infection by T. cruzi, indicating that the ELISA test is sufficiently safe for screening blood prior to use.O objetivo deste estudo foi avaliar, pela hemocultura e PCR, os resultados do teste ELISA utilizado para doença de Chagas na triagem de doadores de sangue na rede pública do Estado do Paraná, Brasil, e traçar o perfil epidemiológico dos doadores quanto ao risco de infecção pelo Trypanosoma cruzi. Os resultados negativos e positivos do ELISA foram confirmados pela hemocultura e PCR em 190/191 indivíduos (99,5%. Para um indivíduo (0,5%, o teste de ELISA foi inconclusivo, hemocultura e IFI foram negativas, HAI e PCR foram positivas. Três indivíduos (1,6% foram positivos para T. cruzi em todos os testes. A maioria dos doadores era do sexo feminino, oriundos do Estado do Paraná, de origem rural, tinham

  9. Quality and Safety of General Anesthesia with Propofol and Sevoflurane in Children Aged 1-14 Based on Laboratory Parameters.

    Science.gov (United States)

    Vanis-Vatrenjak, Selma; Mesic, Amira; Abdagic, Ines; Mujezinovic, Djenita; Zvizdic, Zlatan

    2015-08-01

    Knowledge of anatomic, physiological, biochemical and physical characteristics of children of all age groups, the existing illness and possible pathological response of the organism to the existing situation, require a pediatric anesthesiologist to participate in the preparation of a child for surgical treatment, to choose the best anesthesia technique and medications, and manipulative techniques to enable the scheduled surgical treatment with minimum anesthesia risks. The aim of this clinical study was to prove reliability and quality of propofol or sevoflurane general anesthesia in children in the age group of 1-14 years from the ASA I group and in the elective surgical treatments in duration of 60 minutes, based on preoperative and postoperative levels of laboratory findings (transaminases, blood sugar, urea and creatinine). the study included 160 patients randomized in two groups based on different approaches: total intravenous anesthesia was used for the propofol group (n=80) (TIVA) and the inhalation technique was used for the sevoflurane group (n=80). statistical evaluation of the obtained results indicates stability of laboratory findings in the immediate postoperative course (after 24 hours) in respect to the preoperative period. Based on the Mann Whitney test (P), preoperative and postoperative blood sugar levels in the sevoflurane vs. propofol group were P=0.152 vs. 0.021; creatinine levels P=0.113 vs. 0.325; urea levels P= 0.016 vs. 0.900; AST levels P=0,031 vs. 0,268 and ALT levels P=0.021 vs. 0.058. Level of significance was Psecurity and quality of general anesthesia in children age group 1-14 years, from the ASA I group. All analyzed laboratory levels in the postoperative course remained in their referential values in both groups of participants.

  10. Laboratory tests of overpressure differential systems for smoke protection of lobbies

    Science.gov (United States)

    Szałański, Paweł; Misiński, Jacek

    2017-11-01

    Paper presents the methodology of laboratory tests for ventilation overpressure differential systems for smoke protection of lobbies. Research area consists of two spaces representing the lobby and the area under fire equipped with proper ventilation installation. This allows testing of overpressure differential systems for smoke protection of lobbies. Moreover, piece of laboratory tests results for two selected smoke protection systems for lobbies are presented. First one is standard system with constantly opened transfer-damper mounted between lobby and area under fire. Second one - system with so called "electronic transfer" based on two dampers (supplying air to a lobby and to unprotected area alternatively). Opening and closing both dampers is electronically controlled. Changes of pressure difference between lobby and fire affected area during closing and opening doors between those spaces is presented. Conclusions, concerning the possibility of meeting the time period criteria of pressure difference stabilization required by standards, are presented and discussed for both systems.

  11. A new predictive indicator for development of pressure ulcers in bedridden patients based on common laboratory tests results.

    Science.gov (United States)

    Hatanaka, N; Yamamoto, Y; Ichihara, K; Mastuo, S; Nakamura, Y; Watanabe, M; Iwatani, Y

    2008-04-01

    Various scales have been devised to predict development of pressure ulcers on the basis of clinical and laboratory data, such as the Braden Scale (Braden score), which is used to monitor activity and skin conditions of bedridden patients. However, none of these scales facilitates clinically reliable prediction. To develop a clinical laboratory data-based predictive equation for the development of pressure ulcers. Subjects were 149 hospitalised patients with respiratory disorders who were monitored for the development of pressure ulcers over a 3-month period. The proportional hazards model (Cox regression) was used to analyse the results of 12 basic laboratory tests on the day of hospitalisation in comparison with Braden score. Pressure ulcers developed in 38 patients within the study period. A Cox regression model consisting solely of Braden scale items showed that none of these items contributed to significantly predicting pressure ulcers. Rather, a combination of haemoglobin (Hb), C-reactive protein (CRP), albumin (Alb), age, and gender produced the best model for prediction. Using the set of explanatory variables, we created a new indicator based on a multiple logistic regression equation. The new indicator showed high sensitivity (0.73) and specificity (0.70), and its diagnostic power was higher than that of Alb, Hb, CRP, or the Braden score alone. The new indicator may become a more useful clinical tool for predicting presser ulcers than Braden score. The new indicator warrants verification studies to facilitate its clinical implementation in the future.

  12. Mobile Energy Laboratory energy-efficiency testing programs

    International Nuclear Information System (INIS)

    Parker, G.B.; Currie, J.W.

    1992-03-01

    This report summarizes energy-efficiency testing activities applying the Mobile Energy Laboratory (MEL) testing capabilities during the third and fourth quarters of fiscal year (FY) 1991. The MELs, developed by the US Department of Energy (DOE) Federal Energy Management Program (FEMP), are administered by Pacific Northwest Laboratory (PNL) and the Naval Energy and Environmental Support Activity (NEESA) for energy testing and energy conservation program support functions at federal facilities. The using agencies principally fund MEL applications, while DOE/FEMP funds program administration and capability enhancement activities. This report fulfills the requirements established in Section 8 of the MEL Use Plan (PNL-6861) for semi-annual reporting on energy-efficiency testing activities using the MEL capabilities. The MEL Use Committee, formally established in 1989, developed the MEL Use Plan and meets semi-annually to establish priorities for energy-efficient testing applications using the MEL capabilities. The MEL Use Committee is composed of one representative each of the US Department of Energy, US Army, US Air Force, US Navy, and other federal agencies

  13. Mobile Energy Laboratory energy-efficiency testing programs

    Energy Technology Data Exchange (ETDEWEB)

    Parker, G B; Currie, J W

    1992-03-01

    This report summarizes energy-efficiency testing activities applying the Mobile Energy Laboratory (MEL) testing capabilities during the third and fourth quarters of fiscal year (FY) 1991. The MELs, developed by the US Department of Energy (DOE) Federal Energy Management Program (FEMP), are administered by Pacific Northwest Laboratory (PNL) and the Naval Energy and Environmental Support Activity (NEESA) for energy testing and energy conservation program support functions at federal facilities. The using agencies principally fund MEL applications, while DOE/FEMP funds program administration and capability enhancement activities. This report fulfills the requirements established in Section 8 of the MEL Use Plan (PNL-6861) for semi-annual reporting on energy-efficiency testing activities using the MEL capabilities. The MEL Use Committee, formally established in 1989, developed the MEL Use Plan and meets semi-annually to establish priorities for energy-efficient testing applications using the MEL capabilities. The MEL Use Committee is composed of one representative each of the US Department of Energy, US Army, US Air Force, US Navy, and other federal agencies.

  14. Towards a rational antimicrobial testing policy in the laboratory

    Directory of Open Access Journals (Sweden)

    N Banaji

    2011-01-01

    Full Text Available Antimicrobial policy for prophylactic and therapeutic use of antimicrobials in a tertiary care setting has gained importance. A hospital′s antimicrobial policy as laid down by its hospital infection control team needs to include inputs from the microbiology laboratory, besides the pharmacy and therapeutic committee. Therefore, it is of utmost importance that clinical microbiologists across India follow international guidelines and also take into account local settings, especially detection and presence of resistance enzymes. This article draws a framework for rational antimicrobial testing in our laboratories in tertiary care centers, from the Clinical and Laboratory Standards Institute guidelines. It does not address testing methodologies but suggests ways and means by which antimicrobial susceptibility reporting can be rendered meaningful not only to the treating physician but also to the resistance monitoring epidemiologist. It hopes to initiate some standardization in rational choice of antimicrobial testing in laboratories in the country pertaining to nonfastidious bacteria.

  15. The Tanzania experience: clinical laboratory testing harmonization and equipment standardization at different levels of a tiered health laboratory system.

    Science.gov (United States)

    Massambu, Charles; Mwangi, Christina

    2009-06-01

    The rapid scale-up of the care and treatment programs in Tanzania during the preceding 4 years has greatly increased the demand for quality laboratory services for diagnosis of HIV and monitoring patients during antiretroviral therapy. Laboratory services were not in a position to cope with this demand owing to poor infrastructure, lack of human resources, erratic and/or lack of reagent supply and commodities, and slow manual technologies. With the limited human resources in the laboratory and the need for scaling up the care and treatment program, it became necessary to install automated equipment and train personnel for the increased volume of testing and new tests across all laboratory levels. With the numerous partners procuring equipment, the possibility of a multitude of equipment platforms with attendant challenges for procurement of reagents, maintenance of equipment, and quality assurance arose. Tanzania, therefore, had to harmonize laboratory tests and standardize laboratory equipment at different levels of the laboratory network. The process of harmonization of tests and standardization of equipment included assessment of laboratories, review of guidelines, development of a national laboratory operational plan, and stakeholder advocacy. This document outlines this process.

  16. Laboratory-based testing to evaluate abuse-deterrent formulations and satisfy the Food and Drug Administration's recommendation for Category 1 Testing.

    Science.gov (United States)

    Altomare, Christopher; Kinzler, Eric R; Buchhalter, August R; Cone, Edward J; Costantino, Anthony

    The US Food and Drug Administration (FDA) considers the development of abuse-deterrent formulations of solid oral dosage forms a public health priority and has outlined a series of premarket studies that should be performed prior to submitting an application to the Agency. Category 1 studies are performed to characterize whether the abuse-deterrent properties of a new formulation can be easily defeated. Study protocols are designed to evaluate common abuse patterns of prescription medications as well as more advanced methods that have been reported on drug abuse websites and forums. Because FDA believes Category 1 testing should fully characterize the abuse-deterrent characteristics of an investigational formulation, Category 1 testing is time consuming and requires specialized laboratory resources as well as advanced knowledge of prescription medication abuse. Recent Advisory Committee meetings at FDA have shown that Category 1 tests play a critical role in FDA's evaluation of an investigational formulation. In this article, we will provide a general overview of the methods of manipulation and routes of administration commonly utilized by prescription drug abusers, how those methods and routes are evaluated in a laboratory setting, and discuss data intake, analysis, and reporting to satisfy FDA's Category 1 testing requirements.

  17. Laboratory Diagnosis of Infective Endocarditis

    Science.gov (United States)

    Liesman, Rachael M.; Pritt, Bobbi S.; Maleszewski, Joseph J.

    2017-01-01

    ABSTRACT Infective endocarditis is life-threatening; identification of the underlying etiology informs optimized individual patient management. Changing epidemiology, advances in blood culture techniques, and new diagnostics guide the application of laboratory testing for diagnosis of endocarditis. Blood cultures remain the standard test for microbial diagnosis, with directed serological testing (i.e., Q fever serology, Bartonella serology) in culture-negative cases. Histopathology and molecular diagnostics (e.g., 16S rRNA gene PCR/sequencing, Tropheryma whipplei PCR) may be applied to resected valves to aid in diagnosis. Herein, we summarize recent knowledge in this area and propose a microbiologic and pathological algorithm for endocarditis diagnosis. PMID:28659319

  18. Towards biomarker-based tests that can facilitate decisions about prevention and management of preeclampsia in low-resource settings.

    Science.gov (United States)

    Acestor, Nathalie; Goett, Jane; Lee, Arthur; Herrick, Tara M; Engelbrecht, Susheela M; Harner-Jay, Claudia M; Howell, Bonnie J; Weigl, Bernhard H

    2016-01-01

    In recent years, an increasing amount of literature is emerging on candidate urine and blood-based biomarkers associated with incidence and severity of preeclampsia (PE) in pregnant women. While enthusiasm on the usefulness of several of these markers in predicting PE is evolving, essentially all work so far has focused on the needs of high-resource settings and high-income countries, resulting primarily in multi-parameter laboratory assays based on proteomic and metabolomics analysis techniques. These highly complex methods, however, require laboratory capabilities that are rarely available or affordable in low-resource settings (LRS). The importance of quantifying maternal and perinatal risks and identifying which pregnancies can be safely prolonged is also much greater in LRS, where intensive care facilities that can rapidly respond to PE-related health threats for women and infants are limited. For these reasons, simple, low cost, sensitive, and specific point-of-care (POC) tests are needed that can be performed by antenatal health care providers in LRS and that can facilitate decisions about detection and management of PE. Our study aims to provide a comprehensive systematic review of current and emerging blood and urine biomarkers for PE, not only on the basis of their clinical performance, but also of their suitability to be used in LRS-compatible test formats, such as lateral flow and other variants of POC rapid assays.

  19. Inquiry-based Laboratory Activities on Drugs Analysis for High School Chemistry Learning

    Science.gov (United States)

    Rahmawati, I.; Sholichin, H.; Arifin, M.

    2017-09-01

    Laboratory activity is an important part of chemistry learning, but cookbook instructions is still commonly used. However, the activity with that way do not improve students thinking skill, especially students creativity. This study aims to improve high school students creativity through inquiry-based laboratory on drugs analysis activity. Acid-base titration is used to be method for drugs analysis involving a color changing indicator. The following tools were used to assess the activity achievement: creative thinking test on acid base titration, creative attitude and action observation sheets, questionnaire of inquiry-based lab activities, and interviews. The results showed that the inquiry-based laboratory activity improving students creative thinking, creative attitude and creative action. The students reacted positively to this teaching strategy as demonstrated by results from questionnaire responses and interviews. This result is expected to help teachers to overcome the shortcomings in other laboratory learning.

  20. Laboratory testing of the in-well vapor-stripping system

    International Nuclear Information System (INIS)

    Gilmore, T.J.; Francois, O.

    1996-03-01

    The Volatile organic Compounds-Arid Integrated Demonstration (VOC-Arid ID) was implemented by the US Department of Energy's (DOE's) Office of Technology Development to develop and test new technologies for the remediation of organic chemicals in the subsurface. One of the technologies being tested under the VOC-Arid ID is the in-well vapor-stripping system. The in-well vapor-stripping concept was initially proposed by researchers at Stanford University and is currently under development through a collaboration between workers at Stanford University and DOE's Pacific Northwest National Laboratory. The project to demonstrate the in-well vapor-stripping technology is divided into three phases: (1) conceptual model and computer simulation, (2) laboratory testing, and (3) field demonstration. This report provides the methods and results of the laboratory testing in which a full-scale replica was constructed and tested above ground in a test facility located at DOE's Hanford Site, Washington. The system is a remediation technology designed to preferentially extract volatile organic compounds (VOCs) from contaminated groundwater by converting them to a vapor phase

  1. Laboratory-acquired brucellosis

    DEFF Research Database (Denmark)

    Fabiansen, C.; Knudsen, J.D.; Lebech, A.M.

    2008-01-01

    Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9......Brucellosis is a rare disease in Denmark. We describe one case of laboratory-acquired brucellosis from an index patient to a laboratory technician following exposure to an infected blood culture in a clinical microbiology laboratory Udgivelsesdato: 2008/6/9...

  2. External Quality Control for Dried Blood Spot Based C-reactive Protein Assay: Experience from the Indonesia Family Life Survey and the Longitudinal Aging Study in India

    Science.gov (United States)

    Hu, Peifeng; Herningtyas, Elizabeth H.; Kale, Varsha; Crimmins, Eileen M.; Risbud, Arun R.; McCreath, Heather; Lee, Jinkook; Strauss, John; O’Brien, Jennifer C.; Bloom, David E.; Seeman, Teresa E.

    2015-01-01

    Measurement of C-reactive protein, a marker of inflammation, in dried blood spots has been increasingly incorporated in community-based social surveys internationally. Although the dried blood spot based CRP assay protocol has been validated in the United States, it remains unclear whether laboratories in other less developed countries can generate C-reactive protein results of similar quality. We therefore conducted external quality monitoring for dried blood spot based C-reactive protein measurement for the Indonesia Family Life Survey and the Longitudinal Aging Study in India. Our results show that dried blood spot based C-reactive protein results in these two countries have excellent and consistent correlations with serum-based values and dried blood spot based results from the reference laboratory in the United States. Even though the results from duplicate samples may have fluctuations in absolute values over time, the relative order of C-reactive protein levels remains similar and the estimates are reasonably precise for population-based studies that investigate the association between socioeconomic factors and health. PMID:25879265

  3. E-laboratories : agent-based modeling of electricity markets

    International Nuclear Information System (INIS)

    North, M.; Conzelmann, G.; Koritarov, V.; Macal, C.; Thimmapuram, P.; Veselka, T.

    2002-01-01

    Electricity markets are complex adaptive systems that operate under a wide range of rules that span a variety of time scales. These rules are imposed both from above by society and below by physics. Many electricity markets are undergoing or are about to undergo a transition from centrally regulated systems to decentralized markets. Furthermore, several electricity markets have recently undergone this transition with extremely unsatisfactory results, most notably in California. These high stakes transitions require the introduction of largely untested regulatory structures. Suitable laboratories that can be used to test regulatory structures before they are applied to real systems are needed. Agent-based models can provide such electronic laboratories or ''e-laboratories.'' To better understand the requirements of an electricity market e-laboratory, a live electricity market simulation was created. This experience helped to shape the development of the Electricity Market Complex Adaptive Systems (EMCAS) model. To explore EMCAS' potential as an e-laboratory, several variations of the live simulation were created. These variations probed the possible effects of changing power plant outages and price setting rules on electricity market prices

  4. Getting the right answers from blood

    International Nuclear Information System (INIS)

    Lewis, S.M.

    1988-01-01

    Errors in the results of blood tests can lead to mistaken treatment of disease. The avoidance and correction of errors are clearly helped if laboratory workers are aware of the causes. The procedures of standardization, internal quality control, and external quality assessment should be used in all haematology laboratories, and health workers should be able to assess the reliability of tests and their value in primary care and hospital practice. 4 refs

  5. 21 CFR 660.30 - Reagent Red Blood Cells.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Reagent Red Blood Cells. 660.30 Section 660.30...) BIOLOGICS ADDITIONAL STANDARDS FOR DIAGNOSTIC SUBSTANCES FOR LABORATORY TESTS Reagent Red Blood Cells § 660.30 Reagent Red Blood Cells. (a) Proper name and definition. The proper name of the product shall be...

  6. Testing of Some Canine Blood Types in Transfusion Compatibility Assessment

    Directory of Open Access Journals (Sweden)

    L Ognean

    2014-01-01

    Full Text Available Blood types were determined using SHIGETA (n=136 and DEA1.1 (n=25 kits, in two groups of dogs, consisting of patients that underwent blood transfusions and healthy donors. The tests were conducted in accordance with the procedures established by the manufacturers, using specific monoclonal antibodies kits, heparinized blood for the tube agglutination (TUBE and slide (SLIDE methods, and EDTA treated blood for the CARD and chromatographic (CHROM methods. The clear expression of tube agglutination reaction in the SHIGETA kit provided a good detection of antigens. Positive reactions with anti-DEA1.1 were clear and evident with the CHROM test. SHIGETA tests revealed a predominance 1.1B (47.05% of blood type, common in Rotweilers (81.81% and Romanian Shepherds (73.68% and group 1(-B (24.26%, frequently found in German Shepherds (54.16%, these also representing an important source of compatible blood. DEA1.1 type test, revealed a high frequency of positive dogs (75%, associated with lower number of potential donors. Extrapolation of SHIGETA groups into the DEA system, confirmed the 1(-B positive dogs as DEA 1.1 negative, and their prevalence in German Shepherds also confirmed their known tendency to be “ideal donors”. The CHROME test showed a good efficiency in auto agglutination control and detecting DEA1.1 positive dogs, including patients with severe forms of anemia.

  7. Cord blood testing

    Science.gov (United States)

    ... Blood culture (if an infection is suspected) Blood gases (including oxygen, carbon dioxide, and pH levels) Blood ... 2018, A.D.A.M., Inc. Duplication for commercial use must be authorized in writing by ADAM ...

  8. Choosing the right laboratory: a review of clinical and forensic toxicology services for urine drug testing in pain management.

    Science.gov (United States)

    Reisfield, Gary M; Goldberger, Bruce A; Bertholf, Roger L

    2015-01-01

    Urine drug testing (UDT) services are provided by a variety of clinical, forensic, and reference/specialty laboratories. These UDT services differ based on the principal activity of the laboratory. Clinical laboratories provide testing primarily focused on medical care (eg, emergency care, inpatients, and outpatient clinics), whereas forensic laboratories perform toxicology tests related to postmortem and criminal investigations, and drug-free workplace programs. Some laboratories now provide UDT specifically designed for monitoring patients on chronic opioid therapy. Accreditation programs for clinical laboratories have existed for nearly half a century, and a federal certification program for drug-testing laboratories was established in the 1980s. Standards of practice for forensic toxicology services other than workplace drug testing have been established in recent years. However, no accreditation program currently exists for UDT in pain management, and this review considers several aspects of laboratory accreditation and certification relevant to toxicology services, with the intention to provide guidance to clinicians in their selection of the appropriate laboratory for UDT surveillance of their patients on opioid therapy.

  9. Intraneural blood flow analysis during an intraoperative Phalen's test in carpal tunnel syndrome.

    Science.gov (United States)

    Yayama, Takafumi; Kobayashi, Shigeru; Awara, Kousuke; Takeno, Kenichi; Miyazaki, Tsuyoshi; Kubota, Masafumi; Negoro, Kohei; Baba, Hisatoshi

    2010-08-01

    Phalen's test has been one of the most significant of clinical signs when making a clinical diagnosis of idiopathic carpal tunnel syndrome (CTS). However, it is unknown whether intraneural blood flow changes during Phalen's test in patients with CTS. In this study, an intraoperative Phalen's test was conducted in patients with CTS to observe the changes in intraneural blood flow using a laser Doppler flow meter. During Phalen's test, intraneural blood flow showed a sharp decrease, which lasted for 1 min. Intraneural blood flow decreased by 56.7%-100% (average, 78.0%) in the median nerve relative to the blood flow before the test. At 1 min after completing the test, intraneural blood flow returned to the baseline value. After carpal tunnel release, there was no marked decrease in intraneural blood flow. This study demonstrated that the blood flow in the median nerve is reduced when Phalen's test is performed in vivo. Copyright 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc.

  10. West Nile virus blood transfusion-related infection despite nucleic acid testing.

    Science.gov (United States)

    Macedo de Oliveira, Alexandre; Beecham, Brady D; Montgomery, Susan P; Lanciotti, Robert S; Linnen, Jeffrey M; Giachetti, Cristina; Pietrelli, Larry A; Stramer, Susan L; Safranek, Thomas J

    2004-12-01

    A case of West Nile virus (WNV) encephalitis associated with transfusion of blood that did not react when tested for WNV by minipool (MP) nucleic acid testing (NAT) is described. A Nebraska man developed clinical encephalitis 13 days after surgery and transfusion of 26 blood components. Antibody testing confirmed WNV infection. An investigation was initiated to determine the source of this infection. The patient's family members were interviewed to identify risk factors for WNV infection. Residual samples were retested for WNV RNA using transcription-mediated amplification (TMA) assay and two polymerase chain reaction (PCR) assays. Blood donors' follow-up serum samples were collected. All samples were tested for WNV-specific immunoglobulin M antibodies. The patient's family denied recent mosquito exposure. The 20 blood components collected after July 2003 did not react when tested for WNV in a six-member MP-NAT at the time of donation. Retrospective individual testing identified one sample as WNV-reactive by the TMA assay and one of the PCR assays. Seroconversion was demonstrated in the donor associated with this sample. WNV RNA detection by individual donation NAT demonstrates viremic blood escaping MP-NAT and supports transfusion-related WNV transmission. MP-NAT may not detect all WNV-infected blood donors, allowing WNV transmission to continue at low levels. WNV NAT assays might vary in sensitivity and pooling donations could further impact test performance. Understanding MP NAT limitations can improve strategies to maintain safety of the blood supply in the United States.

  11. Laboratory Testing of Waste Isolation Pilot Plant Surrogate Waste Materials

    Science.gov (United States)

    Broome, S.; Bronowski, D.; Pfeifle, T.; Herrick, C. G.

    2011-12-01

    The Waste Isolation Pilot Plant (WIPP) is a U.S. Department of Energy geological repository for the permanent disposal of defense-related transuranic (TRU) waste. The waste is emplaced in rooms excavated in the bedded Salado salt formation at a depth of 655 m below the ground surface. After emplacement of the waste, the repository will be sealed and decommissioned. WIPP Performance Assessment modeling of the underground material response requires a full and accurate understanding of coupled mechanical, hydrological, and geochemical processes and how they evolve with time. This study was part of a broader test program focused on room closure, specifically the compaction behavior of waste and the constitutive relations to model this behavior. The goal of this study was to develop an improved waste constitutive model. The model parameters are developed based on a well designed set of test data. The constitutive model will then be used to realistically model evolution of the underground and to better understand the impacts on repository performance. The present study results are focused on laboratory testing of surrogate waste materials. The surrogate wastes correspond to a conservative estimate of the degraded containers and TRU waste materials after the 10,000 year regulatory period. Testing consists of hydrostatic, uniaxial, and triaxial tests performed on surrogate waste recipes that were previously developed by Hansen et al. (1997). These recipes can be divided into materials that simulate 50% and 100% degraded waste by weight. The percent degradation indicates the anticipated amount of iron corrosion, as well as the decomposition of cellulosics, plastics, and rubbers. Axial, lateral, and volumetric strain and axial and lateral stress measurements were made. Two unique testing techniques were developed during the course of the experimental program. The first involves the use of dilatometry to measure sample volumetric strain under a hydrostatic condition. Bulk

  12. Earlier stages of colorectal cancer detected with immunochemical faecal occult blood tests

    NARCIS (Netherlands)

    van Rossum, L. G. M.; van Rijn, A. F.; van Munster, I. P.; Jansen, J. B. M. J.; Fockens, P.; Laheij, R. J. F.; Dekker, E.

    2009-01-01

    Background: The aim of colorectal cancer screening is to improve prognosis by the detection of early cancer and precursor stages. We compared the stage distribution of asymptomatic colorectal cancer patients detected by a positive immunochemical or guaiac-based faecal occult blood test (FOBT) with

  13. The performance test of NAA laboratory at radionuclide measure with low activity

    International Nuclear Information System (INIS)

    Sri Murniasih; Sukirno

    2016-01-01

    The performance test to measure the I-131 radionuclide activity has been carried out at CAST-NAA laboratory. The purpose of this activity is to know the performance of a laboratory in the testing of low radioactivity sample. The tested sample consists of the form I-131 radionuclide sources shaped thin plastic disk with a certain weight. Evaluation of laboratory performance test results carried out by the organizer of the program test appeal (PTKMR-BATAN). Evaluation results showed that testing of point source of the I-131 radionuclide with comparative method gives a good enough results with errors below 10%. The results of the performance test evaluation are useful as the external quality control to a testing method that is expected in NAA laboratory. (author)

  14. A comparison of blood alcohol levels as determined by breath and blood tests taken in actual field operations.

    Science.gov (United States)

    1972-01-01

    During its 1972 session, the General Assembly of Virginia enacted Senate Bill 104, which authorizes the breath test, as well as the blood test used previously, as a proper chemical test to determine the alcoholic content of the blood. Any person arre...

  15. Red cell properties after different modes of blood transportation

    Directory of Open Access Journals (Sweden)

    Asya Makhro

    2016-07-01

    Full Text Available Transportation of blood samples is unavoidable for assessment of specific parameters in blood of patients with rare anemias, blood doping testing or for research purposes. Despite the awareness that shipment may substantially alter multiple parameters, no study of that extend has been performed to assess these changes and optimize shipment conditions to reduce transportation-related artifacts. Here we investigate the changes in multiple parameters in blood of healthy donors over 72 hours of simulated shipment conditions. Three different anticoagulants (K3EDTA, Sodium Heparin and citrate-based CPDA for two temperatures (4oC and room temperature were tested to define the optimal transportation conditions. Parameters measured cover common cytology and biochemistry parameters (complete blood count, hematocrit, morphological examination, red blood cell (RBC volume, ion content and density, membrane properties and stability (hemolysis, osmotic fragility, membrane heat stability, patch-clamp investigations and formation of micro vesicles, Ca2+ handling, RBC metabolism, activity of numerous enzymes and O2 transport capacity. Our findings indicate that individual sets of parameter may require different shipment settings (anticoagulants, temperature. Most of the parameters except for ion (Na+, K+, Ca2+ handling and, possibly, reticulocytes counts, tend to favor transportation at 4oC. Whereas plasma and intraerythrocytic Ca2+ cannot be accurately measured in the presence of chelators such as citrate and EDTA, majority of Ca2+-dependent parameters are stabilized in CPDA samples. Even in blood samples from healthy donors transported using optimized shipment protocol the majority of parameters were stable within 24 hours, the condition that may not hold for the samples of patients with rare anemias. This implies for the as short as possible shipping using fast courier services to the closest expert laboratory at reach. Mobile laboratories or the travel of the

  16. Simple Sample Preparation Method for Direct Microbial Identification and Susceptibility Testing From Positive Blood Cultures

    Directory of Open Access Journals (Sweden)

    Hong-wei Pan

    2018-03-01

    Full Text Available Rapid identification and determination of the antibiotic susceptibility profiles of the infectious agents in patients with bloodstream infections are critical steps in choosing an effective targeted antibiotic for treatment. However, there has been minimal effort focused on developing combined methods for the simultaneous direct identification and antibiotic susceptibility determination of bacteria in positive blood cultures. In this study, we constructed a lysis-centrifugation-wash procedure to prepare a bacterial pellet from positive blood cultures, which can be used directly for identification by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS and antibiotic susceptibility testing by the Vitek 2 system. The method was evaluated using a total of 129 clinical bacteria-positive blood cultures. The whole sample preparation process could be completed in <15 min. The correct rate of direct MALDI-TOF MS identification was 96.49% for gram-negative bacteria and 97.22% for gram-positive bacteria. Vitek 2 antimicrobial susceptibility testing of gram-negative bacteria showed an agreement rate of antimicrobial categories of 96.89% with a minor error, major error, and very major error rate of 2.63, 0.24, and 0.24%, respectively. Category agreement of antimicrobials against gram-positive bacteria was 92.81%, with a minor error, major error, and very major error rate of 4.51, 1.22, and 1.46%, respectively. These results indicated that our direct antibiotic susceptibility analysis method worked well compared to the conventional culture-dependent laboratory method. Overall, this fast, easy, and accurate method can facilitate the direct identification and antibiotic susceptibility testing of bacteria in positive blood cultures.

  17. ENVIRONMENTAL RISK ASSESSMENT OF SOME COPPER BASED FUNGICIDES ACCORDING TO THE REQUIREMENTS OF GOOD LABORATORY PRACTICE

    Directory of Open Access Journals (Sweden)

    Marga GRĂDILĂ

    2015-10-01

    Full Text Available The paper presents data demonstrating the functionality of biological systems reconstituted with aquatic organisms developed under Good Laboratory Practice testing facility within Research - Development Institute for Plant Protection Bucharest for environmental risk assessment of four fungicides based on copper, according to Good Laboratory Practice requirements. For risk assessment, according to GLP were made the following steps: Good Laboratory Practice test facility was established, we have ensured adequate space for growth, acclimatization and testing for each test species, it was installed a complex water production instalation needed to perform tests, it was achieved control system for checking environmental conditions and have developed specific operating procedures that have been accredited according to Good Laboratory Practice.The results showed that biological systems model of the Good Laboratory Practice test facility in Research - Development Institute for Plant Protection meet the requirements of Organisation for Economic Co-operation and Development Guidelines regarding GLP, and after testing copper-based fungicides in terms of acute toxicity Cyprinus carpio and to Daphnia magna revealed that three of them (copper oxychloride, copper hydroxide and copper sulphate showed ecological efficiency, ie low toxicity. Metallic copper based fungicides showed a higher toxicity, resulting in fish toxicity symptoms: sleep, sudden immersion, faded, weakness, swimming in spiral, lack of balance, breathing slow and cumbersome, spasms and mortality.

  18. [Revolution of the health care delivery system and its impacts on laboratory testing in the United States].

    Science.gov (United States)

    Takemura, Y; Ishibashi, M

    2000-02-01

    Failure to slow the exponential growth of total health care expenditures in the United States through the government policies resulted in a rapid and progressive penetration of managed care organizations(MCOs) in the early 1990s. Diagnostic testing is viewed as a "commodity" rather than a medical service under the managed care environment. Traditional hospital-based laboratories are placed in a downward spiral with the advent of managed care era. A massive reduction of in-house testing resulted from shorter lengths of patients' hospital stay and a marked decrease in admission under the dominance of managed care urges them to develop strategies for restoring tests deprived by the managed care-associated new businesses: consolidation and networking, participation in the outreach-testing market, and point-of-care/satellite laboratory testing in non-traditional, ambulatory settings are major strategies for survival of hospital laboratories. A number of physicians' office laboratories(POLs) have been closed owing to regulatory restrictions imposed by the Clinical Laboratory Improvement Amendments of 1988(CLIA '88), and to the expanded penetration of MCOs which limit reimbursement to a very few in-house procedures. It seems likely that POLs and hospital laboratories continue to reduce test volumes, while commercial reference laboratories(CRLs) gain more tests through contracting with MCOs. In the current stream of managed care dominance in the United States, clinical laboratories are changing their basic operation focus and mission in response to the aggressively changing landscape. Traditional laboratories which are unwilling to adapt themselves to the new environment will not survive in this country.

  19. Standardization of glycohemoglobin results and reference values in whole blood studied in 103 laboratories using 20 methods.

    Science.gov (United States)

    Weykamp, C W; Penders, T J; Miedema, K; Muskiet, F A; van der Slik, W

    1995-01-01

    We investigated the effect of calibration with lyophilized calibrators on whole-blood glycohemoglobin (glyHb) results. One hundred three laboratories, using 20 different methods, determined glyHb in two lyophilized calibrators and two whole-blood samples. For whole-blood samples with low (5%) and high (9%) glyHb percentages, respectively, calibration decreased overall interlaboratory variation (CV) from 16% to 9% and from 11% to 6% and decreased intermethod variation from 14% to 6% and from 12% to 5%. Forty-seven laboratories, using 14 different methods, determined mean glyHb percentages in self-selected groups of 10 nondiabetic volunteers each. With calibration their overall mean (2SD) was 5.0% (0.5%), very close to the 5.0% (0.3%) derived from the reference method used in the Diabetes Control and Complications Trial. In both experiments the Abbott IMx and Vision showed deviating results. We conclude that, irrespective of the analytical method used, calibration enables standardization of glyHb results, reference values, and interpretation criteria.

  20. Photocleavage-based affinity purification of biomarkers from serum: Application to multiplex allergy testing.

    Directory of Open Access Journals (Sweden)

    Zhi Wan

    Full Text Available Multiplex serological immunoassays, such as implemented on microarray or microsphere-based platforms, provide greater information content and higher throughput, while lowering the cost and blood volume required. These features are particularly attractive in pediatric food allergy testing to facilitate high throughput multi-allergen analysis from finger- or heel-stick collected blood. However, the miniaturization and microfluidics necessary for creating multiplex assays make them highly susceptible to the "matrix effect" caused by interference from non-target agents in serum and other biofluids. Such interference can result in lower sensitivity, specificity, reproducibility and quantitative accuracy. These problems have in large part prevented wide-spread implementation of multiplex immunoassays in clinical laboratories. We report the development of a novel method to eliminate the matrix effect by utilizing photocleavable capture antibodies to purify and concentrate blood-based biomarkers (a process termed PC-PURE prior to detection in a multiplex immunoassay. To evaluate this approach, it was applied to blood-based allergy testing. Patient total IgE was purified and enriched using PC-PURE followed by multiplex microsphere-based detection of allergen-specific IgEs (termed the AllerBead assay. AllerBead was formatted to detect the eight most common pediatric food allergens: milk, soy, wheat, egg, peanuts, tree nuts, fin fish and shellfish, which account for >90% of all pediatric food allergies. 205 serum samples obtained from Boston Children's Hospital were evaluated. When PC-PURE was employed with AllerBead, excellent agreement was obtained with the standard, non-multiplex, ImmunoCAP® assay (average sensitivity above published negative predictive cutoffs = 96% and average Pearson r = 0.90; average specificity = 97%. In contrast, poor ImmunoCAP®-correlation was observed when PC-PURE was not utilized (average sensitivity above published negative

  1. Quality assurance practices in Europe: a survey of molecular genetic testing laboratories

    Science.gov (United States)

    Berwouts, Sarah; Fanning, Katrina; Morris, Michael A; Barton, David E; Dequeker, Elisabeth

    2012-01-01

    In the 2000s, a number of initiatives were taken internationally to improve quality in genetic testing services. To contribute to and update the limited literature available related to this topic, we surveyed 910 human molecular genetic testing laboratories, of which 291 (32%) from 29 European countries responded. The majority of laboratories were in the public sector (81%), affiliated with a university hospital (60%). Only a minority of laboratories was accredited (23%), and 26% was certified. A total of 22% of laboratories did not participate in external quality assessment (EQA) and 28% did not use reference materials (RMs). The main motivations given for accreditation were to improve laboratory profile (85%) and national recognition (84%). Nearly all respondents (95%) would prefer working in an accredited laboratory. In accredited laboratories, participation in EQA (Pquality assurance (Pquality implementation score (QIS), we showed that accredited laboratories (average score 92) comply better than certified laboratories (average score 69, Pquality indicators. We conclude that quality practices vary widely in European genetic testing laboratories. This leads to a potentially dangerous situation in which the quality of genetic testing is not consistently assured. PMID:22739339

  2. Preliminary probe of quality indicators and quality specification in total testing process in 5753 laboratories in China.

    Science.gov (United States)

    Fei, Yang; Kang, Fengfeng; Wang, Wei; Zhao, Haijian; He, Falin; Zhong, Kun; Wang, Zhiguo; Chen, Wenxiang

    2016-08-01

    The aim of the study was to promote the establishment and implementation of quality indicators (QIs) in clinical laboratories, catch up with the state of art, and provide preliminary quality specifications for established QIs. Clinical laboratories from different provinces in China were included in this QIs survey in 2015. All participants were asked to collect data related to QIs and complete QIs questionnaires. Defect percentages and sigma values were calculated for each QI. The 25th percentile, median, and the 75th percentile of defect percentages and TATs were calculated as optimum, desirable and minimum quality specifications. While 25th, median, and 75th of sigma values were calculated as minimum, desirable and optimum quality specifications, respectively. Five thousand seven hundred and fifty-three clinical laboratories from 28 provinces in China participated in this survey. Median defect percentages of pre-examination QIs varied largely from 0.01% (incorrect sample container) to 0.57% (blood culture contamination) with sigma values varied from 4.0σ to 5.1σ. Median defect percentages of examination phase QIs were all really high. The most common problem in examination phase was test uncovered by inter-laboratory comparison (86.67%). Defect percentages of critical values notification and timely critical values notification were all 0.00% (6.0σ). While the median of defect percentages of incorrect laboratory reports was only 0.01% (5.4σ). Improvements are needed in all phases of total testing process (TTP) in laboratories in China, especially in examination phase. More attention should be paid when microbiology specimens are collected and results are reported. Quality specifications can provide directions for laboratories to make effort for.

  3. Near patient cholesterol testing in patients with peripheral arterial disease.

    Science.gov (United States)

    Hobbs, S D; Jones, A; Wilmink, A B; Bradbury, A W

    2003-09-01

    To assess the bias, precision and utility of the Bioscanner 2000 for near patient testing of total cholesterol (NPTC) in patients with peripheral arterial disease (PAD). One hundred consecutive patients attending a hospital-based clinic with symptomatic PAD underwent non-fasting NPTC using finger prick blood sample and a laboratory total cholesterol (TC) using blood drawn from an antecubital fossa vein. The Bioscanner 2000 showed good precision with a coefficient of variation of 1.8-3.8%. NPTC was significantly lower than laboratory TC (mean (S.D.) 4.67 (1.1) vs. 5.12 (1.2) mmol/l), p Bioscanner 2000 compared to laboratory testing, which was demonstrated to be a systematic bias using a Bland-Altman plot. Almost half (46%) of the readings differed by > 0.5 mmol/l, 16% by > 1.0 mmol/l and 3% by > 2 mmol/l. This means that if the cut-off for statin treatment were taken as a TC of 5.0 or 3.5 mmol/l then, based on NPTC, alone 18 and 6% of patients, respectively, would not have received a statin. In the present study, NPTC significantly under-estimated TC when compared to laboratory testing. However, in the majority of cases, this would not have affected the decision to prescribe a statin and NPTC testing allows the immediate institution or titration of statin treatment.

  4. Open-source Software for Demand Forecasting of Clinical Laboratory Test Volumes Using Time-series Analysis.

    Science.gov (United States)

    Mohammed, Emad A; Naugler, Christopher

    2017-01-01

    Demand forecasting is the area of predictive analytics devoted to predicting future volumes of services or consumables. Fair understanding and estimation of how demand will vary facilitates the optimal utilization of resources. In a medical laboratory, accurate forecasting of future demand, that is, test volumes, can increase efficiency and facilitate long-term laboratory planning. Importantly, in an era of utilization management initiatives, accurately predicted volumes compared to the realized test volumes can form a precise way to evaluate utilization management initiatives. Laboratory test volumes are often highly amenable to forecasting by time-series models; however, the statistical software needed to do this is generally either expensive or highly technical. In this paper, we describe an open-source web-based software tool for time-series forecasting and explain how to use it as a demand forecasting tool in clinical laboratories to estimate test volumes. This tool has three different models, that is, Holt-Winters multiplicative, Holt-Winters additive, and simple linear regression. Moreover, these models are ranked and the best one is highlighted. This tool will allow anyone with historic test volume data to model future demand.

  5. Open-source software for demand forecasting of clinical laboratory test volumes using time-series analysis

    Directory of Open Access Journals (Sweden)

    Emad A Mohammed

    2017-01-01

    Full Text Available Background: Demand forecasting is the area of predictive analytics devoted to predicting future volumes of services or consumables. Fair understanding and estimation of how demand will vary facilitates the optimal utilization of resources. In a medical laboratory, accurate forecasting of future demand, that is, test volumes, can increase efficiency and facilitate long-term laboratory planning. Importantly, in an era of utilization management initiatives, accurately predicted volumes compared to the realized test volumes can form a precise way to evaluate utilization management initiatives. Laboratory test volumes are often highly amenable to forecasting by time-series models; however, the statistical software needed to do this is generally either expensive or highly technical. Method: In this paper, we describe an open-source web-based software tool for time-series forecasting and explain how to use it as a demand forecasting tool in clinical laboratories to estimate test volumes. Results: This tool has three different models, that is, Holt-Winters multiplicative, Holt-Winters additive, and simple linear regression. Moreover, these models are ranked and the best one is highlighted. Conclusion: This tool will allow anyone with historic test volume data to model future demand.

  6. Trends in laboratory test volumes for Medicare Part B reimbursements, 2000-2010.

    Science.gov (United States)

    Shahangian, Shahram; Alspach, Todd D; Astles, J Rex; Yesupriya, Ajay; Dettwyler, William K

    2014-02-01

    Changes in reimbursements for clinical laboratory testing may help us assess the effect of various variables, such as testing recommendations, market forces, changes in testing technology, and changes in clinical or laboratory practices, and provide information that can influence health care and public health policy decisions. To date, however, there has been no report, to our knowledge, of longitudinal trends in national laboratory test use. To evaluate Medicare Part B-reimbursed volumes of selected laboratory tests per 10,000 enrollees from 2000 through 2010. Laboratory test reimbursement volumes per 10,000 enrollees in Medicare Part B were obtained from the Centers for Medicare & Medicaid Services (Baltimore, Maryland). The ratio of the most recent (2010) reimbursed test volume per 10,000 Medicare enrollees, divided by the oldest data (usually 2000) during this decade, called the volume ratio, was used to measure trends in test reimbursement. Laboratory tests with a reimbursement claim frequency of at least 10 per 10,000 Medicare enrollees in 2010 were selected, provided there was more than a 50% change in test reimbursement volume during the 2000-2010 decade. We combined the reimbursed test volumes for the few tests that were listed under more than one code in the Current Procedural Terminology (American Medical Association, Chicago, Illinois). A 2-sided Poisson regression, adjusted for potential overdispersion, was used to determine P values for the trend; trends were considered significant at P reimbursement volumes were electrolytes, digoxin, carbamazepine, phenytoin, and lithium, with volume ratios ranging from 0.27 to 0.64 (P reimbursement volumes were meprobamate, opiates, methadone, phencyclidine, amphetamines, cocaine, and vitamin D, with volume ratios ranging from 83 to 1510 (P reimbursement volumes increased for most of the selected tests, other tests exhibited statistically significant downward trends in annual reimbursement volumes. The observed

  7. Antiphospholipid Syndrome Laboratory Testing and Diagnostic Strategies

    Science.gov (United States)

    Ortel, Thomas L.

    2016-01-01

    The Antiphospholipid Syndrome (APS) is diagnosed in patients with recurrent thromboembolic events and/or pregnancy loss in the presence of persistent laboratory evidence for antiphospholipid antibodies. Diagnostic tests for the detection of antiphospholipid antibodies include laboratory assays that detect anticardiolipin antibodies, lupus anticoagulants, and anti-β2-glycoprotein I antibodies. These assays have their origins beginning more than sixty years ago, with the identification of the biologic false positive test for syphilis, the observation of ‘circulating anticoagulants’ in certain patients with systemic lupus erythematosus, the identification of cardiolipin as a key component in the serologic test for syphilis, and the recognition and characterization of a ‘cofactor’ for antibody binding to phospholipids. Although these assays have been used clinically for many years, there are still problems with the accurate diagnosis of patients with this syndrome. For example, lupus anticoagulant testing can be difficult to interpret in patients receiving anticoagulant therapy, but most patients with a thromboembolic event will already be anticoagulated before the decision to perform the tests has been made. In addition to understanding limitations of the assays, clinicians also need to be aware of which patients should be tested and not obtain testing on patients unlikely to have APS. New tests and diagnostic strategies are in various stages of development and should help improve our ability to accurately diagnose this important clinical disorder. PMID:22473619

  8. Predictive Value of Whole Blood and Plasma Coagulation Tests for Intra- and Postoperative Bleeding Risk: A Systematic Review

    DEFF Research Database (Denmark)

    Larsen, Julie Brogaard; Hvas, Anne-Mette

    2017-01-01

    review of the existing literature assessing the ability of whole blood coagulation (thromboelastography [TEG]/thromboelastometry [ROTEM]/Sonoclot), platelet function tests, and standard plasma-based coagulation tests to predict bleeding in the perioperative setting. We searched PubMed and Embase...... value of testing in patients receiving antithrombotic medication. In general, studies reported low positive predictive values for perioperative testing, whereas negative predictive values were high. The studies yielded moderate areas under receiver operator characteristics (ROC) curve (for the majority...... recommend that both whole blood and plasma-based coagulation tests are primarily used in case of bleeding and not for screening in unselected patients prior to surgery....

  9. Comparison of Estrogen Receptor Assay Results from Pathology Reports with Results from Central Laboratory Testing: Implications for Population-Based Studies of Breast Cancer

    Science.gov (United States)

    Collins, LC; Marotti, J; Baer, HJ; Deitz, AC; Colditz, GA; Tamimi, RM

    2014-01-01

    Population-based studies of women with breast cancer commonly utilize information culled from pathology reports rather than central pathology review. The reliability of this information, particularly with regard to tumor biomarker results, is of concern. To address this, we evaluated the concordance between estrogen receptor (ER) results as determined from the original pathology reports and ER results obtained on the same specimens following testing in a single laboratory. Tissue microarrays (TMAs) were constructed from paraffin blocks of 3,167 breast cancers that developed in women enrolled in the Nurses’ Health Study. ER immunostains were performed on all TMA sections in single run. Results of ER immunostains performed on the TMA sections were compared with ER assay results abstracted from pathology reports. Among 1,851 cases of invasive breast cancer in which both ER results from pathology reports and central ER test results were available, the reported ER status and the ER status as determined from immunostains on TMAs were in agreement in 1,651 cases (87.3 %; kappa value 0.64, ppathology reports is a reasonable, albeit imperfect, alternative to central laboratory ER testing for large, population-based studies of patients with breast cancer. PMID:18230800

  10. Laboratory evaluation of immunochromatographic rapid diagnostic tests for cholera in Haiti.

    Directory of Open Access Journals (Sweden)

    Wilfredo R Matias

    Full Text Available Rapid diagnostic tests (RDT for cholera are promising tools for detecting cholera in areas with limited laboratory infrastructure. However, evidence on the characteristics of the many available RDTs is scarce, and their use has been limited by suboptimal performance. We evaluated the performance characteristics of three cholera RDTs from Span Diagnostics, Artron Laboratories, and Standard Diagnostics in a regional laboratory in Haiti.We retrospectively reviewed records from May 2014 to October 2015 of a laboratory-based surveillance program for Vibrio cholerae at Hôpital Saint-Nicolas in Saint-Marc, Haiti. We compared the results of 511 Crystal VC, 129 Artron and 451 SD Bioline RDTs to bacterial culture as the gold standard. Of 905 cultures, 477 (52.7% were positive for V. cholerae O1, of which 27.7% were serotype Inaba. No cultures grew V. cholerae O139. Sensitivity and specificity of Crystal VC were 98.6% (95%CI: 96.5%-99.6% and 71.1% (95%CI: 64.7%-76.9%, respectively. Artron demonstrated a sensitivity of 98.6% (95%CI: 92.7%-100% and specificity of 69.1% (95%CI: 55.2%-80.9%. SD Bioline demonstrated a sensitivity of 81.1% (95%CI: 75.6%-85.8% and specificity of 92.8% (95%CI: 88.4%-95.9%. Crystal VC and Artron frequently showed false positive O139 bands, whereas none were seen with SD Bioline.There is significant variation in the performance of different cholera diagnostic RDTs. Artron and Crystal VC RDTs have high sensitivity and low specificity, while SD Bioline RDT has low to moderate sensitivity and high specificity when performed by laboratory technicians in Haiti. Study limitations included its retrospective design. The suboptimal characteristics of these tests limit their use as clinical point-of-care tests; however, they may be useful in outbreak response, surveillance, and research in resource-limited settings.

  11. Psychosocial stress based on public speech in humans: is there a real life/laboratory setting cross-adaptation?

    Science.gov (United States)

    Jezova, D; Hlavacova, N; Dicko, I; Solarikova, P; Brezina, I

    2016-07-01

    Repeated or chronic exposure to stressors is associated with changes in neuroendocrine responses depending on the type, intensity, number and frequency of stress exposure as well as previous stress experience. The aim of the study was to test the hypothesis that salivary cortisol and cardiovascular responses to real-life psychosocial stressors related to public performance can cross-adapt with responses to psychosocial stress induced by public speech under laboratory setting. The sample consisted of 22 healthy male volunteers, which were either actors, more precisely students of dramatic arts or non-actors, students of other fields. The stress task consisted of 15 min anticipatory preparation phase and 15 min of public speech on an emotionally charged topic. The actors, who were accustomed to public speaking, responded with a rise in salivary cortisol as well as blood pressure to laboratory public speech. The values of salivary cortisol, systolic blood pressure and state anxiety were lower in actors compared to non-actors. Unlike non-actors, subjects with experience in public speaking did not show stress-induced rise in the heart rate. Evaluation of personality traits revealed that actors scored significantly higher in extraversion than the subjects in the non-actor group. In conclusion, neuroendocrine responses to real-life stressors in actors can partially cross-adapt with responses to psychosocial stress under laboratory setting. The most evident adaptation was at the level of heart rate responses. The public speech tasks may be of help in evaluation of the ability to cope with stress in real life in artists by simple laboratory testing.

  12. Operational evaluation of rapid diagnostic testing for Ebola Virus Disease in Guinean laboratories.

    Directory of Open Access Journals (Sweden)

    Amanda VanSteelandt

    Full Text Available Rapid Diagnostic Tests (RDTs for Ebola Virus Disease (EVD at the point of care have the potential to increase access and acceptability of EVD testing and the speed of patient isolation and secure burials for suspect cases. A pilot program for EVD RDTs in high risk areas of Guinea was introduced in October 2015. This paper presents concordance data between EVD RDTs and PCR testing in the field as well as an assessment of the acceptability, feasibility, and quality assurance of the RDT program.Concordance data were compiled from laboratory surveillance databases. The operational measures of the laboratory-based EVD RDT program were evaluated at all 34 sentinel sites in Guinea through: (1 a technical questionnaire filled by the lab technicians who performed the RDTs, (2 a checklist filled by the evaluator during the site visits, and (3 direct observation of the lab technicians performing the quality control test. Acceptability of the EVD RDT was good for technicians, patients, and families although many technicians (69.8% expressed concern for their safety while performing the test. The feasibility of the program was good based on average technician knowledge scores (6.6 out of 8 but basic infrastructure, equipment, and supplies were lacking. There was much room for improvement in quality assurance of the program.The implementation of new diagnostics in weak laboratory systems requires general training in quality assurance, biosafety and communication with patients in addition to specific training for the new test. Corresponding capacity building in terms of basic equipment and a long-term commitment to transfer supervision and quality improvement to national public health staff are necessary for successful implementation.

  13. [Faecal occult blood test for colorectal cancer screening: high quality for a good price].

    Science.gov (United States)

    van Veldhuizen, Harriët; Bonfrer, J M G Hans; Kuipers, Ernst J

    2013-01-01

    The Dutch National Institute for Public Health and the Environment (RIVM) awarded the immunochemical faecal occult blood test (IFOBT) to FOB Gold of Sentinel following a European call for tenders. The contract-awarding procedure included the application of quality knock-out criteria, which were met by two suppliers. The decisive factor was the best price/quality ratio. A recent review indicated that, at present, no single IFOBT is better than any other. The decision to opt for a test manufactured by a different supplier than was used in the previous screening pilots made it necessary to re-determine the cut-off value. This value has now been set (88 ng/ml) and is confirmed by a laboratory test. Colonoscopy-related capacity planning, as well as its diagnostic yield, depends on numerous factors; therefore, the RIVM is currently monitoring the referral percentage and number of adenomas detected and is collaborating on quality terms. Any necessary adjustments are to be made during the introduction of the screening test.

  14. Determination of total galactose from dried blood spots—extensive assay evaluation of a CE-marked test-kit

    OpenAIRE

    Fingerhut, R; Torresani, T

    2013-01-01

    Most newborn screening laboratories use CE-marked or FDA-approved test-kits, like in routine clinical chemistry. National regulations require only minimal evaluation from the customer, if the test-kits are used as specified by the manufacturer. The microtiter-based kit-concept is often based on the perception, that the laboratory always processes whole microtiter plates. However, in the daily routine, this is rather a rare exception, which leads to much higher costs per newborn, compared to t...

  15. Evaluation of three oil spill laboratory dispersant effectiveness tests

    International Nuclear Information System (INIS)

    Sullivan, D.; Farlow, J.; Sahatjian, K.A.

    1993-01-01

    Chemical dispersants can be used to reduce the interfacial tension of floating oil slicks so that the oils disperse more rapidly into the water column and thus pose less of a threat to shorelines, birds, and marine mammals. The laboratory test currently specified in federal regulations to measure dispersant effectiveness is not especially easy or inexpensive, and generates a rather large quantity of oily waste water. This paper describes the results of an effort by the EPA to identify a more suitable laboratory dispersant effectiveness test. EPA evaluated three laboratory methods: the Revised Standard Dispersant Effectiveness Test currently used (and required by regulation) in the United States, the swirling flask test (developed by Environment Canada), and the IFP-dilution test (used in france and other European countries). Six test oils and three dispersants were evaluated; dispersants were applied to the oil at an average 1:10 ratio (dispersant to oil) for each of the three laboratory methods. Screening efforts were used to focus on the most appropriate oil/dispersant combination for detailed study. A screening criterion was established that required a combination that gave at least 20% effectiveness results. The selected combination turned out to be Prudhoe Bay crude oil and the dispersant Corexit 9527. This combination was also most likely to be encountered in US coastal waters. The EPA evaluation concluded that the three tests gave similar precision results, but that the swirling flask test was fastest, cheapest, simplest, and required least operator skill. Further, EPA is considering conducting the dispersant effectiveness test itself, rather than having data submitted by a dispersant manufacturer, and establishing an acceptability criterion (45% efficiency) which would have to be met before a dispersant could be placed on the Product Schedule of the National Contingency Plan (NCP)

  16. 9 CFR 147.3 - The stained-antigen, rapid, whole-blood test. 3

    Science.gov (United States)

    2010-01-01

    ...-blood test. 3 147.3 Section 147.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE... Blood Testing Procedures § 147.3 The stained-antigen, rapid, whole-blood test. 3 3 The procedure described is a modification of the method reported by Schaffer, MacDonald, Hall, and Bunyea, Jour. Amer. Vet...

  17. Radiographic testing at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    Bossi, R.H.

    1982-01-01

    Radiographic testing is a nondestructive inspection technique which uses penetrating radiation. The Nondestructive Evaluation (NDE) Section at Lawrence Livermore National Laboratory has a broad spectrum of equipment and techniques for radiographic testing. These resources include low-energy vacuum systems, low- and mid-energy cabinet and cell radiographic systems, high-energy linear accelerators, portable x-ray machines and radioisotopes for radiographic inspections. For diagnostic testing the NDE Section also has real-time and flash radiographic equipment

  18. Launching a Laboratory Testing Process Quality Improvement Toolkit: From the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP).

    Science.gov (United States)

    Fernald, Douglas; Hamer, Mika; James, Kathy; Tutt, Brandon; West, David

    2015-01-01

    Family medicine and internal medicine physicians order diagnostic laboratory tests for nearly one-third of patient encounters in an average week, yet among medical errors in primary care, an estimated 15% to 54% are attributed to laboratory testing processes. From a practice improvement perspective, we (1) describe the need for laboratory testing process quality improvements from the perspective of primary care practices, and (2) describe the approaches and resources needed to implement laboratory testing process quality improvements in practice. We applied practice observations, process mapping, and interviews with primary care practices in the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP)-affiliated practice-based research networks that field-tested in 2013 a laboratory testing process improvement toolkit. From the data collected in each of the 22 participating practices, common testing quality issues included, but were not limited to, 3 main testing process steps: laboratory test preparation, test tracking, and patient notification. Three overarching qualitative themes emerged: practices readily acknowledge multiple laboratory testing process problems; practices know that they need help addressing the issues; and practices face challenges with finding patient-centered solutions compatible with practice priorities and available resources. While practices were able to get started with guidance and a toolkit to improve laboratory testing processes, most did not seem able to achieve their quality improvement aims unassisted. Providing specific guidance tools with practice facilitation or other rapid-cycle quality improvement support may be an effective approach to improve common laboratory testing issues in primary care. © Copyright 2015 by the American Board of Family Medicine.

  19. Real-Time PCR in Clinical Microbiology: Applications for Routine Laboratory Testing

    Science.gov (United States)

    Espy, M. J.; Uhl, J. R.; Sloan, L. M.; Buckwalter, S. P.; Jones, M. F.; Vetter, E. A.; Yao, J. D. C.; Wengenack, N. L.; Rosenblatt, J. E.; Cockerill, F. R.; Smith, T. F.

    2006-01-01

    Real-time PCR has revolutionized the way clinical microbiology laboratories diagnose many human microbial infections. This testing method combines PCR chemistry with fluorescent probe detection of amplified product in the same reaction vessel. In general, both PCR and amplified product detection are completed in an hour or less, which is considerably faster than conventional PCR detection methods. Real-time PCR assays provide sensitivity and specificity equivalent to that of conventional PCR combined with Southern blot analysis, and since amplification and detection steps are performed in the same closed vessel, the risk of releasing amplified nucleic acids into the environment is negligible. The combination of excellent sensitivity and specificity, low contamination risk, and speed has made real-time PCR technology an appealing alternative to culture- or immunoassay-based testing methods for diagnosing many infectious diseases. This review focuses on the application of real-time PCR in the clinical microbiology laboratory. PMID:16418529

  20. Blood in Urine: MedlinePlus Lab Test Information

    Science.gov (United States)

    ... K. Brunner & Suddarth's Handbook of Laboratory and Diagnostic Tests. 2 nd Ed, Kindle. Philadelphia: Wolters Kluwer Health, Lippincott Williams & Wilkins; c2014. Hemoglobin, Urine; p. 325. Lab Tests ...

  1. Biomagnification of hexachlorobenzene: influence of uptake routes in a laboratory test

    International Nuclear Information System (INIS)

    Egeler, P.; Meller, M.; Roembke, J.; Spoerlein, P.

    2001-01-01

    In order to evaluate such a potential biomagnification, a laboratory test was developed. It consisted of a two-step food chain including the sediment dwelling freshwater oligochaete Tubifex tubifex (Mueller) and the three-spined stickleback (Gasterosteus aculeatus, Linne), a small teleost fish which often feeds primarily on benthic invertebrates. Artificial sediment and reconstituted water were used. To examine the influence of benthic prey on the bioaccumulation of a POP in the predator, fish were exposed to 14 C-labelled hexachlorobenzene via spiked water, spiked sediment, pre-contaminated prey organisms, and to combinations of these exposure routes. Summarising the results of these experiments, it could be shown that the exposure to HCB via different routes resulted in a significantly higher accumulation in fish than an exposure to single pathways. It was concluded that the major uptake routes for fish were the overlying water and the food, whereas the contribution of spiked sediment itself was relatively small. HCB was biomagnified in the tested laboratory food chain. Therefore, concerning secondary poisoning, the environmental risk assessment of POPs like HCB should not be based on existing bioaccumulation tests alone, since they focus only on exposure via the water pathway. Instead, the influence of food and sediment as exposure routes should be considered as well, using comprehensive food chain modelling and/or laboratory studies. (orig.) [de

  2. Selective testing of women based on age for genital Chlamydia trachomatis and Neisseria gonorrhoeae infection in a centralized regional microbiology laboratory.

    Science.gov (United States)

    Church, Deirdre L; Amante, L; Semeniuk, H; Gregson, D B

    2007-04-01

    Calgary Laboratory Services, Alberta, Canada, provides microbiology services via a centralized laboratory to the Calgary Health Region. A selective genital Chlamydia trachomatis (CT)/Neisseria gonorrhoeae (GC) testing policy for women >35 years was implemented. The changes in physician ordering practice, the rate of detection of infections, and the test turnaround times were monitored. The volume of tests, the cost/test, and the total service costs accrued in the year before and after this policy change were compared. An immediate impact was a 30% decrease in tests performed due to the laboratory rejecting samples from older women. Subsequently, physicians' practice changed so that tests were ordered when test criteria were met. Detection rates did not change in any age group. A 27.9% decrease in the total service costs resulted in a labor reduction of 0.2 FTE. Selective testing of women >35 years with a low prevalence of CT/GC infection is clinically relevant and cost-effective.

  3. In Vivo Model to Test Implanted Biosensors for Blood pH

    Science.gov (United States)

    Arnaud, Sara B.; Somps, Chris J.; Madou, Marc; Hines, John; Wade, Charles E. (Technical Monitor)

    1997-01-01

    Biosensors for monitoring physiologic data continuously through telemetry are available for heart rate, respiration, and temperature but not for blood pH or ions affected by hydrogen ion concentration. A telemetric biosensor for monitoring blood pH on-line could be used to identify and manage problems in fluid and electrolyte metabolism, cardiac and respiratory function during space flight and the acid-base status of patients without the need for venipuncture in patients on Earth. Critical to the development of biosensors is a method for evaluating their performance after implantation. Mature rats, prepared with jugular, cannulas for repeated blood samples, were exposed to a gas mixture containing high levels of carbon dioxide (7%) in a closed environment to induce mild respiratory acidosis. Serial blood gas and pH measurements in venous blood were compared with electrical responses from sensors implanted in the subcutaneous tissue. Animals became slightly tachypneic after exposure to excess CO2, but remained alert and active. After 5 minutes, basal blood pH decreased from 7.404 +/- 0.013 to 7.289 +/- 0.010 (p less than 0.001)and PC02 increased from 45 +/- 6 to 65 +/- 4 mm. Hg (p les than 0.001). Thereafter pH and blood gas parameters remained stable. Implanted sensors showed a decrease in millivolts (mV) which paralleled the change in pH and averaged 5-6 mV per 0.1 unit pH. Implanted sensors remained sensitive to modest changes in tissue pH for one week. A system for inducing acidosis in rats was developed to test the in vivo performance of pH biosensors. The system provides a method which is sensitive, rapid and reproducible in the same and different animals with full recovery, for testing the performance of sensors implanted in subcutaneous tissues.

  4. Blood-based biomarkers of aggressive prostate cancer.

    Directory of Open Access Journals (Sweden)

    Men Long Liong

    Full Text Available PURPOSE: Prostate cancer is a bimodal disease with aggressive and indolent forms. Current prostate-specific-antigen testing and digital rectal examination screening provide ambiguous results leading to both under-and over-treatment. Accurate, consistent diagnosis is crucial to risk-stratify patients and facilitate clinical decision making as to treatment versus active surveillance. Diagnosis is currently achieved by needle biopsy, a painful procedure. Thus, there is a clinical need for a minimally-invasive test to determine prostate cancer aggressiveness. A blood sample to predict Gleason score, which is known to reflect aggressiveness of the cancer, could serve as such a test. MATERIALS AND METHODS: Blood mRNA was isolated from North American and Malaysian prostate cancer patients/controls. Microarray analysis was conducted utilizing the Affymetrix U133 plus 2·0 platform. Expression profiles from 255 patients/controls generated 85 candidate biomarkers. Following quantitative real-time PCR (qRT-PCR analysis, ten disease-associated biomarkers remained for paired statistical analysis and normalization. RESULTS: Microarray analysis was conducted to identify 85 genes differentially expressed between aggressive prostate cancer (Gleason score ≥8 and controls. Expression of these genes was qRT-PCR verified. Statistical analysis yielded a final seven-gene panel evaluated as six gene-ratio duplexes. This molecular signature predicted as aggressive (ie, Gleason score ≥8 55% of G6 samples, 49% of G7(3+4, 79% of G7(4+3 and 83% of G8-10, while rejecting 98% of controls. CONCLUSION: In this study, we have developed a novel, blood-based biomarker panel which can be used as the basis of a simple blood test to identify men with aggressive prostate cancer and thereby reduce the overdiagnosis and overtreatment that currently results from diagnosis using PSA alone. We discuss possible clinical uses of the panel to identify men more likely to benefit from

  5. Normative evaluation of blood banks in the Brazilian Amazon region in respect to the prevention of transfusion-transmitted malaria

    Directory of Open Access Journals (Sweden)

    Daniel Roberto Coradi Freitas

    2014-12-01

    Full Text Available Objective:To evaluate blood banks in the Brazilian Amazon region with regard to structure and procedures directed toward the prevention of transfusion-transmitted malaria (TTM.Methods:This was a normative evaluation based on the Brazilian National Health Surveillance Agency (ANVISA Resolution RDC No. 153/2004. Ten blood banks were included in the study and classified as 'adequate' (≥80 points, 'partially adequate' (from 50 to 80 points, or 'inadequate' (<50 points. The following components were evaluated: 'donor education' (5 points, 'clinical screening' (40 points, 'laboratory screening' (40 points and 'hemovigilance' (15 points.Results:The overall median score was 49.8 (minimum = 16; maximum = 78. Five blood banks were classified as 'inadequate' and five as 'partially adequate'. The median clinical screening score was 26 (minimum = 16; maximum = 32. The median laboratory screening score was 20 (minimum = 0; maximum = 32. Eight blood banks performed laboratory tests for malaria; six tested all donations. Seven used thick smears, but only one performed this procedure in accordance with Ministry of Health requirements. One service had a Program of External Quality Evaluation for malaria testing. With regard to hemovigilance, two institutions reported having procedures to detect cases of transfusion-transmitted malaria.Conclusion:Malaria is neglected as a blood–borne disease in the blood banks of the Brazilian Amazon region. None of the institutions were classified as 'adequate' in the overall classification or with regard to clinical screening and laboratory screening. Blood bank professionals, the Ministry of Health and Health Surveillance service managers need to pay more attention to this matter so that the safety procedures required by law are complied with.

  6. A modified isometric test to evaluate blood pressure control with ...

    African Journals Online (AJOL)

    lifting and supporting weights) and have an important influence on blood pressure, it is essential to evaluate blood pressure response to iso- metric effort. This test can reveal high blood pressure that might otherwise not be detected. Only a few ...

  7. Marketing skills for hospital-based laboratory managers in a managed care environment.

    Science.gov (United States)

    Marchwinski, J; Coggins, F

    1997-01-01

    Managers of hospital-based laboratories have begun to realize the importance of a successful outreach program in protecting against declining inpatient activity. Succeeding in the highly competitive field of outpatient testing requires some new skills and techniques that may not have been apparent when addressing normal inpatient requirements. This article provides an overview of some very basic marketing concepts and attempts to show how they can assist the hospital-based laboratory manager in developing a successful outreach program.

  8. Typhidot M and Diazo test vis-à-vis blood culture and Widal test in the early diagnosis of typhoid fever in children in a resource poor setting.

    Science.gov (United States)

    Beig, Farzana K; Ahmad, Faraz; Ekram, Mohd; Shukla, Indu

    2010-01-01

    Typhoid fever is a major public health problem. A test which is simple, reliable and can be carried out in small laboratories is the need of the hour. We prospectively evaluated typhidot M and Diazo tests vis-à-vis blood culture and Widal test in children. Patients aged 6 months to 12 years, having fever of more than four days duration with clinical suspicion of typhoid fever were enrolled. Patients in whom other diagnosis was made served as control. The tests under scrutiny were validated against blood culture and then all the four tests were evaluated among patients who presented in the first week of illness. Blood culture was positive in only 27.3% of the cases. Among these culture positive cases, typhidot M test had the highest sensitivity, specificity, PPV and NPV of 90% (95% CI = 74.4-96.5), 100% (95% CI = 90.1-100), 100% (95% CI = 87.5-100), and 92.1% (95% CI = 79.2-97.3) respectively. Diazo test ranked next with sensitivity, specificity, PPV and NPV of 86.7% (95% CI = 70.3-94.7), 85.7% (95% CI = 70.6-93.7), 83.9% (95% CI = 67.4-92.9), 88.2% (95% CI = 73.4-95.3) respectively. Among clinically suspected typhoid cases, the overall sensitivity, of blood culture, Widal, typhidot M, Diazo was 27.3% (95% CI = 19.8- 36.3), 64.6% (95% CI = 55.3-72.9), 89.1% (95% CI = 81.9-93.7), 80.9% (95% CI = 72.6-87.2) respectively. In the first week of illness, typhidot M showed the best sensitivity [86.2% (95% CI = 69.4-94.5)] followed by Diazo [79% (95% CI = 61.6-90.2)], Widal [41.4% (95% CI = 25.5-59.3)] and blood culture [31% (95% CI = 17.3-49.2)]. Both Typhidot M and Diazo are good screening tests for the diagnosis of typhoid fever. Typhidot M is superior to Diazo but the latter is more suitable to resource poor settings being economic and easy to perform.

  9. Assessment of performance of professionals in immunohematology proficiency tests of the public blood bank network of the state of Minas Gerais.

    Science.gov (United States)

    Brener, Stela; Ferreira, Angela Melgaço; de Carvalho, Ricardo Vilas Freire; do Valle, Marcele Cunha Ribeiro; Souza, Helio Moraes

    2012-01-01

    Despite significant advances, the practice of blood transfusion is still a complex process and subject to risks. Factors that influence the safety of blood transfusion include technical skill and knowledge in hemotherapy mainly obtained by the qualification and training of teams. This study aimed to investigate the relationship between professional categories working in transfusion services of the public blood bank network in the State of Minas Gerais and their performance in proficiency tests. This was an observational cross-sectional study (2007-2008) performed using a specific instrument, based on evidence and the results of immunohematology proficiency tests as mandated by law. The error rates in ABO and RhD phenotyping, irregular antibody screening and cross-matching were 12.5%, 9.6%, 43.8% and 20.1%, respectively. When considering the number of tests performed, the error rates were 4.6%, 4.2%, 26.7% and 11.0%, respectively. The error rates varied for different professional categories: biochemists, biologists and biomedical scientists (65.0%), clinical pathology technicians (44.1%) and laboratory assistants, nursing technicians and assistant nurses (74.6%). A statistically significant difference was observed when the accuracy of clinical pathology technicians was compared with those of other professionals with only high school education (p-value < 0.001). This was not seen for professionals with university degrees (p-value = 0.293). These results reinforce the need to invest in training, improvement of educational programs, new teaching methods and tools for periodic evaluations, contributing to increase transfusion safety and improve hemotherapy in Brazil.

  10. Assessment of performance of professionals in immunohematology proficiency tests of the public blood bank network of the state of Minas Gerais

    Directory of Open Access Journals (Sweden)

    Stela Brener

    2012-01-01

    Full Text Available BACKGROUND: Despite significant advances, the practice of blood transfusion is still a complex process and subject to risks. Factors that influence the safety of blood transfusion include technical skill and knowledge in hemotherapy mainly obtained by the qualification and training of teams. OBJECTIVE: This study aimed to investigate the relationship between professional categories working in transfusion services of the public blood bank network in the State of Minas Gerais and their performance in proficiency tests. METHODS: This was an observational cross-sectional study (2007-2008 performed using a specific instrument, based on evidence and the results of immunohematology proficiency tests as mandated by law. RESULTS: The error rates in ABO and RhD phenotyping, irregular antibody screening and cross-matching were 12.5%, 9.6%, 43.8% and 20.1%, respectively. When considering the number of tests performed, the error rates were 4.6%, 4.2%, 26.7% and 11.0%, respectively. The error rates varied for different professional categories: biochemists, biologists and biomedical scientists (65.0%, clinical pathology technicians (44.1% and laboratory assistants, nursing technicians and assistant nurses (74.6%. A statistically significant difference was observed when the accuracy of clinical pathology technicians was compared with those of other professionals with only high school education (p-value < 0.001. This was not seen for professionals with university degrees (p-value = 0.293. CONCLUSION: These results reinforce the need to invest in training, improvement of educational programs, new teaching methods and tools for periodic evaluations, contributing to increase transfusion safety and improve hemotherapy in Brazil.

  11. 42 CFR 493.1453 - Condition: Laboratories performing high complexity testing; clinical consultant.

    Science.gov (United States)

    2010-10-01

    ... Condition: Laboratories performing high complexity testing; clinical consultant. The laboratory must have a... 42 Public Health 5 2010-10-01 2010-10-01 false Condition: Laboratories performing high complexity testing; clinical consultant. 493.1453 Section 493.1453 Public Health CENTERS FOR MEDICARE & MEDICAID...

  12. Test plan for demonstration of Rapid Transuranic Monitoring Laboratory

    International Nuclear Information System (INIS)

    McIsaac, C.V.; Sill, C.W.; Gehrke, R.J.; Killian, E.W.; Watts, K.D.

    1993-06-01

    This plan describes tests to demonstrate the capability of the Rapid Transuranic Monitoring Laboratory (RTML) to monitor airborne alpha-emitting radionuclides and analyze soil, smear, and filter samples for alpha- and gamma-emitting radionuclides under field conditions. The RTML will be tested during June 1993 at a site adjacent to the Cold Test Pit at the Radioactive Waste Management Complex at the Idaho National Engineering Laboratory. Measurement systems installed in the RTML that will be demonstrated include two large-area ionization chamber alpha spectrometers, an x-ray/gamma-ray spectrometer, and four alpha continuous air monitors. Test objectives, requirements for data quality, experimental apparatus and procedures, and safety and logistics issues are described

  13. Accreditation of testing laboratories in CNEA (National Atomic Energy Commission)

    International Nuclear Information System (INIS)

    Piacquadio, N.H.; Casa, V.A.; Palacios, T.A.

    1993-01-01

    The recognition of the technical capability of a testing laboratory is carried out by Laboratory Accreditation Bodies as the result of a satisfactory evaluation and the systematic follow up of the certified qualification. In Argentina the creation of a National Center for the Accreditation of Testing Laboratories, as a first step to assess a National Accreditation System is currently projected. CNEA, as an institution involved in technological projects and in the development and production of goods and services, has adopted since a long time ago quality assurance criteria. One of their requirements is the qualification of laboratories. Due to the lack of a national system, a Committee for the Qualification of Laboratories was created jointly by the Research and Development and Nuclear Fuel Cycle Areas with the responsibility of planning and management of the system evaluation and the certification of the quality of laboratories. The experience in the above mentioned topics is described in this paper. (author)

  14. Noninferiority of glucose-6-phosphate dehydrogenase deficiency diagnosis by a point-of-care rapid test vs the laboratory fluorescent spot test demonstrated by copper inhibition in normal human red blood cells.

    Science.gov (United States)

    Baird, J Kevin; Dewi, Mewahyu; Subekti, Decy; Elyazar, Iqbal; Satyagraha, Ari W

    2015-06-01

    Tens of millions of patients diagnosed with vivax malaria cannot safely receive primaquine therapy against repeated attacks caused by activation of dormant liver stages called hypnozoites. Most of these patients lack access to screening for glucose-6-phosphate dehydrogenase (G6PD) deficiency, a highly prevalent disorder causing serious acute hemolytic anemia with primaquine therapy. We optimized CuCl inhibition of G6PD in normal red blood cells (RBCs) to assess G6PD diagnostic technologies suited to point of care in the impoverished rural tropics. The most widely applied technology for G6PD screening-the fluorescent spot test (FST)-is impractical in that setting. We evaluated a new point-of-care G6PD screening kit (CareStart G6PD, CSG) against FST using graded CuCl treatments to simulate variable hemizygous states, and varying proportions of CuCl-treated RBC suspensions to simulate variable heterozygous states of G6PD deficiency. In experiments double-blinded to CuCl treatment, technicians reading FST and CSG test (n = 269) classified results as positive or negative for deficiency. At G6PD activity ≤40% of normal (n = 112), CSG test was not inferior to FST in detecting G6PD deficiency (P = 0.003), with 96% vs 90% (P = 0.19) sensitivity and 75% and 87% (P = 0.01) specificity, respectively. The CSG test costs less, requires no specialized equipment, laboratory skills, or cold chain for successful application, and performs as well as the FST standard of care for G6PD screening. Such a device may vastly expand access to primaquine therapy and aid in mitigating the very substantial burden of morbidity and mortality imposed by the hypnozoite reservoir of vivax malaria. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Is Serial Testing Required to Diagnose Imported Malaria in the Era of Rapid Diagnostic Tests?

    Science.gov (United States)

    Pasricha, Janet M.; Juneja, Surender; Manitta, Joseph; Whitehead, Susan; Maxwell, Ellen; Goh, Wai-Keong; Pasricha, Sant-Rayn; Eisen, Damon P.

    2013-01-01

    Exclusion of malaria traditionally requires three negative serial thick and thin blood films. However, many clinical laboratories now routinely perform rapid diagnostic tests (RDTs) in addition to blood films when malaria is suspected. We sought to determine whether serial testing is necessary in this setting. We examined 388 cases of malaria diagnosed during 1999–2010 at three laboratories in Melbourne, Australia. For each case, we ascertained whether the diagnosis was made on initial or follow-up testing. Nine cases (3.5%) were diagnosed after a negative initial blood film and RDT: 7 Plasmodium vivax, 1 P. ovale, and 1 P. falciparum. Of four case-patients with P. vivax in which clinical data were available, all had recent exposure to antimalarial medication. Our data suggest that among patients who have not received recent anti-malarial therapy, and when RDTs are performed and blood films are prepared, most malaria diagnoses are made by using the first set of tests. PMID:23208885

  16. Approaches to quality management and accreditation in a genetic testing laboratory

    Science.gov (United States)

    Berwouts, Sarah; Morris, Michael A; Dequeker, Elisabeth

    2010-01-01

    Medical laboratories, and specifically genetic testing laboratories, provide vital medical services to different clients: clinicians requesting a test, patients from whom the sample was collected, public health and medical-legal instances, referral laboratories and authoritative bodies. All expect results that are accurate and obtained in an efficient and effective manner, within a suitable time frame and at acceptable cost. There are different ways of achieving the end results, but compliance with International Organization for Standardization (ISO) 15189, the international standard for the accreditation of medical laboratories, is becoming progressively accepted as the optimal approach to assuring quality in medical testing. We present recommendations and strategies designed to aid genetic testing laboratories with the implementation of a quality management system, including key aspects such as document control, external quality assessment, internal quality control, internal audit, management review, validation, as well as managing the human side of change. The focus is on pragmatic approaches to attain the levels of quality management and quality assurance required for accreditation according to ISO 15189, within the context of genetic testing. Attention is also given to implementing efficient and effective quality improvement. PMID:20720559

  17. Immediate needs for MQA testing at state secondary calibration laboratories

    Energy Technology Data Exchange (ETDEWEB)

    Cline, R. [Radiation Instrument Calibration Laboratory, Springfield, IL (United States)

    1993-12-31

    The Calibration Laboratory attempts to provide services that satisfy the needs and requests for a variety of customers. New needs and requests have resulted in calibration of instrumentation outside the original laboratory designs. These tasks require several changes at the laboratory and a need for new support services, especially measurement quality assurance (MQA). The MQA tests are gamma (Cs-137) below 0.5 mrem (5{mu}Sv) per hour and x-ray kVp. Modification to the current gamma (Cs-137) MQA test is recommended because lower intensity fields are commonly measured.

  18. Immediate needs for MQA testing at state secondary calibration laboratories

    International Nuclear Information System (INIS)

    Cline, R.

    1993-01-01

    The Calibration Laboratory attempts to provide services that satisfy the needs and requests for a variety of customers. New needs and requests have resulted in calibration of instrumentation outside the original laboratory designs. These tasks require several changes at the laboratory and a need for new support services, especially measurement quality assurance (MQA). The MQA tests are gamma (Cs-137) below 0.5 mrem (5μSv) per hour and x-ray kVp. Modification to the current gamma (Cs-137) MQA test is recommended because lower intensity fields are commonly measured

  19. Simulation-Based System Design Laboratory

    Data.gov (United States)

    Federal Laboratory Consortium — The research objective is to develop, test, and implement effective and efficient simulation techniques for modeling, evaluating, and optimizing systems in order to...

  20. Development of New, Low-Head Hydropower Turbine - Modeling & Laboratory Test DE-EE0005426

    Energy Technology Data Exchange (ETDEWEB)

    Krouse, Wayne [Hydro Green Energy, Westmont, IL (United States)

    2014-12-05

    Hydro Green Energy, LLC (HGE) will complete the design, fabrication and laboratory testing of a scaled, vertically stackable, low-head hydropower turbine called the Modular Bulb Turbine (MBT). HGE will also complete a summary report that includes the laboratory testing results and analysis of the tests. Project Goals: Design, model and test modular bulb turbine for installation in numerous HGE low-head hydropower projects at non-powered USACE dams. Project Results: The sub-scale prototype was tested successfully at a leading US hydraulic laboratory. Laboratory data results agreed well with predicted results from numerical modeling.

  1. Hydrogen Field Test Standard: Laboratory and Field Performance

    Science.gov (United States)

    Pope, Jodie G.; Wright, John D.

    2015-01-01

    The National Institute of Standards and Technology (NIST) developed a prototype field test standard (FTS) that incorporates three test methods that could be used by state weights and measures inspectors to periodically verify the accuracy of retail hydrogen dispensers, much as gasoline dispensers are tested today. The three field test methods are: 1) gravimetric, 2) Pressure, Volume, Temperature (PVT), and 3) master meter. The FTS was tested in NIST's Transient Flow Facility with helium gas and in the field at a hydrogen dispenser location. All three methods agree within 0.57 % and 1.53 % for all test drafts of helium gas in the laboratory setting and of hydrogen gas in the field, respectively. The time required to perform six test drafts is similar for all three methods, ranging from 6 h for the gravimetric and master meter methods to 8 h for the PVT method. The laboratory tests show that 1) it is critical to wait for thermal equilibrium to achieve density measurements in the FTS that meet the desired uncertainty requirements for the PVT and master meter methods; in general, we found a wait time of 20 minutes introduces errors methods, respectively and 2) buoyancy corrections are important for the lowest uncertainty gravimetric measurements. The field tests show that sensor drift can become a largest component of uncertainty that is not present in the laboratory setting. The scale was calibrated after it was set up at the field location. Checks of the calibration throughout testing showed drift of 0.031 %. Calibration of the master meter and the pressure sensors prior to travel to the field location and upon return showed significant drifts in their calibrations; 0.14 % and up to 1.7 %, respectively. This highlights the need for better sensor selection and/or more robust sensor testing prior to putting into field service. All three test methods are capable of being successfully performed in the field and give equivalent answers if proper sensors without drift are

  2. Biometric identification devices -- Laboratory testing vs. real life

    International Nuclear Information System (INIS)

    Ahrens, J.S.

    1997-01-01

    For over fifteen years Sandia National Laboratories has been involved in laboratory testing of biometric identification devices. The key concept of biometric identification devices is the ability for the system to identify some unique aspect of the individual rather than some object a person may be carrying or some password they are required to know. Tests were conducted to verify manufacturer's performance claims, to determine strengths/weaknesses of devices, and to determine devices that meet the US Department of energy's needs. However, during recent field installation, significantly different performance was observed than was predicted by laboratory tests. Although most people using the device believed it operated adequately, the performance observed was over an order of magnitude worse than predicted. The search for reasons behind this gap between the predicted and the actual performance has revealed many possible contributing factors. As engineers, the most valuable lesson to be learned from this experience is the value of scientists and engineers with (1) common sense, (2) knowledge of human behavior, (3) the ability to observe the real world, and (4) the capability to realize the significant differences between controlled experiments and actual installations

  3. A Neural-Network-Based Approach to White Blood Cell Classification

    Directory of Open Access Journals (Sweden)

    Mu-Chun Su

    2014-01-01

    Full Text Available This paper presents a new white blood cell classification system for the recognition of five types of white blood cells. We propose a new segmentation algorithm for the segmentation of white blood cells from smear images. The core idea of the proposed segmentation algorithm is to find a discriminating region of white blood cells on the HSI color space. Pixels with color lying in the discriminating region described by an ellipsoidal region will be regarded as the nucleus and granule of cytoplasm of a white blood cell. Then, through a further morphological process, we can segment a white blood cell from a smear image. Three kinds of features (i.e., geometrical features, color features, and LDP-based texture features are extracted from the segmented cell. These features are fed into three different kinds of neural networks to recognize the types of the white blood cells. To test the effectiveness of the proposed white blood cell classification system, a total of 450 white blood cells images were used. The highest overall correct recognition rate could reach 99.11% correct. Simulation results showed that the proposed white blood cell classification system was very competitive to some existing systems.

  4. Preanalytical errors in primary healthcare: a questionnaire study of information search procedures, test request management and test tube labelling.

    Science.gov (United States)

    Söderberg, Johan; Brulin, Christine; Grankvist, Kjell; Wallin, Olof

    2009-01-01

    Most errors in laboratory medicine occur in the preanalytical phase and are the result of human mistakes. This study investigated information search procedures, test request management and test tube labelling in primary healthcare compared to the same procedures amongst clinical laboratory staff. A questionnaire was completed by 317 venous blood sampling staff in 70 primary healthcare centres and in two clinical laboratories (response rate = 94%). Correct procedures were not always followed. Only 60% of the primary healthcare staff reported that they always sought information in the updated, online laboratory manual. Only 12% reported that they always labelled the test tubes prior to drawing blood samples. No major differences between primary healthcare centres and clinical laboratories were found, except for test tube labelling, whereby the laboratory staff reported better practices. Re-education and access to documented routines were not clearly associated with better practices. The preanalytical procedure in the surveyed primary healthcare centres was associated with a risk of errors which could affect patient safety. To improve patient safety in laboratory testing, all healthcare providers should survey their preanalytical procedures and improve the total testing process with a systems perspective.

  5. Evaluation of the Verigene Gram-positive blood culture nucleic acid test for rapid detection of bacteria and resistance determinants.

    Science.gov (United States)

    Wojewoda, Christina M; Sercia, Linda; Navas, Maria; Tuohy, Marion; Wilson, Deborah; Hall, Geraldine S; Procop, Gary W; Richter, Sandra S

    2013-07-01

    Rapid identification of pathogens from blood cultures can decrease lengths of stay and improve patient outcomes. We evaluated the accuracy of the Verigene Gram-positive blood culture (BC-GP) nucleic acid test for investigational use only (Nanosphere, Inc., Northbrook, IL) for the identification of Gram-positive bacteria from blood cultures. The detection of resistance genes (mecA in Staphylococcus aureus and Staphylococcus epidermidis and vanA or vanB in Enterococcus faecium and Enterococcus faecalis) by the BC-GP assay also was assessed. A total of 186 positive blood cultures (in BacT/Alert FA bottles) with Gram-positive cocci observed with Gram staining were analyzed using the BC-GP assay. The BC-GP results were compared with the identification and susceptibility profiles obtained with routine methods in the clinical laboratory. Discordant results were arbitrated with additional biochemical, cefoxitin disk, and repeat BC-GP testing. The initial BC-GP organism identification was concordant with routine method results for 94.6% of the blood cultures. Only 40% of the Streptococcus pneumoniae identifications were correct. The detection of the mecA gene for 69 blood cultures with only S. aureus or S. epidermidis was concordant with susceptibility testing results. For 3 of 6 cultures with multiple Staphylococcus spp., mecA detection was reported but was correlated with oxacillin resistance in a species other than S. aureus or S. epidermidis. The detection of vanA agreed with susceptibility testing results for 45 of 46 cultures with E. faecalis or E. faecium. Comparison of the mean times to results for each organism group showed that BC-GP results were available 31 to 42 h earlier than phenotypic identifications and 41 to 50 h earlier than susceptibility results.

  6. Evaluation of the effects of insufficient blood volume samples on the performance of blood glucose self-test meters.

    Science.gov (United States)

    Pfützner, Andreas; Schipper, Christina; Ramljak, Sanja; Flacke, Frank; Sieber, Jochen; Forst, Thomas; Musholt, Petra B

    2013-11-01

    Accuracy of blood glucose readings is (among other things) dependent on the test strip being completely filled with sufficient sample volume. The devices are supposed to display an error message in case of incomplete filling. This laboratory study was performed to test the performance of 31 commercially available devices in case of incomplete strip filling. Samples with two different glucose levels (60-90 and 300-350 mg/dl) were used to generate three different sample volumes: 0.20 µl (too low volume for any device), 0.32 µl (borderline volume), and 1.20 µl (low but supposedly sufficient volume for all devices). After a point-of-care capillary reference measurement (StatStrip, NovaBiomedical), the meter strip was filled (6x) with the respective volume, and the response of the meters (two devices) was documented (72 determinations/meter type). Correct response was defined as either an error message indicating incomplete filling or a correct reading (±20% compared with reference reading). Only five meters showed 100% correct responses [BGStar and iBGStar (both Sanofi), ACCU-CHEK Compact+ and ACCU-CHEK Mobile (both Roche Diagnostics), OneTouch Verio (LifeScan)]. The majority of the meters (17) had up to 10% incorrect reactions [predominantly incorrect readings with sufficient volume; Precision Xceed and Xtra, FreeStyle Lite, and Freedom Lite (all Abbott); GlucoCard+ and GlucoMen GM (both Menarini); Contour, Contour USB, and Breeze2 (all Bayer); OneTouch Ultra Easy, Ultra 2, and Ultra Smart (all LifeScan); Wellion Dialog and Premium (both MedTrust); FineTouch (Terumo); ACCU-CHEK Aviva (Roche); and GlucoTalk (Axis-Shield)]. Ten percent to 20% incorrect reactions were seen with OneTouch Vita (LifeScan), ACCU-CHEK Aviva Nano (Roche), OmniTest+ (BBraun), and AlphaChek+ (Berger Med). More than 20% incorrect reactions were obtained with Pura (Ypsomed), GlucoCard Meter and GlucoMen LX (both Menarini), Elite (Bayer), and MediTouch (Medisana). In summary, partial and

  7. Bridging the gap between sample collection and laboratory analysis: using dried blood spots to identify human exposure to chemical agents

    Science.gov (United States)

    Hamelin, Elizabeth I.; Blake, Thomas A.; Perez, Jonas W.; Crow, Brian S.; Shaner, Rebecca L.; Coleman, Rebecca M.; Johnson, Rudolph C.

    2016-05-01

    Public health response to large scale chemical emergencies presents logistical challenges for sample collection, transport, and analysis. Diagnostic methods used to identify and determine exposure to chemical warfare agents, toxins, and poisons traditionally involve blood collection by phlebotomists, cold transport of biomedical samples, and costly sample preparation techniques. Use of dried blood spots, which consist of dried blood on an FDA-approved substrate, can increase analyte stability, decrease infection hazard for those handling samples, greatly reduce the cost of shipping/storing samples by removing the need for refrigeration and cold chain transportation, and be self-prepared by potentially exposed individuals using a simple finger prick and blood spot compatible paper. Our laboratory has developed clinical assays to detect human exposures to nerve agents through the analysis of specific protein adducts and metabolites, for which a simple extraction from a dried blood spot is sufficient for removing matrix interferents and attaining sensitivities on par with traditional sampling methods. The use of dried blood spots can bridge the gap between the laboratory and the field allowing for large scale sample collection with minimal impact on hospital resources while maintaining sensitivity, specificity, traceability, and quality requirements for both clinical and forensic applications.

  8. The testing effect for mediator final test cues and related final test cues in online and laboratory experiments.

    Science.gov (United States)

    Coppens, Leonora C; Verkoeijen, Peter P J L; Bouwmeester, Samantha; Rikers, Remy M J P

    2016-05-31

    The testing effect is the finding that information that is retrieved during learning is more often correctly retrieved on a final test than information that is restudied. According to the semantic mediator hypothesis the testing effect arises because retrieval practice of cue-target pairs (mother-child) activates semantically related mediators (father) more than restudying. Hence, the mediator-target (father-child) association should be stronger for retrieved than restudied pairs. Indeed, Carpenter (2011) found a larger testing effect when participants received mediators (father) than when they received target-related words (birth) as final test cues. The present study started as an attempt to test an alternative account of Carpenter's results. However, it turned into a series of conceptual (Experiment 1) and direct (Experiment 2 and 3) replications conducted with online samples. The results of these online replications were compared with those of similar existing laboratory experiments through small-scale meta-analyses. The results showed that (1) the magnitude of the raw mediator testing effect advantage is comparable for online and laboratory experiments, (2) in both online and laboratory experiments the magnitude of the raw mediator testing effect advantage is smaller than in Carpenter's original experiment, and (3) the testing effect for related cues varies considerably between online experiments. The variability in the testing effect for related cues in online experiments could point toward moderators of the related cue short-term testing effect. The raw mediator testing effect advantage is smaller than in Carpenter's original experiment.

  9. Miniaturized Blood Pressure Telemetry System with RFID Interface

    Directory of Open Access Journals (Sweden)

    Michele Caldara

    2016-08-01

    Full Text Available This work deals with the development and characterization of a potentially implantable blood pressure telemetry system, based on an active Radio-Frequency IDentification (RFID tag, International Organization for Standardization (ISO 15693 compliant. This approach aims to continuously measure the average, systolic and diastolic blood pressure of the small/medium animals. The measured pressure wave undergoes embedded processing and results are stored onboard in a non-volatile memory, providing the data under interrogation by an external RFID reader. In order to extend battery lifetime, RFID energy harvesting has been investigated. The paper presents the experimental characterization in a laboratory and preliminary in-vivo tests. The device is a prototype mainly intended, in a future engineered version, for monitoring freely moving test animals for pharmaceutical research and drug safety assessment purposes, but it could have multiple uses in environmental and industrial applications.

  10. Obtaining patient test results from clinical laboratories: a survey of state law for pharmacists.

    Science.gov (United States)

    Witry, Matthew J; Doucette, William R

    2009-01-01

    To identify states with laws that restrict to whom clinical laboratories may release copies of laboratory test results and to describe how these laws may affect pharmacists' ability to obtain patient laboratory test results. Researchers examined state statutes and administrative codes for all 50 states and the District of Columbia at the University of Iowa Law Library between June and July 2007. Researchers also consulted with lawyers, state Clinical Laboratory Improvement Amendments officers, and law librarians. Laws relating to the study objective were analyzed. 34 jurisdictions do not restrict the release of laboratory test results, while 17 states have laws that restrict to whom clinical laboratories can send copies of test results. In these states, pharmacists will have to use alternative sources, such as physician offices, to obtain test results. Pharmacists must consider state law before requesting copies of laboratory test results from clinical laboratories. This may be an issue that state pharmacy associations can address to increase pharmacist access to important patient information.

  11. Identifying the potential of changes to blood sample logistics using simulation

    DEFF Research Database (Denmark)

    Jørgensen, Pelle Morten Thomas; Jacobsen, Peter; Poulsen, Jørgen Hjelm

    2013-01-01

    of the simulation was to evaluate changes made to the transportation of blood samples between wards and the laboratory. The average- (AWT) and maximum waiting time (MWT) from a blood sample was drawn at the ward until it was received at the laboratory, and the distribution of arrivals of blood samples......, each of the scenarios was tested in terms of what amount of resources would give the optimal result. The simulations showed a big improvement potential in implementing a new technology/mean for transporting the blood samples. The pneumatic tube system showed the biggest potential lowering the AWT...

  12. Development of a Laboratory Test Procedure to Evaluate Tack Coat Performance

    OpenAIRE

    YILDIRIM, Yetkin; SMIT, André de Fortier; KORKMAZ, Armagan

    2014-01-01

    A laboratory testing procedure is presented, the results of which may be used for determining the best combination of tack coat type, mixture type, and application rate to be applied in the field for optimum performance. Tack coat related performance results were determined from Hamburg wheel tracking and simple shear tests on laboratory prepared specimens. This study was undertaken to evaluate the shear strength performance of tack coats under laboratory-controlled conditions. The ...

  13. Comparison of the sensitivity of typhi dot test with blood culture in typhoid

    Energy Technology Data Exchange (ETDEWEB)

    Rizvi, Q [Hamdard College of Medicine, Karachi (Pakistan). Dept. of Pharmacology

    2006-10-15

    To evaluate the sensitivity of Typhi Dot test in comparison to Blood Culture for the diagnosis of Typhoid Fever in our setup. Fifty patients who fulfilled the clinical criteria of having Typhoid Fever. The data of all the patients was documented, and they were submitted to the Typhi Dot and Blood Culture tests, apart from other routine investigations. Out of the total 50 patients, 47(94%) had their Blood Culture positive for Typhoid bacillus, while in 49 (98%) the Typhi Dot test was positive. Two patients which were found positive on Typhi dot test, gave negative results on Blood Culture. One patient with the signs and symptoms of Typhoid Fever was found neither positive on Typhi Dot test nor upon Blood Culture. There was no significant difference between the results of Blood Culture and Typhi Dot test in the diagnosis of Typhoid Fever. However, Typhi Dot has the advantages of being less expensive and quicker in giving results with excellent sensitivity. (author)

  14. Comparison of the sensitivity of typhi dot test with blood culture in typhoid

    International Nuclear Information System (INIS)

    Rizvi, Q.

    2006-01-01

    To evaluate the sensitivity of Typhi Dot test in comparison to Blood Culture for the diagnosis of Typhoid Fever in our setup. Fifty patients who fulfilled the clinical criteria of having Typhoid Fever. The data of all the patients was documented, and they were submitted to the Typhi Dot and Blood Culture tests, apart from other routine investigations. Out of the total 50 patients, 47(94%) had their Blood Culture positive for Typhoid bacillus, while in 49 (98%) the Typhi Dot test was positive. Two patients which were found positive on Typhi dot test, gave negative results on Blood Culture. One patient with the signs and symptoms of Typhoid Fever was found neither positive on Typhi Dot test nor upon Blood Culture. There was no significant difference between the results of Blood Culture and Typhi Dot test in the diagnosis of Typhoid Fever. However, Typhi Dot has the advantages of being less expensive and quicker in giving results with excellent sensitivity. (author)

  15. Position statement executive summary: guidelines and recommendations for laboratory analysis in the diagnosis and management of diabetes mellitus.

    Science.gov (United States)

    Sacks, David B; Arnold, Mark; Bakris, George L; Bruns, David E; Horvath, Andrea Rita; Kirkman, M Sue; Lernmark, Ake; Metzger, Boyd E; Nathan, David M

    2011-06-01

    Multiple laboratory tests are used in the diagnosis and management of patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially. An expert committee compiled evidence-based recommendations for the use of laboratory analysis in patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. A draft of the guidelines was posted on the Internet, and the document was modified in response to comments. The guidelines were reviewed by the joint Evidence-Based Laboratory Medicine Committee of the AACC and the National Academy of Clinical Biochemistry and were accepted after revisions by the Professional Practice Committee and subsequent approval by the Executive Committee of the American Diabetes Association. In addition to the long-standing criteria based on measurement of venous plasma glucose, diabetes can be diagnosed by demonstrating increased hemoglobin A(1c) (HbA(1c)) concentrations in the blood. Monitoring of glycemic control is performed by the patients measuring their own plasma or blood glucose with meters and by laboratory analysis of HbA(1c). The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.

  16. Iatrogenic anemia/Twenty-five million liters of blood into the sewer : comment

    NARCIS (Netherlands)

    Coene, K.L.M.; Roos, A.N.; Scharnhorst, V.

    2015-01-01

    With great interest, we have read the articles by Stefanini [1] and Levi [2] on the waste of patient blood that is left over after laboratory testing. Especially in vulnerable patient populations that are subjected to frequent laboratory testing, iatrogenic anaemia can become a significant problem.

  17. Project development laboratories energy fuels and oils based on NRU “MPEI”

    Science.gov (United States)

    Burakov, I. A.; Burakov, A. Y.; Nikitina, I. S.; Khomenkov, A. M.; Paramonova, A. O.; Khtoo Naing, Aung

    2017-11-01

    In the process of improving the efficiency of power plants a hot topic is the use of high-quality fuels and lubricants. In the process of transportation, preparation for use, storage and maintenance of the properties of fuels and lubricants may deteriorate, which entails a reduction in the efficiency of power plants. One of the ways to prevent the deterioration of the properties is a timely analysis of the relevant laboratories. In this day, the existence of laboratories of energy fuels and energy laboratory oil at thermal power stations is satisfactory character. However, the training of qualified personnel to work in these laboratories is a serious problem, as the lack of opportunities in these laboratories a complete list of required tests. The solution to this problem is to explore the possibility of application of methods of analysis of the properties of fuels and lubricants in the stage of training and re-training of qualified personnel. In this regard, on the basis of MPEI developed laboratory projects of solid, liquid and gaseous fuels, power and energy oils and lubricants. Projects allow for a complete list of tests required for the timely control of properties and prevent the deterioration of these properties. Assess the financial component of the implementation of the developed projects based on the use of modern equipment used for tests. Projects allow for a complete list of tests required for the timely control of properties and prevent the deterioration of these properties.

  18. Comparison of iSTAT and EPOC Blood Analyzers

    Science.gov (United States)

    2017-10-25

    gold standard laboratory testing to two POC devices—iSTAT and EPOC—with and without expired cartridges and conditioned cartridges. The study was...analysis across a range of environmental conditions and, in extreme circumstances, use beyond the expiration date. We compared gold standard laboratory...BE) extra cellular fluid, BE blood, sulfur dioxide, Hgb) to gold standard measurements conducted by the central laboratory. The study also compared

  19. A Blood Test for Alzheimer's Disease: Progress, Challenges, and Recommendations.

    Science.gov (United States)

    Kiddle, Steven J; Voyle, Nicola; Dobson, Richard J B

    2018-03-29

    Ever since the discovery of APOEɛ4 around 25 years ago, researchers have been excited about the potential of a blood test for Alzheimer's disease (AD). Since then researchers have looked for genetic, protein, metabolite, and/or gene expression markers of AD and related phenotypes. However, no blood test for AD is yet being used in the clinical setting. We first review the trends and challenges in AD blood biomarker research, before giving our personal recommendations to help researchers overcome these challenges. While some degree of consistency and replication has been seen across independent studies, several high-profile studies have seemingly failed to replicate. Partly due to academic incentives, there is a reluctance in the field to report predictive ability, to publish negative findings, and to independently replicate the work of others. If this can be addressed, then we will know sooner whether a blood test for AD or related phenotypes with clinical utility can be developed.

  20. Diagnosis of different liver fibrosis characteristics by blood tests in non-alcoholic fatty liver disease.

    Science.gov (United States)

    Calès, Paul; Boursier, Jérôme; Chaigneau, Julien; Lainé, Fabrice; Sandrini, Jeremy; Michalak, Sophie; Hubert, Isabelle; Dib, Nina; Oberti, Frédéric; Bertrais, Sandrine; Hunault, Gilles; Cavaro-Ménard, Christine; Gallois, Yves; Deugnier, Yves; Rousselet, Marie C

    2010-10-01

    Our aim was to develop an accurate, non-invasive, blood-test-based method for identifying the main characteristics of liver fibrosis in non-alcoholic fatty liver disease (NAFLD). Fibrosis was staged according to NASH-CRN and Metavir systems in 226 patients with NAFLD. A fully automated algorithm measured the fractal dimension (FD) and the area of fibrosis (AOF). Independent predictors of diagnostic targets were determined using bootstrap methods. (i) Development. Significant fibrosis defined by NASH-CRN F ≥2 was diagnosed by weight, glycaemia, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and prothrombin index [area under the receiver operating characteristic (AUROC)=0.867]; significant fibrosis defined by Metavir F ≥2 was diagnosed by weight, age, glycaemia, AST, ALT, ferritin and platelets (FibroMeter AUROC=0.941, Pfibrosis staging, Metavir staging was a better reference for blood test. Thus, the patient rate with predictive values ≥90% by tests was 97.3% with Metavir reference vs. 66.5% with NASH-CRN reference (Pfibrosis score for significant fibrosis, but not for severe fibrosis or cirrhosis, with both staging systems. Relationships between fibrosis lesions were well reflected by blood tests, e.g., the correlation between histological area and FD of fibrosis (r(s) =0.971, Pblood tests (r(s) =0.852, Pfibrosis in NAFLD can be diagnosed and quantified by blood tests with excellent accuracy. © 2010 John Wiley & Sons A/S.

  1. Fecal Occult Blood Test and Gastrointestinal Parasitic Infection

    Directory of Open Access Journals (Sweden)

    Majed H. Wakid

    2010-01-01

    Full Text Available Stool specimens of 1238 workers in western region of Saudi Arabia were examined for infection with intestinal parasites and for fecal occult blood (FOB to investigate the possibility that enteroparasites correlate to occult intestinal bleeding. Direct smears and formal ether techniques were used for detection of diagnostic stages of intestinal parasites. A commercially available guaiac test was used to detect fecal occult blood. 47.01% of the workers were infected with intestinal parasites including eight helminthes species and eight protozoan species. The results provided no significant evidence (P-value=0.143 that intestinal parasitic infection is in association with positive guaiac FOB test.

  2. Duplicate laboratory test reduction using a clinical decision support tool.

    Science.gov (United States)

    Procop, Gary W; Yerian, Lisa M; Wyllie, Robert; Harrison, A Marc; Kottke-Marchant, Kandice

    2014-05-01

    Duplicate laboratory tests that are unwarranted increase unnecessary phlebotomy, which contributes to iatrogenic anemia, decreased patient satisfaction, and increased health care costs. We employed a clinical decision support tool (CDST) to block unnecessary duplicate test orders during the computerized physician order entry (CPOE) process. We assessed laboratory cost savings after 2 years and searched for untoward patient events associated with this intervention. This CDST blocked 11,790 unnecessary duplicate test orders in these 2 years, which resulted in a cost savings of $183,586. There were no untoward effects reported associated with this intervention. The movement to CPOE affords real-time interaction between the laboratory and the physician through CDSTs that signal duplicate orders. These interactions save health care dollars and should also increase patient satisfaction and well-being.

  3. Mars Science Laboratory Rover System Thermal Test

    Science.gov (United States)

    Novak, Keith S.; Kempenaar, Joshua E.; Liu, Yuanming; Bhandari, Pradeep; Dudik, Brenda A.

    2012-01-01

    On November 26, 2011, NASA launched a large (900 kg) rover as part of the Mars Science Laboratory (MSL) mission to Mars. The MSL rover is scheduled to land on Mars on August 5, 2012. Prior to launch, the Rover was successfully operated in simulated mission extreme environments during a 16-day long Rover System Thermal Test (STT). This paper describes the MSL Rover STT, test planning, test execution, test results, thermal model correlation and flight predictions. The rover was tested in the JPL 25-Foot Diameter Space Simulator Facility at the Jet Propulsion Laboratory (JPL). The Rover operated in simulated Cruise (vacuum) and Mars Surface environments (8 Torr nitrogen gas) with mission extreme hot and cold boundary conditions. A Xenon lamp solar simulator was used to impose simulated solar loads on the rover during a bounding hot case and during a simulated Mars diurnal test case. All thermal hardware was exercised and performed nominally. The Rover Heat Rejection System, a liquid-phase fluid loop used to transport heat in and out of the electronics boxes inside the rover chassis, performed better than predicted. Steady state and transient data were collected to allow correlation of analytical thermal models. These thermal models were subsequently used to predict rover thermal performance for the MSL Gale Crater landing site. Models predict that critical hardware temperatures will be maintained within allowable flight limits over the entire 669 Sol surface mission.

  4. Chemical Pathology Laboratory Tests in Pregnancy | Bolarin ...

    African Journals Online (AJOL)

    Thus, chemical pathology laboratory investigative test results during normal healthy pregnancy show significant differences from the normal reference intervals or ranges (i.e. non-pregnant woman's reference intervals or ranges) thereby causing misinterpretation as inappropriate or odd. This wrong interpretation of the ...

  5. A simple apparatus for measuring the blood urea, manufactured by Dr. Luigj Benusi in 1943 in Albania

    OpenAIRE

    Tartari, Flamur; Buzo, Stiliano; Vyshka, Gentian

    2009-01-01

    The apparatus invented by Dr. Luigj Benusi in 1943, in Tirana, was a practical application of the Kowarsky technique and Ambard laws, helping in determining blood urea levels and very important to a variety of diseases, mainly kidney disorders. The apparatus was invented and prepared from very simple laboratory materials, such as glasses, test tubes, corks and volumetric cylinders. Technologically, it was based upon the determination of blood urea through hypobromite, and, among the advantage...

  6. Application of flexible scope in large testing laboratories

    Directory of Open Access Journals (Sweden)

    Carina Di Candia

    2011-04-01

    Full Text Available According as the international definition of Flexible Scope, a laboratory must demonstrate face with the accreditation body that it has the knowledge, experience and competence to work within the full range of its flexible scope, as well as possessing suitable laboratory environments and equipment. The laboratory must also demonstrate that it has a management system in place that can control its proposed approach while continuing to comply with the requirements of ISO 17025:2005. In case of UKAS (Unites Kingdom Accreditation Service, prior to offering accreditation for flexible scope they must have a high degree of confidence that the staff are technically competent and that the management system controlling certain key processes as development, review, validation and authorization.LATU apply these requirements since 2004 as "Unified Tests". Until this date, LATU was doing the same type of tests in different materials departments using different equipment, personal, and testing quality control. In order to that were defined cross disciplinary groups to analyze this topic approaching in personal competence and quality control tests improvement, and resource's decrease. For example, LATU has the Unified Test Tensile Strength accredited by UKAS in: corrugated and solid fiberboard, paper board, linerboard, cork plugs, plastic bags, plastic sheeting, paper, woven fabrics, plastic woven bags and woven plastic. As a result of the Unified Tests was generated a general unified manage procedure with unified criteria's, responsibilities and actions. Was written a unique testing procedure not only with the actual flexible scope and the flexibilities limits but also the compliance requirements of ISO 17025 and the accreditations body methodology. We could decrease the amount of documentation to control. Was defined the methodology and implemented periodicaly internal inter comparisons between departments in order to valid the unified tests and has a unique

  7. System Quality Management in Software Testing Laboratory that Chooses Accreditation

    Directory of Open Access Journals (Sweden)

    Yanet Brito R.

    2013-12-01

    Full Text Available The evaluation of software products will reach full maturity when executed by the scheme and provides third party certification. For the validity of the certification, the independent laboratory must be accredited for that function, using internationally recognized standards. This brings with it a challenge for the Industrial Laboratory Testing Software (LIPS, responsible for testing the products developed in Cuban Software Industry, define strategies that will permit it to offer services with a high level of quality. Therefore it is necessary to establish a system of quality management according to NC-ISO/IEC 17025: 2006 to continuously improve the operational capacity and technical competence of the laboratory, with a view to future accreditation of tests performed. This article discusses the process defined in the LIPS for the implementation of a Management System of Quality, from the current standards and trends, as a necessary step to opt for the accreditation of the tests performed.

  8. Use of the National Committee for Clinical Laboratory Standards Guidelines for Disk Diffusion Susceptibility Testing in New York State Laboratories

    Science.gov (United States)

    Kiehlbauch, Julia A.; Hannett, George E.; Salfinger, Max; Archinal, Wendy; Monserrat, Catherine; Carlyn, Cynthia

    2000-01-01

    Accurate antimicrobial susceptibility testing is vital for patient care and surveillance of emerging antimicrobial resistance. The National Committee for Clinical Laboratory Standards (NCCLS) outlines generally agreed upon guidelines for reliable and reproducible results. In January 1997 we surveyed 320 laboratories participating in the New York State Clinical Evaluation Program for General Bacteriology proficiency testing. Our survey addressed compliance with NCCLS susceptibility testing guidelines for bacterial species designated a problem (Staphylococcus aureus and Enterococcus species) or fastidious (Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria gonorrhoeae) organism. Specifically, we assessed compliance with guidelines for inoculum preparation, medium choice, number of disks per plate, and incubation conditions for disk diffusion tests. We also included length of incubation for S. aureus and Enterococcus species. We found overall compliance with the five characteristics listed above in 80 of 153 responding laboratories (50.6%) for S. aureus and 72 of 151 (47.7%) laboratories for Enterococcus species. The most common problem was an incubation time shortened to less than 24 h. Overall compliance with the first four characteristics was reported by 92 of 221 (41.6%) laboratories for S. pneumoniae, 49 of 163 (30.1%) laboratories for H. influenzae, and 11 of 77 (14.3%) laboratories for N. gonorrhoeae. Laboratories varied from NCCLS guidelines by placing an excess number of disks per plate. Laboratories also reported using alternative media for Enterococcus species, N. gonorrhoeae, and H. influenzae. This study demonstrates a need for education among clinical laboratories to increase compliance with NCCLS guidelines. PMID:10970381

  9. Laboratory test for ice adhesion strength using commercial instrumentation.

    Science.gov (United States)

    Wang, Chenyu; Zhang, Wei; Siva, Adarsh; Tiea, Daniel; Wynne, Kenneth J

    2014-01-21

    A laboratory test method for evaluating ice adhesion has been developed employing a commercially available instrument normally used for dynamic mechanical analysis (TA RSA-III). This is the first laboratory ice adhesion test that does not require a custom-built apparatus. The upper grip range of ∼10 mm is an enabling feature that is essential for the test. The method involves removal of an ice cylinder from a polymer coating with a probe and the determination of peak removal force (Ps). To validate the test method, the strength of ice adhesion was determined for a prototypical glassy polymer, poly(methyl methacrylate). The distance of the probe from the PMMA surface has been identified as a critical variable for Ps. The new test provides a readily available platform for investigating fundamental surface characteristics affecting ice adhesion. In addition to the ice release test, PMMA coatings were characterized using DSC, DCA, and TM-AFM.

  10. Pilot instrumentation of a Superpave test section at the Kansas Accelerated Testing laboratory

    Science.gov (United States)

    2003-04-01

    Two Superpave test sections were constructed at the Kansas Accelerated Testing Laboratory (K-ATL) with 12.5 mm (2 in) nominal maximum size Superpave mixture (SM-2A) with varying percentages (15 and 30 percent) of river sand. A 150 kN (34 kip) tandem ...

  11. Acoustic testing and modeling: an advanced undergraduate laboratory.

    Science.gov (United States)

    Russell, Daniel A; Ludwigsen, Daniel O

    2012-03-01

    This paper describes an advanced laboratory course in acoustics, specifically targeted for students with an interest in engineering applications at a school with a strongly integrated industrial co-op program. The laboratory course is developed around a three-pronged approach to problem solving that combines and integrates theoretical models, computational models, and experimental data. The course is structured around modules that begin with fundamental concepts and build laboratory skills and expand the knowledge base toward a final project. Students keep a detailed laboratory notebook, write research papers in teams, and must pass laboratory certification exams. This paper describes the course layout and philosophy and shares personal experience from both faculty and student perspectives. © 2012 Acoustical Society of America

  12. Public banking of umbilical cord blood or storage in a private bank: testing social and ethical policy in northeastern Italy.

    Science.gov (United States)

    Parco, Sergio; Vascotto, Fulvia; Visconti, Patrizia

    2013-01-01

    In northeastern Italy, according to Italian legislation, authorized public facilities can accept the donation and preservation of cord blood stem cells (CB-SC). Attitudes and knowledge in pregnant women differs between the local and immigrant (non-European Union [EU]) population. In this study we assessed the choices that pregnant women have with respect to the public and private harvesting system and the main reasons driving their decisions. We examined the ethnic origin of the families and compared tests for syphilis screening and leukocyte (WBC) counts in the CB-SC bags that are required for validation of the collection. Out of a population of 3450 pregnant patients at the Institute for Maternal and Child Health of Trieste, northeast Italy, 772 women agreed to cord blood harvesting and the associated lab tests. Of these, 221 women (28.6%) were from immigrant families of non-EU countries. Their ethnic affiliation was recorded, and tests were performed for syphilis screening and for nucleated red blood cell (NRBC) interference with the WBC count in CB-SC bags to assess cellularity and to determine if storage was appropriate. Of the 772 pregnant women, 648 (84.0%) accessed the public collection system, which is free of charge, and 124 (15.0%) accessed the private fee-based system. One woman from the non-EU group opted for the private fee-based system. Of the 3450 pregnant women screened for syphilis at the Institute for Maternal and Child Health, the Treponema pallidum hemagglutination (TPHA) and Venereal Disease Research Laboratory (VDRL) tests were the main tests performed (66.0% of total cases) because many gynecologists in the public harvesting system apply the Italian regulations of the 1988 Decree, while the private system requires tests on syphilis and leaves the option to the lab physicians to select the best determination method. We found that the chemiluminescence method was more specific (97.0%) than the TPHA (83.0%) and nontreponemal rapid plasma reagin

  13. Progress in the blood supply of Afghanistan.

    Science.gov (United States)

    Riley, William J; McCullough, Terri Konstenius; Rhamani, Ahmad Masoud; McCullough, Jeffrey

    2017-07-01

    The blood supply system in Afghanistan was badly damaged by years of conflict. In 2009, the Afghanistan National Blood Safety and Transfusion Service (ANBSTS) was established. For 6 years, we collaborated to assist with policy and infrastructure development; blood bank operations; blood collection, testing, and component production; transfusion practices; and training of technicians, nurses, midwives, and physicians. Policies were established, infrastructure was strengthened, and capable staff was acquired and trained. Standard operating procedures were developed, testing was improved, and quality systems were established. Thirty trainings were held for blood center staff. Four additional formal trainings were held for 39 physicians, 36 nurses and/or midwives, and 38 laboratory technicians. During 5 years of this project, blood collection increased by 40%. The ANBSTS has made impressive progress developing infrastructure, personnel, procedures, quality systems, and training programs and increasing blood collection. Knowledge of transfusion medicine was improved through structured training. © 2017 AABB.

  14. Revitalizing pathology laboratories in a gastrointestinal pathophysiology course using multimedia and team-based learning techniques.

    Science.gov (United States)

    Carbo, Alexander R; Blanco, Paola G; Graeme-Cooke, Fiona; Misdraji, Joseph; Kappler, Steven; Shaffer, Kitt; Goldsmith, Jeffrey D; Berzin, Tyler; Leffler, Daniel; Najarian, Robert; Sepe, Paul; Kaplan, Jennifer; Pitman, Martha; Goldman, Harvey; Pelletier, Stephen; Hayward, Jane N; Shields, Helen M

    2012-05-15

    In 2008, we changed the gastrointestinal pathology laboratories in a gastrointestinal pathophysiology course to a more interactive format using modified team-based learning techniques and multimedia presentations. The results were remarkably positive and can be used as a model for pathology laboratory improvement in any organ system. Over a two-year period, engaging and interactive pathology laboratories were designed. The initial restructuring of the laboratories included new case material, Digital Atlas of Video Education Project videos, animations and overlays. Subsequent changes included USMLE board-style quizzes at the beginning of each laboratory, with individual readiness assessment testing and group readiness assessment testing, incorporation of a clinician as a co-teacher and role playing for the student groups. Student responses for pathology laboratory contribution to learning improved significantly compared to baseline. Increased voluntary attendance at pathology laboratories was observed. Spontaneous student comments noted the positive impact of the laboratories on their learning. Pathology laboratory innovations, including modified team-based learning techniques with individual and group self-assessment quizzes, multimedia presentations, and paired teaching by a pathologist and clinical gastroenterologist led to improvement in student perceptions of pathology laboratory contributions to their learning and better pathology faculty evaluations. These changes can be universally applied to other pathology laboratories to improve student satisfaction. Copyright © 2012 Elsevier GmbH. All rights reserved.

  15. Validity of selected cardiovascular field-based test among Malaysian ...

    African Journals Online (AJOL)

    Based on emerge obese problem among Malaysian, this research is formulated to validate published tests among healthy female adult. Selected test namely; 20 meter multi-stage shuttle run, 2.4km run test, 1 mile walk test and Harvard Step test were correlated with laboratory test (Bruce protocol) to find the criterion validity ...

  16. Laboratory-based surveillance in the molecular era: the TYPENED model, a joint data-sharing platform for clinical and public health laboratories.

    Science.gov (United States)

    Niesters, H G; Rossen, J W; van der Avoort, H; Baas, D; Benschop, K; Claas, E C; Kroneman, A; van Maarseveen, N; Pas, S; van Pelt, W; Rahamat-Langendoen, J C; Schuurman, R; Vennema, H; Verhoef, L; Wolthers, K; Koopmans, M

    2013-01-24

    Laboratory-based surveillance, one of the pillars of monitoring infectious disease trends, relies on data produced in clinical and/or public health laboratories. Currently, diagnostic laboratories worldwide submit strains or samples to a relatively small number of reference laboratories for characterisation and typing. However, with the introduction of molecular diagnostic methods and sequencing in most of the larger diagnostic and university hospital centres in high-income countries, the distinction between diagnostic and reference/public health laboratory functions has become less clear-cut. Given these developments, new ways of networking and data sharing are needed. Assuming that clinical and public health laboratories may be able to use the same data for their own purposes when sequence-based testing and typing are used, we explored ways to develop a collaborative approach and a jointly owned database (TYPENED) in the Netherlands. The rationale was that sequence data - whether produced to support clinical care or for surveillance -can be aggregated to meet both needs. Here we describe the development of the TYPENED approach and supporting infrastructure, and the implementation of a pilot laboratory network sharing enterovirus sequences and metadata.

  17. Direct blood culturing on solid medium outperforms an automated continuously monitored broth-based blood culture system in terms of time to identification and susceptibility testing

    Directory of Open Access Journals (Sweden)

    E.A. Idelevich

    2016-03-01

    Full Text Available Pathogen identification and antimicrobial susceptibility testing (AST should be available as soon as possible for patients with bloodstream infections. We investigated whether a lysis-centrifugation (LC blood culture (BC method, combined with matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS identification and Vitek 2 AST, provides a time advantage in comparison with the currently used automated broth-based BC system. Seven bacterial reference strains were added each to 10 mL human blood in final concentrations of 100, 10 and 1 CFU/mL. Inoculated blood was added to the Isolator 10 tube and centrifuged at 3000 g for 30 min, then 1.5 mL sediment was distributed onto five 150-mm agar plates. Growth was observed hourly and microcolonies were subjected to MALDI-TOF MS and Vitek 2 as soon as possible. For comparison, seeded blood was introduced into an aerobic BC bottle and incubated in the BACTEC 9240 automated BC system. For all species/concentration combinations except one, successful identification and Vitek 2 inoculation were achieved even before growth detection by BACTEC. The fastest identification and inoculation for AST were achieved with Escherichia coli in concentrations of 100 CFU/mL and 10 CFU/mL (after 7 h each, while BACTEC flagged respective samples positive after 9.5 h and 10 h. Use of the LC-BC method allows skipping of incubation in automated BC systems and, used in combination with rapid diagnostics from microcolonies, provides a considerable advantage in time to result. This suggests that the usefulness of direct BC on solid medium should be re-evaluated in the era of rapid microbiology.

  18. Theorical and practical bases for blood sample collection from the heel of newborns for neonatal screening

    Directory of Open Access Journals (Sweden)

    Marcela Vela-Amieva

    2014-07-01

    collected in a special filter paper (Guthrie’s card. Despite its apparent simplicity, NBS laboratories commonly receive a large number of samples collected incorrectly and technically unsuitable for perfor4ming biochemical determinations. The aim of the present paper is to offer recommendations based on scientific evidence, for the properly blood collection on filter paper for NBS programs.

  19. Educational ultrasound nondestructive testing laboratory.

    Science.gov (United States)

    Genis, Vladimir; Zagorski, Michael

    2008-09-01

    The ultrasound nondestructive evaluation (NDE) of materials course was developed for applied engineering technology students at Drexel University's Goodwin College of Professional Studies. This three-credit, hands-on laboratory course consists of two parts: the first part with an emphasis on the foundations of NDE, and the second part during which ultrasound NDE techniques are utilized in the evaluation of parts and materials. NDE applications are presented and applied through real-life problems, including calibration and use of the latest ultrasonic testing instrumentation. The students learn engineering and physical principles of measurements of sound velocity in different materials, attenuation coefficients, material thickness, and location and dimensions of discontinuities in various materials, such as holes, cracks, and flaws. The work in the laboratory enhances the fundamentals taught during classroom sessions. This course will ultimately result in improvements in the educational process ["The greater expectations," national panel report, http://www.greaterexpectations.org (last viewed February, 2008); R. M. Felder and R. Brent "The intellectual development of Science and Engineering Students. Part 2: Teaching to promote growth," J. Eng. Educ. 93, 279-291 (2004)] since industry is becoming increasingly reliant on the effective application of NDE technology and the demand on NDE specialists is increasing. NDE curriculum was designed to fulfill levels I and II NDE in theory and training requirements, according to American Society for Nondestructive Testing, OH, Recommended Practice No. SNT-TC-1A (2006).

  20. Detection of Low-volume Blood Loss: Compensatory Reserve Versus Traditional Vital Signs

    Science.gov (United States)

    2014-01-01

    follows: heart rate (HR), blood pressure (BP), respiratory rate, and oxygen saturation. These vital signs are, however, notoriously unreliable.2,3 As...additional tests using specific equipment.22 Base deficit (BD) is a rapidly and widely available serum laboratory marker of systemic acidosis that...and mortality.23,24 BD can increase, however, because of any derangement causing metabolic acidosis and is not limited to intravascular volume loss

  1. Genetic influence on blood pressure measured in the office, under laboratory stress and during real life

    NARCIS (Netherlands)

    Wang, Xiaoling; Ding, Xiuhua; Su, Shaoyong; Harshfield, Gregory; Treiber, Frank; Snieder, Harold

    To determine to what extent the genetic influences on blood pressure (BP) measured in the office, under psychologically stressful conditions in the laboratory and during real life are different from each other. Office BP, BP during a video game challenge and a social stressor interview, and 24-h

  2. Evaluating effectiveness of infection control efforts in hospitals using information in microbiological laboratory databases.

    Science.gov (United States)

    Saito, Norihiro; Itoga, Masamichi; Kimura, Masahiko; Inoue, Fumio; Minakawa, Satoko; Kimura, Toshiyuki; Ozaki, Hiromi; Saito, Yumiko; Takahashi, Mikiko; Fujishima, Tetsuhiro; Mizuno, Sumie; Ogawa, Shin; Kitayama, Yuko; Kudo, Kazumi; Minami, Kazushi; Abo, Fumiko; Takano, Yasuyuki; Ohdaira, Naotake; Hamada, Satoshi; Ueki, Shigeharu; Hirokawa, Makoto; Kayaba, Hiroyuki

    2017-12-01

    To analyze the quality of infection control activities, bacteriological data relevant to infection control was evaluated through the microbiological data warehouse networking hospitals in two medical regions. Data regarding bacterial test results of 19 hospitals were extracted from two microbiological laboratory information data bases. The rate of MRSA among total S. aureus was used as a general indicator of infection control activities. The occupancy rate of nasal or pharyngeal swabs among MRSA-positive bacteriological samples was used as an indicator of attention paid for infection control in intensive care wards. The number of blood culture sets per examined patient was utilized as an indicator for life-long vocational education on updated medical practice relevant to infectious diseases. The rate of MRSA was significantly higher in secondary private hospitals. The occupancy rate of nasal or pharyngeal swabs was significantly higher in tertiary hospitals. The average number of blood culture set per examined patient were 1.55, 1.54 and 1.39 in tertiary, secondary public and secondary private hospitals, respectively; however, there were no statistical differences between groups. Data bases of microbiological test results shared by hospital laboratories are useful for evaluating regional infection control activities.

  3. Diagnostic tests based on human basophils

    DEFF Research Database (Denmark)

    Kleine-Tebbe, Jörg; Erdmann, Stephan; Knol, Edward F

    2006-01-01

    -maximal responses, termed 'intrinsic sensitivity'. These variables give rise to shifts in the dose-response curves which, in a diagnostic setting where only a single antigen concentration is employed, may produce false-negative data. Thus, in order to meaningfully utilize the current basophil activation tests....... Diagnostic studies using CD63 or CD203c in hymenoptera, food and drug allergy are critically discussed. Basophil-based tests are indicated for allergy testing in selected cases but should only be performed by experienced laboratories....

  4. Package testing capabilities at the Pacific Northwest Laboratory

    International Nuclear Information System (INIS)

    Taylor, J.M.

    1993-01-01

    The purpose of this paper is to describe the package testing capabilities at the Pacific Northwest Laboratory (PNL). In the past all of the package testing that was performed at PNL was done on prototype or mocked up radioactive material packaging. Presently, we are developing the capability to perform testing on non-radioactive material packaging. The testing on the non-radioactive material packaging will be done to satisfy the new performance oriented packaging requirements (DOT Docket HM-181, 1991). This paper describes the equipment used to perform the performance oriented packaging tests and also describes some testing capability for testing radioactive material packaging

  5. Routine Laboratory Blood Tests May Diagnose Significant Fibrosis in Liver Transplant Recipients with Chronic Hepatitis C: A 10 Year Experience

    OpenAIRE

    Sheen, Victoria; Nguyen, Heajung; Jimenez, Melissa; Agopian, Vatche; Vangala, Sitaram; Elashoff, David; Saab, Sammy

    2016-01-01

    Background and Aims: The aims of our study were to determine whether routine blood tests, the aspartate aminotransferase (AST) to Platelet Ratio Index (APRI) and Fibrosis 4 (Fib-4) scores, were associated with advanced fibrosis and to create a novel model in liver transplant recipients with chronic hepatitis C virus (HCV). Methods: We performed a cross sectional study of patients at The University of California at Los Angeles (UCLA) Medical Center who underwent liver transplantation for HCV. ...

  6. Digital lock-in amplifier based on soundcard interface for physics laboratory

    Science.gov (United States)

    Sinlapanuntakul, J.; Kijamnajsuk, P.; Jetjamnong, C.; Chotikaprakhan, S.

    2017-09-01

    The purpose of this paper is to develop a digital lock-in amplifier based on soundcard interface for undergraduate physics laboratory. Both series and parallel RLC circuit laboratory are tested because of its well-known, easy to understand and simple confirm. The sinusoidal signal at the frequency of 10 Hz - 15 kHz is generated to the circuits. The amplitude and phase of the voltage drop across the resistor, R are measured in 10 step decade. The signals from soundcard interface and lock-in amplifier are compared. The results give a good correlation. It indicates that the design digital lock-in amplifier is promising for undergraduate physic laboratory.

  7. Typhidot M and Diazo test vis-à-vis blood culture and Widal test in the early diagnosis of typhoid fever in children in a resource poor setting

    Directory of Open Access Journals (Sweden)

    Farzana K Beig

    Full Text Available OBJECTIVE: Typhoid fever is a major public health problem. A test which is simple, reliable and can be carried out in small laboratories is the need of the hour. We prospectively evaluated typhidot M and Diazo tests vis-à-vis blood culture and Widal test in children. METHODS: Patients aged 6 months to 12 years, having fever of more than four days duration with clinical suspicion of typhoid fever were enrolled. Patients in whom other diagnosis was made served as control. The tests under scrutiny were validated against blood culture and then all the four tests were evaluated among patients who presented in the first week of illness. RESULTS: Blood culture was positive in only 27.3% of the cases. Among these culture positive cases, typhidot M test had the highest sensitivity, specificity, PPV and NPV of 90% (95% CI = 74.4-96.5, 100% (95% CI = 90.1-100, 100% (95% CI = 87.5-100, and 92.1% (95% CI = 79.2-97.3 respectively. Diazo test ranked next with sensitivity, specificity, PPV and NPV of 86.7% (95% CI = 70.3-94.7, 85.7% (95% CI = 70.6-93.7, 83.9% (95% CI = 67.4-92.9, 88.2% (95% CI = 73.4-95.3 respectively. Among clinically suspected typhoid cases, the overall sensitivity, of blood culture, Widal, typhidot M, Diazo was 27.3% (95% CI = 19.8- 36.3, 64.6% (95% CI = 55.3-72.9, 89.1% (95% CI = 81.9-93.7, 80.9% (95% CI = 72.6-87.2 respectively. In the first week of illness, typhidot M showed the best sensitivity [86.2% (95% CI = 69.4-94.5] followed by Diazo [79% (95% CI = 61.6-90.2], Widal [41.4% (95% CI = 25.5-59.3] and blood culture [31% (95% CI = 17.3-49.2]. CONCLUSION: Both Typhidot M and Diazo are good screening tests for the diagnosis of typhoid fever. Typhidot M is superior to Diazo but the latter is more suitable to resource poor settings being economic and easy to perform.

  8. Web Based Remote Access Microcontroller Laboratory

    OpenAIRE

    H. Çimen; İ. Yabanova; M. Nartkaya; S. M. Çinar

    2008-01-01

    This paper presents a web based remote access microcontroller laboratory. Because of accelerated development in electronics and computer technologies, microcontroller-based devices and appliances are found in all aspects of our daily life. Before the implementation of remote access microcontroller laboratory an experiment set is developed by teaching staff for training microcontrollers. Requirement of technical teaching and industrial applications are considered when expe...

  9. [Team approaches to critical bleeding (massive bleeding and transfusion) - chairmen's introductory remarks. Questionnaire survey on current status of hospital clinical laboratories evaluating critical hemorrhage].

    Science.gov (United States)

    Kino, Shuichi; Suwabe, Akira

    2014-12-01

    In 2007, "the Guidelines for Actions against Intraoperative Critical Hemorrhage" were established by the Japanese Society of Anaesthesiologists and the Japanese Society of Blood transfusion and Cell Therapy. The documentation of in-hospital procedures for critical hemorrhage, especially about how to select RBC units, has widely standardized hospital practice. Patients with intraoperative critical hemorrhage sometimes suffer from massive blood loss. In this situation, some patients develop coagulopathy. To treat them, we need to evaluate their coagulation status based on laboratory test results. So, we performed a nationwide questionnaire survey on the current status of hospital clinical laboratories evaluating critical hemorrhage. From the results of this survey, it was recommended that central hospital laboratories should try to reduce the turn-around time required to test for coagulation parameters as much as possible for appropriate substitution therapy. (Review).

  10. Public banking of umbilical cord blood or storage in a private bank: testing social and ethical policy in northeastern Italy

    Directory of Open Access Journals (Sweden)

    Parco S

    2013-04-01

    Full Text Available Sergio Parco, Fulvia Vascotto, Patrizia Visconti Institute for Maternal and Child Health, Trieste, Italy Background: In northeastern Italy, according to Italian legislation, authorized public facilities can accept the donation and preservation of cord blood stem cells (CB-SC. Attitudes and knowledge in pregnant women differs between the local and immigrant (non-European Union [EU] population. In this study we assessed the choices that pregnant women have with respect to the public and private harvesting system and the main reasons driving their decisions. We examined the ethnic origin of the families and compared tests for syphilis screening and leukocyte (WBC counts in the CB-SC bags that are required for validation of the collection. Methods: Out of a population of 3450 pregnant patients at the Institute for Maternal and Child Health of Trieste, northeast Italy, 772 women agreed to cord blood harvesting and the associated lab tests. Of these, 221 women (28.6% were from immigrant families of non-EU countries. Their ethnic affiliation was recorded, and tests were performed for syphilis screening and for nucleated red blood cell (NRBC interference with the WBC count in CB-SC bags to assess cellularity and to determine if storage was appropriate. Results: Of the 772 pregnant women, 648 (84.0% accessed the public collection system, which is free of charge, and 124 (15.0% accessed the private fee-based system. One woman from the non-EU group opted for the private fee-based system. Of the 3450 pregnant women screened for syphilis at the Institute for Maternal and Child Health, the Treponema pallidum hemagglutination (TPHA and Venereal Disease Research Laboratory (VDRL tests were the main tests performed (66.0% of total cases because many gynecologists in the public harvesting system apply the Italian regulations of the 1988 Decree, while the private system requires tests on syphilis and leaves the option to the lab physicians to select the best

  11. Guidelines for establishing quality systems in veterinary diagnostic testing laboratories. Report of a Joint FAO/IAEA consultants meeting/workshop. Draft

    International Nuclear Information System (INIS)

    2002-01-01

    The purpose of this report is to assist veterinary testing laboratories to develop and implement a quality system based on the OIE Standard 'Management and Technical Requirements for Laboratories Conducting Tests for Infectious Animal Diseases'. The introduction to the OIE Standard states: This document describes the OIE Standard for management and technical competence that serves as the basis for accreditation of laboratories that conduct tests for infectious animal diseases, especially those laboratories involved in testing for international trade. It contains the specific requirements unique to laboratories conducting tests for infectious animal diseases. These specific requirements represent an interpretation of the generally stated requirements of ISO/IEC 17025:1999, General requirements for the competence of testing and calibration laboratories (as outlined in Annex B of ISO/IEC 17025). Accreditation bodies that recognize the competence of such testing laboratories may use this Standard as the basis for their accreditation. This report gives an example-oriented overview of the structure and contents of critical documents and procedures such as Quality Manual (QM), Standard Operating Procedures (SOPs), etc. inherent to a quality system and describes the different stages in the implementation of the OIE Standard. For that reason it can be used as a practical guide for the production of necessary documents but also as a help to determine the status of a laboratory during its journey towards establishing a QS

  12. Design and development of microcontroller-based clinical chemistry analyser for measurement of various blood biochemistry parameters.

    Science.gov (United States)

    Taneja, S R; Gupta, R C; Kumar, Jagdish; Thariyan, K K; Verma, Sanjeev

    2005-01-01

    Clinical chemistry analyser is a high-performance microcontroller-based photometric biochemical analyser to measure various blood biochemical parameters such as blood glucose, urea, protein, bilirubin, and so forth, and also to measure and observe enzyme growth occurred while performing the other biochemical tests such as ALT (alkaline amino transferase), amylase, AST (aspartate amino transferase), and so forth. These tests are of great significance in biochemistry and used for diagnostic purposes and classifying various disorders and diseases such as diabetes, liver malfunctioning, renal diseases, and so forth. An inexpensive clinical chemistry analyser developed by the authors is described in this paper. This is an open system in which any reagent kit available in the market can be used. The system is based on the principle of absorbance transmittance photometry. System design is based around 80C31 microcontroller with RAM, EPROM, and peripheral interface devices. The developed system incorporates light source, an optical module, interference filters of various wave lengths, peltier device for maintaining required temperature of the mixture in flow cell, peristaltic pump for sample aspiration, graphic LCD display for displaying blood parameters, patients test results and kinetic test graph, 40 columns mini thermal printer, and also 32-key keyboard for executing various functions. The lab tests conducted on the instrument include versatility of the analyzer, flexibility of the software, and treatment of sample. The prototype was tested and evaluated over 1000 blood samples successfully for seventeen blood parameters. Evaluation was carried out at Government Medical College and Hospital, the Department of Biochemistry. The test results were found to be comparable with other standard instruments.

  13. Stress-strain relation of bentonite at undrained shear. Laboratory tests to investigate the influence of material composition and test technique

    Energy Technology Data Exchange (ETDEWEB)

    Dueck, Ann; Boergesson, Lennart; Johannesson, Lars-Erik (Clay Technology AB, Lund (Sweden))

    2010-12-15

    This report describes a laboratory study conducted to update the material model of the buffer material used in the analyses of the effect of a rock shear through a deposition hole. The study considers some new conditions and is especially focused on the reference case with MX-80Ca developed for SR-Site (MX-80 ion exchanged to Ca). The material model is based on relations between density, swelling pressure, shear strength and rate of strain. The reference model is described by Boergesson et al. (2010). The laboratory study is focused on undrained stress-strain-strength properties, which have been studied mainly by conducting triaxial tests and unconfined compression tests. The test results are compared to the earlier measurements and models which show that the new results fit very well into the general picture and models. For the new conditions suitable values of constants included in the model are proposed

  14. Stress-strain relation of bentonite at undrained shear. Laboratory tests to investigate the influence of material composition and test technique

    International Nuclear Information System (INIS)

    Dueck, Ann; Boergesson, Lennart; Johannesson, Lars-Erik

    2010-12-01

    This report describes a laboratory study conducted to update the material model of the buffer material used in the analyses of the effect of a rock shear through a deposition hole. The study considers some new conditions and is especially focused on the reference case with MX-80Ca developed for SR-Site (MX-80 ion exchanged to Ca). The material model is based on relations between density, swelling pressure, shear strength and rate of strain. The reference model is described by Boergesson et al. (2010). The laboratory study is focused on undrained stress-strain-strength properties, which have been studied mainly by conducting triaxial tests and unconfined compression tests. The test results are compared to the earlier measurements and models which show that the new results fit very well into the general picture and models. For the new conditions suitable values of constants included in the model are proposed

  15. Diagnóstico laboratorial da anemia hemolítica auto-imune: características do teste manual direto do PolybreneÒ Laboratory diagnosis of auto-immune hemolytic anemia: characteristics of the manual direct test of PolybreneTM

    Directory of Open Access Journals (Sweden)

    G.W. Braga

    1998-03-01

    Full Text Available O teste manual direto do PolybreneÒ (TDP e o teste de Coombs direto (TCD foram utilizados para a detecção de IgG na superfície de hemácias de pacientes com diagnóstico clínico e laboratorial de anemia hemolítica auto-imune (AHAI. OBJETIVO: Comparar a sensibilidade e especificidade do TPD e do TCD no diagnóstico da AHAI. MÉTODO: Foram estudados 18 pacientes com diagnóstico clínico-laboratorial de AHAI. Como indivíduos controles, foram testados 20 doadores de sangue assintomáticos e 20 pacientes com anemia falciforme. RESULTADOS: O TCD foi positivo em 14 pacientes e negativo em quatro indivíduos, enquanto o TDP foi positivo em 17 pacientes e negativo em um indivíduo que apresentava TCD positivo devido a fixação de complemento (C3d nas hemácias. Todos os eluatos positivos realizados com a técnica de diclorometano revelaram anticorpos quentes com especificidade "anti-Rh". A sensibilidade do TDP (94% para detectar fixação de IgG in vivo foi significantemente maior (pThe direct manual PolybreneTM test (DPT and the direct antiglobulin tests (DAT were employed to detect antibody sensitizing red blood cell (RCB in patients with clinical and laboratorial findings of autoimmune hemolytic anemia (AIHA. PURPOSE: To compare the sensitivity and specificity of DPT and DAT in the diagnosis of AIHA. METHODS: Eighteen consecutive patients with diagnosis of AIHA were evaluated. The control group consisted of 20 normal volunteers blood donors and 20 patients with sickle cell anemia. All patients and controls were submitted to DPT and DAT. All DAT positive samples were further tested using monospecific reagents ( anti-IgG heavy chain and anti-C3d. Positive samples for either DPT or DAT were evaluated by eluate technique using. The dichloromethane (DCM. RESULTS: The DAT was positive in 14 patients and negative in 4 subjects, while the DPT was positive in 17 patients and negative in 1 individual who had a positive DAT owing to complement (C3d. All

  16. Worldwide proficiency test for X ray fluorescence laboratories PTXRFIAEA/05 determination of minor and trace elements in marine sediment

    International Nuclear Information System (INIS)

    2009-01-01

    The proficiency test (code PTXRFIAEA05) was the fifth worldwide exercise organized by the IAEA Seibersdorf Laboratories in order to assist X ray fluorescence laboratories in assessment and improvement of their analytical performance. The test was carried out within the IAEA Project 1.4.3.4 (D.3.03) on Nuclear Spectrometry for Analytical Applications, under the Nuclear Science Programme. The main objective of the project was to enhance capability of interested Member States in effective utilization of nuclear spectrometries and analytical services in industry, human health, agriculture, and in monitoring and evaluation of environmental pollution. Marine sediment test samples with established homogeneity and well characterized known target values of the mass fractions of analytes were distributed to participating laboratories. The laboratories were requested to analyze the sample using established techniques following their analytical procedures. Based on the results of the proficiency test presented in the report each participating laboratory should assess its analytical performance results by using the specified criteria and, if appropriate, to identify discrepancies, and to correct relevant analytical procedures. The next proficiency test exercise will be executed in 2009

  17. Establishing diagnostic cut-off criteria for the COBAS AmpliPrep/COBAS TaqMan HIV-1 Qualitative test through validation against the Amplicor DNA test v1.5 for infant diagnosis using dried blood spots.

    Science.gov (United States)

    Maritz, Jean; Preiser, Wolfgang; van Zyl, Gert U

    2012-02-01

    As antibody testing cannot confirm HIV-1 infection in children less than 18 months of age, diagnosis in these children depends on nucleic acid testing. The COBAS(®) AmpliPrep/COBAS(®) TaqMan(®) (CAP/CTM, Roche(®) Molecular Systems, Inc., Branchburg, NJ) HIV-1 Qualitative test is a total nucleic acid real-time PCR assay utilising whole EDTA blood or dried blood spots (DBS), which recently replaced the Roche(®) AMPLICOR(®) DNA test v1.5 (Amplicor) as the diagnostic HIV PCR assay in many South African laboratories. For the Amplicor assay, stringent diagnostic criteria were previously formulated for the local population, and a comparison reported the CAP/CTM's sensitivity at 99.7% and specificity at 100% for both sample types compared to these Amplicor criteria. To validate the assay prior to introduction in our laboratory and to define stringent diagnostic cut-off criteria. Whole EDTA blood samples from patients younger than 18 months sent for routine HIV-1 diagnosis were tested by Amplicor, and positive results were confirmed from DBS. CAP/CTM assays were subsequently performed from DBS. The CAP/CTM had a sensitivity of 98.8% and a specificity of 97.1%, but a positive predictive value (PPV) of only 78.7% compared to the Amplicor assay. Samples positive by CAP/CTM but negative by Amplicor displayed poor amplification curves compared to concordant positive samples. Upon re-testing those with sufficient material available by CAP/CTM, all showed negative results. The decreased PPV may either be due to false positive CAP/CTM results, or increased sensitivity compared to the Amplicor assay. Criteria were formulated for defining presumed false-positive results. Copyright © 2011 Elsevier B.V. All rights reserved.

  18. Text Messaging Improves Participation in Laboratory Testing in Adolescent Liver Transplant Patients.

    Science.gov (United States)

    McKenzie, Rebecca B; Berquist, William E; Foley, Megan A; Park, K T; Windsheimer, Jered E; Litt, Iris F

    In solid organ transplant patients, non-participation in all aspects of the medical regimen is a prevalent problem associated with adverse consequences particularly in the adolescent and young adult (AYA) age group. This study is the first to evaluate the feasibility, utility and impact of a text messaging (TM) intervention to improve participation in laboratory testing in adolescent liver transplant patients. AYA patients, aged 12 to 21 years, were recruited for a prospective pilot trial evaluating a TM intervention delivered over a 1-year period. The intervention involved automated TM reminders with feedback administered according to a prescribed laboratory testing frequency. Participation rate in laboratory testing after the intervention was compared to the year prior. Patient responses and feedback by text and survey were used to assess feasibility, acceptability and use of the intervention. Forty-two patients were recruited and 33 patients remained enrolled for the study duration. Recipients of the TM intervention demonstrated a significant improvement in participation rate in laboratory testing from 58% to 78% (Prate was also significantly higher than in non-intervention controls (P=.003). There was a high acceptability, response rate and a significant correlation with reported versus actual completion of laboratory tests by TM. TM reminders significantly improved participation in laboratory testing in AYA liver transplant patients. The intervention demonstrated feasibility, acceptability, and use with a high proportion of patients who engaged in and perceived a benefit from using this technology.

  19. Interpretation of Blood Microbiology Results - Function of the Clinical Microbiologist.

    Science.gov (United States)

    Kristóf, Katalin; Pongrácz, Júlia

    2016-04-01

    The proper use and interpretation of blood microbiology results may be one of the most challenging and one of the most important functions of clinical microbiology laboratories. Effective implementation of this function requires careful consideration of specimen collection and processing, pathogen detection techniques, and prompt and precise reporting of identification and susceptibility results. The responsibility of the treating physician is proper formulation of the analytical request and to provide the laboratory with complete and precise patient information, which are inevitable prerequisites of a proper testing and interpretation. The clinical microbiologist can offer advice concerning the differential diagnosis, sampling techniques and detection methods to facilitate diagnosis. Rapid detection methods are essential, since the sooner a pathogen is detected, the better chance the patient has of getting cured. Besides the gold-standard blood culture technique, microbiologic methods that decrease the time in obtaining a relevant result are more and more utilized today. In the case of certain pathogens, the pathogen can be identified directly from the blood culture bottle after propagation with serological or automated/semi-automated systems or molecular methods or with MALDI-TOF MS (matrix-assisted laser desorption-ionization time of flight mass spectrometry). Molecular biology methods are also suitable for the rapid detection and identification of pathogens from aseptically collected blood samples. Another important duty of the microbiology laboratory is to notify the treating physician immediately about all relevant information if a positive sample is detected. The clinical microbiologist may provide important guidance regarding the clinical significance of blood isolates, since one-third to one-half of blood culture isolates are contaminants or isolates of unknown clinical significance. To fully exploit the benefits of blood culture and other (non- culture

  20. Blood Culture Testing via a Mobile App That Uses a Mobile Phone Camera: A Feasibility Study.

    Science.gov (United States)

    Lee, Guna; Lee, Yura; Chong, Yong Pil; Jang, Seongsoo; Kim, Mi Na; Kim, Jeong Hoon; Kim, Woo Sung; Lee, Jae-Ho

    2016-10-26

    To evaluate patients with fever of unknown origin or those with suspected bacteremia, the precision of blood culture tests is critical. An inappropriate step in the test process or error in a parameter could lead to a false-positive result, which could then affect the direction of treatment in critical conditions. Mobile health apps can be used to resolve problems with blood culture tests, and such apps can hence ensure that point-of-care guidelines are followed and processes are monitored for blood culture tests. In this pilot project, we aimed to investigate the feasibility of using a mobile blood culture app to manage blood culture test quality. We implemented the app at a university hospital in South Korea to assess the potential for its utilization in a clinical environment by reviewing the usage data among a small group of users and by assessing their feedback and the data related to blood culture sampling. We used an iOS-based blood culture app that uses an embedded camera to scan the patient identification and sample number bar codes. A total of 4 medical interns working at 2 medical intensive care units (MICUs) participated in this project, which spanned 3 weeks. App usage and blood culture sampling parameters (including sampler, sampling site, sampling time, and sample volume) were analyzed. The compliance of sampling parameter entry was also measured. In addition, the participants' opinions regarding patient safety, timeliness, efficiency, and usability were recorded. In total, 356/644 (55.3%) of all blood culture samples obtained at the MICUs were examined using the app, including 254/356 (71.3%) with blood collection volumes of 5-7 mL and 256/356 (71.9%) with blood collection from the peripheral veins. The sampling volume differed among the participants. Sampling parameters were completely entered in 354/356 cases (99.4%). All the participants agreed that the app ensured good patient safety, disagreed on its timeliness, and did not believe that it was